Changes in dependence over one year among US adults who smoke cigarettes and switched completely or partially to use of the JUUL-brand electronic nicotine delivery system

Background: Electronic nicotine delivery systems (ENDS) are substitute sources of nicotine for adults who smoke cigarettes. Understanding changes in dependence as people switch from cigarettes to ENDS is relevant to public health. This study assessed changes in dependence among adults who switched c...

Full description

Bibliographic Details
Main Authors: Saul Shiffman, Nicholas I. Goldenson
Format: Article
Language:English
Published: Elsevier 2023-03-01
Series:Drug and Alcohol Dependence Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2772724623000070
_version_ 1797867352287608832
author Saul Shiffman
Nicholas I. Goldenson
author_facet Saul Shiffman
Nicholas I. Goldenson
author_sort Saul Shiffman
collection DOAJ
description Background: Electronic nicotine delivery systems (ENDS) are substitute sources of nicotine for adults who smoke cigarettes. Understanding changes in dependence as people switch from cigarettes to ENDS is relevant to public health. This study assessed changes in dependence among adults who switched completely or partially (dual users) from cigarettes to JUUL-brand ENDS over 12 months. Methods: US adults who smoke and purchased a JUUL Starter Kit (n = 17,619) completed a baseline assessment and were invited to 1-, 2-, 3-, 6-, 9- and 12-month follow-ups. Dependence on cigarettes at baseline and on JUUL at follow-ups was assessed with the Tobacco Dependence Index (TDI; Range 1–5). Analyses estimated the minimal important difference (MID) for the scale, compared JUUL dependence to baseline cigarette dependence and assessed changes in JUUL dependence over 1-year, including among those using JUUL at all follow-ups. Results: Participants who switched at month 2 had month 1 JUUL TDI scores 0.24 points greater than those who continued smoking (p<0.001); thus MID=0.24. Among both switchers and dual users overall, dependence on JUUL 1 and 12 months later was lower than baseline dependence on cigarettes (ps<0.001); participants who smoked every day showed more consistent and larger reductions. Among participants who persistently used JUUL without smoking, dependence increased 0.01 points per month (p<0.001), but was leveling off over time. Conclusions: Dependence on JUUL was lower than baseline cigarette dependence. Increases in JUUL dependence were small over 12 months of continual JUUL use. These data indicate that ENDS, including JUUL, have lower dependence potential than cigarettes.
first_indexed 2024-04-09T23:39:55Z
format Article
id doaj.art-e1e4fc9e566741d48c36b9dedeafc537
institution Directory Open Access Journal
issn 2772-7246
language English
last_indexed 2024-04-09T23:39:55Z
publishDate 2023-03-01
publisher Elsevier
record_format Article
series Drug and Alcohol Dependence Reports
spelling doaj.art-e1e4fc9e566741d48c36b9dedeafc5372023-03-19T04:39:02ZengElsevierDrug and Alcohol Dependence Reports2772-72462023-03-016100137Changes in dependence over one year among US adults who smoke cigarettes and switched completely or partially to use of the JUUL-brand electronic nicotine delivery systemSaul Shiffman0Nicholas I. Goldenson1Pinney Associates, Inc.; Corresponding author at: Pinney Associates, Inc., 201 North Craig Street, Suite 320, Pittsburgh, PA 15213, United States.Juul Labs, Inc.Background: Electronic nicotine delivery systems (ENDS) are substitute sources of nicotine for adults who smoke cigarettes. Understanding changes in dependence as people switch from cigarettes to ENDS is relevant to public health. This study assessed changes in dependence among adults who switched completely or partially (dual users) from cigarettes to JUUL-brand ENDS over 12 months. Methods: US adults who smoke and purchased a JUUL Starter Kit (n = 17,619) completed a baseline assessment and were invited to 1-, 2-, 3-, 6-, 9- and 12-month follow-ups. Dependence on cigarettes at baseline and on JUUL at follow-ups was assessed with the Tobacco Dependence Index (TDI; Range 1–5). Analyses estimated the minimal important difference (MID) for the scale, compared JUUL dependence to baseline cigarette dependence and assessed changes in JUUL dependence over 1-year, including among those using JUUL at all follow-ups. Results: Participants who switched at month 2 had month 1 JUUL TDI scores 0.24 points greater than those who continued smoking (p<0.001); thus MID=0.24. Among both switchers and dual users overall, dependence on JUUL 1 and 12 months later was lower than baseline dependence on cigarettes (ps<0.001); participants who smoked every day showed more consistent and larger reductions. Among participants who persistently used JUUL without smoking, dependence increased 0.01 points per month (p<0.001), but was leveling off over time. Conclusions: Dependence on JUUL was lower than baseline cigarette dependence. Increases in JUUL dependence were small over 12 months of continual JUUL use. These data indicate that ENDS, including JUUL, have lower dependence potential than cigarettes.http://www.sciencedirect.com/science/article/pii/S2772724623000070NicotineSmokingElectronic cigarettesDependenceAddictionTobacco
spellingShingle Saul Shiffman
Nicholas I. Goldenson
Changes in dependence over one year among US adults who smoke cigarettes and switched completely or partially to use of the JUUL-brand electronic nicotine delivery system
Drug and Alcohol Dependence Reports
Nicotine
Smoking
Electronic cigarettes
Dependence
Addiction
Tobacco
title Changes in dependence over one year among US adults who smoke cigarettes and switched completely or partially to use of the JUUL-brand electronic nicotine delivery system
title_full Changes in dependence over one year among US adults who smoke cigarettes and switched completely or partially to use of the JUUL-brand electronic nicotine delivery system
title_fullStr Changes in dependence over one year among US adults who smoke cigarettes and switched completely or partially to use of the JUUL-brand electronic nicotine delivery system
title_full_unstemmed Changes in dependence over one year among US adults who smoke cigarettes and switched completely or partially to use of the JUUL-brand electronic nicotine delivery system
title_short Changes in dependence over one year among US adults who smoke cigarettes and switched completely or partially to use of the JUUL-brand electronic nicotine delivery system
title_sort changes in dependence over one year among us adults who smoke cigarettes and switched completely or partially to use of the juul brand electronic nicotine delivery system
topic Nicotine
Smoking
Electronic cigarettes
Dependence
Addiction
Tobacco
url http://www.sciencedirect.com/science/article/pii/S2772724623000070
work_keys_str_mv AT saulshiffman changesindependenceoveroneyearamongusadultswhosmokecigarettesandswitchedcompletelyorpartiallytouseofthejuulbrandelectronicnicotinedeliverysystem
AT nicholasigoldenson changesindependenceoveroneyearamongusadultswhosmokecigarettesandswitchedcompletelyorpartiallytouseofthejuulbrandelectronicnicotinedeliverysystem