• Meghan E Morean, Krysten W Bold, Grace Kong, Ralitza Gueorguieva, Deepa R Camenga, Patricia Simon, Asti Jackson, Dana A Cavallo, and Suchitra Krishnan-Sarin.
• Oberlin College, 120 West Lorain Street, Oberlin, OH, 44074, USA; Yale University School of Medicine, 34 Park Street, New Haven, CT, 06519, USA. Electronic address: meghan.morean@gmail.com.
• Drug Alcohol Depend. 2019 Nov 1; 204: 107512.

BackgroundJUUL e-cigarettes are popular among youth. However, it is unknown whether adolescents understand that 5% JUUL pods contain a high nicotine concentration or consider JUULs to be e-cigarettes.Method3170 students from 4 Connecticut high schools completed a school-based survey (May-October 2018). Students reported on lifetime and past-month JUUL use and perceived JUUL nicotine strength (low/medium/high/don't know) when no information about nicotine concentration was provided and, subsequently, when informed JUULs contain 5% nicotine. Students reported whether they believe JUULs are e-cigarettes (no/yes/don't know).ResultsStudents were never JUUL users (56.6%), ever users (13.2%), and past-month users (30.2%). When no information was provided, students reported that JUULs contain low (10.5%), medium (26.9%), or high nicotine levels (31.1%); 31.4% did not know. When informed JUULs contain 5% nicotine, students were more likely to believe JUUL's nicotine strength was low (29.5%) or medium (29.3%) than high (21.3%) and less likely to report not knowing (19.9%). 39% of students believed JUULs are not e-cigarettes or did not know.DiscussionMost students were unaware of JUUL's high nicotine concentration, with more believing that JUULs contain low or medium nicotine concentrations when informed JUULs contain 5% nicotine. Thus, youth may misinterpret the nicotine concentration printed on JUUL pod packaging, raising concerns about inadvertent exposure to high nicotine levels and dependence risk. Further, 39% of adolescents believed JUULs are not e-cigarettes or were unsure. Regulatory efforts are needed to establish understandable nicotine concentration labels, require products to be labeled accordingly, and clarify what products constitute e-cigarettes.Copyright © 2019 Elsevier B.V. All rights reserved.

20 keywords...

hide…