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JUUL from the USA to Indonesia: implications for expansion to LMICs
  1. Elizabeth N Orlan1,
  2. Mark Parascandola2,
  3. Rachel Grana2
  1. 1 Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  2. 2 Tobacco Control Research Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
  1. Correspondence to Elizabeth N Orlan, Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7440, USA; eorlan{at}

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Indonesia has one of the largest tobacco markets in the world, well known for their clove cigarettes, kreteks. However, electronic cigarettes (e-cigarettes) are growing in popularity among Indonesians. While conventional cigarettes are sold in stores and kiosks,1 e-cigarettes are sold online (35.3%) and through vape shops (64.7%).2 The 2011 Indonesian Global Adult Tobacco Survey, the latest available national data, reported awareness of e-cigarettes was 10.9% and current use was 2.5%.3 Recent social media and sales data imply that e-cigarette use has grown since then. Indonesia has the second largest share of Instagram posts about vaping of any country,4 and e-cigarette sales reached 2.1 trillion rupiah (US$144.5 million) in 2018. Total sales are forecasted to reach 6.1 trillion rupiah (IDR) (US$419.6 million) by 2022.2

JUUL is the leading e-cigarette brand in the United States of America (USA), with 72% of the vapour product market share as of August 2018.5 According to their website, JUUL sells their products in the USA, Canada, Israel, UK, Italy, Germany, Switzerland, France and Russia.6 However, these products are also reported to be sold in low-income and middle-income countries (LMICs) like Indonesia, where interest in vaping and JUUL (as measured by Google Trends) has increased from …

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  • Contributors ENO conceptualised this manuscript alongside MP and RG while doing a fellowship under their supervision at the National Cancer Institute. All authors contributed to drafting and editing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.