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Acute effects of JUUL and IQOS in cigarette smokers
  1. Sarah Maloney1,2,
  2. Alisha Eversole1,2,
  3. Melanie Crabtree1,2,
  4. Eric Soule2,3,
  5. Thomas Eissenberg1,2,
  6. Alison Breland1,2
  1. 1 Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
  2. 2 Virginia Commonwealth University, Center for the Study of Tobacco Products, Richmond, Virginia, USA
  3. 3 College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
  1. Correspondence to Dr Alison Breland, Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA; abbrelan{at}


Background JUUL is an electronic cigarette that aerosolises a nicotine-containing liquid, while IQOS heats tobacco to produce an aerosol. Both are marketed to smokers, but their effects have seldom been examined in this population.

Methods Eighteen cigarette smokers (13 men) with no JUUL or IQOS experience completed a within-subject, laboratory study assessing nicotine delivery and subjective effects after controlled (10 puffs, ~30 s interpuff interval) and ad libitum (90 min) use of JUUL, IQOS or own-brand (OB) cigarettes.

Results JUUL increased mean plasma nicotine concentration significantly from 2.2 (SD=0.7) ng/mL to 9.8 (4.9) ng/mL after 10 puffs and to 11.5 (9.3) ng/mL after ad libitum use. IQOS increased mean plasma nicotine significantly from 2.1 (0.2) ng/mL to 12.7 (6.2) ng/mL after 10 puffs and to 11.3 (8.0) ng/mL after ad libitum use. OB increased mean plasma nicotine significantly from 2.1 (0.2) ng/mL to 20.4 (11.4) ng/mL after 10 puffs and to 21.0 (10.2) ng/mL after ad libitum use. Mean OB plasma nicotine concentration was significantly higher than JUUL and IQOS. OB increased expired carbon monoxide concentration, but IQOS and JUUL did not. ‘Craving a cigarette/nicotine’ and ‘Urges to smoke’ were reduced significantly for all products following the directed bout.

Conclusions Among smokers, JUUL and IQOS delivered less nicotine than cigarettes. Also, in this sample, IQOS and OB reduced abstinence symptoms more effectively than JUUL. Additional work with experienced JUUL and IQOS users is needed, as their nicotine delivery profiles and subjective experiences may differ.

  • electronic nicotine delivery devices
  • non-cigarette tobacco products
  • addiction

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  • Contributors SM, AE, MC and AB were involved in writing this manuscript. ES and TE designed this study and contributed to the write up of this manuscript.

  • Funding This study was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number P50DA036105 and U54DA036105 and the Center for Tobacco Products of the US Food and Drug Administration.

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Food and Drug Administration.

  • Competing interests TE is a paid consultant in litigation against the tobacco and electronic cigarette industry and is named on a patent for a device that measures the puffing behavior of ECIG users.

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