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JUUL releases more nicotine in the first puffs
  1. Rola Salman1,2,
  2. Soha Talih1,2,
  3. Ebrahim Karam1,2,
  4. Nareg Karaoghlanian1,2,
  5. David L Ashley3,
  6. Alan Shihadeh1,2
  1. 1 Mechanical Engineering, American University of Beirut, Beirut, Lebanon
  2. 2 Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
  3. 3 School of Public Health, Georgia State University, Atlanta, Georgia, USA
  1. Correspondence to Professor Alan Shihadeh, Mechanical Engineering, American University of Beirut, Beirut, Lebanon; as20{at}

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Analytical studies that estimate nicotine and other toxicant emissions from electronic cigarettes (e-cigarettes) typically employ a puffing machine to generate 10 or 15 puffs in rapid succession (eg, 30 s between puffs) for subsequent assays.1 2 Such puffing patterns model combustible cigarette use in which every hour or so a smoker takes a 5 min break to consume a cigarette, a use duration intrinsic to the burning rate and length of the cigarette rod. A single cigarette is the default ‘serving size’ to which the consumer commits once the cigarette has been lit. On the contrary, e-cigarettes such as JUUL have no intrinsic serving size; the design is agnostic to a user drawing a single puff or tens of puffs in a use bout. Indeed, emerging evidence suggests that JUUL use patterns are characterised by sporadic puffing throughout the day, for example, at the work desk, during exercise and during class.3 4 …

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  • Contributors RS, ST, EK, NK and AS designed the experiments. RS, EK and NK performed the measurements. RS, ST, EK and AS analysed the data. AS, ST, RS, EK, NK and DLA wrote the original draft.

  • Funding This research is supported by grant number U54DA036105 from the National Institute on Drug Abuse of the National Institutes of Health 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 views of the NIH or the FDA.

  • Competing interests The authors declare the following competing financial interest: AS is named on a patent application for a device that measures the puffing behaviour of electronic cigarette users and is a paid consultant in litigation against the tobacco industry.

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