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Exposure to JUUL use: cue reactivity effects in young adult current and former smokers
  1. Ashley Vena1,
  2. Krista Miloslavich1,
  3. Meghan Howe1,
  4. Dingcai Cao2,
  5. Andrea C King1
  1. 1Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
  2. 2Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
  1. Correspondence to Dr Andrea C King, Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL 60637, USA; aking{at}


Background Exposure to the use of first, second and third generations of electronic cigarettes (e-cigarettes) elicits the desire to vape and smoke among observers, as well as facilitates smoking behaviour. Given the rapid rise in the popularity of the pod mod JUUL, we examined whether observing the use of this device would elicit similar responses in smokers. Exploratory analyses were also conducted to determine whether JUUL can act as a smoking cue for former smokers.

Methods The sample consisted of 82 young adult participants (62 current smokers and 20 former smokers approximately 1 year smoke free). The study examined their response to observing use of bottled water (control cue) and JUUL (active cue) in a controlled laboratory paradigm. Both cues were delivered by a trained study confederate under the guise of a social interaction task, and participants completed mood and desire and urge surveys precue and postcue exposures.

Results In current smokers, exposure to the JUUL cue increased smoking urge and desire for a cigarette, mod/vape pen and JUUL, and two-thirds chose to smoke in the behavioural analogue task. In former smokers, the JUUL cue evoked modest and transient increases in desire for a cigarette and JUUL.

Conclusions The use of JUUL affects the user and elicits responses in observers; this study is the first to demonstrate that exposure to JUUL use may act as a smoking cue and exposure to JUUL use may affect tobacco control efforts.

  • electronic nicotine delivery devices
  • addiction
  • environment
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  • Contributors ACK conceived and supervised the study. AV performed basic analyses and wrote the introduction, results and discussion with input from all authors. KM carried out the study, organised the data for analyses and wrote the methods. MH contributed to data analyses and writing the results and methods sections. DC performed the statistical analyses. All authors have approved the final manuscript for submission.

  • Funding This study was funded by the National Institutes of Health (R56-DA044210, R01-DA044210, T32-DA043469).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the University of Chicago Institutional Review Board.

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

  • Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Deidentified participant data are available from ACK at Reuse may be permitted, depending on various circumstances, upon documented consent from ACK.

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