@article {Prochaskae88, author = {Judith J Prochaska and Erin A Vogel and Neal Benowitz}, title = {Nicotine delivery and cigarette equivalents from vaping a JUULpod}, volume = {31}, number = {e1}, pages = {e88--e93}, year = {2022}, doi = {10.1136/tobaccocontrol-2020-056367}, publisher = {BMJ Publishing Group Ltd}, abstract = {With patented nicotine salt technology, JUUL dominates the e-cigarette market. We reviewed studies of JUUL{\textquoteright}s nicotine pharmacokinetic profile and studies quantifying nicotine in a JUULpod, emitted in the aerosol and absorbed by users. Examined in eight studies, JUUL{\textquoteright}s peak nicotine levels were half to three-quarters that of a combustible cigarette in industry-conducted studies with JUUL-na{\"\i}ve users, while comparable to or greater than combustible cigarettes in independent studies of experienced e-cigarette users. JUUL Labs reports each 5\% (nicotine-by-weight) cartridge contains approximately 40 mg nicotine per pod and is {\textquoteleft}approximately equivalent to about 1 pack of cigarettes.{\textquoteright} In five independent studies, nicotine in the liquid in a JUULpod ranged from 39.3 to 48.3 mg. Seven studies measured nicotine delivery via vaping-machine generated aerosols, varying in puffing regimes and equipment. One study estimated 68\% transfer efficiency to the aerosol, measuring 28.8 mg nicotine per JUULpod. The other studies reported nicotine values ranging from 72 to 164 {\textmu}g/puff. At 200 puffs, this is 14.4{\textendash}32.8 mg of nicotine per pod with equivalence to 13{\textendash}30 cigarettes. A study measuring nicotine levels in JUUL users during a 5-day controlled switch found equivalence to 18 cigarettes. One JUULpod appears capable of delivering the nicotine equivalent to smoking about a pack of cigarettes, with variability. In JUUL-na{\"\i}ve smokers, JUUL{\textquoteright}s nicotine boost was lower than that of combustible cigarettes; while in experienced users, JUUL was comparable. Minimising harshness and adaptive to user experience, JUUL{\textquoteright}s design facilitates initiation to a high nicotine, and ultimately, highly addictive vaping product.}, issn = {0964-4563}, URL = {https://tobaccocontrol.bmj.com/content/31/e1/e88}, eprint = {https://tobaccocontrol.bmj.com/content/31/e1/e88.full.pdf}, journal = {Tobacco Control} }