Comparing the Effects of the EU- Versus the US-JUUL Pod in a Sample of UK Smokers: Nicotine Absorption, Satisfaction and Other Nicotine-Related Subjective Effects

Abstract Introduction Pod Vaping Devices (PVD) such as JUUL have become extremely popular in the US although their uptake and use in the UK remains lower. A key difference between the US and the UK is the nicotine strength legally permitted, typically 59mg/mL in the US but capped at 20mg/mL in the UK and EU. This may limit the ability of EU vaping devices to deliver satisfactory nicotine levels. The primary aim was to compare the EU- (18mg/mL nicotine strength) with the US-JUUL (59mg/mL) on daily smokers’ subjective experiences, craving relief and blood nicotine levels. Methods Double-blind, counter-balanced within-participants design with 2 conditions: 18mg/mL vs. 59mg/mL. On two separate occasions, UK smokers (N=19, 10 Males, 9 Females) vaped ad libitum for 60 mins and provided blood samples at baseline 5, 15, 30 and 60 mins. Subjective effects (incl. satisfaction) were measured at 10 and 60 mins and, craving and withdrawal symptoms (WS) at baseline, 10 and 60 mins. Results Satisfaction did not differ between conditions. There was a significant interaction between Time and Nicotine concentration for Nicotine Hit (p=.045). Mean self-report of Nicotine Hit increased under the use of the 59mg/mL from 10 to 60 mins and decreased under the 18mg/mL. Participants reported higher Throat Hit following use of the 59mg/mL (p=.017). There were no differences in other subjective effects including craving, WS relief (ps>.05). Liquid consumption was doubled under the 18 versus the 59mg/mL (p=.001) and nicotine boost was significantly higher in the 59mg/mL at all time-points (p≤.001). Conclusions The results did not support our hypotheses that satisfaction, craving and withdrawal reduction would be higher with the 59mg/mL JUUL. This could be due to the doubling of liquid consumption in the 18mg/mL. Whether satisfaction and craving relief persists over the longer-term outside of the lab remains to be determined. Implications In a 60-min ad lib vaping session, the EU-JUUL was found to produce comparable satisfaction, craving- and withdrawal-relief as the US-JUUL in this sample of UK smokers. These findings could suggest that the higher nicotine concentrations available in PVDs in the US are not necessary for providing satisfaction and improving craving and WS. However, this was at the expense of a considerable increase in liquid consumption indicative of compensatory puffing.