TY - JOUR
T1 - Sources of awareness, perceptions, and use of JUUL e-cigarettes among adult cigarette smokers
AU - Chen-Sankey, Julia Cen
AU - Tan, Andy S.L.
AU - Moran, Meghan Bridgid
AU - Soneji, Samir
AU - Lee, Stella J.
AU - Choi, Kelvin
N1 - Funding Information:
Efforts of JCC and KC were supported by the Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health.
Funding Information:
Fiveyearssinceitslaunch,JUUL,asmall,rechargeablee-cigarettedevicemanufacturedby JUULLabs,hasbecometheleadinge-cigarettebrandintheU.S.Unliketraditionale-cigarette productsthatusefree-basenicotine,JUULproductsusenicotinesaltderivedfromloose-leaf tobacco,whichenableshighefficiencyinnicotinedeliveryandmakesinhalinghigherlevelsof nicotinelessharshfortheuser[1].Duetothisdesign,JUULmayproduceamoresatisfying userexperienceevenathighnicotineconcentrationsthantraditionale-cigarettesandcombus-tiblecigarettes[2].WithincreasedpopularityintheU.S.market,thesalesofJUULincreased fromUS$2.2toUS$16.2millionbetween2016and2017alone[3].AsofJuly2018,JUULrep-resentedmorethan70%oftheU.S.conveniencestoremarketfore-cigaretteproductsandis currentlyconsideredthee-cigarette“brandleader”[4].AU.S.nationalrepresentativesurvey showedthatin2018,about10%ofyouth(ages15–17)and11%ofyoungadults(ages18–21) reportedeverusingJUUL,and6%and8%,respectively,reportedpast-30-dayuse[5].The samestudyshowedthatJUULuseismoreprevalentamongcombustibletobaccousersthan thosewhodonotusecombustibletobacco.Amongsmokersaged15–34,14%and10%had everusedJUULandusedJUULinthepast30days,respectively[5].Anotherrecentstudy foundthatin2018,amongadultcombustibletobaccousersaged18–54intheU.S.,15%and 12%hadeverusedJUULandusedJUULinthepast30days,respectively[6]. JUULLabshasclaimedthattheproductisan“alternativetosmoking”[7].Afewstudies fundedbyJUULLabshavesuggestedthatusingJUULe-cigarettesmayindeedserveasan effectivesmokingcessationmethodforadultsmokersgivenitshighefficiencyofnicotine delivery and flavors [8,9]. Other research funded by the U.S. National Institute on Drug Abuse andtheU.S.FoodandDrugAdministrationsuggestedthatJUULusealonemaybelessharm-fulthansmokingcigarettesorusingothertypesofe-cigarettes,producinglowerlevelsoftoxi-cantsincludingfreeradicalsandcarbonyls[10].Therefore,JUULmaybealessharmful alternativetocigarettesmokingiffurtherresearchdemonstratesitseffectivenessinpromoting smokingcessationaswellasreducedharmfulnessandaddictivenesscomparedtocigarettes. OnepotentialinfluencingfactorthatshapestheperceptionsandbehaviorofusingJUUL amongadultsmokersisthesourcesofawarenessaboutJUULproducts.Exposuretoe-ciga-rettemarketing—onemajorsourceoflearningaboute-cigarettes—hasbeenfoundtobeone oftheimportantpredictorsfore-cigaretteuse[11–15].Investigatingsourcesofawarenessmay helpusunderstandhowJUULgarneredsuchpopularityinashortperiodoftime;investigating theassociationbetweenuseofthesesourcesandJUUL-usebehaviorprovidesvaluableinfor-mationonpotentialcommunicationandpolicystrategiesforregulatingJUULe-cigarettesand itsmarketingpractices.Onepotentialmechanismbywhiche-cigarettemarketingandsources ofawarenessinfluenceproductuseispromotingfavorableperceptionstowardse-cigarettes [16–18].EvidencehasshownthatJUULLabs’advertisingandpromotionalpracticeshave includedtheplacementofmaterialsonmyriadmediaplatformsincludingwebsites,social mediasites,magazines,radio,andTV[19–21].Mostoftheseadvertisementshavedepicted attractivelifestylesandattitudes(e.g.,relaxation,freedom)andconveyedsexappeal,while simultaneouslymakingclaimsaboutthepotentialefficacyoftheproductforsmokingreduc-tionandcessation[19–21].Othersourcesofawarenessincludingword-of-mouthfromfriends andfamilyaswellasnewsfromTVandradiomayalsoinfluenceperceptionsandbehaviorof usingtobaccoproducts[22].
Publisher Copyright:
This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
PY - 2020/9
Y1 - 2020/9
N2 - Introduction Given JUUL e-cigarettes’ potential for smoking cessation and its drastically increased sales in the U.S., more evidence is needed to understand the antecedents of JUUL use among adult cigarette smokers. This study assessed the relationships between awareness sources, perceptions about using JUUL, and JUUL use behavior. Methods In an online study with adult smokers who were aware of JUUL e-cigarettes (n = 341), respondents reported their sources for learning about JUUL, perceptions of using JUUL versus Vuse (a competitor brand), and ever and past-30-day (current) JUUL use. Multivariable logistic regressions were used to examine the associations between awareness sources, perceptions, and JUUL use, adjusting for covariates. Results Learning about JUUL through internet ads was associated with positive perceptions about JUUL compared to Vuse, including JUUL was more fun to use (AOR = 2.04, 95% CI = 1.21, 3.42) and tastier (AOR = 1.96, 95% CI = 1.19, 3.22). Perceiving JUUL as being tastier (AOR = 2.07, 95% CI = 1.23, 3.49), more helpful for quitting smoking (AOR = 2.07, 95% CI = 1.22, 3.53), and cooler (AOR = 2.07, 95% CI = 1.21, 3.56) than Vuse was associated with ever using JUUL. Only perceiving JUUL as being tastier (AOR = 1.98, 95% CI = 1.10, 3.59) than Vuse was associated with current use of JUUL. Discussion Adult smokers may be more likely to focus on the sensory and social experience of using JUUL rather than JUUL’s smoking cessation benefits. These positive perceptions are likely to be influenced by internet ads in general instead of JUUL’s official marketing outlets. They are also more likely to sustain JUUL use than JUUL’s perceived smoking cessation benefits.
AB - Introduction Given JUUL e-cigarettes’ potential for smoking cessation and its drastically increased sales in the U.S., more evidence is needed to understand the antecedents of JUUL use among adult cigarette smokers. This study assessed the relationships between awareness sources, perceptions about using JUUL, and JUUL use behavior. Methods In an online study with adult smokers who were aware of JUUL e-cigarettes (n = 341), respondents reported their sources for learning about JUUL, perceptions of using JUUL versus Vuse (a competitor brand), and ever and past-30-day (current) JUUL use. Multivariable logistic regressions were used to examine the associations between awareness sources, perceptions, and JUUL use, adjusting for covariates. Results Learning about JUUL through internet ads was associated with positive perceptions about JUUL compared to Vuse, including JUUL was more fun to use (AOR = 2.04, 95% CI = 1.21, 3.42) and tastier (AOR = 1.96, 95% CI = 1.19, 3.22). Perceiving JUUL as being tastier (AOR = 2.07, 95% CI = 1.23, 3.49), more helpful for quitting smoking (AOR = 2.07, 95% CI = 1.22, 3.53), and cooler (AOR = 2.07, 95% CI = 1.21, 3.56) than Vuse was associated with ever using JUUL. Only perceiving JUUL as being tastier (AOR = 1.98, 95% CI = 1.10, 3.59) than Vuse was associated with current use of JUUL. Discussion Adult smokers may be more likely to focus on the sensory and social experience of using JUUL rather than JUUL’s smoking cessation benefits. These positive perceptions are likely to be influenced by internet ads in general instead of JUUL’s official marketing outlets. They are also more likely to sustain JUUL use than JUUL’s perceived smoking cessation benefits.
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U2 - 10.1371/journal.pone.0238377
DO - 10.1371/journal.pone.0238377
M3 - Article
C2 - 32870924
AN - SCOPUS:85090181181
SN - 1932-6203
VL - 15
JO - PloS one
JF - PloS one
IS - 9 September
M1 - e0238377
ER -