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Correspondence to Professor Linnea Laestadius, Zilber School of Public Health, University of Wisconsin–Milwaukee, Milwaukee, WI 53201, USA; [email protected]
Introduction
The novel electronic cigarette (‘e-cigarette’) product JUUL has experienced rapid market growth since its introduction to US consumers in 2015. As of March 2018, JUUL held a 54.6% market share for e-cigarettes.1 JUUL devices resemble flash drives and are designed for use with JUUL pods, which contain 0.7 mL by volume/5% nicotine by weight and come in eight flavour varieties. By comparison, blu e-cigarette ‘liquidpods’ are offered in a range of nicotine levels spanning from 0% to 4%.2 JUUL starter kits come with a mixed flavour package of Virginia tobacco, cool mint, fruit medley and crème brulee pods, although JUUL recently changed these names to mint, fruit, and creme and also added a 3% nicotine level for select flavors. JUUL devices can also be accessorised with decorative wraps/decals. In addition to being popular among adult users, JUUL appears to have become extremely popular with youth. Anecdotal evidence suggests widespread usage in schools.3 An initial Truth Initiative survey using a convenience sample drawn in November 2017 found that 7% of youth aged 15–17 years have used JUUL devices.4 While there are no current data on the proportion of current e-cigarette users who use JUUL, the number suggests that a sizeable proportion of the overall 11.7% of high school students who use e-cigarettes may be using JUUL devices.5
While it is still unclear where youth obtain JUUL devices and pods online, the online auction site eBay has been mentioned as a source of JUUL access for youth.3 The importance of eBay as a source of JUULs was highlighted by the US Food and Drug Administration’s (FDA) Youth Tobacco Prevention Plan actions announced on 24 April 2018, which included contacting eBay about multiple JUUL listings on the platform. While eBay had already formally banned listings for all ‘electronic cigarettes and components as defined under FDA regulations’ in its terms of service policy,6 the FDA reported that it was thankful that the site had now removed the listings in question and implemented ‘new measures to prevent new listings from being posted…’.7
Despite recent FDA and eBay actions, there has been no empirical...