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We just got the first clear evidence that some people are using Juul e-cigs to cut back on smoking

Mar 29, 2019, 22:32 IST

Sarah Johnson/Flickr

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  • Juul, which is partially owned by Altria, the tobacco giant behind Marlboro cigarettes, is the most popular e-cigarette in America.
  • Juul wants to show that its sleek devices can help adult smokers take up a healthier habit, despite pushback from regulators who are concerned about youth vaping.
  • The company has gotten a makeover in recent years and recently began doing health research.
  • Its latest study has some positive takeaways for smokers. As with any study, there are limitations.

E-cigarette company Juul is on a quest to prove that its sleek devices can help smokers take up a healthier habit.

Now, for the first time since its products debuted four years ago with the tagline "smoking evolved," the company has published evidence that some adult smokers may be using the device to wean themselves off regular cigarettes.

Christopher Russell, the study's lead author and a psychologist at the Scotland-based research consulting firm CSUR, believes it shows the Juul can be used to quit.

"For people who use the Juul, it satisfies them, the convenience suits them, they like the flavors," Russell told Business Insider. "It's great to see them finally find something that competes with cigarettes and ultimately replaces cigarettes."

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Outside experts say the findings are promising, especially for smokers who are making a concerted effort to quit.

Partially owned by Altria, the tobacco giant behind Marlboro cigarettes, Juul is the most popular e-cigarette in America. Its devices have gobbled up roughly 80% of the e-cig market share, according to the most recent Nielsen data.

But Juul has faced scrutiny in recent years for its reported popularity among young people. At the center of the debate is a six-month launch campaign that the company kicked off with a promotional party. The campaign featured images of young models on bright, colorful backgrounds, and included ads on social media.

Regulators have since cracked down on the company, and on e-cigarettes in general. Some cities have banned e-cigarettes entirely.

Juul says that its sole mission is to help adult smokers transition to something healthier. The company also maintains that its devices are not and were never intended for young people. In recent years, Juul has transformed its public presence to cater more to adult smokers.

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It has also begun doing health research. The new study is part of that work. Its findings suggest that for some people, the Juul may help them cut back on smoking. As with any study, however, there are limitations.

From Silicon Valley startup to established e-cigarette giant

SRITA

For a study Juul published last month, researchers looked at the total number of cigarettes Juul users said they'd smoked and suggested customers were using the devices to cut back.

Its latest study is somewhat similar to the last, but some characterize it as stronger and more significant.

Juul's new study, published this week in the journal Harm Reduction, suggests that a sizeable chunk of its adult customers spent at least a month without a traditional cigarette.

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The new study also looked at the role flavors play in adults using the Juul to cut back on cigarettes. It suggests that Juul's mint and mango flavors are more strongly tied to cutting back on smoking than its tobacco flavor. The company voluntarily pulled its mango (along with its other sweet and fruit options) from retail stores last fall in response to concerns about youth use.

Good news for smokers with some key limitations

REUTERS/Ronen Zvulun

Daniel Giovenco, an assistant professor of socio-medical sciences at Columbia University, characterized Juul's latest study as potentially good news for smokers, with some key limitations.

"A lot of what they found is very consistent with what we see in other nationally representative studies of e-cigarettes," he told Business Insider.

Giovenco was also the lead study author of a 2017 paper which suggested that e-cigs could help smokers quit.

One strength of Juul's study was its large sample size, he said. For its research, Juul recruited nearly 16,000 adults who'd purchased a $45 Juul Starter Kit which includes the Juul device, a charger, and a selection of refillable cartridges or pods. They then used questionnaires to confirm that those customers were current conventional cigarette smokers and followed up with them after three months.

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At that three-month point, 28% of all the customers they'd recruited said they hadn't smoked a traditional cigarette in the past 30 days.

When Russell's team homed in only on the people who'd actually completed its three-month follow-up survey, the figure was even more impressive: 47% of those people said they hadn't smoked a regular cigarette in the past month.

Russell called the figure "very high" but cautioned that it was still too early to say whether those findings translate to the wider population of smokers.

Giovenco agreed. He said both of the figures are positive signs for Juul and for smokers in that they suggest that a big chunk of adult smokers might be Juuling instead of smoking. But Juul's customers - at least the ones in this study - don't represent most adult smokers, he said.

In comparison to the majority of US smokers, Juul's sample was whiter, more well-educated, and wealthier. They were also lighter cigarette smokers to begin with. Rather than the 10-20 cigarettes per day smoked by the average smoker who gravitates toward a stop-smoking intervention like nicotine gums or patches, the majority of Juul's study participants were smoking between one and nine cigarettes a day. About 30% were smoking 10-19 daily. Only 18% were smoking 20 or more each day.

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For those reasons, Giovenco cautioned that Juul's study does not definitively show that the Juul can be used to quit.

What Juul needs to show it can be used to quit

In order to show that people are reaching for a Juul instead of a traditional cigarette, researchers will have to compare a group of smokers who used the Juul against a group of smokers who did not use one - otherwise known as a control group, Giovenco said.

They'll also need to include a more representative sample of American smokers than the ones in this study.

"Their sample does not look like the average smoker in the US," said Giovenco.

But those caveats do not make Juul's study insignificant, he said.

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In fact, Juul's paper aligns fairly well with the findings from his previous research demonstrating that e-cigarettes may help smokers kick the habit.

"Some evidence does suggest - and I do believe - that using e-cigarettes can help some people quit," he said.

"But this study is not the study that proves that," he added.

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