Pharmacokinetic assessment of JUUL2 18 mg/mL electronic nicotine delivery system in four flavors relative to cigarettes and a 5% (58 mg/mL) nicotine pod-based electronic nicotine delivery system among adult dual users.

Abstract

Assessing the nicotine pharmacokinetics of new electronic nicotine delivery system (ENDS) products can inform their abuse liability and public health effects. Nicotine delivery from JUUL2 ENDS products in four flavors (Virginia Tobacco, Polar Menthol, Autumn Tobacco, and Summer Menthol [18 mg/mL nicotine]) was compared to combustible cigarettes and NJOY Ace 5.0%, a pod-based ENDS authorized by Food and Drug Administration (classic tobacco and menthol flavors; 58 mg/mL), in two similarly designed but independent randomized crossover pharmacokinetics studies. All participants were adults who were daily cigarette smokers and concurrently used ENDS-dual users (Study 1, N = 44; Study 2, N = 30). Participants first used each product in a controlled use session (10 standardized 3-second puffs) and then a 5-min ad libitum use session. In both studies, when used by experienced ENDS users: (a) JUUL2 18 mg/mL products delivered statistically significantly lower peak levels of nicotine and exposed dual users to lower total levels of nicotine than combustible cigarettes; (b) nicotine delivery from use of JUUL2 18 mg/mL products was significantly lower than NJOY Ace 5.0% following controlled use, but more similar after ad libitum use; and (c) nicotine exposure did not significantly vary between tobacco- and menthol-flavored JUUL2 products. These results indicate that (a) JUUL2 18 mg/mL products expose users to significantly lower levels of nicotine than cigarettes, suggesting lower abuse liability; (b) abuse liability of JUUL2 18 mg/mL products is within the range of NJOY Ace 5%, an Food and Drug Administration-authorized pod-based ENDS; and (c) flavor did not significantly affect nicotine delivery from JUUL2 18 mg/mL products. (PsycInfo Database Record (c) 2026 APA, all rights reserved).