Willett et al conducted a national Web-based survey to investigate youth and young adults’ knowledge, attitude, and use of JUUL. Moran et al studied sources of awareness of JUUL e-cigarettes in 2 surveys of American adults. Several studies have been conducted to investigate the prevalence of JUUL use among adolescents, youth, and college students. With the rapid increase in JUUL use, there have been a few studies about JUUL. Thus, this sharp increase in teen JUUL usage, and the potential health impacts, has raised great public health concerns. In addition, as social media has become an emerging channel for information diffusion, JUUL-related discussions on platforms such as Twitter and Reddit have also experienced a sharp increase since 2015. Substantial and growing evidence shows that e-cigarette use by youth and young adults increases the risk of ever using conventional cigarettes, according to a 2018 report by the National Academies of Sciences, Engineering, and Medicine.

The popularity of JUUL among youth has also recently been reported in news media. JUUL’s manufacturer claims “JUUL is for adult smokers seeking a satisfying alternative to cigarettes.” However, a recent survey reported 8% of Americans aged 15 to 24 years used JUUL in the 30 days before the survey. Third, JUUL offers a wide array of flavor options. Second, nicotine delivery via JUUL is effective it is sufficiently high to warrant concern about development of nicotine addiction. Compared with traditional cigarette appearance, USB-like appearance has less of a negative perceived social image in public locations. First, JUUL’s appearance is similar to a universal serial bus (USB), which makes it easy to carry and hide as a portable device. JUUL’s popularity is due to several characteristics. JUUL, the most popular e-cigarette brand in the United States, currently holds 71% of the market share, according to data from Wells Fargo in July 2018.

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