Randomized trial assessing the effect of the JUUL system on switching away from cigarettes and smoking reduction among U.S. adults who smoke cigarettes.

Observational studies show high rates of switching away from cigarettes among adult purchasers of JUUL-brand electronic nicotine delivery system (ENDS); data are needed to evaluate switching with JUUL in randomized general population trials. The association of ENDS flavor availability and switching is pertinent. This study assessed switch rates and smoking reduction among participants randomized to use JUUL in a choice of flavors or tobacco-only, compared to a condition provided smoking-cessation materials.

The impact of JUUL market entry on cigarette sales: evidence from a major chain retailer in Canada.

Background: Electronic nicotine delivery systems (ENDS), such as the JUUL system, are nicotine products for adults who currently smoke cigarettes but are looking for an alternative to combustible cigarettes. Sales of ENDS products were legislatively acknowledged and authorized federally in Canada with the Royal Assent of the Tobacco and Vaping Products Act in 2018.

Methods: With the unique dataset from a major chain retailer in Canada, we evaluated the impacts of JUUL market entry on cigarette sales across Canada from January 2017 to August 2019 using two-way fixed effects panel regression models by leveraging on the entry time variation at the city level.

The Impact of Banning Electronic Nicotine Delivery Systems on Combustible Cigarette Sales: Evidence From US State-Level Policies.

Objectives: In the fall of 2019, several states in the United States passed emergency bans on the sale of electronic nicotine delivery systems (ENDS), in response to an outbreak of illnesses strongly linked to tetrahydrocannabinol vaping products that received national news coverage. Given that ENDS are potential alternative nicotine products for adult smokers, banning ENDS may have unintended consequences. This study provides evidence of an association between state-level ENDS bans and cigarette sales.

Differences in Switching Away From Smoking Among Adult Smokers Using JUUL Products in Regions With Different Maximum Nicotine Concentrations: North America and the United Kingdom.

Introduction: Electronic nicotine delivery systems (ENDS) may improve public health if they facilitate smokers switching away from cigarettes. Conceptually, switching is facilitated when ENDS provide adequate nicotine delivery. Switching rates among smokers who purchased the JUUL System ("JUUL") were compared in the United Kingdom (UK), where regulations limit nicotine concentration to 20 mg/mL versus North America (N.

Modeling the Population Health Impact of ENDS in the U.S.

Our objective was to improve understanding of the population health impact of electronic nicotine delivery systems (ENDS) availability in the US via computational modeling. We present an agent-based population health model (PHM) that simulates annual smoking, ENDS use, and associated mortality for individual agents representing the US population, both adults and youth, between 2000 and 2100. Model transitions were derived from key population surveys and a large longitudinal study of JUUL purchasers.

Improving Retailer Compliance for Tobacco Purchases: Pilot Study Findings.

Those underage should not use tobacco products, including electronic nicotine delivery systems. A technologically-based solution developed by Juul Labs Inc to restrict underage access seeks to automate transactions, structurally mandate age-verification, and limit the quantity of JUUL products purchased per transaction. A pilot of this standards-based approach, referred to as RACS™ (Retail Access Control Standards), was conducted to assess efficacy.

Transitions in Smoking among Adults Newly Purchasing the JUUL System.

In this study, we prospectively assessed changes in smoking a year after US adults' first-time purchase of a JUUL Starter Kit (JSK). Descriptive analyses assessed transitions in smoking status at 12 months among adult (age ≥21) JSK purchasers providing baseline and 12-month follow-up data (N = 27,164 [49.0% of baseline]), stratified by baseline smoking status.

Switching away from Cigarettes across 12 Months among Adult Smokers Purchasing the JUUL System.

In this study, we assessed complete switching away from cigarette smoking among adult smokers who purchased a JUUL Starter Kit (JSK). Adult (age ≥ 21) established smokers (smoked ≥ 100 lifetime cigarettes) who purchased a JSK in 2018 were invited to complete online surveys 1, 2, 3, 6, 9 and 12 months after initial JSK purchase. Point prevalence of switching (no past 30-day smoking) was assessed at each follow-up.

Prevalence of ENDS and JUUL Use, by Smoking Status, in National Samples of Young Adults and Older Adults in the U.S.

In this paper, we estimate the prevalence of electronic nicotine delivery systems (ENDS) and JUUL brand ENDS use among adults in the US, overall and by smoking history. We obtained 2019 cross-sectional online surveys assessing smoking, use of any ENDS, and JUUL specifically, in a national probability sample of 11,833 US adults. Data were analyzed for young adults (YA; aged 18-24) and older adults (OA; aged 25+).

Behavioral Health Coverage In The Individual Market Increased After ACA Parity Requirements.

As of January 1, 2014, the Affordable Care Act designated mental health and substance use services as an essential health benefit in Marketplace plans and extended parity protections to the individual and small-group markets. We analyzed documents for seventy-eight individual and small-group plans in 2014 (after parity provisions took effect) and sixty comparison plans in 2013 (the year before parity provisions took effect) to understand the degree to which coverage for mental health and substance use care improved relative to medical/surgical benefits. The results suggest that plan issuers did what the provisions required them to do.

Effect of the bathing without a battle training intervention on bathing-associated physical and verbal outcomes in nursing home residents with dementia: a randomized crossover diffusion study.

Objectives: To evaluate the effectiveness of the Bathing Without a Battle intervention in reducing physical and verbal aggressive behaviors for nursing home residents with dementia.

Design: A randomized crossover diffusion study, with one group receiving the intervention after one round of baseline observations and a delayed intervention group receiving the intervention after two rounds of baseline observations.

Setting: Six nursing home facilities in the state of New York.

Quantifying school officials' exposure to bacterial pathogens at graduation ceremonies using repeated observational measures.

The purpose of this study was to estimate the risk of acquiring pathogenic bacteria as a result of shaking hands at graduation ceremonies. School officials participating in graduation ceremonies at elementary, secondary, and postsecondary schools were recruited. Specimens were collected before and immediately following graduation.

Impact of non-alcoholic fatty liver disease on chronic hepatitis B.

Background: The impact of superimposed non-alcoholic fatty liver disease (NAFLD) is well established in patients with chronic hepatitis C (CH-C), but the impact in patients with chronic hepatitis B (CH-B) is less clear.

Aim: This study aims to evaluate the prevalence of NAFLD in patients with CH-B and the association with viral and host factors, particularly in patients with metabolic syndrome (MS).

Design: Data from patients with CH-B was obtained from our databases.