JUUL in school: JUUL electronic cigarette use patterns, reasons for use, and social normative perceptions among college student ever users.

Background: JUUL electronic cigarettes have surged in popularity since their emergence on the market in 2015. JUUL is slim and simple in design and is capable of delivering cigarette-like levels of nicotine. However, little research has examined JUUL use patterns, reasons for use, and normative perceptions of JUUL among young adults.

Methods: Participants were college students (N = 243) who reported ever using a JUUL electronic cigarette. Eligible participants completed a survey assessing JUUL use patterns, reasons for JUUL use, and normative perceptions of JUUL.

Results: Most participants reported using JUUL once or twice (47.7%) and almost one-third reported using JUUL daily or monthly (29.6%). Overall, participants reported a low level of nicotine dependence (M = 0.93, SD = 2.04). Cool Mint was the most preferred flavor (35.8%) followed by Mango (12.0%). The top reasons for use were because "friends were using it" (27.0%) and "curiosity" (19.4%). Nearly half (49.8%) of participants reported that they would tell all five of their five closest friends that they use JUUL. Only 10.7% reported a belief that none of their friends would approve of their JUUL use.

Conclusions: The high percentage of daily and monthly JUUL users coupled with the relatively high rates of perceived acceptability of use indicates the possibility of high uptake among college students. Findings also suggest college students perceive JUUL as highly acceptable and that their friend's use and curiosity were primary motivators of their initial use, indicating the importance of peer influence in college student JUUL use.