Changes in exposure to tobacco-related harmful and potentially harmful constituents among adults who switched completely from smoking cigarettes to use of the JUUL2 system for six days

Introduction: Adults who switch from smoking cigarettes to use of electronic nicotine delivery systems (ENDS) may reduce their exposure to harmful and potentially harmful constituents (HPHCs). This study assessed changes in exposure to HPHCs, assessed via biomarkers of exposure (BOEs), among adults who switched to a new ENDS product. Methods: Adults who smoke cigarettes (N = 89) were randomized to: (1) switch completely to using JUUL2 Virginia Tobacco (N = 24) or Polar Menthol (N = 24); (2) continue smoking usual brand (UB) cigarettes (N = 21); or (3) abstain from all tobacco/nicotine products (N = 20) for 6 d. Changes in exposure to nicotine and 11 other HPHCs from Baseline to Day 6 were compared among study groups. Results: Changes in nicotine exposure did not significantly differ between JUUL2 and UB Cigarette groups (ps > 0.37). Among participants who switched completely to JUUL2 products, median percent reductions (Day 6–Baseline) in non-nicotine BOEs ranged from 65% to 94%, significantly greater than changes in the UB Cigarette group (ps < 0.001). None of the non-nicotine BOEs significantly differed between the JUUL2 groups and the Abstinence group (ps > 0.025). Conclusions: This randomized study demonstrates that adults who switch completely from smoking cigarettes to use of JUUL2 ENDS products substantially reduce their exposure to HPHCs associated with smoking-related diseases. International Standard Registered Clinical Trial Number: ISRCTN27662176.