Nicotine arms race: JUUL and the high-nicotine product market

Tob Control. 2019 Nov;28(6):623-628. doi: 10.1136/tobaccocontrol-2018-054796. Epub 2019 Feb 6.


Objective: Until recently, purveyors of vaping products marketed e-liquids in the 1%-3% range of nicotine concentration with those at 3% described as 'super high' intended for two packs/day smokers. The goal of this study is to evaluate the degree to which JUUL, with its 5% nicotine and 75% US market share, has spurred other e-liquid vendors to raise the nicotine levels of their products.

Methods: Online search to identify brands offering e-liquid in exceptionally high nicotine concentration (≥5%) and to catalogue the appearance of devices which emulate JUUL.

Results: JUUL compatible pods (14) and JUUL knock off devices (39) were identified which offer equal or higher nicotine than JUUL. More than 70 e-liquid brands sell high-nicotine products (≥5%) in bulk (≥30 mL) equivalent to >40 cigarette packs. All of these products come in multiple youth appealing sweet and fruity flavours. It was noted that nicotine percentage is inconsistently reported (eg, JUUL is 5% by weight vs 5.9% by volume).

Conclusions: JUUL has triggered a widespread rush among aerosol purveyors to market e-liquid in unprecedentedly high nicotine concentrations. The rapidly rising popularity of high-nicotine e-liquids threatens to addict a generation of youth. When sold in large quantity bottles (eg, 30 mL) they represent a childhood poisoning risk. Labelling of nicotine concentration in e-liquids needs to be standardised to avoid consumer confusion. The addictiveness and toxicity of these products makes it imperative that regulators act swiftly to enact protective measures.

Keywords: electronic nicotine delivery devices; nicotine; non-cigarette tobacco products; public policy.

MeSH terms

  • Adolescent
  • Commerce*
  • Electronic Nicotine Delivery Systems*
  • Flavoring Agents / analysis
  • Humans
  • Nicotine / analysis*
  • Product Labeling*
  • Tobacco Products / analysis
  • United States


  • Flavoring Agents
  • Nicotine