Author ORCID Identifier

0000-0002-1155-4266

Date of Award

12-18-2024

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Scott R. Weaver, Ph.D.

Second Advisor

Claire A. Spears, Ph.D.

Abstract

Introduction: Tobacco smoking is a leading preventable cause of death in the U.S., with around 34 million adults using cigarettes and two-thirds wanting to quit. Many smokers turn to electronic nicotine delivery systems (ENDS) like Juul and Vuse Alto to help them quit smoking, but their effectiveness remains unclear. This study compares 30-day cigarette smoking abstinence rates at the 12-month follow-up for users of Juul and Vuse Alto.

Methods: Utilizing data from a longitudinal survey of US adults who currently use Juul or Vuse Alto and who had smoked (at least one or two puffs) in the past year, this study evaluated differences in 30-day smoking abstinence at 12-month follow-up between Juul and Vuse Alto users while examining moderation by satisfaction with ENDS, smoking craving reduction when using ENDS, and perceived harm of ENDS.

Results: Results indicated that users of Vuse Alto had significantly higher odds of past 30-day smoking abstinence at the 12-month follow-up than Juul users (OR: 1.756, p = .0286). Those who reported having a reduction in craving to smoke a cigarette when using ENDS have 4.6 times greater odds of being abstinent from smoking at 12-month follow-up (OR: 4.616, p < .0001). Higher quitting intentions were associated with higher odds of being a non-smoker (OR: 1.152, p = .0310).

Conclusions: In conclusion, the results suggest that Vuse Alto might better facilitate switching away from cigarettes than Juul, though alternative explanations must be ruled out. Using ENDS to reduce cravings to smoke a cigarette and having stronger quitting smoking intentions were key predictors of smoking abstinence, informing public health approaches regarding the effectiveness of ENDS in promoting smoking abstinence.

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