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Cho J, Miech RA, Harlow AF, et al. Nicotine Concentration of E-Cigarettes Used by US Youths. JAMA Netw Open. 27 Mar 2025;8(3):e252215. doi:10.1001/jamanetworkopen.2025.2215

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831999

“This study investigated the prevalence of nicotine concentrations that US youths reported vaping; associations of vaping nicotine concentrations at or above two thresholds (≥5% vs ≤4% and ≥6% vs 5%) with chronic, frequent vaping and polytobacco and substance use; and association of e-cigarettes obtained from third parties with not knowing nicotine concentration.”

Result: “Among 2318 youths with past-30-day-vaping nicotine concentration data (18.7% eighth, 32.0% tenth, and 49.4% twelfth grade; 53.6% female; 19.4% Hispanic, 12.0% non-Hispanic Black, 45.0% non-Hispanic White, and 23.6% other non-Hispanic race), 41.4% (95% CI, 38.7%-44.0%) reported not knowing nicotine concentration.”

“In demographic-adjusted contrasts, we found higher odds of vaping more than 20 of 30 days, 5-year vaping expectations, early-age vaping onset, and past-30-day use of most or all tobacco products and polytobacco use in youths vaping 5% or greater vs 4% and 6% or greater vs 5% nicotine concentrations. We found higher odds of vaping-relapse histories and past-30-day alcohol and marijuana use in the first comparison (5% or greater vs 4%) and no difference in non-nicotine substance use in the second comparison.

We observed dose–response–like associations of nicotine concentration with frequent, chronic vaping and polytobacco use. Youths who vaped ultrahigh (≥6%) vs very high (5%) nicotine e-cigarettes had incrementally increased risk of using various nicotine products and frequent, chronic vaping patterns. Still, they did not differ in other substance use.”

Note: In this US study, youth vaping very high nicotine concentrations often did not know what nicotine concentrations they were using, and their use was associated with frequent, chronic vaping and polytobacco use (other nicotine products including regular cigarettes), with higher odds of past-30-day alcohol and marijuana use.

TRC Research Commentary

Tobacco Industry Fraud and Disinformation (Link to Thai Summary)

Drs. Stanton Glantz and Prakit Vateesatokit listed 16 ways E-cigarettes are promoted through false and deceptive claims appealing to youth. The link to the Thai listing is given below.

ASH Thailand. Catching Up on the Lies and Claims about E-cigarettes. 28 March 2025.

https://drive.google.com/file/d/1nxKy-vh5LE2sQ89vMSS-u4e3ZZfDLKH8/view

It is essential to understand how nicotine sellers use false claims through various media to attract new nicotine users. Stephen Hamann