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The trends observed in our study align with those seen in countries such as Japan and China, where similar increases in all-cause and lung cancer mortality among smokers have been reported 22,27

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Cigarette companies were also among the first to work with Black magazines to advertise their product, and once the barriers were reluctantly broken, tobacco giants began aggressively targeting Black Americans (who were generally smoking far less than white Americans at the time)

In one study, Cunningham and colleagues (2016) assigned experienced e-cigarette users to either a first-generation device (Vype Reload, classic flavor bold containing 4.5 percent nicotine by volume) (n = 32) or to a button-activated, variable-voltage e-cigarette that uses prefilled cartridges containing e-liquid (Vype ePen with 3.0 percent nicotine by volume) (n = 28)

The study also found that while many young people are aware of JUUL, many are unaware that the product always contains the addictive chemical nicotine