On October 25, foreign media reported a research report on the impact of e-cigarette nicotine concentration on smoking cessation in the United Kingdom and the United States. The specific report is as follows:

Introduction: Assuming that the atomized electronic nicotine delivery system (ENDS) helps smokers quit smoking, it can improve public health. Conceptually, when ENDS provides enough nicotine delivery, conversion will become easy.

The conversion rate of smokers who purchased the JUUL system ("JUUL") was compared in the United Kingdom (United Kingdom). The United Kingdom (United Kingdom) regulations limit the nicotine concentration to 20 mg/ml, while North America (North America; the United States and Canada) is Higher concentrations can be used.

Purpose and methods: To recruit newly purchased adult smokers (age = 21, smoking 2 100 cigarettes, smoking for several days or a day at baseline) for a longitudinal study (UK: N=1247; USA: N=8835).

Evaluation of complete conversion (230 days without smoking) at 1, 3, and 6 months after purchase: Propensity score matching (PSM) and logistic regression compared the switch after adjusting for baseline characteristics.

Results: In N.Am. and the United Kingdom, 282% of participants reported using the highest available JUUL nicotine concentration (United Kingdom: 18 mg/ml: United States: 59 mg/ml).

The unadjusted conversion rate did not change at 1 month (17%-18%): the unadjusted and adjusted ratio of NAm was significantly higher. (Compared to the UK) at 3 and 6 months. In the PSM sample, after adjusting for additional covariates, the ratio of N.Am was significantly higher. (Compared with the United Kingdom) at 3 months (31.5% vs. 22.7%; odds ratio [95% confidence interval, CI] = 1.59 [1.25, 2.02]) and 6 months (38.0% vs. 26.0%; odds ratio [95 %) Cl=1.79 [1.37, 2.35).

Conclusion: These results indicate that the availability of ENDS with a nicotine concentration greater than 20 mg/mL may be related to the increased conversion of adult smokers.

Differences in smoking and ENDS use characteristics cannot explain the association between location and conversion; however, differences between countries may be affected by unmeasured factors.

Impact: Smokers who purchase the JUUL system ("JUUL") in the UK have a lower conversion rate, where regulations limit the nicotine concentration to 20 mg/mL, while N.Am. (the United States and Canada) is used in the control of smoking and ENDS. Before and after the difference in characteristics, a higher concentration can be obtained.

These results indicate that the availability of ENDS with a nicotine concentration greater than 20 mg/mL may be related to the increased conversion of adult smokers.

Differences between countries may be affected by unmeasured factors: future research should consider these factors and the extent to which the regulatory policy environment can explain the differences in conversion between adult smokers.

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