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Open Access The Adult JUUL Switching and Smoking Trajectories (ADJUSST) Study: Methods and Analysis of Loss-to-Follow-up

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This article is Open Access under the terms of the Creative Commons CC BY-NC-ND licence.

Objectives: The Adult JUUL System User Switching and Smoking Trajectories (ADJUSST) study assessed the smoking and JUUL use trajectories of adults who purchased JUUL. In this paper, we describe study methods, characterize the sample, and assesses potential for bias due to loss to follow-up. Methods: We entered 55,414 US adults (≥ age 21) who purchased a JUUL Starter Kit for the first time (online or at retail) in 2018 into a naturalistic, longitudinal observational study, irrespective of baseline smoking status. Participants were invited for follow-ups 1, 2, 3, 6, 9, and 12 months later, focused on assessing past-30-day smoking and JUUL use. Analyses assessed potential bias due to non-response. Results: Over 90% of participants had a history of smoking; 62.8% were past-30-day smokers; 23.3% were former smokers. Participants' average age was 30; 75% were white. Most participants (77.6%) completed some follow-ups; 25% completed all follow-ups. Baseline differences among complete responders (N = 13,729), partial responders (N = 29,252), and complete non-responders (N = 12,433) were small. When recontacted, few 12-month non-responders said their non-response was due to smoking; many reported no past-30-day smoking. Conclusions: The study may elucidate smoking trajectories of adult JUUL users. The potential for bias due to loss to follow-up in ADJUSST was limited.
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Keywords: ELECTRONIC NICOTINE DELIVERY SYSTEMS; JUUL; LONGITUDINAL STUDY; LOSS-TO-FOLLOW-UP; SMOKING

Document Type: Research Article

Affiliations: 1: Senior Scientific Advisor, Behavioral Science, Study Design, and Analysis, PinneyAssociates Inc, Pittsburgh, PA, United States 2: Director, Data Management and Statistical Analysis, PinneyAssociates Inc, Pittsburgh, PA, United States 3: Senior Director, Behavioral Affairs, Juul Labs Inc, Washington, DC, United States 4: Behavioral Scientist, Juul Labs Inc, Washington, DC, United States 5: Director of Research, Centre for Substance Use Research, Glasgow, United Kingdom 6: Director, Centre for Substance Use Research, Glasgow, United Kingdom 7: Deputy Director, Centre for Substance Use Research, Glasgow, United Kingdom

Publication date: May 1, 2021

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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