Online Interest in Elf Bar in the United States: Google Health Trends Analysis

Background: Despite the popularity of JUUL e-cigarettes, other brands (eg, Elf Bar) may be gaining digital attention. Objective: This study compared Google searches for Elf Bar and JUUL from 2022 to 2023 using Google Health Trends Application Programming Interface data. Methods: Using an infodemiology approach, we examined weekly trends in Google searches (per 10 million) for "Elf Bar" and "JUUL" at the US national and state levels from January 1, 2022, to December 31, 2023. Joinpoint regression was used to assess statistically significant trends in the search probabilities for "Elf Bar" and "JUUL" during the study period. Results: Elf Bar had less online interest than JUUL at the beginning of 2022. When the US Food and Drug Administration denied JUUL marketing authority on June 23, 2022, JUUL searches peaked at 2609.3 x 10(7 )and fell to 83.9 x 10(7) on September3, 2023. Elf Bar searches surpassed JUUL on July 10, 2022, and steadily increased, reaching 523.2 x 107on December 4, 2022.Overall, Elf Bar's weekly search probability increased by 1.6% (95% CI 1.5%-1.7%; P=.05) from January 2022 to December2023, with the greatest increase between May 29 and June 19, 2022 (87.7%, 95% CI 35.9%-123.9%; P=.001). Elf Bar searches increased after JUUL's suspension in Pennsylvania (1010%), Minnesota (872.5%), Connecticut (803.5%), New York (738.1%),and New Jersey (702.9%). Conclusions: Increasing trends in Google searches for Elf Bar indicate that there was a growing online interest in this brand in the United States in 2022