And business is booming despite regulations

Despite a new report from the CDC and the FDA that shows a significant decline in vaping among children and teens, the FDA said in a statement that the agency “remains very concerned about the 3.6 million U.S. youth who currently use e-cigarettes and we acknowledge there is work that still needs to be done to curb youth use.”

New data from the 2020 National Youth Tobacco Survey (NYTS), published in the Morbidity and Mortality Weekly Report, shows that 1.8 million fewer kids and teens are using e-cigarettes compared with last year.

The NYTS, a school-based, self-administered survey conducted among U.S. middle and high schools, took place from Jan. 16 to March 16. The students were asked to report their use of tobacco products over the past 30-days, as well as their overall use, the devices used, and flavors.

Among the findings:

  • 3.02 million (19.6%) high school students reported current e-cigarette use.
  • 550,000 (4.7%) middle school students reported current e-cigarette use.
  • Among current e-cigarette users, 38.9% of high school students and 20% of middle school students surveyed reported 20 or more days of e-cigarette use within the preceding 30 days.
  • Among current users, 22.5% of high school students and 9.4% of middle school students reported daily use.
  • Flavored e-cigarettes were favored by 82.9% of the students who reported current use — 84.7% (2.53 million) of high schoolers and 73.9% (400,000) of middle schoolers.
  • Prefilled pods or cartridges were the most common device type, used by 48.5% or 1.45 million of the high school students and by 41.3% or 220,000 middle schoolers.
  • Disposables were used by 26.5% or 790,000 of the high school students and by 15.2% or 80,000 of the middle school students who reported current use.
  • Tanks were used by 14.8% or 440,000 of the high school students and 21.5% or 110,000 of the middle school students who reported current use.

“In 2020, approximately one in five high school students and one in 20 middle school students currently used e-cigarettes,” the CDC reported. “By comparison, in 2019, 27.5% of high school students (4.11 million) and 10.5% of middle school students (1.24 million) reported current e-cigarette use.” The CDC noted that, while the 2020 data do show a decline in current e-cigarette use since 2019, of the 3.6 million youth still using e-cigarettes, eight in 10 report using flavored cigarettes.

And the e-cigarette business is booming.

Another Morbidity and Mortality Weekly Report study found that, despite the decline in use among middle and high school students, from Sept. 2014 to May 2020, total unit sales of e-cigarettes increased by 122.2% — from 7.7 million to 17.1 million units per 4-week interval. However, over the time period, the sales were variable — there was an increase of 294.3% from Nov. 2016 to Aug. 2019, but sales decreased 32.7%, from 22 million to 14.8 million units per period, from Aug. 2019 to Feb. 2020.

Prefilled cartridges are the top selling e-cigarette products, but there has been an increase in use of disposables since Aug. 2019. As for flavored products, sales of mint-flavored products decreased, and menthol and tobacco flavors dominated the market at 61.8% and 37.1%, respectively.

The decline in mint and other flavored products might have been influenced by some manufacturers, such as JUUL, voluntarily removing fruit and other flavored cartridges from the market in Nov. 2018. “Moreover, on Jan. 2, 2020, the [FDA] finalized an enforcement policy that prohibits the sale of prefilled cartridge e-cigarettes in any flavor other than tobacco or menthol,” the CDC researchers wrote.

Limitations of this study include that the data did not include purchases over the Internet or from vape shops, “which accounted for approximately one half of U.S. e-cigarette sales in 2019.” Also, the ages of the purchasers could not be determined, and the flavors might have been misclassified.

Sept. 9, when these two MMWR reports came out, marked the deadline for the premarket review submissions for manufacturers and importers for tobacco products and electronic nicotine delivery systems (ENDS).

“Companies must demonstrate that each product meets the applicable statutory criteria for receiving marketing authorization, such as whether marketing the product is appropriate for the protection of the public health,” the FDA noted in its statement. “In such cases, the FDA may assess, among other things, how particular e-cigarettes or other electronic nicotine delivery systems (ENDS) could help addicted adult smokers seeking to transition away from cigarettes, while also weighing the concerning popularity of these products with young people.”

The agency also noted that it will undertake enforcement actions against any illegally sold product or one that did not submit a premarket authorization. It is especially targeting products that appear to be advertising to kids and teens.

“In line with its enforcement priorities, today the FDA issued warning letters notifying three companies who sell or distribute unauthorized ENDS products to remove those products from the market,” the FDA wrote. “These companies are XL Vape LLC (doing business as Stig Inc.), Flavour Warehouse LTD (doing business as Vampire Vape) and Pretty Women UK LTD (T/A Coil2oil and Mad Kingdom Liquids).”

  1. The 2020 National Youth Tobacco Survey (NYTS) shows that 1.8 million fewer kids and teens are using e-cigarettes compared with last year.

  2. However, be aware that there are 3.6 million U.S. kids and teens currently using e-cigarettes.

Candace Hoffmann, Managing Editor, BreakingMED™

None of the study authors had relevant relationships to disclose.

Cat ID: 143

Topic ID: 86,143,730,138,139,143,192,151,489,925