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June 23, 2023

E-cigarette sales surged during the pandemic, CDC says

Health officials say the proliferation of vapes with flavors like fruit or candy can make young people more vulnerable to nicotine addiction and health issues

Sales of e-cigarettes, particularly those with sweet flavors that appeal to children, surged during the first two years of the COVID-19 pandemic, prompting the Centers for Disease Control and Prevention to warn of the risk of nicotine addiction among young Americans. 

The CDC report, published on Thursday, found that e-cigarette sales increased by 46.6% between 2020 and 2022, from 15.5 million per month to 22.7 million per month. Likewise, the number of brands sold increased from 184 to 269. While sales of pre-filled devices (in which users replace vape pods when empty) decreased, the use of disposable vapes and those with candy, fruit and other flavors increased.

Pre-filled e-cigarette sales dropped following the Food and Drug Administration's 2020 announcement that it would enhance enforcement against pre-filled e-cigarettes with flavors other than tobacco and menthol. The surge in flavored disposable e-cigarettes is in line with data from the 2022 National Youth Tobacco Survey, which found that they are increasingly popular among middle and high school students in the U.S. 

Over the two-year period, sales of tobacco and mint-flavored e-cigarettes fell from 28.4% to 20.1% and from 10.1% to 5.9%, respectively. Sales in flavors like fruit, cloves, spice, sweets and chocolate increased from 29.2% to 41.3%. Officials from the CDC said that monitoring e-cigarette sales can provide real-time data to help reduce youth nicotine use.

"The tobacco industry is well aware that flavors appeal to and attract kids, and that young people are uniquely vulnerable to nicotine addiction," said Robin Koval, president and CEO of Truth Initiative. "While we are encouraged by FDA's recent actions to curb unlawful marketing of flavored e-cigarettes, we all must work with even greater urgency to protect our nation's youth from all flavored e-cigarettes, including disposables." 

While total sales increased over the two years, they decreased by 12.1% from May to December 2020. This is largely due to local and state restrictions on flavored tobacco products, pandemic-related supply chain issues and the FDA's order requiring Juul Labs Inc. to take its popular e-cigarettes and tobacco- and menthol-flavored pods off the market in June. 

An initial surge in e-cigarette sales, which occurred in 2017 and 2018, was largely due to Juul's proliferation, the CDC said. As the safety of Juul products was routinely called into question, the FDA took them off the market to crack down on e-cigarette companies that have played a role in the rise of youth vaping. 

Two other e-cigarette brands, Elf Bar and Esco Bar, received warning letters from the FDA earlier this week for selling unauthorized tobacco products. The brands, both of which sell disposable e-cigarettes in sweet flavors like bubblegum and cotton candy, have been named among the most popular products in the U.S. with demand from youth. 

separate CDC study uncovered thousands of e-cigarette exposure cases reported to U.S. poison centers in the last year, the majority of which were among kids younger than 5. Of the e-cigarettes exposed to children, Elf Bar products were cited more than all of the other brands combined.

E-cigarettes have been the most commonly used tobacco product among youth since 2014. In 2021, 11.3% of high school students reported they had used e-cigarettes within the last 30 days. Public health officials fear the popularization of e-cigarettes could wipe out health gains made in cigarette use, with research indicating that children who vape are three times more likely to smoke cigarettes as adults. 

While e-cigarettes are frequently touted as tools to help adults quit smoking tobacco, research has suggested that they are not a cessation aid. In a study that analyzed data from 2017 to 2019, 60% of former smokers who were vaping daily began smoking again by 2019. E-cigarettes can also lead to nicotine addiction and future addiction to other harmful drugs.

The use of e-cigarettes has been linked to higher risk of stroke, risk of stroke at a younger age, increased risk of developing COVID-19 and changes in the brain that can affect attention, learning, mood and impulse control, particularly among young people whose brains have not fully developed. Vaping can increase the risk of cavities, tooth disease, impaired blood vessel function and cardiovascular disease. 

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