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Increasing e-cigarette sales and flavor shifts underscore the need for stricter regulations, according to a CDC Foundation, Truth Initiative.
E-cigarette unit sales in the US experienced a significant increase of 46.6% between January 2020 and December 2022, according to a new report by the CDC Foundation, Truth Initiative, and the Centers for Disease Control and Prevention (CDC).1
The study revealed the changing landscape of e-cigarette products, with flavored disposable e-cigarettes gaining prominence over prefilled cartridges. Especially among young people, e-cigarette use has been a growing concern, the study stated. E-cigarette use among youths and young adults is significantly higher than among adults overall.
In 2022, an estimated 2.14 million high school students, or approximately 14.1%, reported current e-cigarette use. These devices, which often contain high levels of nicotine, can have adverse effects on the developing adolescent brain.
Fatma Romeh M. Ali, PhD, from the CDC Foundation Truth Initiative, and a team of investigators, said tracking e-cigarette sales and understanding usage patterns is crucial to inform public health strategies aimed at preventing youth tobacco use.
The investigation analyzed retail scanner data from January 2020 to December 2022, provided by Information Resources, Inc., a US data analytics and market research company. The team observed sales of mint and other flavored prefilled cartridges declined, while sales of disposable e-cigarettes in fruit, sweet, and other flavors increased after January 2020.
This indicated disposable e-cigarettes in youth-appealing flavors have become more prevalent in the market compared to prefilled units.
Among the key findings, the unit shares of tobacco and mint-flavored products decreased, while other flavors saw an increase. The unit shares of prefilled cartridges declined from 75.2% to 48%, whereas disposable e-cigarette unit shares rose from 24.7% to 51.8% of total unit sales during the study period.
The top-selling e-cigarette brands during the 4-week period ending December 25, 2022, were Vuse, JUUL, Elf Bar, NJOY, and Breeze Smoke. The report also highlighted the dynamic nature of the e-cigarette market, with changes observed in the top 5 brands and an overall increase in the number of available e-cigarette brands during the study period.
The decline in total e-cigarette unit sales observed from May to December of 2022 can be attributed to multiple factors, according to the research. This included local and state restrictions on flavored tobacco product sales, FDA regulatory actions, supply chain disruptions caused by the COVID-19 pandemic, inflation, and the introduction of large-format disposable e-cigarettes capable of delivering higher nicotine consumption.
The report emphasized the need for comprehensive restrictions on the sale of all flavored tobacco products, including e-cigarettes, menthol cigarettes, and flavored cigars, in order to protect public health. Several states and jurisdictions have already implemented restrictions on flavored e-cigarette sales, but the comprehensiveness of these policies varies.
Research suggests that well-enforced flavor restrictions lead to declines in total e-cigarette sales and tobacco product use among young people. The FDA has taken steps to address flavored e-cigarette products, including issuing marketing denial orders and warning letters to manufacturers, distributors, and retailers for unauthorized sales.2
However, more efforts are needed to combat the use of flavored disposable e-cigarettes, which have gained popularity among youth, investigators noted.1