Uncertain decline in vaping use among young Americans

Results of the 2021 National Youth Tobacco Survey (NYTS)[1] In the United States, data shows that more than 2 million middle and high school students reported frequent e-cigarette use during the first half of this year. This figure is down 401% from 2020. However, public health associations are calling for vigilance and a complete ban on flavors for vaping products.

This survey highlights both that the use of e-cigarettes by young people remains a major public health problem, including in the context of the Covid pandemic, and also that the e-cigarette market is driven by flavored products, including menthol.

Encouraging results but to be interpreted with caution

The national survey found that 11% of high school students and 3% of middle school students had used e-cigarettes in the past 30 days in the first quarter of 2021, compared to 20% of high school students and 5% of middle school students in 2020. 43.6TP3T of users reported frequent use (at least 20 days per month) and 27.6TP3T reported daily use. The most commonly used type of e-cigarette was disposable devices (53.7TP3T), followed by pre-filled or refillable cartridges (28.7TP3T) and finally e-cigarettes with refillable tanks (9%).

While these figures are encouraging for anti-smoking groups like the Campaign for Tobacco-Free Kids (CTFK),[2] and Truth Initiative[3], the latter call for vigilance because this survey was conducted at the height of the pandemic when many young people were at home. The results reveal higher rates of e-cigarette use among high school students who responded to the survey at school compared to those who participated from home (15 % vs. 8.1 %). The rates could therefore have been much higher if the survey had been conducted entirely in schools as in previous years.

Consumption that remains stimulated by aromas

This survey confirms that flavored products continue to drive vaping consumption among youth. Eighty-five percent of young e-cigarette users reported using flavored products. Fruit flavors and other sweet flavors, followed by menthol, are the most popular flavors.

The FDA recently denied marketing applications for more than one million flavored e-cigarette products.[4]However, the agency has not yet made any decisions on which e-cigarette brands have the largest market share or are most popular with youth, such as Puff Bar, JUUL, SMOK, or Vuse. The FDA is not considering banning the sale of all menthol-flavored e-cigarettes, even though 30% of survey respondents reported using this type of product.

Puff Bar, the most popular brand among young people, circumvents FDA regulations

The 2021 NYTS survey also shows that Puff Bar, a disposable e-cigarette brand that offers a wide variety of flavors, has become the most popular e-cigarette brand among middle and high school students. Nearly 271 users report it as their regular brand. This is followed by Vuse (111), SMOK (101), and Juul (5.7).

In July 2020, the FDA sent warning letters to several vaping companies, including the maker of the Puff Bar brand. In the letter, the FDA ordered the manufacturer to remove its flavored disposable e-cigarettes and youth-appealing e-liquids from the market. These e-liquids had not been approved for sale. Puff Bar then announced it was halting online sales until further notice. In an email to customers in February 2021,[5], this same manufacturer announced that it had adapted its electronic cigarettes of this brand and that the latter now contain “tobacco-free nicotine”[6]In other words, these products now contain synthetic nicotine. This is a reaction adopted by a growing number of e-cigarette manufacturers to circumvent FDA regulations on traditional tobacco and nicotine products. The inability to sell its products following the FDA order, posted by the manufacturer on its website, has since disappeared, and online sales have resumed. About fifteen flavors are now offered on the site, including sweet and fruity flavors.

Keywords: United States, youth, vaping, Puff Bar, flavors, public health, FDA ©Generation Without Tobacco

AE

---

[1] Park-Lee E, Ren C, Sawdey MD, et al. Notes from the Field: E-Cigarette Use Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021. MMWR Morb Mortal Wkly Rep 2021;70:1387–1389. DOI: http://dx.doi.org/10.15585/mmwr.mm7039a4external icon [2] Press release, 2021 Survey Shows Over 2 Million Kids Used E-Cigarettes Even During Covid-19 School Shutdown and 85% Used Flavored Products – FDA Must Eliminate All Flavored E-Cigarettes to Prevent Resurgence of Youth Epidemic, Campaign for Tobacco-Free Kids, September 30, 2021, accessed October 5, 2021 [3] Press release, Ending youth e-cigarette epidemic at risk if FDA doesn't act fast to remove flavors and fully regulate products as industry quickly innovates, Truth Initiative, September 30, 2021, accessed October 5, 2021 [4] Tobacco Free Generation, FDA Bans Marketing of 55,000 Flavored Vaping Products, August 31, 2021, accessed October 5, 2021 [5] Jennifer Maloney, Puff Bar Defies FDA Crackdown on Fruity E-Cigarettes by Ditching the Tobacco, The Wall Street Journal, March 2, 2021, accessed October 5, 2021 [6] Tobacco Free Generation, Nicotine without tobacco, a new challenge for public health, July 8, 2021, accessed October 5, 2021 National Committee Against Smoking |