United States: Puffs with ever stronger nicotine and cheaper prices

According to a study by the American organization Truth Initiative, published in the journal Tobacco Control[1]Between 2017 and 2022, the average nicotine levels of disposable e-cigarettes (puffs) sold in the United States nearly tripled and their e-liquid capacity quintupled, while their price fell by nearly $70 %.

The researchers estimated the U.S. puff market using NielsenIQ* retail scanner data from January 2017 to September 2022. In 2022, 48 disposable e-cigarettes were launched with nicotine levels of 6 % or higher, and 18 products with a capacity of 20 ml, or 29 times that of a JUUL pod.

Very high nicotine levels in disposable vaping devices

The United States currently has no federal limits on the nicotine concentration of e-cigarettes, although several states and localities are considering establishing a concentration ceiling. In the European Union, the maximum tolerated nicotine concentration is 2 %.

Between 2017 and 2022, the average nicotine strength increased from less than 2 % to 5 %, and in 2022, 48 puffs newly introduced to the market had a nicotine strength of 6 % or more.

At the same time, the proportion of sales of high-nicotine e-cigarettes increased from 5% of total sales in 2017 to 81% in 2022. This increase in nicotine content puts young people at increased risk of addiction, and limits their ability to quit vaping.

High-capacity, low-cost devices

While from 2017 to 2019, the average e-liquid capacity of puffs remained stable at 1.1 ml, from 2021 it was 3.6 ml, then 5.7 ml at the end of 2022. During the period studied, the average capacity thus increased by 518 %. At the end of 2022, 18 products placed on the market had a capacity of 20 ml.

Alongside this evolution in nicotine concentrations and capacity, the average prices of puffs per ml of liquid have decreased. While these prices had remained relatively stable from 2017 to 2019, on average 8.68 USD per unit and 8.56 USD per ml of e-liquid, from 2020 onwards, prices have evolved with an average price per unit increasing to 14.07 USD, with at the same time an increase in the capacity of the devices, explaining an average price for 1 ml of e-liquid which has gone from 7.96 USD to 2.45 USD, a decrease of 70 % between 2017 and 2022.

According to Truth Initiative researchers, cheap, high-capacity disposable devices are an attractive entry point for young people into nicotine addiction, much as small packs of cigarettes appeal to occasional, price-sensitive smokers.

Disposable Devices' Popularity Worsened by FDA Regulatory Loopholes

The shift in the e-cigarette market toward disposables was partly driven by the U.S. Food and Drug Administration (FDA) policy, which, when it banned flavors for vaping products in 2020, excluded flavored disposables from the ban, leading to a shift in consumption from banned products (e.g., JUULs with pre-filled flavored cartridges) to disposable e-cigarettes, which now account for the majority of sales. In the year following the ban, puff use among high school students increased by 1,000 %.

To discourage experimentation and reduce access to these highly addictive products for young people, researchers recommend limiting the capacity of disposable e-cigarettes and the permitted nicotine levels, while setting a minimum price.

Keywords: Truth Initiative, United States, vaping, puff, vaping devices, electronic cigarette, nicotine, e-liquid

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[1] Diaz MC, Silver NA, Bertrand A, et al Bigger, stronger and cheaper: growth in e-cigarette market driven by disposable devices with more e-liquid, higher nicotine concentration and declining pricesTobacco Control Published Online First: 03 August 2023. doi: 10.1136/tc-2023-058033

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