United States: Menthol and disposable e-cigarettes continue to drive youth vaping epidemic

In the United States, new federal data released by the Centers for Disease Control and Prevention (CDC) shows that vaping has declined, but remains at high levels in the absence of comprehensive e-cigarette regulation. Disposable, menthol-flavored e-cigarettes are seeing significant uptake among teens.

More than 80% of young American vapers consume flavored products

According to the 2020 National Youth Tobacco Survey, 19.6% of high school students and 4.7% of middle school students report consuming vaping products. They were 27.5% and 10.5% respectively in 2019.[1]. While pre-filled refills (pods) like JUUL remain the most popular device type, use of flavored disposable e-cigarettes (such as Puff Bar) increased by 10,000% among high school students and 4,000% among middle school students compared to 2019.[2].

Flavors continue to fuel consumption, with 83% of youth reporting use. In May 2020, menthol-flavored products accounted for more than half (51.6%) of total e-cigarette sales among middle and high school students. From August 2019 to May 2020, the proportion of sales of pre-filled cartridges containing menthol increased from 10.7% to 61.8%. This increase largely follows the end of sales of mint cartridges in November 2019.[3] by Juul and the Food and Drug Administration (FDA) decision to ban the sale of flavored cartridges other than menthol in February 2020[4].

FDA's Partial Ban Measures Explain Consumption Shifts

The increase in the use of disposable products follows the recent federal policy on flavored e-cigarettes that went into effect in February 2020. This includes a major exception for disposable e-cigarettes.[5]The FDA is allowing the sale of menthol in all forms and is limiting the ban to only fruity or sweet flavors for closed-system pre-filled e-cigarettes. This means that disposable and open-system rechargeable devices still offer a variety of flavors targeted at children.

These loopholes leave many flavors on the market, with flavors that are no longer available in pre-filled cartridges now accounting for the majority of disposable e-cigarette sales. As of May 2020, nearly three-quarters - 72.6% - of disposable e-cigarette sales were of flavors that are banned in pods.[6].

Keywords: Menthol, vaping, USA, youth

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[1] Wang TW, Neff LJ, Park-Lee E, Ren C, Cullen KA, King BA. E-cigarette Use Among Middle and High School Students — United States, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1310–1312. DOI: http://dx.doi.org/10.15585/mmwr.mm6937e1external icon. [2] Ibid [3] Sheilan Kaplan, Juul Ends E-Cigarette Sales of Mint-Flavored Pod, New York Times, November 7, 2019, accessed September 25, 2020 [4] FDA finalizes enforcement policy on unauthorized flavored cartridge-based e-cigarettes that appeal to children, including fruit and mint, US Food and Drug Administration, January 2, 2020, accessed September 25, 2020 [5] Ibid [6] New federal data: Flavored e-cigarettes continue to drive youth vaping epidemic, with disposable use up 1,000% among high schoolers, Truth Initiative, September 15, 2020, accessed September 25, 2020 National Committee Against Smoking |