High-Nicotine Vaping Products Dominate U.S. Sales

According to a study by the American organization Truth Initiative[1] published in the Centers for Disease Control's journal Nicotine & Tobacco research[2], sales of e-cigarettes with the highest nicotine levels (5 % or more nicotine) have grown exponentially over the past five years, from 5 % of total vaping product sales in 2017 to 81 % in 2022, a nearly 15-fold increase.

In 2022, more than 2.5 million middle and high school students reported using vaping products, according to the National Youth Tobacco Survey, and nearly half (46,133) are daily users.

Nicotine levels in vaping devices continue to rise

As e-cigarettes have expanded to include a diverse range of flavors and device types, nicotine concentrations have increased. During the period January 2017-March 2022, the percentage of sales with products containing 5% and above nicotine increased from 5.1% to 80.9% of total unit sales.

Prior to 2013, nicotine levels in vaping products ranged from 0.05% to 1.5%. This increased from 2.10 % to 4.34 % between 2013 and 2018, more than doubling. JUUL devices, which are very popular with youth, were initially launched in 2015 with a 5 % nicotine salt pod. JUUL’s competitors were encouraged to also offer much higher nicotine salt concentrations of up to 7 %.

Flavored and high nicotine puffs are popular

According to the study, in 2022, products with the highest nicotine levels accounted for the majority of e-cigarette sales, regardless of device type and flavor. For example, 96% of e-cigarettes (disposable or with pods) sold in fruit and sweet flavors had a nicotine content of 5% or higher; 87% for mint-flavored vaping products, 79% for menthol products, and 61% for tobacco flavors. In contrast, products with a nicotine content of less than 1 %, including zero nicotine products, accounted for less than 0.1 % of sales.

In 2022, over 90% of disposable e-cigarettes sold contained the highest nicotine levels (5%). Disposable e-cigarettes, known as puffs, are the most popular vaping product among youth in the United States. Puffs have seen their popularity skyrocket in the country following the exemption of the product from federal restrictions on flavors in vaping products in 2020. Use of flavored puffs, such as the Puff Bar brand, increased by 10,000% among high school students and 4,000% among middle school students in 2020 compared to 2019.[3].

Price increases for low nicotine products are a deterrent

Products with low nicotine levels have seen very dissuasive price increases. The increases for products with a high nicotine content have had a much more moderate increase and especially the intermediate niche likely to constitute a gateway, particularly for the youngest, has had a downward trend, making the product particularly attractive. For example, the prices of products with a nicotine content of between 1 and 2 % have increased on average from 10.40$ to 29.20$ between 2017 and 2022, an increase of 180%, while those containing between 4 and 5 % of nicotine have, on the contrary, seen a drop in their prices from 20$ to 12.80$ on average over the same period. The price of products containing 5% or more nicotine increased by 20.7%, from $16.4 to $19.8 on average.

A call to regulate nicotine levels

There are no limits on nicotine concentrations in e-cigarettes in the United States. In June 2022, the Biden administration enshrined a plan to reduce nicotine in manufactured cigarettes to non-addictive levels. Truth believes that reducing nicotine to non-addictive levels should extend to all nicotine-containing products, including e-cigarettes. High-nicotine products represent a significant public health concern, particularly for young people who experiment with these products, with an increased risk of addiction.

The authors note that for adult smokers, e-cigarettes with higher nicotine concentrations may be an adequate substitute for the amount of nicotine delivered in traditional cigarettes. This could help ease the smoker's transition to exclusive e-cigarette use. However, they caution that no e-cigarette is currently approved by the Food and Drug Administration as a smoking cessation aid.

Keywords: nicotine, addiction, vaping products, e-cigarettes, puffs, United States, youth

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[1] High-nicotine e-cigarettes dominate the market, with sales increasing 15-fold in five years, Truth Initiative, published January 5, 2023, accessed January 10, 2023

[2] Fatma Romeh M Ali, PhD, Elizabeth L Seaman, PhD, Elisha Crane, MPH, Barbara Schillo, PhD, Brian A King, PhD, Trends in US E-cigarette Sales and Prices by Nicotine Strength, Overall and by Product and Flavor Type, 2017–2022, Nicotine & Tobacco Research, 2022;, ntac284, https://doi.org/10.1093/ntr/ntac284

[3] Generation without tobacco, United States: Menthol and disposable e-cigarettes continue to drive youth vaping epidemic, published on September 28, 2020, consulted on January 10, 2023