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JAMA Studies Show Youth E-Cigarette Epidemic Is Getting Worse and Kids Shifted to Mint/Menthol After Other Flavors Were Restricted

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
November 05, 2019

WASHINGTON, D.C. – Two new studies published today in JAMA leave no doubt that the youth e-cigarette epidemic is getting worse and it is being driven by Juul and its flavored products, especially mint. Importantly, these studies indicate that youth use of mint and menthol e-cigarettes increased after Juul restricted the availability of other flavors, like mango, in November 2018. These findings underscore why the Trump Administration must stand strong and implement its plan to clear the market of all flavored e-cigarettes. If menthol or any other flavors are left on the market, the evidence is clear that kids will move to them and this epidemic will continue.

The JAMA studies highlight the severity of the youth epidemic, Juul’s role in creating it and the need for bold action. The first study, based on data from the 2019 National Youth Tobacco Survey, shows:

  • 5.3 million middle and high school students used e-cigarettes in 2019, up from 3.6 million in 2018. From 2017 to 2019, current e-cigarette use more than doubled among high school students (from 11.7% to 27.5%) and tripled among middle school students (from 3.3% to 10.5%).
  • More students are reporting frequent use of e-cigarettes, indicating possible addiction. In 2019, 1.6 million middle and high school students used e-cigarettes on at least 20 days a month (34.2% of high school e-cigarette users and 18% of middle school e-cigarette users). Nearly a million (970,000) are daily e-cigarette users, including 1 out of 5 high school e-cigarette users.
  • Juul is by far the most popular e-cigarette brand among kids. Among current e-cigarette users, 59.1% of high school students and 54.1% of middle school students reported Juul as their usual e-cigarette brand. No other brand topped 10%.
  • The large majority of youth e-cigarette users use flavored e-cigarettes, “with fruit, menthol or mint, and candy, desserts, or other sweets being the most commonly reported flavors.” The data also shows how rapidly trends can change. Over the last four years, mint and menthol went from among the least popular to among the most popular e-cigarette flavors among high school students. Youth use of mint and menthol e-cigarettes increased sharply in 2019 after Juul restricted the availability of other flavors.

The second study, based on data from the 2019 Monitoring the Future study, confirms the popularity of mint products with kids. It found that mint was the most popular flavor among Juul users in 10th and 12th grades.

These studies provide powerful scientific support for the Administration’s plan to clear the market of all flavored e-cigarettes, including mint and menthol. Only the elimination of all flavored e-cigarettes can reverse this epidemic and stop the e-cigarette industry from addicting a generation of kids.