New Study Shows Continuing Popularity of Juul and Other Flavored E-Cigarettes Among Youth – Underscores Why FDA and Other Policymakers Must Eliminate All Flavored E-Cigarettes

WASHINGTON, D.C. – A new CDC and FDA study published today in the journal JAMA Network Open underscores that flavored e-cigarettes, especially Juul, have caused the epidemic of youth e-cigarette use and nicotine addiction in the U.S. and shows why the FDA and other policymakers must act now to eliminate all flavored e-cigarettes.

Based on data from the 2020 National Youth Tobacco Survey (NYTS), the study’s key findings include:

• Juul remained the most popular e-cigarette brand among youth in 2020, with 25.4% of high school and 35.1% of middle school e-cigarette users reporting Juul as their usual brand. This finding demonstrates that Juul remains a serious threat to the health of our nation’s kids – and that Juul’s voluntary actions and the FDA’s current policy on flavored e-cigarettes, which eliminated flavors other than menthol in cartridge-based e-cigarettes, have failed to eliminate this threat.
• Kids have shifted dramatically to using flavored disposable e-cigarettes like Puff Bar and pre-filled menthol cartridge products, which were left on the market by loopholes in the FDA’s flavor policy (implemented in February 2020). It is alarming that 7.3% of high school e-cigarette users wrote in Puff Bar as their usual brand although it was not named in the survey. Previously released results of the 2020 NYTS showed that use of disposable e-cigarettes increased by an astounding 1,000% among high school e-cigarette users and 400% among middle-school e-cigarette users from 2019 to 2020.
• Menthol-flavored e-cigarettes are popular among kids. The new study shows that 37% of all high school e-cigarette users use menthol products. Among all youth who use flavored, pre-filled cartridge products (like Juul), 44.5% used menthol products. The authors write that these findings suggest “prominent use” of menthol e-cigarettes among U.S. youth.

This study demonstrates once again that as long as any flavored e-cigarettes remain on the market, kids will get their hands on them and we will not end the youth e-cigarette epidemic. As it considers applications from e-cigarette makers to keep their products on the market, the FDA should not allow the sale of any flavored e-cigarettes, including menthol-flavored products. In particular, it should reject Juul’s application to keep selling its products given the unquestionable evidence that Juul drove the youth e-cigarette epidemic and remains highly popular with kids. The FDA must side with America’s kids, not the companies that created the youth e-cigarette epidemic.

Youth e-cigarette use remains an enormous problem – 3.6 million kids used e-cigarettes in 2020 and a growing percentage of them did so frequently or daily, a sure sign of addiction. The evidence is also clear that flavored e-cigarettes have driven this epidemic – 83% of youth e-cigarette users use flavored products.

Other Recent Data Shows Increasing Sales of Disposable and Menthol E-Cigarettes

Today’s study follows other recent data that shows overall e-cigarette sales in the U.S. have climbed steadily since the FDA implemented its flavored e-cigarette policy in February 2020 and reached a record-high 22 million units in March 2021. Released by the CDC Foundation in May, the data shows that this increase is being driven by sales of flavored disposable e-cigarettes and menthol-flavored, pre-filled cartridge products. Specific findings of the CDC Foundation report include:

• From February 2020 to March 2021, total e-cigarette sales increased by nearly 50% (from 14.8 million units to 22 million units). Sales of flavored e-cigarettes increased by 64%.
• The vast majority (69.8%) of this increase was from sales of disposable products. From February 2020 to March 2021, sales of disposable e-cigarettes increased by nearly 200% (from 2.8 million to 7.8 million units). Since September 2020, when the 2020 NYTS results were first released and the FDA said it would prioritize enforcement against disposable e-cigarettes, sales of disposable e-cigarettes nearly doubled, from 4 million to 7.8 million units. Disposable e-cigarettes are sold in a wide assortment of kid-friendly flavors.
• From February 2020 to March 2021, sales of menthol-flavored e-cigarettes increased by 42% (from 6.4 million to 9 million units). As of March 2021, menthol e-cigarette sales accounted for 41% of the e-cigarette market.

The CDC Foundation data is from Information Resources, Inc., and includes e-cigarette sales data from convenience stores, gas stations and other retail store chains. Sales from the internet and tobacco-specialty stores, including vape shops, are not included.