sign up

E-cigarettes are hooking a new generation on nicotine – putting millions of kids at risk and threatening decades of progress in reducing youth tobacco use. It’s a nationwide crisis of youth addiction, fueled by thousands of kid-friendly flavors and massive doses of nicotine.

According to the 2021 National Youth Tobacco Survey (NYTS), over 2 million U.S. kids used e-cigarettes in the first half of 2021, even as many schools remained closed because of the Covid-19 pandemic. While the percentage of youth using e-cigarettes is lower than in previous years, it follows unprecedented increases in youth e-cigarette use. From 2017 to 2019, e-cigarette use among high school students more than doubled to 27.5%, leading the U.S. Surgeon General and other public health authorities to declare the problem an “epidemic.”

Still A Serious Public Health Problem

The latest data show the scope and cause of the problem:

  • Kids aren’t just experimenting with e-cigarettes. Many are using these products most days or every day, a sure sign they’re becoming addicted. In 2021, 43.6% of high school e-cigarette users vaped on at least 20 days a month, and 27.6% reported vaping every single day.
  • Flavored products are driving youth use. In fact, 85% of youth e-cigarette users use flavored products, with fruit, candy/desserts/other sweets, mint and menthol reported as the most popular flavors. Among high school students who reported using flavored e-cigarettes, 30% used menthol-flavored products.
  • Kids have shifted dramatically to disposable and menthol e-cigarettes, two categories of products that were left on the market under current federal restrictions. These shifts show that the only way to end this crisis is to eliminate all flavored e-cigarettes.

FDA and Other Policymakers Must Eliminate All Flavored E-Cigarettes

To address this problem, the Campaign for Tobacco-Free Kids and other public health organizations have called on the U.S. Food and Drug Administration to eliminate all flavored e-cigarettes. However, the FDA has missed deadline after deadline to protect kids from these products, leaving flavored e-cigarettes widely available and our kids at risk of nicotine addiction and other health harms.

Under a federal court order, the FDA faced a deadline of September 9, 2021, to rule on applications from e-cigarette manufacturers to keep their products on the market. But the FDA failed to meet this deadline and subsequently told the court that it would not finish its review of marketing applications for the most popular e-cigarette brands until June 2023 – nearly two years after the court-ordered deadline.

The FDA has reported that it has denied marketing applications for over 1 million flavored e-cigarette products. However, the FDA has yet to issue decisions about many of the e-cigarette brands that have the largest market share or are most commonly used by youth. The FDA is also considering whether to authorize any menthol-flavored e-cigarettes despite the popularity of these products with kids. In addition, e-cigarette companies have filed over 50 lawsuits challenging the FDA’s marketing denial orders.
While the FDA denied marketing applications for all Juul products in June 2022, it subsequently put that decision on hold in the face of a lawsuit by Juul.

In an effort to evade FDA regulation completely, some e-cigarette makers – including Puff Bar, the flavored disposable e-cigarette that is the most popular brand among kids – switched to using synthetic nicotine (nicotine made in a lab rather than derived from tobacco). In March 2022, Congress passed a new law closing this loophole and giving the FDA authority to regulate synthetic nicotine products as tobacco products. This law set clear deadlines: Manufacturers of synthetic nicotine products had until May 14, 2022, to submit marketing applications to the FDA; if the products did not receive marketing authorization by July 13, 2022, they would be illegal and must be removed from the market.

Again, the FDA failed to enforce these deadlines. Despite not authorizing a single synthetic nicotine product, it has allowed these products – including e-cigarettes in kid-friendly flavors – to stay on the market after the July 13 deadline.

As a result of the FDA’s missed deadlines and delays, flavored e-cigarettes remain widely available online and in stores across the country. Every day flavored e-cigarettes remain on the market, our kids remain at risk. The FDA must act without further delay to eliminate all flavored e-cigarettes.

To protect kids now, states and cities must also continue their growing efforts to end the sale of flavored e-cigarettes, as well as other flavored tobacco products.

Health Risks to Kids

E-cigarettes pose serious risks to the health of young people:

  • The U.S. Surgeon General has concluded that youth use of nicotine in any form, including e-cigarettes, is unsafe. Nicotine is a highly addictive drug and can harm adolescent brain development, particularly the parts of the brain responsible for attention, memory and learning. The Surgeon General also found that using nicotine in adolescence can increase risk of future addiction to other drugs.
  • Juul and other e-cigarettes deliver massive doses of nicotine, putting youth users at greater risk of addiction. Each Juul pod (cartridge of nicotine) contains as much nicotine as a pack of 20 cigarettes.
  • Studies have found that young people who use e-cigarettes are more likely to become smokers, and many are low-risk youth who would not have otherwise smoked cigarettes.

In contrast to the clear evidence that flavored products fueled the youth e-cigarette epidemic, every major U.S. public health authority – including the U.S. Surgeon General, the U.S. Preventive Services Task Force, the CDC and even the FDA itself – has found there is inadequate evidence to conclude that e-cigarettes are effective at helping smokers quit.

Last updated Aug. 19, 2022