E-Cigarettes: Flavored Products Fuel… | Campaign for Tobacco-Free Kids
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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 2023 National Youth Tobacco Survey (NYTS), over 2.1 million U.S. kids used e-cigarettes in 2023. While youth e-cigarette use has declined since 2019, it remains a serious public health problem. 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 2023, nearly 40% of high school e-cigarette users vaped on at least 20 days a month, and nearly 30%reported vaping every day.
  • Flavored products are driving youth use. In fact, nearly 90% of youth e-cigarette users use flavored products, with fruit, candy/desserts/other sweets, mint and menthol reported as the most popular flavors.
  • 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.

Video: Pediatrician Dr. Deepa Camenga describes how e-cigarettes are addicting kids

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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. While FDA has made progress in reviewing marketing applications for flavored e-cigarettes, it has repeatedly missed deadlines to complete its review of major products and failed to clear the market of these illegal flavored products.

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 now estimates that it will not finish its review of marketing applications for the most popular e-cigarette brands until June 2024 – nearly three years after the court-ordered deadline. This delay means that these flavored e-cigarettes will remain widely available and easily accessible to kids, placing their health at risk.  

The FDA has not authorized any flavored e-cigarette products and reports that it has denied marketing applications for millions of flavored products. E-cigarette companies have filed over 60 lawsuits challenging the FDA’s marketing denial orders. In addition, 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 Elf Bar, the flavored disposable e-cigarette that is the most popular brand among kids – began 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 are 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 well past the July 13 deadline.

As a result of the FDA’s missed deadlines and inadequate enforcement, 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 remove all flavored e-cigarettes from the market.

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 April 1, 2024