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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 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, as well as high-nicotine products that put kids at risk of addiction.


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. The court order required manufacturers to submit marketing applications to the FDA by September 9, 2020, and products that were the subject of timely applications were allowed to stay on the market for up to one year while the FDA reviewed the applications, a period that expired September 9, 2021.

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 the e-cigarette brands that have the largest market share or are most popular with kids, such as Juul, most Vuse products, NJOY, blu, Smok and Suorin. 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 40 lawsuits challenging the FDA’s marketing denial orders, and other companies – including Puff Bar, the flavored disposable e-cigarette that is the most popular brand among kids – have sought to evade FDA regulation by using synthetic nicotine (nicotine made in a lab rather than derived from tobacco).

As a result, the most popular youth e-cigarette brands and kid-friendly flavors 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 and high-nicotine 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 Feb. 22, 2022