The sale of e-cigarettes leapt almost 50% during a three-year period ending in December, fueled by a skyrocketing number of brands, the prevalence of disposable devices and the continued rise of youth-appealing flavors, according to a study released Thursday by the Centers for Disease Control and Prevention.
E-cigarette sales increased 46.6% — from 15.5 million units sold in January, 2020 to 22.7 million units sold in December, 2022, according to data analyzed by the CDC Foundation and the Truth Initiative, a nonprofit health organization.
"The surge in total e-cigarette sales during 2020-2022 was driven by non-tobacco flavored e-cigarette sales, such as menthol, which dominates the pre-filled cartridge market, and fruit and candy flavors, which lead the disposable e-cigarette market," said Fatma Romeh Ali, a health economist at the CDC Foundation and lead author of the study.
The study tracked retail sales nationwide but does not include purchases from vape shops or those made online, nor does it track the age of the buyer, the report said.
WHAT TO KNOW
- The sale of e-cigarettes in retail stores increased 46.6% from January of 2020 to December to 2022, according to a new report released Thursday by the Centers for Disease Control and Prevention.
- The increase, which does not include sales online or at vape shops, was fueled by an increase in disposable products and a continued rise in fruit and candy flavors popular with teens and young adults.
- Health experts contend existing regulations are behind the curve and a universal ban on all disposable e-cigarettes and on all flavored vape products is necessary.
The report found several revealing trends about how Americans are vaping.
For example, the use of pre-filled cartridges dropped from 75.2% to 48% during the three years — a period that coincided with a crackdown on the devices by the Food and Drug Administration — while disposable e-cigarettes increased from 24.7% to 51.8%, the authors found. The number of brands marketing e-cigarettes also jumped from 184 to 269, the study found.
And while the popularity of tobacco and mint-flavored products declined and menthol-flavored sales remained stable, the sale of flavors known to appeal to young adults, including fruit, candy and chocolate, grew from 29.2% to 41.3% over the three years, the study found.
In 2020, New York banned the sale of all flavored vape products but industry officials said the products are still easily available at some gas stations, delis and bodegas.
Dr. Mangala Narasimhan, senior vice president and director of Critical Care Services at Northwell Health, said authorities crack down on one brand or flavor and another quickly pops up.
"We're just putting out fires," said Narasimhan, adding that education remains the key to keeping e-cigarettes out of the hands of young people. "Another company will come up tomorrow and it will take a year to get them banned."
Dr. Rachel Boykan, a pediatrician and professor of clinical pediatrics at the Renaissance School of Medicine at Stony Brook University, adds that "we've been behind the curve for a while … We need universal restrictions on flavored tobacco products, all of them, including the disposables."
Vaping involves inhaling nicotine and other chemicals that are heated in e-cigarettes. Vaping can impair brain development in kids and young adults, and can potentially cause cancer and other health problems, health experts said.
While teenage use of vaping products appears to be on the decline, both nationally and in New York State, more than 2.5 million middle and high school students nationwide reported using the products, according to a 2022 survey by the FDA and CDC. In 2019, the legal age nationwide to vape was raised to 21.
Suffolk Health Commissioner Gregson Pigott said the county offers educational programs, vaping cessation classes and community workshops to combat the rise of e-cigarettes.
"Our programs teach youth and community members that nicotine changes adolescent brains in the areas of attention, impulse control, mood, memory and in the ability to calm oneself," Pigott said. "The only thing we should ever inhale is clean air."
Also Thursday, the FDA sent warning letters to 189 retailers nationwide, including Mineola Cigar & Vapor on Jericho Turnpike, for selling Esco Bars and Elf Bar. The disposable e-cigarettes brands, which come in flavors such as bubble gum and cotton candy, do not have the required marketing authorization from the FDA.
A message left at the Mineola shop, which was cited for selling Elf Bars, the top selling disposable brand, was not returned.
The FDA sends warning letters the first time an inspection reveals a violation of the law, and recipients are given 15 working days to make the necessary fixes.