SILVER SPRING, Md. — About 1.8 million fewer U.S. youth are using e-cigarettes now compared to 2019, according to new data from the 2020 National Youth Tobacco Survey.
And while the U.S. Food and Drug Administration (FDA), which released the survey in partnership with the Centers for Disease Control and Prevention (CDC), said it found the decrease encouraging, it is concerned about the 3.6 million youth who currently use e-cigarettes.
Among those current e-cigarette users, 38.9% of high school students and 20% of middle school students reported using e-cigarettes on 20 or more of the past 30 days, while 22.5% of high school users and 9.4% of middle school users reported daily use, the survey found. The survey was self-administered to middle and high school students between Jan. 16 and March 16, 2020.
“Youth use of e-cigarettes remains a public health crisis that is affecting children, families, schools and communities, and we will do everything possible to stop it—including new actions we are taking today,” a Sept. 9 statement from FDA’s Commissioner of Food and Drugs Stephen Hahn said.
Those actions include putting resources into the premarket tobacco product application (PMTA) process and cracking down on disposables, he said.
PMTAS, which were due on Sept. 9, will help the FDA assess, among other things, how particular e-cigarettes or other electronic nicotine delivery systems (ENDS) could help addicted adult smokers seeking to transition away from cigarettes, while also weighing the concerning popularity of these products with young people, Hahn said.
The FDA will also prioritize enforcement against any ENDS product that continues to be sold and for which the agency has not received a product application, said Hahn. Recently, the FDA issued warning letters to Flavour Warehouse LTD, doing business as Vampire Vape, and Pretty Women UK LTD, trading as Coil2oil and Mad Kingdom Liquids, for illegally marketing unauthorized menthol-flavored e-liquids, the agency said.
It also sent a warning letter to disposable e-cigarette brand XL Vape LLC, dba Stig Inc., warning the company to remove its disposable e-cigarettes from the market because they do not have premarket authorization.
Flavored disposable ENDS will also be an enforcement priority for the agency, Hahn said.
The survey showed an “alarming uptick” in use of disposable e-cigarettes by youth, Hahn said. In 2020, 26.5% of high school e-cigarette users are using disposable e-cigarettes, up from 2.4% in 2019. More than eight out of 10 youth e-cigarette users report use of flavored products—with fruit, mint, candy and menthol among the most used.
“The warning letters issued today underscore our concern with the rise in youth use of disposable e-cigarettes and the notable use of menthol-flavored e-cigarettes,” Hahn said. “As we have said many times, the FDA will take action against any ENDS product—regardless of whether it is cartridge-based, disposable, flavored or otherwise—if it is targeted to kids, if its marketing is likely to promote use by minors or if the manufacturer fails to take adequate measures to prevent youth access.”
E-cigarette maker Juul Labs, San Francisco, said last August it was implementing a series of new measures in the U.S. that build upon its existing efforts to combat the issue of youth access, appeal and use of vapor products. The company stopped accepting retail orders for some of its flavors in 2018 amid concerns about the appeal of flavored electronic cigarettes among young people and growing scrutiny by the FDA. It later suspended the sale of all flavored pods in October 2019 and in recent months applied through the PMTA process to sell Virginia Tobacco and Menthol pods.
Juul released the following statement about the survey:
“We are encouraged that underage use has declined significantly, which shows the importance of evidence-based interventions. As we continue to reset the vapor category and seek to earn trust, we remain committed to working with regulators and stakeholders to combat underage use and transition adult smokers from combustible cigarettes. We remain fully committed to the PMTA process and continue to support FDA’s active enforcement against illegally marketed products that jeopardize the category and its harm reduction potential for adult smokers. We will also continue to work with states toward full implementation and enforcement of Tobacco 21.”