Sales of e-cigarettes rose by nearly 47 percent from January 2020, just before the pandemic hit the United States, to December 2022, according to an analysis released on Thursday by the Centers for Disease Control and Prevention.
The increase over that period occurred while teenagers and young adults reported in surveys that they had recently tried e-cigarettes at much higher rates than older adults did.
According to the C.D.C., about 4.5 percent of all adults said they used e-cigarettes. But the rates went up as the age dropped. About 14 percent of high school students and 11 percent of young adults reported using the devices within the last 30 days of the survey, the C.D.C. data showed.
Sales were still growing through May of last year, but then dropped by 12 percent through December. Researchers attributed the decline to several possible factors, including state or local bans on flavored products; government enforcement; and the introduction of devices that offered thousands of “puffs” in a single device.
Overall, four-week sales of e-cigarettes climbed to 25.9 million units late last year, from 15.5 million units in early 2020.
Why It Matters: Effects of vaping are still unknown
The Food and Drug Administration has embraced the use of e-cigarettes, regulating their sale on the market as an aid for adult smokers to make the transition to a less harmful product.
But tobacco opponents and public health experts warn that the popular devices have lured teenagers and young people — who would be unlikely to smoke traditional cigarettes — into an addictive habit amid growing concerns about vaping nicotine.
The C.D.C.’s analysis reinforces data indicating that fruit and candy flavors have surged in popularity. The vaping devices often contain high levels of nicotine and are sold in appealing colors and flavors, like strawberry ice cream and mango ice.
The American Heart Association has called for more action to reduce youth vaping and issued a scientific statement last year saying that e-cigarettes appeared to lead to increased risk of heart and lung disease. The American Lung Association has also aired concerns, saying it was “very troubled by the evolving evidence about the impact of e-cigarettes on the lungs” and citing the known and unknown toxic effects of chemicals used in vapes.
Background: Youth vaping was on the rise
The C.D.C. study does not include sales from vaping and tobacco shops or internet sales, so the findings are limited.
Still, trends have shifted in the last few years. Vaping of e-cigarettes among minors has declined from a record high in 2019, when nearly 28 percent of high school students reported vaping within the last 30 days. At the time, products that were sleek and produced by Juul Labs were the most popular, and the company was largely blamed for the soaring rate of teenage vaping. Juul has since resolved myriad lawsuits brought by many states and individuals, resulting in settlements adding up to nearly $3 billion.
The F.D.A. has rejected applications for millions of products to get on the market, approving only about two dozen tobacco-flavored vaping devices. Yet the agency has struggled with enforcement; flavored vapes have flooded gas stations, convenience stores and vape shops nationwide.
The agency prevailed in court in recent weeks against the makers of Hyde vapes, which were a favorite among high school students in a recent youth tobacco survey. The latest report from the C.D.C. shows Elf Bar Vapes rising in popularity. The F.D.A. has issued an import alert for them to be seized at the border and on Thursday announced enforcement against nearly 200 retailers selling those vapes and Esco Bar products.
What’s Next: Regulation and enforcement
The F.D.A. has said it will issue final decisions by the end of this year on the remaining applications for selling vaping products to address the top sellers by Vuse, Juul and others.
Tobacco control advocates are pressuring the F.D.A. to step up its enforcement of unauthorized e-cigarettes and to also move forward with a proposed ban on menthol cigarettes.
Many interested parties are also watching the effects of a statewide flavor ban unfolding in California — one similar to those in six other states and more than 300 jurisdictions. Since Dec. 21, when the ban took effect, vape product sales fell 35 percent through late March, according to data from the C.D.C. Foundation.