As sales of flavored e-cigarettes continue to rise, state policies are critical to protecting young people

U.S. e-cigarette sales increased by 47% between 2019 and 2023 with 80.6% of sales attributed to flavored products, according to a report by the CDC Foundation and Truth Initiative.

A gap in federal regulation has left many of these youth-appealing flavored e-cigarettes widely available. In 2020, the U.S. Food and Drug Administration enacted a restriction that eliminated all flavors – except menthol and tobacco – for pod-based e-cigarettes, and exempted disposable e-cigarettes. Since then, the tobacco industry continues to exploit a lack of comprehensive flavor restrictions to flood the market with disposable products containing fruit, candy, mint, menthol, and dessert flavors.

Individual states have started to take action to address the sale of flavored products, and these policies have proven to be highly successful. Lessons learned from effective state policies should provide a roadmap for future action to protect young people from these highly addictive products.

Read three takeaways from the report below and view the full report here.

Disposable e-cigarettes still dominate the market

As of December 2023, sales of disposable e-cigarettes increased 541.3% and comprised 57.8% of the e-cigarette market, making them the most commonly sold device on the market.

In addition, sales of e-cigarettes with high concentrations of nicotine increased, with the average nicotine strength increasing three-fold in the span of five years. Disposable e-cigarettes can have nicotine levels similar to several cartons of cigarettes and may be contributing to the rise in youth nicotine addiction. According to data from the National Youth Tobacco Survey, 38.4% of middle and high school e-cigarette users reported frequent use of e-cigarettes (20 out of the past 30 days) in 2024.

Youth-appealing flavors are driving e-cigarette sales

Sales of flavored e-cigarette products have surged since 2019, with flavors like fruit, candy, mint, menthol, and dessert flavors making up 80.6% of all e-cigarette sales in 2023. The majority (79.1%) of all disposable e-cigarette sales were also for flavored products, up from 50.9% in 2019.

In addition, the report found that sales of menthol-flavored products also increased dramatically from 2019 to 2023, rising 175.8%. Sales of e-cigarettes with “clear” or other cooling flavor names also increased 872.1% between 2020 to 2023.

It is well established that flavors play a significant role in enticing youth and young adults to try and use tobacco products, with research showing that youth and young adults perceive flavored tobacco products as more appealing, better tasting, and less harmful than non-flavored tobacco products.

State policies lead the way in successfully reducing flavored e-cigarette sales

In the face of limited federal policies that curb the sale of flavored tobacco products, a growing number of states and local governments have enacted their own laws to prohibit or strictly limit the sale of flavored e-cigarettes.

These policies range in scope and comprehensiveness. The report highlighted successful policies in three states: California, Massachusetts, and New York.

1. California’s policy covers all flavored tobacco products except loose leaf pipe tobacco, premium cigars, and flavored hookah in certain retailers. A year after the policy went into effect, flavored e-cigarette sales in the state decreased by 67.7%.

2. A comprehensive flavored tobacco policy in Massachusetts reduced flavored e-cigarette sales by 98.2%, leading to significant statewide decreases in youth access to and use of flavored tobacco products.

3. New York’s policy restricts the sale of all flavored e-cigarettes. Following the policy’s implementation in May 2020, flavored e-cigarette sales in the state decreased by 79.1%.

The findings of the report make it clear that state policies can be extremely effective in reducing sales of flavored e-cigarettes and limiting youth access – a crucial step in preventing youth and young adult nicotine addiction and fostering a healthier nation.