Ending youth e-cigarette epidemic at risk if FDA doesn’t act fast to remove flavors and fully regulate products as industry quickly innovates

Statement from Robin Koval, CEO and President of Truth Initiative

The latest National Youth Tobacco Survey (NYTS) data are consistent with other research which showed that youth e-cigarette use was significantly impacted during the height of the pandemic. We, and many of our partners, have been working hard to reverse the youth and young adult vaping epidemic through education about the risks of e-cigarettes, and by helping those who vape to quit. Today’s data underscore that time is of the essence to accelerate progress while we have momentum to save this generation from the harms of nicotine addiction and industry innovation reliant upon gaining new tobacco users. While these numbers provide a hopeful signal of what’s possible, we must not grow complacent. The fact that 43.6% of high school students who vape reported using e-cigarettes on 20 or more of the past 30 days, almost daily, underscores the trap of nicotine addiction and the risk that once hooked, many young people will be users of these and potentially even more dangerous tobacco products for life. This is especially troubling given the youth mental health crisis exacerbated by the pandemic, and the fact that nicotine can worsen symptoms of anxiety and depression in addition to the physical health risks associated with its use.

While the NYTS results are an important data point, it’s very important to note that this survey was conducted during the height of the pandemic while many young people were in remote school away from in-person socializing and the influence of peers, factors which drive e-cigarette use among youth. Important methodological differences also make it impossible to compare these data to prior surveys, as the CDC itself has clearly stated. We know that since the NYTS data were collected, e-cigarette sales have increased and are at record highs compared to pre-pandemic levels. A recent survey of 15- to 24-year-olds by Truth Initiative showed that the majority (70%) of young people anticipated seeing people vape at similar or higher rates as they went back to school. With the return to in-person learning; easy access at retail; the continued increase of youth appealing flavors; unabated product proliferation, including new synthetic nicotine products; and 18-20 year olds using e-cigarettes at much higher rates than other age groups, youth and young adults remain at great risk.

The FDA has yet to regulate the overwhelming majority of products that make up the e-cigarette market—like JUUL—despite a court order requiring it to do so. Flavors, including menthol, are still a major driver of e-cigarette popularity among adolescents, with 8 in 10 using flavored e-cigarettes, according to these latest CDC data. Brands such as Vuse have seen skyrocketing sales making them the number two choice among youth and yet remain illegally on the market due to FDA inaction. The number one brand used by youth, Puff Bar, not only comes in a wide variety of flavors, but has also recently indicated that it will now be manufactured with synthetic nicotine in a brazen attempt to thwart FDA oversight.

We remain hopeful that the FDA will choose to remove all flavors, including menthol, from the market and regulate access to e-cigarettes as a harm reduction methodology exclusively and very carefully made available only for adult smokers. Further, FDA must determine how it will regulate synthetic nicotine as well as limit ever increasing levels of nicotine in these products. We urge the FDA to harness this momentum and consider the human cost of its delayed decisions regarding access to high nicotine, youth-appealing e-cigarettes, otherwise even these gains may be rapidly erased.

Truth Initiative will continue to fight the youth nicotine epidemic through education, proven-effective tools, and sound scientific research. This includes our truth^® youth and young adult public education and prevention campaigns; Vaping: Know the truth, a national youth vaping prevention curriculum available for free to schools and communities; and This is Quitting, a free and anonymous text message-based quit program that has enrolled more than 375,000+ young people to help them quit vaping e-cigarettes.