Monitoring E-Cigarette Unit Sales in the United States, 2014-2020

Since their introduction into the U.S. marketplace in 2007, the number, type, and flavors of e-cigarettes available for purchase has increased dramatically. These product innovations and flavors have contributed to increases in U.S. youth e-cigarette use to epidemic levels. The availability of flavors is one of the most cited reasons for using e-cigarettes among youth, according to the Centers for Disease Control and Prevention (CDC). A new article released today provides insights into trends in e-cigarette usage.

Aiming to curb the e-cigarette epidemic, various state and local governments have passed laws to restrict the sale of flavored e-cigarettes. Furthermore, in January 2020, the Food and Drug Administration issued a policy prioritizing enforcement against certain unauthorized flavored e-cigarette products that appeal to youth, including fruit and mint flavors. However, the policy did not cover disposable e-cigarette products, or e-cigarettes with menthol flavors.

To assess trends in U.S. e-cigarettes sales by product type and flavor, a team of authors analyzed retail scanner data from September 14, 2014–May 17, 2020 from Information Resources, Inc (IRI). This work included collaboration of co-authors from CDC, CDC Foundation, and Truth Initiative. The lead author for this article is Dr. Fatma Romeh M. Ali of the CDC Foundation.

The findings of this study show that disposable e-cigarettes and menthol-flavored prefilled cartridges have experienced significant increases in sales since August 2019. Specifically, disposable e-cigarette sales increased from 10.3 percent of total sales in August 2019 to 19.8 percent by May 2020. Among cartridge-based e-cigarettes sales, the proportion of menthol-flavored product sales increased from 10.7 percent to 61.8 percent during August 2019 to May 2020. Moreover, this study shows that mint-flavored product sales were increasing until August 2019, after which mint-flavored product sales declined. As mint-flavored product sales declined, sale of menthol-flavored e-cigarettes increased, suggesting that users are substituting menthol for mint.

Changes in sales by flavor are likely influenced by retailers, such as JUUL, removing mango, creme, fruit, and cucumber-flavored cartridges from retail stores (November 2018) and online (October 2019), as well as state and local policies that have banned or limited the sale of flavored products other than tobacco or menthol. Furthermore, the increase in menthol-flavored product sales among cartridge-based e-cigarettes, as well as the increase in disposable devices, are likely influenced by the FDA enforcement policy which exempted these flavors and product types.

This study underscores significant changes in the e-cigarette sales landscape, which could inform regulatory efforts to prevent and reduce e-cigarette use among youth at the national, state, and local levels. The Monitoring E-Cigarette Use Among Youth project team will continue to assess changes in e-cigarette retail sales and youth behaviors. The CDC Foundation is grateful to Bloomberg Philanthropies for supporting the Monitoring E-Cigarette Use Among Youth project.

Fatma Ali-headshot-image.jpg
Fatma Romeh Ali, PhD, is a health scientist for the CDC Foundation.
Jamie Cordova is a data analyst for the CDC Foundation.