New CDC Foundation Study Finds Increases in Cooling Flavored E-Cigarette Sales


E-cigarettes pose a significant public health challenge, particularly among youth and young adults. Flavors are among the most commonly cited reasons for youth e-cigarette use. While menthol flavor additive in e-cigarettes creates a cooling sensation that reduces the product’s harshness for users, this cooling sensation can also be produced through other flavor additives, usually labeled with a characterizing flavor (e.g., fruity/sweet) and a cooling sensation (e.g., mango ice, iced blueberry or frosted apple). These cooling flavors were found to be associated with nicotine vaping frequency and dependence as well as both disposable e-cigarette and combustible tobacco use among youth and young adults.

A new study, published today in Tobacco Control, found that during 2017-2021, the percentage of cooling flavored e-cigarettes sold doubled from 26 percent of all sales to nearly 55 percent. Led by the CDC Foundation’s Dr. Fatma Romeh M. Ali, this is the first study to evaluate the sales landscape of cooling e-cigarettes in the United States, both overall and by major characterizing flavor and product type, from 2017 to 2021. While menthol remained the predominant cooling flavor, sales of non-menthol cooling disposable e-cigarettes during the study period experienced the highest growth rate, indicating shifts in the marketplace. With no price difference between cooling and non-cooling disposable e-cigarettes, the increase in cooling disposable e-cigarette sales was likely driven by user taste preferences for these flavors.

As more policies are implemented that address menthol flavored tobacco products, it is important to consider other flavors that might have the same sensation as menthol on individual users but are not currently designated as “characterizing flavors” under existing national, state or local regulatory standards.

The study was co-authored by CDC Foundation employees Dr. Elizabeth Seaman and Ms. Julianah Ajose, along with Dr. Megan Diaz from the Truth Initiative and Dr. Brian King from the CDC’s Office on Smoking and Health, and builds on prior work from the Monitoring E-Cigarette Use Among Youth project . The project 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.
Elizabeth Seaman PhD, MHS is a project manager for "Monitoring E-Cigarette Use Among Youth in Select U.S. Cities and States".