The Rise and Fall of E-Cigarettes Among Youth

At 21 years old, Ross is among a generation of nicotine users who became captivated by e-cigarettes when the technology and viral marketing strategies first emerged on social media. The advent of e-cigarettes has sparked a resurgence in nicotine use among American youth, reversing the decade-long downward trend in smoking rates. Today, 14.1% of high school students report using e-cigarettes. Despite the rapid rise in nicotine use, regulatory responses have been slow to materialize.

The FDA has received 8 million applications.

In 2020, the US Food and Drug Administration launched a requirement for all e-cigarette products to apply for and receive regulatory approval before they could continue to be sold on the market. The FDA allowed for some time lag in processing applications and stated that products could continue to be sold until their application was evaluated.

What happened next may help explain why the rate at which teenagers are using e-cigarettes has yet to slow down. Brian King, Director of the FDA Center for Tobacco Products, stated that the agency is overwhelmed with nearly 8 million applications for various e-cigarette products. He explained that each review must be conducted carefully because everything the FDA does, particularly the Center for Tobacco Products, is subject to litigation. "Therefore," he said, "on the front end, we ensure that everything we do is scientifically and legally sound, which is crucial and also takes time.

An FDA crackdown may be imminent.

According to Jin, the review process of the agency is nearing completion. Although he did not discuss the yet-to-be-released review results, experts anticipate that the FDA will intensify efforts to remove various e-cigarette products from the market in the upcoming months.

I think we will see products being removed from the market relatively quickly, these products have been the main cause of the teenage vaping epidemic," said Matthew Myers, President of the Campaign for Tobacco-Free Kids.

Miles and others point out that recent actions taken by the FDA are signs of an upcoming crackdown. This month, the FDA rejected an application for mint-flavored e-cigarettes from manufacturer Logic. This marks the first time the FDA has turned down a mint-based product, which it has long considered a separate category from other flavors. In June, the agency attempted to remove other e-cigarette products produced by Juul, a company that has gained widespread popularity due to the popularity of e-cigarettes. (This decision has not yet been implemented as Juul is appealing.)

Preventing children from using electronic cigarettes remains a top priority," said Jin.

Meanwhile, some states are taking their own measures, such as the recent ban on all flavored tobacco products including e-cigarettes and menthol in California. Massachusetts and Washington, D.C. have similar bans, while other states have limited bans on flavored products.

Other countries are also strengthening their regulations. China recently banned fruit-flavored e-cigarette products, and the EU is also considering a similar broad ban on flavors. Many other countries in Asia and the Middle East have completely banned e-cigarettes.

In the United States, experts including Matthew Myers, chairman of the Campaign for Tobacco-Free Kids, believe that the most effective form of prevention would be to target the equipment itself. Myers stated, "The most direct impact will come from shutting off the source.

While it may sound simple, Dr. Robert Jackler warns that regulatory agencies have been playing a game of cat and mouse with the tobacco industry. "By the time a regulatory agency implements a measure, the industry has already found 10 ways around it," said Jackler, a professor of medicine at Stanford University and a prominent researcher in tobacco marketing.

Recently, Jackler pointed out that the FDA's ban on flavored pods in 2020 did not have any impact on the rate of youth vaping. He stated that this is because the ban left a significant number of alternative technologies on the market, such as disposable devices and refillable pods. "It left an eight-lane escape highway," he said, as it is easy to obtain very similar substitutes with unregulated devices.

This is the recollection of Sam Rose, an electronic cigarette user from South Carolina, regarding the events of 2020. When the FDA cut off the supply of their favorite mango-flavored electronic pods, Rose and his teenage friends switched to a different flavor.

Almost everyone who tries it becomes addicted, so they just switch to mint flavor or disposable e-cigarette devices," Ross said.

This workaround drives parents like Meredith Berkman crazy. The co-founder of Parents Against Vaping E-Cigarettes claims that until this month, the FDA seemed unwilling to regulate or ban menthol, a reason she cannot comprehend.

Burkman stated, "This makes it easier for the poison to disappear, and until these flavored products are removed from the market, we really can't contain the teenage popularity of e-cigarettes, nor can we stop young children from starting to use e-cigarettes.

Jackler, a researcher from Stanford University, agrees and suggests that regulatory agencies need to take action against the three main factors that make e-cigarettes appealing to young people: "flavors, nicotine, and price.

For $20, a teenager can obtain nicotine equivalent to 800 cigarettes.

Jackler stated that the company has steadily increased the concentration of nicotine in its e-liquids, from around 1% to approximately 6% or higher. This makes e-cigarettes more addictive compared to tobacco products, and provides a very affordable source of nicotine. For $20, a teenager can purchase the nicotine equivalent of several packs of cigarettes - approximately 40 packs or 800 cigarettes.

To address this issue, Jackler believes that states and cities should impose taxes on electronic cigarettes at a rate similar to the high tax rate that most young people cannot afford for traditional cigarettes.

In less than four years, he spent over $10,000 on his electronic cigarette habit.

In fact, cost was a significant factor that motivated Sam Rose to quit smoking. He calculated that over a period of three and a half years, he spent over $10,000 on e-cigarettes by smoking a box and a half per day. "Every time I think about this number, I feel sick," he said.

However, his early attempts to quit smoking had failed until he opened up to his brother and mother. "She was surprised, but her attitude was, 'let's move forward!'" he said. "This completely changed the game." His sense of responsibility to his family helped him overcome the craving for nicotine until the smoking habit disappeared several weeks later.

Ross is currently a sophomore in college and serves as an ambassador for the Truth Initiative, an anti-smoking organization. He also manages a fast-food restaurant and works alongside his siblings and mother. He mentors a predominantly teenage staff, encouraging them to avoid e-cigarettes and taking them out for physical activities on weekends.

Ross said it was great to serve in this role, providing a safe space for people to feel secure and not worry about being bullied for not vaping or using similar products. He also noted that he has seen fewer people vaping in his community lately. Additionally, Ross said he feels closer to his mother than ever before and appreciates the sacrifices she has made for their family.

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