June 22 (UPI) -- Despite tighter marketing regulations and studies that indicates health concerns, new data released Thursday by the Centers for Disease Control and Prevention showed that overall e-cigarette monthly unit sales increased nearly 50% from 2020 to 2022.
Researchers said that youths have been driving the increase in brands, disposable device units sold and flavors. In the past two years going into 2022, e-cigarette unit sales ballooned from 15.5 million units to 22.7 million, a 46.6% jump.
E-cigarette offerings over that period rose to meet demand, rising from 184 brands to 269 brands, according to the CDC. In one bright spot in the study, unit sales decreased over the last six months of 2022 by 12.3%.
Researchers said they believe that new Food and Drug Administration regulations, local and state restrictions and COVID-19 supply chain issues may have all played a role in that drop.
"The dramatic spikes in youth e-cigarette use back in 2017 and 2018, primarily driven by JUUL, showed us how quickly e-cigarette sales and use patterns can change," said Deirdre Lawrence Kittner, director of the CDC's Office of Smoking Health.
"Retail sales data are key to providing real-time information on the rapidly changing e-cigarette landscape," she said, adding that watching usage trends "is essential to reducing youth tobacco use."
Researchers said recent lower unit sales may not be as significant as first thought because of the proliferation of large-format, disposable e-cigarettes that may permit higher nicotine consumption per unit.
"The surge in total e-cigarette sales during 2020-2022 was driven by non-tobacco flavored e-cigarette sales, such as menthol, which dominates the prefilled cartridge market, and fruit and candy flavors, which lead the disposable e-cigarette market," said Fatma Romeh Ali, a health economist with the CDC Foundation.
"Data from the 2022 National Youth Tobacco Survey also highlight the popularity of these flavored e-cigarettes among U.S. middle and high school students."
The study also showed that JUUL remained near the top of the best-selling e-cigarette brands along with Vuse, Elf Bar, NJOY and Breeze Smoke. The CDC said the Elf Bar, which has since rebranded as EBDESIGN, has emerged as the top disposable brand.
The agency cited Elf Bar/EBDESIGN for driving the recent uptick of e-cigarette use among those aged 16 to19 in Britain.
"The dramatic spikes in youth e-cigarette use back in 2017 and 2018, primarily driven by JUUL, showed us how quickly e-cigarette sales and use patterns can change," Kittner said.
CDC researchers said one way to reduce the use of tobacco products is to have commercial control strategies reach all population groups equitably, including comprehensive restrictions on the sale of all flavored tobacco products, including e-cigarettes, menthol cigarettes and flavored cigars.
They said companies can use strategies like price increases to slow sales, and establishments can create and enforce comprehensive smoke-free policies that prohibit using of e-cigarettes and smoked tobacco products indoors.
In response to the report, American Lung Association National President and CEO Harold Wimmer said, "E-cigarettes continue to hook our kids."
He added: "This new report highlights the need for the FDA to complete its review of e-cigarette marketing applications and deny applications for all flavored e-cigarettes, including menthol-flavored products as soon as possible, but no later than the end of 2023.
"FDA must protect our youth and end the youth vaping epidemic."
