In January 2020, the Food and Drug Administration (FDA) began stepping up enforcement against the sale of most sweet-flavored e-cigarette cartridges as part of an effort to reduce e-cigarette use among youth. A study published today in JAMA Network Open suggests that this targeted enforcement was not associated with a significant decline in e-cigarette use among youth.
Karin Kasza, Ph.D., of Roswell Park Comprehensive Cancer Center in Buffalo, N.Y., and colleagues wrote that the FDA’s limited action “left open an avenue through which youth continued use of flavored e-cigarettes through using devices not covered by the enforcement guidance.”
Kasza and colleagues analyzed data from the Population Assessment of Tobacco and Health (PATH) Study for 2019 and 2021. This is a nationally representative longitudinal study of tobacco use among youth that tracks transitions in e-cigarette use, flavor/device combination used, brand used, nicotine use, and frequency of use. The analysis included responses from 9,088 youth aged 12 to 17 years in 2019 who also participated in 2021 when they were up to age 20.
Among youth aged 12 to 17 who used sweet-flavored e-cigarette cartridges in 2019, 51.5% continued to use e-cigarettes in 2021; this was similar to the 47.6% continuation rate among youth who used other e-cigarette flavors or devices (such as disposable e-cigarettes) in 2019. Eighty four percent of youth who used sweet-flavored cartridges in 2019 switched to another e-cigarette combination, with the use of sweet-flavored disposable e-cigarettes rising significantly between 2019 and 2021.
“Multiple sources identified that the disposable e-cigarette market, which contains inexpensive flavored products that appeal to youth, began proliferating in late Spring 2019,” Kasza and colleagues wrote. “Restrictions and enforcement efforts that only cover a subset of products do not appear to be associated with preventing youth flavored e-cigarette use.”
To read more on this topic, see this month’s Psychiatric News special report, “Vaping—A Call to Action for Psychiatrists.”
(Image: iStock/bymuratdeniz)
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