Disposable E-Cigarette Use among US Youth — An Emerging Public Health Challenge | NEJM - nejm.org

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To the Editor:

Previous increases in the use of electronic cigarettes (e-cigarettes) by youth were driven by multiple factors, including advertising, the use of appealing flavors, and the introduction of new devices with prefilled pods or cartridges and high nicotine levels, such as Juul.¹ According to data from the National Youth Tobacco Survey (NYTS), 19.6% of high school students (3.02 million) and 4.7% of middle school students (550,000) reported current (within the preceding 30 days) e-cigarette use in 2020 — 1.8 million fewer than in 2019.² However, e-cigarette use among youth remains prominent and the landscape of devices is evolving, both of which pose a public health challenge. We assessed the changes in device type–specific e-cigarette use during 2019 and 2020.

The NYTS is a cross-sectional, school-based electronic survey that uses a stratified, three-stage, cluster-sampling design (across counties, schools, and classrooms) to generate a nationally representative sample of U.S. middle school students (grades 6 through 8) and high school students (grades 9 through 12).³ Data collection for the 2019 NYTS took place from February 15 through May 24, 2019, among 19,018 respondents (overall response rate, 66.3%). Data collection for the 2020 NYTS took place from January 16 through March 16, 2020, among 14,531 respondents (overall response rate, 43.6%). Weighted estimates of device type–specific use were assessed among current e-cigarette users and students overall according to school level.

Table 1. Table 1. Use of E-Cigarettes in the Preceding 30 Days (Current Use) According to Device Type in 2019 and 2020 as Reported by Middle and High School Students in the National Youth Tobacco Survey.

Among middle school students currently using any type of e-cigarette, disposable e-cigarette use was reported by 3.0% (95% confidence interval [CI], 1.7 to 5.4) in 2019, corresponding to 30,000 students, and by 15.2% (95% CI, 9.1 to 24.1) in 2020, corresponding to 80,000 students. Among high school students currently using any type of e-cigarettes, disposable e-cigarette use was reported by 2.4% (95% CI, 1.6 to 3.7) in 2019 (90,000 students) and 26.5% (95% CI, 20.0 to 34.2) in 2020 (790,000 students) (Table 1). Among all middle school students, disposable e-cigarette use was reported by 0.3% (95% CI, 0.2 to 0.6) in 2019 and by 0.7% (95% CI, 0.4 to 1.2) in 2020; 0.7% (95% CI, 0.4 to 1.0) and 5.1% (95% CI, 3.9 to 6.8) of all high school students reported disposable e-cigarette use in 2019 and 2020, respectively. Prefilled pods or cartridges remained the most commonly used device type in 2020 (220,000 middle school students and 1.45 million high school students).

This emerging shift in youth e-cigarette use according to device type aligns with retail sales data indicating increased sales of disposable e-cigarettes.⁴ Ongoing efforts to further address youth e-cigarette use across the diversity of device types, including disposable products, are critical. For example, the Food and Drug Administration prioritized enforcement against certain unauthorized flavored, cartridge-based e-cigarettes in January 2020 and in July 2020 sent warning letters to 10 companies to stop the sale or distribution of flavored disposable e-cigarettes and e-liquid products that appeal to youth.⁵

These findings reinforce the rapidly dynamic nature of the e-cigarette landscape and the need for clinicians, public health practitioners, and the general public to keep pace with these changes. Although the 2020 NYTS data-collection period was truncated owing to the Covid-19 pandemic, this did not affect the survey design or its national representativeness.³

Teresa W. Wang, Ph.D.
Andrea S. Gentzke, Ph.D.
Linda J. Neff, Ph.D.
Emily V. Glidden, M.P.H.
Ahmed Jamal, M.B., B.S.
Brian A. King, Ph.D.
Karen A. Hacker, M.D.
Centers for Disease Control and Prevention, Atlanta, GA
[email protected]

Eunice Park-Lee, Ph.D.
Chunfeng Ren, Ph.D.
Karen A. Cullen, Ph.D.
Food and Drug Administration, Silver Spring, MD

Disclosure forms provided by the authors are available with the full text of this letter at NEJM.org.

The findings and conclusions reported are those of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention (CDC) or the Food and Drug Administration (FDA). The use of brand names does not imply an endorsement of any product, service, or enterprise by the CDC, the FDA, or the Department of Health and Human Services.

This letter was published on March 16, 2021, at NEJM.org.

1. 1. Barrington-Trimis JL, Leventhal AM. Adolescents’ use of “pod mod” e-cigarettes — urgent concerns. N Engl J Med 2018;379:1099-1102.

2. 2. Wang TW, Neff LJ, Park-Lee E, Ren C, Cullen KA, King BA. E-cigarette use among middle and high school students — United States, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1310-1312.

3. 3. Centers for Disease Control and Prevention. National Youth Tobacco Survey (NYTS). December 21, 2020 (https://www.cdc.gov/tobacco/data_statistics/surveys/nyts/index.htm).

   Google Scholar

4. 4. Ali FRM, Diaz MC, Vallone D, et al. E-cigarette unit sales, by product and flavor type — United States, 2014-2020. MMWR Morb Mortal Wkly Rep 2020;69:1313-1318.

5. 5. Food and Drug Administration. FDA notifies companies, including Puff Bar, to remove flavored disposable e-cigarettes and youth-appealing e-liquids from market for not having required authorization. July 20, 2020 (https://www.fda.gov/news-events/press-announcements/fda-notifies-companies-including-puff-bar-remove-flavored-disposable-e-cigarettes-and-youth).

   Google Scholar

10.1056/NEJMc2033943-t1

Table 1. Use of E-Cigarettes in the Preceding 30 Days (Current Use) According to Device Type in 2019 and 2020 as Reported by Middle and High School Students in the National Youth Tobacco Survey.*

Characteristic	2019				2020				Absolute Difference, 2019 vs. 2020†
	Unweighted Analysis‡	Weighted Analysis‡	Weighted Percentage, All Students	Weighted Percentage, Current Users	Unweighted Analysis	Weighted Analysis	Weighted Percentage, All Students	Weighted Percentage, Current Users	Among All Students	Among Current Users
	no.		% (95% CI)		no.		% (95% CI)		% (95% CI)
Middle school (grades 6–8)
Current e-cigarette use§	902	1,240,000	10.5 (9.4 to 11.8)	—	316	550,000	4.7 (3.6 to 6.0)	—	–5.9 (–7.6 to –4.2)	—
Device type
Disposable	26	30,000	0.3 (0.2 to 0.6)	3.0 (1.7 to 5.4)	43	80,000	0.7 (0.4 to 1.2)	15.2 (9.1 to 24.1)	0.4 (0 to 0.8)	12.1 (4.6 to 19.7)
Prefilled pod or cartridge	418	560,000	4.8 (4.1 to 5.6)	45.3 (40.5 to 50.2)	143	220,000	1.9 (1.5 to 2.4)	41.3 (31.9 to 51.4)	−2.9 (−3.7 to −2.0)	−4.0 (−14.9 to 6.9)
Tank	239	340,000	2.9 (2.4 to 3.6)	28.1 (23.8 to 32.8)	55	110,000	Not shown¶	21.5 (13.8 to 31.8)	Not shown¶	−6.6 (−16.6 to 3.4)
Mod system	94	130,000	1.1 (0.9 to 1.4)	10.6 (8.3 to 13.4)	23	40,000	0.4 (0.2 to 0.6)	8.2 (5.5 to 12.3)	−0.7 (−1.1 to −0.4)	−2.3 (−6.5 to 1.8)
Don’t know	122	160,000	1.4 (1.1 to 1.7)	13.0 (10.6 to 15.9)	45	70,000	0.6 (0.4 to 1.0)	13.8 (10.4 to 18.2)	−0.7 (−1.2 to −0.3)	0.8 (−3.9 to 5.4)
High school (grades 9–12)
Current e-cigarette use§	2709	4,110,000	27.5 (25.3 to 29.7)	—	1448	3,020,000	19.6 (17.2 to 22.2)	—	−7.9 (−11.2 to –4.6)	—
Device type
Disposable	77	90,000	0.7 (0.4 to 1.0)	2.4 (1.6 to 3.7)	386	790,000	5.1 (3.9 to 6.8)	26.5 (20.0 to 34.2)	4.5 (3.0 to 5.9)	24.1 (17.0 to 31.2)
Prefilled pod or cartridge	1480	2,310,000	15.5 (13.6 to 17.5)	56.7 (52.4 to 60.8)	667	1,450,000	9.4 (7.8 to 11.3)	48.5 (42.5 to 54.6)	−6.1 (−8.7 to −3.5)	−8.1 (−15.5 to −0.8)
Tank	670	950,000	6.4 (5.6 to 7.3)	23.3 (20.5 to 26.3)	229	440,000	2.9 (2.2 to 3.8)	14.8 (11.8 to 18.4)	−3.5 (−4.6 to −2.3)	−8.5 (−12.8 to −4.1)
Mod system	256	400,000	2.7 (2.2 to 3.4)	10.0 (8.1 to 12.2)	61	120,000	0.8 (0.6 to 1.2)	4.2 (2.9 to 6.1)	−1.9 (−2.6 to −1.3)	−5.7 (−8.3 to −3.2)
Don’t know	210	310,000	2.1 (1.8 to 2.4)	7.6 (6.5 to 9.0)	91	170,000	1.2 (0.8 to 1.6)	5.9 (4.5 to 7.8)	−0.9 (−1.4 to −0.5)	−1.7 (−3.8 to 0.3)

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