Background and Description of E-Cigarette Products and Solutions

Adolescents, Young Adults, and Adults Continue to Use E-Cigarette Devices and Flavors Two Years after FDA Discretionary Enforcement

“…The popularity of disposables among AYAs under 21 is likely also because after the FDA adopted its 2020 enforcement policy, cheap disposables were available in kid-friendly flavors, whereas pod/cartridge-based e-cigarettes were not, making these disposable devices a popular alternative for young users [ 13 ]. On the other hand, JUUL (i.e., the most popular pod/cartridge-based e-cigarette) entered the market in 2015 and accounted for stark increases in e-cigarette use among high school students through 2019 [ 14 , 27 ], a period when many 21–24-year-olds in the current study would have been in high school. Other e-cigarettes, such as “mods” and “tanks,” entered the market as part of an even earlier generation of devices, which likely predated 13–20-year-olds’ e-cigarette initiations [ 14 ].…”

“…On the other hand, JUUL (i.e., the most popular pod/cartridge-based e-cigarette) entered the market in 2015 and accounted for stark increases in e-cigarette use among high school students through 2019 [ 14 , 27 ], a period when many 21–24-year-olds in the current study would have been in high school. Other e-cigarettes, such as “mods” and “tanks,” entered the market as part of an even earlier generation of devices, which likely predated 13–20-year-olds’ e-cigarette initiations [ 14 ]. Furthermore, these particular devices are known for their larger sizes, which limit concealability [ 14 ], a salient factor for younger users striving to avoid detection by adults [ 28 , 29 ].…”

“…Other e-cigarettes, such as “mods” and “tanks,” entered the market as part of an even earlier generation of devices, which likely predated 13–20-year-olds’ e-cigarette initiations [ 14 ]. Furthermore, these particular devices are known for their larger sizes, which limit concealability [ 14 ], a salient factor for younger users striving to avoid detection by adults [ 28 , 29 ].…”

“…Citing these data, in January 2020 the FDA first announced that it would prioritize enforcement against the following products on the market that did not have premarket authorization: (1) flavored pod/cartridge-based e-cigarettes (with the exception of menthol- and tobacco-flavored), (2) e-cigarette products without adequate measures to prevent use by minors, and (3) products targeting minors or whose marketing is likely to promote use by minors [ 12 ]. Notably exempt from the FDA’s 2020 enforcement policy were disposable e-cigarette devices, which are discarded when the e-liquid is depleted rather than re-filled [ 13 ], other e-cigarettes such as “tank” or “mod” devices [ 14 ], and tobacco- and menthol-flavored pod/cartridge-based e-cigarettes [ 12 ].…”

“…Citing these data, in January 2020 the FDA first announced that it would prioritize enforcement against the following products on the market that did not have premarket authorization: (1) flavored pod/cartridge-based ecigarettes (with the exception of menthol-and tobacco-flavored), (2) e-cigarette products without adequate measures to prevent use by minors, and (3) products targeting minors or whose marketing is likely to promote use by minors [12]. Notably exempt from the FDA's 2020 enforcement policy were disposable e-cigarette devices, which are discarded when the e-liquid is depleted rather than re-filled [13], other e-cigarettes such as "tank" or "mod" devices [14], and tobacco-and menthol-flavored pod/cartridge-based e-cigarettes [12]. Data collected following the FDA's 2020 prioritized enforcement announcement illustrate a number of notable trends, including an increase in AYAs' use of newer disposabletype e-cigarette devices and menthol flavors, as well as continued use of fruit, candy, and mint-flavored products, even in targeted pod/cartridge-based e-cigarettes [15][16][17].…”