Why Young People Use E-Cigarettes: Are E-Cigarettes Harmful to Young Users?

Let’s start with a set of data. In 2020, 82.9% of youth e-cigarette users used flavored e-cigarettes, including 84.7% of high school users and 53.73% of middle school users.

Among high school students currently using any type of flavored e-cigarette, the most commonly used flavor categories were fruit (73.1%), mint (55.8%), menthol (37.0%), and candy, desserts, or other sweets (36.4%). Among middle school students currently using any type of flavored e-cigarette, the most commonly used flavor categories were fruit (75.6%), candy, desserts, or other sweets (47.2%), mint (46.5%), and menthol (23.5%).

Youth e-cigarette users cite flavors as the leading reason they started using e-cigarettes, second only to family or friends using them.

One study involving middle and high school students reported that 43% of young people who had ever used e-cigarettes tried them because the flavors were appealing.

The FDA also reported that among current youth e-cigarette users, 97% had used flavored e-cigarettes in the past month.

Although the most commonly used type of e-cigarette device among young people is prefilled pod devices such as JUUL, disposable e-cigarettes have seen enormous growth. In fact, from 2019 to 2020, disposable e-cigarette use among current high school e-cigarette users increased by nearly 1,000%.

JUUL continues to hold a large share of the U.S. e-cigarette sales market, but the rise of disposable e-cigarettes and other brands has begun to erode that leading position.

From October 2019 to January 2020, the market share of disposable e-cigarettes nearly doubled in just a few months. After the FDA restricted flavors in non-disposable e-cigarettes, the market share of disposable e-cigarettes likely rose further, making disposable products in youth-appealing flavors such as candy and fruit the only flavored products still widely available for purchase.

Research shows that menthol, which remained on the market, has become increasingly popular. By July 2020, menthol-flavored e-cigarette sales had risen to a record-high market share of 57.7%.

According to 2020 data reported by The New York Times, 37% of high school e-cigarette users used menthol-flavored e-cigarettes. In fact, following FDA guidance issued in January 2020 to remove non-menthol cartridge-based e-cigarettes from the market, sales of menthol e-cigarettes increased by $59 million, and their market share surged from 24% to 49% within about eight weeks of the announcement. During the same period, the market share of mint e-cigarettes fell from 26% to 4%, while sales dropped by $79 million, indicating that as other flavors were voluntarily withdrawn or removed due to policy changes, users simply switched to menthol.

Like teenagers, young adults aged 18-24 are also increasingly using e-cigarettes. According to a recent analysis, the proportion of young adults who used e-cigarettes every day or on some days increased from 2.4% in 2012 and 2013 to 5.2% in 2017, and then rose again to 7.6% in 2018.

A 2016 report from the Behavioral Risk Factor Surveillance System found that 44.3% of current young adult e-cigarette users had never smoked before trying e-cigarettes.

Compared with adults aged 25 and older, young adults are more likely to try e-cigarettes and to report using e-cigarettes in the past 30 days.

A study in Mississippi found that JUUL use was more sustained than use of other e-cigarettes. It concluded that undergraduate students in Mississippi were more likely to continue using JUUL after initial experimentation than to continue using other e-cigarettes. The study found that people who had tried JUUL were three times more likely to still be using it after 30 days than users of other e-cigarettes.

The growing popularity of e-cigarettes among young people has raised concerns that e-cigarette use may lead to the initiation of cigarettes and other tobacco products.