Trends in Nicotine Strength in Electronic Cigarettes Sold in the United States by Flavor, Product Type, and Manufacturer, 2017–2022

Details

• Alternative Title:
  Nicotine Tob Res
• Personal Author:
  Wang, Xu ; Ghimire, Ramesh ; Shrestha, Sundar S. ; Borowiecki, Mateusz ; Emery, Sherry ; Trivers, Katrina F.
• Description:
  Introduction:
  
  Most e-cigarettes contain highly addictive nicotine. This study assessed trends in nicotine strength in e-cigarettes sold in the United States during January 2017–March 2022.
  
  Aims and Methods:
  
  We obtained January 2017–March 2022 national retail e-cigarette sales data from NielsenIQ. We assessed monthly average nicotine strength overall, by e-cigarette product and flavor type, and manufacturer. A Joinpoint regression model assessed the magnitude and significance of changes in nicotine strength.
  
  Results:
  
  During January 2017–March 2022, monthly average nicotine strength of e-cigarette products increased from 2.5% to 4.4%, an average of 0.8% per month (p < .001). Monthly average nicotine strength of disposable e-cigarettes increased the most (average monthly percentage change [AMPC] = 1.26%, p < .001) as compared to prefilled pods (AMPC = 0.6%, p < .001) and e-liquids (AMPC = 0.5%, p = .218). Monthly average nicotine strength for all flavors of e-cigarette products increased except for mint-flavored products. Increases were greatest for beverage-flavored products (AMPC = 2.1%, p < .001), followed by menthol-flavored products (AMPC = 1.2%, p < .001). Among the top 10 e-cigarette manufacturers assessed, monthly average nicotine strength decreased for Juul Labs products from 5% to 4.7% (AMPC = −0.1%, p < .001) but increased significantly for five manufacturers’ products and remained unchanged at 5%–6% for four manufacturers’ products.
  
  Conclusions:
  
  Monthly average nicotine strength of e-cigarette products increased overall, for most product and flavor types, and for some manufacturers in the United States during the study period. Imposing maximum limits on nicotine strength of e-cigarettes together with other evidence-based tobacco control strategies can help reduce the use of e-cigarettes among youth and increase tobacco product cessation among adults.
  
  Implications:
  
  From January 2017 to March 2022, the monthly average nicotine strength of disposable e-cigarettes increased substantially and exceeded prefilled pods since May 2020. E-cigarettes with menthol flavor and youth-appealing flavors, like fruit, also had sharp increases in monthly average nicotine strength. Among the top 10 e-cigarette manufacturers, monthly average nicotine strength increased or remained unchanged at a high nicotine level for all manufacturers’ products, except Juul Lab’s products. Comprehensive strategies including restricting sales of all flavored e-cigarettes, restricting youth tobacco product access, and imposing maximum limits on nicotine strength may help reduce youth e-cigarette use and increase tobacco cessation.
  
  
• Subjects:
  Adolescent Adult Electronic Nicotine Delivery Systems Flavoring Agents Humans Menthol Nicotine Tobacco Products United States Vaping
• Source:
  Nicotine Tob Res. 25(7):1355-1360
• Pubmed ID:
  36929029
• Pubmed Central ID:
  PMC10461184
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; CC/CDC HHSUnited States/
• Volume:
  25
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:58799cea1ce4e3e8217c20820d87edd05f3cd9a27813c9d073bd6b07bfaeed149fa0b41aceb6cf0a5ba11789f34ea62388266f1ae8e8c4317b2631e1df3b3f97
• Download URL:
  https://stacks.cdc.gov/view/cdc/132424/cdc_132424_DS1.pdf
• File Type:
  [PDF - 359.84 KB ]