National Trends in E-Cigarette Use

National trends: E-cigarette sales at their highest; More than 3 million U.S. youth said they used e-cigarettes in 2020


As the world returns to the “new normal,” the dangers of e-cigarettes and vaping still remain a public health threat. New research shows that national e-cigarette unit sales are among the highest ever recorded based on CDC Foundation data – a worrisome trend that schools should remain aware of as students return in the fall.

In its latest data brief, the CDC Foundation reports that from January 2017 to May 2021:

  • National e-cigarette unit sales are at record-high levels, based on current CDC Foundation data. Many believed e-cigarette use would drop due to the EVALI (e-cigarette or vaping product use-associated lung injury) outbreak in April 2019, as well as school and store closures caused by the COVID-19 pandemic. However, research by the CDC Foundation discovered the opposite was true. National e-cigarette unit sales increased by 48.9 percent –22.0 million units – from February 23, 2020 to May 16, 2021, despite the U.S. Food and Drug Administration’s (FDA) 2020 enforcement policies banning menthol cigarettes, flavored cigars and flavored cartridge-based e-cigarettes.

  • The use of disposable e-cigarette devices has skyrocketed. Because the FDA allowed disposable e-cigarette devices and menthol tobacco prefilled cartridges to remain on the market, their sales increased exponentially. Sales of disposable devices rose by 195.8% (from 2.8 million to 8.2 million). In addition, prefilled cartridge sales increased by 15.1% (from 12.0 million to 13.8 million).

  • Menthol-, tobacco-, mint- and other-flavored e-cigarettes are among the most popular products, according to national retails sales.

  • Tobacco-flavored e-cigarette sales increased by 11.7% (from 5.1 million to 5.7 million)

  • Mint-flavored e-cigarette sales increased by 26.2% (from 0.7 million to 0.8 million)

  • Menthol-flavored e-cigarette sales increased by 41.2% (from 6.4 million to 9.0 million)

  • All other-flavored e-cigarette sales increased by 142.3% (from 2.7 million to 6.5 million)

E-cigarette use among middle and high school students is still problematic.

An estimated 3.6 million U.S. youth said they used e-cigarettes in 2020, with more than 8 in 10 reporting use of flavored e-cigarettes. With the halt of the 2020 Monitoring the Future Survey – which gathers drug use and attitudes among middle and high school students – the impact of the pandemic on teen vaping is still being determined. However, a recent study among young adults ages 18 to 24 shows an increase in self-reported symptoms of anxiety and/or depression, substance use and suicidal thoughts among this population.

For advice on how schools can help students quit vaping, read this Zeptive article.

By Kristin Erekson Barton, MA, CHES

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  1. CDC Foundation. (2021). Monitoring U.S. E-Cigarette Sales: National Trends.

  2. Panchal N, Kamal R, Cox C, & Garfield R. The Implications of COVID-19 for Mental Health and Substance Abuse. Kaiser Family Foundation.

  3. Volkow, N. (2020, December 15). As 2020 Closes, Many Questions Remain about Youth Substance Abuse Trends. National Institute on Drug Abuse.