E-cigarettes, commonly known as vapes, are electronic devices that heat liquid and produce aerosol. These devices are the most popular commercial tobacco product among youth, typically contain nicotine, and come in several enticing flavors including candy, fruit, and menthol, making them highly addictive and dangerous. Findings from the 2024 National Youth Tobacco Survey report that among youth who currently use e-cigarettes, three of the five most commonly used products are Elf Bar (36.1%), Breeze (19.9%), and Mr. Fog (15.8%). What else do these popular brands among youth have in common? They are all illegal. None of these products are a part of the 34 e-cigarette products and devices authorized by the Food and Drug Administration (FDA), which are the only e-cigarette products that can be lawfully marketed and sold in the United States. In order for a new tobacco product to be lawfully sold, manufacturers must submit a premarket tobacco product application (PMTA) that provides comprehensive scientific data demonstrating the new product is suitable for the protection of public health. However, due to the millions of PMTAs being submitted and the speed of new products being launched, particularly disposable e-cigarettes, the FDA and its enforcement partner, the Department of Justice (DOJ), continue to experience significant challenges in preventing illegal e-cigarettes from flooding the market.
Recent efforts by the FDA to curb the sale of illegal e-cigarettes include the creation of a federal multi-agency task force in June 2024. Director of the FDA’s Center for Tobacco Products, Dr. Brian King, stated, “This ‘All Government’ approach – including the creation of this new Task Force – will bring the collective resources and experience of the federal government to bear on this pressing public health issue.” The FDA is working to curb the sale of illegal products in part by issuing warning letters and fines to brick-and-mortar stores selling unauthorized products, as well as seizing shipments of these products.
State health departments play a critical role in combating the rise of illegal e-cigarettes on the market, starting with enhancing enforcement of existing regulations. Completing regular inspections and compliance checks of retailers, along with instilling tobacco retailer merchant education programs will help ensure retailers adhere to laws regarding all commercial tobacco products. States can pursue stronger policies (e.g. through tobacco retail licensing or zoning measures) to regulate how tobacco products are marketed and sold and control the overall density, type, and location of retailers within a community, thus helping to prevent youth tobacco use initiation. Some states have enacted e-cigarette registry bills, which aim to prohibit retailers from selling e-cigarettes not authorized by the FDA. In order for this law to be effective, proper surveillance along with adequate funding and meaningful penalties for retailers that violate the law must be in place, which can be achieved through tobacco retail licensing.
The ongoing presence of illegal e-cigarette products continues to undermine efforts by state and federal agencies to instill effective regulatory measures. A multifaceted approach, including stronger enforcement, increased collaboration, and public education is needed to protect public health and is essential to safeguard youth from the dangers of nicotine addiction and other associated health risks. The collective call from public health organizations for comprehensive enforcement further emphasizes the urgency of addressing the issue of illegal e-cigarettes and ensuring only FDA-authorized e-cigarette products remain available on the market, which in turn will increase positive health outcomes for all.
Learn more from Counter Tobacco’s evidence summary on e-cigarettes at the point of sale.
This post was originally published as a feature article for The Geographic Health Equity Alliance (GHEA), a CADCA initiative. GHEA is a CDC funded National Network dedicated to reducing geographic health disparities related to tobacco and cancer.
