American Cancer Society researchers stress health interventions to continue reducing e-cigarette use among youth.
New research led by scientists atthe American Cancer Society (ACS) shows the need for continued surveillance of the changes in shopping interest and sales for Puff Bar, the most preferred brand of electronic cigarettes or e-cigarettes among youth in the United States. Public interest in shopping and sales of Puff Bar skyrocketed in 2020.The findings were published today in the journal Tobacco Control.
“Adoption of Puff Bar products in the U.S. may pose threats to public health and potentially exacerbate the youth vaping epidemic in the U.S.,“ said Dr. Anuja Majmundar, principal scientist, tobacco control research at the American Cancer Society, and lead author of the study. “E-cigarette use was at its highest peak among youth just less than two years ago. Our findings highlight how crucial it isto continuously monitor these products and prevent such unprecedented peaks in the future.”
Puff Bar is a leading e-cigarette brand vaping device pre-filled with synthetic
nicotine. The market for Puff Bar exploded in early 2020 after the U.S. Food and Drug Administration (FDA) published an enforcement guidance policy on unauthorized flavored cartridge-based e-cigarettes. Puff Bar, a single-use e-cigarette, has overtaken JUUL, a reusable e-cigarette, as the most preferred e-cigarette product among youth in the recent past.
In this study, researchers mapped trends in relative search volume (RSV) from Google shopping queries which would indicate the shopping interest in Puff Bar and JUUL products and their point-of-sales from March 2019 until May 2021. They mapped these trends in relation to significant regulatory, company sales policy announcements, and other events that may have potentially shaped the trajectory of these products:
Time period 1 (T1): Both JUUL and Puff Bar were sold and marketed as tobacco-derived nicotine-containing products (3/24/19 - 9/10/19).
Time period 2 (T2): Trump Administration announced plans to ban flavors; JUUL Labs’ voluntary announcement to halt online sales of its sweet and fruity products (9/11/19 - 1/1/20).
Time period 3 (T3): FDA published enforcement guidance policy on unauthorized flavored cartridge-based e-cigarettes; House approved flavored e-cigarette ban bill (1/2/20 - 6/14/20).
Time period 4 (T4): Puff Bar battled counterfeit sales, received an FDA warning letter, and suspended sales (6/15/20 - 3/1/21).
Time period 5 (T5): Puff Bar resumed sales as a synthetic nicotine-containing product (3/2/21 - 5/22/21).
After the Trump administration announced its plans to ban flavored e-cigarettes in September 2019 and JUUL Labs, Inc. decided to suspend the sales of its sweet and fruity flavored products in October 2019, JUUL’s shopping interest RSV and sales declined while Puff Bar’s shopping interest RSV peaked, and its sales increased, the study found. From the period following the FDA’s announcement of its enforcement guidance policy on unauthorized flavored cartridge-based e-cigarettes (March 2020 until May 2021,) JUUL’s shopping interest RSV and sales continued to decline. Puff Bar’s shopping interest RSV increased, and its sales peaked until lawmakers approved the flavored e-cigarette ban bill in February 2020. Puff Bar’s sales steeply declined following the suspension of its sales in February 2020. Between March 2, 2020, and May 15, 2020, the decline in Puff Bar sales slowed when they relaunched their products as synthetic nicotine-containing e-cigarettes, at a time when the FDA did not have regulatory authority over synthetic nicotine-containing tobacco products.
“However, we need more recent data to closely monitor whether Puff Bar sales increased after the relaunch,” warned Zheng Xue, senior associate scientist at the American Cancer Society and co-author.
As of April 2022, the FDA will regulate e-cigarette products containing synthetic nicotine. “These findings offer useful baseline measures to track the impact of the recent FDA regulatory authority over these products’ sales and public interest in the future,” said Majmundar.
The American Cancer Society’s advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN) advocated for closing the loophole that allowed products labeled as synthetic nicotine to circumvent FDA regulation and is calling on the FDA to enforce this new law.
Resources from the American Cancer Society about e-cigarettes and vaping can be found here.
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