A recent Public Health Alerts report, published in The New England Journal of Medicine, reveals that more than 69% of electronic cigarette sales in the United States are illicit, with a special focus on the youth market. The data comes from an analysis conducted by the Centers for Disease Control and Prevention (CDC) Foundation, which used information from Circana.

The Family Smoking Prevention and Tobacco Control Act of 2009 stipulates that manufacturers must obtain a marketing authorization (MGO) from the Food and Drug Administration (FDA).

However, as of December 2025, only 39 e-cigarette products had such authorization, underscoring the presence of thousands of unauthorized products on the market.

Use among young people and adults

The figures indicate that 7% of adults and 24.8% of young people aged 18 to 24 are using electronic cigarettes, while use is 7.8% among secondary school students and 3.5% among primary school students.

Disposable e-cigarettes with flavors appealing to youth make up the majority of unauthorized sales. Among sales of products containing specific flavors, 93.1% of tobacco-flavored e-cigarettes were authorized, while only 26.1% of menthol were authorized, and none of the other flavors (fruit, candy, candy, mint) were authorized.

The report's authors emphasize that the lack of public information on the marketing of tobacco products creates compliance difficulties for retailers and complicates research on the use of these products, especially among young people.

Impact of electronic cigarettes among young people

The use of flavors often increases the appeal of e-cigarettes among young people, because it masks the strong taste of nicotine and makes trying them seem more pleasant. It is also associated with greater curiosity, a greater likelihood of continued use, and an easier time for them to become regular consumers.

Why do they influence so much?

Sweet, fruity, or dessert-like flavors reduce the irritating sensation when inhaled, so the product is less intimidating for teenagers and young adults. In addition, eye-catching packaging and social media campaigns reinforce that appeal.

What the sources show

A review of adolescents notes that flavors are one of the most cited reasons for using e-cigarettes, and that many young people perceive them primarily as “flavors” rather than as nicotine products. Another medical source summarizes that young users of flavored products are more likely to continue using them than those who start with unflavored versions.

Important nuance

Not all surveys find flavors to be the only main reason; In some studies, curiosity appears earlier, although flavors continue to be a relevant factor. Even so, the general trend in public health is that flavors facilitate initiation and help sustain youth consumption.

In one sentence. Flavors are not the only reason, but they are one of the main drivers of the popularity of electronic cigarettes among young people, because they make them more attractive, easier to try and more difficult to quit.

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