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

Introduction:
This text provides an analysis of trends in nicotine strength in electronic cigarettes (e-cigarettes) sold in the United States during January 2017-March 2022. The study uses data from NielsenIq to examine monthly average nicotine strength overall, by e-cigarette product and flavor type, and manufacturer. The findings highlight the increasing trend in nicotine strength and its implications for public health.

Key Points:

* The monthly average nicotine strength of e-cigarette products increased from 2.5% to 4.4% during the study period.
* Disposable e-cigarettes showed the greatest increase in monthly average nicotine strength (1.26%), followed by prefilled pods (0.6%) and e-liquids (0.5%).
* Monthly average nicotine strength increased for all flavors of e-cigarette products, except for mint-flavored products.
* among the top 10 e-cigarette manufacturers, monthly average nicotine strength decreased for Juul Labs products (0.1%) but increased significantly for five manufacturers’ products and remained unchanged at 5%-6% for four manufacturers’ products.
* The increase in nicotine strength is a concern for public health, particularly for youth and young adults who are more likely to use e-cigarettes with high nicotine strength and flavors appealing to them.
* Imposing maximum limits on nicotine strength of e-cigarettes can help reduce the use of e-cigarettes among youth and increase tobacco product cessation among adults.
* Comprehensive strategies, including restricting sales of all flavored e-cigarettes and imposing maximum limits on nicotine strength, may help reduce the health and economic burden of tobacco use.

Main Message:
The study highlights the increasing trend in nicotine strength in e-cigarettes sold in the United States, which poses a public health concern, particularly for youth and young adults. Imposing maximum limits on nicotine strength and comprehensive strategies, such as restricting sales of all flavored e-cigarettes, can help reduce the use of e-cigarettes among youth and increase tobacco product cessation among adults. Therefore, regulatory measures are necessary to address the public health implications of the increasing trend in nicotine strength in e-cigarettes.

Wang X, Ghimire R, Shrestha SS, Borowiecki M, Emery S, Trivers KF. Trends in Nicotine Strength in Electronic Cigarettes Sold in the United States by Flavor, Product Type, and Manufacturer, 2017-2022. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2023;25(7):1355-1360. doi:10.1093/ntr/ntad033