THURSDAY, April 16, 2020 (HealthDay News) -- Weeks after e-cigarette giant Juul voluntarily stopped selling many flavored vaping products popular with U.S. teens, sales rebounded as customers switched to varieties still on the shelves.
In fact, sales eventually surpassed previous records, according to new American Cancer Society (ACS) research.
"When companies are able to make these decisions for themselves, they are theoretically looking out for consumers, but are really making decisions that are good for the company's bottom line, whereas a regulator is able to make a sweeping decision that can serve the interests of public health," said lead researcher Alex Liber, an ACS senior scientist.
In 2018, as vaping surged particularly among American teens, the U.S. Food and Drug Administration pressured e-cigarette makers to stop selling most flavored products.
Liber said that it's likely that when teens couldn't get Juul's fruit flavors, they simply switched to menthol, mint or tobacco flavors, which remained available.
Between 2017 and 2018, sales of Juul's fruit flavors grew from 13% of sales ($10.2 million per month) to 33% of sales ($96.5 million).
Fruit briefly exceeded menthol and mint as the best-selling flavor category in October 2018, while sales of tobacco-flavored e-cigarettes fell from 39.7% to 16.6% of sales.
Juul's voluntary decision to remove fruit flavors in November 2018 caused a drop in sales of fruit-flavored products to 9% ($30.5 million) by April 2019. But at the same time, sales of menthol and mint flavors rose -- from 33% of sales ($95.5 million) to 62.5% ($209.5 million), researchers found.
Meanwhile, sales of tobacco-flavored e-cigarettes rose from nearly 17% to 22% ($48 million to $75 million).
And Juul captured about 90% of the industry's growth in sales of tobacco flavors and all of the growth in menthol and mint, the study found. Its overall sales grew more than in any other 12-week period.
Even under government and public pressure to stop selling fruit- and sweet-flavored products, some brands didn't, however. By 2019, sales of fruit flavors rose to 16% ($60.5 million), thanks to the Njoy brand.
In 2019, total e-cigarette sales were about $441 million per month, including hardware.
"The FDA has made only the most cursory beginning of starting to address this," Liber said. "In January, they said that we will advise companies to not sell flavored products. By flavor they mean non-mint, non-menthol or non-tobacco flavors."
But that advisory only included Juul-like products. The FDA left open disposable e-cigarettes and refillable systems, he said.
"Demand followed where there were exemptions, so people went to the products that were still available," Liber said. "If their goal is to not let people have access to fruit flavors, then they need to consider how to make that a more sweeping policy."
For the study, his team used data from the Nielsen Company.
Stanton Glantz, a professor of medicine at the Center for Tobacco Control Research and Education at the University of California, San Francisco, believes the FDA should do more.
"The FDA has given e-cigarettes a pass," Glantz said.
Under the current law, the FDA has regulatory authority over electronic cigarettes. No e-cigarettes have been approved, but the FDA is not going to ban them, Glantz said. Though manufacturers are supposed to provide product data to the FDA to get them approved, those deadlines have been pushed back.
"Every noise the FDA has made so far is to continue to give the industry time. What that shows is it's going to keep kids smoking," Glantz said.
The report was published online April 16 in the American Journal of Public Health.
For more about e-cigarettes, visit the U.S. National Institute on Drug Abuse.