Trends in unit sales of cooling flavoured e-cigarettes, USA, 2017-2021.

ABSTRACT

OBJECTIVE: Flavours that produce a cooling sensation, such as menthol, enhance the appeal of e-cigarettes among youth; but not all e-cigarettes that produce cooling sensations are labelled as menthol. This study assessed trends in unit sales of cooling flavoured e-cigarettes in the USA. DESIGN: E-cigarette retail sales during 26 January 2017 to 28 November 2021 were licensed from Information Resources, Inc, which records brick-and-mortar retail scanner sales but not online or vape shop sales. Cooling flavours were identified using six descriptors menthol, ice, cool, chill, freeze or frost; ambiguous flavours were verified using online searches. Cooling flavours were categorised by characterising flavour (menthol, mint, other) and product type (prefilled cartridges, disposables, e-liquids). Joinpoint regression was used to assess sales and price trends. RESULTS: During January 2017 to November 2021, unit sales of cooling flavoured e-cigarettes increased by 693.0% (1.5 to 12.0 million units); the percentage of these sales from total sales increased from 26.4% to 54.9%. Among cooling flavours, percentage of menthol sales decreased from 94.5% to 73.0% (p<0.001). Among menthol cooling flavours, percentage of prefilled cartridges increased from 67.2% to 96.6% (p<0.001); among non-menthol cooling flavours, percentage of disposable e-cigarettes increased from 5.2% to 99.2% (p<0.001). There were no significant price differences between cooling and non-cooling flavoured disposable e-cigarettes. CONCLUSION: The percentage of cooling flavoured e-cigarette sales from total sales doubled during 2017-2021, and sales of non-menthol cooling disposable e-cigarettes experienced the highest percentage increase. Cooling flavoured e-cigarettes are important to consider when developing strategies to address flavoured e-cigarette use among youth.