National and State-Specific Sales and Prices for Electronic Cigarettes—U.S., 2012–2013

Introduction

The growing market for electronic cigarettes (e-cigarettes) has been widely reported in the media, but very little objective data exist in the scientific literature, and no data have been published on state-specific trends in prices or sales. Our objective is to assess state-specific annual sales and average prices for e-cigarettes in the U.S.

Methods

Commercial retail scanner data were used to assess total dollar sales and average price per unit for disposable e-cigarettes, starter kits, and cartridge refills for selected states and the total U.S. during 2012−2013. Data were analyzed in 2014. Data were available for convenience stores (29 states) and food, drug, and mass merchandisers (44 states).

Results

In convenience stores, dollar sales increased markedly during 2012−2013: 320.8% for disposable e-cigarettes, 72.4% for starter kits, and 82% for cartridges. In food, drug, and mass merchandisers, dollar sales increased 49.5% for disposable e-cigarettes, 89.4% for starter kits, and 126.2% for cartridges. Average prices across all product categories increased in convenience stores and decreased in food, drug, and mass merchandisers. Sales and prices varied substantially across states included in the analyses.

Conclusions

Sales of all e-cigarette device types grew considerably in convenience stores and food, drug, and mass merchandisers during 2012−2013. The market for e-cigarettes is growing rapidly, resulting in dynamic sales and price changes that vary across the U.S. Continued state-specific surveillance of the e-cigarette market is warranted.

Introduction

Electronic nicotine delivery systems (ENDSs), including electronic cigarettes (e-cigarettes), are battery-powered devices that heat liquid in a cartridge to deliver an inhaled dose of nicotine and other additives. Although the impact of e-cigarettes on public health is unclear,1, 2 awareness and use has increased markedly since being introduced into the U.S. in 2007.3, 4, 5, 6 During 2011–2013, ever use of e-cigarettes increased from 1.4% to 3.0% among middle school students and from 4.7% to 11.9% among high school students.⁷ Similarly, ever use of e-cigarettes has increased among adults, from 3.3% in 2010 to 8.5% in 2013, with higher prevalence among current (36.5%) and former (9.6%) cigarette smokers than never smokers (1.2%) in 2013.⁸ Despite the low proportion of tobacco product sales accounted for by e-cigarettes, monitoring e-cigarette sales is warranted, given the rapid increase in e-cigarette use and the continuing decline in conventional cigarette sales.⁹

Several factors may be driving the surge in popularity of e-cigarettes. First,¹⁰ e-cigarettes have been promoted as socially acceptable alternatives in situations where conventional tobacco smoking is not allowed.11, 12 Second, e-cigarettes have been promoted as safer alternatives to conventional tobacco products¹¹ and are used as a cessation aid by consumers.¹³ There is, however, no conclusive scientific evidence that e-cigarettes promote long-term cessation, and the products are not currently approved by the U.S Food and Drug Administration (FDA) for smoking cessation.¹⁴ Third, annual advertising expenditures for e-cigarettes across multiple channels tripled from $6.4 million in 2011 to $18.3 million in 2012, including advertising on TV,¹⁵ where advertising of conventional cigarettes has been banned since 1971.¹⁶ Smokers are particularly receptive to e-cigarette TV advertisements.¹⁷ Increasing cigarette prices are associated with decreasing cigarette consumption,¹⁸ and recent evidence suggests that e-cigarette sales are also price sensitive.¹⁹ Fourth, e-cigarettes are available in numerous configurations, and many e-cigarettes contain interchangeable components, allowing users to modify the device and customize its performance.²⁰ Finally, e-cigarettes are available in a variety of flavors, including fruit, alcohol, and chocolate, which are banned in conventional cigarettes in the U.S.²¹

E-cigarettes may have lower potential harm to the individual user than smoked tobacco²² and may aid in short-term smoking cessation²³; however, concerns exist, including the potential for e-cigarettes to promote continued smoking of cigarettes among current smokers, promote relapse among former smokers, encourage uptake of e-cigarettes among nonsmokers, and renormalize smoking behaviors.²⁴ The current dearth of objective data on the effects of e-cigarettes on individuals, populations, and the environment presents a challenge for protecting the public’s health.25, 26 On April 24, 2014, the FDA proposed to extend its tobacco regulatory authority to include e-cigarettes, but implementation could take several years.²⁷ However, some states have implemented policies to prevent youth access to e-cigarettes, avoid renormalization of tobacco use, and preserve clean indoor air standards. As of November 2014, a total of 40 states regulate youth access to e-cigarettes, and three states prohibit e-cigarette use in indoor areas of worksites, restaurants, and bars.²⁸ Currently, only two states tax e-cigarettes: Minnesota applies a tax to some e-cigarettes equal to 95% of the wholesale price,²⁹ and North Carolina applies a tax of 5 cents per milliliter of nicotine liquid.³⁰

Although the increasing market for e-cigarettes has been widely reported in the media,31, 32, 33 very few data exist in the scientific literature documenting sales and prices of e-cigarettes in the U.S., and no data have yet been published on state-specific trends in these measures. To address this gap, this study assessed state-specific sales and prices of disposable e-cigarettes, starter kits, and replacement cartridges.