Display case of e-cigarettes in a retail store

E-cigarettes first entered the US market in 2007 and have since surged in popularity, gaining status as the most popular product among youth since 2014.[1] According to the National Youth Tobacco Survey [NYTS], current (past 30-day) use of e-cigarettes among youth doubled between 2011 and 2012,[2]  and tripled among youth from 2013 to 2014.[1] While current e-cigarette use declined among middle and high school youth from 2015 to 2016,[4] between 2017 and 2018, current e-cigarette use grew by 78% among high school students and by 48% among middle schools students, driven largely by new USB-shaped e-cigarette products like Juul.[5] E-cigarettes  remain the most commonly used tobacco product among youth. Data from the 2019 NYTS shows that 53.3% of US high school students had ever used a tobacco product with approximately 27.5% of high school students reporting current e-cigarette use. While these statistics are alarming, newly released data from the 2020 NYTS shows some promising decline in youth vaping rates. From 2019 to 2020, current e-cigarette use in high school students dropped from 27.5% to 19.6% and in middle school students from 10.5% to 4.7%. Despite this significant decline, 3.6 million youth still currently use e-cigarettes, with many of these youth pivoting from pre-filled pods and cartridges (many of which were banned in the federal restrictions on the sale of flavored e-cigarette products at the beginning of 2020) to disposable e-cigarettes. In fact, rates of disposable e-cigarette use have skyrocketed by roughly 1000%, with rates of use in high school students jumping from 2.4% in 2019 to 26.5% in 2020. As well, more than 80% of youth reported using flavored varieties of e-cigarettes, with the most commonly used flavors being fruit, mint, candy, and menthol. In previous years, menthol was not assessed independently; this year’s data shows that nearly half of youth and young adults who use e-cigarettes have used a menthol flavored pre-filled pod or cartridge and one quarter have used a menthol flavored disposable vaping product. Furthermore, concerns abound regarding the link between early e-cigarette use and cigarette smoking initiation; a meta-analysis concluded that young adults who used e-cigarettes but had never smoked combustible cigarettes had 4.59 times of the odds of smoking cigarettes in the future, compared to those who never used e-cigarettes.[41]  As well, the most recent data from 2018 on adult use in the US shows that 14.9% of adults had ever used an e-cigarette and 3.2% were current users.

For general information on e-cigarette and nicotine-delivery device patterns of use, health effects, marketing, and policy implications, review:

According to the FDA, e-cigarettes as battery-operated tobacco products designed to deliver nicotine, flavor, and other chemicals. They turn nicotine, which is highly addictive, and other chemicals into an aerosol that is inhaled by the user. However, the industry is rapidly evolving, and many variations and categories of these products exist, including tanks and mods, “pod mod” styles with cartridges, and disposable e-cigarettes, as well as “heat-not-burn” cigarettes. To add to the confusion, e-cigarettes carry a number of different names, such as “vape products,” “vaping products,” “electronic smoking products,” “vaporizers,” and “electronic nicotine delivery systems.” For the purposes of this evidence summary, we will loosely refer to the entire category of devices as e-cigarettes.


Depending on which definitions are used in a state or local policy, there may be different legal considerations and implications. The FDA extended the agency’s authority to cover all tobacco products including e-cigarettes in their “deeming” rule, released on May 5, 2016. Many states and communities have also begun to address e-cigarette use by restricting sales to minors, regulating pricing and promotion of e-cigarettes, and limiting the advertising and availability of these products. How state and local laws define e-cigarettes, and whether these products are categorized separately from “other tobacco products,” or included in the definition of “smoking” will determine whether existing regulations apply.[7]  Review the Public Health Law Center’s review of current e-cigarette regulations in all 50 states for more details on varying state definitions and regulations.

E-Cigarette Devices

Classifying e-cigarettes can be tricky, as the differences between the various types are often distinguished by the internal structure of the device, and not by the external appearance. Conceptually, there are two types of e-cigarette devices:

  1. e-cigarettes in various styles Open systems are rechargeable devices that allow the user to add an e-liquid solution or loose-leaves into the system. They also allow the user to adjust the settings to personalize the devices. Open systems are becoming increasingly popular and individualized. Mods/RBAs/RDAs/RTAs are larger open-system devices, usually made of metal, which can be modified (hence the name “mod”) or rebuilt to fit customer preferences for battery size, voltage, temperature control, coils, etc. Herbal/dry chamber vaporizers are open-systems designed to heat loose-leaf plant material without burning it. These are marketed to create a “cleaner” high than traditional forms of smoking, and are often used for marijuana. They are sold as a pen style, portable style, or desktop style.
  2. Closed systems are those that cannot be taken apart, have the tank refilled, or be altered by the user. They can be disposable or rechargeable. Some, like Juul and other similarly designed products sometimes referred to as “pod mods“, allow the user to replace cartridges. Cig-a-likes and pre-filled vape pens or vape sticks fall into this category. Cig-a-likes, the first generation of e-cigarette developed, were designed with the same size and shape of a conventional cigarette to maintain the look and feel of smoking a cigarette. Many have a tip that lights up when activated to mimic smoking as closely as possible. For more information on the different categories of e-cigarette devices and images of each, please visit our vSTARS Training Manual.

E-liquid solutions and flavors

Similar to the difficulty inherent in naming e-cigarettes, the liquid solutions used inside of the e-cigarettes also carry a myriad of undefined labels, including “e-juice”, “e-liquids,” and “e-liquid solutions”. These liquids are used in all types of e-cigarette devices except for the open-system, dry-chamber, herbal vaporizers. E-liquid solutions may or may not contain nicotine, which is then added to a base of propylene glycol or vegetable glycerin. They also may or may not contain flavors, menthol, caffeine, THC, CBD or other psychoactive substances dissolved into a liquid base.

The endless variety of flavors available for e-liquid solutions pose a particular problem for youth initiation. A study in 2014 found a total of 7,765 flavors and 466 brands, and the market has only grown since then.[8] Common flavors with a strong youth appeal include fruit flavors (e.g. cherry, blueberry, melon) and candy flavors (e.g. cotton candy, bubblegum, chocolate, and vanilla). An increasing number of e-liquid solutions have names that do not reflect the precise flavoring, such as “Lizard Guts” or “Unicorn Puke”. Similarly, most major e-liquid manufacturers create menthol e-liquid solutions, which are often labeled as mint, wintergreen, ice, or frost. Also common are e-liquid solutions that share the same flavor profiles as alcoholic beverages, such as “sex on the beach” or “mojito.” While the FDA has prohibited the sale of flavored cartridge-based (closed-system) e-cigarette products other than menthol or tobacco flavor, that restriction does not include e-liquids (or popular disposable e-cigarettes like Puff Bar). 

E-liquid solutions that do not contain any nicotine are often marketed as a “healthy” alternative to smoking or vaping nicotine, particularly if these e-liquid solutions contain vitamins, such as the 0-nicotine VitaVape products. However, a study of e-cigarette sales between 2013 – 2018 found that zero-nicotine e-cigarettes comprised less than 1% of the e-cigarette marketshare.[9] Similarly, a study in 2015 found that 99% of e-cigarette products sold contained nicotine.[10] With the introduction of Juul to the market, nicotine concentrations have risen from an average of 2.19% in 2013 to 4.34% in 2018.[9] These greater nicotine concentrations increase the risk of nicotine addiction and subsequent health consequences, especially for youth, whom these high-nicotine concentration products are popular with, and who may not realize that the products contain nicotine at all. [11]

New lines of e-liquids are emerging that are labelled as TFN (Tobacco-Free Nicotine). These e-liquids contain nicotine allegedly not derived from tobacco plants. However, comprehensive policy language intentionally defines products broadly, such that restrictions on e-cigarettes can encompass both 0-nicotine solutions and nicotine derived from sources other than tobacco.

Vape shop culture: a constant evolution

A vape shop sells products such as vape pens, tanks, mods, e-juices, e-hookahs, advanced systems, and their accompanying components along with e-liquid solutions or cartridges. These stores may or may not have a vaping lounge or vaping bar inside as well. Many vape shops operate on non-traditional retail hours, opening closer to noon and closing later at night. Head shops have also started carrying advanced, open-system e-cigarettes in addition to other smoking-related paraphernalia, usually related to recreational drug use (e.g., bongs, glassware, incense).

As vape shops strive to create a unique retail environment, they have promoted certain messages to customers in an attempt to differentiate their products from combustible cigarettes and other tobacco products. Although research on vape shops is still limited, a study by Sussman et al. reflects the anecdotal evidence that most vape shop owners (76%) believe that their products are a safer alternative to cigarettes.[12] This belief is often conveyed via posters inside vape shops that convey harm reduction messages about vaping, along with staff’s personal testimonials. Modified risk claims that are not approved by the FDA are prohibited under the deeming rule. Many vape shops also purport the theory that vaping saves money when compared with smoking conventional cigarettes. To further the perceived economic benefits to vaping, stores will offer individual discounts to active duty or former military members or college students. 

Similarly, many vape store owners or staff members claim that vaping is an effective method of smoking cessation, and they may use signs or images to depict this theory inside their store, along with sharing personal testimonials of how e-cigarettes helped them to stop smoking. While marketing e-cigarettes as cessation aids is illegal under federal law, a study of North Carolina vape shops showed that many vape shops still display signs with these claims.[13] Conflicting evidence exists in the literature on whether e-cigs help or undermine quit attempts. They are not an FDA-approved cessation device/quit aid; however, some researchers argue that e-cigarettes are less dangerous than regular cigarettes, and they have the potential to assist with smoking cessation for adult smokers. Accordingly, the United Kingdom’s Royal College of Physicians has publicly stated that they have reviewed the evidence and believe the benefits of e-cigarettes outweigh the harms. Some research suggests the effectiveness of e-cigarettes for smoking cessation, while evidence has also surfaced that e-cigarettes are no more effective than alternative smoking aids, and rather may lead to more long-term nicotine dependence.[47,48, 49, 50]  Research is still emerging on whether e-cigarettes can be an effective cessation device among smokers who desire to quit smoking. However, a Lancet systematic review looking at dual use concluded, “association of e-cigarette use with quitting did not significantly differ among studies of all smokers using e-cigarettes (irrespective of interest in quitting cigarettes) compared with studies of only smokers interested in cigarette cessation.”[14]

For more information, review the following:

vape shop

Many vape shops take great lengths to differentiate themselves from traditional tobacco retailers, and as such, a different type of store assessment is needed to describe the store environment and marketing practices used. To this end, SCTC researchers, state, and local practitioners collaborated to develop the Standardized Tobacco Assessment for Retail Settings: Vape Shops (vSTARS) surveillance tool, designed for practitioners to inform state and local tobacco control policies for the point of sale. The assessment items (e.g., types of products sold, flavors, health messaging) were selected exclusively for their policy relevance. No items function as compliance checks for federal regulations. This user-friendly tool can be filled out by professionally-trained data collectors, as well as self-trained adults. Learn more about tracking vape shops, how to use the tool, and download the materials here.

Vape store customers may also differ from those who obtain their e-cigarettes through other channels. A survey conducted between 2014-2016 comparing e-cigarette users’ behaviors based on their primary place of purchase found that vape shops were the most popular place of purchase, preferred by 37.6% of users.[15] Vape shop customers were the most likely to be daily users (59.1%) and former smokers (40.2%), followed by internet customers.[15] Vape shop and internet customers were also most likely to have made an attempt to quit smoking cigarettes in the past 12 months, but retail store customers were most likely to have used an FDA-approved cessation aid. The large majority of vape shop customers (92.8%) used open-system models.[15]

Vape shops should also be included in tobacco control compliance and enforcement efforts. Data from the 2018 California Tobacco Control Program’s Young Adult Tobacco Purchase Survey, which uses 18-19-year-olds as underage decoys to attempt to purchase either cigarettes or vape product, found that about half (49.8%) of tobacco and vape shops that primarily sell tobacco products did not check IDs for the youth, and 44.7% sold to them.[16] The rates of sales to underage youth in these types of stores was significantly higher than in other types of stores.[16] Another study that used mystery shoppers to examine regulatory compliance in 30 randomly selected vape shops in six US cities found that while nearly all shops displayed minimum-age signage, only about a third of shops asked for age verification upon entry and less than a quarter of shops asked for age verification upon purchase. [44] As well, 16% of vape shops offered free samples of e-liquids and 29% had signage with prohibited health claims. [44] This underscores the need for strong age-verification requirements and strong enforcement efforts, including, as study authors suggest, an increase in the number and frequency of FDA compliance checks.

Research has also revealed socioeconomic disparities in vape shop density and proximity, especially in relation to schools. One study found that school districts with higher proportions of Asian and Black populations had a greater density of vape shops, and more vape shops in close proximity to schools.[43] 


e-cigarette display on the counter next to candy The tobacco industry heavily advertises e-cigarettes, relying on similar advertising strategies that have proven effective with traditional cigarettes, including marketing to youth. The Campaign for Tobacco Free Kids outlines some of these tactics in 7 Ways E-Cigarette Companies are Copying Big Tobacco’s Playbook. The tobacco industry has begun to channel vast sums of money into the marketing of e-cigarettes. In fact, a 2013 study found that of noncombustible tobacco products, advertisements for e-cigarettes are the most widely circulated.[17] Across the top 10 major brands, e-cigarette advertising expenditures grew by 52% between 2013 and 2014, rising to a combined total of $115.3 million in 2014. The brand MarkTen alone spent $54 million on advertising in 2014. In 2018, tobacco industry giant Altria invested $38 billion for a 35% stake in the e-cigarette company Juul. 

A pilot conducted in Central Harlem, NYC in 2013 found that among the 156 stores licensed to sell tobacco, 26% had e-cigarette advertising on the exterior of the store and 45% of these stores sold e-cigarettes.[18] A 2016 study found that e-cigarette advertisements with visual depictions increase the urge to smoke a traditional cigarette among daily smokers, and they reduce intentions to remain abstinent among former smokers.[19]

e-cigarette display on the counter next to candyThe report, “Gateway to Addiction? A Survey of Popular Electronic Cigarette Manufacturers and Targeted Marketing to Youth,” found major e-cigarette companies take part in marketing strategies that target youth through promotional activities like sponsorships or free samples at youth-oriented events and TV ads. However, a study by the Truth Initiative found youth awareness of e-cigarette advertisements to be highest at retail locations such as convenience stores, gas stations, and supermarkets. In 2016, 7 out of 10 middle- and high-school students were exposed to e-cigarette advertisements in the retail setting, representing a 24% increase in youth exposure since 2014. Research shows this marketing works and youth exposure to it is having an impact on youth e-cigarette use. A randomized controlled trial conducted in 2013 and 2014 found that young adults who had never tried an e-cigarette before but who were exposed to e-cigarette advertisements had greater curiosity about, and were twice as likely to have tried e-cigarettes six months later than young adults who were not exposed to e-cigarette advertisements.[20] Similarly, a study conducted between 2014-2015 among 12-17-year-old students in Texas found that students who recalled seeing e-cigarette advertisements in stores were three times as likely to have ever-used e-cigarettes 6 months later compared to those who did not recall seeing e-cigarette advertisements in stores.[21] A study of Scottish youth found that those who recalled seeing e-cigarettes in retail settings were nearly twice as likely to have tried an e-cigarette, and also more likely to report intentions to try them within the next six months.[22] Recent evidence has also shown e-cigarette advertisements with visual depictions to increase the urge to smoke a traditional cigarette among daily smokers and reduce intentions to remain abstinent among former smokers.[23] 

The Federal Cigarette Labeling and Advertising Act prohibits states and communities from regulating the marketing and sale of cigarettes, but this law does not apply to other non-cigarette tobacco products like e-cigarettes. While this may be an option, advertising restrictions may face legal challenges related to commercial speech. Consult legal counsel and review the following resources from the Public Health Law Center for more information:

Health & Safety Issues

Although e-cigarette proponents argue that vaping is safer than smoking combustible cigarettes, there are still demonstrated health risks to vaping due to chronic nicotine use, inhaled particulate matter, and toxic chemicals of certain e-liquid solutions. While it has been established that nicotine has adverse effects on the developing brain, other issues, like whether or not e-cigarettes are an effective method of harm reduction, are still debated.[24] Research is still emerging in the area of e-cigarettes and health, but some of the risks are outlined below.

One of the most obvious health issues with any nicotine product, including e-cigarettes, is the risk of developing addiction. As advanced system e-cigarette devices continue to allow for enhanced specificity on features that control nicotine flux (amount of nicotine emitted per puff second), they may not only be helpful in predicting e-cigarette use patterns, but also allow an opportunity to improve their effectiveness as a potential cessation aid.[25]

In addition to addiction, chronic nicotine use has been linked to cardiovascular, respiratory, and gastrointestinal disorders. Also of note, certain flavors of e-liquid solutions containing diacetyl can cause a disease, bronchiolitis obliterans, commonly referred to as “popcorn lung”. One Harvard study showed that 75% of all e-cigarettes had diacetyl within the e-liquid solutions.[26]

Similarly, cinnamon flavored e-liquids, particularly those containing cinnamaldehdye, are cytotoxic, despite being safe for oral consumption.[27] 

Webinar: Research on the Health Impacts of E-cigarettes & What We Should All Know

On September 28, 2017 Counter Tools hosted a webinar with guest presenters and research scientists, Dr. Ilona Jaspers, Dr. Flori Sassano from the UNC/Tobacco Centers of Regulatory Science (TCORS). They discussed their findings on what is in e-liquids used in e-cigarettes and other vaping devices as well as the possible impacts of e-liquids on the lungs. View a recording of the webinar here.

Other potential pulmonary problems are outlined in the articles below:

E-cigarette devices have been linked to explosions from lithium-ion batteries, small fires, and overheating. Examples of these safety issues are listed below:

In 2019, the FDA began investigating reports of seizures, mostly among youth and young adults, suspected to be linked to vaping and nicotine poisoning. In addition, severe lung injuries and deaths have been linked to the use of electronic cigarettes. Get the latest on the EVALI outbreak of lung injury associated with e-cigarette use from the CDC here.

E-Cigarettes & FDA Regulations

The FDA has passed a number of regulations in 2016 that impact e-cigarette manufacturing, marketing, and the prohibition of free sampling of e-liquid solutions inside stores. Included in these are the following regulations:

  • Regulation of adulterated products
  • Prohibition on false or misleading advertising
  • Regulation of modified risk claims
  • Registration of manufacturers and disclosure of product lists
  • Disclosure of ingredients, substances, compounds, and additives
  • Disclosure of health-related documents
  • Prohibition on the use of “light,” “mild,” “low,” or similar descriptors
  • Premarket review* 
  • Disclosure of harmful and potentially harmful constituents

*Premarket review for non-combustible products was delayed until August 8, 2022 as part of the FDA’s new tobacco regulatory plan announced in July 2017. This would have allowed any product on the market as of August 8, 2016 to remain on the market through this date, by when they would need to submit an application for FDA review. They then could remain on the market indefinitely unless the FDA decides otherwise. However, several public health organizations sued the FDA for this delay, arguing that the delay was unlawful and harmful to public health. On July 12, 2019 a federal judge ruled to set a new 10-month deadline for FDA premarket review applications for e-cigarettes. This moved the deadline from August 2022 to May 2020. However, the FDA was also granted another extension due impacts from the Covid-19 pandemic, setting another new deadline of September 9, 2020. After that point, the FDA has one year to review the applications, during which time the products can stay on the market unless the FDA says otherwise. This is also a change from the previous timeline, which set no deadline for the end of the review process. For more on the FDA’s premarket review process for e-cigarettes, see the Public Health Law Center’s factsheet, “Extensions and Epidemics: The FDA’s Gatekeeping Authority for E-Cigarettes.”

Prior to FDA “deeming”, a number of vape shops created their own e-liquid solutions onsite by mixing propylene glycol and vegetable glycerin with nicotine, flavors, or colors. Other shops allowed store staff to mix existing e-liquids to create new flavors onsite (e.g., mixing a chocolate flavored e-liquid with a strawberry e-liquid to create a new chocolate-strawberry flavor). Since the FDA regulations were signed, if a vape shop “mixes or prepares e-liquids or creates or modifies aerosolizing apparatus for direct sale to consumers for use in ENDS, the establishment fits within the definition of ‘tobacco product manufacturer’.” These tobacco product manufacturers are subject to more stringent regulations than vape shops that only sell pre-fabricated e-liquid solutions.

As of May 2016, FDA regulations now require all newly-deemed products to have health warnings that state, “WARNING: This product contains nicotine. Nicotine is an addictive chemical.” For products that do not contain nicotine at detectable levels, the warning is revised to read: “This product is made from tobacco.” E-liquid solutions that do not contain tobacco or nicotine, or are not derived from tobacco or nicotine, do not meet the definition of a “covered tobacco product” under the new FDA Deeming regulations, and they will not be required to carry an addiction warning. Some states also require health warnings or ingredient lists on e-liquid packaging, an approach which a 2014 public opinion poll showed two-thirds of adults support.[28]

In November 2018, the FDA announced their intention to create a new policy framework that would restrict the sale of any flavored electronic nicotine delivery system (ENDS) other than tobacco, mint, or menthol flavors to age-restricted retail locations only. This includes e-liquids, cartridge-based systems, and cig-a-like products. Vape shops or other age-restricted retail stores can still sell flavored e-cigarettes.  The FDA will also require that online sales include “heightened age verification.” While the FDA has not outlined was this should look like yet, the e-cigarette company Juul has begun to implement new standards of their own. On March 13, 2019, the FDA issued a draft compliance policy for flavored e-cigarettes and flavored cigars. However, FDA Commissioner Scott Gottlieb left his post the following month. In response to youth e-cigarette epidemic, on September 11, 2019, the Trump administration announced a future ban on the sale of flavored e-cigarettes, but final guidance from the FDA, issued January 2, 2020, only prohibits the sale of flavored cartridge-based (closed system) e-cigarette products other than menthol or tobacco flavor and does not apply to e-liquids or popular disposable e-cigarettes like Puff Bar. No further federal action has been taken on flavored cigars or menthol cigarettes. 

Policy Options


Broadly written policies concerning e-cigarettes should not be exempt from regulations around advertising, marketing, and warning labeling, nor preempt strong regulations at the state or local levels.[25] For more information, review the following:

You can see what laws states across the U.S. have in place regarding e-cigarettes through the Public Health Law Center’s E-Cigarette Regulation: a 50 State Review or this Law Atlas map.

Youth Access

On December 20, 2019, federal legislation was signed into law raising the minimum legal sales age for tobacco products, including e-cigarettes from 18 to 21. nationwide. As with many policies, state action preceded federal action both with setting a minimum age for sale and in raising it to 21. In March 2010, New Jersey became the first state to ban the sale of e-cigarettes to minors. As of June 2019, 49 states and many communities had passed similar legislation. As states started to raise the minimum age to purchase tobacco products to 21, many states also included e-cigarettes in these restrictions. 

E-cigarette use among middle and high school students has surpassed use of any other tobacco product [29] A 2013-2014 study of high school age youth in Los Angeles, CA found that youth who had previously tried e-cigarettes were more likely to later try other types of tobacco products including cigarettes, cigars, or hookah than youth who had not tried e-cigarettes.[30] A 2014 public opinion poll found that over 70% of adults support policies prohibiting the sale and marketing of e-cigarettes to youth.[31] Similar to strategies used to curtail youth access to conventional tobacco products, restrictions could include limiting self-service access of e-cigarettes, or prohibiting the placement of e-cigarettes near candy/toys. Currently, federal legislation banning cigarette self-service displays do not apply to e-cigarettes. As of 2015, 38% of states had banned self-service displays for e-cigarettes, and some cities and counties have as well. Review ChangeLab Solutions’ model self-service display ordinance for more information.

Of note, Juul e-cigarettes have become increasingly popular with youth as they are easily concealed and look similar to a USB stick. While only introduced in the U.S. in 2015, they quickly captured the large majority of the market share, ending 2018 with 76% of the market. However, since the FDA’s January 2020 rule prohibiting the sale of flavored cartridge-based products like Juul, youth use of Juul is declining as youth switch to products that are still allowed to be flavored, including flavored disposable e-cigarettes like PuffBar and Smok. Learn more about youth use of e-cigarettes here:


flavored e-liquid

Another option for restricting the availability of e-cigarettes is to place restrictions on flavored products, which have a strong youth appeal. The 2009 Tobacco Control Act banned flavored cigarettes, but other tobacco products, including e-cigarettes, can still be flavored. In November 2018, the FDA announced their intention to restrict the sale of flavored electronic nicotine delivery system products (including e-liquids, cartridge-based systems and cig-a-likes) other than tobacco, mint and menthol, to age-restricted (18+) locations. On March 13, 2019, the FDA issued a draft compliance policy for flavored e-cigarettes and flavored cigars. However, FDA Commissioner Scott Gottlieb left his post the following month. In response to youth e-cigarette epidemic, on September 11, 2019, the Trump administration announced a future ban on the sale of flavored e-cigarettes, but final guidance from the FDA, issued January 2, 2020, only prohibits the sale of flavored cartridge-based (closed system) e-cigarette products other than menthol or tobacco flavor. With products like flavored disposable e-cigarettes left on the market, data from the Truth Initiative shows youth are switching from products like JUUL to products like PuffBar and Smok. No further federal action has been taken on flavored cigars or menthol cigarettes. 

In November 2019, Massachusetts became the first state to prohibit the sale of flavored e-cigarettes along with all other flavored tobacco products, including menthol cigarettes. Numerous localities around the country have restricted the sale of flavored tobacco/liquid nicotine products, initially near schools and/or limiting their sale to adult-only establishments. In 2018, San Francisco became the first major metropolitan area to comprehensively prohibit the sale of any flavored tobacco product without exception within city limits. 

The states of  New Jersey and Rhode Island have also passed policies that prohibit the sale of any flavored e-cigarette product. 

You can review ChangeLab Solutions’ model ordinance and the following resources from the Public Health Law Center for more information on flavor bans:


E-cigarettes also introduced a new health risk to children: the accidental ingestion of e-cigarette liquids. Between 2011 and 2014, poisoning cases related to e-cigarettes increased tenfold, with 3,638 e-cigarette-related calls to poison control centers in 2014. In response, the federal Child Nicotine Poisoning Prevention Act, signed into law in January 2016, requires all liquid nicotine containers used for e-cigarettes and other vaping devices to be sold in child-resistant packaging. For more information, review the following resource: Public Health Law Center’s “Policy Approaches to Prevent Liquid Nicotine Poisonings” 


Many states and localities have begun incorporating vape shops and e-cigarette retailers into their tobacco retailer licensing ordinances. As of September 30, 2016, 14 states passed legislation requiring licensing for over-the-counter sales of e-cigarettes. As of June 15, 2019, 26 states require a license for retail sales of e-cigarettes or e-liquid (either over-the-counter, in vending machines, or online).

Licensing e-cigarette retailers can also help reduce e-cigarette use. In states that license e-cigarette retailers, the odds of adult e-cigarette use were significantly lower that in states without licensing.[45] Another study assessing the impact of state e-cigarette regulations on prevalence of use found that when licensing was established, 18-24-year-olds were 6% less likely to initiate e-cigarette use.[46] In California localities that had a strong tobacco retailer license, a 2014 study showed that youth were 26% less likely to initiate e-cigarette use and 55% less likely have become a current e-cigarette user over the course of 1.5 years compared to localities that had no licensing law or did not have a licensing fee high enough to cover the costs of enforcement.[32] Another study found that in Pennsylvania, youth e-cigarette use dropped significantly following the implementation of licensing for e-cigarette retailers.[33]

Licensing can also be used as a tool to reduce retailer density. A 2014 study in New Jersey found that rates of both ever and past-month e-cigarette use were higher among students in schools located in an area with greater e-cigarette retail density.[34]

One additional option that some localities have pursued is to temporarily prohibit vape shops from starting a business in their city limits (e.g., institute a 90 day moratorium) until further research is presented to policymakers for them to develop a policy. For example, Hayward, CA and Union City, CA used a temporary moratorium  to consider instituting a comprehensive regulation of tobacco products and electronic smoking devices. As a result, new vapor/e-cigarette bars and lounges are prohibited from opening within city limits.

Story from the Field: Licensing E-Cigarette Retailers and Vape Shops

In April 2016, the Washington state legislature adopted rules to create a statewide licensing system for businesses that sell and distribute “vapor products,” including liquid nicotine.  The state estimates that approximately 6,000 retailers will be affected by the new licensing rules, along with roughly 150 “vapor products” distributors. The rules, which are expected to take effect in fall 2016, require retailers to obtain a separate license to sell “vapor products” online. In addition, many local communities have adopted their own licensing and permit requirements for e-cigarette retailers and vape shops. For example, San Marcos, California, recently passed an ordinance requiring any shop that sells tobacco products, including e-cigarettes and related devices, to purchase a city-issued “tobacco retail license.”  The city partnered with the San Marcos Prevention Coalition and the Vista Community Clinic, which conducted surveys of local e-cigarette retailers and vape shops and determined that a number of businesses were selling these products to minors in violation of state law.  San Marcos plans to use the tobacco license fees (roughly $190 per establishment) to ensure that businesses are complying with tobacco control regulations, including restrictions on selling to underage users. Read more. 

Restrict Advertising, Particularly Towards Youth

Exposure to ads triggers cravings for traditional cigarettes among current smokers and reduced intentions to remain abstinent among former smokers.[35]

The Federal Cigarette Labeling and Advertising Act prohibits states and communities from regulating the marketing and sale of cigarettes, but this law does not apply to other non-cigarette tobacco products like e-cigarettes. While this may be an option, advertising restrictions may face legal challenges related to commercial speech. Consult legal counsel and review the following resources from the Public Health Law Center for more information:

The report, “Gateway to Addiction? A Survey of Popular Electronic Cigarette Manufacturers and Targeted Marketing to Youth,” found major e-cigarette companies take part in marketing strategies that target youth through promotional activities like sponsorships or free samples at youth-oriented events and TV ads. However, a study by the Truth Initiative found youth awareness of e-cigarette advertisements to be highest at retail locations such as convenience stores, gas stations, and supermarkets. A randomized, controlled trial found that young adults (who had never tried an e-cigarette) exposed to e-cigarette advertisements had greater curiosity about, and were twice as likely to have tried e-cigarettes six later, when compared with young adults who were not exposed to e-cigarette advertisements.[36] Similarly, a study of Scottish youth found that those who recalled seeing e-cigarettes in retail settings were nearly twice as likely to have tried an e-cigarette, and also more likely to report intentions to try them within the next six month.[37]  Another study of over 2,000 youth, ages 12-17, and 2,000 young adults, ages 18-29, found that, compared to those who could not recall exposure to ENDS marketing in the retail environment, youth and young adults who were able to recall exposure to ENDS marketing at the POS had 1.99 and 1.30 times the odds, respectively of initiating ENDS use up to 2.5 years later.[42]

A 2014 study in New Jersey found higher rates of e-cigarette use among youth who attend schools located in areas with higher amounts of advertising for e-cigarettes within a half-mile compared to those in schools with less advertising nearby. [38]  Some studies have also shown youth exposed to e-cigarette ads were also more likely to later try combustible tobacco products like cigarettes and cigars. [39]


E-cigarettes are not taxed as tobacco products at the Federal level, which makes the disposable and less advanced e-cigarettes cheaper than conventional cigarettes. However, 30 states  have taken initiative to create policies at the state level as of June 2021. At the forefront of the issue, several questions arise on whether the tax should apply to e-liquid solutions, devices, cartridges, and/or component parts and accessories; be applied at the retail or wholesale level; at the state or local level; and what type of tax (e.g. specific, ad volorem, or a combination) is most effective. Some, including California, Minnesota, and Pennsylvania, and D.C. tax e-cigarettes on a percentage of the wholesale price in order to apply across a wide variety of products and sizes, while others, including Delaware, North Carolina, Kansas, Louisiana, and West Virginia tax per milliliter of nicotine liquid. Some local governments have also implemented taxes on e-cigarette products. For example, Chicago taxes by unit and volume: $0.80 per product unit, plus an additional $0.55 per mL liquid. 

Review the Public Health Law Center’s resource Taxing E-Cigarette Products for more information.

Price Promotions

The tobacco industry also uses prices, promotions, and coupons to make e-cigarettes cheaper to the consumer. States and communities may consider restricting or prohibiting coupon redemption and other price promotions such as buy-one-get-one-free offers. Like other tobacco products, e-cigarette sales are responsive to price changes. When prices of both disposable and reusable e-cigarettes increase, sales decrease.[40] Providence, RI enacted an ordinance banning coupon redemption and multipack offers for tobacco products. While the tobacco industry challenged the ordinance on First Amendment and preemption grounds, the ordinance was upheld by a Federal district court.

Review the following resources from the Public Health Law Center to learn more about restricting price promotions. While e-cigarettes are not specified in these resources, similar strategies may be used. is a project of Counter Tools. Counter Tools (logo)