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E-cigarette use among teens has declined recently, but still, more than 1.6 million middle and high school studentsreportedusing the products in the 2024 National Youth Tobacco Survey.

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In 2020, thePreventing Online Sales of E-Cigarettes to Children Actbanned e-cigarettes and vaping products from being shipped through the United States Postal Service and introduced an ID scan requirement to accept deliveries. Though the sales of flavored tobacco products have been restricted ineight statesand in nearly 400 cities or counties, these regulations don’t completely cover e-commerce or online shopping.

“We knew that there is a well-established system for monitoring brick-and-mortar retailers’ compliance with tobacco policies, but there is not one for online sales,” said Raquel Harati, the lead study author and a former research coordinator for the University of California, San Diego’s School of Public Health. “So we wanted to develop a method of systematically checking for compliance online.”

For the study,published Mondayin the journal JAMA Network Open, researchers looked at attempts to purchase flavored nicotine vaping products from 78 websites and have them delivered to private homes. They found that among 105 deliveries, delivery personnel scanned the package receiver’s ID only one time. Most of the products (78%) were delivered with no delivery interaction, 16% spoke with delivery personnel with no ID check, and only 5.7% had their ID checked but not scanned.

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“There is a federal law that very clearly states that USPS cannot be used to ship tobacco products but it is clearly still being used frequently,” Harati said. “Health experts should advocate for more routine compliance assessments among online retailers to prevent youth access. “The method our team used could, for example, be replicated monthly or yearly to monitor policy compliance for online stores.”

USPS said in a statement that the agency is working with other partners to “combat the illegal distribution of vaping products.”

“Under federal law, it is generally illegal to use the mails to fulfill retail orders of certain tobacco and vaping products. Certain noncommercial and business-to-business shipments may be allowed under conditions detailed in USPS regulations, but those permissions do not apply to e-commerce shipments (other than those entirely within Alaska or Hawaii),” USPS said in the statement.

In 2019, Congressraised the legal purchasing age for tobacco productsfrom 18 to 21, including a requirement for retailers to verify photo ID. The study highlights how delivery personnel may not be following this rule, allowing an avenue for underage customers to avoid age restrictions.

“Age-gating technology on these websites don’t actually work,” said Thomas Carr, director of national policy for the American Lung Association, who was not involved with the new study. “People will not tell the truth when they enter their age, and it’s remarkably easy for kids to get tobacco products mailed to them. At brick-and-mortar stores, you have a clerk who could check ID and actually look at the person, which you can’t do online.”

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Experts agree that there is no “safe” form of smoking. E-cigarettes, vapes and other electronic tobacco products use a liquid solution that containsnicotine, an infamously addictive substance that, when paired with the various fruity flavoring chemicals, makes it hard to quit. E-cigarette aerosol solution also contains flavoring chemicals and variousharmful liquid metalsincluding cadmium, chromium, lead, manganese and nickel.

“Young people are particularly susceptible to the addictive properties of nicotine,” Harati said. “Their brains are still developing and forming neural networks that regulate their emotions, and nicotine strongly impacts those networks.”

In August, the American Lung Association, the American Academy of Pediatrics and several other US health organizationsurged the FDA to actagainst these online loopholes, calling their failure to do so an “unlawful withholding of agency action.”

Carr and Harati both agreed that some policy changes could help restrict young people’s access to these products.

“Prohibiting tobacco sales completely, or states putting some more restrictions on how the products are delivered to people, can help make e-cigarettes harder to purchase,” he said. “Reducing the attractiveness of the products can help, too.”

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