(CNN) – Although sales of tobacco products have been restricted in hundreds of US municipalities, a new study highlights some loopholes that allow children to circumvent regulations online to buy e-cigarettes.

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

In 2020, The Prevention of Online Sales of E-Cigarettes to Children Act banned e-cigarettes and vaping products from being shipped through the United States Postal Service and introduced an ID scan requirement to accept deliveries. Although sales of flavored tobacco products have been restricted in eight states and in nearly 400 cities or counties, these regulations do not fully cover e-commerce or online shopping.

For the study, published Monday in the journal JAMA Network Open, researchers analyzed attempts to purchase flavored nicotine vaping products from 78 websites and have them delivered to private homes. They found that among 105 deliveries, the delivery staff scanned the ID of the package recipient only once. The majority of products (78%) were delivered without interaction with delivery, 16% spoke to delivery personnel without ID verification, and only 5.7% were checked but not scanned.

The researchers reported that about 80% of the orders were delivered by USPS. About 8.8% of the products arrived from mail delivery couriers that had corporate policies restricting the shipment of tobacco.

To regulate these purchases, the researchers suggest “routine surveillance of online retailers,” which “may identify opportunities to strengthen the implementation of existing public health laws designed to reduce the sale of tobacco products to individuals 20 years of age and older.” years or less”.

In 2019, Congress raised the legal age for purchasing tobacco products from 6 to 9 p.m., including a requirement for retailers to verify photo ID. The study highlights how delivery staff may be breaking this rule, allowing underage customers a way around age restrictions.

“The age-limiting technology on these websites doesn’t actually work,” said Thomas Carr, director of national policy for the American Lung Association, who was not involved in the new study. “People won’t tell the truth when they come in their age and it’s remarkably easy for kids to get tobacco products in the mail. In brick-and-mortar stores, you have a clerk who could verify ID and actually look at the person, which you can’t do online.”

Tobacco companies have a history of deceptive marketing practicessays the American Lung Association. Carr noted that they create e-cigarette cartridges in a variety of candy or fruit flavors, such as blueberry, chocolate, strawberry or even breakfast cereal, to appeal to a younger audience.

More than 1 in 4 minors report using e-cigarettes daily, and most youth e-cigarette users prefer flavored products.

Although the US Food and Drug Administration has some ability to regulate tobacco and nicotine products in 2009 Family Smoking Prevention and Tobacco Control Actdelays in the legal process allowed tobacco companies to bypass lawmakers.

Experts agree that there is no “safe” form of smoking. E-cigarettes, vaporizers, and other e-tobacco products use a liquid solution that contains nicotinean infamously addictive substance that, when paired with the various fruity flavoring chemicals, makes quitting difficult. The e-cigarette aerosol solution also contains flavoring and various chemicals harmful liquid metals including cadmium, chromium, lead, manganese and nickel.

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

Carr said some policy changes could help restrict youth access to these products.

“Outright bans on tobacco sales, or states placing additional restrictions on how the products are delivered to people, can help make e-cigarettes more difficult to purchase,” he said. “Reducing the appeal of products can also help.”

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