Forty states have prohibited the sales of electronic nicotine delivery systems to minors, leaving 16 million children legally able to purchase e-cigarettes and other devices, the Centers for Disease Control and Prevention reported Dec. 12.

Texas, Pennsylvania, and Michigan are the largest of the 11 states (including the District of Columbia) that allow minors to purchase electronic nicotine delivery systems (ENDS), which include – in addition to e-cigarettes – electronic hookahs, electronic cigars, and vape pens, according to the CDC (MMWR 2014;63:1145-50). ENDS are battery-powered devices that deliver aerosolized nicotine and additives to the user, and “use in public indoor areas might passively expose bystanders” to same.

Of the 40 states with laws preventing sales to minors, only two (New Jersey and Utah) have laws prohibiting indoors ENDS use in private work sites, restaurants, and bars. One state, North Dakota, prohibits ENDS use indoors but does not restrict sales to minors, data from the CDC’s State Tobacco Activities Tracking and Evaluation System show.

“The relatively rapid adoption of laws prohibiting ENDS sales to minors, compared with the slow adoption of laws prohibiting ENDS use in public indoor spaces, might be attributable, in part, to the tobacco industry, which has actively advocated for state legislation to prevent minors from purchasing ENDS,” the CDC report noted.