and sold in the United States, which is considered a fourth generation device , most frequently contains an e-liquid with 59 milligrams per milliliter of nicotine. (8) In response, the European Union, the United Kingdom, and Israel implemented regulations to cap the concentration of nicotine in e-cigarette e-liquids to 20 milligrams per milliliter. (9) The United Kingdom’s nicotine cap went into effect on May 20, 2017. As youth use skyrocketed in the United States between 2017 and 2018, the percentage of youth e-cigarette users who use more than once a week only rose from 1.2 percent to 1.7 percent, and the percentage of youth who use less than weekly decreased from 2.2 percent to 1.8 percent. (10) E-cigarettes manufactured and sold in the United States are currently not subject to any nicotine cap, and e-cigarette manufacturers are permitted to design their products to be as addictive as possible. (11) According to the CDC, e-cigarette use rose by 78 percent among high schoolers and 48 percent among middle schoolers between 2017 and 2018. (12) Preliminary results from the CDC’s annual National Youth Tobacco Survey published in September 2019 show that 27.5 percent of high school students reported using an e-cigarette in the previous 30 days, up from 20.8 percent in 2018. (13) The CDC, the Food and Drug Administration, the Department of Health and Human Services, the Surgeon General of the Public Health Service, and various State and local health authorities have determined the skyrocketing e-cigarette use amongst American youth to be an “epidemic”. 3. Sense of Congress It is the sense of the Congress that— (1) effectively combating the youth e-cigarette epidemic will require the implementation of bold and enduring policy solutions