Associations between e-cigarette policies and adolescent use and access to e-cigarettes

Area of Science:

• Public Health
• Adolescent Health
• Tobacco Control Research

Background:

• Adolescent e-cigarette use is rising, prompting policy adaptations.
• Existing tobacco control policies face challenges in restricting youth access to e-cigarettes.

Purpose of the Study:

• To examine the impact of state-level e-cigarette policies on adolescent use and access.
• To assess the differential effects of Minimum Legal Sales Age (MLSA) laws, taxes, and smoke-free legislation.

Main Methods:

• Analysis of 2015-2019 Youth Risk Behavior Survey data from 503,154 adolescents (ages 14-18) across 40 states.
• Utilized two-way fixed effects probit regression to model associations between policies and e-cigarette use/access.
• Examined interactions between age and policy implementation, including short-term and longer-term effects (≥1 year post-implementation).

Main Results:

• MLSA laws showed initial increases in use but no significant long-term effect; they decreased in-store purchases but increased peer acquisition, especially among 18-year-olds.
• E-cigarette taxes significantly decreased adolescent use but had limited impact on access.
• Smoke-free legislation initially increased use but led to decreased use long-term; effects on purchase location varied by age.

Conclusions:

• Understanding policy consequences is crucial for effective adolescent e-cigarette use reduction.
• Addressing adolescent access to e-cigarettes is vital, as they will seek alternative sources if supply-side policies are insufficient.