Patterns, clusters, and transitions in U.S. state ENDS policy implementation: 2010-2020.

Area of Science:

• Public Health
• Health Policy
• Tobacco Control

Background:

• Electronic nicotine delivery systems (ENDS), including e-cigarettes, have seen a global rise in use.
• Governments worldwide are implementing policies to address public health concerns related to vaping.
• Understanding the landscape of ENDS policy implementation is crucial for effective public health strategies.

Purpose of the Study:

• To analyze patterns, clustering, and temporal transitions in U.S. state-level ENDS policy implementation from 2010 to 2020.
• To identify common policy bundles and trajectories of policy adoption across states.
• To provide insights into the uneven geographical and temporal development of ENDS regulations.

Main Methods:

• Analysis of ENDS and tobacco policy data from 2010-2020 for all 50 U.S. states and Washington D.C.
• Assessment of policy patterns and clusters using data primarily from Americans for Nonsmokers' Rights Foundation (ANRF).
• Modeling of latent trajectories for ENDS policy implementation across states over time.

Main Results:

• ENDS policies often mirrored existing tobacco control policies and were frequently implemented in policy bundles.
• Three distinct latent trajectories of ENDS policy implementation were identified across states.
• A majority of states acted as 'catch-up implementers,' increasing their policy adoption by 2020, irrespective of initial 2010 tobacco policies.

Conclusions:

• ENDS policy development in U.S. states has been characterized by temporal and geographical unevenness.
• The common practice of implementing policies in bundles has significant implications for policy evaluation methodologies.
• Despite initial disparities, many states demonstrated a trend towards comprehensive ENDS policy adoption by 2020.