Associations Between County-Level Vape-Free Air Law Coverage and E-Cigarette Use Behaviors Among U.S. Adolescents in...

We examined whether workplace and hospitality vape-free air law (VAL) population coverage was associated with adolescent e-cigarette use and related disparities in the United States.

We analyzed associations between county-level workplace and hospitality VAL coverage (100% vs. <100%) and current e-cigarette use (2014-2022) and first e-cigarette initiation (2015-2022) among US 8th, 10th, and 12th graders using nationally representative, cross-sectional Monitoring the Future data. We implemented weighted, grade-stratified, modified Poisson regression models, adjusted for individual-, county-, and state-level confounding factors, examining disparities by sex, race and ethnicity, parental education, and college educational expectations through two-way interactions.

Workplace and hospitality VAL coverage was not associated with adolescent e-cigarette use or initiation overall. However, we did find that VAL coverage was associated with lower current e-cigarette use in some sociodemographic subgroups. Full (100%) hospitality VAL coverage was linked to lower e-cigarette use among male 8th and 12th graders, 12th graders with parents without a bachelor's degree, Hispanic 8th and 12th graders, and 8th and 12th graders of other races and ethnicities than their peers living in partially covered (<100%) counties. Full hospitality VAL coverage was linked to higher e-cigarette use among non-Hispanic Black 8th graders and non-Hispanic White 12th graders than their peers living in partially covered counties.

Though not linked to adolescent e-cigarette use behaviors overall, we found that male adolescents and adolescents from low socioeconomic status backgrounds were more responsive to VAL with associations by race and ethnicity depending on grade and subgroup.