Association for Public Policy Analysis & Management

Panel: A New Era of Tobacco Control Policy

(Health Policy)

Tobacco use remains the leading cause of disease and death in the United States. The recent introduction of e-cigarettes, followed by the increasing popularity of flavored cigars, has brought tremendous change to the US tobacco industry. National surveys indicate that, within a short time period, e-cigarette use has increased more than eightfold among middle and high school students, surpassing cigarettes as the most commonly used tobacco product among adolescents. In 2014, 13% of youth reported using e-cigarettes at some point over the past month, and 13% of adults had ever tried e-cigarette at least one time. In the same year, over 60% of current cigar users who were middle and high school students reported using flavored cigars. The increasing use of flavored e-cigarettes and cigars may be in part due to the federal law outlawing the sale of non-mentholated flavored cigarettes starting in 2009.

 

While cigarette use among youth continues to fall overall, the rapid growth in e-cigarette and cigar use has triggered government attention to regulating these alternative tobacco products. The first e-cigarette Minimum Legal Sales Age law was passed by New Jersey in 2010, and the number of states adopting a purchasing law grew until all states had laws in place by the end of 2016. Additionally, three states have raised the minimum purchasing age to 21 for all tobacco products. Seven states now tax e-cigarettes and nine states prohibit vaping inside bars, restaurants, and private workplaces. In the meantime, municipalities are passing laws to restrict the sale of flavored tobacco products.

 

What are the likely impacts of these regulations on public health? A study by the British government recently suggested that e-cigarettes are no more than 5% as harmful as conventional cigarettes. If e-cigarettes and conventional cigarettes are substitutes or e-cigarettes can help smokers quit, stricter regulations on e-cigarettes may inadvertently cause harm to public health if the regulations cause smoking to increase. However, if e-cigarettes and cigarettes are complements (as advocated by a “gateway” theory), greater regulations of e-cigarettes, especially targeted towards youth, could be justified. As nearly 80% of 12-17 year olds initiate tobacco with flavored options, tighter regulations to address flavored products could be warranted. Our session provides evidence on whether e-cigarettes serve as economic substitutes or complements to cigarettes, as well as providing evidence on the effects of flavor bans on cigar use among youth.

 

The organized session contains four papers, and each paper will be discussed by one of two discussants. One study evaluates the effect of banning legal sales of e-cigarettes to minors on youth demand for cigarettes, marijuana, and alcohol. A second study evaluates the effects of indoor vaping restrictions on prenatal smoking and birth outcomes. A third study estimates the potential impact on smokers’ and recent quitters’ demand for cigarettes and e-cigarettes if the FDA’s recent proposal to ban flavors from e-cigarettes comes into effect. A fourth study estimates the policy impact of banning flavors from small cigars and smokeless tobacco on consumer tobacco product use and consumer welfare.