Association for Public Policy Analysis & Management

Since 2016, e-cigarette use has increased dramatically in many countries. The prevalence of past 30 day e-cigarette use is upwards of 20% amongst youth in Canada and the US. Millions of adult combustible cigarette smokers have tried e-cigarettes, some have successfully quit combustibles, many co-use e-cigarettes and combustibles and many return to exclusive combustible smoking.

Countries and regional governments (states, provinces, and municipalities) have responded to the rise in e-cigarette use in substantially different ways including, for example, outright bans, bans on nicotine e-cigarettes, restrictions on nicotine concentrations, flavor bans and marketing restrictions. There are also several examples of policy reversals, for example on marketing restrictions. Yet, these widely varying policy approaches draw on the same evidence base about the potential benefits and harms of e-cigarettes.

What then explains why jurisdictions are arriving at different solutions to solve what apparently are similar policy problems. Using the multiple streams framework, this paper examines differences and changes over time in the perceptions of the e-cigarette problem, the feasibility and effectiveness of alternative solutions in different places and over time and in the political climate.