Youth access to e-cigarettes and downtrends in combusted smoking

A major FDA research priority is understanding patterns of substitution between combusted and electronic tobacco products.  Currently available research suggests electronic products have much lower health risks than combusted products -- although they are not risk free. This suggests e-cigarettes could be welfare improving if people who otherwise would have smoked combusted products shift into e-cigarettes. Yet this potential gain may be offset if availability of novel electronic products having lower but non-negligible risks cause people to start using them who otherwise would not have smoked.

Important in this respect is effects of e-cigarettes on youth uptake of tobacco products. Although adolescent cigarette smoking has fallen consistently since the mid-1990s, use of e-cigarettes has increased sharply, causing overall use of tobacco products to rise. A recent study (Friedman, JHE) found that states that implemented early bans of sales of electronic cigarettes to minors saw their downtrends in cigarette smoking slow. This raises the possibility that FDA regulatory actions intending to limit youth access to e-cigarettes and reduce their appeal to youth could actually increase combusted smoking over what it would have been in the absence of regulation. 

This paper revisits Friedman’s finding using a different data source, different control variables, and different empirical measures of smoking; it also accounts for other tobacco-control policies related to e-cigarettes (notably, policies that extended smoke-free laws to include electronic products). Preliminary results suggest that findings using “past 30-day use” as the measure of smoking do not hold up when a “regular use” measure is used, and that slowing downtrends in combusted smoking in states with early sales bans were likely due to other factors. This undercuts the view that FDA regulation of electronic products could drive adolescent uptake of combusted cigarettes back up.