States With Strict Tobacco Regulations Have Lower Incidence of E-Cigarette Users

States that implement strict laws to limit smoking in public areas and add heavy taxes on cigarettes have a lower rate of not only cigarette users, but also e-cigarette users, according to a report from NYU School of Medicine and the NYU College of Global Public Health.

“Our research adds to the understanding of the geographic and sociodemographic factors underlying e-cigarette use within the existing tobacco control environment,” Omar El-Shahawy, MD, MPH, PhD, a postdoctoral fellow in the Department of Population Health at NYU School of Medicine and the study’s lead author, said in a statement.

On a global level, recent control efforts by governments have decreased the cultural trend of cigarette smoking. Smoke-free air laws, cigarette taxes, increasing the availability of smoking cessation medications and counseling are regulations countries and states have implemented to improve public health. Organizations like the American Heart Association have advocated for smoke-free air laws in the United States to limit the ability of cigarette users to smoke in public.

E-cigarette use has skyrocketed over the past few years, and the study published in Nicotine & Tobacco Research analyzed the trends among state-level e-cigarette use and tobacco control policies. Data from the American Lung Association’s State of Tobacco Control reports from 2013 and 2014 were used to evaluate tobacco control policies and e-cigarette rates.

The 2012-2013 and 2013-2014 National Tobacco Survey, a telephone survey of over 60,000 American adults, was also used to measure the prevalence of smoking and vaping in a participant’s lifetime.

From the collected data, researchers found that over 16% of US adults have tried e-cigarettes. Of this population, one-third were current e-cigarette users. The findings also show that cigarette smoking is more than 3 times prevalent than vaping in the US.

States with stronger smoking regulations tended to have lower rates of cigarette smoking and vaping.

E-cigarette use was higher in western and southern states compared to eastern states, with the highest prevalence in Oklahoma at 10.3% and the lowest in Delaware at 2.7%.

At 26.1%, West Virginia had the highest prevalence of cigarette use and Utah had the lowest with 10.7%.

“Several decades of research on traditional cigarettes guided the existing tobacco control environment. E-cigarettes are relatively new and constantly evolving, which makes the FDA’s task in regulating them very challenging,” stated El-Shahawy. “There are still many unknowns pertaining to the role of e-cigarette in tobacco control. Until this ongoing debate is settled, tobacco control advocates and policy makers should continue focusing on enforcing the existing tobacco control interventions and regulatory framework.”