Youth and Regulations


How does electronic cigarette access affect adolescent smoking?

Abigail S. Friedman
Published online: Dec 2015

Abstract: “Understanding electronic cigarettes’ effect on tobacco smoking is a central economic and policy issue. This paper examines the causal impact of e-cigarette access on conventional cigarette use by adolescents. Regression analyses consider how state bans on e-cigarette sales to minors influence smoking rates among 12 to 17 year olds. Such bans yield a statistically significant 0.9 percentage point increase in recent smoking in this age group, relative to states without such bans. Results are robust to multiple specifications as well as several falsification and placebo checks. This effect is both consistent with e-cigarette access reducing smoking among minors, and large: banning electronic cigarette sales to minors counteracts 70 percent of the downward pre-trend in teen cigarette smoking for a given two-year period.” 


The influence of electronic cigarette age purchasing restrictions on adolescent tobacco and marijuana use

Michael F. Pesko, Jenna M. Hughes, Fatima S. Faisal
Published online: Jun 2016

Conclusion: “We document a concerning trend of cigarette smoking among adolescents increasing when ENDS become more difficult to purchase.”


E-cigarette minimum legal sale age laws and traditional cigarette use among rural pregnant teenagers

Michael F. Pesko, Janet M. Currie
Published online: Jul 2019

Teenagers under 18 could legally purchase e-cigarettes until states passed minimum legal sale age laws. These laws may have curtailed teenagers’ use of e-cigarettes for smoking cessation. 

These results suggest that the laws reduced cigarette smoking cessation during pregnancy rather than causing new cigarette smoking initiation. Our results may indicate an unmet need for assistance with smoking cessation among pregnant teenagers.


Perverse Psychology How Anti-Vaping Campaigners Created the Youth Vaping “Epidemic”

Michelle Minton
Published online: 15 Jun 2020

It is reasonable for anti-tobacco advocates to worry about youth experimentation with nicotine, but the evidence is clear that their interventions have backfired and made the problem worse. Their attempts to dissuade teenagers from vaping increased their awareness of the behaviour, made it more attractive, and convinced them that everyone around them was doing it.

Anti-tobacco advocates argue that the government can end the “epidemic” by raising the minimum tobacco age to 21, banning non-tobacco e-cigarette flavors, and increasing funding for anti-vaping education. But, as this paper has demonstrated, these measures will not only fail, they will actually make matters worse by increasing the coolness of vaping and youth attraction to it.

Teen vaping did not escalate despite the increased anti-vaping messaging. Adolescents’ curiosity and subsequent experimentation with vaping rose because of anti-vaping messaging.


The Impact of Banning Electronic Nicotine Delivery Systems on Combustible Cigarette Sales: Evidence From US State-Level Policies

Yingying Xu, PhD, MSc; Lanxin Jiang, MPH; Shivaani Prakash, PhD, MSc; Tengjiao Chen, PhD, MPP, MSc
Published online: 5 Mar 2022
  • In the fall of 2019, several US states passed short-term bans on the sale of electronic nicotine delivery systems (ENDS) in response to an outbreak of illnesses strongly linked to tetrahydrocannabinol vaping products that received national news coverage. This study assessed how such state-level ENDS bans in 3 US states may have affected cigarette sales.
  • Cigarette sales in states banning ENDS were significantly higher than would have been observed otherwise. A full ban on ENDS was associated with increased cigarette sales of 7.5% in Massachusetts. Banning non-tobacco flavored ENDS was associated with a 4.6% increase in cigarette sales.
  • This study provides new evidence that banning ENDS was associated with increased cigarette sales using commercial sales data. Our results highlight and quantify potential unintended consequences of ENDS sale restrictions, which should be considered in the future as part of public health impact analyses of such policies.