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Seidenberg AB, Braganza K, Chomas M, Diaz MC, Friedman AS, Phillips S, Pesko M. Coverage of Indoor Smoking and Vaping Restrictions in the US, 1990-2021. Am J Prev Med 2024:S0749-3797(24)00197-1. [PMID: 38876294 DOI: 10.1016/j.amepre.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 06/07/2024] [Accepted: 06/07/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION Secondhand smoke exposure increases the risk of premature death and disease in children and non-smoking adults. As a result, many U.S. states and local jurisdictions have enacted comprehensive indoor smoking restrictions (ISR). Indoor vaping restrictions (IVR) have also been adopted to protect against exposure to secondhand e-cigarette aerosol. This study aimed to quantify state and national U.S. coverage of policies restricting indoor cigarette and e-cigarette use over time. METHODS Data from the American Nonsmokers Rights' Foundation on U.S. ISR from 1990 to 2021 and IVR from 2006 to 2021 were analyzed. Combining these data with 2015 U.S. Census population estimates, the percentage of state and national residents covered by partial and comprehensive restrictions in bars, restaurants, and workplaces, were calculated (analysis in 2023-2024) over time. RESULTS Between 1990 and 2021, national coverage of comprehensive ISR increased for bars (0% to 67.3%), restaurants (0%-78.2%), and workplaces (0%-77.5%). Partial ISR coverage decreased for bars (14.8%-13.9%), restaurants (40.2%-15.4%) and workplaces (40.2%-22.5%). From 2006 to 2021, comprehensive IVR coverage increased for bars (0%-43.5%), restaurants (0%-51.5%), and workplaces (0%-53.2%). Despite these increases in coverage, by the end of 2021, <50% of the population was protected by comprehensive ISR for bars, restaurants, and workplaces in 19, 12, and 14 states, respectively. DISCUSSION The percentage of the U.S. population protected by ISR and IVR has increased over time. However, gaps in coverage remain, which may contribute to disparities in tobacco-related disease and death.
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Affiliation(s)
| | - Karl Braganza
- Truth Initiative Schroder Institute, Washington, District of Columbia
| | - Maxwell Chomas
- Georgia State University, Department of Economics, Atlanta, Georgia
| | - Megan C Diaz
- Truth Initiative Schroder Institute, Washington, District of Columbia
| | - Abigail S Friedman
- Yale School of Public Health, Department of Health Policy & Management, New Haven, Connecticut
| | - Serena Phillips
- University of Missouri, Department of Economics, Columbia, Missouri
| | - Michael Pesko
- University of Missouri, Department of Economics, Columbia, Missouri
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Vuolo M, Orsini MM, Staff J, Maggs JL, Kelly BC. Comprehensive vaping bans are associated with lower odds of initiation into electronic nicotine delivery systems use among young people. Addiction 2024; 119:1037-1047. [PMID: 38413382 DOI: 10.1111/add.16450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/06/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND AND AIMS E-cigarette and other electronic nicotine delivery systems (ENDS) use has grown considerably over the past decade, with notable increases among young people. US state policy contexts for ENDS and tobacco may shape initiation into ENDS use among adolescents as they age into early adulthood. We aimed to determine whether state-level comprehensive vaping ban policies reduce the odds of youth initiation into ENDS use, net of additional state-level ENDS and tobacco policies, as well as the youth's cigarette smoking status. DESIGN Longitudinal data from the Population Assessment of Tobacco and Health study were merged with a state-year database on tobacco and ENDS policies. Multivariable discrete-time event history models of ENDS initiation were estimated. SETTING United States. PARTICIPANTS Twenty thousand twelve youth assessed over six waves from 2013 to 2019 (n = 53 974 observations). MEASUREMENT We examined comprehensive indoor vaping bans (i.e. 100% vape-free workplaces, restaurants and bars) as a key factor in initiation into ENDS use (i.e. first instance of vaping) from age 13 to 22. FINDINGS Among young people, residing in a state with a comprehensive vaping ban was associated with 18% lower odds of ENDS initiation (odds ratio = 0.82; 95% confidence interval =[0.71, 0.94]), even after controlling for other state ENDS and tobacco policies, the youth's cigarette smoking and socio-demographic background and state-level covariates. CONCLUSIONS In the United States, state-level vaping bans (i.e. 100% vape-free workplaces, restaurants and bars) are associated with reduced odds of youth initiation into electronic nicotine delivery systems use.
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Affiliation(s)
- Mike Vuolo
- Department of Sociology, The Ohio State University, Columbus, OH, USA
| | - Maria M Orsini
- Department of Sociology, The Ohio State University, Columbus, OH, USA
| | - Jeremy Staff
- Department of Sociology and Criminology, The Pennsylvania State University, University Park, PA, USA
| | - Jennifer L Maggs
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Brian C Kelly
- Department of Sociology, Purdue University, West Lafayette, IN, USA
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He Y, Liber A, Driezen P, Thompson ME, Levy DT, Fong GT, Cummings KM, Shang C. How do users compare the costs between nicotine vaping products and cigarettes? Findings from the 2016-2020 International Tobacco Control United States surveys. Addiction 2024; 119:885-897. [PMID: 38186201 PMCID: PMC11009094 DOI: 10.1111/add.16425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/23/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND AND AIMS Nicotine vaping products (NVPs) can potentially help adult tobacco users quit smoking. This study evaluated how adult consumers compare the costs between NVPs and cigarettes. METHOD We used data from the US arm of the 2016-2020 International Tobacco Control Four Country Smoking and Vaping (ITC 4CV) surveys to perform a multinomial logit model with two-way fixed effects to measure how perceived cost comparisons are associated with NVP and cigarette taxes, use patterns, NVP device types and individual sociodemographic factors. RESULTS Higher cigarette taxes are associated with a greater likelihood of perceiving NVPs and cigarettes as costing the same for the overall population and among people who exclusively smoke, and a lower likelihood of perceiving NVPs as more expensive among people who exclusively vape, compared with lower cigarette taxes. Pre-filled cartridge and tank users are more likely to perceive NVPs as less expensive than cigarettes, compared with people who use other types of NVPs. The associations between taxes and perceived cost comparison were more pronounced among males, younger and low-income populations. CONCLUSIONS Higher cigarette taxes are associated with perceived financial incentives for nicotine vaping products (NVPs) over cigarettes, whereas NVP taxes are not associated with perceived cost comparison between NVPs and cigarettes.
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Affiliation(s)
- Yanyun He
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Alex Liber
- Department of Oncology, School of Medicine, Georgetown University, Washington, DC, USA
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Mary E. Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - David T. Levy
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Ce Shang
- Department of Internal Medicine, Medical Oncology Division, The Ohio State University, Columbus, OH, USA
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Ma S, Yang Q, Ahn S, Park H, He Y, Bridges JFP, Shang C. Cost Comparison and Spending on Tobacco Products: Evidence from A Nationally Representative Sample of Adult E-Cigarette Users. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.03.24305296. [PMID: 38633785 PMCID: PMC11023667 DOI: 10.1101/2024.04.03.24305296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Background Over 20 states and local jurisdictions in the U.S. have imposed e-cigarette taxes. It is important to evaluate how adult vapers, including those who also smoke respond to e-cigarette taxation. The purpose of this study is to examine factors associated with adult vapers' cost perception of e-cigarettes relative to cigarettes and budget allocations between two products. Methods We recruited a nationally representative sample of 801 adult e-cigarette users in the U.S., who participated in an online survey in April and May 2023. Nested-ordered logit models and ordinary least squares regressions were used in the analysis. Results On average, monthly e-cigarette spending was $82.22, and cigarette spending was $118.77 among dual users. Less frequent e-cigarette use and higher state-level e-cigarette taxes were associated with perceiving smoking as cheaper than vaping. Age and exclusive use of tank systems were associated with perceiving vaping as cheaper than smoking. Exclusive use of tank systems was also associated with lower e-cigarette spending. Adults who used e-cigarettes more frequently preferred to report weekly budget on e-cigarettes ( p < 0.01), and among dual users, everyday smokers preferred to report weekly (versus monthly) budget on cigarettes compared to someday smokers ( p < 0.001). Conclusion Among US adult vapers, frequencies of tobacco use and e-cigarette device type are closely related to cost measures; and e-cigarette taxes are associated with cost perception of e-cigarettes relative to cigarettes, suggesting potential financial disincentive for vaping. Policymaker may consider imposing differential taxes by e-cigarette product types due to their different costs to consumers.
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He Y, Fong GT, Cummings KM, Hyland A, Shang C. The association between excise taxes and smoking and vaping transitions-Findings from the 2016-2020 ITC United States surveys. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 126:104372. [PMID: 38422713 PMCID: PMC11200209 DOI: 10.1016/j.drugpo.2024.104372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND While a growing number of studies examined the effect of e-cigarette (EC) excise taxes on tobacco use behaviors using cross-sectional surveys or sales data, there are currently no studies that evaluate the impact of EC taxes on smoking and vaping transitions. METHODS Using data from the US arm of the 2016-2020 International Tobacco Control Four Country Smoking and Vaping Survey (ITC 4CV), we employed a multinomial logit model with two-way fixed effects to simultaneously estimate the impacts of cigarette/EC taxes on the change in smoking and vaping frequencies. RESULTS Our benchmark model suggests that a 10 % increase in cigarette taxes led to an 11 % reduction in smoking frequencies (p < 0.01), while EC taxes did not have a significant effect on smoking frequencies. CONCLUSION Our findings suggest that increasing cigarette taxes may serve as an effective means of encouraging people who smoke to cut back on smoking or quit smoking. The impact of increasing EC taxes on smoking transitions is less certain at this time.
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Affiliation(s)
- Yanyun He
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada; School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Andrew Hyland
- Department of Health Behaviors, Division of Cancer Prevention and Population Sciences, Roswell Park Comprehensive Cancer Center, USA
| | - Ce Shang
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Internal Medicine, Medical Oncology Division, The Ohio State University, Columbus, OH, USA
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Friedman AS, Pesko MF. Tobacco 21 Laws and Youth Tobacco Use: The Role of Policy Attributes. Am J Public Health 2024; 114:90-97. [PMID: 38091563 PMCID: PMC10726938 DOI: 10.2105/ajph.2023.307447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Objectives. To estimate Tobacco-21 policies' relationships to 18- to 20 year-old youth cigarette, cigar, and electronic nicotine delivery system (ENDS) use, and to test for effect modification by policy attributes. Methods. In fall 2022, we used Tobacco 21 Population Coverage Database data to calculate the percentage of state residents covered by state or local Tobacco 21 (T21) laws monthly through June 2020. Matching T21 coverage to Population Assessment of Tobacco and Health and Behavioral Risk Factor Surveillance System data, we used 2-way fixed effect analyses to assess the relationship between T21 laws and 18- to 20-year-old youth cigarette, cigar, and ENDS use, and tested for differences by policy attributes: possession, use, or purchase (PUP) penalties, retailer noncompliance penalties, and compliance check requirements. Results. Increased T21 exposure yielded significant reductions in cigarette and cigar use, as well as in ENDS use, when accounting for policy attributes. These effects were dampened in T21 laws with PUP penalties relative to those without. Conclusions. Tobacco-21 laws yield reductions in 18- to 20-year-old youth cigarette, cigar, and ENDS use, with dampened effects when policies include PUP penalties. Public Health Implications. State policymakers should consider implementing T21 laws without PUP penalties to reduce underage nicotine and tobacco use. (Am J Public Health. 2024;114(1):90-97. https://doi.org/10.2105/AJPH.2023.307447).
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Affiliation(s)
- Abigail S Friedman
- Abigail S. Friedman is with the Department of Health Policy and Management, Yale School of Public Health, Yale University, New Haven CT. Michael F. Pesko is with the Department of Economics, University of Missouri, Columbia
| | - Michael F Pesko
- Abigail S. Friedman is with the Department of Health Policy and Management, Yale School of Public Health, Yale University, New Haven CT. Michael F. Pesko is with the Department of Economics, University of Missouri, Columbia
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Kelly BC, Vuolo M, Orsini MM, Maggs JL, Staff J. Tobacco Policy and ENDS Policy Influences on Adolescent Vaping Across the U.S. States. Am J Prev Med 2023; 65:1026-1033. [PMID: 37482258 PMCID: PMC10799971 DOI: 10.1016/j.amepre.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
INTRODUCTION Although the use of tobacco has declined among youth, ENDS has the potential to disrupt or reverse these trends. Policies for tobacco and ENDS may have an impact on adolescent ENDS use. The impacts of state-level policies were examined for both tobacco and ENDS indoor use bans, excise taxes, and age-of-purchase laws on past-month adolescent ENDS use from 2013 to 2019. METHODS This study used cohort data from the Population Assessment of Tobacco and Health study and policy data from the Americans for Nonsmokers' Rights Foundation repository-3 policies for ENDS and 2 policies for tobacco products. Policies included comprehensive indoor vaping/smoking bans, purchase-age restrictions, and excise taxes. Hybrid panel models were estimated in 2022 using data merged from the 2 longitudinal sources on past-month vaping. The analytic sample (observations=26,008) included adolescents aged 12-17 years, yielding a total of 72,684 observations. RESULTS The odds of adolescent ENDS use were 21.4% lower when the state had an ENDS purchase-age restriction and 55.0% lower when the state had a comprehensive tobacco smoking ban than in the years when the state did not have the ban. CONCLUSIONS During a period of significant growth in ENDS use among U.S. youth, ENDS purchase-age restrictions and smoking bans reduced the odds of past-month vaping among adolescents. Wider implementation of policies may help intervene in youth vaping.
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Affiliation(s)
- Brian C Kelly
- Department of Sociology, College of Liberal Arts, Purdue University, West Lafayette, Indiana.
| | - Mike Vuolo
- Department of Sociology, College of Arts and Sciences, The Ohio State University, Columbus, Ohio
| | - Maria M Orsini
- Department of Sociology, College of Arts and Sciences, The Ohio State University, Columbus, Ohio
| | - Jennifer L Maggs
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, State College, Pennsylvania
| | - Jeremy Staff
- Department of Sociology and Criminology, College of Liberal Arts, The Pennsylvania State University, State College, Pennsylvania
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Maclean JC, Khan T, Tsipas S, Pesko MF. The effect of cigarette and e-cigarette taxes on prescriptions for smoking cessation medications. Health Serv Res 2023; 58:1245-1255. [PMID: 36271500 PMCID: PMC10622273 DOI: 10.1111/1475-6773.14088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To test the effect of cigarette and e-cigarette taxes on prescriptions for smoking cessation medications. DATA SOURCE Symphony Health, IDV all-payer prescription claims data for the United States over the period 2009-2017. Prescription fills for smoking cessation products were provided at the patient's age, patient's sex, brand/generic, payment type, year, and quarter levels. STUDY DESIGN We study the effect of state-level cigarette and e-cigarette tax rates on prescriptions for smoking cessation medications using two-way fixed effect modified difference-in-differences regressions. We also use a multiperiod difference-in-differences estimator robust to bias from dynamic and heterogeneous treatment effects with a staggered policy rollout. DATA COLLECTION/EXTRACTION METHODS We use fills for Chantix, Zyban, and their generics, as well as Food and Drug Administration-approved nicotine replacement therapies that are paid for by insurance. PRINCIPAL FINDINGS We observe no statistically significant change in prescription fills following an increase in the e-cigarette tax rate, though we are unable to rule out potentially large effects. However, following a $1.00 increase in the cigarette tax rate, we observe a 1052 increase in prescription fills per 100,000 adults (95% CI: 57, 2046; 4.2% increase). The effect of cigarette taxes on prescription fills was particularly large for 18-34 year-olds. CONCLUSIONS Our findings suggest that, during a period when e-cigarettes are widely available, cigarette tax increases remain effective in increasing use of these medications, but e-cigarette taxes do not increase use of these medications.
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Affiliation(s)
| | - Tamkeen Khan
- Improving Health OutcomesAmerican Medical AssociationChicagoIllinoisUSA
| | - Stavros Tsipas
- Improving Health OutcomesAmerican Medical AssociationChicagoIllinoisUSA
| | - Michael F. Pesko
- Andrew Young School of Policy StudiesGeorgia State UniversityAtlantaGeorgiaUSA
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Cohen JE. Broad range of research on e-cigarettes. Tob Control 2023; 32:e137-e138. [PMID: 37468153 PMCID: PMC10423542 DOI: 10.1136/tc-2023-058209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Affiliation(s)
- Joanna E Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Diaz MC, Donovan E, Tauras J, Stephens D, Schillo B, Phillips S, Chaloupka FJ, Pesko M. Effect of e-cigarette taxes on e-cigarette and cigarette retail prices and sales, USA, 2014-2019. Tob Control 2023:tc-2022-057743. [PMID: 37479474 DOI: 10.1136/tc-2022-057743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 07/05/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVE To use a standardised e-cigarette tax measure to examine the impact of e-cigarette taxes on the price and sales of e-cigarettes and cigarettes in the USA. DESIGN We used State Line versions of NielsenIQ Retail Scanner data from quarter 4 of 2014 through quarter 4 of 2019 to calculate e-cigarette and cigarette prices and sales in 23 US states. We then estimated how these outcomes are associated with standardised state-level e-cigarette taxes, controlling for state fixed effects, quarter-by-year fixed effects, cigarette taxes, other tobacco control policies and other state-level time-varying characteristics. RESULTS A real $1 increase in the e-cigarette standardised tax increases the price of 1 mL of e-liquid between $0.43 and $0.59 depending on specification. Controlling for fixed effects and cigarette taxes, a 10% increase in e-cigarette taxes is estimated to reduce e-cigarette sales by 0.5% and increase cigarette sales by 0.1%, though both results are attenuated and statistically insignificant in a model with full controls. CONCLUSIONS Our study finds that e-cigarette taxes increase e-cigarette retail prices by approximately half of the tax. Further, e-cigarette taxes are associated with reduced sales of e-cigarettes and increased sales of cigarettes in some specifications. Our estimates are sizably lower than from other studies using sales and survey data.
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Affiliation(s)
- Megan C Diaz
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | - Emily Donovan
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | - John Tauras
- Department of Economics, University of Illinois Chicago, Chicago, Illinois, USA
- Health Economics Program, National Bureau of Economic Research, Cambridge, Massachusetts, USA
| | | | | | - Serena Phillips
- Department of Economics, Georgia State University, Atlanta, Georgia, USA
| | - Frank J Chaloupka
- Institute for Health Research and Policy, University of Illinois, Chicago, Illinois, USA
| | - Michael Pesko
- Department of Economics, Georgia State University, Atlanta, Georgia, USA
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Azagba S, Ebling T, Adekeye OT, Hall M, Jensen JK. Loopholes for Underage Access in E-Cigarette Delivery Sales Laws, United States, 2022. Am J Public Health 2023; 113:568-576. [PMID: 36893366 PMCID: PMC10088963 DOI: 10.2105/ajph.2023.307228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 03/11/2023]
Abstract
Objectives. To comprehensively catalog and review state e-cigarette delivery sales laws as well as capture their scope and dimensions. Methods. We conducted an in-depth review to determine whether states had at least 1 form of e-cigarette delivery sales law. We coded laws for 5 key policy domains: (1) delivery terminology used in laws, (2) age verification requirements, (3) packaging label requirements, (4) permit or registration requirements, and (5) fines and penalties for violations. Results. Overall, 34 states had e-cigarette delivery sales laws with varying scopes and dimensions. In 27 states, these laws required at least 1 form of age verification requirements. We identified mandatory packaging labels in 12 states, and 7 states where permits were required. There were considerable differences among states on the scale of fines and penalties for violations. Conclusions. Our findings reveal extensive heterogeneity in e-cigarette delivery sales laws among states, particularly regarding the scope and dimensions of these laws. Public Health Implications. The mapping of e-cigarette delivery sales policies showed several potential loopholes that may diminish their effectiveness. (Am J Public Health. 2023;113(5):568-576. https://doi.org/10.2105/AJPH.2023.307228).
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Affiliation(s)
- Sunday Azagba
- Sunday Azagba, Todd Ebling, and Olayemi Timothy Adekeye are with the Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park. Mark Hall is with the Department of Social Science and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC. Jessica King Jensen is with the Department of Health and Kinesiology, University of Utah, Salt Lake City
| | - Todd Ebling
- Sunday Azagba, Todd Ebling, and Olayemi Timothy Adekeye are with the Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park. Mark Hall is with the Department of Social Science and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC. Jessica King Jensen is with the Department of Health and Kinesiology, University of Utah, Salt Lake City
| | - Olayemi Timothy Adekeye
- Sunday Azagba, Todd Ebling, and Olayemi Timothy Adekeye are with the Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park. Mark Hall is with the Department of Social Science and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC. Jessica King Jensen is with the Department of Health and Kinesiology, University of Utah, Salt Lake City
| | - Mark Hall
- Sunday Azagba, Todd Ebling, and Olayemi Timothy Adekeye are with the Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park. Mark Hall is with the Department of Social Science and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC. Jessica King Jensen is with the Department of Health and Kinesiology, University of Utah, Salt Lake City
| | - Jessica King Jensen
- Sunday Azagba, Todd Ebling, and Olayemi Timothy Adekeye are with the Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park. Mark Hall is with the Department of Social Science and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC. Jessica King Jensen is with the Department of Health and Kinesiology, University of Utah, Salt Lake City
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Diaz MC, Kierstead EC, Khatib BS, Schillo BA, Tauras JA. Investigating the Impact of E-Cigarette Price and Tax on E-Cigarette Use Behavior. Am J Prev Med 2023; 64:797-804. [PMID: 36841634 DOI: 10.1016/j.amepre.2023.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 02/27/2023]
Abstract
INTRODUCTION Although the relationship between tax and price and youth cigarette use is well established, little is known about these associations and youth e-cigarette use. This research examines U.S. youth sensitivity to changes in e-cigarette prices and tax using standardized measures of e-cigarette taxes and prices. METHODS This analysis uses national data on past 30-day use and the number of days using e-cigarettes (i.e., the intensity of use) from the repeat cross-sectional 2015-2019 Youth Risk Behavior Survey, in combination with inflation-adjusted standardized e-cigarette price and tax data to understand whether changes in e-cigarette price and tax were associated with changes in e-cigarette use. Two-part demand regression models controlling for demographics and e-cigarette restriction policies were conducted to calculate price and tax elasticities of demand, in addition to $0.50 and $1.00 price and tax increase simulations. RESULTS Increased e-cigarette prices and taxes were associated with significant reductions in past 30-day use. Prices were also significantly associated with decreases in the intensity of use. A $0.50 and $1.00 tax increase leads to a 6.3% and 12.2% decrease in past 30-day use and a 4.7% and 9.3% decrease in intensity, respectively. A $0.50 and $1.00 price increase leads to a 4.1% and 8.2% decrease in past 30-day use and a 4.2% and 8.3% decrease in intensity, respectively. CONCLUSIONS Higher prices and taxes reduce youth current e-cigarette use and days using e-cigarettes. Policies increasing e-cigarette prices, such as excise taxes, can reduce youth current e-cigarette use and days using e-cigarettes.
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Affiliation(s)
- Megan C Diaz
- Schroeder Institute, Truth Initiative, Washington, District of Columbia.
| | | | - Bushraa S Khatib
- Schroeder Institute, Truth Initiative, Washington, District of Columbia
| | - Barbara A Schillo
- Schroeder Institute, Truth Initiative, Washington, District of Columbia
| | - John A Tauras
- Department of Economics, College of Liberal Arts and Sciences, University of Illinois at Chicago, Chicago, Illinois; Health Economics Program, National Bureau of Economic Research, Cambridge, Massachusetts
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Abouk R, Courtemanche C, Dave D, Feng B, Friedman AS, Maclean JC, Pesko MF, Sabia JJ, Safford S. Intended and unintended effects of e-cigarette taxes on youth tobacco use. JOURNAL OF HEALTH ECONOMICS 2023; 87:102720. [PMID: 36565585 PMCID: PMC9879683 DOI: 10.1016/j.jhealeco.2022.102720] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/23/2022] [Accepted: 12/13/2022] [Indexed: 05/26/2023]
Abstract
Over the past decade, rising youth use of e-cigarettes and other electronic nicotine delivery systems (ENDS) has contributed to aggressive regulation by state and local governments. Between 2010 and mid-2019, ten states and two large counties adopted ENDS taxes. We use two large national surveys (Monitoring the Future and the Youth Risk Behavior Surveillance System) to estimate the impact of ENDS taxes on youth tobacco use. We find that ENDS taxes reduce youth ENDS consumption, with estimated ENDS tax elasticities of -0.06 to -0.21. However, we estimate sizable positive cigarette cross-tax effects, suggesting economic substitution between cigarettes and ENDS for youth. These substitution effects are particularly large for frequent cigarette smoking. We conclude that the unintended effects of ENDS taxation may considerably undercut or even outweigh any public health gains.
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Affiliation(s)
- Rahi Abouk
- Department of Economics, Finance, and Global Business, William Paterson University, Wayne, NJ, United States
| | - Charles Courtemanche
- Department of Economics, Gatton College of Business and Economics, University of Kentucky, Lexington, KY, United States; National Bureau of Economics Research, Cambridge, MA, United States; Institute for Labor Studies, Bonn, Germany
| | - Dhaval Dave
- National Bureau of Economics Research, Cambridge, MA, United States; Institute for Labor Studies, Bonn, Germany; Department of Economics, Bentley University, Waltham, MA, United States
| | - Bo Feng
- American Institutes for Research, Columbia, MD, United States
| | - Abigail S Friedman
- Department of Health Policy & Management, Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Johanna Catherine Maclean
- National Bureau of Economics Research, Cambridge, MA, United States; Institute for Labor Studies, Bonn, Germany; Schar School of Policy and Government, George Mason University, Arlington, VA, United States
| | - Michael F Pesko
- Institute for Labor Studies, Bonn, Germany; Department of Economics, Andrew Young School of Policy Studies, Georgia State University, Atlanta, GA, United States.
| | - Joseph J Sabia
- Institute for Labor Studies, Bonn, Germany; Center for Health Economics & Policy Studies, San Diego State University, San Diego, CA, United States
| | - Samuel Safford
- Center for Health Economics & Policy Studies, San Diego State University, San Diego, CA, United States; Department of Sociology, Michigan State University, East Lansing, MI, United States
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Cotti C, Courtemanche C, Maclean JC, Nesson E, Pesko MF, Tefft NW. The effects of e-cigarette taxes on e-cigarette prices and tobacco product sales: Evidence from retail panel data. JOURNAL OF HEALTH ECONOMICS 2022; 86:102676. [PMID: 36103752 PMCID: PMC11268994 DOI: 10.1016/j.jhealeco.2022.102676] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/26/2022] [Accepted: 09/01/2022] [Indexed: 06/15/2023]
Abstract
We estimate the effect of e-cigarette tax rates on e-cigarette prices, e-cigarette sales, and sales of other tobacco products using NielsenIQ Retail Scanner data from 2013 to 2019. We find that 90% of e-cigarette taxes are passed on to consumer retail prices. We then estimate reduced form and instrumental variables regressions to examine the effects of e-cigarette and cigarette taxes and prices on sales. We calculate an e-cigarette own-price elasticity of -2.2 and particularly large elasticity of demand for flavored e-cigarettes. Further, we document a cigarette own-price elasticity of -0.4 and positive cross-price elasticities of demand between e-cigarettes and cigarettes, suggesting economic substitution.
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Affiliation(s)
- Chad Cotti
- Department of Economics, College of Business, University of Wisconsin-Oshkosh, Oshkosh, WI 54901, United States
| | - Charles Courtemanche
- Department of Economics, Gatton College of Business and Economics, University of Kentucky, Lexington, KY 40506, United States; NBER, IZA, United States
| | - Joanna Catherine Maclean
- NBER, IZA, United States; Schar School of Policy and Government, George Mason University, Arlington, VA 22201, United States
| | - Erik Nesson
- Department of Economics, Miller College of Business, Ball State University Muncie, IN 47306, United States; National Bureau of Economic Research, United States
| | - Michael F Pesko
- Department of Economics, Andrew Young School of Policy Studies, Georgia State University, Atlanta, GA 30303, United States; Institute for Labor Economics, Germany.
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Friedman AS, Pesko MF. Young adult responses to taxes on cigarettes and electronic nicotine delivery systems. Addiction 2022; 117:3121-3128. [PMID: 35852452 PMCID: PMC9796020 DOI: 10.1111/add.16002] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 06/27/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS Although over half of United States states have passed taxes on electronic nicotine delivery systems (ENDS), recent evidence links ENDS tax rates to increases in smoking, suggesting potentially substantive health costs. Overall health implications will depend on how these taxes affect transitions from experimentation to regular smoking and vaping. Current analyses have not assessed ENDS tax rates' effects in young adulthood (ages 18-25). This study measures the relationship between ENDS and cigarette tax rates and ENDS use and smoking in young adulthood, a key period for initiation of regular tobacco use. DESIGN Observational study of data from the Current Population Survey's 2010-2019 Tobacco Use Supplements. SETTING The United States. PARTICIPANTS/CASES A total of 38 906 18 to 25 year-olds MEASUREMENTS: Multivariable linear regressions estimated two-way fixed effects analyses to assess ENDS and cigarette tax rates' relationships to recent and daily smoking and vaping, adjusting for an array of potential sociodemographic and policy confounders along with state and year fixed effects. FINDINGS A $1 increase in ENDS taxes yielded significant reductions in young adults' daily vaping ( β ̂ = -0.025; 95% CI, -0.037, -0.014) alongside increases in recent smoking ( β ̂ = 0.037; 95% CI, 0.013, 0.061), primarily reflecting greater dual use ( β ̂ =2.078; 95% CI, 0.890, 4.852; P = 0.09). A $1 cigarette tax increase yielded 2.1 and 2.5 percentage point increases in recent and daily vaping, with 95% CIs of (0.004, 0.038) and (0.018, 0.032) respectively. CONCLUSIONS In the United States, higher ENDS tax rates are associated with decreased ENDS use but increased cigarette smoking among 18- to 25-year-olds, with associations reversed for cigarette taxes.
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Affiliation(s)
| | - Michael F. Pesko
- Georgia State UniversityAtlantaGAUSA,Institute of Labor EconomicsBonnGermany
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