U.S. state regulations regarding e-cigarettes may be associated with reduced e-cigarette use among adults, according to a study published Jan. 31 in JAMA Network Open.

Yang Du, MD, MS, et al., looked at data from 894,997 U.S. adults ages 18 years or older from the Centers for Disease Control and Prevention 2016 and 2017 Behavioral Risk Factor Surveillance System who were evaluated for state residence and e-cigarette use. State laws were organized into the following categories: prohibiting e-cigarette use in indoor areas of private workplaces, restaurants, and bars; requiring retailers to purchase a license to sell e-cigarettes; prohibiting self-service displays of e-cigarettes; prohibiting sales of tobacco products, including e-cigarettes, to persons under the age of 21; and e-cigarette taxes.

Results showed that 28,907 participants (4.4 percent) were identified as e-cigarette users. In addition, after adjustment for demographic, socioeconomic, and lifestyle factors, including conventional cigarette use, the odds ratios of current e-cigarette use were 0.90 (95 percent CI, 0.83-0.98) for state laws prohibiting e-cigarette use in indoor areas; 0.90 (95 percent CI, 0.85-0.95) for requiring retailers to purchase a license to sell e-cigarettes; 1.04 (95 percent CI, 0.99-1.09) for prohibiting self-service displays of e-cigarettes; 0.86 (95 percent CI, 0.74-0.99) for prohibiting sales of tobacco products, including e-cigarettes, to persons under the age of 21; and 0.89 (95 percent CI, 0.83-0.96) for e-cigarette taxes. Further, the researchers also found that the age-standardized prevalence of current e-cigarette use varied across states.

The researchers explain that "In addition to e-cigarette regulations at the federal level by the U.S. Food and Drug Administration, state and local regulations and policies regarding e-cigarettes can help reduce the public health risks associated with e-cigarettes, particularly among at-risk populations."

They add that moving forward, "future studies are needed to continue monitoring the patterns of state-level variations in e-cigarette use and the outcomes of changing state laws on e-cigarette use."

ACC's Advocacy team has been dedicated to reducing usage of tobacco products, including e-cigarettes, to protect public health, especially among youth. Read ACC President Richard J. Kovacs, MD, FACC's response to the recent sweeping federal legislation addressing e-cigarettes and Tobacco 21.

Clinical Topics: Prevention, Smoking

Keywords: ACC Advocacy, Electronic Nicotine Delivery Systems, Tobacco, Tobacco Products, Behavioral Risk Factor Surveillance System

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