Heather Posner1, Katelyn F Romm2, Lisa Henriksen3, Debra Bernat4, Carla J Berg2. 1. Global Health Epidemiology and Disease Control, Milken Institute School of Public Health, George Washington University, Washington, DC, USA. 2. Department of Prevention and Community Health, Milken Institute School of Public Health; George Washington Cancer Center, George Washington University, Washington, DC, USA. 3. Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, USA. 4. Department of Epidemiology, Milken Institute School of Public Health; George Washington Cancer Center, George Washington University, Washington, DC, USA.
Abstract
INTRODUCTION: Despite increases in e-cigarette sales restrictions, support for sales restrictions and perceived impact on young adult use are unclear. AIMS AND METHODS: We analyzed February-May 2020 data from a longitudinal study of 2159 young adults (ages 18-34; Mage = 24.75 ± 4.71; n = 550 past 30-day e-cigarette users) in six metropolitan areas (Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, and Seattle). We examined support for e-cigarette sales restrictions and-among e-cigarette users-perceived impact of flavored vape product and all vape product sales restrictions on e-cigarette and cigarette use (and potential correlates; ie, e-cigarette/tobacco use, use-related symptoms/health concerns). RESULTS: About 24.2% of e-cigarette users (and 57.6% of nonusers) supported (strongly/somewhat) sales restrictions on flavored vape products; 15.1% of e-cigarette users (45.1% of nonusers) supported complete vape product sales restrictions. If restricted to tobacco flavors, 39.1% of e-cigarette users reported being likely (very/somewhat) to continue using e-cigarettes (30.5% not at all likely); 33.2% were likely to switch to cigarettes (45.5% not at all). Considering complete vape product sales restrictions, equal numbers (~39%) were likely versus not at all likely to switch to cigarettes. Greater policy support correlated with being e-cigarette nonusers (adjusted R2 [aR2] = .210); among users, correlates included fewer days of use and greater symptoms and health concerns (aR2 = .393). If such restrictions were implemented, those less likely to report continuing to vape or switching to cigarettes used e-cigarettes on fewer days, were never smokers, and indicated greater health concern (aR2 = .361). CONCLUSIONS: While lower-risk users may be more positively impacted by such policies, other young adult user subgroups may not experience benefit. IMPLICATIONS: Young adult e-cigarette users indicate low support for e-cigarette sales restrictions (both for flavored products and complete restrictions). Moreover, if vape product sales were restricted to tobacco flavors, 39.1% of users reported being likely to continue using e-cigarettes but 33.2% were likely to switch to cigarettes. If vape product sales were entirely restricted, e-cigarette users were equally likely to switch to cigarettes versus not (~40%). Those most likely to report positive impact of such policies being implemented were less frequent users, never smokers, and those with greater e-cigarette-related health concerns. This research should be considered in future tobacco control initiatives.
INTRODUCTION: Despite increases in e-cigarette sales restrictions, support for sales restrictions and perceived impact on young adult use are unclear. AIMS AND METHODS: We analyzed February-May 2020 data from a longitudinal study of 2159 young adults (ages 18-34; Mage = 24.75 ± 4.71; n = 550 past 30-day e-cigarette users) in six metropolitan areas (Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, and Seattle). We examined support for e-cigarette sales restrictions and-among e-cigarette users-perceived impact of flavored vape product and all vape product sales restrictions on e-cigarette and cigarette use (and potential correlates; ie, e-cigarette/tobacco use, use-related symptoms/health concerns). RESULTS: About 24.2% of e-cigarette users (and 57.6% of nonusers) supported (strongly/somewhat) sales restrictions on flavored vape products; 15.1% of e-cigarette users (45.1% of nonusers) supported complete vape product sales restrictions. If restricted to tobacco flavors, 39.1% of e-cigarette users reported being likely (very/somewhat) to continue using e-cigarettes (30.5% not at all likely); 33.2% were likely to switch to cigarettes (45.5% not at all). Considering complete vape product sales restrictions, equal numbers (~39%) were likely versus not at all likely to switch to cigarettes. Greater policy support correlated with being e-cigarette nonusers (adjusted R2 [aR2] = .210); among users, correlates included fewer days of use and greater symptoms and health concerns (aR2 = .393). If such restrictions were implemented, those less likely to report continuing to vape or switching to cigarettes used e-cigarettes on fewer days, were never smokers, and indicated greater health concern (aR2 = .361). CONCLUSIONS: While lower-risk users may be more positively impacted by such policies, other young adult user subgroups may not experience benefit. IMPLICATIONS: Young adult e-cigarette users indicate low support for e-cigarette sales restrictions (both for flavored products and complete restrictions). Moreover, if vape product sales were restricted to tobacco flavors, 39.1% of users reported being likely to continue using e-cigarettes but 33.2% were likely to switch to cigarettes. If vape product sales were entirely restricted, e-cigarette users were equally likely to switch to cigarettes versus not (~40%). Those most likely to report positive impact of such policies being implemented were less frequent users, never smokers, and those with greater e-cigarette-related health concerns. This research should be considered in future tobacco control initiatives.
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