How does electronic cigarette access affect adolescent smoking?

J Health Econ. 2015 Dec;44:300-8. doi: 10.1016/j.jhealeco.2015.10.003. Epub 2015 Oct 19.


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.

Keywords: Adolescent behavior; Cigarettes; Electronic cigarettes; Smoking.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Child
  • Commerce / economics
  • Commerce / legislation & jurisprudence
  • Commerce / statistics & numerical data
  • Electronic Nicotine Delivery Systems / economics
  • Electronic Nicotine Delivery Systems / legislation & jurisprudence*
  • Electronic Nicotine Delivery Systems / statistics & numerical data
  • Humans
  • Minors / legislation & jurisprudence
  • Regression Analysis
  • Smoking / economics
  • Smoking / epidemiology
  • Smoking / legislation & jurisprudence*
  • State Government
  • United States / epidemiology