Tobacco Policy and ENDS Policy Influences on Adolescent Vaping Across the U.S. States

Am J Prev Med. 2023 Dec;65(6):1026-1033. doi: 10.1016/j.amepre.2023.07.010. Epub 2023 Jul 21.


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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Humans
  • Non-Smokers
  • Smoke-Free Policy*
  • Taxes
  • Tobacco Control
  • Vaping* / epidemiology
  • Vaping* / prevention & control