Local and State Policy Action Taken in the United States to Address the Emergence of E-Cigarettes and Vaping: A Scoping Review of Literature

Abstract

Introduction In response to rising rates of youth vaping and e-cigarette use, states and localities in the United States have adopted various tobacco control policies and have extended their utility to these emerging products. However, the extent to which these policies have been evaluated for their impact on youth use is unknown. Method Two databases (PubMed, Google Scholar) were searched for English language peer-reviewed articles pertaining to electronic cigarette policy evaluation between 2009 and 2020. Primary articles of interest were journal articles that evaluated an e-cigarette policy. Secondary articles of interest were journal articles that identified any e-cigarette policy action without a formal evaluation component, those that evaluated tobacco policy, or those that described e-cigarette behaviors and trends. Tertiary articles included gray literature that provided context for e-cigarette trends and additional policy identification. Results The final sample consisted of 12 relevant articles with an e-cigarette policy evaluation component and 62 relevant articles without such component, and 19 gray literature sources. Findings were synthesized based on policy type: product classification, age restrictions, smoke-free policies, flavor bans, sales restrictions, taxation, packaging, and advertising. Conclusion Policies that address access and use of e-cigarettes are common on the federal, state, and local level, are mostly reactionary, and mimic tobacco control efforts. Few policies have been formally evaluated for their effectiveness in reducing or preventing youth vaping. Strengthening the evidence base should be a priority for researchers going forward, given the potential of these policies to intervene on social and environmental conditions that affect youth initiation and uptake.

How do underage youth access e-cigarettes in settings with minimum age sales restriction laws? A scoping review

“…To address the research gaps identified above and improve comparability between studies, we suggest developing a standardised approach, including common questions. Rigorous evaluation of policies aimed at limiting youth EC access would provide a robust basis for future policy development [ 41 , 62 ]. For instance, better knowledge of how national legislation (e.g., T21 measures), flavour restrictions, and public education campaigns have contributed to decreases in EC use among US youth could identify opportunities to strengthen existing measures [ 50 ].…”

Effects of vaping on uptake and cessation of smoking: Longitudinal analysis in Aotearoa New Zealand adults

“…Understanding the trajectory of the relationship between smoking and e-cigarette use is critical to ensure the development of appropriate policy related to e-cigarette use. For example, a recent review suggested that US policies related to e-cigarette use tend to be modelled on tobacco control strategies (e.g., age restriction to reduce retail access, taxation) and are reactionary to industry tactics for promotion (e.g., flavour restrictions; [21]). If e-cigarettes increase uptake of later smoking behaviours, then using tobacco control strategies as a model is warranted to minimise possible harm.…”

Normalization of Vaping on TikTok: A Mixed-Methods Approach Using Computer Vision, Natural Language Processing, and Qualitative Thematic Analysis (Preprint)

“…Policymakers could develop regulations to enforce more strict advertising policies explicitly prohibiting the promotion of vaping products, including restrictions on content that indirectly promotes vaping [99,100].…”