The Impact of Banning Electronic Nicotine Delivery Systems on Combustible Cigarette Sales: Evidence From US State-Level Policies

Xu, Yingying; Jiang, Lanxin; Prakash, Shivaani; Chen, Tengjiao

doi:10.1016/j.jval.2021.12.006

Cited by 13 publications

(12 citation statements)

References 39 publications

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“…Some recent policies have focused on restricting ENDS products, motivated out of a desire to protect youth. Unfortunately, such policies can have unintended consequences of increasing cigarette smoking in youth 18 and adults 20 when the possible interrelationship between cigarettes and ENDS is not considered.…”

Section: Introductionmentioning

confidence: 99%

Meta-Analysis of E-Cigarette Price Elasticity

Selya¹,

Foxon²,

Chandra³

et al. 2022

Preprint

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Background: Adoption of electronic nicotine delivery systems (ENDS) has the potential to impact the prevalence of combusted cigarette use. Understanding whether and how much ENDS act as economic substitutes for cigarettes helps inform tobacco policy to minimize harm. Objectives: The goals of this study are to review the own-price elasticity of ENDS, the cross-price elasticity of ENDS with respect to cigarette price (including taxes), and the cross-price elasticity of cigarettes with respect to ENDS price.Methods: Pre-registered systematic review and meta-analysis following Cochrane review guidelines where applicable. Articles were sourced from PubMed and Google Scholar. Where appropriate, effects were combined in random-effects models with a two-step estimator. Other articles were reviewed narratively. Results: A 10% increase in ENDS price is associated with a 10.7% (7.7%–13.6%) decrease in ENDS sales/purchases, and also decreased ENDS use prevalence. A 10% increase in cigarette price is associated with an 18.3% (9.3%–27.4%) increase in ENDS sales/purchases, and also increased ENDS use prevalence. No evidence for increased cigarette sales/purchases after increased ENDS price was found, but increased ENDS price was associated with increased smoking prevalence, propensity, and number of cigarettes smoked.Discussion: These data suggest ENDS are substitutes for cigarettes. Taxing cigarettes encourages switching away from the more harmful product. More research is needed to clarify the association between ENDS price and cigarette demand.Conclusions: Policymakers should consider using taxation to influence behavior and tax tobacco products in proportion to their harm.

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Section: Introductionmentioning

confidence: 99%

Meta-Analysis of E-Cigarette Price Elasticity

Selya¹,

Foxon²,

Chandra³

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…Finally, a group of researchers from JUUL used a DiD design and IRI data to evaluate the impact of the 2019 restrictions in Massachusetts, Rhode Island, and Washington on per capita cigarette sales [ 33 ]. They found that Massachusetts’s complete ENDS ban significantly increased cigarette sales.…”

Section: Resultsmentioning

confidence: 99%

“…Of the five sales studies, one reported a reduction in cigarette sales, [ 28 ] one flat sales, [ 29 ] and two an increase [ 30 , 33 ]. Three studies reported a decline in ENDS sales [ 29 – 31 ] and one an increase following the restrictions, although the increase was lower than observed in control regions [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

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The actual and anticipated effects of restrictions on flavoured electronic nicotine delivery systems: a scoping review

et al. 2022

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Objective To synthesize the outcomes of policy evaluations of flavoured electronic nicotine delivery systems (ENDS) restrictions. Data sources PubMed, Scopus, Embase and Web of Science before May 3, 2022. Study selection Studies that report sales, behaviour, or compliance outcomes related to implemented or hypothetical ENDS flavour restrictions. Data extraction Restriction details, whether implemented or hypothetical, whether additional products were restricted, jurisdictional level, study locations, and outcomes classified by sales, behaviour, and compliance. Data synthesis We included 30 studies. Of those, 26 were conducted exclusively in the US, two in India, and two surveyed respondents in multiple countries, including the US. Twenty-one evaluated implemented restrictions, while nine considered hypothetical restrictions. Five studies evaluated product sales, 17 evaluated behaviour, and 10 evaluated compliance, with two studies reporting multiple outcomes. Two studies reported an increase and one a reduction in cigarette sales following restrictions, while three reported reductions in ENDS sales. Behavioural studies presented a mixed view of the impacts of regulations on ENDS and cigarette use. However, the use of disparate outcomes limits the comparability of studies. Studies of hypothetical restrictions suggest decreased ENDS use, increased cigarette use, and increased use of illicit markets. Studies of compliance with flavoured product restrictions that included ENDS found that 6–39% of stores sold restricted flavoured products post-restrictions. Online stores remain a potential source of restricted products. Conclusion Our findings highlight the need for additional research on the impacts of ENDS restrictions. Research should further evaluate the impact of restrictions on youth and adult use of nicotine and tobacco products in addition to the effects of restrictions in countries beyond the US to enable a robust consideration of the harm-benefit trade-off of restrictions.

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“…Relapse to tobacco cigarette smoking was not observed in this study. Recent work in the US has found that ECs bans have been associated with a substantial increase in cigarette sales and relapse back to smoking (43). However, RCT of vapers with a strong desire to quit are different from research in the context of real-world setting (44).…”

Section: Discussionmentioning

confidence: 99%

A Double-Blind, Randomized, Controlled Phase III Trial Investigating Efficacy and Safety of Varenicline for Vaping Cessation in Adult Users

Caponnetto

Campagna

Ahluwalia

et al. 2022

Preprint

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Background: Vaping cessation is virtually unexplored. The efficacy and safety of varenicline for vaping cessation has not been studied and rigorous research is required to advance best practice and outcomes for e-cigarettes users who want to quit. Methods: Eligible patients were randomized to either varenicline (1 mg, administered twice daily for 12 weeks) or placebo treatment (administered twice daily, for 12 weeks) combined with vaping cessation counseling. The trial consisted of a 12-week treatment phase followed by a 12-week follow-up, nontreatment phase. The primary efficacy endpoint of the study was biochemically validated continuous abstinence rate (CAR) at weeks 4 to 12. Secondary efficacy end points were the CAR at weeks 4 to 24 and 7-day point prevalence of vaping abstinence at weeks 12 and 24. Results: CAR was significantly higher for varenicline vs placebo at each interval: weeks 4-12, 40.0% and 20.0%, respectively (OR = 2.67, 95% CI = [1.25 - 5.68], P = 0.011); weeks 4-24, 34.3% for varenicline and 17.2% for placebo (OR = 2.52, 95% CI = [1.14 - 5.58], P = 0.0224). The 7-day point prevalence of vaping abstinence was also higher for the varenicline than placebo at each time point. Serious adverse events were infrequent in both groups and not treatment-related. Conclusions: Inclusion of varenicline and counseling in a vaping cessation program for EC users intending to quit may result in prolonged abstinence. These positive findings may also help guiding future recommendations for vaping cessation by health authorities and healthcare providers.

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The Impact of Banning Electronic Nicotine Delivery Systems on Combustible Cigarette Sales: Evidence From US State-Level Policies

Cited by 13 publications

References 39 publications

Meta-Analysis of E-Cigarette Price Elasticity

Meta-Analysis of E-Cigarette Price Elasticity

The actual and anticipated effects of restrictions on flavoured electronic nicotine delivery systems: a scoping review

A Double-Blind, Randomized, Controlled Phase III Trial Investigating Efficacy and Safety of Varenicline for Vaping Cessation in Adult Users

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