cover image: Comprehensive E-cigarette Flavor Bans and Tobacco Use among Youth and Adults


Comprehensive E-cigarette Flavor Bans and Tobacco Use among Youth and Adults

6 Jun 2024

The vast majority of youth e-cigarette users consume flavored e-cigarettes, raising concerns from public health advocates that flavors may drive youth initiation into and continued use of e-cigarettes. Flavors drew further notice from the public health community following the sudden outbreak of lung injury among vapers in 2019, prompting several states to enact sweeping bans on flavored e-cigarettes. In this study, we examine the effects of these comprehensive bans on e-cigarette use and potential spillovers into other tobacco use by youth, young adults, and adults. We utilize both standard difference-in-differences (DID) and synthetic DID methods, in conjunction with four national data sets. We find evidence that young adults decrease their use of the banned flavored e-cigarettes as well as their overall e-cigarette use, by about two percentage points, while increasing cigarette use. For youth, there is some suggestive evidence of increasing cigarette use, though these results are contaminated by pre-trend differences between treatment and control units. The bans have no effect on e-cigarette and smoking participation among older adults (ages 25+). Our findings suggest that statewide comprehensive flavor bans may have generated an unintended consequence by encouraging substitution towards traditional smoking in some populations.
health labor economics health, education, and welfare demography and aging economics of health


Henry Saffer, Selen Ozdogan, Michael Grossman, Daniel L. Dench, Dhaval M. Dave

Acknowledgements & Disclosure
After this paper was completed, we learned of a closely related paper by Charles Courtemanche, Chad Cotti, Catherine Maclean, Erik Nesson, Joseph Sabia, and Yang Liang. Their paper is entitled "The Effect of E-Cigarette Flavor Bans on Tobacco Use" and reaches similar conclusions to our study. We are grateful to the National Institute of Drug Abuse (5 R01 DA055976), which provided funding support for this research. We thank Ege Aksu for excellent research assistance and comments on an earlier draft of this study. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.
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United States of America

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