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    1 Comment for this article
    Next study to look at
    Christina Tansy, MS, MMS, PA-C |
    Regulations may reduce e-cig use but is there an increase in people going back to combustible cigarette use? As bad as either product is, I feel there is a small mitigation of risk with the e-cigs as long as people are not using “street juice,” which is the substance that has been linked to the e-cig related deaths. Vitamin E, or any other oil, is not good for the lungs when inhaled. I believe, the CDC has linked Vit E containing street juice to most of the e-cig deaths.
    Also, a better age breakdown would be helpful.
    CONFLICT OF INTEREST: None Reported
    Original Investigation
    Public Health
    January 31, 2020

    Association of Electronic Cigarette Regulations With Electronic Cigarette Use Among Adults in the United States

    Author Affiliations
    • 1Department of Epidemiology, University of Iowa College of Public Health, Iowa City
    JAMA Netw Open. 2020;3(1):e1920255. doi:10.1001/jamanetworkopen.2019.20255
    Key Points español 中文 (chinese)

    Question  Are US state regulations regarding electronic cigarettes (e-cigarettes) associated with current e-cigarette use among US adults?

    Findings  This cross-sectional study used national data from 894 997 participants aged 18 years or older from the 2016 and 2017 Behavioral Risk Factor Surveillance System surveys. State regulations prohibiting e-cigarette use in indoor areas, requiring retailers to purchase a license to sell e-cigarettes, prohibiting sales of tobacco products to persons younger than 21 years, and applying taxes to e-cigarettes were associated with a lower prevalence of current e-cigarette use among US adults.

    Meaning  Several state regulations regarding e-cigarettes may be associated with reduced current e-cigarette use among US adults.

    Abstract

    Importance  Millions of Americans use electronic cigarettes (e-cigarettes). A growing number of state and local governments have started to draft and implement laws regarding the sale, marketing, and use of e-cigarettes. The association of US state regulations regarding e-cigarettes with e-cigarette use remains unknown.

    Objective  To examine the association of US state regulations regarding e-cigarettes with current e-cigarette use among adults in the United States.

    Design, Setting, and Participants  This cross-sectional study included adults aged 18 years or older from the 2016 and 2017 Behavioral Risk Factor Surveillance System, which is a nationwide, telephone-administered survey that collects state-representative data on health-related risk behaviors, chronic health conditions, and use of preventive services. Data analysis was performed from February 1, 2019, to April 31, 2019.

    Exposures  United States state laws regulating e-cigarette use, including prohibiting e-cigarette use in indoor areas of private workplaces, restaurants, and bars; requiring retailers to purchase a license to sell e-cigarettes; prohibiting self-service displays of e-cigarettes; prohibiting sales of tobacco products, including e-cigarettes, to persons younger than 21 years; and e-cigarette taxes.

    Main Outcomes and Measures  Current use of e-cigarettes.

    Results  Among 894 997 participants aged 18 years or older (503 688 women [51.3%], 679 443 non-Hispanic white [62.6%], 71 730 non-Hispanic black [16.3%], 69 823 Hispanic [11.4%], and 74 001 non-Hispanic other races [9.8%]), 28 907 (weighted prevalence, 4.4%) were currently using e-cigarettes. The age-standardized weighted prevalence of current e-cigarette use varied across US states and territories, from 1.0% in Puerto Rico to 6.2% in Guam. After adjustment for demographic, socioeconomic, and lifestyle factors, including conventional cigarette use, the odds ratios of current e-cigarette use were 0.90 (95% CI, 0.83-0.98) for state laws prohibiting e-cigarette use in indoor areas of private workplaces, restaurants, and bars; 0.90 (95% CI, 0.85-0.95) for state laws requiring retailers to purchase a license to sell e-cigarettes; 1.04 (95% CI, 0.99-1.09) for state laws prohibiting self-service displays of e-cigarettes; 0.86 (95% CI, 0.74-0.99) for state laws prohibiting sales of tobacco products, including e-cigarettes, to persons younger than 21 years; and 0.89 (95% CI, 0.83-0.96) for state laws applying taxes to e-cigarettes.

    Conclusions and Relevance  These findings suggest that several state regulations regarding e-cigarettes may be associated with reduced e-cigarette use among US adults.

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