Association between Inclusion of E-Cigarettes in Statewide Comprehensive Smoke-Free Indoor Air Laws and Vaping Behaviors: Results from a Longitudinal Population Study

Abstract

Background

Several states have included e-cigarettes in their comprehensive smoke-free indoor air laws (i.e., aerosol-free policies), prohibiting the use of e-cigarettes––in addition to combustible tobacco products––in workplaces, restaurants, and bars. However, whether these policies contribute to reductions in e-cigarette use remains largely unknown.

Objective

This study utilized a nationally representative longitudinal sample to examine the association between the implementation of statewide aerosol-free policies and e-cigarette use behaviors. Methods: This longitudinal retrospective study implemented a quasi-experimental design. Waves 1–4 (2013–2018) restricted-use data from adult participants (weighted N = 22,838,787; unweighted N = 8,663) in the Population Assessment of Tobacco and Health (PATH) study were analyzed. The generalized difference-in-difference approach along with weighted hurdle and multinomial logistic regressions were conducted to examine the associations between aerosol-free policies and three measures of e-cigarette use (past 30-day e-cigarette abstinence status and number of use days, and past-12-month use frequency) pre- and post-policy implementation.

Results

Results indicated there were not statistically significant differences in e-cigarette use behaviors between participants living in states with and without the aerosol-free policies (ps ranged from 0.301 to 0.831), considering pre- and post-policy implementation.

Conclusions

Findings indicated that the effectiveness of the aerosol-free policies on e-cigarette use behaviors was not supported by longitudinal national data. States that have implemented aerosol-free policies should make pertinent efforts to enhance the awareness of these policies and to strengthen their enforcement. Future investigation into e-cigarette use in places where it is prohibited and implications with regard to effectiveness of aerosol-free policies is warranted.

Keywords:

• E-cigarette
• aerosol-free policy
• adult
• longitudinal

Conflicts of interest

The authors declare that they have no conflict of interest.

Funding

This study did not receive any funding.