Banning ENDS is associated with increased cigarette sales | Study

Date:

In the fall of 2019, several US states passed short-term bans on the sale of electronic nicotine delivery systems (ENDS) in response to an outbreak of illnesses strongly linked to tetrahydrocannabinol vaping products that received national news coverage.

This study assessed how such state-level ENDS bans in 3 US states may have affected cigarette sales.

  • Cigarette sales in states banning ENDS were significantly higher than would have been observed otherwise. A full ban on ENDS was associated with increased cigarette sales of 7.5% in Massachusetts. Banning non-tobacco flavored ENDS was associated with a 4.6% increase in cigarette sales.
  • This study provides new evidence that banning ENDS was associated with increased cigarette sales using commercial sales data. Our results highlight and quantify potential unintended consequences of ENDS sale restrictions, which should be considered in the future as part of public health impact analyses of such policies.

Objectives

In the fall of 2019, several states in the United States passed emergency bans on the sale of electronic nicotine delivery systems (ENDS), in response to an outbreak of illnesses strongly linked to tetrahydrocannabinol vaping products that received national news coverage. Given that ENDS are potential alternative nicotine products for adult smokers, banning ENDS may have unintended consequences. This study provides evidence of an association between state-level ENDS bans and cigarette sales.

Methods

We used difference-in-differences and generalized synthetic control methods to estimate the impacts of the emergency ENDS bans on cigarette sales by comparing treatment states that passed ENDS bans in fall 2019 (Massachusetts, Washington, and Rhode Island), halted states that revoked the announced ENDS bans, and control states.

Results

Our results show that cigarette sales in ban states were higher than would have been observed otherwise in the post-ban period. A full ban on ENDS was associated with increased cigarette sales of 7.5% in Massachusetts (P < .01); banning non-tobacco flavored ENDS was associated with 4.6% (P < .1) higher-than-expected cigarette sales. We did not detect statistically significant impacts in halted states, and placebo tests, which randomly assigned control states as treatments, showed no difference in observed cigarette sales in the same period.

Conclusions

This study provides evidence that banning ENDS is associated with increased cigarette sales. Future research is needed to determine the long-term impact of these policies.

Read full article here.

Yingying Xu et al. – ISPOR- 2022-03-05.

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