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How Do Electronic Cigarettes Affect Adolescent Smoking?

April 22, 2015
By Abigail S. Friedman

This research paper, written by Yale University associate professor of public health Abigail Friedman, studies the effects of state bans on e-cigarette sales to minors affect underage smoking rates in those states.

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This research paper, written by Yale University associate professor of public health Abigail Friedman, studies the effects of state bans on e-cigarette sales to minors affect underage smoking rates in those states.

“Considering both unweighted regressions and synthetic control analyses, bans on e-cigarette sales to minors yield a statistically significant 1.0 percentage point increase in the recent smoking rate among 12 to 17 year olds, relative to states without such bans,” Friedman writes. “This effect is both consistent with e-cigarettes reducing smoking among minors, and large: on average, state smoking rates for this age group fell 1.3 percentage points per two-year interval from 2002 to 2009, the year before the first bans went into effect. A 1.0 percentage point increase in smoking over two years counters more than 75 percent of that downward trend.”

“Overall, these results, from two distinct sets of analyses using different data and identification strategies, yield consistent implications: prior to 2014, e-cigarette access reduced adolescent smoking, operating particularly as a means of harm reduction by decreasing smoking participation among teens who were otherwise likely to smoke,” she writes. “By estimating subgroup specific effects, the propensity to smoke analyses present the first evidence that e-cigarettes’ impact on adolescent smoking appears specific to those teens who are most likely to smoke ex ante, and again suggests that e-cigarette availability reduces smoking among such youths. These results are consistent with the harm reduction hypothesis, but find no evidence supporting the claim that e-cigarettes increase smoking (i.e., gateway effects or renormalization of smoking).”