Evaluation of Statewide Restrictions on Flavored e-Cigarette Sales in the US From 2014 to 2020.

Introduction:
This text summarizes a study evaluating the impact of statewide restrictions on flavored e-cigarette sales in Massachusetts, New York, Rhode Island, and Washington, compared to 35 control states without such restrictions. The study used a difference-in-differences (DID) analysis to compare e-cigarette sales before and after implementation of restrictions, controlling for other population-based policies and emergent events.

Key Points:

* The study used e-cigarette retail sales data from IRI, covering 77% of retail stores in the US.
* Four-week e-cigarette unit sales were summed and standardized to reflect the most common package sizes for each product type.
* E-cigarette flavors were categorized into tobacco, menthol, mint, and other.
* Dichotomous variables were created to indicate dates when flavored e-cigarette sales restrictions were in effect in intervention states.
* The analysis controlled for other state tobacco control policies, state demographic and economic characteristics, and COVID-19 and EVALI measures.
* Prohibition of all e-cigarette products in Massachusetts was associated with a 94.38% reduction in mean 4-week total e-cigarette unit sales.
* Restrictions on non–tobacco-flavored e-cigarette sales in New York, Rhode Island, and Washington were associated with reductions of 30.65%, 31.26%, and 25.01%, respectively.
* Except in Massachusetts, where all sales of flavored e-cigarettes decreased, reductions were found only for non–tobacco-flavored e-cigarette sales in the other states with restrictions.

Main Message:
The main message of this study is that statewide restrictions on flavored e-cigarette sales were associated with a reduction in total e-cigarette sales. These findings suggest that such restrictions may be an effective policy tool in reducing e-cigarette use among youth and young adults, who are particularly attracted to flavored products. However, the study also highlights the need to consider unintended consequences, such as potential increases in tobacco-flavored e-cigarette sales, when implementing such policies.

Ali FRM, Vallone D, Seaman EL, et al. Evaluation of Statewide Restrictions on Flavored e-Cigarette Sales in the US From 2014 to 2020. JAMA network open. 2022;5(2):1. doi:10.1001/jamanetworkopen.2021.47813