Evaluation of statewide restrictions on e-cigarette nicotine strength-United States, 2017-2022.

Introduction:
This text provides an evaluation of statewide policies restricting e-cigarette nicotine strength in the United States. The study compares e-cigarette sales in states that restrict nicotine strength with states with no restrictions, while also considering the impact of flavor restrictions. The research aims to determine the effect of these policies on average nicotine strength and unit sales.

Key Points:

* The study uses a difference-in-difference regression analysis to compare e-cigarette sales in states with and without nicotine strength restrictions.
* Three intervention groups were used to assess varying intensities of policy implementation: restrictions on both nicotine strength and flavor, restrictions on nicotine strength only, and restrictions on flavor only.
* The analysis controlled for factors such as price, tobacco control policies, public health emergency responses, state demographics, state and time fixed effects, and state-specific time trends.
* Restricting both nicotine strength and flavors in Massachusetts was associated with a 2.04 percentage point reduction in mean nicotine strength and an 86.76-unit reduction in monthly unit sales per 1000 persons.
* Restricting nicotine strength only in Utah was associated with a 1.77 percentage point reduction in mean nicotine strength but had no impact on unit sales.
* Restricting nontobacco flavor sales only in Rhode Island, New York, and Washington slightly reduced mean nicotine strength and sales.
* The study found that policies restricting both nicotine strength and flavors were associated with reductions in both average nicotine levels and overall e-cigarette sales.

Main Message:
The text conveys that statewide policies restricting e-cigarette nicotine strength, when implemented along with flavor restrictions, can lead to reductions in average nicotine strength and overall e-cigarette sales. This finding highlights the potential benefits of comprehensive tobacco control policies in reducing e-cigarette use and its associated health risks.

Ali FRM, Schillo B, Crane E, Seaman EL, King BA. Evaluation of statewide restrictions on e-cigarette nicotine strength-United States, 2017-2022. Addiction (Abingdon, England). Published online April 11, 2023. doi:10.1111/add.16206