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*Acknowledgement: Portions of this paper were adapted from a paper submitted by these authors to The Economics of Neuroscience. 37 The preparation of this paper was partially supported by unrestricted funding by SmithKline Beecham Consumer Healthcare for which the authors also provide consulting services. | *Acknowledgement: Portions of this paper were adapted from a paper submitted by these authors to The Economics of Neuroscience. 37 The preparation of this paper was partially supported by unrestricted funding by SmithKline Beecham Consumer Healthcare for which the authors also provide consulting services. | ||
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='''Studies - Expansion/Contraction of the Alternative Nicotine Products Market vs Smoking'''= | |||
===2022: [https://www.qeios.com/read/GM2450 Higher Sales of Electronic Nicotine Delivery Systems (ENDS) in the US Are Associated with Cigarette Sales Declines, according to a Trend Break Analysis]=== | |||
*Higher ENDS sales were significantly associated with a greater cigarette shortfall: for every additional per-capita ENDS unit, cigarette sales were 1.4 packs-per-capita lower than expected... These findings support ENDS serving as a substitute for cigarettes (through potentially many mechanisms including cigarette price), causing cigarette consumption to decline. Since ENDS potentially pose a lower risk than cigarettes, this general substitution effect suggests that risk-proportionate tobacco regulation could mitigate the tobacco-related health burden. | |||
===2022: [https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-14341-z Population-level counterfactual trend modelling to examine the relationship between smoking prevalence and e-cigarette use among US adults]=== | |||
*Population-level data suggest that smoking prevalence has dropped faster than expected, in ways correlated with increased e-cigarette use. This population movement has potential public health implications. | |||
===2022: PREPRINT: [https://www.medrxiv.org/content/10.1101/2022.11.14.22282288v1 A decision aid for policymakers to estimate the impact of e-cigarette flavour restrictions on population smoking and e-cigarette use prevalence among youth versus smoking prevalence among adults]=== | |||
*[https://www.medrxiv.org/content/10.1101/2022.11.14.22282288v1.full.pdf PDF of full paper] | |||
===2022: [https://www.sciencedirect.com/science/article/abs/pii/S0091743522001116 Effect of flavored E-cigarette bans in the United States: What does the evidence show?]=== | |||
*However, in this paper, we propose an evidence-based version of this model based on several years' worth of longitudinal and econometric research, which suggests that youth e-cigarette use has instead worked to replace a culture of youth smoking. From this analysis, we propose a re-evaluation of current policies surrounding e-cigarette sales so that declines in e-cigarette use will not come at the cost of increasing cigarette use among youth and adults. | |||
===2022: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287473/ Impact of existing and potential e-cigarette flavor restrictions on e-cigarette use among young adult e-cigarette users in 6 US metropolitan areas]=== | |||
*Results from this study highlight heterogeneity in young adult e-cigarette users’ reactions to existing flavored e-cigarette sales restrictions and hypothetical restrictions. Some reduced e-cigarette use, but many reported intentions to continue e-cigarette use, by using tank-based e-cigarettes, available flavors, or flavors accessed through alternative sources. More concerning, some switched to cigarettes. Similarly, in response to future restrictions of all flavored e-liquids, young adult e-cigarette users largely indicated that they would either quit vaping – the ideal scenario – or switch to cigarettes – the least desirable scenario. Another major concern highlighted was access to flavored e-cigarettes despite restrictions (e.g., online, across state lines). Collectively, findings suggest that implications of flavored e-cigarette sales restrictions are complex, with the potential for both reductions in e-cigarette use and unintended consequences among young adults, including continued use of flavored e-cigarettes or switching to cigarettes, and retail and consumer circumvention of restrictions. | |||
===2021: [https://www.mdpi.com/1660-4601/18/9/4876 US Nicotine Vaping Product SimSmoke Simulation Model: The Effect of Vaping and Tobacco Control Policies on Smoking Prevalence and Smoking-Attributable Deaths]=== | |||
*Our model results imply that historical and ongoing tobacco control policies in the US cannot fully explain the accelerated reductions in smoking prevalence in the time period when NVP use became more prevalent. These reductions were found mainly among those at younger ages who are more likely to use NVPs. | |||
===2021: [https://www.ingentaconnect.com/content/png/ajhb/2021/00000045/00000003/art00012 Modeling the Population Health Impact of ENDS in the U.S.]=== | |||
*The availability of ENDS in the US is projected to reduce smoking and prevent 2.5 million premature deaths by 2100 in the Modified Case. Sensitivity analyses show that a significant population health benefit occurs under all plausible scenarios. | |||
===2021: [https://aip.scitation.org/doi/10.1063/5.0063593 Modeling the public health impact of e-cigarettes on adolescents and adults]=== | |||
*Using a simple model of competition between traditional cigarettes and e-cigarettes for users, we predict the change in smoking prevalence due to the introduction of vaping in the U.S. Vaping products appear to decrease the prevalence of smoking among both adult and adolescent populations. Because the long-term health risks of vaping are currently unknown, the public health cost and/or benefit of e-cigarette is less clear. However, as suggested by our model, it is possible that the introduction of e-cigarettes will have positive effects for both adult and youth populations depending on the relative health risk of smoking and vaping. | |||
===2021: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145156/ A Difference-in-Differences Analysis of Youth Smoking and a Ban on Sales of Flavored Tobacco Products in San Francisco, California]=== | |||
*San Francisco’s ban on flavored tobacco product sales was associated with increased smoking among minor high school students relative to other school districts. While the policy applied to all tobacco products, its outcome was likely greater for youths who vaped than those who smoked due to higher rates of flavored tobacco use among those who vaped. This raises concerns that reducing access to flavored electronic nicotine delivery systems may motivate youths who would otherwise vape to substitute smoking. Indeed, analyses of how minimum legal sales ages for electronic nicotine delivery systems are associated with youth smoking also suggest such substitution. | |||
*Citation: Friedman AS. A Difference-in-Differences Analysis of Youth Smoking and a Ban on Sales of Flavored Tobacco Products in San Francisco, California. JAMA Pediatr. 2021;175(8):863-865. doi:10.1001/jamapediatrics.2021.0922 | |||
===2021: [https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntab154/6332852?redirectedFrom=fulltext Reactions to sales restrictions on flavored vape products or all vape products among young adults in the US]=== | |||
*Young adult e-cigarette users indicate low support for e-cigarette sales restrictions (both for flavored products and complete restrictions). Moreover, if vape product sales were restricted to tobacco flavors, 39.1% of users reported being likely to continue using e-cigarettes but 33.2% were likely to switch to cigarettes. If vape product sales were entirely restricted, e-cigarette users were equally likely to switch to cigarettes versus not (~40%). | |||
*Free version of full study or PDF not available | |||
*Citation: Heather Posner, MPH, Katelyn F Romm, PhD, Lisa Henriksen, PhD, Debra Bernat, PhD, Carla J Berg, PhD, MBA, Reactions to Sales Restrictions on Flavored Vape Products or All Vape Products Among Young Adults in the United States, Nicotine & Tobacco Research, 2021;, ntab154, doi: 10.1093/ntr/ntab154 | |||
===2021: [https://f1000research.com/articles/10-619/v1 Vaping liquid flavour preferences, oral nicotine pouch and cannabis use: A survey of participants in the 2019 Oceania Vape Expo (version 1; peer review: awaiting peer review)]=== | |||
*In the event of a ban on other flavours, 20% of the NZ residents said they would probably go back to smoking (see Table 3). A majority (57%) indicated they intended to circumvent the ban, by mixing their own liquids and/or buying from overseas or the black market. Only 29% indicated they would change their vaping consumption to comply with the ban, as is typically implicitly assumed will happen. Nine percent would try to stop vaping and 35% would buy only the legal products (which includes the 18% who were already buying only products that would not be banned). | |||
*[https://f1000research.com/articles/10-619/v1/pdf?article_uuid=853423ae-6086-4c13-a7bc-87b28d81a4a6 PDF Version] | |||
*Citation: Glover M, Phillips CV, Selket K and Jeffares Y. Vaping liquid flavour preferences, oral nicotine pouch and cannabis use: A survey of participants in the 2019 Oceania Vape Expo [version 1; peer review: awaiting peer review]. F1000Research 2021, 10:619 doi:10.12688/f1000research.54582.1 | |||
*Acknowledgement: This study was conducted by the Centre of Research Excellence: Indigenous Sovereignty & Smoking as part a wider programme of research aimed at building scientific knowledge on how to reduce tobacco-related harms among Indigenous peoples. The funding for that programme of work was obtained following submission of a researcher-initiated application for funding from the Foundation for a Smoke-Free World. The Foundation had no involvement in the conception, design, analysis or writing of the study results, nor did they have any input into the decision to publish. That is, this study was not commissioned by the Foundation. | |||
===2021: [https://onlinelibrary.wiley.com/doi/10.1111/1753-6405.13143 Reactions on Twitter towards Australia's proposed import restriction on nicotine vaping products: a thematic analysis]=== | |||
*Approximately three-quarters of tweets that cited potential adverse consequences of the policy mentioned smoking relapse as their primary concern. | |||
===2020: [https://www.sciencedirect.com/science/article/pii/S2352853220300134 The impact of a comprehensive tobacco product flavor ban in San Francisco among young adults]=== | |||
*Among the 18–24 age group, there was a significant increase in cigarette smoking. | |||
*Cigarette smoking increased among 25–34 years old. | |||
*'''Banning flavors in e-cigarettes can push some e-cigarette users to turn to cigarette smoking''' and could prompt some youth to initiate into smoking instead of e-cigarette use. | |||
*The proportions of e-cigarettes, cigarettes, and cigars obtained over the internet increased after the ban, and the proportions obtained from retailers outside of San Francisco also increased overall. | |||
*[https://sci-hub.st/10.1016/j.abrep.2020.100273 PDF Version] | |||
*Citation: Yang, Y., Lindblom, E. N., Salloum, R. G., & Ward, K. D. (2020). The impact of a comprehensive tobacco product flavor ban in San Francisco among young adults. Addictive Behaviors Reports, 11, 100273. doi:10.1016/j.abrep.2020.100273 | |||
*Acknowledgement: This research was supported by the National Institute of Drug Abuse of the National Institutes of Health (R03DA048460). | |||
===2019: [https://www.atsjournals.org/doi/full/10.1513/AnnalsATS.201906-472OC Changes in Flavor Preference in a Cohort of Long-Term Electronic Cigarette Users]=== | |||
*Our results regarding anticipated reactions to FDA e-cigarette flavor regulation suggest complexities such that the benefits and risks of flavor ban need to be carefully evaluated. | |||
*'''A majority anticipated that they would personally attempt to circumvent potential FDA regulations of e-cigarettes by obtaining e-cigarette flavors from various illicit sources''' (e.g., Internet orders from foreign countries) or even self-making flavors. | |||
*The use of flavoring agents purchased from unregulated sources could lead to additional unanticipated toxicities. | |||
*'''It is also concerning that some established e-cigarette users believed that they would return to cigarette smoking if nontobacco e-cigarette flavors were banned'''. Thus, for adult e-cigarette users who use certain flavors to facilitate smoking cessation or reduction, banning all nontobacco flavors could precipitate relapse to smoking. | |||
*[https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201906-472OC PDF Version] | |||
*Citation: Ann Am Thorac Soc Vol 17, No 5, pp 573–581, May 2020, Copyright © 2020 by the American Thoracic Society, DOI: 10.1513/AnnalsATS.201906-472OC | |||
*Acknowledgement: Supported by the National Institute on Drug Abuse of the National Institutes of Health (NIH) and the Center for Tobacco Products of the U.S. Food and Drug Administration (FDA) (P50-DA-036107) for the Penn State Tobacco Center of Regulatory Science. | |||
===2019: [https://www.tandfonline.com/doi/abs/10.1080/10826084.2019.1626435?journalCode=isum20 Young adult dual combusted cigarette and e-cigarette users’ anticipated responses to hypothetical e-cigarette market restrictions]=== | |||
*Hypothetical regulations resulted in reported intentions to reduce EC (e-cigarette) use and increase CC (combustible cigarette) use; the greatest impact was found for restrictions regarding e-liquid nicotine content, followed by flavor | |||
*This work provides preliminary evidence that restrictive regulations regarding key EC characteristics may increase intentions to increase CC use among young adult dual EC and CC users. | |||
*[https://sci-hub.se/10.1080/10826084.2019.1626435 PDF Version] | |||
*Citation:: Lauren R. Pacek, Olga Rass, Maggie M. Sweitzer, Jason A. Oliver & F. Joseph McClernon (2019): Young adult dual combusted cigarette and e-cigarette users’ anticipated responses to hypothetical e-cigarette market restrictions, Substance Use & Misuse, DOI:10.1080/10826084.2019.1626435 | |||
*Acklnowledgement: This work was supported by the National Institutes of Health (K01DA043413, K23DA039294, and K23DA042898). The funding source had no other role other than financial support. | |||
===2018: [https://tobaccocontrol.bmj.com/content/28/2/168 Should flavours be banned in cigarettes and e-cigarettes? Evidence on adult smokers and recent quitters from a discrete choice experiment]=== | |||
*A ban on flavoured e-cigarettes would likely increase the choice of cigarettes in smokers, the more harmful way of obtaining nicotine. | |||
*[https://tobaccocontrol.bmj.com/content/tobaccocontrol/28/2/168.full.pdf PDF Version] | |||
*Citation:Buckell J, Marti J, Sindelar JLShould flavours be banned in cigarettes and e-cigarettes? Evidence on adult smokers and recent quitters from a discrete choice experimentTobacco Control 2019;28:168-175. | |||
*Acknowledgement: Research reported in this publication was supported by grant number P50DA036151 from the National Institute on Drug Abuse (NIDA) and FDA Center for Tobacco Products (CTP). | |||
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='''Studies Alternative Nicotine Products- Facilitators and Barriers to Quitting Smoking'''= | ='''Studies Alternative Nicotine Products- Facilitators and Barriers to Quitting Smoking'''= | ||
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