The impact of local regulation on reasons for electronic cigarette use among Southern California young adults.

objectiveTobacco control policies have decreased tobacco use among youth and young adults. We aimed to identify whether specific local tobacco retail licensing ordinances were associated with reasons for e-cigarette use, in order to examine whether strong local policies may reduce e-cigarette initiation rates by influencing the appeal of these products.

methodsOnline questionnaires were completed by Southern California Children's Health Study participants in 2015-2016 (mean age = 18.9 years). Those who had ever used an e-cigarette (N = 614) were asked about reasons for use; additional data were collected on local jurisdiction tobacco sales policy, friends' attitudes toward e-cigarette use, e-cigarette characteristics (level of nicotine, flavorings), and history of tobacco use. Multivariate logistic regression models evaluated associations of each factor with reasons for e-cigarette use, adjusting for gender, ethnicity, highest parental education, tobacco use history and with a random effect of jurisdiction.

resultsThe top reason for e-cigarette use was "They come in flavors I like" (56.6%). Using e-cigarettes to quit smoking was uncommon (12.8%). Participants in jurisdictions with weaker tobacco retail licensing ordinances were more likely to report use of e-cigarettes because they are less harmful than cigarettes (50.1% vs. 36.2%), more acceptable to non-tobacco users (38% vs. 25%), and because they can use e-cigarettes in places where smoking is prohibited (30.7% vs. 18.3%; all p < .05).

conclusionTargeted policy to enforce a strong regulatory environment that denormalizes e-cigarette use, conveys the adverse impact of e-cigarettes, and restricts use in public places may reduce e-cigarette use among adolescents and young adults.