ArticleNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco2025
The Effects of State-Level Flavored Electronic Cigarette Restrictions on Adult Tobacco Use Using Multilevel Modeling: Findings From the PATH Study Waves 5 and 7 (2018-2023).
Article in Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- A Qualitative Comparative Analysis of State Flavored E-Cigarette Policy Implementation and E-Cigarette Use.American journal of preventive medicine · 2026Article
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6 authors.
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Abstract
introductionFlavors play an important role in e-cigarette use among both young people and adults, but evaluations of flavored e-cigarette policies have focused almost exclusively on youth. This longitudinal study examined how flavored e-cigarette policies affect tobacco use over time for different adult age groups using data from the Population Assessment of Tobacco and Health (PATH) Study.
methodsAdults aged 21 or above at Wave 5 (2018-2019) comprised the analytic sample. Multilevel models were used to examine changes in past 30-day and established e-cigarette use, and past 30-day tobacco use other than e-cigarettes at Wave 7 (2022-2023) for residents of states that had (vs had not) implemented flavored e-cigarette policies between Waves 5 and 7. Sociodemographic variables and state-level tobacco control policies (eg, e-cigarette tax, clean indoor air) were controlled. Regression models tested effects overall and by age group: 21-24, 25-29, 30-39, 40, or above. Full-sample and replicate weights accounted for the complex sample design and nonresponse.
resultsAmong those exposed to a flavored e-cigarette policy, there was a significant decrease in odds of past 30-day e-cigarette use for those age 21-24 (AOR = 0.59; 95% CI: 0.36, 0.97) and in odds of established e-cigarette use for those age 25-29 (AOR = 0.32; 95% CI: 0.14, 0.76) compared to those who were unexposed, adjusting for covariates. There was no change in use of tobacco products other than e-cigarettes by flavored policy exposure.
conclusionsFlavored e-cigarette policies are effective at reducing past 30-day and established e-cigarette use among younger adults (aged 21-29). The impact among older adults (30 or above) is less evident. IMPLICATIONS: Using longitudinal data and multilevel models, this study demonstrates how flavored e-cigarette policies influence e-cigarette use (and other tobacco product use) for younger adults (21-29). We find limited evidence of policies influencing older adults (30 or above). This work suggests that flavored e-cigarette policies may play an important role in stopping young people from initiating e-cigarette use, and in stopping older young adults who are 25-29 from progressing to more established e-cigarette use.
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