E-cigarette Regulations Increase Prenatal Cigarette Use Among Teen Smokers, Study Shows

ATLANTA—Earlier studies have shown passage of minimal legal sale age (MLSA) laws regulating the purchase of e-cigarettes among teens succeeded in reducing e-cigarette use, but may have unintentionally increased cigarette use by teen smokers. New research published in the Journal of Health Economics supports these findings.

The new study evaluates, for the first time, the effect of e-cigarette MLSA laws on pregnant teens in particular and finds the laws caused higher rates of prenatal smoking among teens who smoked prior to pregnancy, but not among non-smokers.

Economists Michael Pesko of Georgia State University and Janet Currie of Princeton University evaluated the effects of these e-cigarette regulations among pregnant teens using data from 325,000 birth certificates for 32 states from 2010-16. They took advantage of the gradual roll-out of e-cigarette MLSA laws across these states over time as well as cigarette smoking information provided by each pregnant teen at four points in time during her pregnancy.

“We found the laws reduced prenatal smoking cessation by 0.6 percentage points overall in rural areas where the concentration of teen births and teen smoking is the highest,” said Pesko, an assistant professor in Georgia State’s Andrew Young School of Policy Studies. “Pregnant women are highly motivated to quit cigarette smoking, and our results suggest that many try to do so with e-cigarettes.”

“These teens switch from cigarettes to e-cigarettes when they get pregnant and this switching is reduced by e-cigarette MLSAs, which likely indicates an unmet need for assistance with ending their smoking,” said Currie, a professor in Princeton’s Department of Economics. “Our findings suggest that many pregnant smokers want to quit and are especially open to counseling and guidance about how to quit from their physicians at this time.”

Pregnancy may provide a unique window when women are open to guidance about resources and products available to help them quit smoking, the report concludes.

The main impact of MLSA laws was concentrated among teens who smoked prior to their pregnancy, the researchers found. They found no evidence teens who did not smoke prior to their pregnancy initiated cigarette use in response to e-cigarette purchasing laws.

This study follows in the footsteps of another study reaching similar conclusions that e-cigarette indoor vaping restrictions also reduced smoking cessation for adult pregnant women.

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