However, declines in cigarette smoking slowed in states with flavor bans relative to other states
By Elana Gotkine HealthDay Reporter
FRIDAY, Aug. 8, 2025 (HealthDay News) — Electronic cigarette (e-cigarette) flavor restriction policies are associated with reductions in e-cigarette use, according to a study published online July 30 in JAMA Network Open.
David Cheng, Ph.D., from Massachusetts General Hospital in Boston, and colleagues examined associations of e-cigarette flavor restriction policies with e-cigarette and cigarette use in a cross-sectional study. Annual state-level prevalence rates of e-cigarette and cigarette use were examined in the United States between 2015 and 2023 among youths (high school age), young adults (aged 18 to 24 years), and adults (aged 25 years and older). Multiple years of postpolicy data were available for six policy states, while other states were control states.
The researchers found that e-cigarette use prevalence decreased among youths in recent years, but increased in control states among young adults. In policy and control states, cigarette use prevalence decreased, but lower prepolicy prevalence and attenuated postpolicy decreases were seen in policy states relative to control states. Among young adults in 2022 and adults aged 25 years or older in 2023, flavor policies were associated with reduced e-cigarette use (average treatment effect among the treated [ATT], −6.7 and −1.2 percentage points, respectively), and they were associated with increased cigarette use among youths in 2021 (ATT, 1.8 percentage points) and young adults in 2021, 2022, and 2023 (ATT, 3.7, 2.7, and 3.2 percentage points, respectively).
“Policies were associated with reduced e-cigarette use among young adults and adults aged 25 years or older but also with increased cigarette use among youths and young adults,” the authors write.
Several authors disclosed ties to the pharmaceutical and technology industries.
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