E-cigarette Regulations Increase Prenatal Cigarette Use among Teen Smokers, New Study Shows
Earlier studies have shown that the 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.
New research published in Journal of Health Economics for the first time evaluates the effect of e-cigarette MLSA laws on pregnant teens, finding that 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 carefully evaluated the effects of these laws among pregnant teens using data from 325,000 birth certificates for 32 states from 2010-2016. They took advantage of the gradual roll-out of e-cigarette MLSA laws across these 32 states over time. Additionally, they took into account cigarette smoking information provided by each pregnant teen at four points in time during her pregnancy.
“We found that 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 University’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.”
The authors found the main impact of these laws was concentrated among teens who smoked prior to their pregnancy. Therefore, it seems that these teens were trying to use e-cigarettes to quit cigarette smoking, and continued to smoke when access to e-cigarettes was curtailed by laws preventing their sale to teens. The authors found no evidence that teens that did not smoke prior to their pregnancy initiated cigarette use in response to e-cigarette purchasing laws.
“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, Henry Putnam Professor of Economics and Public Affairs and co-director of Princeton’s Center for Health and Wellbeing.
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.
“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,” Currie said.
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.