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Impact of E-cigarette Minimum Legal Sales Age Laws on Current Cigarette Smoking
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    Research using state-level data suggests e-cigarette minimum legal sale age (MLSA) laws are positively associated with cigarette smoking among U.S. adolescents; research using individual-level data suggests a negative association. Existing studies have not controlled for e-cigarette use.


    In 2016 and 2017, we regressed (logistic) current (past 30-day) cigarette smoking (from 2009–2014 National Youth Tobacco Surveys [NYTS]) on lagged (laws enacted each year counted for the following year) and unlagged (laws enacted January–June counted for that year) state e-cigarette MLSA laws prohibiting sales to youth aged <18 or <19 years (depending on the state). Models were adjusted for year and individual- (e-cigarette and other tobacco use, sex, race/ethnicity, and age) and state-level (smokefree laws, cigarette taxes, medical marijuana legalization, income, and unemployment) covariates.


    Cigarette smoking was not significantly associated with lagged MLSA laws after adjusting for year (OR=0.87, 95% CI:0.73–1.03; p=0.10) and covariates (OR=0.85, 0.69–1.03; p=0.10). Unlagged laws were significantly and negatively association with cigarette smoking (OR=0.84, 0.71–0.98, p=0.02), but not after adjusting for covariates (OR=0.84, 0.70–1.01, p=0.07). E-cigarette and other tobacco use, sex, race/ethnicity, age, and smokefree laws were associated with cigarette smoking (p<0.05). Results unadjusted for e-cigarette use and other tobacco use yielded a significant negative association between e-cigarette MLSA laws and cigarette smoking (lagged: OR=0.78, 0.64–0.93, p=0.01; unlagged: OR=0.80, 0.68–0.95, p=0.01).


    After adjusting for covariates, state e-cigarette MLSA laws did not affect youth cigarette smoking. Unadjusted for e-cigarette and other tobacco use, these laws were associated with lower cigarette smoking.

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