Adding vaping restrictions to smoke-free air laws: associations with conventional and electronic cigarette use

Background and Aims In the United States, some states and localities have added vaping restrictions to established smoke-free indoor air laws in order to reduce electronic cigarette use. Yet, if smokers use e-cigarettes to quit, such restrictions could have the unintended effect of attenuating the original smoke-free air policy's effects on smoking. This study estimated changes in current smoking, past-year smoking cessation, and recent vaping following the introduction of smoke- and vape-free air laws. Design Observational study of nationally representative data from the 2014-2018 National Health Interview Survey. Setting United States. Participants/Cases 87 334 participants, 18-54 years of age. Measurements Multivariable linear regressions estimated the association between increased exposure to smoke- and vape-free worksite and restaurant laws and self-reported current smoking and recent vaping among emerging adults (ages 18-25), as well as past-12-month smoking cessation among prime age adults (ages 26-54). All regressions adjusted for respondent sociodemographic and other tobacco control policies, along with state and year fixed effects. Findings Smoke-free worksite laws were associated with significant reductions in the likelihood of current smoking ( beta = - 0.050, 95% CI: -0.098, -0.002, P = 0.038) and recent vaping ( beta = - 0.040, 95% CI: -0.072, -0.007, P = 0.013), as well as increases in the likelihood of smoking cessation ( beta = 0.026, 95% CI: 0.000, 0.052, P = 0.046). Adding vaping restrictions to smoke-free worksite laws did not yield further reductions in recent vaping ( beta = 0.008, 95% CI: -0.021, 0.036, P = 0.568) and counteracted over half of the estimated association with current smoking relative to smoke-free policies alone ( beta = 0.030, 95% CI: -0.028, 0.088, P = 0.301). Conclusions From 2014 to 2018, increased adoption of smoke-free worksite laws in the United States was associated with reductions in both current smoking and recent vaping, as well as increases in smoking cessation. Adding vaping restrictions to smoke-free worksite laws, however, was not associated with a reduction in recent vaping among emerging adults and may have attenuated the smoke-free policy's impact on current smoking in this age group.

Automated summary

The study found that from 2014 to 2018, increased adoption of smoke-free worksite laws in the United States was associated with reductions in both current smoking and recent vaping, as well as increases in smoking cessation. However, adding vaping restrictions to smoke-free worksite laws did not result in a decrease in recent vaping and may have weakened the impact on current smoking among emerging adults aged 18-25.