New research suggests policy change and pricing strategies to reduce e-cigarette use and protect kids

Nearly one-third of convenience stores, pharmacies, supercenters, and other retailers located near schools nationwide sell e-cigarettes, according to research published today in a special issue of Tobacco Control. In the absence of federal regulation on e-cigarettes, 34 states have taken the initiative to regulate e-cigarettes and other tobacco-derived products, but those policies are not comprehensive and only 22 states have laws that restrict youth access to e-cigarettes.

The research presented in the special issue also provides new insight about how price impacts demand of the potentially harmful products and finds policies that increase e-cigarette retail prices, such as limiting rebates, discounts and coupons and imposing a tax, will reduce e-cigarette consumption among youth and adults.

“Not only are kids seeing advertising for e-cigarettes on TV, they’re seeing them in local stores near school and can buy them for relatively low prices,” said Frank J. Chaloupka, PhD, director of the Health Policy Center at University of Illinois at Chicago. “We know enough about e-cigarettes to say with certainty that policymakers need to act now and need to take strong measures to prevent the use of these products among young people.”

Researchers working together as part of Tobacconomics, an initiative led by Chaloupka, authored three of the studies included in the special issue, which was funded by the National Cancer Institute State and County Tobacco Control (SCTC) Research Initiative.

The new studies help make the case for stronger regulation of e-cigarettes and identify specific policy solutions for protecting children and adults from potential exposure risks while in public places where state regulation lags behind. Key findings show that:

There has been a dramatic increase in the number of U.S. retailers that sell e-cigarettes. In 2012, e-cigarettes were available in 31% of retailers located in middle and high school enrollment zones, up from only 3% in 2010. E-cigarettes are more available in areas where tax and smoke-free air policies are weak. The authors conclude that tobacco retailers are likely selling e-cigarettes where there are more smokers and greater demand, in part due to weaker tobacco control regulation.

States need to expand and strengthen their existing laws. While 34 states have preceded the federal government by setting their own regulations for e-cigarettes, existing polices are not comprehensive. In 2013, 22 states restricted youth access to e-cigarettes, 12 states applied smoke-free air provisions to e-cigarettes, and only Minnesota had an excise tax on e-cigarettes. The authors caution that the policy gap undermines the clean indoor air environment that smoke-free air laws are designed to protect and allows youth access to e-cigarette products that may contain nicotine and other harmful ingredients.

Raising the price of e-cigarettes will reduce consumption. E-cigarette sales are very sensitive to price changes, 2 to 3 times more sensitive than traditional cigarettes. A 10% increase in price would reduce sales of reusable e-cigarettes by about 19% and sales of disposable e-cigarettes by about 12%. E-cigarettes are promoted as cheaper alternatives to traditional cigarettes and users often cite the lower cost as a reason for use. Daily e-cigarette users spend about $33 per month, while a pack-a-day cigarette smoker spends $150–$200 per month. The tax imbalance between e-cigarettes and traditional cigarettes is a major contributor to the price difference.

The full-text articles from the special issue, Electronic Nicotine Delivery Systems (ENDS): New Evidence from the State and Community Tobacco Control Research Initiative, are available at: http://tobaccocontrol.bmj.com/content/23/suppl_3.toc.