HMN 2025: How State bans on flavored e-cigarettes could inadvertently increase traditional cigarette use among young adults

A study in Health Economics reveals that comprehensive state bans on flavored e-cigarettes may reduce vaping among young adults, but they can also lead to increased use of traditional cigarettes.

Using information from national datasets and advanced statistical methods, researchers found evidence that young adults 18–24 years of age decrease their use of e-cigarettes by about 2–3 percentage points after state bans, while increasing traditional cigarette use by a similar amount. Because cigarettes are more dangerous to health than e-cigarettes, there appears to be a net negative effect on health for this age group.

For youth under 18 years of age, there was some suggestive evidence of increasing cigarette use. The bans had no effect on e-cigarette and smoking participation among adults aged 25 years and older.

“Although the bans aim to curb youth initiation into nicotine use, the findings suggest a troubling substitution effect that could undermine broader tobacco control efforts,” said corresponding author Henry Saffer, Ph.D., of the National Bureau of Economic Research and the Graduate Center of the City University of New York.

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