Smoke-free worksite laws curbing vaping

A new observational study from researchers at the Yale School of Public Health suggests smoke-free worksite laws may yield reductions, not only in conventional cigarette use, but in the use of electronic nicotine delivery systems as well.

The researchers also found that adding vaping restrictions to these laws did not lead to further reductions in use of electronic nicotine delivery systems. Indeed, such restrictions appeared to reduce smoke-free worksite laws' effects on conventional cigarette use.

By estimating effects on both smoking and vaping—an increasingly popular alternative to traditional cigarette smoking—this study's findings clarify how clean air laws can be used to best promote population health. Specifically, with 76% of the U.S. population covered by smoke-free worksite laws, evidence of ongoing benefits from these policies suggests nationwide adoption as a means to improve public health. The study was published in the journal Addiction.

Studies have already shown that smoke-free air laws reduce smoking rates and increase quitting. However, much of that research was performed before e-cigarettes became easily accessible. In their study, the YSPH research team noted that access to electronic nicotine delivery systems could have altered these policies' effects, since smokers might switch to vaping in smoke-free areas and continue to smoke elsewhere.

Considering smoke-free worksite, smoke-free restaurant, vape-free worksite, and vape-free restaurant laws, the team used nationally representative U.S. survey data from 2014-2018 to compare respondent behaviors in areas with more versus less coverage under each of these policies, as the percent of a respondent's county covered by a particular policy increased. Separate analyses considered current smoking and recent vaping among people aged 18 to 25 (as almost all smoking initiation occurs by age 25), and smoking cessation among those aged 26 to 54, excluding older respondents so that early tobacco-related deaths would not skew the data.

The study's findings concur with prior research on smoke-free worksites and conventional cigarette use: adoption of smoke-free worksite laws was associated with a substantive reduction in current smoking among young adults (5 percentage points, or about 36% of the mean), and an increase in past-year smoking cessation among those 26 to 54 years old (2.6 percentage points, or about 21% of the mean). However, results also suggest that adding vape-free worksite restrictions may have muted the smoke-free law's reduction in young adult smoking by over 50%.

A variety of mechanisms might explain the latter relationship; for example, restricting vaping to the same extent as smoking may reduce smokers' incentives to switch, leading some would-be-vapers to continue smoking instead. The study authors wrote that more research is needed to fully understand these restrictions' effects.

"The bulk of current evidence finds that smoking cigarettes is likely to be far more harmful than vaping nicotine. To promote public health, policymakers need to understand how tobacco control laws affect both of these behaviors," said YSPH Assistant Professor Abigail Friedman, who led the study.