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The Unintended Consequences of E-Cigarette Rules and Regulations

Age limits on and advertising for e-cigarettes is having surprising effects on who uses them and who doesn’t. So found Dr. Dhaval M. Dave, Stanton Research Professor of Economics, Research Associate at the National Bureau of Economic Research, and member of the Health Thought Leadership Network at Bentley University, who received a grant from the National Institutes of Health (NIH) in 2016 to study what was then an emerging nicotine product that a lot of people didn’t know much about.

“On one side, people thought that e-cigarettes might be the help those final Americans still smoking needed to quit, and nicotine replacement therapy had been on the market for years,” he said. “On the other side, we saw that e-cigarettes were becoming attractive to kids and could maybe lead them to becoming dependent on nicotine, and we would have a whole new generation of nicotine addicts.”

In one study, his team looked at the effects of e-cigarette advertising and found that television ads lead adult cigarette smokers to quit by using e-cigarettes as a cessation aid. They concluded that if the FDA hadn’t been considering regulations and mandates, e-cigarette ads might have reached more smokers during the period they studied and would have reduced the number of smokers who quit by as much as 10%.

“Cigarette advertising has been banned from TV and the radio since 1970, so we were curious to see how do all those advertising messages sponsored by the e-cigarette companies work?” Dr. Dave explained. “Would they encourage folks to quit smoking, or is this having no effect on smoking or even reducing smoking cessation, in which case it would undermine the argument that e-cigarettes could help adults quit the habit.”

In another study, his team looked at how legal age limits of e-cigarette sales affected youth substance abuse. They found that raising the e-cigarette purchase age had an unintended consequence: it increased youth cigarette smoking by 7%, though they found little evidence that the higher rates of cigarette smoking persisted after teens aged out of the law.

“It’s a no-brainer that kids should not be able to buy e-cigarettes,” he said. “We want to make sure kids do not get their hands on these nicotine products but not make the laws so stringent that they incentivize substitution into smoking or other substances.”

Dr. Dave’s work also looks at how factors like increased access to healthcare and welfare reform affect everything from occupational choice to voter participation to crime, though he expects his NIH funding to continue as the FDA raises concerns about e-cigarette products like JUUL being marketed to kids.

Dr. Dave came to Bentley in 2004 and said “it checks all the boxes in what you are looking for as an academic.”

That isn’t just when it comes to his own research, but what students are doing too.

“One of the things that really continues to make me smile every time I go to work is that I love working with students, especially in upper level classes where they get to really work hands-on with data on their research projects,” he said. “It’s really fun for me and really valuable for them to have that experience.”