While the reason for enacting smokefree laws and implementing voluntary smokefree policies has been to protect people from secondhand smoke, a well-established side effect is that they help adult smokers quit and help prevent youth smoking (laws, home policies). Now Jeremy Staff and his colleagues have shown that kids living in vapefree households are much less likely to use e-cigarettes.
Their paper Household vaping bans and youth e-cigarette use found that, after controlling for a wide range of factors for both the youth (age 12-17) themselves and their parents, found that home vaping bans were associated with about half the odds of youth vaping in half (adjusted OR = 0.44; 95% CI = 0.33-0.58). An additional analysis that followed individual young people forward in time, found 37% lower odds of vaping in waves during the time that when they lived in a vape-free household compared to when they didn’t (OR = 0.63; 95% CI = 0.50-0.78). These effects are huge.
Staff and colleagues used data from the national PATH study collected between 2016 and 2020 and controlled for prior adolescent smoking, vaping, and other nicotine product use; parent current smoking, vaping, and other nicotine use; adolescent peer e-cigarette and cigarette use; parental monitoring; and demographic characteristics. They conducted extensive sensitivity analysis to show that these results were robust and unlikely to be due to unidentified confounding variables.
They also found significant associations between smokefree home rules and youth smoking, but this association lost significance after controlling for the other variables. This loss of significance may be due to the fact that vaping is much more common among youth than smoking.
Practical Implications
Just as smokefree environments have turned out to be one of the most powerful interventions to reduce smoking, this study indicates that vapefree environments are also powerful. While Staff and colleagues did not explore why vapefree homes had this big effect, like smokefree homes, it is likely a combination of highlighting the right of non-users to be protected from secondhand e-cig aerosol exposure, undermining the social acceptability of vaping, and removing pro-vaping cues.
Policymakers should incorporate vaping into smokefree laws and promote voluntary vape-free homes as central elements of policies to reduce vaping. Public education campaigns by state tobacco control programs, the FDA, Truth Initiative and others should highlight the fact that bystanders are inhaling toxic chemicals exhaled by vapers.
The better informed people are the more likely non-users will demand that vapers to it somewhere else and the more likely vapers will feel guilty about what they are doing to their friends and family. After all, as with smoking, more people are non-vapers than vapers. Empowering them to object to secondhand e-cig pollution is a key step in removing the social support system for e-cigarettes.
Here is the abstract:
Aims: The aims of this study were to measure whether household bans on vaping were associated with lower odds of youth past-month vaping when compared with (1) otherwise similar youth whose households did not have a vaping ban (using coarsened exact matching); and (2) themselves in waves when their household did not have a ban (using hybrid panel models). We used the same analytical strategies to examine cross-sectional associations between household smoking bans and adolescents’ past-month cigarette smoking.
Design: This was a longitudinal study using data from a nationally representative sample of youth (age 12-17 years) in the Population Assessment of Tobacco and Health Study.
Setting: United States of America.
Participants: A total of 16 214 adolescents followed over 48 103 total observations (approximately three waves).
Measurements: Measurements comprised youth past-month e-cigarette and cigarette use and parent-reported household bans on vaping and smoking. Potential confounders were prior adolescent smoking, vaping, and other nicotine product use; parent current smoking, vaping, and other nicotine use; adolescent peer e-cigarette/cigarette use; parental monitoring; and demographic characteristics.
Findings: Before matching, smoking bans were associated with 46% lower odds of youth smoking [odds ratio (OR) = 0.54; 95% confidence interval (CI) = 0.41-0.70] and vaping bans with 37% lower odds of youth e-cigarette use (OR = 0.63; 95% CI = 0.50-0.80). However, households with and without bans differed significantly on all confounders before matching. After matching, household vaping bans were associated with 56% lower odds of youth vaping (OR = 0.44; 95% CI = 0.33-0.58). Results from hybrid panel models also revealed 37% lower odds of vaping in waves when youth lived in a vape-free household compared to waves when they did not (OR = 0.63; 95% CI = 0.50-0.78). Associations between smoking bans and youth smoking were not statistically significant after matching or when using hybrid panel models.
Conclusions: Household vaping bans appear to be associated with lower odds of past-month vaping among US adolescents, compared with similar youth whose households did not have a ban and to themselves in waves when their households did not have a ban.
The full citation is: Staff J, Mongilio JM, Maggs JL, Vuolo M, Kelly BC. Household vaping bans and youth e-cigarette use. Addiction. 2024 Jan;119(1):74-83. doi: 10.1111/add.16335. Epub 2023 Sep 15. PMID: 37715485. It is available here.
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