Changes in adults' vaping and smoking behaviours associated with aerosol-free laws.

ABSTRACT

OBJECTIVES: Banning e-cigarette use in public places has attracted considerable debate, with governments adopting different policies. However, little is known about the outcomes of such bans. We investigated the association of banning e-cigarette use in public places and workplaces in Canadian provinces with adults' vaping and smoking behaviours. DESIGN: Difference-in-differences. SETTING: Nationally representative Canadian Tobacco Use Monitoring Survey (CTUMS) and Canadian Tobacco, Alcohol and Drugs Survey (CTADS). PARTICIPANTS: Adults aged 19 and older from CTADS 2013-2017 for e-cigarette outcomes (N=36 562) and from CTUMS/CTADS 2004-2017 for combustible cigarette outcomes (N=178 654). INTERVENTIONS: Bans on e-cigarette use in public places and workplaces in Canadian provinces. MAIN OUTCOME MEASURES: Past 30-day e-cigarette use, current combustible cigarette use, use of e-cigarettes when unable to smoke combustible cigarettes. RESULTS: After the bans, e-cigarette use in the past 30 days did not change significantly in provinces with a ban compared with provinces without a ban (0.004; 95% CI -0.025 to 0.032; p=0.783). The bans also had no impact on current combustible cigarette use (0.009; 95% CI -0.019 to 0.037; p=0.488). There is evidence of ban evasion among young people aged 19-24 who, after the bans, reported higher use of e-cigarettes when unable to smoke combustible cigarettes (0.114; 95% CI -0.023 to 0.250; p=0.092). CONCLUSIONS: Two years after implementation, the aerosol-free laws in Canada had no impacton adults' vaping and smoking behaviours. Policy efforts are urgently needed to improve the ban enforcement and to deal with discreet vaping among young adults.