E-cigarettes and Planned Smoking Cessation

Abstract

We provide evidence on whether e-cigarette accessibility reduces planned smoking cessation. Substantial evidence indicates e-cigarettes and cigarettes are substitutes, but whether e-cigarettes compete with safer FDA-approved smoking cessation products, or whether they entice people to quit smoking that had no interest in quitting otherwise, is little understood and important from a public health and regulatory perspective. We study this question by using e-cigarette taxes as a proxy for e-cigarette accessibility, and studying the effect these taxes have on sales of over-the-counter nicotine replacement therapies (NRTs), prescriptions for smoking cessation pills, calls to state quitlines, and overall reports of cessation available in a large-scale health survey. We combine four national data sets from 2010 to 2021 in the United States with quasi-experimental difference-indifferences (DID) methods. Our findings imply that taxing e-cigarettes does not disrupt planned smoking cessation efforts. We can rule out effects larger than a 3.0% decrease or a 3.6% increase in NRT sales following a $1 e-cigarette tax increase.

Keywords: smoking cessation, nicotine replacement therapy, smoking cessation products, e-cigarettes, taxation

JEL Classification: I1, I11, I18