Journal of Health Economics · 2026 · Ege Aksu、Charles Courtemanche、Dhaval Dave、Daniel Dench、Grossman Michael、Jongoh Kim
中文摘要
州和联邦两级政策制定者一直将限制电子尼古丁传送系统(ENDS)的线上销售作为减少青少年吸电子烟的一项重要工具加以推广。本研究首次全面评估了全州范围的线上ENDS销售限制及其对青少年和年轻成年人烟草相关行为的影响。我们利用四个具有全国代表性的数据集——《监测未来》调查(Monitoring the Future survey)、州级及综合青少年危险行为监测系统调查(State and Combined Youth Risk Behavior Surveillance System surveys)、烟草与健康人群评估研究(Population Assessment of Tobacco and Health study)以及行为危险因素监测系统调查(Behavioral Risk Factor Surveillance System survey)——并采用广义双重差分框架,考察了这些政策对产品获取、ENDS使用及相关烟草结果的影响。我们发现,线上销售限制大幅减少了ENDS产品的线上购买,表明这些政策影响了其针对的获取渠道。一些证据表明存在向社交来源的替代,但从"其他"来源(如黑市)获取ENDS产品的情况也有所减少。我们没有发现证据表明这些法律减少了青少年ENDS的总体使用、频繁使用、初次使用或香烟吸食。这些零结果与如下事实相符:即便在政策实施之前,线上购买在青少年ENDS获取中所占份额也很小。综合来看,研究结果表明,限制线上销售能够成功限制特定获取渠道,而不会导致ENDS使用的总体模式发生较大变化。
Abstract
Policymakers at both the state and federal levels have promoted restrictions on online sales of electronic nicotine delivery systems (ENDS) as an important tool for reducing youth vaping. This study provides the first comprehensive evaluation of statewide online ENDS sales restrictions and their effects on youth and young adult tobacco-related behaviors. Using data from four nationally representative datasets—the Monitoring the Future survey, the State and Combined Youth Risk Behavior Surveillance System surveys, the Population Assessment of Tobacco and Health study, and the Behavioral Risk Factor Surveillance System survey—and a generalized difference-in-differences framework, we examine the effects of these policies on product acquisition, ENDS use, and related tobacco outcomes. We find that online sales restrictions substantially reduce online purchases of ENDS products, indicating that the policies affect the targeted channel of access. Some evidence suggests substitution to social sources but also a decrease in obtaining ENDS products from “other” sources such as the black market. We find no evidence that these laws reduce overall youth ENDS use, frequent use, initiation, or cigarette smoking. These null results are consistent with online purchasing accounting for a small share of youth ENDS acquisition even prior to policy adoption. Taken together, the results suggest that restricting online sales can successfully limit a specific access channel without producing large changes in overall patterns of ENDS use.