E-cigarette, cigar use among youth focus of study

Hongying Dai, Ph.D., associate professor of biostatistics, UNMC College of Public Health, recently received a two-year, $165,165 grant from the National Institutes of Health (NIH) to conduct a national study to assess the impact of FDA retail compliance inspections on youth behaviors in the use of electronic cigarettes (e-cigarettes) and cigars.

Among U.S. high school students, current use of e-cigarettes has outpaced the use of traditional cigarettes. The recently finalized “Deeming Rule” from the Food and Drug Administration (FDA) expanded the agency’s regulatory authority over tobacco to include e-cigarettes, cigars and other emerging tobacco products.

Tobacco use is the leading cause of preventable death, accounting for more than 480,000 deaths each year in the U.S. While the cigarette smoking rate among youth has been declining over the last several decades, the use of emerging tobacco products has been rising.

The use of e-cigarettes among high school students has increased dramatically from 1.5 percent in 2011 to 11.3 percent in 2016. Among teens, use of e-cigarettes has outpaced the use of traditional cigarettes. E-cigarettes contain varying levels of nicotine and a number of potentially toxic substances.

Cigars rank third among the most commonly used tobacco products after e-cigarettes and cigarettes. Cigar smoke contains toxic and cancer-causing chemicals that are harmful to youth. It is possibly more toxic than cigarette smoke.

This study will be the first population study to use a quasi-experimental design to examine the effects of FDA compliance inspections on youth e-cigarette and cigar use behaviors. Dr. Dai’s research team will develop advanced statistical models in analyzing data from more than 300,000 FDA compliance inspections and a national youth behavior survey of 45,000 adolescents.

Dr. Dai will seek to assess whether the FDA regulatory actions of compliance inspections serve as an environmental factor that interacts with other factors of age, race/ethnicity, sex and other tobacco policies to impact youth smoking behaviors.

Findings from this study are expected to inform appropriate retail compliance inspection strategies and further expand our knowledge of the potential impacts of regulatory actions on youth e-cigarette and cigar use behaviors.

Studies using national probability samples have shown that retail compliance with underage sales laws and restricting tobacco sales to minors are important tobacco prevention strategies. No study has examined the effectiveness of FDA inspections of retailers selling e-cigarettes and cigars. Also, the relationship between compliance inspections of tobacco retailers and youth use behaviors is unknown.