E-cigarette Policymaking by Local and State Governments: 2009-2014.

Policy Points: E-cigarettes are new products that are generating policy issues, including youth access and smokefree laws, for local and state governments. Unlike with analogous debates on conventional cigarettes, initial opposition came from e-cigarette users and retailers independent of the multinational cigarette companies. After the cigarette companies entered the e-cigarette market, the opposition changed to resemble long-standing industry resistance to tobacco control policies, including campaign contributions, lobbying, and working through third parties and front groups. As with earlier efforts to restrict tobacco products, health advocates have had the most success at the local rather than the state level. Context E-cigarettes entered the US market in 2007 without federal regulation. In 2009, local and state policymakers began identifying ways to regulate their sale, public usage, taxation, and marketing, often by integrating them into existing tobacco control laws. Methods We reviewed legislative hearings, newspaper articles, financial disclosure reports, NewsBank, Google, Twitter, and Facebook and conducted interviews to analyze e-cigarette policy debates between 2009 and 2014 in 4 cities and the corresponding states. Findings Initial opposition to local and state legislation came from e-cigarette users and retailers independent of the large multinational cigarette companies. After cigarette companies entered the e-cigarette market, e-cigarette policy debates increasingly resembled comparable tobacco control debates from the 1970s through the 1990s, including pushing pro-industry legislation, working through third parties and front groups, mobilizing “grassroots” networks, lobbying and using campaign contributions, and claiming that policy was unnecessary due to “imminent” federal regulation. Similar to the 1980s, when the voluntary health organizations were slow to enter tobacco control debates, because they saw smoking restrictions as controversial, these organizations were reluctant to enter e-cigarette debates. Strong legislation passed at the local level because of the committed efforts of local health departments and leadership from experienced politicians but failed at the state level due to intense cigarette company lobbying without countervailing pressure from the voluntary health organizations. Conclusions Passing e-cigarette regulations at the state level has become more difficult since cigarette companies have entered the market. While state legislation is possible, as with earlier tobacco control policymaking, local governments remain a viable option for overcoming cigarette company interference in the policymaking process.