In the roughly 20 years since e-cigarettes were introduced in the United States, use among young people has grown substantially. By 2022, more than one in five high school seniors reported they had vaped nicotine in the past month.
Household smoking bans - rules against anybody smoking inside a home - are an effective tool for delaying or preventing teen cigarette smoking, according to Jennifer Maggs, professor of human development and family studies at Penn State, and her collaborators, so they examined if the same might hold true for vaping. They assessed how many households with teenage children in the United States had bans against e-cigarette use or vaping. Over 82% of U.S. households in the study had a vaping ban in 2016. Most households maintained these bans over time, but within four years, 13.5% had relaxed their ban even though teenage children still lived there.
Maggs and her colleagues found that households were twice as likely to relax their smoking ban if parents in the home vaped or smoked, if youth in the home smoked or if there had been an e-cigarette ban but not a smoking ban. Results from the study were recently published in Journal of Adolescent Health.
The researchers examined data for 6,514 youth between the ages of 12 and 17 from the Population Assessment of Tobacco and Health Study, a collaborative study run by the National Institutes of Health and the Food and Drug Administration. Households were included in the current research project if parents reported a strict vaping ban in 2016. Follow-up surveys each year through 2020 asked parents whether they continued to have a household ban on e-cigarette use by anyone in their home.
"When a family sets a norm that nobody - even visitors - vapes inside the home, it communicates a family value of health for all." Maggs said. "But a consistent household ban will be much harder and more awkward to sustain if family members and friends are smokers or vapers."
In addition to the risks posed by smoking or vaping in the home, households with children who reported they were unaware of any vaping ban were almost two times more likely to have relaxed their ban on vaping.
"Every family should consider the fact that almost 10% of teens were unaware their household had a ban on e-cigarettes. These homes were more likely to drop the ban in subsequent years," Maggs said. "Many parents talk to their children about drinking and smoking, but how many address e-cigarettes and vaping specifically? Teenagers will have opportunities to experiment with e-cigarettes. Devices can be tiny, disposable, odorless or smell like lip gloss. They are widely available and easily concealed at school and at home."
Demographic factors were not strongly related to which households maintained a vaping ban, the results demonstrated. Parental education and race had small associations with maintaining household vaping bans, but other factors - including household income and the biological sex of the child - were not related to consistently maintaining bans, according to Maggs.
"Traditional cigarette smoking among teens has been declining from a peak in the mid 1990s when one in three high school seniors had smoked in the last 30 days. Now, it is only one in 25 seniors," said co-author Jessica Mongilio who earned her doctorate in criminology at Penn State in 2024 and is now a postdoctoral scholar at University of Michigan. "This major change has been a huge public health and policy success story."
"Unfortunately, many innovations in nicotine delivery products threaten to make new generations dependent on nicotine," Mongilio continued. "E-cigarettes have increased the number of young people who consume nicotine, and now one in five high school seniors report vaping nicotine in the last month. Since nicotine is extremely addictive, we might be on a path to restarting a public health crisis that we were defeating."
Maggs said that while adult smokers report e-cigarettes may help them reduce or quit smoking, there are no known benefits to teens being exposed to nicotine at a young age, especially when there is strong evidence that nicotine is harmful to developing brains.
In addition to encouraging parents to talk to their children about vaping, Maggs said she believes that other areas of society need to support parents.
"Educators, doctors, religious leaders and other adults who work with children and youth should support messaging that helps parents maintain clear, consistent, continuous restrictions on vaping," Maggs said. "Electronic nicotine delivery devices are always evolving to enhance their appeal to young people. Now is the time for parents and others who support and guide children to address the potential dangers of vaping."
Jeremy Staff, professor of sociology, criminology, and demography at Penn State; Sara Miller, postdoctoral scholar in the Penn State Edna Bennett Pierce Prevention Research Center; Mike Vuolo, professor of sociology at Ohio State University; and Brian Kelly, professor of sociology at Indiana University Bloomington, also contributed to this research.
The National Institute on Drug Abuse funded this research through a grant to Brian Kelly.
