Nicotine Vaping and Youth Mental Health: New Evidence from E-Cigarette Regulations

The confluence of a youth mental health crisis and high rates of teenage nicotine vaping has led some U.S. tobacco control advocates to argue that reducing access to electronic nicotine delivery systems (ENDS) — through policies such as ENDS taxation — may improve youth and young adult mental health. Using data from several nationally representative surveys (Youth Risk Behavior Survey, Behavioral Risk Factor Surveillance System, and Population Assessment of Tobacco and Health) and a generalized difference-in-differences approach, we find no evidence that ENDS taxation improves youth and young adult mental health. With 95 percent confidence, we can rule out that the mean state ENDS tax increase adopted during our analysis sample ($0.34 per mL of e-liquid in 2023$) reduces persistent depressive symptoms among youths by more than 0.3 percent and suicide ideation by more than 1.0 percent. Moreover, discrete-time hazard models provide little evidence that ENDS taxes affect dynamics in youth mental health. A similar pattern of results emerges when we examine a wider set of ENDS regulations, including minimum legal purchasing ages, e-cigarette licensure laws, online sales restrictions, and restrictions on indoor nicotine vaping.