A review of the current geographic distribution of and debate surrounding electronic cigarette clean air regulations in the United States

Abstract

In this article, we present the results of a systematic review of state, county, and municipal restrictions on the use of electronic cigarettes (e-cigarettes) in public spaces within the United States, alongside an overview of the current legal landscape. The lack of federal guidance leaves lower-level jurisdictions to debate the merits of restrictions on use in public spaces without sufficient scientific research. As we show through a geographic assessment of restrictions, this has resulted in an inconsistent patchwork of e-cigarette use bans across the United States of varying degrees of coverage. Bans have emerged over time in a manner that suggests a "bottom up" diffusion of e-cigarette clean air policies. Ultimately, the lack of clinical and scientific knowledge on the risks and potential harm reduction benefits has led to precautionary policymaking, which often lacks grounding in empirical evidence and results in spatially uneven diffusion of policy.

Keywords: Electronic cigarettes; Geographic distribution of policy; Health policy; Policy debate.

Figure 1. Geographic Coverage of Electronic Cigarette Clean Air Regulations in the U.S.

Source: American Nonsmokers’ Rights Foundation U.S. Tobacco Control Laws Restricted Use Database (current as of March 2014). Note 1: Irregular shapes represent counties. Black-outlined circles represent a local municipality that passed a restriction at that location. Note 2: Alaska and Hawaii are not shown. The only restriction in Alaska is a comprehensive ban in the town of Palmer. The only restriction in Hawaii is a statewide ban on e-cigarette use specifically on grounds of the State Department of Health. Note 3: States whose only statewide restrictions apply to correctional facilities are not colored. These states are Colorado, Kansas, Oklahoma, and South Dakota. Note 4: Restrictions superseded by higher level geographic unit restrictions are not shown. Note that some county-level restrictions only apply to unincorporated areas; therefore, local ordinances of the same category are retained in the figure for such municipalities.