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September 2016 (Volume 94)
Quarterly Article
Elizabeth Cox
Rachel Ann Barry
Stanton A. Glantz
Sep 14, 2026
Sep 9, 2026
Back to The Milbank Quarterly
Policy Points:
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.
Author(s): Elizabeth Cox, Rachel Ann Barry, and Stanton Glantz
Keywords: advocacy coalitions, tobacco control policy, public health policy, e-cigarettes, tobacco companies, cigarette companies.
Read on Wiley Online Library
Volume 94, Issue 3 (pages 520–596) DOI: 10.1111/1468-0009.12212 Published in 2016