When China raised taxes on e-cigarettes, the aim was to reduce vejpa. A recent follow-up study also shows that use actually decreased. The price, however, was an increase in smoking among the same people, who simply swapped e-cigs for regular cigarettes again.
Tax as a policy tool was tested in China when a substantial tax increase on e-cigarettes was introduced in 2022. The measure was part of the country's broader nicotine policy and aimed to reduce the use of vejp among adults. Three years later, researchers have followed up on how users were actually affected - and the results show a clear, but problematic, effect.
The study followed over 90 adult e-cigarette users for almost a year, measuring them before the tax increase and twice after it came into force. Participants were asked about their habits, their use of different nicotine products, and their perceptions of risks and costs, among other things.
Fewer vejps - but more smokers
The results show that e-cigarette use gradually decreased after the tax was introduced. More people stopped using vejpa altogether, and daily use went down in the group as a whole. On the surface, the stated objective of the tax increase was thus fulfilled.
But when the researchers scratched the surface a little more, a different picture emerged. A large proportion of those who quit e-cigarettes started smoking regular cigarettes instead. Among those who initially used e-cigarettes alone, more than a third had switched to cigarettes after 10 months. Among those who already used both, smoking became even more common. The study thus suggests that reduced e-cigarette use did not automatically mean reduced nicotine use - but rather a shift from one nicotine use to another.
No clear changes in risk perception
Another key finding of the study is that participants' perceptions of risk did not change significantly after the tax increase. Perceptions of how dangerous it is to vejpa, how serious the consequences could be or whether the behaviour is bad remained largely at pre-reform levels.
According to the researchers, this suggests that price, rather than changing attitudes or increased risk awareness, was the factor influencing behaviour. As e-cigarettes became more expensive, use declined - but without participants seeing smoking as a worse alternative.
Limited study - but clear signal
The researchers behind the study are based at universities and research institutions in China and the United States. Published in the scientific journal ”Tobacco Induced Diseases”, the study is based on repeated measurements of the same individuals - making it possible to track changes over time. However, the sample size is relatively small and participants were recruited through online forums, so the results do not necessarily reflect the whole population, but the researchers believe that the results send a clear signal: when e-cigarettes are heavily taxed, without corresponding measures for other nicotine products, there is a risk that their use will not disappear - but simply shift.
The researchers note that policies such as taxes can influence behaviour - but they can also have unintended effects, especially when different nicotine products are treated differently.
