Nali Matthew C, Purushothaman Vidya, Xu Qing, Cuomo Raphael E, Mackey Timothy K
Global Health Policy Institute, San Diego, United States.
Department of Anesthesiology, University of California San Diego School of Medicine, San Diego, United States.
Tob Induc Dis. 2021 Jan 20;19:05. doi: 10.18332/tid/131199. eCollection 2021.
Recent reports of lung injury associated with Electronic Nicotine Delivery System (ENDS) products precipitated by increasing vaping prevalence and interest in flavors among adolescents has led to policies that restrict the sale, distribution, and accessibility of ENDS products. This study assessed compliance of online ENDS vendors to the Massachusetts temporary sales ban.
The study involved structured web surveillance for online ENDS vendors using keyword searches on Google search engine (October to November 2019.) Once vendors were identified, we conducted simulated online purchases, defined as placing an order for an ENDS product by putting it in the website shopping cart without finalizing payment. Simulated purchases and content analysis of websites was conducted to determine compliance characteristics. Fisher's exact test was used to identify associations between compliance and website characteristics such as location and age verification requirements.
Simulated online purchases from 50 identified ENDS vendors yielded 72% (n=36) stores that were non-compliant and allowed placement of ENDS product orders, without restrictions, to a Massachusetts address. The remaining 14 websites had processes in place to prevent orders from buyers located in Massachusetts. Other characteristics of interest, including use of age verification, location data, and web registrar/registrant data were collected and reported.
The September 2019 Massachusetts executive order was a comprehensive ban on selling ENDS products both online and offline. However, our study found that close to three-fourths of the vendors appeared to be non-compliant, indicating that implementation and enforcement are ongoing challenges for future tobacco control efforts on the internet. Policymaking needs to be specifically tailored to address the unique challenges of online environments, particularly in the context of identifying non-compliant sites, ensuring age verification, and addressing non-US sellers.
随着电子烟在青少年中的流行率上升以及对口味的兴趣增加，近期有关电子尼古丁传送系统（ENDS）产品导致肺损伤的报告促使出台了限制ENDS产品销售、分销和获取的政策。本研究评估了在线ENDS供应商对马萨诸塞州临时销售禁令的遵守情况。
该研究通过在谷歌搜索引擎上进行关键词搜索（2019年10月至11月），对在线ENDS供应商进行结构化网络监测。一旦确定了供应商，我们进行了模拟在线购买，即通过将ENDS产品放入网站购物车但不完成付款来下单。对网站进行模拟购买和内容分析以确定合规特征。使用Fisher精确检验来确定合规与网站特征（如位置和年龄验证要求）之间的关联。
从50家已确定的ENDS供应商进行的模拟在线购买中，72%（n = 36）的商店不符合规定，允许无限制地向马萨诸塞州地址下达ENDS产品订单。其余14个网站有措施防止来自马萨诸塞州买家的订单。还收集并报告了其他感兴趣的特征，包括年龄验证的使用、位置数据以及网络注册商/注册者数据。
2019年9月马萨诸塞州的行政命令全面禁止在线和离线销售ENDS产品。然而，我们的研究发现，近四分之三的供应商似乎不符合规定，这表明实施和执法是未来互联网烟草控制工作面临的持续挑战。政策制定需要专门针对解决在线环境的独特挑战进行调整，特别是在识别不符合规定的网站、确保年龄验证以及处理非美国卖家方面。
