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Mental health: There is a strong relationship between youth smoking and depression, anxiety, and stress.2 Personal perceptions: Expectations of positive outcomes from smoking, such as coping with stress and controlling weight, are related to youth tobacco use.2 Other influences that affect youth tobacco use include:2,8 Lower socioeconomic status, including lower income or education Lack of skills to resist influences to tobacco use Lack of support or involvement from parents Accessibility, availability, and price of tobacco products Low levels of academic achievement Low self-image or self-esteem Exposure to tobacco advertising Reducing Youth Tobacco Use National, state, and local program activities have been shown to reduce and prevent youth tobacco use when implemented together

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(California recently raised the minimum legal age to purchase tobacco and e-cigarette products from 18 to 21.) Ensuring regulatory compliance at the point of sale is just one of many ways in which licensing e-cigarette retailers and vape shops can be an effective tobacco control tool for both state and local governments

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