Variation in adults' use of flavored tobacco products by sales restrictions in California jurisdictions

David S Timberlake; Julian Aviles; Denise Diaz Payán

doi:10.1016/j.drugpo.2023.104041

Variation in adults' use of flavored tobacco products by sales restrictions in California jurisdictions

Int J Drug Policy. 2023 Jun:116:104041. doi: 10.1016/j.drugpo.2023.104041. Epub 2023 Apr 27.

Authors

David S Timberlake¹, Julian Aviles², Denise Diaz Payán³

Affiliations

¹ Department of Population Health and Disease Prevention, Program in Public Health, College of Health Sciences, University of California, Irvine, 856 Medical Sciences, Irvine, CA 92697, USA. Electronic address: dtimberl@uci.edu.
² UCLA Center for Health Policy Research, University of California, Los Angeles,10960 Wilshire Blvd, Suite 1550, Los Angeles, CA 90024, USA.
³ Department of Health, Society and Behavior, Program in Public Health, College of Health Sciences, University of California, Irvine, 856 Medical Sciences, Irvine, CA 92697, USA.

PMID: 37119644
DOI: 10.1016/j.drugpo.2023.104041

Abstract

Background: State and local policies prohibiting the sales of flavored tobacco have been effective in curtailing retail availability and sales of products across the United States. Less is known about the use of flavored tobacco which could vary as a function of type of ordinance, product category, policy implementation, and other factors.

Methods: The 2019-2020 California Health Interview Surveys were used to estimate flavored and non-flavored tobacco use among adults (n = 43,681) residing in a California jurisdiction with a comprehensive (n = 48), partial (n = 35), or no flavored tobacco sales restriction (FTSR) (n = 427). Multinomial logistic regression models, which accounted for clustering within jurisdictions (n = 510), were separately developed for outcomes corresponding to use of any tobacco, non-cigarette tobacco products (NCTPs), electronic nicotine delivery systems, and conventional cigarettes. Individual-level effects of policy on tobacco use were estimated due to the overlap between the survey periods and effective policy dates.

Results: Approximately 22% of Californians were subject to a partial or comprehensive FTSR by December 31, 2020. Accounting for potential confounders, residents of jurisdictions with a comprehensive FTSR (vs. no ban) had 30% lower odds of using any flavored tobacco. The strongest and only statistically significant association by product category was exposure to a comprehensive FTSR and use of a flavored NCTP (aOR=0.4 (0.2, 0.8); p=0.008). Null or positive associations were primarily observed between a partial FTSR and flavored tobacco use, as well as associations between any FTSR and non-flavored tobacco use.

Conclusion: Recent passage of a statewide ban in California will close gaps from the patchwork of local policies and eliminate most partial FTSR exemptions. However, state law still exempts the sales of some flavored tobacco products (e.g., hookah), leaving jurisdictions the option of enacting comprehensive FTSRs that may be more effective than partial FTSRs in reducing use of flavored tobacco.

Keywords: California jurisdictions; Flavored tobacco; Flavored tobacco sales restrictions; Ordinances; Policy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
California
Commerce
Electronic Nicotine Delivery Systems*
Flavoring Agents
Humans
Tobacco Products*
Tobacco Use
United States

Substances

Flavoring Agents