Summary
Summary: 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.
The 2019–2020 California Health Interview Surveys (CHIS) were used to estimate flavored and nonflavored tobacco use among adults residing in a California jurisdiction with a comprehensive, partial, or no-flavored tobacco sales restriction (FTSR). Multinomial logistic regression models, which accounted for clustering within jurisdictions, were separately developed for outcomes corresponding to use of any tobacco, noncigarette 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.
Findings: 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. Null or positive associations were primarily observed between a partial FTSR and flavored tobacco use, as well as associations between any FTSR and nonflavored tobacco use.
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.
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