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Short-Term Impact of a Flavored Tobacco Restriction: Changes in Youth Tobacco Use in a Massachusetts Community

Published:October 24, 2019DOI:https://doi.org/10.1016/j.amepre.2019.07.024

      Introduction

      To counter the high prevalence of flavored tobacco use among youth, many U.S. localities have passed policies that restrict youth access to these products. This study aims to evaluate the short-term impact of a flavored tobacco restriction policy on youth access to, and use of, flavored tobacco products in a Massachusetts community.

      Methods

      A community with the policy (Lowell) was matched to a community without the policy (Malden) with similar demographics, retailer characteristics, and point-of-sale tobacco policies. Product inventories were assessed in tobacco retailers in the 2 communities, and surveys were administered to high school–aged youth in those communities. Inventories and surveys were conducted around the time the policy took effect in October 2016 (baseline) and approximately 6 months later (follow-up); all data were analyzed in 2017. Chi-squared tests and difference-in-difference models were used to estimate the impact of the policy on flavored tobacco availability and youth perceptions and behaviors related to flavored tobacco use.

      Results

      Flavored tobacco availability decreased significantly in Lowell from baseline to follow-up periods by 70 percentage points (p<0.001), whereas no significant changes in flavored tobacco availability were seen in Malden. In addition, current use of both flavored and non-flavored tobacco decreased in Lowell, but increased in Malden from baseline to follow-up; these changes were significantly different between communities (flavored tobacco: −5.7%, p=0.03; non-flavored tobacco: −6.2%, p=0.01).

      Conclusions

      Policies that restrict the sale of flavored tobacco have the potential to curb youth tobacco use in as few as 6 months.
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      REFERENCES

      1. U.S. Food and Drug Administration. Family Smoking Prevention and Tobacco Control Act-An Overview.www.fda.gov/tobacco-products/rules-regulations-and-guidance/family-smoking-prevention-and-tobacco-control-act-overview. Updated January 17, 2018. Accessed June 26, 2019.

        • Harrell MB
        • Loukas A
        • Jackson CD
        • Marti CN
        • Perry CL
        Flavored tobacco product use among youth and young adults: what if flavors didn't exist?.
        Tob Regul Sci. 2017; 3: 168‒173
        • Corey CG
        • Ambrose BK
        • Apelberg BJ
        • King BA
        Flavored tobacco product use among middle and high school students‒United States, 2014.
        MMWR Morb Mortal Wkly Rep. 2015; 64: 1066‒1070
        • Dai H
        Changes in flavored tobacco use among current youth tobacco users in the United States, 2014‒2017.
        JAMA Pediatr. 2019; 173: 282-284
        • Villanti AC
        • Johnson AL
        • Ambrose BK
        • et al.
        Flavored tobacco product use in youth and adults: findings from the first wave of the PATH Study (2013‒2014).
        Am J Prev Med. 2017; 53: 139‒151
        • Dai H
        • Hao J
        Flavored electronic cigarette use and smoking among youth.
        Pediatrics. 2016; 138e20162513
        • Ribsil KM
        • D'Angelo H
        • Schleicher NC
        • et al.
        Disparities in tobacco marketing and product availability at the point of sale: results of national study.
        J Prev Med. 2017; 105: 381‒388
        • Sanders-Jackson A
        • Parikh NM
        • Schleicher NC
        • Fortmann SP
        • Henriksen L
        Convenience store visits by US adolescents: rationale for healthier retail environments.
        Health Place. 2015; 34: 63‒66
        • Adams ML
        • Jason LA
        • Pokorny S
        • Hunt Y
        Exploration of the link between tobacco retailers in school neighborhoods and student smoking.
        J Sch Health. 2013; 83: 112‒118
        • Massachusetts Department of Public Health
        Youth tobacco use in Massachusetts: survey results from 1995 to 2017.
        2019 (Accessed July 29, 2019In: Published)
        • Wilson DJ
        Local policies restricting flavored ‘other tobacco products’ (OTP) to adult-only retailers.
        Massachusetts Municipal Association, 2019 (Published April 24)
      2. Kingsley M, Song G, Robertson J, P Henley, WWS Ursprung. Impact of flavoured tobacco restriction policies on flavoured product availability in Massachusetts. Tob Control. In press. Online February 18, 2019. https://doi.org/10.1136/tobaccocontrol-2018-054703.

        • Farley SM
        • Johns M
        New York City flavoured tobacco product sales ban evaluation.
        Tob Control. 2017; 26: 78‒84
      3. CounterTools. Counter store audit center. https://assess.countertools.org/. Accessed December 10, 2018.

      4. Dean AG, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version 3.01. www.OpenEpi.com. Accessed August 28, 2018; Updated 2013.

        • HHS
        The Epidemiology of Tobacco Use Among Young People in the United States and Worldwide. Preventing Tobacco Use Among Youth and Young Adults: a Report of the Surgeon General.
        HHS, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA2012
        • Brock B
        • Carlson SC
        • Leizinger A
        • et al.
        A tale of two cities: exploring the retail impact of flavoured tobacco restrictions in the twin cities of Minneapolis and Saint Paul, Minnesota.
        Tob Control. 2019; 28: 176‒180
        • Eisenberg ME
        • Forster JL
        Adolescent smoking behavior: measures of social norms.
        Am J Prev Med. 2003; 25: 165‒166
        • Hamilton WL
        • Biener L
        • Brennan RT
        Do local tobacco regulations influence perceived social norms? Evidence from adult and youth surveys in Massachusetts.
        Health Educ Res. 2008; 23: 709‒722
      5. Lowell walk Score®.
        Published 2019
        www.walkscore.com/MA/Lowell
        Date accessed: June 26, 2019
        • Lee YO
        • Glantz SA
        Menthol: putting the pieces together.
        Tob Control. 2011; 20: ii1‒ii7