Search

Background: As of September 2020, more than 300 state and local jurisdictions restrict the sales of flavored tobacco, with some including menthol. Aims: To evaluate the impact of local ordinances restricting the sale of flavored tobacco, we surveyed Californians regarding policy support and perceived access to flavored tobacco. Methods: In 2019, we conducted an online survey of 3,075 California youth and young adults recruited via social media, about half of whom lived in a policy jurisdiction. Logistic regressions assessed differences on propensity score--weighted outcomes, policy support, and perceived access. Results Most respondents indicated agreement with almost all policy support statements. Although policy respondents were less likely than rest-of-California respondents to report perceived difficulty in buying flavored cigars, flavored vape users in policy jurisdictions were more likely than those in the rest of California to report perceived difficulty in buying flavored e-liquid. Regardless of jurisdiction, certain priority subgroups were significantly more likely to report perceived difficulty in accessing flavored cigars, flavored vaping products, flavored e-liquid, and menthol cigarettes. Discussion: With some exceptions, these findings demonstrate that among vape users in policy jurisdictions and priority subgroups, there is a higher likelihood of reporting perceived difficulty to access flavored tobacco products. Conclusions: Findings might be an early indication of shifts in social norms about flavored tobacco products in California, which could gain traction as local sales restriction ordinances proliferate throughout the state and a statewide flavored-tobacco sales restriction goes into effect.

IntroductionFlavored tobacco appeals to new users. This paper describes evaluation results of California's early ordinances restricting flavored tobacco sales.MethodsA multicomponent evaluation of proximal policy outcomes involved the following: (a) tracking the reach of local ordinances; (b) a retail observation survey; and (c) a statewide opinion poll of tobacco retailers. Change in the population covered by local ordinances was computed. Retail observations compared availability of flavored tobacco at retailers in jurisdictions with and without an ordinance. Mixed models compared ordinance and matched no-ordinance jurisdictions and adjusted for store type. An opinion poll assessed retailers' awareness and ease of compliance with local ordinances, comparing respondents in ordinance jurisdictions with the rest of California.ResultsThe proportion of Californians living in a jurisdiction with an ordinance increased from 0.6% in April 2015 to 5.82% by January 1, 2019. Flavored tobacco availability was significantly lower in ordinance jurisdictions than in matched jurisdictions: menthol cigarettes (40.6% vs. 95.0%), cigarillos/cigar wraps with explicit flavor descriptors (56.4% vs. 85.0%), and vaping products with explicit flavor descriptors (6.1% vs. 56.9%). Over half of retailers felt compliance was easy; however, retailers in ordinance jurisdictions expressed lower support for flavor sales restrictions.ConclusionsThe proportion of California's population covered by a flavor ordinance increased nine-fold between April 2015 and January 2019. Fewer retailers in ordinance jurisdictions had flavored tobacco products available compared to matched jurisdictions without an ordinance, but many still advertised flavored products they could not sell. Comprehensive ordinances and retailer outreach may facilitate sales-restriction support and compliance.

Objectives. To assess tobacco product availability, advertised discounts, and prices in rural and nonrural stores, comparing results for two definitions of rural. Method. This geospatial study linked data from marketing surveillance in a representative sample of licensed tobacco retailers in California (n = 1,276) and categorized rural/nonrural stores at the county and tract levels. Data were collected from January to March, 2017, and mixed-models analyses tested for differences by location (rural vs. nonrural). Results. Compared to nonrural stores, rural-county stores were 2.1 (95% confidence interval [CI; 1.2, 3.6]) times more likely to sell chewing tobacco and 2.5 (95% CI [1.4, 4.2]) times more likely to sell roll-your-own. Rural-county stores sold larger packs of cigarillos for less than $1 (coefficient = 0.22, 95% CI [0.05, 0.39]) and charged less for the cheapest cigarette pack regardless of brand (estimated mean difference = $-0.21, 95% CI [-0.39, -0.03]). Contrary to expectation, a popular brand of chewing tobacco cost more in rural-county stores. A tract-level definition of rural reclassified only 1 in 10 stores, and did not substantially alter the results. Overall, 32.9% of stores advertised discounts on chewing tobacco, but this was more common in rural than nonrural census tracts (adjusted odds ratio = 1.81, 95% CI [1.14, 2.88]). Discussion. Evidence that $1 buys more cigarillos in rural-county stores than elsewhere adds to health equity concerns that the prevalence of cheap, flavored tobacco is not limited to neighborhoods characterized by socioeconomic disadvantage, higher proportions of African Americans, and higher proportions of school-age youth. Policies that focus on the retail environment for tobacco are needed to make tobacco less attractive and more costly everywhere, including rural areas.

IntroductionAmerican Spirit cigarettes feature American Indian/Alaska Native (AI/AN) imagery in the branding and are marketed as environmentally friendly, without additives, and four varieties contain organic tobacco. This study is the first to examine retail price of American Spirit relative to other cigarette brands and to assess how its price varies by neighborhood demography.MethodsIn a random sample of licensed tobacco retailers (n = 1277), trained data collectors recorded availability and price of American Spirit, Pall Mall, Newport, Marlboro, and the cheapest cigarettes regardless of brand. Data were collected in January-March 2017 in California, the state with the largest AI/AN population. Paired t tests assessed prices (before sales tax) of American Spirit relative to others. Ordinary least squares regressions modeled prices as a function of neighborhood demography, adjusting for store type.ResultsAmerican Spirit was sold in 77% of stores at an average price of $7.03 (SD = 0.66), which was $0.75-$1.78 (12.0%-34.4%) higher than Pall Mall, Newport, and Marlboro in the same stores. American Spirit costs significantly less in neighborhoods with a higher proportion of school-age residents; however, this pattern was not unique to that brand. Contrary to expectation, American Spirit did not cost less in neighborhoods with a higher proportion of AI/ANs.ConclusionThis study is the first to document lower prices for American Spirit in neighborhoods with a higher proportion of school-age youth. Future research should consider whether the ultra-premium price of American Spirit contributes to misperceptions that the brand is organic and less harmful than other cigarettes.ImplicationsIn a large random sample of licensed tobacco retailers in California, American Spirit costs significantly more than other brands, 12.0%-34.4% more than Pall Mall, Newport, and Marlboro in the same stores. After controlling for store type, American Spirit price was significantly lower in neighborhoods with a higher proportion of school-age residents. Research about how an ultra-premium price contributes to misperceptions that all American Spirit varieties are organic and the brand is less harmful and less addictive than other cigarette brands would be informative for ongoing litigation and product regulation.

Introduction Beverly Hills and Manhattan Beach were the first California cities to end tobacco sales. Previous research assessed retailers' perceptions of the laws. This study is the first to evaluate compliance (Study 1), assess whether branded or unbranded tobacco cues remain, and examine cigarette prices/discounts in cross-border stores (Study 2). Aims and Methods Each of the four data collectors requested Marlboro or e-cigarettes (randomly assigned) in all restricted stores (n  = 33) until four attempts were exhausted or a violation occurred. Follow-up visits recorded whether former tobacco retailers advertised tobacco or contained unbranded cues. In a random sample of 126 cross-border stores (half within 1 mile of no-sales cities and half 2–4 miles away), data collectors recorded price of Marlboro and presence of cigarette discounts. Mixed models (stores within tracts), tested for differences between near and far stores, adjusting for store type and median household income. Results Compliance was 87.5%: three stores sold Marlboro (US $8, $10, and $10) and one sold Puff Bar (US $16). Tobacco-branded items and unbranded tobacco cues remained in one store each. Mean Marlboro price was US $10.61 (SD = 1.92) at stores within 1 mile of no-sales cities, averaging US $0.73 more than at stores farther away (p  < .05). However, odds of advertising cigarette discounts did not differ between stores nearby and farther from no-sales cities. Conclusions Nearly all retailers complied with tobacco sales bans within 6–12 months of implementation. In addition, retail tobacco marketing was nearly eliminated in the two cities. There was no evidence of price gouging for Marlboro cigarettes in cross-border stores. Implications Evidence from two early adopters of tobacco sales bans suggests that such local laws can be implemented effectively in California, although results from these high-income cities in a state with a strong tobacco control record limits generalizability. Enforcement involving routine purchase attempts rather than visual inspection of tobacco products is recommended. Although Beverly Hills and Manhattan Beach are each surrounded by communities where tobacco sales persist, there was no evidence of price gouging for cigarettes or greater presence of discounts in cross-border stores. Evaluations of the economic impacts and public health benefits of tobacco sales bans are much needed. [ABSTRACT FROM AUTHOR]

To assess the retail availability of cigar products that refer to marijuana and the largest package size of cigarillos available for ≤$1.Trained data collectors conducted marketing surveillance in a random sample of licensed tobacco retailers that sold little cigars/cigarillos (LCCs) (n=530) near a statewide sample of middle and high schools (n=132) in California. Multilevel models examined the presence of marijuana co-marketing and cigarillo pack size as a function of school/neighbourhood characteristics and adjusted for store type.Of stores that sold LCCs, approximately 62% contained at least one form of marijuana co-marketing: 53.2% sold cigar wraps marketed as blunt wraps, 27.2% sold cigarillos marketed as blunts and 26.0% sold at least one LCC with a marijuana-related 'concept' flavour. Controlling for store type, marijuana co-marketing was more prevalent in school neighbourhoods with a higher proportion of young residents (ages 5-17 years) and with lower median household income. Nearly all stores that sold LCCs (87.9%) offered the products for ≤$1. However, significantly larger packs at similarly low prices were available near schools in lower-income neighbourhoods and with a lower percentage of Hispanic students.Understanding how the tobacco industry manipulates cigar products and marketing to capitalise on the appeal of marijuana to youth and other priority populations is important to inform regulation, particularly for flavoured tobacco products. In addition, the retail availability of five and six packs of LCCs for ≤$1 near California schools underscores policy recommendations to establish minimum prices for multipacks.

Objective: two-thirds of U.S. colleges are near vape shops, where higher rates of underage sales exist. this study examined vape shop compliance with state-mandated age-of-sale signs, the presence of age-of-entry signs and the tobacco industry's "We Card" sign. Participants: Random sample of 614 California vape shops, stratified by distance to community colleges or 4-year universities/colleges; visited June--August, 2019. Methods: Logistic regressions examined whether signage varied by distance to colleges and whether stores sold other tobacco products (otp). Results: Compliance with the state-mandated age-of-sale sign was 69.4%; vape-only stores were less compliant than vape + otp (AoR = 0.39, 95% CI = 0.22,0.70). Age-of-entry signs were more common in vape-only (AoR = 1.87, 95% CI = 1.07,3.28) than vape + otp stores. However, this difference was greater for vape-only stores near community colleges and attenuated for vape-only stores near 4-year universities/colleges. Conclusion: Improved enforcement and retailer education regarding age-of-sale signage are needed, particularly near colleges where greater potential for underage sales presumably exists. [ABSTRACT FROM AUTHOR]

Introduction E-cigarette retail surveillance is needed during regulatory changes, like the U.S. increasing minimum legal sales age to 21 (T21) and flavor restrictions (2019 and 2020) and certain state/localities increasing related restrictions. Aims and Methods We examined regulatory compliance (eg, minimum-age signage), promotional strategies (eg, health claims), and products at 2 timepoints among vape shops across six U.S. metropolitan statistical areas (MSAs; Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, Seattle). In summer 2018, pairs of trained auditors assessed randomly selected shops (n = ~30/MSA). In fall 2021, audits were conducted among 2018 shops (if open and allowed) and additional randomly selected shops (n = ~20/MSA). Data from 179 shops in 2018 and 119 in 2021 (43 from the 2018 sample) were compared. Results There were decreases (p  < .01) in the proportion of shops with (1) minimum-age signs (90.5% vs. 73.9%), (2) their own e-liquid brand (68.2% vs. 44.5%), onsite vaping (73.2% vs. 46.2%), counter seating (65.2% vs. 34.5%), and e-liquid sampling (90.0% vs. 33.6%), and (3) signs with product/price promotions (89.9% vs. 65.5%), health/cessation claims (29.1% vs. 12.6%), and cartoon imagery (27.4% vs. 11.8%). The proportions selling wet/dry vaporizers (26.4% vs. 39.5%), CBD products (23.3% vs. 71.4%), and pipes/glassware/papers (18.4% vs. 52.9%) increased. In 2021, many sold THC (12.6% e-liquids, 62.2% other products) and kratom (40.3%). Conclusions With increasing restrictions (eg, on flavors, sampling, and T21), fewer shops sold their own e-liquid brands or accommodated onsite use/sampling, but fewer also posted minimum-age signage. Notably, more offered cannabis-related products. These changes underscore the need for comprehensive surveillance to assess regulatory impact. Implications The past 6 years marked increasing e-cigarette sales restrictions in the United States, yet limited research has examined the implications for tobacco specialty shops selling e-cigarettes. This study found that, from 2018 to 2021, there were significant decreases in the proportion of vape shops with their own e-liquid, onsite vaping, e-liquid sampling, lounge/counter seating, and price promotions, as well as minimum-age signs. There were increases in the proportion selling cannabis-derived products and related paraphernalia. Tobacco control research and regulatory agencies must consider how tobacco specialty stores have evolved alongside legislative changes that impact them and consumers. [ABSTRACT FROM AUTHOR]

Background: As of September 2020, more than 300 state and local jurisdictions restrict the sales of flavored tobacco, with some including menthol. Aims: To evaluate the impact of local ordinances restricting the sale of flavored tobacco, we surveyed Californians regarding policy support and perceived access to flavored tobacco. Methods: In 2019, we conducted an online survey of 3,075 California youth and young adults recruited via social media, about half of whom lived in a policy jurisdiction. Logistic regressions assessed differences on propensity score–weighted outcomes, policy support, and perceived access. Results: Most respondents indicated agreement with almost all policy support statements. Although policy respondents were less likely than rest-of-California respondents to report perceived difficulty in buying flavored cigars, flavored vape users in policy jurisdictions were more likely than those in the rest of California to report perceived difficulty in buying flavored e-liquid. Regardless of jurisdiction, certain priority subgroups were significantly more likely to report perceived difficulty in accessing flavored cigars, flavored vaping products, flavored e-liquid, and menthol cigarettes. Discussion: With some exceptions, these findings demonstrate that among vape users in policy jurisdictions and priority subgroups, there is a higher likelihood of reporting perceived difficulty to access flavored tobacco products. Conclusions: Findings might be an early indication of shifts in social norms about flavored tobacco products in California, which could gain traction as local sales restriction ordinances proliferate throughout the state and a statewide flavored-tobacco sales restriction goes into effect. [ABSTRACT FROM AUTHOR]

INTRODUCTION This study characterizes the retail environment for Electronic Nicotine Delivery Systems (ENDS) near public universities in California, assesses marketing in the first random sample of ENDS retailers, and compares ENDS retailer density and retail marketing near campuses with and without tobacco-free policies. METHODS Two data sources were used to construct a sampling frame of possible ENDS retailers, which were mapped within 1-4 miles of 33 campuses of the University of California and the California State University systems. To assess retailer density, a telephone survey of possible ENDS retailers (n=1186) determined who sold e-cigarettes or e-liquids (completion rate=72.9%). To assess retail marketing, trained data collectors completed observations in a random sample (n=438, mean M=13.3 stores per campus, SD=11.2) in the Fall of 2015. RESULTS In a telephone survey, 59.1% of retailers reported selling e-cigarettes or e-liquids. Half of the campuses had 10 or more ENDS retailers nearby. Most ENDS retailers were convenience stores (42.5%), and more were head shops (8.4%) than smoke shops (6.8%) or vape shops (6.2%). Nearly half (43.6%) of ENDS retailers sold products marketed as zero-nicotine and 13.9% sold NRT. ENDS advertising was visible in 72.4% and on the exterior of 28.1% of retailers. However, the presence of exterior advertising for ENDS was significantly lower near campuses with established tobacco-free policies than near campuses with recent or no tobacco-free policies (OR=0.45, 95% CI: 0.22-0.94). CONCLUSIONS The large number of tobacco retailers that sell ENDS near colleges suggests a need for better monitoring and regulation of ENDS availability and marketing. The widespread availability of zero-nicotine products suggests a need to examine whether nicotine-free products are as advertised and safe to use. Longitudinal research is needed to understand how retail marketing for ENDS responds to change in tobacco-free policies at nearby campuses. [ABSTRACT FROM AUTHOR]