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 Researchers compared two towns 30 miles apart and found that after
one community passed a restrictive policy in 2016, flavored tobacco
availability and use dropped the next year. There was little change
in the other community, according to the results in the American
Journal of Preventive Medicine.
"Given recent nationwide increases in youth tobacco use, largely
driven by youth e-cigarette use, and the recent emergence of lung
disease linked to e-cigarette use and vaping, it is critically
important to implement and evaluate strategies to curb youth use,"
said lead study author Melody Kingsley of the Massachusetts
Department of Public Health in Boston.
Public health experts are trying to find the best tactics to slow
youth use of all types of tobacco products, including bans on
flavors, which tend to appeal to kids.
"The majority of youth who use tobacco begin with flavored products,
which are available in thousands of flavors with youth appeal,"
Kingsley told Reuters Health by email. "To date, a few studies have
found that flavored tobacco restriction policies reduce sales and
availability of flavored tobacco, but to our knowledge, no prior
evidence exists on the short-term impact."
The two towns in the study were Lowell, where a such a policy took
effect in October 2016, and Malden, a town without a policy. The two
communities have similar demographics, retailer characteristics and
point-of-sale tobacco policies.
The researchers analyzed the inventories of tobacco stores and
surveyed more than 500 high school students in both places. About
six months later, they surveyed students again and measured
inventories of flavored cigars, cigarillos, hookah, smokeless
tobacco and e-cigarettes.
The researchers found that availability of flavored tobacco products
plummeted in Lowell, from 77% of retailers to 7%. No changes
occurred in Malden.
Among teen current- and ever-users of tobacco products, use of both
flavored and non-flavored tobacco decreased in Lowell - by 5.7% for
flavored tobacco and 6.2% for non-flavored tobacco – while it
increased slightly in Malden.
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"Even though the flavored tobacco restriction did not directly
impact availability of non-flavored tobacco, these findings may be
due in part to changes in social norms around use of all tobacco
products," Kingsley said. "It is encouraging to see that these
changes can happen very quickly after policy implementation."
Her team is interested in the long-term impact of these policies,
including the age when teens start using tobacco. Some Massachusetts
towns have also started to include menthol in their list of banned
products, since the marketing of menthol-flavored tobacco has
historically targeted people of color, low-income communities and
LGBTQ individuals, she said.
"We expect that flavored tobacco restrictions that include menthol
will have an even greater impact on youth tobacco use," she said.
Researchers also want to know other factors that may influence
policy, such as enforcement. Retail compliance in this case was
high, and Massachusetts is known for strict tobacco enforcement and
education efforts, said Melissa Harrell of the University of Texas
School of Public Health in Austin, who wasn't involved in the study.
"Some of the results are a bit 'perplexing' to me," she told Reuters
Health by email. "Lowell consistently showed reductions in tobacco
use across almost every measure."
These may not be due to the ban alone, particularly in such a short
period, Harrell noted. Other efforts around the same time, such as
news coverage or education programs at the schools, could have
influenced the changes, she said, which is an important area for
future research.
SOURCE: https://bit.ly/2BZYuHA American Journal of Preventive
Medicine, online October 24, 2019.
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