Classifying the comprehensiveness of flavoured tobacco sales restrictions: development and application of a tool to examine US state and local tobacco policies

Abstract

ObjectivesComprehensive tobacco control policies with minimal exemptions can reduce tobacco use and sales. Many states and localities have adopted flavoured tobacco product (FTP) sales restrictions. This study describes the development and application of a schema to characterise the comprehensiveness of these FTP sales restrictions.DesignWe coded state and local FTP sales restrictions enacted June 2007–March 2021 for retailer, tobacco product, and flavour inclusions and exemptions. Guided by FTP literature, legal resources and meetings with FTP policy experts, we developed a six-level classification scheme to characterise coded FTP policies from least to most comprehensive. We present descriptive statistics of FTP policy features and comprehensiveness.ResultsAs of 31 March 2021, 7 state-level and 327 local-level FTP sales restrictions were enacted in the USA. Most state-level policies (71.4%) were categorised in the second lowest comprehensiveness category; local policies most commonly fell within the lowest (48.9%) or highest (26.0%) comprehensiveness categories. Across jurisdictions, adult-only retailers were most frequently exempted from the FTP sales restrictions (state: n=1, 14.3%; local: n=184, 56.3%); and most jurisdictions included electronic cigarettes (e-cigarettes) as a banned product (state: n=6, 87.5%; local: n=227, 100%). While just over half of state (n=4, 57.1%) and local (n=169, 51.7%) sales restrictions included menthol e-cigarettes, most excluded menthol cigarettes and/or menthol smokeless tobacco.ConclusionsComprehensiveness of FTP sales restrictions in the USA varies widely. Current and future FTP policies would be strengthened by including all flavours and all tobacco products—particularly menthol cigarettes—and by avoiding exemptions for certain retailers, particularly adult-only retailers.

Discussions of Flavored ENDS Sales Restrictions: Themes Related to Circumventing Policies on Reddit

“…The qualitative review revealed ten dominant themes across workaround-related content, with some posts containing more than one theme. More than one in three posts (39%) were seeking advice on disposable or refillable substitute brands that offered newly unavailable flavors, including 5.9% which named specific refillable pod device brands including Caliburn (9), Smok (7), Voopoo (1), Novo (7), and Vuse (5). One post mentioned OVNS, a refillable pod brand that is compatible with JUUL devices.…”

“…Flavored Tobacco Product (FTP) policies play a critical role in reducing the access and availability of these products [5], particularly given the tobacco industry's historical targeting of youth using flavored products that are easier to initiate and thus more likely to lead to sustained use [6]. However, unintended consumer adaptations to FTP restrictions such as switching to alternative products or identifying alternative supply sources can undermine the effectiveness of such policies [7].…”

The Impact of Recent Tobacco Regulations and COVID-19 Restrictions and Implications for Future E-Cigarette Retail: Perspectives from Vape and Vape-and-Smoke Shop Merchants

“…Due to the exemptions in the federal ban, state and local restrictions on flavored e-cigarettes are closing important loopholes [ 11 ]. As of October 2021, 5 states and 338 localities have implemented more comprehensive restrictions on flavors, with state and local sales restrictions on flavored e-cigarettes likely to continue to expand [ 12 , 13 ]. Moreover, the Prevent All Cigarette Trafficking (PACT) Act (which prohibits USPS delivery of cigarettes and smokeless tobacco to consumers) was expanded to include e-cigarettes in December 2020 [ 14 ].…”

Dissonance in Young Adult Cigarillo Users’ Categorization of Concept Flavored and Unflavored Products

“…In the U.S., concept-named cigar products have increased their market share—a trend associated with various policies throughout the country that restrict the sale of flavored cigars [ 16 , 32 , 37 , 38 ]. Similar phenomena have appeared in other nicotine products, including electronic vapor products [ 39 , 40 ].…”

“…This shift to concept-flavored tobacco products may signal manufacturers’ anticipation of a 2022 U.S. prohibition on the sale and manufacture of cigar products with characterizing flavors, similar to an earlier 2009 U.S. federal law prohibiting characterizing flavors in cigarettes [ 23 , 41 ]. This 2009 legislation did not provide a specific definition of “characterizing”, and manufacturers appear to interpret this term as only a feature of a flavor name rather than discernable experiential aspects of the product, such as taste and smell or the additives used to create them [ 18 , 19 , 38 ].…”