Local sales restrictions significantly reduce the availability of menthol tobacco: findings from four Minnesota cities

D’Silva, Joanne; Moze, Joanne; Kingsbury, John H.; Lien, Rebecca K.; Matter, Christine M; Brock, Betsy; Akom, Antwi

doi:10.1136/tobaccocontrol-2019-055577

Cited by 18 publications

(18 citation statements)

References 13 publications

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“… 21 , 24 , 25 Five studies used retail observational methods to evaluate policy effects on marketing/advertising of flavored or menthol tobacco products, typically operationalized as the presence of tobacco marketing materials or advertisements within or outside of stores. 21 , 22 , 24 , 30 , 32 …”

Section: Resultsmentioning

confidence: 99%

A Comprehensive Qualitative Review of Studies Evaluating the Impact of Local US Laws Restricting the Sale of Flavored and Menthol Tobacco Products

Rogers

Brown

Siegel-Reamer

et al. 2021

Nicotine &Amp; Tobacco Research

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Objectives To assess the quality of evidence on the effectiveness of local US laws restricting the sale of flavored tobacco products. Methods We conducted a systematic search and qualitative scoping review of English-language papers published through May 2020 that evaluated flavored tobacco sales policies implemented by US jurisdictions during 2010-2019. We constructed a conceptual model for flavored and menthol tobacco sales restriction outcomes, assigned GRADE quality of evidence ratings to policy outcomes evaluated through the included studies, and summarized factors that might explain weak or inconsistent findings. Results We found moderate to high quality of evidence associating policy implementation with reduced availability, marketing, and sales of policy-restricted products, and decreased youth and adult tobacco use of these products; however, policy exclusions and exemptions, implementation challenges, tobacco industry actions (e.g., marketing of concept-named flavored products; exploiting policy exemptions for certain store types), and consumer responses (e.g., cross-border or illicit purchasing) might undermine or mitigate intended policy effects. Conclusions Flavored and menthol tobacco product sales restrictions implemented and evaluated in US jurisdictions appear to have achieved some of their intended outcomes; however, deficiencies in study designs, methods, and metrics could contribute to equivocal findings on quality of evidence associating policy implementation and outcomes. Gaps in the evidence are beginning to be filled with research using more rigorous study designs, improved measurement and analytic methods, and longer-term follow-up. Implications In the absence of comprehensive federal action, US jurisdictions have the obligation to restrict flavored and menthol product sales to protect vulnerable populations from tobacco-related harms. The considerable expenditure of financial resources, political will, and time dedicated to policy adoption and implementation argue for evaluation studies designed to maximize the quality of evidence. This review offers generalizable insights into evaluation findings that can inform efforts to enhance tobacco control policy implementation and impact in the US and globally.

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Section: Resultsmentioning

confidence: 99%

A Comprehensive Qualitative Review of Studies Evaluating the Impact of Local US Laws Restricting the Sale of Flavored and Menthol Tobacco Products

Rogers

Brown

Siegel-Reamer

et al. 2021

Nicotine &Amp; Tobacco Research

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“…The findings of this study are consistent with previous evaluations of flavored tobacco product restrictions at the substate level in New York City 17 ; Lowell, Massachusetts 19,20 ; and Minneapolis, St Paul, Duluth, and Falcon Heights in Minnesota. 22,23 The sales assessed in this study included products purchased by adults and those that could have been directly or indirectly obtained by youths. Given that flavors have been associated with initiation and continued use of e-cigarettes by youths, 3,43 the decrease in sales of these products would have likely included products obtained directly or indirectly by youths; for example, threequarters of youths who use JUUL e-cigarettes, the most commonly sold e-cigarette brand in the US, reported purchasing it from a retail store.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Statewide Restrictions on Flavored e-Cigarette Sales in the US From 2014 to 2020

et al. 2022

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IMPORTANCE e-Cigarettes are the most commonly used tobacco product among US youths.Flavors are among the most cited reasons for use of e-cigarettes among youths, and therefore, some states have imposed restrictions on flavored e-cigarette sales. To our knowledge, no study has compared e-cigarette sales between states with statewide flavored e-cigarette restrictions and states without such restrictions while controlling for co-occurring events. OBJECTIVE To assess whether implementation of statewide restrictions on flavored e-cigarette sales in Massachusetts, New York, Rhode Island, and Washington was associated with a reduction in total e-cigarette unit sales from 2014 to 2020. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study with difference-in-differencesanalysis used e-cigarette retail sales data from Massachusetts, Rhode Island, and Washington, which implemented restrictions on flavored e-cigarette sales in October 2019; New York, which implemented these restrictions in May 2020; and 35 states without these restrictions (control states). Sales were summed into 4-week periods from August 24, 2014, to December 27, 2020, for a total of 2988 state-period observations. MAIN OUTCOMES AND MEASURESA difference-in-differences analysis was conducted to compare e-cigarette unit sales in the 4 states with flavor restrictions (before and after implementation) with those in the 35 control states. The model controlled for other populationbased policies and emergent events (eg, the COVID-19 pandemic). Data on 4-week e-cigarette unit sales were sorted into 4 flavor categories (tobacco, menthol, mint, and other). Unit sales were standardized to reflect the most common package sizes for each product type. RESULTSStatewide restrictions on non-tobacco-flavored e-cigarette sales were associated with the following reductions in mean 4-week total e-cigarette sales in intervention states compared with control states from October 2019 to December 2020: 30.65% (95% CI, 24.08%-36.66%) in New York, 31.26% (95% CI, 11.94%-46.34%) in Rhode Island, and 25.01% (95% CI, 18.43%-31.05%) in Washington. In Massachusetts, the comprehensive sales prohibition of all e-cigarette products was associated with a 94.38% (95% CI, 93.37%-95.23%) reduction in 4-week sales compared with control states. Except in Massachusetts, where all sales of flavored e-cigarettes decreased, reductions were found only for non-tobacco-flavored e-cigarette sales in the other states with restrictions. Among control states, mean sales decreased by 28.4% from August 2019 to February 2020 but then increased by 49.9% from February through December 2020. CONCLUSIONS AND RELEVANCEIn this cross-sectional study, statewide restrictions on the sale of flavored e-cigarettes in Massachusetts, New York, Rhode Island, and Washington were associated with a reduction in total e-cigarette sales. These findings suggest that not all e-cigarette users who (continued)

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“…From patients' and CLs' interviews and tours, we cataloged key neighborhood sites and features identified as facilitators or barriers to health using the Streetwyze digital health platform. 26 Neighborhood features were then summarized and organized into broad categories.…”

Section: Discussionmentioning

confidence: 99%

The Role of Community-Based Organizations in Improving Chronic Care for Safety-Net Populations

et al. 2021

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Introduction: Social determinants of health (SDoH) influence health outcomes and contribute to disparities in chronic disease in vulnerable populations. To inform health system strategies to address SDoH, we conducted a multi-stakeholder qualitative study to capture the multi-level influences on health for those living in socio-economically deprived contexts.Methods: Varied qualitative inquiry methods -in-depth interviews, participant-led neighborhood tours, and clinic visit observations -involving a total of 23 participants (10 patients with chronic illnesses in San Francisco neighborhoods with high chronic disease rates, 10 community leaders serving the same neighborhoods, and 3 providers from San Francisco's public health care delivery system). Qualitative analyses were guided by the Chronic Care Model (CCM).Results: Several key themes emerged from this study. First, we enumerated a large array, neighborhood resources such as food pantries, parks/green spaces, and financial assistance services that interact with patients' self-management. Health service providers leveraged these resources to address patients' social needs but suggested a clear need for expanding this work. Second, analyses uncovered multiple essential mechanisms by which community-based organizations (CBOs) provided and navigated among many neighborhood health resources, including social support and culturally aligned knowledge. Finally, many examples of how structural issues such as institutional racism, transportation, and housing inequities are intertwined with health and social service delivery were elucidated. Conclusion:The results contribute new evidence toward the community domain of the CCM. Health care systems must intentionally partner with CBOs to address SDoH and improve community resources for chronic care management, and directly address structural issues to make progress.

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Local sales restrictions significantly reduce the availability of menthol tobacco: findings from four Minnesota cities

Cited by 18 publications

References 13 publications

A Comprehensive Qualitative Review of Studies Evaluating the Impact of Local US Laws Restricting the Sale of Flavored and Menthol Tobacco Products

A Comprehensive Qualitative Review of Studies Evaluating the Impact of Local US Laws Restricting the Sale of Flavored and Menthol Tobacco Products

Evaluation of Statewide Restrictions on Flavored e-Cigarette Sales in the US From 2014 to 2020

The Role of Community-Based Organizations in Improving Chronic Care for Safety-Net Populations

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