JUUL's 2019 Removal of Mint-Flavored Pods and Changes to the Retail Environment of Electronic Nicotine Delivery Systems in Florida and the United States.

INTRODUCTION: The increase in youth electronic nicotine delivery system (ENDS) use coincided with JUUL's rapid rise, which prompted investigations and lawsuits aimed at this leading brand. In response, JUUL discontinued sweet flavors in late 2018, followed by mint flavors in November 2019. We assessed ENDS sales and prices at both the state and national level before and after JUUL's removal of mint flavors. AIMS AND METHODS: Nielsen retail sales data on ENDS products from convenience and food stores in 4-week aggregates were analyzed between January 2019 and January 2020 in Florida and the United States. Standardized units were created. Unit market share and growth rates were calculated for top brands and flavors in the periods before and after JUUL's mint removal. Average prices within brand and product type were calculated. RESULTS: Following JUUL's removal of mint in November 2019, JUUL's market share dropped from over 66% in Florida and the United States to 37.1% (Florida) and 55.1% (United States). In January 2020, the second leading brands were Puff Bar (15.0%) in Florida and Vuse (18.1%) in the United States. Mint market share decreased and share of all other flavor categories increased, particularly menthol and concept. Total ENDS sales increased in Florida but decreased in the United States. Average prices of ENDS devices decreased. CONCLUSIONS: While JUUL's actions led to a decline in its sales, Puff Bar emerged and menthol and concept flavors experienced growth. Findings also demonstrate how changes by influential brands differentially affect purchase patterns at the national and state level. IMPLICATIONS: These findings support the growing body of evidence that tobacco industry self-regulation, with selective flavor removal by the leading ENDS brand in this case, is insufficient to reduce total ENDS sales, including sales of flavored products which are preferred by youth. Results suggest that brand and flavor substitution compensated for the removal of mint JUUL pods. Understanding changes to the ENDS market in response to industry actions, at both the state and national level, can inform future regulation and interventions. These findings can also inform efforts to prevent and reduce youth ENDS use.

Changes in retail sales of tobacco products in Ontario after a menthol sales restriction.

BACKGROUND: Ontario, Canada prohibited menthol tobacco product sales beginning 1 January 2017. We measured retail sales of menthol cigarettes and possible substitute products before and after policy implementation in Ontario. METHODS: We licensed retail scanner data for tobacco product sales in Ontario and British Columbia (BC), a comparison province without a menthol tobacco policy at that time. We assessed changes in per capita unit sales (per 1000 people) from pre-policy (January-June 2016) to post-policy (January-June 2017) periods. Classification of cigarettes as menthol or non-menthol, or having menthol-suggestive descriptors ('green', 'blue', 'silver' and 'fresh'), was based on scanner data. RESULTS: Ontario menthol cigarette sales decreased 93%, from 596 to 40 packs per capita compared with a 2% decrease (696 to 679 packs per capita) in BC. Menthol capsule cigarette sales remained low in Ontario (<1% of total cigarette sales) but rose sixfold in BC. Although cigar sales data were unavailable, substitution appeared minimal; sales of non-menthol cigarettes increased 0.4% in Ontario (11 470 to 11 519 packs per capita) while vaping product sales decreased. Ontario had a larger increase in sales of cigarettes with menthol-suggestive descriptors (11% increase) than BC (3% increase). In Ontario, nearly all (>99%) pre-policy sales of cigarettes with 'green' menthol-suggestive descriptors were menthol cigarettes, but post-policy, 94% of 'green' cigarettes sold were non-menthol. CONCLUSIONS: Ontario's menthol policy was associated with a decrease in retail sales of cigarettes classified as menthol, with little evidence of product substitution. Understanding changes in sales of cigarettes with menthol-suggestive descriptors would be informative.

Expanding local sales restrictions on flavoured tobacco products to include menthol: retail sales changes in two Minnesota cities.

BACKGROUND: In 2018, Minneapolis and St. Paul, Minnesota, expanded existing local sales restrictions on flavoured (non-menthol/mint/wintergreen) tobacco products ('flavour policies') to include menthol/mint/wintergreen-flavoured tobacco products ('menthol policies'). All policies included exemptions for certain store types. METHODS: We obtained weekly retail tobacco product sales for 2015 through 2019 from NielsenIQ for convenience stores and other outlets in the policy jurisdictions and two comparison areas (rest of the state of Minnesota and total USA). We standardised unit sales across product categories and used NielsenIQ-provided descriptors to classify products as menthol (including mint/wintergreen) or flavoured (non-menthol/non-tobacco). Using single group interrupted time series models, we analysed unit sales by product category and by flavour separately for each geography to assess associations between menthol policy implementation and trends in tobacco product unit sales. RESULTS: Following menthol policy implementation, unit sales of menthol cigarettes and menthol smokeless tobacco decreased in both cities, with smaller decreases in comparison areas. Flavoured cigar sales-which decreased following the flavour policies-further decreased after the menthol policies, while sales of menthol electronic nicotine delivery systems (ENDS) increased in both cities and sales of flavoured ENDS increased in St. Paul. CONCLUSION: Expanding flavour policies to include menthol/mint/wintergreen was associated with significant decreases in unit sales of most menthol products and in total unit sales by tobacco product category. Increases in menthol and flavoured ENDS sales in these cities may be associated with legal sales by exempted retailers and/or illicit sales by non-compliant retailers, highlighting opportunities for retailer education and enforcement.

Changes in cigarillo availability following implementation of a local flavoured tobacco sales restriction.

INTRODUCTION: Providence, Rhode Island (RI) was among the first US jurisdictions to enact a policy (effective 3 January 2013) restricting the retail sale of non-cigarette tobacco products with a characterising flavour other than the taste or aroma of tobacco, menthol, mint or wintergreen. We used scanner data to assess the impact of this sales restriction on retail availability of cigarillos, flavoured and otherwise, in Providence and a rest-of-state (ROS) comparison area. METHODS: Every unique cigarillo product-each indicated by a universal product code (UPC)-available for sale in RI from January 2012 to December 2016 was assigned to an exclusive flavour-name category (tobacco; explicit or concept flavour; or menthol/mint) based on characteristics in the scanner dataset and, as necessary, information from online websites. We calculated weekly unique cigarillo UPC counts and market share by flavour category and used difference-in-difference regression to assess prepolicy and postpolicy changes in counts and share in Providence relative to ROS. RESULTS: The prepolicy to postpolicy decrease in the number of unique cigarillo products available in Providence was 28.64 (±5.83) UPCs greater than the comparable decrease in ROS (p<0.05). The prepolicy to postpolicy increase in the number of unique concept-named flavoured cigarillo products in Providence was 6.08 (±2.31) UPCs greater than the increase in ROS (p<0.05). The postpolicy market share of concept-named flavoured cigarillos was higher in Providence (27.32%, ±1.77) than ROS (12.67%, ±1.67) (p<0.05). CONCLUSIONS: After policy implementation, Providence consumers were exposed to fewer cigarillo UPCs but a greater variety and proportion of concept-named flavoured cigarillos in the retail marketplace.

Cigarette and cigar sales in Hawaii before and after implementation of a Tobacco 21 Law.

INTRODUCTION: On 1 January 2016, Hawaii raised the minimum legal age for tobacco access from 18 to 21 years ('Tobacco 21 (T21)') statewide, with no special population exemptions. We assessed the impact of Hawaii's T21 policy on sales of cigarettes and large cigars/cigarillos in civilian food stores, including menthol/flavoured product sales share. METHODS: Cigarette and large cigar/cigarillo sales and menthol/flavoured sales share were assessed in Hawaii, California (implemented T21 in June 2016 with a military exemption), and the US mainland using the only Nielsen data consistently available for each geographical area. Approximate monthly sales data from large-scale food stores with sales greater than US$2 million/year covered June 2012 to February 2017. Segmented regression analyses estimated changes in sales from prepolicy to postpolicy implementation periods. RESULTS: Following T21 in Hawaii, average monthly cigarette unit sales dropped significantly (-4.4%, p<0.01) coupled with a significant decrease in menthol market share (-0.8, p<0.01). This combination of effects was not observed in comparison areas. Unit sales of large cigars/cigarillos decreased significantly in each region following T21 implementation. T21 policies in Hawaii and California showed no association with flavoured/menthol cigar sales share, but there was a significant increase in flavoured/menthol cigar sales share in the USA (7.1%, p<0.01) relative to Hawaii's implementation date, suggesting T21 may have attenuated an otherwise upward trend. CONCLUSIONS: As part of a comprehensive approach to prevent or delay tobacco use initiation, T21 laws may help to reduce sales of cigarette and large cigar products most preferred by US youth and young adults.

Implementation of a comprehensive flavoured tobacco product sales restriction and retail tobacco sales.

OBJECTIVE: San Francisco's comprehensive restriction on flavoured tobacco sales applies to all flavours (including menthol), all products and all retailers (without exemptions). This study evaluates associations of policy implementation with changes in tobacco sales in San Francisco and in two California cities without any sales restriction. METHODS: Using weekly retail sales data (July 2015 through December 2019), we computed sales volume in equivalent units within product categories and the proportion of flavoured tobacco. An interrupted time series analysis estimated within-city changes associated with the policy's effective and enforcement dates, separately by product category for San Francisco and comparison cities, San Jose and San Diego. RESULTS: Predicted average weekly flavoured tobacco sales decreased by 96% from before the policy to after enforcement (p<0.05), and to very low levels across all products, including cigars with concept-flavour names (eg, Jazz). Average weekly flavoured tobacco sales did not change in San Jose and decreased by 10% in San Diego (p<0.05). Total tobacco sales decreased by 25% in San Francisco, 8% in San Jose and 17% in San Diego (each, p<0.05). CONCLUSIONS: San Francisco's comprehensive restriction virtually eliminated flavoured tobacco sales and decreased total tobacco sales in mainstream retailers. Unlike other US flavoured tobacco policy evaluations, there was no evidence of substitution to concept-flavour named products. Results may be attributed to San Francisco Department of Health's self-education and rigorous retailer education, as well as the law's rebuttable presumption of a product as flavoured based on manufacturer communication.

Differences in price of flavoured and non-flavoured tobacco products sold in the USA, 2011-2016.

BACKGROUND: Limited data exist on whether there is differential pricing of flavoured and non-flavoured varieties of the same product type. We assessed price of tobacco products by flavour type. METHODS: Retail scanner data from Nielsen were obtained for October 2011 to January 2016. Universal product codes were used to classify tobacco product (cigarettes, roll-your-own cigarettes (RYO), little cigars and moist snuff) flavours as: menthol, flavoured or non-flavoured. Prices were standardised to a cigarette pack (20 cigarette sticks) or cigarette pack equivalent (CPE). Average prices during 2015 were calculated overall and by flavour designation. Joinpoint regression and average monthly percentage change were used to assess trends. RESULTS: During October 2011 to January 2016, price trends increased for menthol (the only flavour allowed in cigarettes) and non-flavoured cigarettes; decreased for menthol, flavoured and non-flavoured RYO; increased for flavoured little cigars, but decreased for non-flavoured and menthol little cigars; and increased for menthol and non-flavoured moist snuff, but decreased for flavoured moist snuff. In 2015, average national prices were US$5.52 and US$5.47 for menthol and non-flavoured cigarettes; US$1.89, US$2.51 and US$4.77 for menthol, non-flavoured and flavoured little cigars; US$1.49, US$1.64 and US$1.78 per CPE for menthol, non-flavoured and flavoured moist snuff; and US$0.93, US$1.03 and $1.64 per CPE flavoured, menthol and non-flavoured RYO, respectively. CONCLUSION: Trends in the price of tobacco products varied across products and flavour types. Menthol little cigars, moist snuff and RYO were less expensive than non-flavoured varieties. Efforts to make flavoured tobacco products less accessible and less affordable could help reduce tobacco product use.

Changes in cigar sales following implementation of a local policy restricting sales of flavoured non-cigarette tobacco products.

INTRODUCTION: On 3 January, 2013, the city of Providence, Rhode Island, began enforcing a restriction on the retail sale of all non-cigarette tobacco products with a characterising flavour other than tobacco, menthol, mint or wintergreen. We assessed the policy impact on cigar sales-which comprise 95% of flavoured non-cigarette tobacco products sold through conventional tobacco retail outlets (eg, convenience stores, supermarkets) in Providence-over time and in comparison to the rest of the state (ROS). METHODS: Weekly retail scanner sales data were obtained for January 2012 to December 2016. Cigar sales were categorised into products labelled with explicit-flavour (eg, Cherry) or concept-flavour (eg, Jazz) names. Regression models assessed changes in prepolicy and postpolicy sales in Providence and ROS. RESULTS: Average weekly unit sales of flavoured cigars decreased prepolicy to postpolicy by 51% in Providence, while sales increased by 10% in ROS (both p<0.01). The Providence results are due to a 93% reduction in sales of cigars labelled with explicit-flavour names (p<0.01), which did not change significantly in ROS. Sales of cigars labelled with concept-flavour names increased by 74% in Providence and 119% in ROS (both p<0.01). Sales of all cigars-flavoured and otherwise-decreased by 31% in Providence (p<0.01). We detected some evidence of product substitution and cross-border purchasing. CONCLUSIONS: The Providence policy had a city-specific impact on retail sales of flavoured cigars, which was attenuated by an increase in sales of concept flavour-named cigars. Products with concept-flavour names may avoid enforcement agency detection, and their continued sale undermines the intent of the policy.

Trends in Manufacturer-Reported Nicotine Yields in Cigarettes Sold in the United States, 2013-2016.

INTRODUCTION: A gradual reduction of cigarette nicotine content to nonaddictive levels has been proposed as an endgame strategy to accelerate declines in combustible tobacco smoking. We assessed manufacturer-reported nicotine yield in cigarettes sold in the United States from 2013 to 2016. METHODS: We merged machine-measured nicotine yield in cigarette smoke and pack characteristics obtained from reports filed by tobacco manufacturers with the Federal Trade Commission for 2013-2016 with monthly Nielsen data on US cigarette sales. Manufacturer-reported, sales-weighted, average annual nicotine yield was assessed, as were nicotine yield sales trends by quartile: markedly low (0.10-0.60 mg/stick), low (0.61-0.80 mg/stick), moderate (0.81-0.90 mg/stick), and high (0.91-3.00 mg/stick). Trends in overall, menthol, and nonmenthol pack sales, by nicotine yield quartiles over the study period and by year, were determined by using Joinpoint regression. RESULTS: During 2013-2016, average annual sales-weighted nicotine yield for all cigarettes increased from 0.903 mg/stick (95% CI, 0.882-0.925) in 2013 to 0.938 mg/stick (95% CI, 0.915-0.962) in 2016 (P < .05). For menthol cigarettes, yield increased from 0.943 mg/stick in 2013 (95% CI, 0.909-0.977) to 1.037 mg/stick in 2016 (95% CI, 0.993-1.081), increasing 0.2% each month (P < .05). Most pack sales occurred among high (41.5%) and low (30.7%) nicotine yield quartiles. Cigarette sales for the markedly low quartile decreased by an average of 0.4% each month during 2013-2016 (P < .05). CONCLUSION: During 2013-2016, manufacturer-reported, sales-weighted nicotine yield in cigarettes increased, most notably for menthol cigarettes. Continued monitoring of nicotine yield and content in cigarettes can inform tobacco control strategies.

Little filtered cigars: US sales, flavours, package sizes and prices.

OBJECTIVE: At least four varieties of little filtered cigars (LFCs) violate the US prohibition on flavoured cigarettes other than menthol. This study characterises the sales of prohibited products and other LFCs by flavour category and pack size, as well as the price of LFCs relative to cigarettes. METHODS: Using retail sales data for 2016, we computed the sales volume in dollars and equivalent units and the percentage of total sales by flavour and pack size for the USA by region and state. Paired t-tests compared the prices for LFCs and cigarettes sold in same-sized packs and cartons. RESULTS: LFC sales totalled 24 033 equivalent units per 100 000 persons in 2016. Flavoured LFC varieties accounted for almost half (47.5%) of the total sales. LFCs were sold in 12 different pack sizes, but 79.7% of sales were packs of 20. The price of 20-packs averaged $2.41 (SD=$1.49), which was significantly less than cigarettes (M=$5.90, SD=$0.85). Regional differences suggest a greater proportion of menthol/mint LFCs and lower prices in the South than in other regions. CONCLUSION: Classifying all LFCs as cigarettes would require that they be offered in a minimum package of 20, eliminate flavoured varieties other than menthol and increase prices through applicable state and local cigarette taxes.

National and state patterns of concept-flavoured cigar sales, USA, 2012-2016.

INTRODUCTION: Cigar sales have increased in the USA in recent years. A growing proportion of cigar sales are of flavoured varieties, many bearing ambiguous or 'concept' flavour descriptions (eg, Jazz). This study assessed US cigar sales by flavour category (ie, concept flavoured, characterising flavoured and tobacco), at national, regional and state levels. METHODS: Sales of cigarillos, large cigars and little cigars from chain, franchise and convenience stores, mass merchandisers, supermarkets, drug, dollar and club stores, and military commissaries during 2012-2016 were acquired from the Nielsen Company. US national-level and state-level sales, including District of Columbia, were analysed by flavour category. Flavour descriptors were classified as 'tobacco', 'characterising' or 'concept', based on Universal Product Code (UPC)-linked characteristics and brand website and consumer review descriptions. RESULTS: Cigar sales increased by 29% during 2012-2016, driven by a 78% increase in cigarillo sales. The proportion of concept-flavoured sales increased from 9% to 15%, while the proportion of sales decreased for tobacco (50% to 49%) and characterising flavours (eg, cherry) (41% to 36%). Cigarillos had the greatest increase in unique concept flavour descriptions (17 to 46 unique UPCs), with most sales occurring among Sweet, Jazz and Green Sweets concept flavours. By US region, total and concept-flavoured cigarillo sales were highest in the South. CONCLUSIONS: Flavoured cigars are increasingly labelled with concept flavours, including in areas with flavoured tobacco sales restrictions. Cigarillos are driving recent increases in US cigar and concept-flavoured cigar sales. It is important to consider concept flavours when addressing flavoured tobacco product sales and use.

Sales Trends in Price-Discounted Cigarettes, Large Cigars, Little Cigars, and Cigarillos-United States, 2011-2016.

Introduction: Tobacco manufacturers continue to implement a range of pricing strategies to increase the affordability and consumption of tobacco products. To demonstrate the extent of retail- and brand-level price discounts at the point of sale, this study assessed national sales trends in price-discounted cigarettes, large cigars, little cigars, and cigarillos. Methods: Retail scanner data for tobacco product sales were obtained for convenience stores (C-store) and all-other-outlets-combined (AOC) from September 25, 2011, to January 9, 2016. The proportion of price-discounted sales, average nondiscounted unit price, and average discounted unit price were examined by product category and brand. JoinPoint regression was used to assess average monthly percentage change. Results: Overall, price-discounted sales accounted for 11.3% of cigarette, 3.4% of large cigar, 4.1% of little cigar, and 3.9% of cigarillo sales. The average difference between nondiscounted and discounted prices was 25.5% (C-store) and 36.7% (AOC) for cigarettes; 11.0% (C-store) and 11.2% (AOC) for large cigars; 19.2% (C-store) and 9.6% (AOC) for little cigars; and 5.3% (C-store) and 14.7% (AOC) for cigarillos. Furthermore, price-discounted sales of top-selling tobacco brands comprised up to 36% of cigarette, 7.4% of large cigar, 7.7% of little cigar, and 4.2% of cigarillo unit sales. Conclusions: These findings highlight the use of price discounts by tobacco manufacturers to reduce the cost of cigarettes, large cigars, little cigars, and cigarillos to consumers. These sales patterns underscore the importance of sustained efforts to implement evidence-based strategies to increase prices and reduce availability and consumption of combustible tobacco in the United States. Implications: This study highlights the prevalence and provides a baseline of price-discounted cigarettes, large cigars, little cigars, and cigarillos. Surveillance of tobacco sales data, including state-level trends and additional product types, is critical for informing approaches to reduce tobacco consumption. These approaches include countering tobacco product price-discounting practices and raising and maintaining a high sales price for all tobacco products. The implementation of evidence-based population-level interventions, together with local, state, and federal regulation of tobacco products, could prevent tobacco initiation, increase tobacco cessation, and reduce overall tobacco use among US youth and adults.

National and State-Specific Unit Sales and Prices for Electronic Cigarettes, United States, 2012-2016.

INTRODUCTION: Few studies have explored patterns of electronic cigarette (e-cigarette) sales and prices by product type over time. We used US retail scanner data to assess national and state-specific trends in e-cigarette unit sales and prices for 4 product types sold from 2012 through 2016. METHODS: Using retail scanner data from the 48 contiguous states and Washington, DC, for convenience stores; supermarkets; mass merchandisers; drug, dollar, and club stores; and military commissaries, we assessed data on monthly unit sales and inflation-adjusted prices by 4 products (rechargeables, disposables, prefilled cartridges, and e-liquids) sold during the 5-year study period. We evaluated national and state trends by using Joinpoint regression (P < .05). RESULTS: From 2012 through 2016, average national monthly unit sales significantly increased for all products, while average monthly prices of rechargeables, disposables, and prefilled cartridges significantly decreased. In 2016, prefilled cartridges had the highest average sales (766 units per 100,000 people) and the lowest average price ($14.36 per unit). By state, average monthly sales significantly increased for at least 1 of 4 e-cigarette products in all 48 states and Washington, DC. However, during the same period, average monthly prices significantly decreased in 39 states for rechargeables, in 31 states for disposables, in 20 states for prefilled cartridges, and in 8 states for e-liquids. CONCLUSION: Overall, US e-cigarette unit sales generally increased as product prices decreased. These findings demonstrate the rapidly evolving landscape of US e-cigarette retail marketplace. Ongoing surveillance of e-cigarette unit sales and price is critical for informing and evaluating evidence-based tobacco control strategies.

Trends in Unit Sales of Flavored and Menthol Electronic Cigarettes in the United States, 2012-2016.

INTRODUCTION: The use of flavored tobacco products, including electronic cigarettes (e-cigarettes), is common in the United States, and flavored products are particularly appealing to young people. The objective of this study was to describe national and state trends in flavored and menthol e-cigarette unit sales. METHODS: We examined data on 4 types of e-cigarette products (rechargeables, disposables, prefilled cartridges, and e-liquid refills). We used Universal Product Code retail scanner data from 2 sources: 1) convenience stores and 2) all other outlets combined, including supermarkets, drug stores, mass merchandisers (including Walmart), dollar stores, club stores, and US Department of Defense commissaries. We aggregated data in 4-week periods for the 48 contiguous states and the District of Columbia for the 5-year period from 2012 through 2016. Data from vape shops and internet sales were not available. We used Joinpoint regression to assess trends. RESULTS: From 2012 through 2016, flavored e-cigarette sales as a percentage of all e-cigarette sales increased nationally (from 2.4% to 19.8%) and in all but 4 states (North Dakota, South Dakota, Utah, and Vermont). Nationally, flavored disposable and prefilled cartridge sales increased. Menthol e-cigarette sales were stable nationally at 35% to 40%, while the percentage of menthol disposable, prefilled cartridge, and e-liquid refill sales decreased. By state, menthol e-cigarette sales increased in 2 states (Idaho and Nebraska) and decreased in 7 states. During 2015-2016, the percentage of flavored sales decreased in one state (Rhode Island) and increased in 29 states. CONCLUSION: These findings demonstrate that sales of flavored e-cigarette products have increased dramatically since 2012, with variations by product type and state. Continued monitoring of sales trends at all retail outlets can inform federal, state, and local efforts to address flavored tobacco product use, including e-cigarettes, in the United States.

Sales of Nicotine-Containing Electronic Cigarette Products: United States, 2015.

OBJECTIVES: To assess the proportion of electronic cigarette (e-cigarette) products sold in the United States that contain nicotine according to retail scanner data. METHODS: We obtained unit sales data from January 11, 2015, to December 12, 2015, from The Nielsen Company for convenience stores; supermarkets; mass merchandisers; drug, club, and dollar stores; and Department of Defense commissaries. The data did not include purchases from tobacco specialty shops, "vape shops," or online sources. Nicotine content was assessed by product type (disposables, rechargeables, and refills), region, and flavor status based on nicotine strength listed in the Universal Product Codes. For the 36.7% of entries lacking nicotine content information, we conducted Internet searches by brand, product, and flavor. RESULTS: In 2015, 99.0% of e-cigarette products sold contained nicotine, including 99.0% of disposables, 99.7% of rechargeables, and 98.8% of refills. Overall, 98.7% of flavored e-cigarette products and 99.4% of nonflavored e-cigarette products contained nicotine. CONCLUSIONS: In 2015, almost all e-cigarette products sold in US convenience stores and other assessed channels contained nicotine. Public Health Implications. Findings reinforce the importance of warning labels for nicotine-containing products, ingredient reporting, and restrictions on sales to minors.

Internet cigarette vendors make tax-free claims and sell cigarettes cheaper than retail outlets.

OBJECTIVE: This paper aims to (1) assess whether promotion of tax-free sales among Internet cigarette vendors (ICVs) changed between 2009 and 2011, (2) determine which types of ICVs are most likely to promote tax-free sales (eg, US-based, international or mixed location ICVs), and (3) compare the price of cigarettes advertised in ICVs to prices at brick-and-mortar retail outlets. METHODS: We analysed data from the 200 most popular ICVs in 2009, 2010 and 2011 to assess promotion of tax-free sales and the price of Marlboro cigarette cartons. We used Nielsen scanner data from 2009, 2010 and 2011 to measure the price of Marlboro cartons in US grocery stores. FINDINGS: The odds of ICVs claiming tax-free status were higher in 2011 than in 2009 (OR=1.58, p<0.01). Mixed location and international vendors had higher odds of promoting tax-free sales than US-based ICVs (OR=4.95 and 6.23, respectively, both p<0.001). In 2011, the average price of one Marlboro carton was $35.27 online, compared to $52.73 in US grocery stores. We estimated that in 2011, a pack-a-day smoker living in an area with high cigarette prices would save $1508 per year buying cigarettes online. CONCLUSIONS: ICVs commonly promote tax-free sales, and cigarettes are cheaper online compared to US grocery stores. Better enforcement of the Prevent All Cigarette Trafficking Act is needed to address tax-free cigarette sales among ICVs.

Effect of price changes in little cigars and cigarettes on little cigar sales: USA, Q4 2011-Q4 2013.

INTRODUCTION: Little cigars are comparable to cigarettes in terms of shape, size, filters and packaging. Disproportionate tobacco excise taxes, which directly affect purchase price, may lead consumers to substitute cigarettes with less expensive little cigars. This study estimated the effects of little cigar and cigarette prices on little cigar sales. METHODS: Sales data from a customised retail scanner database were used to model a log-log equation to infer own-price and cross-price elasticity of demand for little cigars relative to little cigar and cigarette prices, respectively, from quarter 4 of 2011 to quarter 4 of 2013. Data were available for convenience stores (C-stores) (n=29 states); food, drug and mass merchandisers (FDMs) (n=44 states); and C-stores and FDMs combined (n=27 states). The dependent variable was per capita little cigar pack sales, and key independent variables were the price index for little cigars and cigarettes. RESULTS: A 10% increase in little cigar price was associated with a 25% (p<0.01) decrease in little cigar sales in C-stores alone, and a 31.7% (p<0.01) decrease in C-stores and FDMs combined. A 10% increase in cigarette price was associated with a 21.5% (p<0.05) increase in little cigar sales in C-stores, and a 27.3% (p<0.01) increase in C-stores and FDMs combined. CONCLUSIONS: Our results suggest that US cigarette smokers are avoiding the high cost of cigarettes by switching to lower priced little cigars. Increasing and equalising prices among comparable products, like cigarettes and little cigars, may motivate cost-conscious smokers to quit.

Changes in Availability of ENDS: 2019-2020, U.S.

INTRODUCTION: Events during 2019 and 2020, such as the outbreak of e-cigarette, or vaping, product use‒associated lung injury; manufacturer product withdrawals; federal regulations; and coronavirus disease 2019, potentially affected the retail availability of ENDS in the U.S. Measuring changes in ENDS availability informs the understanding of the ENDS marketplace and contextualizes sales trends. METHODS: Joinpoint regression was used to estimate slope changes in the number of available ENDS in 2019 and 2020 and considered correspondence with tobacco marketplace events. Availability, the weekly number of unique universal product codes with nonzero sales, was derived from NielsenIQ scanner data. U.S. ENDS availability was modeled overall and by subproduct and flavor category within subproduct: mint, menthol, tobacco flavored, and undetermined. RESULTS: ENDS availability increased by 66% from January 2019 to December 2020. Availability decreased by 43% among prefilled cartridges and increased by 511% among disposables, both led by flavored varieties. During January 2020-February 2020, prefilled cartridge availability decreased by 23.71 universal product codes per week. During July 2020-August 2020, disposable availability increased by 27.90 universal product codes per week, led by flavored products. CONCLUSIONS: ENDS availability increased during 2019 through 2020, led by a rise in flavored disposables. Multiple slope changes in ENDS availability occurred, many coinciding with tobacco marketplace events. The slope of ENDS explicitly prioritized for federal enforcement (i.e., flavored prefilled cartridges) notably decreased in early 2020 and, soon thereafter, the slope of ENDS not explicitly prioritized for enforcement (e.g., flavored disposables) notably increased, suggesting an association with U.S. Food and Drug Administration's prioritized enforcement guidance.