Flavored E-Cigarette Sales in the United States Under Self-Regulation From January 2015 Through October 2019.

Objectives. To describe the evolution of flavored e-cigarette sales since the expansion of the JUUL brand, and to describe the effect of JUUL's November 2018 decision to self-regulate the flavors it sold in stores on flavored e-cigarette sales.Methods. We used Scantrack data on sales of e-cigarettes in the United States from January 2015 to October 2019 provided by The Nielsen Company. National sales values were aggregated monthly in 5 flavor categories (fruit, menthol/mint, sweet, tobacco, and other).Results. The expansion of JUUL sales coincided with an expansion in fruit-flavor sales through October 2018. Once JUUL withdrew fruit and sweet flavors from stores, menthol/mint came to dominate the e-cigarette market, but through 2019, a new surge in fruit-flavor sales by non-JUUL brands was observed.Conclusions. After a decline in sales following JUUL's decision to withdraw some flavored products from stores, JUUL sales recovered within weeks and surpassed their previous maximum in those same channels, as consumption shifted to the menthol/mint and tobacco flavors that remained on shelves.Public Health Implications. These trends suggest shortcomings of self-regulation and highlight the utility of government regulation.

Effects of Prices on Youth Cigarette Smoking and Tobacco Use Initiation in Ghana and Nigeria.

Background: Population growth in the African region is set to outpace the rate of decline in smoking prevalence, leading to a projected increase in the total number of smokers. As most tobacco users initiate during their adolescent years, tobacco prevention strategies targeting youth will be particularly important. Methods: This study estimated the impact of cigarette prices on youth cigarette smoking and tobacco use initiation in Ghana and Nigeria using the Global Youth Tobacco Survey data. First, we used cross-section data and logit models to estimate the effects of prices on youth cigarette smoking. Second, we created pseudo longitudinal data and used continuous-time hazard models to evaluate the impact of cigarette prices on tobacco use initiation. Results: We found that higher cigarette prices decreased both 30-day cigarette smoking and tobacco use onset significantly in both Ghana and Nigeria. Additionally, the price elasticity of cigarette smoking and tobacco use initiation ranged from -0.44 to -1.13, and -1.04 to -3.66, respectively. Conclusions: As one of the first studies on youth tobacco consumption in Sub-Saharan Africa, this study strongly suggests that policies that increase real cigarette prices can lower both cigarette smoking and tobacco use initiation among youth in Ghana and Nigeria.