Evaluating the Impact of Strong and Weak California Flavored Tobacco Sales Restriction Policies on the Tobacco Retail Environment.

ABSTRACT

PURPOSE: Evaluate success of local flavored tobacco (FT) policies in reducing availability of FT products in California. DESIGN: Matched-jurisdiction cross-sectional design compared availability of FT at licensed tobacco retailers (LTR) in jurisdictions with and without such policies in 2013 and 2019. Flavor policy jurisdictions were split into strong and weak groups using Flavored Tobacco Policy Rating Rubric. SETTING: 32 local California jurisdictions. SUBJECTS: Final sample included 306 LTR in 2013 and 1441 LTR in 2019. LTR were classified as convenience store, liquor store, pharmacy, small market, supermarket, gas station booth, tobacco/vape product store, or other. MEASURES: Retail availability of menthol cigarettes and flavored non-cigarette tobacco. ANALYSIS: Logistic regression analysis including covariate (store type) determined whether differences existed in availability of FT in jurisdictions with and without FT policies. Percentage change assessed difference in proportion of retailers that sold FT in 2013 (i.e. before-policies-passed) and in 2019 (i.e. after-policies-became-effective). RESULTS: Strong flavor-policy jurisdictions significantly differed from matched no-policy jurisdictions in availability of menthol cigarettes (OR = .04, 95% CI .02-.08) and flavored non-cigarette tobacco (OR = .07, 95% CI .05-.11). From 2013 to 2019, these jurisdictions experienced significant declines in menthol cigarettes (87.9% to 35.4%) and flavored non-cigarette tobacco sales (63.8% to 37.0%). CONCLUSION: Strong FT sales restriction policies appear to be effective in reducing availability of FT, thereby creating a healthier retail environment in California.