E-CIGARETTE FLAVOR RESTRICTIONS' EFFECTS ON TOBACCO PRODUCT SALES

Area of Science:

• Public Health
• Tobacco Control
• Health Economics

Background:

• Over 385 US localities and 7 states have enacted flavored electronic nicotine delivery systems (ENDS) sales restrictions.
• The public health impact of these flavor policies remains incompletely understood.

Purpose of the Study:

• To estimate the effects of ENDS flavor restrictions on sales of both ENDS and combustible cigarettes.
• To analyze the net public health implications of these tobacco control policies.

Main Methods:

• Utilized comprehensive data linking tobacco product flavor policies to retail sales data.
• Analyzed sales data from January 2018 through March 2023.
• Estimated the impact of flavor restrictions on ENDS and cigarette sales volumes.

Main Results:

• ENDS flavor restrictions led to substantial decreases in total ENDS sales, driven by declines in flavored ENDS.
• A significant increase in combustible cigarette sales was observed: 11-15 additional cigarettes sold per 0.7 mL ENDS pod reduction.
• The rise in cigarette sales was concentrated in non-menthol brands, including those popular among underage youth.

Conclusions:

• The public health benefits of reducing ENDS sales through flavor restrictions may be counteracted by increased cigarette consumption.
• Flavor restriction policies warrant careful consideration of potential unintended consequences on the sales of more harmful tobacco products.
• Further research is needed to understand the long-term health outcomes associated with these policy-induced shifts in product use.