Background Flavoured tobacco products are widely available in youth-accessible retailers and are associated with increased youth initiation and use. The city of Boston, Massachusetts restricted the sale of flavoured tobacco products, including cigars, smokeless tobacco and e-cigarettes, to adult-only retailers. This paper describes the impact of the restriction on product availability, advertisement and consumer demand.
Methods Between January and December 2016, data were collected in 488 retailers in Boston at baseline and 469 retailers at 8-month follow-up, measuring the type, brand and flavour of tobacco products being sold. Process measures detailing the educational enforcement process, and retailer experience were also captured. McNemar tests and t-tests were used to assess the impact of the restriction on product availability.
Results After policy implementation, only 14.4% of youth-accessible retailers sold flavoured products compared with 100% of retailers at baseline (p<0.001). Flavoured tobacco product advertisements decreased from being present at 58.9% of retailers to 28.0% at follow-up (p<0.001). Postimplementation, retailers sold fewer total flavoured products, with remaining products often considered as concept flavours (eg, jazz, blue). At follow-up, 64.0% of retailers reported that customers only asked for flavoured products a few times a week or did not ask at all. Retailers reported that educational visits and the flavoured product guidance list aided with compliance.
Conclusion Tobacco retailers across Boston were largely in compliance with the regulation. Availability of flavoured tobacco products in youth-accessible retailers declined city-wide after policy implementation. Strong educational and enforcement infrastructure may greatly enhance retailer compliance.
- Public policy
- Non-cigarette tobacco products
- Surveillance and monitoring
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Contributors LK assisted in study design, creation of data collection instruments, data analysis and led the development and writing of the manuscript. CS supported study design, analysis design and provided manuscript edits. JP conducted primary data analysis and provided manuscript edits. WS supported analysis design and provided manuscript edits. GS assisted in study design, survey instrument development, data collection logistics and critical review of the manuscript. JR assisted in study design, survey instrument development and data collection logistics. NH contributed significant background text. All authors contributed ideas used in the manuscript, and helped to review and revise.
Funding This study was supported by funding from CDC cooperative agreement CDC-RFA-DP15-1509.
Disclaimer The findings and conclusions in this report do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement No data are available.
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