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.
- public policy
- surveillance and monitoring
Data availability statement
Retail scanner data are available from third party vendors and are not publicly available.
Statistics from Altmetric.com
Contributors TR, DGG, LH and EA-R conceptualised and designed the study; DGG and JG conducted data analyses; DGG, JG, TR and AF drafted the article; all authors contributed to writing and editing, and approved the final version of the article.
Funding Funding for this study was provided by the Centers for Disease Control and Prevention Grant #5 NU58DP005969-04-00 and the California Department of Public Health under contract from Stanford Prevention Research Center to RTI International (Contract #17-10041). Additional support for LH and TOJ was provided by the National Institutes of Health/National Cancer Institute, grant #1P01CA225597.
Competing interests The California Department of Public Health was involved in the study design, data collection, analysis, interpretation and writing. CDPH reviewed the text prior to submission and did not influence whether and where to submit for publication.
Provenance and peer review Not commissioned; externally peer reviewed.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.