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Youth tobacco use before and after flavoured tobacco sales restrictions in Oakland, California and San Francisco, California
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  • Published on:
    In Reply: Youth tobacco use before and after flavoured tobacco sales restrictions in Oakland, California and San Francisco, California
    • Jessica Liu, PhD Candidate Harvard T.H. Chan School of Public Health
    • Other Contributors:
      • Lester Hartmann, Pediatrician
      • Andy Tan, Associate Professor of Communication
      • Jonathan Winickoff, Professor of Pediatrics, Pediatrician

    Pesko’s central argument is that it does not matter that Friedman’s assessment of the effect of San Francisco’s ban on the sale of flavored tobacco products is not based on any data collected after the ban actually went into force. In particular, Friedman’s “after” data were collected in fall 2018, before the ordinance was enforced on January 1, 2019.[1] Pesko incredibly argues that Friedman’s “before-after” difference-in-difference analysis is valid despite the fact that she does not have any “after” data.

    Pesko justifies this position on the grounds that the effective date of the San Francisco ordinance was July, 2018. While this is true, it is a matter of public record that the ordinance was not enforced until January 1, 2019 because of the need for time for merchant education and issuing implementing regulations.[2]

    Friedman is aware of the fact that the enforcement of the ordinance started on January 1, 2019 and used that date in her analysis. In her response[3] to critiques[4] of her paper, she stated “retailer compliance jumped from 17% in December 2018 to 77% in January 2019 when the ban went into effect.” Friedman thought the YRBSS data was collected in Spring 2019; she only learned that the “2019” San Francisco YRBSS data she used were in fact collected in fall 2018 from our paper.[1]

    Rather than simply accepting this as an honest error and suggesting Friedman withdraw her paper, Pesko is offering an after-the-fact justification for the cl...

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    Conflict of Interest:
    Name: Jessica Liu
    ORCID: 0000-0002-8455-0127
    Position: PhD Candidate in Population Health Sciences, Harvard T.H. Chan School of Public
    Health
    Date: May 10, 2022
    I have read and understood BMJ’s policy on declaration of interests and declare the following:
    Personal financial interests: None to declare.
    Organisational financial interests: Within the last 5 years I have received grant funding from the
    National Cancer Institute (Grant # T32CA057711-27) and Harvard T.H. Chan School of Public
    Health.
    Non-financial interests: None to declare.
    Interests of related parties: None to declare.
    Interests of related parties: None to declare.

    Name: Andy SL Tan
    ORCID: http://orcid.org/0000-0001-6459-6171
    Position: Associate Professor, University of Pennsylvania, Philadelphia
    Date: 5/10/2022
    I have read and understood BMJ’s policy on declaration of interests and declare the following:
    Personal financial interests: Since 2020, I am a faculty employee of the University of
    Pennsylvania Annenberg School for Communication, Philadelphia. From 2014-2020, I was a
    faculty employee of the Dana-Farber Cancer Institute and the Harvard TH Chan School of
    Public Health. I have received honoraria from the California Tobacco-Related Disease Research
    Program (serving on a research study section), Memorial Sloan Kettering Cancer Center
    (invited speaker), Rutgers University (invited speaker), Stanford University (invited speaker),
    Johns Hopkins University (guest lecturer), American Institutes of Research (for contribution to
    the 2020 Surgeon General’s Report), the TCC Group (advisory board member for a COVID-19
    study among young adults), and the Society For Personality And Social Psychology (invited
    panelist). I have received travel reimbursements from Johns Hopkins University (invited
    speaker), the Aetna Foundation (to attend a conference), the Society for Research in Nicotine
    and Tobacco Health Equity Network (to attend the annual meeting), and the National Cancer
    Institute (to attend an invited workshop).
    Organisational financial interests: Within the last 5 years I have received grant funding from
    the National Cancer Institute, National Institute on Drug Abuse, and the National Health, Lung,
    and Blood Institute (National Institutes of Health), the US Food and Drug Administration Center
    for Tobacco Products, the US Centers for Disease Control and Prevention (CDC), and Cancer
    Research UK. I do not and have never received any financial support from any tobacco industry
    companies, vape product companies, or tobacco industry affiliated organizations.
    Non-financial interests: I have published or collaborated on research with over 50 colleagues,
    postdoctoral fellows and students.
    Interests of related parties: None to declare.

    Dr. Hartmann:
    Personal financial interests: None to decalre.
    Organizational financial interests: I have not received any grant funding within the last five years.
    Non-financial interests: None to declare

    Dr. Winickoff:
    ORCID: https://orcid.org/0000-0001-6126-9095

    Positions: Professor of Pediatrics Harvard Medical School, Professor of Pediatrics MassGeneral Hospital for Children, Practicing Pediatrician Pediatric Group Practice MGH, Director Pediatric Research MGH Tobacco Research and Treatment Center, Director of Translational Research American Academy of Pediatrics Richmond Center.

    Date: May 15, 2022

    I have read and understood BMJ’s policy on declaration of interests and declare the following:

    Personal financial interests: I have worked at MGH as practicing general pediatrician for over 20 years. Over the past 25 years, I have received grants from the following governmental and non-profit organizations: NIH, NCI, NIDA, NHLBI, AHRQ, Robert Wood Johnson Foundation, Flight Attendant Medical Research Institute, The American Legacy Foundation, and the Medical Foundation. I have received travel/accommodation expenses and consulting fees or honoraria from the World Health Organization (for serving as a Senior Policy Fellow while on sabbatical in Switzerland), U.S. Centers for Disease Control (for consulting on Communities Putting Prevention to Work grants), NIH (for serving as a grant proposal reviewer), the American Academy of Pediatrics (for serving as the Director of Translational Research of the Richmond Center). I have also received travel/accommodation expenses and honoraria for speaking to various public health groups. In addition, I have received funding for serving as an expert witness in legal cases against the tobacco industry.

    Organisational financial interests: I have been the PI or Co-PI on multiple NIH R01s in the past 5 years. I have been Co-Investigator on multiple NIH grants in the past 5 years. I do not and have never received any financial support from any tobacco industry companies, vape product companies, or tobacco industry affiliated organizations.

    Non-financial interests: I have published or collaborated on research with more than 50 colleagues, postdoctoral fellows and students. I have served as a scientific advisor to the Massachusetts Tobacco Control Program, Massachusetts Attorney General’s Office, Indiana Tobacco Control Program, North Carolina Tobacco Control Program, Head Start, WIC, the Food and Drug Administration, Department of Housing and Urban Development, the National Academy of Medicine, and the U.S. Surgeon General through the Interagency Committee on Smoking and Health. I testified before the U.S. Congress about the adolescent vaping epidemic.

    Interests of related parties: None to declare.



  • Published on:
    Scientific concerns

    ¶ The authors make some points in their article that are reasonable: 1) the generalizability of San Francisco's flavor ban compared to other places is an open question, and 2) the original study uses the San Francisco ban effective date rather than enforcement date. The original author (Friedman), who does not accept tobacco industry funding and is a well-respected scientist in the field, had pointed to both facts in her original article. So that information isn’t new.
    ¶ The current authors appear to construct a straw man argument claiming that Friedman argued that she was studying the effect of San Francisco enforcing its flavor ban policy. Friedman specifically wrote in her original article that she was studying, “a binary exposure variable [that] captured whether a complete ban on flavored tobacco product sales was in effect in the respondent’s district on January 1 of the survey year.” She specifically uses effect in the above sentence, so there is no ambiguity that she is studying effective date. San Francisco’s flavor ban effective date was July 2018 (Gammon et al. 2021).
    ¶ The authors found new information that the San Francisco YRBSS survey was collected between November to December of 2018. Gammon et al. 2021 (Appendix Figure 1) shows that flavored e-cigarette sales declined in San Francisco between the effective date and the end of August 2018 (compensating for a 30-day look-back period for the YRBSS question wording), even though the flavor ban...

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    Conflict of Interest:
    I have never accepted tobacco industry funding. Over the past 10 years I have received funding from the National Institutes of Health, American Cancer Society, Centers for Disease Control and Prevention, World Health Organization, Agency for Healthcare Research and Quality, Virginia Foundation for Healthy Youth, and the University of Kentucky’s Institute for the Study of Free Enterprise.