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Classifying the comprehensiveness of flavoured tobacco sales restrictions: development and application of a tool to examine US state and local tobacco policies
  1. Emily Donovan1,
  2. Shanell Folger1,
  3. Maham Akbar2,
  4. Barbara Schillo1
  1. 1Schroeder Institute, Truth Initiative, Washington, DC, USA
  2. 2Truth Initiative, Washington, DC, USA
  1. Correspondence to Emily Donovan, Truth Initiative Schroeder Institute, Washington, DC 20001, USA; edonovan{at}truthinitiative.org

Abstract

Objectives Comprehensive tobacco control policies with minimal exemptions can reduce tobacco use and sales. Many states and localities have adopted flavoured tobacco product (FTP) sales restrictions. This study describes the development and application of a schema to characterise the comprehensiveness of these FTP sales restrictions.

Design We coded state and local FTP sales restrictions enacted June 2007–March 2021 for retailer, tobacco product, and flavour inclusions and exemptions. Guided by FTP literature, legal resources and meetings with FTP policy experts, we developed a six-level classification scheme to characterise coded FTP policies from least to most comprehensive. We present descriptive statistics of FTP policy features and comprehensiveness.

Results As of 31 March 2021, 7 state-level and 327 local-level FTP sales restrictions were enacted in the USA. Most state-level policies (71.4%) were categorised in the second lowest comprehensiveness category; local policies most commonly fell within the lowest (48.9%) or highest (26.0%) comprehensiveness categories. Across jurisdictions, adult-only retailers were most frequently exempted from the FTP sales restrictions (state: n=1, 14.3%; local: n=184, 56.3%); and most jurisdictions included electronic cigarettes (e-cigarettes) as a banned product (state: n=6, 87.5%; local: n=327, 100%). While just over half of state (n=4, 57.1%) and local (n=169, 51.7%) sales restrictions included menthol e-cigarettes, most excluded menthol cigarettes and/or menthol smokeless tobacco.

Conclusions Comprehensiveness of FTP sales restrictions in the USA varies widely. Current and future FTP policies would be strengthened by including all flavours and all tobacco products—particularly menthol cigarettes—and by avoiding exemptions for certain retailers, particularly adult-only retailers.

  • public policy
  • prevention
  • priority/special populations

Data availability statement

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Footnotes

  • Correction notice The article has been corrected since it was published online first. In the results section of the abstract, the data count of the localities including flavored e-cigarettes as banned products has been updated from n=227 to n=327.

  • Contributors ED, SF and BS designed the study, developed drafts of the classification scheme and conducted expert interviews. SF, MA and ED coded the laws. ED, SF, MA and BS finalised the classification scheme and interpreted study results. ED and SF drafted the manuscript with oversight and editing from BS and MA. BS is the guarantor.

  • Funding This study was funded by Truth Initiative.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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