Table 4

Concepts and themes to consider related to policy impact of a state-wide flavoured tobacco ban

Themes	Codes	Sample responses
Evaluation of flavour policies	Potential indicators could include purchase data, smoking/vaping rates, use of cessation resources and marketing data. Potential data sources could include point of sales data, household and school surveys, observational assessments in stores or development of a special survey/new questions to integrate into existing surveys. Importance of baseline data and gathering relevant information prior to passage and implementation to demonstrate impact. Importance of disaggregated data: asking about different target populations, specifically about flavours and menthol separately, information specific to different geographies. Little data collected in other jurisdictions on internet sales. Passage of multiple tobacco policies complicates efforts to attribute causation and behaviour change.	‘We also have some data specifically looking at what is the store environment. Have there been changes? Now the caveat to that is that we’re like a policy incubator, right?…We’ve had tobacco 21 has happened locally and statewide. We’ve got this flavor restriction and now one of our supervisors has proposed eliminating the sales of e-cigarettes altogether. So there’s a lot of things that pop in and it makes it really hard to parse out and even evaluate what thing, what levers are changing behavior, even if we do see behavior changing…So there’s just a lot of activity which is good, but not good from a scientific, let’s figure out how to measure this, perspective.’
Perceived success of bans and restrictions	High compliance and retailer cooperation assessed across jurisdictions, primarily from in-store inspections. Most retailers want to be in compliance once the policy passes, but may need help understanding the nuances of flavoured products. Flavour bans are still an emerging area, but recognition that more evaluation data are needed to demonstrate impact. Full bans are easier to implement and evaluate than partial restrictions. Awareness that implementation challenges exist (eg, concept flavours, illicit products).	‘Overall the compliance has been pretty good and I don’t think we’ve seen tremendous backlash. I think small businesses aren’t super happy about it, but they’re also compliant, which is really appreciated.’ ‘”How do you know if it’s effective?”…I say the reason that the tobacco industry is sitting here is because from the effects of policy…The industry recognizes this is a very effective policy and they're willing to spend a lot of money to protect it.’
Lawsuits and industry pushback	Past and pending litigation is a constant threat across jurisdictions. Many saw coordinated industry pushback throughout the legislative and implementation processes as proof of impact. Be aware of Data Practice Act (DPA) issues: the public (including the tobacco industry) has the right to request copies of public government data, so be careful about what is put in writing.	‘We really couldn’t go the state level, because we needed to start with the cities and towns and then go up, which is what kind of sucks about the lawsuits, because the industry has such a big presence in our state house. I just would never undermine that. They’re everywhere. Really, they have legislators’ ears and they are the small businesses in all of these cities and towns and counties. They’re the life blood of the system, etc. etc. It was very hard to counter that.’