Flavored tobacco sales bans reduce tobacco advertising: An added benefit

The evidence that comprehensive bans on the sale of flavored tobacco products work continues to grow.  And the latest study by Louisa Holmes, Lauren Lempert and Pam Ling adds a new benefit: There is less tobacco product advertising in cities that have flavor bans. 

Their paper, Flavored Tobacco Sales Restrictions Reduce Tobacco Product Availability and Retailer Advertising, compared changes in tobacco product availability and advertising at tobacco retailers in San Francisco and in cities across the San Francisco Bay in Alameda County (map above) in 2015 and 2019-2020 (before and after laws were passed). They also compared cities with comprehensive flavor policies (prohibiting retail sales of all flavored tobacco products, including menthol) to availability in cities with partial flavor bans (exempting menthol or limiting sales only in distance of schools) or to cities that have not adopted flavored tobacco policies of any kind.

They found that most flavored tobacco products became less available in cities with restrictions while remaining the same or became more available in cities with no restrictions.  Consistent with a study using sales data, they also found differences between cities with comprehensive bans compared to partial bans.  The availability of flavored tobacco decreased by 90.6% in cities with comprehensive flavored tobacco sales restrictions and 62.7% in cities with partially restrictive policies, compared to 13.6% in cities without any restrictions.

Advertising for tobacco products outside and inside retailers, including some non-flavored products which continued to be legal, decreased in cities with restrictions on sales of flavored tobacco products.  This is another benefit of these laws because they lower advertising stimuli for all people, including non-users and former users.

This indirect effect of voluntary reductions on advertising is an important added benefit. Imposing legal requirements limiting advertising is very difficult because of First Amendment challenges by the tobacco companies.

The bottom line: “Comprehensive policies eliminating flavored tobacco sales are associated with significant decreases in flavored product availability and advertising, with greater effects in communities with more comprehensive implementation.”

Here is the abstract:

Objective: This study examined differences in the availability and advertising of flavored tobacco products before and after flavored tobacco sales restrictions were enacted in Alameda and San Francisco Counties in California. Main outcome measures: Data were collected from a sample of tobacco retailers in Alameda and San Francisco Counties at two time points: 2015, before flavored tobacco policies were enacted, and in 2019–2020, after some cities had enacted policies. Retailers were separated by city into Category 1 (n = 442)—retailers in cities that enacted a flavored tobacco policy between the two data collection periods, and Category 2 (n = 89), those that had not. Means comparison tests were conducted to evaluate significant differences over time and by category. Results: There was significantly reduced availability of menthol cigarettes, flavored little cigars, smokeless tobacco, vape pens, and Blu brand menthol e-cigarettes between 2015 and 2020 in Category 1 retailers. Category 2 retailers had reduced availability only for Blu menthol e-cigarettes and demonstrated an increase in smokeless tobacco availability. Exterior store advertising for cigarettes, little cigars, cigars, and e-cigarettes also decreased significantly in Category 1 cities relative to Category 2 cities; 8.1% of Category 1 stores were advertising flavored tobacco products in 2019–2020 compared to 36.2% of Category 2 stores. There was also a 78% reduction in flavored ads between 2015–2019 in Category 1 cities compared to a 38% decrease in Category 2 cities. Tobacco advertising inside Category 2 stores increased. Finally, Category 2 cities had significantly greater availability of cigalikes, mod or tank vapes, flavored e-cigarettes, and e-liquids compared to Category 1 cities. Conclusions. Comprehensive flavored sales restriction policies reduce flavored tobacco availability and tobacco advertising, which may help prevent youth tobacco initiation and exposure.

The full citation is: Holmes LM, Lempert LK, Ling PM. Flavored Tobacco Sales Restrictions Reduce Tobacco Product Availability and Retailer Advertising. International Journal of Environmental Research and Public Health. 2022; 19(6):3455. https://doi.org/10.3390/ijerph19063455. It is available here.