Two new papers, The Effect of State and Local Flavored Cigar Sales Restrictions, on Retail Sales of Large Cigars, Cigarillos, and Little Cigars in Massachusetts, California, Illinois, and New York and The Association Between the License Fee Increase and The Density of Tobacco Retailers in California – A Segmented Interrupted Time Series Analysis by Income and Race/Ethnicity, show that tobacco control policies have the desired effects.
The first, by Megan Diaz and colleagues as Truth Initiative, cross-tabluated information on state and local restrictions on sales of flavored tobacco products with sales data for California, Illinois, Massachusetts, and New York to assess the impact on per capita unit sales of cigars. They found that a 25% increase in the percentage of the population covered by a flavored cigar sales restriction was associated with a decrease in per capita all cigar sales of 15-19%, 4-10% for large cigars, 17-21% for cigarillos, and 2-41% for little cigars. They note that the FDA’s proposed product standard would increase the covered by a flavored cigar sales restriction to 100%, leading to potential significant reductions in cigar sales, especially little cigar, and cigarillo sales, which would likely also substantially reduce youth cigar use and racial disparities in cigar use.
The second, by Yanyun He and colleagues at Ohio State University, collected data on the number of active tobacco retailer licenses from 2011 to 2020 in every zip code in California and linked it to corresponding income, race/ethnicity, and population measures to estimate the association between the increase in licensing fees and retailer densities by neighborhood income and race/ethnicity. They found that retailer density dropped immediately and gradually after imposing the fees. They concluded that, “Given that higher smoking prevalence is associated with greater tobacco outlet density, the licensing fee increase could be an effective policy tool to reduce tobacco use among economically disadvantaged and minority Black communities, thereby addressing tobacco-use disparities.”
Here are the full citations and abstracts:
Diaz MC, Yoon SN, Donovan E, Akbar M, Schillo BA. The effect of state and local flavored cigar sales restrictions, on retail sales of large cigars, cigarillos and little cigars in Massachusetts, California, Illinois, and New York. Nicotine Tob Res. 2023 Jul 15:ntad121. doi: 10.1093/ntr/ntad121. Epub ahead of print. PMID: 37453140. It is available here.
Introduction: In 2009, the Family Smoking Prevention and Tobacco Control Act prohibited flavored cigarettes but allowed for flavored cigars. Since, there has been a 34% increase in youth cigar use and widened racial disparities. State and local jurisdictions have increasingly enacted flavored tobacco product sales restrictions. As more jurisdictions consider implementing flavor restrictions, it is important to understand their effect on tobacco markets that have high flavor proliferation, including the cigar market.
Methods: This study uses data from Truth Initiative’s flavor policy database and NielsenIQ retailer scanner for California, Illinois, Massachusetts, and New York. We use a three-way fixed-effect model to assess the impact of the percentage of the population covered by a flavored cigar sales restriction on per capita unit sales of cigars.
Results: We find that population coverage by cigar sales restrictions was significantly associated with decreases in per capita cigar sales. More specifically, a 25% increase in the percentage of the population covered by a flavored cigar sales restriction was associated with a decrease in per capita all cigar sales of 15-19%, 4-10% for large cigars, 17-21% for cigarillos, and 2-41% for little cigars.
Conclusion: Flavored cigar sales restrictions are an effective policy to reduce per capita cigar sales. The Food and Drug Administration’s proposed product standards would increase population covered by a flavored cigar sales restriction to 100%, leading to potential significant reductions in cigar sales, especially little cigar, and cigarillo sales. This may also substantially reduce youth cigar use and racial disparities in cigar use.
Implications: In April 2022, the US Food and Drug Administration published a proposed rule to prohibit characterizing flavors in all cigars and menthol cigarettes. Besides this proposed rule, there has been little federal action to date to reduce sales of flavored cigars. However, as of March 31, 2022, Massachusetts and 333 localities across 10 states have enacted policies that restrict the sale of flavored cigars and other tobacco products. We find that population coverage by cigar sales restrictions is significantly associated with decreases in per capita cigar sales.
He Y, Yang Q, Lu B, Shang C. The Association Between the License Fee Increase and The Density of Tobacco Retailers in California – A Segmented Interrupted Time Series Analysis by Income and Race/Ethnicity. Nicotine Tob Res. 2023 Sep 13:ntad174. doi: 10.1093/ntr/ntad174. Epub ahead of print. PMID: 37702761. It is available here.
Introduction. On May 9, 2016, the State of California passed a law to increase the licensing fee for tobacco retailers from a one-time-only fee of $100 to an annual fee of $265, effective on June 9, 2016. This study investigates the association between this fee increase and retailer densities by neighborhood income and race/ethnicity characteristics.
Methods. We obtained quarterly data on the number of active tobacco retailer licenses from 2011 to 2020 in every zip code in California from the California Department of Tax and Fee Administration. These data were then linked to zip code-level income, race/ethnicity, and population measures. We used a single-group segmented interrupted time-series analysis to assess the association between the increase in licensing fees and retailer densities by neighborhood income and race/ethnicity.
Results. After the implementation of the annual licensing fees, the retailer density decreased both immediately and gradually. Specifically, the retailer density dropped by 0.47 in the first quarter following the intervention. Compared to the pre-intervention time trend, the retailer density decreased quarterly by 0.05. Furthermore, the impacts of increasing licensing fees were more pronounced in low-income and the majority Black zip codes.
Conclusions. Given that higher smoking prevalence is associated with greater tobacco outlet density, the licensing fee increase could be an effective policy tool to reduce tobacco use among economically disadvantaged and minority Black communities, thereby addressing tobacco-use disparities.
Implications. This study used the single-group segmented interrupted time-series analysis to assess the association between the licensing fee increase and tobacco retailer densities by neighborhood income and race/ethnicity. We found that this licensing fee increase was associated with reduced retailer densities and the total number of active retailers right after the implementation. We further found that the annual licensing fee policy had a continuous effect in reducing tobacco retailer densities in all zip codes. The impacts of increasing licensing fees were more pronounced in low-income and majority of Black zip codes.
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