June 2024 News and Research Roundup

Cigarettes, E-Cigarettes, Endgame, Flavors (including Menthol), oral nicotine products, Product Availability, Youth

Welcome to CounterTobacco.org’s “News and Research Roundup!” Each month we post a summary of the latest research, reports, and news stories on counteracting tobacco product sales and marketing at the point of sale (POS). Keeping up with what’s happening in the POS movement all across the country can help you choose policies and strategies that work best for your community. New research can help provide support for your work and evidence for the importance of the “War in the Store.” Have a story you don’t want us to miss? E-mail it to us!

New Research

Oral Nicotine Pouches 

  • The Potential Impact of Oral Nicotine Pouches on Public Health: A Scoping Review, Nicotine & Tobacco Research
    • A scoping review of sixty-two studies, of which seventeen were industry-funded, analyzed oral nicotine pouches (ONP) characteristics, use patterns, beliefs and perceptions toxicity, and marketing sales through January 10, 2024. Industry-funded studies suggest ONP delivers similar amounts of nicotine to cigarettes, yet appear to be less toxic, thus suggesting their use for harm reduction methods. The tobacco control community expresses concern about the attractiveness of ONP products to youth and potential to create a reliance on nicotine products with 9%-21% of tobacco-naive youth being susceptible to trying ONP and 35%-42% of youth and young adults being aware of ONP. Additionally, confusion around ONP labeling as “tobacco-free” has the potential to create false perceptions of the safety of the product. 17% of U.S. young adults mistakenly believed tobacco-free ONPs contained neither tobacco nor nicotine. Further independent studies are needed to determine the public health impact of ONP.
    • Learn more about oral nicotine products at the point of sale


  • Modification of Electronic Nicotine Delivery Systems Among Adolescents and Young Adults, Pediatrics
    • A Qualtrics online sample of 1,018 individuals between 14 and 29 years old who had used ENDS at least one day in the past month completed a 20-minute online survey from November 2022 to February 2023 on awareness and perceptions of ENDS modifications. Survey participants indicated the most commonly tried modifications were refilling rechargeable pod/cartridge devices (40.1%) and recharging disposable pod devices (35.8%). Indicated sources of ENDS modifications were friends (64.4%), social media (46.7%), nonsocial media websites (14.8%) and vape shops (11.3%). The adjusted models indicated that lower perceptions of harm and higher perceptions of coolness were linked to an increased likelihood of modifying ENDS. Further research is needed to examine how ENDS are modified or hacked for unintended purposes. Regulatory decisions should account for ENDS modifications to  prevent potential harm to adults and youth alike.
    • Learn more about e-cigarettes at the point of sale.

Menthol and Other Flavored Tobacco Products

  • Selective Reduction of Socioeconomic Disparities in the Experimental Tobacco Marketplace: Effects of Cigarette and E-cigarette Flavor Restrictions, Nicotine & Tobacco Research
    • This study aimed to investigate the impact of cigarette and e-cigarette flavor restrictions on individuals with different socioeconomic statuses (SES). Secondary analysis of previously collected data on 280 individuals who smoked cigarettes from July to August 2021 was used to determine expected participant purchasing behavior in four policy scenarios. The policy scenarios included cigarette flavor restrictions versus unrestricted and e-cigarette flavor restricted versus unrestricted. Findings indicated flavor restrictions significantly changed tobacco product purchasing in the group with lower SES. Cigarette flavor restrictions led to decreased cigarette purchases and increased nicotine replacement therapy (NRT) purchases among lower SES individuals, but not among higher SES individuals. Lower SES individuals showed higher demand for cigarettes and lower substitution with e-cigarettes and NRT compared to higher SES individuals under unrestricted conditions. SES differences in e-cigarette purchases persisted when all restrictions were enforced. The study concludes that flavor restrictions affect lower SES individuals more significantly than higher SES individuals, potentially reducing SES disparities in cigarette demand and NRT use. These findings suggest that flavor restrictions in cigarettes, combined with increased availability and affordability of NRT, could improve health equity by addressing SES disparities in tobacco use.
    • Learn more about restrictions on the sale of flavored tobacco products.
  • Use of Menthol-Flavored Tobacco Products among US Middle and High School Students: National Youth Tobacco Survey, 2022, CDC Preventing Chronic Disease
    • Analysis of the 2022 National Youth Tobacco Survey showed 23.8% of students who currently use any tobacco product used menthol-flavored tobacco products, and 39.5% of students who currently use any flavored tobacco product used menthol-flavored tobacco products. Prevalence of use of any menthol-flavored tobacco product was highest among non-Hispanic White youth. Of students who currently used only flavored e-cigarettes, 30.6% used menthol e-cigarettes. Modeling studies indicate that banning menthol cigarettes in the U.S. could lead to a 15% reduction in smoking prevalence and potentially prevent between 324,000 and 654,000 deaths over the next 40 years. Analyzing menthol and other characterizing flavors or additives in all tobacco products is essential to understanding factors that may contribute to the initiation and continued use of tobacco products.
  • Learn more about menthol.                                      


  • Reactions to a Nicotine Reduction Policy Among Adolescents Who Smoke: A Qualitative Study, Nicotine & Tobacco Research
    • This study analyzed adolescents’ responses and adherence to very low nicotine content (VLNC) cigarettes, as discussion around a nicotine reduction policy in the U.S. is growing. Sixty adolescentes ages 15-19 years who smoke cigarettes daily partook in a three-week double-blind randomized clinical trial and were assigned to smoke normal nicotine content (NNC) or VLNC research cigarettes. After the trial, 52 participants were interviewed qualitatively to gather their feedback on both the cigarettes and the concept of a nicotine reduction policy. Results found an incomplete adherence and negative evaluations to the research cigarettes as participants expressed dislike for the cigarette taste and lower satisfaction compared to usual brand cigarettes. Participants in both groups stated they would decrease their smoking or quit entirely if the VLNC research cigarettes were the only ones legally available for purchase in the U.S. Findings indicate a nicotine reduction policy may reduce smoking initiation and progression in young people.   
  • Public Support for Tobacco Endgame Policies: A Systematic Review and Meta-analysis, Nicotine & Tobacco Research
    • This systematic review of 47 articles published from 2013 to date on public support for a tobacco endgame policy indicated overall high support for the policy. Individuals who smoked reported lower levels of support as compared to those who did not smoke. Three-level meta-analyses demonstrated the highest support for mandating very low nicotine levels in tobacco products (76%), followed by setting a tobacco endgame goal (73.5%). More research is needed to evaluate levels of support for tobacco endgame policies to indicate political feasibility.

New Reports and Resources 

Industry News

POS Policy in the Media

Menthol and Other Flavored Tobacco Products

Licensing, Zoning, and Retailer Density 


Tobacco 21


Find more stories in last month’s News and Research Roundup.

Know of a story that we missed? Email us, and we’ll be sure to include it in next month’s roundup!


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