March 2024 News and Research Roundup

Cigarettes, Disparities, Displays/Display Ban, E-Cigarettes, Endgame, FDA, Flavors (including Menthol), Health Warnings, Licensing, Product Availability, Smokeless Tobacco and SNUS, Tobacco21

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

Menthol and Other Flavored Tobacco Products 

  • Brief report: Should menthol e-cigarettes be banned? Reaction of adults smokers and users of e-cigarettes to hypothetical bans, Tobacco Control 
    • This study surveyed people who currently smoke about whether they would quit all tobacco-nicotine use, continue use, or start using other legal products in three hypothetical scenarios: 1) a ban on the sale of menthol cigarettes and flavored cigars; 2) a ban on menthol cigarettes, flavored cigars, and flavored e-cigarettes other than menthol and tobacco flavors; and 3) a ban on the sale of menthol cigarettes, flavored cigars, and flavored e-cigarettes other than tobacco flavor. The results showed that “A ban on menthol cigarettes and flavoured cigars would lead to 12%–20% of flavoured smokers trying to quit all tobacco use and 32%–52% switching to non-flavoured smoking, with the remaining switching to e-cigarettes or other products. Compared with a ban on only menthol cigarettes and flavoured cigars, also banning flavoured e-cigarettes would increase the likelihood of quitting all tobacco-nicotine use (OR=2.58) but also increase the likelihood of switching to non-flavoured smoking (OR=1.74).” 
  • Smoking prevalence and purchasing of menthol cigarettes since the menthol flavour ban in Great Britain: a population-based survey between 2020 and 2023, Tobacco Control
    • Great Britain banned the sale of menthol cigarettes in 2020. However, due to the tobacco industry exploiting loopholes in the law, other menthol products such as accessories and “unlabeled cigarettes perceived as mentholated” are available, and people also can buy menthol cigarettes from other countries or illicitly. This survey found that the percentage of adults smoking menthol cigarettes (~16%) did not decline from 2020 to 2023 across Great Britain except in Wales (where the rate fell by two-thirds) and among young adults ages 18-24. The study also found that nearly 94% of adults smoking menthol cigarettes purchased them from legal sources, indicating the importance of closing existing loopholes to prohibit “all menthol and its analogues and derivatives in all tobacco-related products, including accessories.”
    • News story: One million adults smoke menthol-flavoured cigarettes in Britain despite ban, EurekAlert!
  • Learn more about menthol.

E-Cigarettes

  • Associations between e-cigarette marketing exposure and vaping nicotine and cannabis among U.S. adults, 2021, MedRxiv
    • This cross-sectional study aimed to identify associations between e-cigarette marketing exposure and nicotine and cannabis vaping behaviors among adults. Respondents to the Population Assessment of Tobacco and Health (PATH) Study, conducted from March to November 2021, reported past 30-day e-cigarette marketing exposure and past 30-day vaping behavior (sole- and dual-vaping of nicotine and cannabis). Overall, 52.0% of respondents reported past 30-day e-cigarette marketing exposure. Results show exposure to e-cigarette marketing was associated with increased odds of reporting sole-cannabis vaping versus no vaping and dual-vaping versus no vaping.  Those exposed to e-cigarette marketing also had increased odds of reporting sole-cannabis vaping versus sole-nicotine vaping. When stratified for age, associations were mainly found among young adults aged 18-24 and 25-35 years. 
  • Exposure among middle and high school students to warning labels on e-cigarette packages before and after an FDA requirement, 2018-2019, Preventing Chronic Disease
    • In August 2018, the FDA began requiring all e-cigarette packaging to contain a health warning about nicotine. This study analyzed data from the National Youth Tobacco Survey and found that between 2018 the percentage of students who currently used any tobacco e-cigarette product self-reporting any level and a high level of exposure to e-cigarette warning labels increased significantly from 75.7% to 82.0%. Exposure also increased among students who currently use e-cigarette from 77.4% to 83.1%, and among students who currently use e-cigarettes frequently from 81.0% to 89.2%. 
  • Disposable e-cigarette use and subsequent use patterns in adolescents and young adults, Pediatrics 
    • An analysis of combined data from surveys of adolescents and young adults ages 14-24 from Southern California in 2021 found that among those who currently used e-cigarettes, those who used disposable e-cigarettes were nearly twice as likely to continue using e-cigarettes 8 months later compared to those who used other types of e-cigarettes. 
    • News story: Teen use of disposable e-cigarettes linked to persistent use patterns, Medical Xpress 
  • Reducing attractiveness of e-liquids: proposal for a restrictive list of tobacco-related flavourings, Tobacco Control
    • This study proposes a list of e-liquid flavoring additives that could be used to implement a ban on flavors other than tobacco. They used e-liquid ingredient data from the European Common Entry Gate system for e-liquids marketed as tobacco-flavored. While tobacco-flavored e-liquids contained 503 flavorings overall, the researchers excluded the ones that were only used in a small percentage of the e-liquids, those from plant extracts, those that were sweet or not associated with a tobacco flavor, and those that have known health risks. 
  • Industry watch: Spree Bar, a vaping system delivering a synthetic nicotine analogue, marketed in the USA as ‘PMTA exempt,’ Tobacco Control
    • According to this report, as of October 2023, some vape shops in the US were selling an pre-filled pod-based electronic cigarette called “Spree Bar,” which is advertised as “PMTA exempt.” The product contains flavored e-liquid with metanine, which “produces the same sensation as nicotine and may also be addictive.” Since they do not contain any tobacco or nicotine, these products may pose a challenge for FDA regulation. “…While many countries have updated their tobacco product laws to cover synthetic nicotine, or are in the process of doing so, a recent WHO report warned that non-nicotine tobacco alkaloids or synthetic nicotine analogues could be used by manufacturers to bypass regulatory schemes focusing on nicotine alone.” 
  • Suggestions to avoid perpetuating tobacco industry reduced-harm marketing tropes, Pediatrics 
    • This article identifies language that the tobacco industry promotes in describing tobacco products and proposes alternative terms to ensure that they do not falsely imply reduced risk. For example, the authors suggest using “nicotine device” instead of “vape,” “nicotine liquid” instead or “e-liquid” or “e-juice,” and “nicotine pouches/gums/lozenges/toothpicks” instead of “modern oral nicotine.”
    • News story: A new study highlights the impact of tobacco company marketing on teen e-cigarette usage, KOAM
  • Learn more about e-cigarettes at the point of sale. 

Nicotine Pouches 

Tobacco Advertising and Display

  • Differences in tobacco advertising receptivity among young adults by sexual identity and sex: findings from the Population Assessment of Tobacco and Health Study, Annals of LGBTQ Public and Population Health 
    • This study analyzed data from young adults (ages 18-24) participants in the Population Assessment of Tobacco and Health study and found that those who identified as lesbian, gay, or bisexual also had higher levels of receptivity to tobacco marketing. Specifically, “gay males had higher odds of receptivity to cigar advertising and gay and bisexual males had higher odds of receptivity to e-cigarette advertising, compared with straight/heterosexual males. Compared with straight/heterosexual females, bisexual females had higher odds of receptivity to advertising for all products; lesbian/gay females had higher odds of receptivity to any tobacco advertising.” 
    • News story: Lesbian, gay and bisexual women smoke more, are less likely to quit, EurekAlert!
  • Does reducing the size of the tobacco power wall affect young people’s risk of future use of tobacco products? An experimental investigation, Journal Studies on Alcohol and Drugs
    • This study utilized RAND StoreLab, a life-sized replica of a convenience store to examine the influence of the size of the power wall on young people’s susceptibility to tobacco use. Participants between the ages of 11–20 were randomly assigned to shop in a version of the store featuring a large (status quo), medium, or small power wall situated behind the checkout counter. The results of the experiment showed power wall size to be unrelated to future risk of smoking unflavored cigarettes, using menthol vaping products, or using sweet-flavored vaping products. These findings indicate that reducing the size of the power wall alone may not be a sufficient strategy for reducing its influence on youth susceptibility to tobacco use. 

Tobacco 21 

  • Estimating the effects of tobacco-21 on youth tobacco use and sales, Journal of Health Economics 
    • This study analyzed the impact of policies raising the minimum legal sales age for tobacco to 21 on cigarette and e-cigarette use and sales using the Monitoring the Future survey data and Nielsen Retail Scanner data from 2012 to 2019. They found that across the United States, in counties with the highest proportion of residents living where a Tobacco 21 policy was in place, cigarette sales decreased by 12.4% and e-cigarette sales decreased by 69.3%. They also found that Tobacco 21 laws reduced current use of cigarettes among 12th grade students.
    • Learn more about Tobacco 21 policies.

New Reports and Resources 

Industry News

POS Policy in the Media

Menthol and Other Flavored Tobacco Products

Licensing, Zoning, and Retailer Density 

E-Cigarettes

Nicotine Pouches 

Preemption 

Tobacco-Free Pharmacies

Endgame

Other

 

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!

Last updated April 11, 2024

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