November 2022 News and Research Roundup

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

Youth Perspectives on Menthol Sales Restrictions in Minneapolis and Duluth, Minnesota, Health Promotion Practice
- The cities of Minneapolis and Duluth in Minnesota implemented menthol tobacco sales restrictions in 2018, limiting their sale to adult-only stores. Menthol cigarettes are a starter tobacco product among youth, and African American and LGBTQ youth are more likely to smoke menthol cigarettes compared with youth who smoke and are in other racial/ethnic groups or are heterosexual due to the tobacco industry’s continued targeting of these groups. This evaluation assesses the policy impact via youth perception of access to menthol-flavored tobacco products, exposure to menthol-related advertising, and menthol tobacco use. The researchers used a “youth participatory framework,” recruiting thirty youth aged 14-17 living in Minneapolis and Duluth from community-based organizations that work with LGBTQ youth and youth of color to participate in focus groups, surveys, peer interviews, and photo documentation 2 months before and after policy implementation.Pre-policy implementation, these youth cited obtaining tobacco through more informal means like school peers, family members, strangers, and online. For the retail setting, they reported building connections and trust with store staff, buying tobacco products with older people who can legally purchase, and knowing which stores don’t routinely check IDs, which were typically smaller, independently owned locations. Post-policy implementation, youth said that the restrictions caused more inconvenience for their peers who smoke menthol cigarettes. They saw lots of retail tobacco-related advertising pre-policy and observed decreases in retail advertising of menthol cigarettes post-policy implementation, with fewer menthol ads in corner stores or gas stations. However, they cited that youth regularly navigated between localities with and without menthol restriction policies. They were also uncertain about the impacts of the policies in encouraging people to quit or switch to other products. This feedback from youth shows the need for more comprehensive approaches that address the range of tobacco products and channels of tobacco product access by youth, particularly for implementing policies across jurisdictions. Additionally, the youth participants didn’t necessarily think of themselves or their peers as menthol product users, and these perceptions show the need for increased education and awareness-building within this age group around the harms of menthol-flavored tobacco.
- Learn more about menthol.

E-Cigarettes

The actual and anticipated effects of restrictions on flavoured electronic nicotine delivery systems: a scoping review, BMC Public Health\
- This scoping literature review of 30 different studies provides evidence of implemented or hypothetical flavored ENDS sales restrictions and their impact. Of the 5 studies evaluating impact on sales following restrictions, three reported a decline in ENDS sales, and one an increase that was lower than the increase in control areas; in addition, one reported a decrease in cigarette sales, two reported an increase, and one reported no change. Of the 17 studies that evaluated impact on behavior, the outcomes measured varied considerably, limiting comparability. However, some studies found that restrictions play a role in changes in the frequency or intensity of tobacco product use extending beyond ENDS. Among the 9 hypothetical studies, reports of the participants’ behavioral intentions show that flavored ENDS restrictions may decrease ENDS use, encourage people who use ENDS to switch to combustible cigarettes, and/or result in people who use ENDS trying to evade restrictions. Of the 10 studies evaluating compliance, the studies found that with strong enforcement in place, restrictions can reduce the availability of flavored ENDS products in retail stores even when some retailers still illegally sell. Researchers conclude that there are still clear gaps and uncertainty in the effect of flavored ENDS restrictions on adult use of nicotine and tobacco products and point to a need to more evaluation, specifically on the impacts for different age groups aside from youth and young adults, across large and small jurisdictions (including outside the US), and based on policy comprehensiveness.
- Learn more about e-cigarettes at the point of sale.
Review of Use Prevalence, Susceptibility, Advertisement Exposure, and Access to Electronic Nicotine Delivery Systems among Minorities and Low-Income Populations in the United States, International Journal of Environmental Research and Public Health
- The use of and littering of ENDS is an environmental hazard and may be an environmental justice issue if the burden falls disproportionately on minorities and people of low socioeconomic statuses (termed environmental justice or “EJ” populations in this paper). However, studies reporting sociodemographic differences in environmental exposure from ENDS are limited. This review highlights results from 32 studies on ENDS use prevalence, susceptibility to ENDS use, exposure and access to ENDS, and the environmental tobacco exposure (ETE) among EJ populations. Studies that examined ENDS use by race/ethnicity generally reported lower prevalence of use among minorities overall, higher susceptibility to ENDS use among minority youth, and lower susceptibility among minority adults compared to non-Hispanic White populations. The results for socioeconomic status were mixed, with four studies reporting lower use prevalence, five studies reporting higher prevalence, and one study reporting unclear results. Results examining exposure to ENDS advertising and access to ENDS found generally higher exposure among racial/ethnic minority youth and adults, influenced by SES. These results indicate overall lower potential ETE among racial/ethnic minorities compared to non-Hispanic Whites for ENDS use prevalence. Although there is lower use of ENDS among EJ populations, there may be greater future susceptibility to ETE based on persistent factors such as advertisement exposure and access to ENDS. Researchers conclude these findings show the need for education campaigns to prevent initiation, limiting vape shops in low income and minority communities, and monitoring targeted ENDS advertisements.
- Learn more about e-cigarettes at the point of sale.
Ethyl maltol, vanillin, corylone and other conventional confectionery-related flavour chemicals dominate in some e-cigarette liquids labelled ‘tobacco’ flavoured, Tobacco Control
- This study analyzed the number and concentration of flavor chemicals in 63 tobacco-flavored e-liquid refill fluids purchased between 2011 and 2019 and 2 popular disposable/pod-style e-cigarettes: JUUL and Puff Bar. The flavor tobacco-flavored e-liquid refills had low flavor chemical concentrations with a few exceptions.JUUL’s two tobacco flavors studied, including “Classic” and “Virginia,” contained very low levels of flavor chemicals (<0.35 mg/mL), whereas Puff Bar’s ‘Tobacco’ had 27 different flavor chemicals with a total concentration of 34.3 mg/mL, which was higher than other Puff Bar products. The flavor chemicals of ethyl maltol, corylone, menthol, vanillin, maltol and triacetin were most frequently used and had the highest concentrations. The researchers conclude that tobacco-flavored e-cigarettes purchased in recent years have higher concentration of sweet and fruity flavor chemicals, likely to circumvent regulations, intensify the use experience, facilitate nicotine addiction, and appeal to youth. The researchers advocate for identifying and quantifying flavor chemicals in e-cigarette products during the Premarket Tobacco Application (PMTA) process.
- Learn more about e-cigarettes at the point of sale.