October 2022 News and Research Roundup

Cigarettes, E-Cigarettes, FDA, Flavors (including Menthol), International, Product Availability, Tobacco21, 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

E-Cigarettes

  • Notes from the Field: E-cigarette Use Among Middle and High School Students — United States, 2022, CDC Morbidity and Mortality Weekly Report (MMWR)
    • Display of flavored Puff Bar e-cigarettesThe 2022 National Youth Tobacco Survey (NYTS) shows that 2.55 million U.S. middle and high school students currently use e-cigarettes, with 14.1% high school students 3.3% of middle school students reporting current use. In addition, 46.0% of high school students and 20.8% of middle school students reported using e-cigarettes frequently, and daily use was reported among 30.1% of high school students and 11.7% of middle school students. Students reporting using disposable e-cigarette devices most often (57.2% of high school students; 45.8% of middle school students). However, some respondents reported not even knowing the type of e-cigarette device they used, including nearly 23% of middle school students. Puff Bar was the most commonly reported (29.7%) brand of e-cigarettes used in the past 30 days by both middle and high school students, followed most closely by Vuse (23.6%) and JUUL (22.0%), though the most popular brand that respondents reported typically using was Puff Bar (14.5%) followed by Hyde (5.5%) and Smok (4.0)%). Flavored e-cigarette use remained common, with 84.9% of current middle and high school students reporting use, and the most commonly used flavor type was fruit (69.1%), followed by candy, desserts, or other sweets (38.3%); mint (29.4%); and menthol (26.6%). Disposables, fruit flavors, and the brand Puff Bar were reported as most frequently used out of all e-cigarette types in the 2022 NYTS, which follows trends from previous years. 
  • Longitudinal associations between U.S. youth exposure to E-cigarette marketing and E-cigarette use harm perception and behavior change, Preventive Medicine 
    • This study used data from the Population Assessment of Tobacco and Health Study to examine e-cigarette marketing exposure from December 2016-January 2018 and e-cigarette use harm perception and behavior change a year later from December 2017-December 2018  among youth who had never used tobacco. E-cigarette marketing exposure was reported by 60.8% of youth, and those who reported exposure were more likely to be younger (aged 12–14), female, non-Hispanic White, have higher parental educational attainment, have experienced more personal and substance abuse problems, and have a higher annual household income compared to those who reported no exposure. The most frequently recalled channel of e-cigarette marketing exposure was retail stores (50.3%), followed by TV (22.2%), websites/social media (20.2%), billboards (18.9%), newspapers/magazines (14.8%), radio (7.8%), events (3.8%), and club/bars (3.3%). Youth who recalled seeing e-cigarette marketing materials were more likely to have reduced e-cigarette harm perceptions and were more likely to have ever or currently use e-cigarettes a year later. This data was collected prior to enactment of national policies including Tobacco 21 and the cartridge-based flavored e-cigarette sales restriction. Studies like this show the need for continuing to understand the channels and types of marketing that expose youth to e-cigarettes, as well as for using policy to help reduce the impact of e-cigarette marketing on youth.
  • Learn more about e-cigarettes at the point of sale. 

Flavored Tobacco Products

  • Calculating the potential environmental impact of a menthol cigarette ban in the USA, Tobacco Control 
    • ad for Newport menthol cigarettesThere are widespread environmental impacts of tobacco products. Cigarette butts are one of the most littered items on earth and contain non-biodegradable elements, like filters, that persist in the environment as plastic waste, leach into soil and water, and threaten aquatic and non-aquatic organisms. Tobacco control policies, like bans on tobacco product sales in retail stores, can reduce environmental harms along with reducing tobacco consumption. This study used the impact of the Canadian menthol cigarette ban on post-ban smoking cessation to compute the potential effects of FDA’s proposed menthol cigarette ban on reduced cigarette litter in the USA. Based on the proportion of people in Canada who quit smoking after their menthol ban, researchers estimate that a US menthol cigarette ban would lead to 1,337,988 people who smoke in the U.S quitting. This projected number of people who would quit smoking in the U.S. was multiplied by the average daily number of cigarettes (11.9 cigarettes) smoked among people in the U.S. who smoke menthol cigarettes across 365 days. This multiplication results in a total of 5,811,550,878 fewer cigarettes per year smoked due to a U.S. menthol ban. Lastly, after multiplying this number by an estimate that 65% of cigarettes are littered, the final results find that a U.S. menthol cigarette ban would lead to a reduction of 3,777,508,071 fewer cigarettes littered, or 755,502 kg of waste annually. This study shows the direct impact of a tobacco control policy in reducing tobacco product waste and negative environmental effects. Future adoption of the FDA’s menthol cigarette rule could offer substantial environmental benefits.
  • Impact of the European Union’s menthol cigarette ban on smoking cessation outcomes: longitudinal findings from the 2020–2021 ITC Netherlands Surveys, Tobacco Control
    • The European Union banned menthol as a characterizing flavor in cigarettes in May 2020. This study evaluated the impact of this ban on smoking cessation among Dutch smokers. Using the International Tobacco Control Netherlands Surveys, researchers found that menthol use decreased from 7.8% pre-ban to 4% post-ban. People who smoked menthol cigarettes before the ban had greater odds of making quit attempts after the ban than people who smoked non-menthol cigarettes, with 66.9% of people who smoked menthol cigarettes making a post-ban quit attempt compared to 49.6% of people who smoked non-menthol cigarettes. People who smoked menthol cigarettes who had a greater likelihood of post-ban quit attempts were primarily men, those aged 18–39 years, those with high education, people who smoked daily, and those with higher nicotine dependence. These results show the EU menthol ban was effective in reducing menthol use and in increasing quit attempts, and provides an example of menthol-ban effectiveness as rationale for other countries. 
  • Learn more about flavored tobacco products, including menthol.

Tobacco 21

  • Retailer compliance with Tobacco 21 in New Jersey, 2019-2020, JAMA Network Open
    • In this study, researchers assessed retailer compliance after the 2017 enactment of a Tobacco 21 policy in New Jersey. Between August 2019 and March 2020, underage youth (aged 18-20 years) were recruited to attempt purchasing tobacco products at a random sample of 86 licensed tobacco retailers. They recorded any age verification done (e.g. carding) and purchase attempt outcomes (if products were sold to them) at each visit. Out of these retailers, 100% sold cigarettes, 79.1% sold cigars, and 45.3% sold e-cigarettes. For a total of 780 visits, the underage youth were carded in 65.9% of visits and successfully purchased products in 42.3% of visits. Even when retailers checked identification, they still sold to underage youth at 14% of visits. When youth were not carded, they had  higher odds of a successful tobacco purchase. “Nonchain” convenience stores and gas kiosks had lower odds of carding compared with “chain” convenience stores. In areas with greater tobacco retailer density, there were lower odds of age verification.. This data shows the need for increased education around age verification and holding retailers more accountable for underage sales.
    • Learn more about Tobacco 21 best practices.

COVID-19

  • COVID-19 Restrictions and Adolescent Cigarette and E-Cigarette Use in California, Preventive Medicine 
    • This study examined whether the duration of and compliance with “shelter-in-place (SIP) orders” during the early stages of the COVID-19 pandemic influenced adolescent cigarette and e-cigarette use. SIP orders included stay-at-home mandates, restrictions on social gatherings, and other rules to mitigate the spread of the virus. These orders created barriers to tobacco product access (like closing of tobacco stores), which in turn, could have influenced adolescence tobacco product exposure, use and related motivations. Data from a web-based survey on substance use California administered April 2020-December 2020 assessed self-reported past 6-month cigarette or e-cigarette use and past 6-month frequency of cigarette or e-cigarette use among a sample of 1,196 adolescents ages 13-19 years old across 49 counties. Data on SIP order compliance was gathered in the survey by asking how often (never, rarely, sometimes, often, very often) participants went out to a variety of places (e.g., grocery store, friend’s house etc.). A “never” response indicated highest compliance with SIP orders and a “very often” showed least compliance. Greater compliance with SIP orders was associated with lower odds of past 6-month cigarette and e-cigarette use and lower frequency of use, especially for business/retail-related SIP orders. For business/retail related compliance with SIP orders, with each 1-point increase in the SIP compliance score (greatest to least compliance), there were 43% lower odds that participants would report past 6-month cigarette use and 22% lower odds that participants would report past 6-month e-cigarette use. Through SIP orders, the reduced opportunities for exposure to and purchase of tobacco products in the retail environment contributed to reduced tobacco product use among adolescents in this study. This shows the positive influence of policy, whether pandemic related or not, on youth tobacco use.

Rebutting Tobacco Industry Claims

  • Tobacco industry claims about transformation are inconsistent with combustible cigarette innovations: The case of flavour capsule cigarettes, Nicotine & Tobacco Research 
    • Advertisement for This commentary dispels current tobacco company rhetoric for a smoke-free future, movement away from cigarettes, and effectiveness of reduced risk products. The continued development and sale of new combustible tobacco products, like flavor capsule cigarettes, negates the industry’s claims that they are moving away from cigarettes. Flavor capsule cigarettes work by smokers crushing flavored capsules with liquid, gel or solid material (e.g., powder) in the filter of the cigarette to change the flavor of the smoke. For example, flavors like menthol can be crushed into the cigarette (e.g., Camel Crush). The flavor capsule market has been one of the fastest growing product segments since 2007, and current estimates project continued international growth until 2026. Moldova, Turkey, and the UK are currently the only countries that ban flavor capsule cigarettes. The research shows these flavor capsule cigarettes are highly appealing to young people, and play a role in both new smoker initiation and continued use. The retail environment is a key channel for marketing of flavor capsule cigarettes. The authors of this commentary argue that when the tobacco industry stops sales of their harmful tobacco products and stops challenging flavored tobacco product bans, then there may be a stronger argument for their commitment to change. 
  • Tobacco mythbusting—tobacco is not a major driver of foot traffic in low socio-economic small retail stores, Tobacco Control
    • In this study, researchers tested industry claims that purchases of tobacco products lead to unplanned purchasing of other items in small retail stores and that restrictions on the sale of tobacco products may therefore adversely impact small retail stores. Between July and October 2018, this study gathered data using 1,487 consumer intercept surveys conducted outside 136 small stores selling tobacco products in 27 lower socioeconomic suburbs within Australia. The consumer intercept survey asked about consumer purchasing habits like major reasons for visiting stores, planned or unplanned purchases made, and usual purchasing location for tobacco products. Only 3% of consumers surveyed cited purchasing tobacco as the primary motivation for visiting the store, and only 8% purchased tobacco. A majority of consumers (97.5%) who visited small retail stores in low socioeconomic areas did not do so with the primary aim of purchasing tobacco. A greater proportion of consumers who did not purchase tobacco products made planned purchases of non-tobacco products. Hot food, groceries and lottery tickets were most frequently purchased. Also, consumers who purchased tobacco were no more likely to buy other non-tobacco products. Additionally, less than half of those surveyed identified small retail stores as their usual location for buying tobacco products. This survey data shows that tobacco purchases were not a key driver of foot traffic at small retail stores. There are similar findings from the U.S., U.K,, and New Zealand that show that consumers who visit small retail stores do not only purchase tobacco products. Restricting the retail sales of tobacco products may not have such a profound negative impact on small retail stores as industry arguments assert.

Reports

Industry News

POS Policy in the Media

Flavored Tobacco Products

Tobacco 21 and Sales to Minors

Reduced Nicotine Cigarettes 

Preemption

E-cigarettes 

Federal

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 October 27, 2022

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