By banning flavored tobacco products at a local level in California, the rate of youth vaping declines without a corresponding increase in cigarette smoking, a UC San Diego report found Friday.
The findings, based on an analysis of more than 2.8 million middle and high school students, were published Friday in JAMA Health Forum. The research team analyzed responses from students who took the California Healthy Kids Survey between 2017 and 2022. The survey includes students in grades 7, 9 and 11 and asks about past-month use of tobacco products.
“Our findings suggest that local flavored tobacco bans can be an effective strategy for reducing youth e-cigarette use,” said Eric Leas, assistant professor at UCSD Herbert Wertheim School of Public Health and Human Longevity Science and senior author of the study. “Importantly, we did not find evidence that these policies led young people to switch to cigarettes, which has been a major concern raised in policy debates.”
According to national data, youth vaping peaked in 2019 when more than a quarter of high school students reported using electronic nicotine delivery systems — more commonly known as e-cigarettes or vapes. The rate has since declined, but concerns about nicotine dependence and long-term health risks continue.
In an effort to combat the use of e-cigarette products, some policymakers have restricted the sale of flavored tobacco products, which they say are a draw for young users.
The UCSD researchers compared tobacco use among students attending schools in areas with flavored tobacco bans to those in areas without such policies.
Youth vaping rates were lower in areas with flavored tobacco bans. In jurisdictions with a ban, 6.2% of students reported current e-cigarette use, compared with 7.7% in areas without one, the researchers reported.
Cigarette use remained roughly the same in jurisdictions with and without the policies.
California voters approved a statewide flavored tobacco sales ban in 2022, which took effect in 2023. But because many cities had implemented their own restrictions years earlier — some as early as 2011 — the researchers said these local policies provide an opportunity to study longer-term impacts of flavor bans.
According to the researchers, resources and support for enforcing these laws also grew over time, particularly after the statewide ban took effect, helping local communities better implement the restrictions.
“Local policies gave us a valuable window into how flavored tobacco restrictions may influence youth behavior over time,” said Giovanni Appolon, first author of the study who conducted this research as part of experiential learning as a doctoral candidate in the UC San Diego – San Diego State University Joint Doctoral Program in Public Health. “As more jurisdictions adopt these policies, continued monitoring will help determine how enforcement, policy design and community context shape their public health impact.”
However, the authors did note that the study focused on California, a state with historically strong tobacco control policies and relatively low youth smoking rates compared with other states. As a result, “the magnitude and timing of the effects may differ in places with different policy environments,” a UCSD statement read.
Future research is needed to understand the long-term impact of statewide bans and how similar policies affect youth tobacco use across different regions and communities, the authors of the paper write.
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