Impact of the California state flavoured tobacco sales restriction on e-cigarette use behaviours among youth.

BACKGROUND

In December 2022, California prohibited the sale of most flavoured tobacco products; however, limited data are available assessing the impact on adolescent tobacco use behaviours.

METHODS

We compared data from youth in 11th grade prior to (fall 2022; n=1212; 'prelaw') and after implementation of the law (fall 2023; n=1026; 'postlaw') at four schools in Southern California (panel study). We assessed past 30-day e-cigarette use, e-cigarette flavours used, perceived difficulty in getting preferred flavours and (among new initiators), flavour at first use, and support for, anticipated impact, and perceived actual impact of the law. We also assessed change in e-cigarette use behaviours prelaw, prelaw to postlaw and postlaw in the same individuals (cohort study).

RESULTS

There was little change in past 30-day e-cigarette use prelaw (5.8%) vs postlaw (4.1%) (p=0.11). At both time points, all new initiators (100%) reported starting vaping with a flavoured product, most reported past 30-day flavoured e-cigarette use (89.8% vs 90.9%), and most also reported that access to flavours was very or somewhat easy (85.5% vs 83.9%). Youth observed limited impact on e-cigarette use among peers. In the cohort study, few (6.3%) switched completely from e-cigarettes to another nicotine product; many (46.5%) reported no past 30-day nicotine use postlaw (demonstrating a similar pattern as prelaw).

CONCLUSIONS

We observed limited change in the use of flavoured e-cigarettes after a state-wide law restricting flavoured tobacco sales was enacted. Findings may reflect inadequate implementation (eg, insufficient enforcement efforts), which warrants further study to reduce youth access to flavoured tobacco products.