In a special communication published in Tobacco Control, investigators report finding considerable weaknesses in a previous analysis of San Francisco data suggesting that flavored tobacco bans applied to electronic nicotine delivery systems and combustible tobacco products might increase youth combustible cigarette use, and instead reached the opposite conclusion.
The team’s own research in Oakland, California, supports this conclusion.
“Flavored tobacco products appeal to kids, lead to more adolescent tobacco use and addiction, and increase the odds of using other tobacco products like cigarettes,” says senior author Jonathan P. Winickoff, MD, MPH, a pediatrician at MassGeneral Hospital for Children and a professor of pediatrics at Harvard Medical School. “However, a recent research letter published in JAMA Pediatrics in 2021 concluded that the law in San Francisco banning the sale of flavored tobacco products—which was enforced starting in January 2019—was followed by a statistically significant increase in cigarette smoking by San Francisco high school students.”
That study used data from the Youth Risk Behavior Surveillance System (YRBSS), which has collected data from more than 4.9 million U.S. high school students in more than 2,100 separate surveys from 1991 to 2019. Following its publication, non-academic community members and an organization associated with the tobacco industry used the study to justify their opposition to flavored tobacco restrictions.
When Winickoff and his team carried out a more thorough analysis, however, they noted that although the data used in the study came from the 2019 YRBSS, the surveys were actually conducted in late 2018, when compliance with the city’s flavored tobacco sales restriction was fairly low. Compliance was only 17% in December 2018, and it increased through 2019, after the restriction was enforced, to up to 80%.
Massachusetts General Hospital – 2022-03-22.
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