This study assessed support for commercial tobacco retail policies among adults.
Data came from SpringStyles 2021, a web panel survey of adults in the US aged 18 years or older (N = 6,455).
Overall, 62.3% of adults supported a policy prohibiting the sale of menthol cigarettes, and 57.3% supported a policy prohibiting the sale of all tobacco products. A majority of adults supported tobacco retail policies aimed at preventing initiation, promoting quitting, and reducing tobacco-related disparities. These findings can help inform federal, state, and local efforts to prohibit the sale of tobacco products, including menthol cigarettes.
Objective
Commercial tobacco products, including menthol cigarettes, are disproportionately marketed and advertised to certain population groups (eg, Black people, youth, people who identify as LGBTQ+ [lesbian, gay, bisexual, transgender, queer or questioning]), increasing the likelihood of use and risk for tobacco-related harms among people in these groups (1,2). This might help to explain why disparities in tobacco product use persist, despite considerable declines in US cigarette smoking (3). Additionally, disparities exist in who is covered by comprehensive policies that reduce tobacco product use (4). Public opinion can serve as a lever and influential factor in the acceleration of policy adoption (5). As such, we assessed support among adults for policies aimed at reducing tobacco product use and associated disparities.
Methods
We used data from SpringStyles, a web panel survey of adults in the US aged 18 years or older. Porter Novelli conducts SpringStyles via Ipsos’s KnowledgePanel; panel members are randomly recruited by mail by using address-based probability sampling. During late March to mid-April 2021, 6,455 participants completed SpringStyles (response rate, 59.1%). Data were weighted to match the US Census Bureau’s American Community Survey (ACS) proportions for demographic variables, including sex, age, household income, race and ethnicity, household size, education, census region, and metro status. The study was exempt from human subjects review because it was a secondary analysis of de-identified data.
To assess support for tobacco retail policies among adults, respondents were asked 1) “To what extent would you support a policy to prohibit the sale of menthol cigarettes?” and 2) “To what extent would you support a policy to prohibit the sale of all tobacco products?” Response options were “strongly support,” “somewhat support,” “somewhat oppose,” and “strongly oppose.” Adults who responded strongly support or somewhat support were considered to support such a policy, and adults who responded strongly oppose or somewhat oppose were considered to oppose such a policy.
Weighted point estimates and 95% CIs were calculated overall and by sociodemographic characteristics (sex, age, race and ethnicity, education, annual household income, US region), current tobacco product use (cigarette use, menthol cigarette use, and noncigarette tobacco product use), and support or opposition toward tobacco retail policies. We performed χ2 tests to assess differences between support for policies, sociodemographic characteristics, and current tobacco product use. Significance was set at P < .05, and analyses were conducted using SAS version 9.4 (SAS Institute Inc).
Results
Demographic characteristics of respondents are shown in Table 1. Overall, 62.3% of adults supported a policy to prohibit the sale of menthol cigarettes (Table 2). Significant differences in support existed by sex (59.5% among men, 65.0% among women; P < .001); educational attainment (57.4% among adults with a high school diploma or less, 68.7% among adults with a college degree or higher; P < .001); annual household income (57.0% among adults with <$25,000 in annual household income, 64.4% among adults with ≥$75,000 in annual household income; P = .005); and by all 3 tobacco product-use variables (P < .001 for all). Approximately two-thirds of respondents who did not currently use tobacco products and more than one-third who currently used tobacco products, including menthol cigarettes, supported this policy. No differences in support for this policy were observed by age (P = .08), race and ethnicity (P = .44), or US region (P = .06) (Table 2).
In addition, 57.3% of respondents supported a policy to prohibit the sale of all tobacco products (Table 2). Significant differences in support were found by sex (52.2% among men, 62.2% among women; P < .001); age (57.7% of respondents aged ≥60 y, 61.7% of respondents aged 18–29 y; P = .03); race and ethnicity (54.4% among non-Hispanic White adults, 60.5% among Hispanic adults, 63.4% among non-Hispanic Black adults, and 67.4% among non-Hispanic adults from other racial and ethnic population groups; P < .001); educational attainment (56.3% among adults with a high school diploma or less, 60.6% among adults with a college degree or higher; P = .008); US region (54.1% among respondents in the South, 61.1% among respondents in the Northeast; P = .004); and by all 3 tobacco product-use variables (P < .001). More than 61% of respondents who did not currently use tobacco products and about one-fourth of respondents who currently used tobacco products supported this policy. No differences in policy support existed by annual household income (P = .54) (Table 2).
Maeh Al-Shawaf et al. – U.S. Centers for Disease Control – 2023-02-02.
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