Division of Health Policy and Management, Department of Public Health Sciences, University of California, Davis, USA.
School of Education, University of California, Davis, USA.
Nicotine Tob Res. 2023 Jan 1;25(1):127-134. doi: 10.1093/ntr/ntac200.
Flavored tobacco sales restrictions (FTSRs) are implemented to reduce access to flavored tobacco products. We examined the association between seven cities with local FTSRs implemented in 2018/2019 and e-cigarette use among high school students in the California Bay Area.
We analyzed data from the California Healthy Kids Survey using a difference-in-differences (D-I-D) strategy. We compared pre- and post-policy changes one year after implementation in current and ever e-cigarette use among students attending school in a city with a FTSR (exposed) (n = 20 832) versus without (unexposed) (n = 66 126). Other outcomes included ever marijuana use in an e-cigarette and ease of access to e-cigarettes.
Pre- to post-policy, the adjusted odds of current and ever e-cigarette use did not significantly change among students exposed and unexposed to a FTSR. In the adjusted D-I-D analysis, the odds of current (aOR: 1.25, 95% CI: 0.95, 1.65) and ever e-cigarette use (aOR: 1.06, 95% CI: 0.89, 1.26) did not significantly change by exposure group. However, one year post-implementation, the odds of ease of access to e-cigarettes significantly increased among exposed (aOR: 1.57, 95% CI: 1.27, 1.95) and unexposed students (aOR: 1.54, 95% CI: 1.39, 1.70). Similarly, the odds of ever using marijuana in an e-cigarette significantly increased among exposed (aOR: 1.35, 95% CI: 1.19, 1.53) and unexposed students (aOR: 1.29, 95% CI: 1.20, 1.39).
Local FTSRs in the California Bay Area were not associated with a change in e-cigarette use one year post-implementation. Increased ease of access and marijuana use may be explanatory factors.
FTSRs were not associated with a decrease in current or ever e-cigarette use among high school students in the California Bay Area one-year post-implementation. Potential explanatory factors are that ease of access to e-cigarettes and using marijuana in an e-cigarette increased. More research is needed to understand the influence of these factors on youth access and behaviors. To address the youth e-cigarette epidemic, a comprehensive approach is needed, including policies, media campaigns, education programs, and cessation tools targeted to youth.
调味烟草销售限制（FTSR）的实施旨在减少对调味烟草产品的获取。我们研究了 2018/2019 年实施当地 FTSR 的七个城市与加利福尼亚湾区高中生使用电子烟之间的关联。
我们使用差异分析（DID）策略分析了来自加利福尼亚健康儿童调查的数据。我们比较了在有（暴露）（n=20832）和没有（未暴露）（n=66126）调味烟草销售限制的城市中，学生在政策实施一年后的当前和过去使用电子烟的情况。其他结果包括在电子烟中使用大麻的情况和电子烟的易获得性。
在政策实施前后，暴露和未暴露于调味烟草销售限制的学生中，当前和过去使用电子烟的调整后几率没有显著变化。在调整后的 DID 分析中，当前（调整后的优势比[aOR]：1.25，95%置信区间[CI]：0.95，1.65）和过去使用电子烟（aOR：1.06，95%CI：0.89，1.26）的几率没有因暴露组而显著变化。然而，在实施一年后，电子烟易获得性的几率在暴露组（aOR：1.57，95%CI：1.27，1.95）和未暴露组（aOR：1.54，95%CI：1.39，1.70）学生中显著增加。同样，在电子烟中使用大麻的几率在暴露组（aOR：1.35，95%CI：1.19，1.53）和未暴露组（aOR：1.29，95%CI：1.20，1.39）学生中显著增加。
加利福尼亚湾区的当地 FTSR 并没有在实施一年后改变电子烟的使用情况。增加电子烟的易获得性和大麻的使用可能是解释因素。
在实施一年后，加利福尼亚湾区的高中生当前或过去使用电子烟的情况并没有因当地 FTSR 而减少。潜在的解释因素是电子烟的可获得性增加，以及在电子烟中使用大麻。需要进一步的研究来了解这些因素对青少年获取和行为的影响。为了解决青少年电子烟流行问题，需要采取综合措施，包括针对青少年的政策、媒体宣传、教育计划和戒烟工具。
