Whitacre Travis R, Crippen Alyssa, Monthrope Mayah, Narine Tanisha, Liber Alex C, Friedman Abigail S
Department of Health Policy and Management, Yale University School of Public Health, New Haven, Connecticut, USA.
Yale College, Yale University, New Haven, Connecticut, USA.
Tob Control. 2025 Jan 27. doi: 10.1136/tc-2024-058895.
Characterise US residents' exposure to restrictions on sales of flavoured electronic nicotine delivery system (ENDS), cigars and menthol cigarettes across states and time, and assess correlations between these policies.
From 2022 to 2024, we compiled flavour policy locations from advocacy groups and online searches, located corresponding legal texts and reviewed these to identify policy details, including effective dates. Using census data, we calculated the proportion of state residents covered by each policy quarterly from 2009 to 2024 and estimated correlations between them and cigarette taxes.
By January 2024, menthol cigarettes, flavoured cigars and flavoured ENDS sales restrictions covered 17.6%, 18.1% and 28.1% of US residents. About 1 in 10 US residents is subject to flavoured ENDS restrictions without concurrent restrictions on flavoured cigar and menthol cigarette sales. Strong correlations between flavour policy coverage and cigarette tax rates indicate a need to adjust for exposure to a range of tobacco control policies in analyses evaluating any one of these regulations' effects.
While state and local adoption of restrictions on flavoured tobacco product sales has proliferated, flavour policy coverage for combustible tobacco products lags well behind that for ENDS. If this leads some people who vape flavoured ENDS to substitute towards flavoured cigars and/or menthol cigarettes, this policy combination could harm population health.
Rapid implementation of proposed US Food and Drug Administration rules barring flavoured cigar and menthol cigarette sales is needed to ensure that regulation of more lethal, combustible tobacco products is not more lenient than restrictions on less harmful nicotine products.
描述美国居民在不同州和不同时间内接触调味电子烟输送系统（ENDS）、雪茄和薄荷醇香烟销售限制的情况，并评估这些政策之间的相关性。
从2022年到2024年，我们从倡导组织和在线搜索中收集了调味政策的地点，找到相应的法律文本并进行审查以确定政策细节，包括生效日期。利用人口普查数据，我们计算了2009年至2024年每季度各州居民受每项政策覆盖的比例，并估计了这些政策与香烟税之间的相关性。
到2024年1月，薄荷醇香烟、调味雪茄和调味ENDS销售限制覆盖了17.6%、18.1%和28.1%的美国居民。约十分之一的美国居民受到调味ENDS限制，但同时没有对调味雪茄和薄荷醇香烟销售的限制。调味政策覆盖范围与香烟税率之间的强相关性表明，在评估这些法规中任何一项的影响时，需要在分析中调整对一系列烟草控制政策的接触情况。
虽然州和地方对调味烟草产品销售的限制不断增加，但可燃烟草产品的调味政策覆盖范围远远落后于ENDS。如果这导致一些吸食调味ENDS的人转而吸食调味雪茄和/或薄荷醇香烟，这种政策组合可能会损害公众健康。
需要迅速实施美国食品药品监督管理局提议的禁止调味雪茄和薄荷醇香烟销售的规定，以确保对更致命的可燃烟草产品的监管不会比对危害较小的尼古丁产品的限制更为宽松。
