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CC WORKSESSION PACKET 04132021
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CC WORKSESSION PACKET 04132021
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7 <br />However, 93% of the sales reduction in <br />Providence was due to a decrease in sales of <br />cigars with characterizing flavors; sales of <br />concept flavored cigars actually increased by <br />74%.28 <br /> <br />A separate discrete choice study presented adult <br />smokers and recent quitters with a number of <br />products and asked which product they would <br />choose. By restricting certain product choices, <br />these data were then modeled to examine the <br />potential impact of a comprehensive flavor ban. <br />They found a comprehensive flavor ban might <br />reduce ‘choice’ of any tobacco product by 5% <br />while simultaneously decreasing e-cigarette <br />‘choice’ by 8% and increasing cigarette ‘choice’ <br />by 3%.29 This particular study did not model how <br />such a policy would impact youth and young <br />adults. <br /> <br />E-cigarette Flavor Ban or Restriction <br />A study predicting the impact of an e-cigarette <br />flavor restriction suggests a product-specific <br />restriction may reduce selection of e-cigarettes <br />by 20% among younger adult smokers and have <br />no functional impact on older adult smokers. <br />Irrespective of interest in quitting cigarettes, <br />decreasing flavor availability might decrease <br />choice of e-cigarettes.30 Another study from <br />2015 asked youth and young adults from Texas <br />who use flavored e-cigarettes if they would <br />continue using their product of choice if it were <br />not flavored. With the caveat that these data <br />predate JUUL and other pod-based e-cigarettes, <br />they found 66% of those 25-29 years of age, 74% <br />of those 18-24 years of age, 74% of those in high <br />school, and 93% of those in middle school would <br />not use their e-cigarette anymore.31 In addition, <br />researchers found that a policy that prohibits <br />flavors in e-cigarettes and permits menthol <br />cigarettes may drive adult smokers and former <br />smokers to products known to cause significant <br />long-term harm. In fact, such a policy may <br /> <br />** No data on youth were found as part of our literature search. <br />decrease selection of e-cigarettes by 11% and <br />increase selection of cigarettes by 8.3%.29 <br />These data suggest an e-cigarette flavor ban or <br />restriction may reduce e-cigarette use among <br />adults and youth, with larger reductions for <br />younger users. One possible unintended <br />consequence is an uptick in cigarette use among <br />adults,** but a comprehensive flavor ban may <br />prevent or mitigate such a consequence. <br />Menthol Cigarette Ban or Restriction <br /> <br />In 2017, the province of Ontario, Canada <br />implemented a menthol ban on all tobacco <br />products, including cigarettes. Evaluation data <br />of the Ontario policy is the best evidence to-date <br />regarding the potential impact of a menthol <br />cigarette ban in the U.S. Given policies <br />restricting the sale of menthol cigarettes have <br />only recently begun being implemented in the <br />U.S., there is limited research on their <br />observable public health impact. However, <br />researchers have used modeling and surveys to <br />project their impact. <br />To evaluate the policy in Ontario, researchers <br />compared menthol smokers planned behavior <br />before the ban to their actual behavior one <br />month following the ban. Before the ban, 15% <br />said they would quit, 60% of smokers said they <br />would switch to nonmenthol cigarettes, and 6% <br />said they would use other flavored tobacco or e- <br />cigarette products. One month following the <br />ban, 29% had attempted to quit smoking, only <br />28% of respondents had switched to smoking <br />nonmenthol cigarettes, and 29% reported using <br />other flavored tobacco or e-cigarette products.32 <br />One year following the ban, 63% of daily and 62% <br />of occasional menthol smokers reported having <br />made a quit attempt versus 43% of non-menthol <br />smokers who were not directly impacted by the <br />policy. Furthermore, 24% of daily and 20% of <br />occasional menthol smokers quit smoking versus <br />14% of non-menthol smokers.33 These data are <br />reinforced by another study that found the ban
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