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11 <br />that distributors would not take back the <br />flavored product supply, 34% did not know <br />which products they were allowed to sell, and <br />30% reported not having enough time to sell <br />down their supply.43 <br />Between 2015 and 2017, several other <br />Massachusetts communities implemented <br />flavored tobacco product restrictions allowing <br />researchers to evaluate additional jurisdictions. <br />The researchers found 6 months to 1 year post- <br />implementation that 21 of the 38 communities <br />with a restriction achieved 100% compliance. <br />While 11 of the communities had non-compliant <br />retailers,§§ only 12% of retailers in those <br />communities were not in compliance. Among <br />those not in compliance, retailers cited <br />uncertainty as to whether particular products, <br />particularly concept flavors, were on the <br />Guidance List.52 <br />In order to reduce youth access to flavored <br />tobacco products, Minneapolis and St. Paul, <br />Minnesota restricted the sale of flavored <br />tobacco to adult-only tobacco product shops in <br />2016. Their policies applied to all tobacco <br />products, including e-cigarettes, and exempted <br />menthol. An observational study was conducted <br />pre- and post- policy implementation at retail <br />stores. In both cities, significantly fewer stores <br />sold flavored tobacco after the policy went into <br />effect; in Minneapolis the number of stores <br />selling flavored tobacco dropped from 85% to <br />39% and in St. Paul from 97% to 8%.53 While the <br />sample sizes were small, these data were similar <br />to those found in Boston and other <br />Massachusetts communities. <br />In 2017, Minneapolis City Council closed their <br />menthol flavored tobacco product exemption <br />but allowed the products to be sold in adult-only <br />tobacco product shops and liquor stores. At the <br />time the ordinance was passed, there were 342 <br /> <br />§§ The remaining 6 communities did not have data collected. <br />*** Existing shops with licenses to sell exclusively tobacco products were grandfathered in. <br />††† It may also increase the direct cost (i.e., purchase price of cigarettes) and indirect cost (i.e., travel costs and opportunity cost <br />of time not doing other things) by 10% for menthol smokers and 9% for African American menthol smokers thereby reducing <br />access to menthol tobacco products.56 <br />outlets selling menthol tobacco (317 <br />convenience stores, gas stations, and liquor <br />stores and 25 tobacco product shops) and the <br />shops were given a year before the policy was <br />implemented. In anticipation of fewer sales or <br />because of them, 24 convenience store owners <br />applied for licenses to establish new adult-only <br />tobacco product shops. Some store owners split <br />their existing stores into two stores: an adult- <br />only tobacco product shop and a convenience <br />store. Other owners simply converted their <br />store into adult-only tobacco product shops. <br />Many additional owners had inquired about <br />applying for these licenses before the city passed <br />a moratorium on the establishment of new <br />tobacco product shops in August 2018 in order <br />to study the issue.54,55 In July 2019, to combat <br />the licensure loophole, the city passed a <br />requirement that there must be 2000 feet <br />between any two adult-only tobacco product <br />shops.*** The requirement is theorized to work, <br />in part, by minimizing the number of new and <br />existing retailers who can apply for licenses.††† <br />As of August 2019, there were 52 exclusive <br />tobacco product shops in Minneapolis, up from <br />25 shops in 2017 (108% increase). Assuming the <br />buffer zone provision is effective, this trend <br />should slow or reverse with time. Beyond these <br />24 convenience store owners, the policy has <br />been relatively effective at reducing the total <br />number of retailers authorized to sell menthol <br />flavored tobacco products, with the number <br />decreasing by 76% since 2017.54 <br />Finally, a research team examined compliance <br />with a menthol cigarette restriction in Chicago, <br />Illinois, which banned menthol cigarette sales <br />within 500 feet of schools starting in 2016. <br />Compliance of relevant retailers was 57%, with <br />gas stations complying less with the ban as <br />compared to larger/chain stores. The authors <br />concluded that a partial menthol ban (i.e. near <br />schools) results in poor compliance.20