Changes in cigar sales following implementation of a local policy restricting sales of flavoured non-cigarette tobacco products.

INTRODUCTION: On 3 January, 2013, the city of Providence, Rhode Island, began enforcing a restriction on the retail sale of all non-cigarette tobacco products with a characterising flavour other than tobacco, menthol, mint or wintergreen. We assessed the policy impact on cigar sales-which comprise 95% of flavoured non-cigarette tobacco products sold through conventional tobacco retail outlets (eg, convenience stores, supermarkets) in Providence-over time and in comparison to the rest of the state (ROS). METHODS: Weekly retail scanner sales data were obtained for January 2012 to December 2016. Cigar sales were categorised into products labelled with explicit-flavour (eg, Cherry) or concept-flavour (eg, Jazz) names. Regression models assessed changes in prepolicy and postpolicy sales in Providence and ROS. RESULTS: Average weekly unit sales of flavoured cigars decreased prepolicy to postpolicy by 51% in Providence, while sales increased by 10% in ROS (both p<0.01). The Providence results are due to a 93% reduction in sales of cigars labelled with explicit-flavour names (p<0.01), which did not change significantly in ROS. Sales of cigars labelled with concept-flavour names increased by 74% in Providence and 119% in ROS (both p<0.01). Sales of all cigars-flavoured and otherwise-decreased by 31% in Providence (p<0.01). We detected some evidence of product substitution and cross-border purchasing. CONCLUSIONS: The Providence policy had a city-specific impact on retail sales of flavoured cigars, which was attenuated by an increase in sales of concept flavour-named cigars. Products with concept-flavour names may avoid enforcement agency detection, and their continued sale undermines the intent of the policy.

Implementation of the New York City Policy Restricting Sales of Flavored Non-Cigarette Tobacco Products.

Flavored tobacco products appeal to youth, and jurisdictions have implemented policy interventions to reduce youth tobacco initiation. This study reviews the process, challenges, and compliance monitoring of a flavored tobacco sales restriction. New York City (NYC) passed a policy restricting the sale of flavored non-cigarette tobacco products in 2009. To describe the policy's passage, legal defense, implementation, and enforcement, we conducted stakeholder interviews, reviewed legislative and legal records, and analyzed administrative data on retailer inspections and violations. Extensive public and policy maker education efforts preceded this policy. Barriers included opposition to the policy's passage and a tobacco manufacturer's lawsuit that sought to halt the law's implementation and to establish that NYC lacked the authority to restrict the sale of flavored products. The city implemented the flavored tobacco policy as intended and it withstood legal challenges. NYC integrated enforcement into the city's retailer compliance monitoring infrastructure, and the violation rate is low. Our investigation of NYC's experience with flavored tobacco policy implementation and enforcement can provide policy makers and health professionals with insights relevant to policy implementation, expand understanding of the potential impact of these kinds of policies, and inform compliance monitoring efforts.

Compliance with a Sales Policy on Flavored Non-cigarette Tobacco Products.

OBJECTIVES: We assessed the effect of the New York City (NYC) policy restricting sales of flavored non-cigarette tobacco products on retail sales using a quasi-experimental comparison design. We also studied possible cross-border purchasing and product substitution by consumers. METHODS: We compiled retail scanner data for January 2010-January 2014 for NYC, a proximal comparison area (PCA) surrounding NYC, and the US. We used regression models to assess trends in sales of flavored cigars, smokeless tobacco (SLT), loose tobacco (RYO), and total cigars in all areas. RESULTS: Sales of flavored cigars (-22.3%), SLT (-97.6%), and RYO (-42.5%) declined following policy implementation (all ps < .01). Flavored cigar sales declined nonsignificantly in the comparison areas. An average 7.4% reduction in total cigar sales was seen in NYC following the policy (p < .01), as cigar sales increased 12% nationally, suggesting that NYC consumers did not substitute flavored cigars with non-flavored varieties. CONCLUSIONS: Implementation of the NYC policy was associated with significant reductions in sales of all restricted products, both absolutely and relative to comparison areas. Despite persistent sales of flavored cigars, overall cigar sales in NYC declined following the policy, although more intensive enforcement is needed to ensure greater policy compliance.

Adapting evidence-based strategies to increase physical activity among African Americans, Hispanics, Hmong, and Native Hawaiians: a social marketing approach.

INTRODUCTION: Using a social marketing approach, we studied how best to adapt proven, evidence-based strategies to increase physical activity for use with underserved racial or ethnic groups. METHODS: We conducted focus groups with low-income Hispanic women in Texas, Hmong parents and their children in California, low-income African American women and men in the Mississippi Delta, and Native Hawaiian college students in Hawaii. We also interviewed key leaders of these communities. Topics of discussion were participants' perceptions about 1) the benefits of engaging in physical activity, 2) the proposed evidence-based strategies for increasing each community's level of physical activity, and 3) the benefits and barriers to following the proposed interventions for increasing physical activity. A total of 292 individuals participated in the study. RESULTS: All groups considered that being physically active was part of their culture, and participants found culturally relevant suggestions for physical activities appealing. Overwhelmingly, strategies that aimed to create or improve social support and increase access to physical activity venues received the most positive feedback from all groups. Barriers to physical activity were not culturally specific; they are common to all underserved people (lack of time, transportation, access, neighborhood safety, or economic resources). CONCLUSION: Results indicate that evidence-based strategies to increase physical activity need to be adapted for cultural relevance for each racial or ethnic group. Our research shows that members of four underserved populations are likely to respond to strategies that increase social support for physical activity and improve access to venues where they can be physically active. Further research is needed to test how to implement such strategies in ways that are embraced by community members.