Changes in Cigarette Availability and Sales Associated With California's Statewide Flavored Tobacco Sales Restriction: A Synthetic Control Analysis.

Abstract

California enacted a statewide restriction on flavored tobacco product sales on December 21, 2022. Policy efforts to eliminate flavored tobacco products from retail environments are designed to restrict consumer access, with the goal of reducing initiation and experimentation and supporting cessation. This study used NielsenIQ retail scanner data to study cigarette pack sales and availability (i.e., the weekly number of universal product codes with positive sales) before intervention (January 1, 2021, to December 17, 2022) to after intervention (December 18, 2022, to December 30, 2023) overall and by flavor category: tobacco/unflavored, menthol, and nonmenthol labeled. A control method was employed to create a synthetic California on the basis of preintervention-period data to compare with California after intervention. From before to after intervention, average weekly availability of menthol cigarettes decreased by 44% in California, with ∼175 products still available in December 2023; sales decreased by 90%. Nonmenthol-labeled cigarette availability increased by 194%, and sales increased by 708%. Total cigarette availability in California decreased, but total sales were unchanged. Changes in California were distinct from those in synthetic California. California's statewide flavored tobacco sales restriction was effective at reducing the availability and sale of menthol cigarettes despite the increase in availability and sales of nonmenthol-labeled cigarettes. Total cigarette sales remain unchanged 1 year after intervention owing to the increase in sales of nonmenthol-labeled cigarettes.