Item 39 - Ordinance Prohibiting the Sale of Flavored Tobacco Products

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Keck School of Medicine of USC Flavor and Menthol Tobacco Products and E-cigarettes There is inconsistent evidence regarding the use of e-cigarette as a cessation tool among youth,young adult, and adult smokers. Studies have shown that many cigarette smokers, after using e-cigarettes, are likely to remain cigarette smokers rather than transitioning to e-cigarettes or quitting smoking, and this effect may be particularly salient in Hispanic young adults (19, 23-25)*. More recently, a single clinical trial has shown that regular e-cigarette use alongside counseling services increased cessation relative to other cessation products among participants in England; similar findings have not been observed in the US to date (37).t Menthol products makes smoking cessation more difficult and are disproportionately marketed to vulnerable populations such as ethnic minorities. Among adult smokers in California, 18%of white cigarette smokers smoke menthol cigarettes where as 70%of African American cigarette smokers use menthol. Additionally, almost 50%of LGB smokers use menthol cigarettes compared to 28%of straight smokers (31).t Among Hispanic/Latino current adult smokers in the US, 46%smoke menthol cigarettes (27).t Among Hispanic/Latino young adult current smokers(aged 18-25) in the US from 2008 to 2010, 47.3% smoked menthol cigarettes (28).t Between 2008-2010 and 2012-2014, the largest increase in menthol cigarette use among race/ethnic groups was in found in Hispanic smokers (rising 9.8 percentage points) (29).t The use of flavored products, such as menthol cigarettes, makes cessation more difficult (26).t Studies have displayed negative associations among menthol cigarette use and successful cessation in Hispanic communities (30).t Approximately 90%of all cigarettes have menthol in them regardless of if they are advertised as menthol cigarettes or not(34).t Implementing enforceable regulations can prevent youth initiation of e-cigarettes and other tobacco products. In Southern California, strong enforcement preventing sales to minors was associated with lower rates of youth and adult initiation of combustible and e-cigarette use (35). Communities that had tobacco retail licenses with sufficient fees to conduct enforcement efforts (e.g., sting operations) had lower rates of youth cigarette and e-cigarette use. A retail license ordinance to regulate e-cigarettes, flavored, and menthol tobacco products in Los Angeles County has tremendous potential to substantially reduce youth-use of tobacco products including e-cigarettes (35). The availability of e-cigarettes in flavors, and current location of retailers in close proximity to areas where youth congregate increases use of these products among young people (35); policies to reduce availability of these products across the community will likely have a substantial impact on youth use of tobacco products. Current research suggests that it is important to consider the overall impact of e-cigarettes on all segments of the population; however,the weight of the evidence points to a far more detrimental effect on youth. We hope that this research can educate and inform future decision-makers. For additional information, contact Yaneth Rodriguez at vlr@usc.edu Research conducted outside of USC *Both USC and Outside Research Updated 5/22/2019