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California​ tobacco control branch

CTCB Peer-Reviewed Publications​​

Evaluations of Compliance With California’s First Tobacco Sales Bans and Tobacco Marketing in Restricted and Cross-Border Stores (2024)​

Beverly Hills and Manhattan Beach were the first California cities to end tobacco sales. This study is the first to evaluate compliance, assess whether branded or unbranded tobacco cues remain, and examine cigarette prices/discounts in cross-border stores. Nearly all retailers complied with tobacco sales bans within 6–12 months of implementation. In addition, retail tobacco marketing was nearly eliminated in the two cities. There was no evidence of price gouging for Marlboro cigarettes in cross-border stores.​​

Patterns in Tobacco, E-Cigarette, and Cannabis Advertising Exposure Among California Adolescents and Associations With Future Use Expectations​

This study assessed past 30-day recalled exposure to promotional messages about tobacco, e-cigarettes, and cannabis from various sources among the 2022 Teens, Nicotine, and Tobacco online panel survey. Findings suggest exposure to tobacco, e-cigarette, and cannabis marketing is common among California adolescents, follows similar patterns, and is associated with product use susceptibility.​


Chemical Composition of Electronic Vaping Products from School Grounds in California (2024)​​

This study sought to understand the chemical composition of electronic vaping products (EVPs) being used by youth in California. Nicotine was detected in 204 of 208 (98.1%) samples of e-cigarette cartridges/pods/bottled e-liquids. Propylene glycol and vegetable glycerin were dominant solvents in nicotine-containing EVPs. Measured nicotine was inconsistent with labels on some confiscated or collected bottled e-liquids.​


Impact of survey item wording on reported tobacco use among youth: effect of adding ‘even one or two puffs’ to use questions​

​This study aimed to measure how minimal use language affects tobacco ever use prevalence using data from 2022 Teens, Nicotine, and Tobacco Project online panel survey.  Findings suggest that minimal use language yields modestly higher tobacco use prevalence, with implications for comparing and interpretating surveillance data.


Youth mental health and nicotine vape use: The moderating role of rural-urban/suburban school environments (2023)

This study sought to understand and compare the association between nicotine vape use and mental health among youth in rural and urban/suburban areas using data from the 2019-20 California Student Tobacco Survey. Findings showed that vaping nicotine was associated with poorer overall mental health, and that this association differed based on rural versus urban/suburban school environments. Specifically, the relationship between vaping and poor mental health was stronger for youth attending school in rural areas than in urban/suburban localities.​


Flavored Tobacco and Nicotine Use Among California Adolescents: Preferences by Use Experience and Survey Format Effects (2023)

This study assessed flavored tobacco use among adolescent users, specific e-cigarette flavor preferences, risk profiles of youth that use various flavors, and the impact of survey question wording on prevalence using data from 2021-22 Teens, Nicotine, and Tobacco online panel survey. The majority of current users reported using flavored products for all tobacco product types, and sweet flavors were used most often among adolescents otherwise at low risk of tobacco use. Survey item format did not meaningfully affect overall prevalence of flavored product use but did impact reports of specific e-cigarette flavors.​​


“I think we can do without [tobacco]”: support for policies to end the tobacco epidemic among California adolescents (2023)​

This study assessed endgame support among California (USA) adolescents, including their reasons and associated participant and policy-specific factors. Most participants supported strong tobacco control policies, with some differences depending on question language and respondent demographics.​


Online Purchase Attempts of Flavored E-Cigarettes to Minors in California Before and After Senate Bill 793 (2023)

This survey study examined attempted online purchases of flavored e-cigarette products to researchers posing as minors (age <21 years) before and after California Senate Bill (SB) 793, which was passed in December 2022 and prohibited the sale of most flavored tobacco products. No statistically significant differences were observed between the pre-SB 793 and post-SB 793 periods in the rate of purchase attempts of flavored e-cigarettes, suggesting that SB 793 had yet to influence online retailers.

Associations for subgroups of E-cigarette, cigarette, and cannabis use with asthma in a population sample of California adolescents (2023)

This study analyzed whether e-cigarettes, combustible cigarettes, and cannabis were independently associated with asthma in California adolescents using 2019-2020 California Student Tobacco Survey data. Findings showed that youth using either cannabis or e-cigarettes or dual use of both products showed significant associations with diagnosis of asthma

Flavors increase adolescents’ willingness to try nicotine and cannabis vape products (2023)

This paper describes the results from a discrete choice experiment embedded within the 2021–2022 California Teens Nicotine and Tobacco Project Online Survey. Key findings were that candy/dessert, fruit, and fruit-ice combination flavors were all associated with greater willingness to try a vape product among non-users in comparison to unflavored products.

Intersectional Disparities in Youth Tobacco Use by Sexual and/or Gender Minority Status and Race and/or Ethnicity (2022)

This study applied an intersectional lens to examine societal factors, individual psychological outcomes, and youth combustible tobacco and vape use at the intersection of sexual and/or gender minority (SGM) status and race and/or ethnicity. This representative study of California youth supports that identifying as a sexual and/or gender minority (SGM) is an important risk factor for combustible tobacco use, especially for youth belonging to marginalized race/ethnicity groups.

E-cigarette imagery in Netflix scripted television and movies popular among young adults: A content analysis (2022)

This study aimed to determine the extent of e-cigarette-related imagery and dialogue in Netflix content popular with young adults. A sample of 12 films and 113 TV episodes released between June 1, 2020, and May 31, 2021, was analyzed. Out of 125 titles, 16 (13%) had e-cigarette-related content. Thirteen titles (10%) showed at least one character holding an e-cigarette, and three others mentioned vaping without showing e-cigarettes. Ninety-nine percent of the time an e-cigarette appeared on screen it was being held by a character.

Nicotine vaping for relaxation and coping: Race/ethnicity differences and social connectedness mechanisms (2022)

This study examined the relationship between race/ethnicity and vaping reasons in youth. The data from this study came from the 2019-2020 California Student Tobacco Survey.

Evaluating the Impact of Strong and Weak California Flavored Tobacco Sales Restriction Policies on the Tobacco Retail Environment (2022)

This study evaluated the success of local flavored tobacco policies in reducing the availability of flavored tobacco products in California from 2013 to 2019. This study found that strong flavored tobacco sales restriction policies appeared to be effective in reducing the availability of flavored tobacco.

Are California’s Local Flavored Tobacco Sales Restrictions Effective in Reducing the Retail Availability of Flavored Tobacco Products? A Multicomponent Evaluation (2021)

This paper describes evaluation results of California’s early ordinances restricting flavored tobacco sales, which resulted in a nine-fold increase in the proportion of California’s population covered by a flavored tobacco ordinance between April 2015 and January 2019. In addition to reporting on policy tracking, the studies assessed retail availability and advertising of flavored tobacco products, as well as retailer attitudes and ease of compliance.

Impact of California’s tobacco and cannabis policies on the retail availability of little cigars/cigarillos and blunt wraps (2021)

Recent changes in California’s tobacco and cannabis policies could impact the retail availability of little cigars/cigarillos (LCCs) and blunt wraps that are used for blunt smoking. This study was intended to test whether tobacco flavor bans and minimum pack sizes of LCCs have reduced tobacco availability in California jurisdictions, whereas, permissive policies on sales and marketing of cannabis increased availability. This study concluded that a tobacco flavor ban may be an effective strategy to reduce retail availability of LCCs, blunt wraps and possibly other tobacco in California jurisdictions.

The changing retail landscape for tobacco: dollar stores and the availability of cheap cigarettes among tobacco-related priority populations (2021)

This study sought to examine whether dollar stores are more likely to be located in disadvantaged neighborhoods and whether dollar stores charge less for cigarettes than other tobacco retailers. It found that dollar stores may exacerbate smoking-related inequities by contributing to the availability of cheaper cigarettes in neighborhoods that are lower income, rural and have greater proportions of youth.

Impact of Local Flavored Tobacco Sales Restrictions on Policy-Related Attitudes and Tobacco Product Access (2021)

To evaluate the impact of local ordinances restricting the sale of flavored tobacco, this study surveyed California youth and young adults regarding policy support and perceived access to flavored tobacco. With some exceptions, these findings demonstrate that among vape users in policy jurisdictions and priority subgroups, there is a higher likelihood of reporting perceived difficulty to access flavored tobacco products.

Implementation of a comprehensive flavoured tobacco product sales restriction and retail tobacco sales (2021)

This study evaluates associations of policy implementation with changes in tobacco sales in San Francisco and in two California cities without any sales restriction. San Francisco’s comprehensive restriction virtually eliminated flavoured tobacco sales and decreased total tobacco sales in mainstream retailers.

Vaping identity in adolescent e-cigarette users: A comparison of norms, attitudes, and behaviors (2021)

This study analyzed differences in demographic characteristics, beliefs, and behaviors of vapers and non-vapers.

Sources of flavoured e-cigarettes among California youth and young adults: associations with local flavoured tobacco sales restrictions (2021)

This study compares access to flavoured JUUL and other e-cigarettes from retail, online and social sources among underage and young adult e-cigarette users who live in California jurisdictions that restrict sales of flavoured tobacco with the rest of the state.

Characteristics of E-cigarette, or Vaping, Products Confiscated in Public High Schools in California and North Carolina (2020)

This is a study exploring e-cigarette, or vaping, products used on school grounds. CDC conducted an environmental assessment in California and North Carolina public high schools in March and May 2019.

Tobacco use and tobacco services in California substance use treatment programs (2020)

This study examines smoking prevalence among persons enrolled in substance use dependence treatment programs, and whether persons who wanted help with quitting smoking received such help.

Retail Tobacco Marketing in Rural Versus Nonrural Counties: Product Availability, Discounts, and Prices, 2020

A study investigating tobacco product availability, advertised discounts, and prices in rural and nonrural stores.

Mind the Gap: Changes in Cigarette Prices after California’s Tax Increase, 2019

A study evaluating California’s 2017 cigarette tax increase, which found that it was not passed onto consumers equally.

Evaluation of California’s ‘Tobacco 21’ law, 2018

A study that describes the T21 evaluation plan and initial evaluation results for California’s law that raised the minimum tobacco sales age to 21 and expanded the definition of tobacco to include electronic smoking devices.

Neighborhood Variation in the Price of Cheap Tobacco Products in California: Results From Healthy Stores for a Healthy Community, 2017

A study that examines neighborhood variation in prices for the cheapest cigarettes including a popular brand of cigarillos and health disparities with results from the Healthy Stores for a Healthy Community survey in a large statewide sample of licensed tobacco retailers in a low-tax state.

The Quarter that Changed the World, 2010

A summary review of the operation, structure, evolution, and results from California’s comprehensive tobacco control program.​

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