Researchers analyzed survey data from more than 2.8 million California middle and high school students.
Areas with flavored tobacco bans reported lower youth vaping rates than areas without restrictions.
The study found no evidence that the bans led to an increase in cigarette smoking among teens.
Flavored vape products have been at the center of public health debates for years, especially because flavors like fruit, mint, and candy are often seen as appealing to younger users. Now, a new California-based study suggests local restrictions on flavored tobacco products may be linked to lower rates of teen vaping.
Researchers from University of California San Diego and San Diego State University examined how local flavored tobacco bans affected youth vaping habits across California communities. Their findings, published in JAMA Health Forum, showed that students living in areas with these policies were less likely to report current e-cigarette use compared with students in places without such bans.
“Our findings suggest that local flavored tobacco bans can be an effective strategy for reducing youth e-cigarette use,” researcher Eric Leas, Ph.D., MPH, said in a news release.
“Importantly, we did not find evidence that these policies led young people to switch to cigarettes, which has been a major concern raised in policy debates.”
The study
To study the impact of those local policies, the research team analyzed responses from 2,805,708 students who participated in the California Healthy Kids Survey between 2017 and 2022. The survey included students in seventh, ninth, and eleventh grades and asked questions about tobacco and e-cigarette use during the previous month.
Researchers compared students attending schools in jurisdictions that had active flavored tobacco bans with students in areas that did not. They used a statistical method known as a dynamic difference-in-differences analysis, which allowed them to evaluate how vaping trends changed over time as different communities adopted the restrictions at different points.
The analysis also adjusted for several community-level factors that could influence tobacco use, including racial and ethnic diversity, poverty levels, and educational attainment. According to the study, this approach helped researchers better isolate the association between flavored tobacco bans and youth vaping behaviors.
The results
The results showed lower vaping rates among students living in areas with flavored tobacco restrictions. In jurisdictions with bans in place, 6.2% of students reported current e-cigarette use, compared with 7.7% in jurisdictions without bans.
Researchers also found that the reductions appeared to strengthen over time. Three years after a ban was implemented, youth vaping rates were nearly two percentage points lower in areas with restrictions. Four years after implementation, the difference grew to more than nine percentage points.
At the same time, the study found no significant association between flavored tobacco bans and youth cigarette smoking. Cigarette use among teens remained relatively similar in jurisdictions with and without the policies, addressing concerns that some young users might switch from vaping to traditional cigarettes if flavored products became harder to access.
The authors said continued monitoring will be important as California’s statewide flavored tobacco restrictions remain in effect. They also noted that future research could help determine how enforcement and community differences influence the long-term impact of these policies.
“Local policies gave us a valuable window into how flavored tobacco restrictions may influence youth behavior over time,” researcher Giovanni Appolon, MPH, said in the news release. “As more jurisdictions adopt these policies, continued monitoring will help determine how enforcement, policy design and community context shape their public health impact.”