British study reveals health equity impacts of restrictions on the sale of flavored tobacco
A five-year, $ 2.8 million grant from the National Cancer Institute (NCI) will support the
study on the impact of local policies on at-risk groups – including communities of color, low-income populations and young people – who are more likely to use flavored tobacco products.
The findings could help lawmakers create more equitable policies, says study lead researcher Shyanika Rose, Ph.D., a faculty member at the Center for Transformation of Health Equity (CHET), lecturer at the Department of Behavioral Sciences and member of Markey Cancer Center Cancer Prevention and Control Program.
“We already know that stopping the sale of these products can reduce their availability and use in these communities,” Rose said. “But understanding the impact of policies on race and socioeconomic status will provide insight into the types of policies that work and have the most equitable benefits.”
Rose says flavored tobacco products, which are more attractive, easier to use and more addicting, have a long history of being disproportionately marketed to vulnerable communities, particularly African Americans. According to the Truth Initiative, nearly 90% of all black smokers use menthol cigarettes and more than 39,000 African Americans die from tobacco-related cancers each year.
Currently, federal laws only prohibit the sale of certain flavored tobacco products. The sale of menthol cigarettes and all flavors of smokeless tobacco, cigars and hookah is still permitted. While the Food and Drug Administration recently announced new milestones To implement a ban on the sale of menthol cigarettes and flavored cigars, the proposal will not eliminate from the market all flavored tobacco products, in particular electronic cigarettes and flavored e-liquids.
In the absence of general federal laws, several state and local jurisdictions across the country have adopted their own policies. Rose says about 30% of localities with a policy have a comprehensive policy that prohibits the sale of all flavors, including menthol, in all tobacco products.
“As the FDA moves federal policy in the right direction, comprehensive policies that restrict the sale of all flavored tobacco products may be more likely to protect the health of the most vulnerable populations and that is something that project will investigate, ”said Rose.
Rose’s team will examine these local policies and expand the evidence base on their effectiveness in reducing access to flavored tobacco products, exposure to associated marketing materials, and ultimately reducing tobacco consumption. Their findings will be used to help inform community leaders about how policies can help eliminate health disparities.
The project will use a large national longitudinal cohort of youth and young adults to identify the outcomes of tobacco use among those exposed to local policies and those who are not. The team will also explore the relationship between exposure to flavored tobacco marketing and initiation of use among young non-smokers and continued use among young tobacco users who will be monitored in real time in eight communities with different types of flavor policies.
Marketing exposure and tobacco use outcomes in the national data set and local data collection will then be assessed based on the socio-economic status and race / ethnicity of the respondents.
Rose’s research team is made up of UK experts in several disciplines, including W. Jay Christian, Ph.D., assistant professor at Department of Epidemiology, British College of Public Health; Mary Kay Rayens, Ph.D, professor at the British College of Nursing; and Melinda Ickes, Associate Professor and Director of Graduate Studies at UK College of Education Department of Kinesiology and Health Promotion.
Ickes, who will lead the outreach and dissemination component of the study, says lessons learned will be shared in an ongoing dialogue with community partners. Partners will help develop personalized messages about the risks of flavored tobacco products to generate broader political support and deter young people from their community.
“I am truly delighted to be working with Dr Rose on this innovative and meaningful project,” said Ickes. “Engaging community members and ensuring that their voices are heard throughout the research process will improve the quality and meaning of the research. We also know that through participatory and inclusive efforts, community members can be agents of change to influence policy change towards health for all. “
The team will join forces with Truth initiative, experts from Stanford University and the University of Southern California, national flavored tobacco policy experts, and an advisory committee of local representatives from eight communities with different types of flavor policies. The results will be shared with communities and others who are considering a local policy restricting the sale of flavored tobacco products.
Rose says engagement with community partners is starting, secondary analysis of national data will begin this year, and recruitment of youth and young adults in the eight communities will begin in 2022.