Abstract

Massachusetts signed into law An Act Modernizing Tobacco Control (hereinafter, the Act) in 2019, which restricted retail sales of flavored tobacco products, including menthol cigarettes. This study assessed differences in advertising exposure to flavored tobacco products among adolescents in Massachusetts compared with adolescents in 4 neighboring states after passage of the Act. We collected monthly cross-sectional survey data from April 2021 through August 2022 among a convenience sample of adolescents (aged 13-17 y) in Massachusetts and 4 control states: Connecticut, New Hampshire, Rhode Island, and Vermont. We measured self-reported past-30-day exposure to advertising for flavored electronic cigarette (e-cigarette) products and flavored cigarettes or other tobacco products across 9 channels. After implementation of the Act, adolescents in Massachusetts, compared with adolescents in the 4 control states, reported significantly lower levels of exposure to advertisements for flavored e-cigarettes (convenience store: adjusted odds ratio [AOR] = 0.80 [95% CI, 0.66-0.96]; supermarket/grocery store: AOR = 0.66 [95% CI, 0.52-0.84]; gas station: AOR = 0.61 [95% CI, 0.51-0.75]) and flavored cigarette/other tobacco products (convenience store: AOR = 0.69 [95% CI, 0.57-0.83]; supermarket/grocery store: AOR = 0.63 [95% CI, 0.49-0.79]; gas station: AOR = 0.55 [95% CI, 0.45-0.66]) in retail channels, which were the intended targets of the Act. We found no significant differences in flavored tobacco product advertising exposure for non-retail channels (television, radio, posters/billboards, newspapers/magazines, social media, and streaming services/movies in a theater). Future research should further examine the effects of statewide flavored tobacco sales restrictions on the availability of and exposure to advertisements for flavored tobacco products.

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