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Study: Changes in Teen Tobacco Use Behaviour Following SF’s Flavour Ban

A recent study published in JAMA Pediatrics, found that following San Francisco’s flavour ban, teenagers in the city’s high schools were more likely to take up smoking than teenagers in school districts with no such ban in place.

Diane Caruana

December 9, 2021

In August 2020, SB 793 by Senator Jerry Hill, banned the sale of flavoured tobacco products, including non-tobacco products such as e-cigarettes across the city of San Francisco. The study titled, “A Difference-in-Differences Analysis of Youth Smoking and a Ban on Sales of Flavored Tobacco Products in San Francisco, California,” aimed to determine any relationship between San Francisco’s ban on flavoured tobacco product sales and smoking among high school students younger than 18 years.

The city’s chief economist had predicted that the money spent on vaping products prior to the ban would still be spent on other nicotine products such as conventional cigarettes.

In line with expert predictions before the ban had even gone into effect, the researchers found that following the ban, teenagers in the city’s high schools were more likely to take up smoking than teenagers in US school districts where no flavour bans were imposed. While prior to the ban, smoking rates in San Francisco were similar to those of many cities across the country.

“To understand this conceptually, think about youth preferences between tobacco products,” said study author Abigail Friedman, an assistant professor in the Department of Health Policy and Management at the Yale School of Public Health, in a statement. “Among youths who vape, some likely prefer ENDS to combustible products because of the flavors.”

“For these individuals as well as would-be vapers with similar preferences, banning flavors may remove their primary motivation for choosing vaping over smoking,” she continued. “Thus, some of them will respond to a ban on flavors by choosing to use combustible products instead of ENDS.”

Previous data compiled from a convenience sample of residents of San Francisco, California, aged 18 to 34 years who had ever used a tobacco product, had already shown an increase in combustible cigarette use (smoking) among those aged 18 to 24 years.

The vape flavour ban led to an increase in smoking

Meanwhile, the likelihood of this happening was predicted back in 2019 by San Francisco’s chief economist Ted Egan. Egan’s office is charged with analyzing the economic impact of legislation in San Francisco, reports of which are then sent to the Board of Supervisors and made public on the Controller’s Office website.

When it’s found that a legislation will have no impact on the local economy, no more analysis is conducted. To this effect, since Egan and his colleagues concluded that banning e-cigarette sales would have no material effect on the city’s economy, no further enquirers were made into the matter.

However, in a revealing interview published on the San Francisco Chronicle in May 2019, Egan had explained that the reason why his office reached such a conclusion, ie. that the ban will not affect the city’s economy, is because the money spent on vaping products prior to the ban would still be spent on other nicotine products such as conventional cigarettes.