The First State Tobacco Flavor Ban: High School Tobacco Control Needs in a Changing Landscape

Abstract

BACKGROUND: Despite recent tobacco control efforts, adolescent vaping remains an epidemic in the United States. The purpose of our study was to understand high school student vaping behaviors using the perceptions of Massachusetts school personnel during the critical window from when the Massachusetts statewide flavor ban legislation was passed in November 2019 through the first year of the COVID-19 pandemic. METHODS:High school personnel throughout Massachusetts were invited to complete a cross-sectional survey. Analysis of survey responses was conducted in R. RESULTS:A total of 162 respondents completed the survey representing 137 schools that draw enrollments from 216 (61%) of the 352 cities and towns in Massachusetts. The most popular products that respondents believed their students were using were JUULs (95.7%), other e-cigarettes (85.3%), and disposable vapes (79.6%). Following the flavor ban, the majority (90.7%) did not report an increase in combusted tobacco product use. All participants (100%) reported wanting more access to prevention and treatment resources.

Nicotine Addiction and Intensity of e-Cigarette Use by Adolescents in the US, 2014 to 2021

“…This increase in intensity may reflect increasing use of nicotine for self-medication in response to increases in adolescent depression, anxiety, tic disorders, and suicidality that occurred during the COVID-19 pandemic . The pandemic has also been a lost year for school-based prevention and treatment efforts, meaning that abatement plans will need to be intensified to address the nicotine addiction in those adolescents who missed a year of contact with adults who might have otherwise helped them get treatment …”

“… 28 The pandemic has also been a lost year for school-based prevention and treatment efforts, meaning that abatement plans will need to be intensified to address the nicotine addiction in those adolescents who missed a year of contact with adults who might have otherwise helped them get treatment. 47 …”

“…28 The pandemic has also been a lost year for school-based prevention and treatment efforts, meaning that abatement plans will need to be intensified to address the nicotine addiction in those adolescents who missed a year of contact with adults who might have otherwise helped them get treatment. 47 The change in e-cigarette use and intensity of use among adolescents contrasts with what was happening in the adult e-cigarette market at the same time. [48][49][50] The prevalence of current adult e-cigarette use in the Tobacco Use Supplement to the Current Population Survey showed an upward trend from 2010 until 2014, 51 followed by a decline to the 2019 rate of 2.3%, 52 less than one-tenth of the 27.5% prevalence among high school respondents in the NYTS that year.…”