Evaluating Massachusetts' Flavored Tobacco Ban and Smoking Trends
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objectives: The effectiveness of comprehensive statewide flavored tobacco bans (FTBs) in reducing cigarette smoking remains uncertain. Massachusetts (MA) implemented a comprehensive FTB in June 2020; evidence on its behavioral impact is limited. Methods: Restricted-use, state-delineated National Survey on Drug Use and Health (NSDUH) data from 2015–2019 (pre-ban) and 2021–2022 (post-ban) were analyzed for underage (12–20 years) and adult (21+) populations. Difference-in-Differences (DiD) models assessed changes in smoking prevalence and menthol use in MA relative to 36 Comparison states without flavored tobacco restrictions. Clinical significance was evaluated using odds-ratio thresholds (OR ≤ 0.80 or ≥ 1.20). Results: Observed adult smoking prevalence was consistently higher in Comparison states than in MA, with parallel pre-ban trends. DiD estimates indicated a negligible policy effect of the FTB on adult smoking in MA. Post-ban, estimated underage smoking increased modestly in MA (7.5% to 9.6%) while declining in comparison states (10.3% to 9.4%), though DiD estimates indicated negligible policy effects. Observed adult menthol use showed volatility, and 24.7% (approximately one-quarter) of MA adults who smoked continued smoking menthol cigarettes two years post-ban in 2022. The FTB had little effect on cessation. Conclusion: The MA FTB had little impact on smoking prevalence or cessation among underage and adults, with substantial menthol use persisting among adults.
Institution: Altria (United States)
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7203588577