Work

Impact of the District of Columbia’s Flavored Tobacco Ban on Adult Cigarette Smoking: A Difference-in-Differences Analysis Using U.S. National Data

Year: 2026

Type: article

Abstract: In October 2022, the District of Columbia (D.C.) enacted a comprehensive ban on the sale of flavored tobacco products, including menthol cigarettes. To date, no study has examined the behavioral impact of this policy on smoking outcomes. Using Behavioral Risk Factor Surveillance System data, this study utilized difference-in-difference (DiD) models to assess adult smoking behaviors in D.C. before (January 2019–September 2022) and after the ban (October 2022–December 2024), compared to 32 states without similar bans. Smoking prevalence declined in both D.C. (from 13.1% in 2019 to 8.6% in 2024) and the comparator states (from 17.5% in 2019 to 12.4% in 2024). After adjusting for sociodemographic and year-fixed effects, there were no significant effects of time (AOR=1.01; 95% CI=0.95, 1.06, p=0.7771), treatment (AOR=0.93; 95% CI=0.85, 1.02, p=0.1135), or the DiD estimate (AOR=1.06; 95% CI=0.90, 1.25, p=0.4832). Sensitivity analyses aligned with these findings. These findings suggest that D.C.'s flavor ban did not meaningfully influence adult smoking prevalence compared with states without such policies. Based on the findings of previous research, the results may reflect continued access to menthol cigarettes, switching from menthol cigarettes to non‑menthol cigarettes, or the substitution towards cigarettes following the removal of flavored e-cigarettes.

Source: AJPM Focus

DOI: 10.1016/j.focus.2026.100547

Authors: Evan A. Winiger, Pavel N. Lizhnyak, Derek A. Pope, Andrea R. Vansickel

Institution: Altria (United States)

Language: English

Topic: Smoking Behavior and Cessation

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,910