Association for Public Policy Analysis & Management

In 2009, the United States Food and Drug Administration banned the sale of cigarettes with characterizing flavors like fruit or candy. Menthol cigarettes were excluded from this rule, as were all other tobacco products such as cigars and smokeless tobacco. Internal industry documents reveal the tobacco industry’s use of menthol and other flavors to target youth and young adults, people of color, and women. In light of continued high rates of menthol use among youth, people of color, women, and sexual minority individuals, and the proliferation of other flavored tobacco products including e-cigarettes, it is critical to know how the use of flavored products affects long-term product use and nicotine addiction. We analyzed data from the PATH study, a longitudinal (2-wave; 2013-2015) national survey of youth and adults (n= 28,362) to determine (1) whether demographics help predict initiation of tobacco use with a flavored product, (2) if initiation of tobacco use with a flavored product predicts future smoking or nicotine addiction, and (3) whether demographic factors moderate any relationship between flavored tobacco use and future smoking. We employed hierarchical linear models to account for respondent clustering by region, and controlled for details of current and former tobacco product use and for demographic characteristics. Interaction terms were used to test moderation effects. As some local and state governments consider and adopt local policies to limit the sales of menthol and flavored tobacco products, the results of this study have implications for the potential impact of such policies on long-term tobacco use.