Local sales ban on flavored tobacco in California linked to decline in youth vaping

Researchers at the University of California San Diego have found that local sales restrictions on flavored tobacco in California are associated with less smoking among youth over time without increasing cigarette smoking. The findings, based on an analysis of more than 2.8 million middle and high school students, were published on April 10, 2026. JAMA Health Forum.

Our findings suggest that banning locally flavored tobacco may be an effective strategy to reduce e-cigarette use among youth. “Importantly, we did not find evidence that these policies led young people to turn to cigarettes, which has been a major concern raised in policy debates.”

Eric Lees, PhD, MPH, assistant professor at the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Sciences and senior author of the study

Electronic nicotine delivery systems (ENDS), commonly known as e-cigarettes or vaping products, have been widely used by teenagers in the US. National data shows youth vaping peaked in 2019 when more than a quarter of high school students reported using e-cigarettes, although prevalence has declined since then. Despite this reduction, frequent use remains common among current users, raising concerns about nicotine dependence and long-term health risks.

One approach policymakers have taken to reduce youth vaping is to restrict the sale of flavored tobacco products, which often include fruit, candy or mint flavors that appeal to youth users. Prior research has shown that flavored products are a major driver of e-cigarette use among youth.

To better understand the impact of these policies, the research team analyzed responses from 2,805,708 students who participated in the California Healthy Kids Survey between 2017 and 2022. The survey involves students in grades 7, 9 and 11 and asks about use of tobacco products in the past month.

The researchers compared tobacco use among students attending schools in areas with flavored tobacco bans to students living in areas without such policies. The study used a dynamic difference-in-differences design to track when different cities adopted restrictions and how the outcomes changed over time. The dynamic difference-in-differences design method allowed researchers to see whether youth vaping changed after flavored tobacco was banned in different cities — and whether those changes extended over several years, rather than just looking at a before-and-after comparison.

Vaping rates were lower among youth in areas with flavored tobacco bans. In areas with restrictions, 6.2% of students reported current use of e-cigarettes, compared to 7.7% in areas without restrictions. Over time, the study found that these policies were associated with sustained declines in youth vaping.

In contrast, the study found no significant association between the flavored tobacco ban and cigarette smoking among youth. Cigarette use remained approximately the same in jurisdictions with and without policies.

The delayed reductions in vaping may reflect how policies evolve and are implemented over time. Many local jurisdictions gradually strengthened their rules after initial adoption, for example by expanding the definitions of flavored products or adding enforcement provisions. Resources and support for enforcing these laws also increased over time, especially after California’s statewide ban went into effect, helping local communities better enforce the restrictions.

California voters approved a statewide flavored tobacco sales ban in 2022, taking effect in 2023. Because many cities enacted their own bans years ago – some as early as 2011 – researchers say these local policies provide an opportunity to study the long-term effects of flavor bans.

The authors say the study focused on California, a state with historically strong tobacco control policies and relatively low youth smoking rates compared to other states. As a result, the magnitude and timing of impacts may vary across locations with different policy environments.

Future research will be needed to understand the long-term impact of statewide bans and how similar policies affect youth tobacco use in different areas and communities.

“Local policies have given us a valuable window into how flavored tobacco bans may affect youth behavior over time,” said Giovanni Apollon, MPH, the study’s first author, who conducted this research as part of experiential learning as a doctoral candidate at the UC San Diego – San Diego State University joint doctoral program in public health. “As more jurisdictions adopt these policies, continued monitoring will help determine how enforcement, policy design, and community context shape their public health impact.”