College Students' Awareness of California's Law Prohibiting Sales of Flavored Tobacco.

Abstract

Introduction: Laws prohibiting sales of flavored tobacco are increasingly prevalent across the US, with eight states and 402 localities passing such laws between 2010 and 2024. California's statewide law prohibiting sales of flavored tobacco products went into effect on December 21, 2022. It is unknown whether California college students are aware of this law.

Methods: An online survey of California college students (ages 18-24) was conducted April 4-August 6, 2024 (n=3,919). Mixed models estimated associations between awareness of the state law and any tobacco product use (including nicotine vapes, cigarettes, cigars, hookah, and nicotine pouches), adjusting for sociodemographic characteristics.

Results: Overall, only 20.8% of students were aware of the state law. Awareness differed by any tobacco use: 16.1% among never, 23.3% ever (not current), and 24.4% current. Compared to students who never used tobacco, students who reported ever using were more likely to be aware (aOR=1.50, 95% CI: 1.19, 1.90), as were those who reported current use (aOR=1.53, 95% CI: 1.24, 1.87). Among students who reported current use, those who used flavored tobacco were less likely to be aware compared to those who used unflavored tobacco (23.3% vs. 31.6%; aOR=0.59, 95% CI: 0.42, 0.83).

Conclusions: More than 15 months after California prohibited flavored tobacco sales, only one in five college students was aware of the law. Surprisingly, awareness was lower among students who used flavored tobacco than those who used unflavored tobacco. Students who use unflavored tobacco may have greater awareness as a result of challenges with purchasing flavored tobacco.

Implications: This is the first study to examine awareness of California's law prohibiting sales of flavored tobacco among young adults (ages 18-24). Only 20.8% of California college students were aware of the law. Notably, awareness was lower among students who reported current use of flavored tobacco compared to those who reported current use of unflavored tobacco. Some students may have faced difficulties purchasing flavored tobacco, which raised their awareness of the law. These results suggest the need for public health campaigns and retail signage to improve awareness of the law, particularly among young adults.