An evaluation of Massachusetts’ flavored tobacco restriction one year after policy implementation: Is it promoting equity?

Abstract In the United States certain groups, such as African Americans (AA) and sexual minorities (SM) have disproportionately high rates of flavored tobacco use. Policies restricting flavored tobacco may especially benefit these groups and lead to an equitable reduction in tobacco use. This study used Behavioral Risk Factor Surveillance System data from Massachusetts and Connecticut (control state) to evaluate changes in cigarette use before and after Massachusetts’ flavor restriction policy was implemented. Difference-in-difference (DID) was used to evaluate the overall impact and difference-in-difference-in-difference (DDD) was used to evaluate the impact on AAs and SMs. There were no significant differences in the change in cigarette use for adults overall or for AA adults in Massachusetts compared to Connecticut. Among SMs, Connecticut had a greater decrease in cigarette use compared to Massachusetts. As more data become available, it will be crucial to monitor the longer-term impact of the policy and any differences in policy impact among groups.