Evidence map›Paper›PMID 39024798›Full record

ArticleDrug and alcohol dependence2024

Education, organizational changes, and enforcement challenges of the 2019 flavored tobacco sales restriction in Massachusetts.

Jessica Liu, Jane Roberts, Jonathan P Winickoff, Elaine P Hanby, Matthew J Reynolds, Daniel A Gundersen, Karen M Emmons, Andy Sl Tan

Abstract read
In one paragraph

Article in Drug and alcohol dependence, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. A systematic review investigating policy design and implementation of US state and local policy to restrict the sale of flavored tobacco products.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026
    Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jessica LiuREACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, United States.
Jane RobertsDana-Farber Cancer Institute, Survey and Qualitative Methods Core, Boston, MA, United States.
Jonathan P WinickoffMassGeneral Hospital Division of General Academic Pediatrics, Boston, MA, United States; MGH Tobacco Research and Treatment Center, Boston, MA, United States; American Academy of Pediatrics Julius B. Richmond Center, Itasca, IL, United States.
Elaine P HanbyUniversity of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, United States.
Matthew J ReynoldsHarvard Medical School, Boston, MA, United States.
Daniel A GundersenRutgers Institute for Nicotine and Tobacco Studies, New Brunswick, NJ, United States; Division of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States.
Karen M EmmonsHarvard T.H. Chan School of Public Health, Social and Behavioral Sciences Department, Boston MA, United States.
Andy Sl TanUniversity of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, United States; University of Pennsylvania, Leonard Davis Institute of Health Economics, Philadelphia, PA, United States; Abramson Cancer Center, Tobacco and Environmental Carcinogenesis Program, Philadelphia, PA, United States. Electronic address: andy.tan@asc.upenn.edu.

Funding

The Implementation Science Center for Cancer Control Equity - Research ProgramP50CA244433 · NCI · HARVARD SCHOOL OF PUBLIC HEALTH · PI EMMONS, KAREN M. · 2019 to 2023
$12.5M
Measuring the Public Health Impact of State-Level Flavored Tobacco Bans on Youth and Adult Tobacco UseR21DA052421 · NIDA · UNIVERSITY OF PENNSYLVANIA · PI TAN, ANDY SL · 2020 to 2021
$446k
NCI NIH HHS P50 CA244433NIDA NIH HHS R21 DA052421
6 · The paper itself

Abstract

objectivesIn November 2019, the Massachusetts legislature passed An Act Modernizing Tobacco Control and became the first state to restrict retail sales of all flavored (including menthol) cigarettes, e-cigarettes, and other tobacco products (the Act). Additional tobacco control policies and health insurance coverage for tobacco treatment were included as part of the Act. Implementation of these policies occurred between November 2019 and June 2020. This study explored challenges and facilitators during the implementation of the Act experienced by public health officials, school personnel, and healthcare providers.

methodsWe conducted in-depth interviews with a purposive sample of 9 public health officials and advocates, 9 school personnel, and 8 healthcare providers from March to December 2021. We conducted thematic analysis of interview transcripts using inductive codes of key themes emerging from the interviews.

resultsInterviewees highlighted three key themes that impacted the implementation of the Act: 1) Education of those impacted by the Act, 2) Organizational-level changes to incorporate the Act, and 3) Enforcement challenges. Examples of challenges to the implementation of the Act included COVID-19 pandemic restrictions, navigating tobacco industry tactics around naming flavors, and confusion regarding health insurance coverage for tobacco use cessation programs. Examples of facilitators were enforcement leading to retailer compliance, committed advocacy efforts of leadership/champions, and strong coordination within and between organizations.

conclusionsThese findings of Massachusetts's experience in policy implementation can inform the preparation to implement similar tobacco control policies in other states.

Indexed as

CommerceFlavoring AgentsTobacco ProductsCOVID-19Electronic Nicotine Delivery SystemsHealth PersonnelHumansMassachusettsPublic HealthTobacco IndustryFlavoring AgentsAdvocacyEducationImplementationSchoolsTobacco legislation

Identifiers

PMID39024798
PMCPMC11363149

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.