{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T23:05:54Z","timestamp":1783897554565,"version":"3.55.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R21DA052421"],"award-info":[{"award-number":["R21DA052421"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Cancer Institute of the National Institutes of Health","award":["P50CA244433"],"award-info":[{"award-number":["P50CA244433"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In 2019, Massachusetts enacted the nation\u2019s first comprehensive statewide restriction on flavored tobacco sales and expanded tobacco cessation coverage. This study assessed the policy\u2019s sustained effectiveness by examining trends and factors associated with tobacco use during the maintenance phase of the policy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted monthly cross-sectional surveys (April 2021 to July 2022) to assess trends of past 30-day use of cigarettes, e-cigarettes, and other tobacco products of youth (ages 13-17, N\u2009=\u20091858) and adults (ages 18+, past 30-day tobacco use, N\u2009=\u20091548), including quit attempts among adults. We compared trends in Massachusetts to four neighboring states that did not have similar statewide restrictions using generalized linear models, modeling each outcome as a function of time (1-month increments), state (Massachusetts vs. four neighboring states), and an interaction between month and state, and adjusted for demographic covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Analyses identified no significant differences in tobacco use trends between residents of Massachusetts and comparison states. While Massachusetts youth showed stable cigarette use and slower increases in e-cigarette use compared to steeper rises in neighboring states, these differences were not statistically significant. Among adults who currently use tobacco, monthly trends of their tobacco use and past-year quit attempts were also comparable across states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings highlight the need for comprehensive approaches combining sales restrictions with enhanced cessation support and prevention programs to achieve sustained effects on reducing population tobacco use. We found no unintended increase in trends of cigarette use among youth or adults in response to the Massachusetts flavor restrictions versus comparison states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>This study aimed to compare trends in tobacco use for youth and adults, and quit attempts for adults in Massachusetts with those in neighboring states over a 16-month period in the maintenance period of implementation (in 2021 and 2022) of the statewide Massachusetts flavored tobacco sales restriction. We found no unintended increase in trends of cigarette use among youth or adults, and findings highlight the need for comprehensive approaches to achieve sustained effects on reducing population tobacco use. Given the focused New England population of this study, additional evaluation of the sustained impact of flavored tobacco sales restrictions is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntag128","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T11:43:46Z","timestamp":1780141426000},"source":"Crossref","is-referenced-by-count":0,"title":["Trends of past 30-day use of commercial tobacco products among youth and adults in Massachusetts compared to four neighboring states after the 2019 statewide flavored tobacco sales restriction"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8455-0127","authenticated-orcid":false,"given":"Jessica","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Health Science, California State University , Long Beach, CA 90840 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6126-9095","authenticated-orcid":false,"given":"Jonathan P","family":"Winickoff","sequence":"additional","affiliation":[{"name":"Division of General Academic Pediatrics, MassGeneral Hospital , Boston, MA 02114, \u00a0","place":["United States"]},{"name":"Tobacco Research and Treatment Center, MassGeneral Hospital , Boston, MA 02114, \u00a0","place":["United States"]},{"name":"Julius B. Richmond Center, American Academy of Pediatrics , Itasca, IL ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine P","family":"Hanby","sequence":"additional","affiliation":[{"name":"Annenberg School for Communication, University of Pennsylvania , Philadelphia, PA 19104 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M","family":"Emmons","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health , Boston, MA 02215 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6459-6171","authenticated-orcid":false,"given":"Andy S L","family":"Tan","sequence":"additional","affiliation":[{"name":"Annenberg School for Communication, University of Pennsylvania , Philadelphia, PA 19104 ,","place":["United States"]},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania , Philadelphia, PA 19104 ,","place":["United States"]},{"name":"Abramson Cancer Center, University of Pennsylvania, Tobacco and Environmental Carcinogenesis Program , Philadelphia, PA 19104, \u00a0","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"2026071210263999200_ref1","volume-title":"U.S. Sales Restrictions on Flavored Tobacco Products [Internet]","author":"Public Health Law 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