The Implementation of Local Flavored Cigar Restrictions

About This Grant

PROJECT SUMMARY In 2023, over 9 million adults and 1 million youth in the US reported using cigars in the past 30 days, with most indicating flavor use. Policies restricting the sale of flavored cigars have been adopted across the US to improve public health. However, written policies often do not accurately represent their practical implementation. From an implementation science perspective, there is limited evidence on the extent and effectiveness of existing strategies to implement flavored cigar policies, despite their growing prevalence. The long-term goal of this research is to inform best practices for implementing local public health policies. In this study we will conduct a comprehensive retrospective analysis of real-world policy implementation, capitalizing on a natural experiment to enrich our understanding of the policy implementation process and identify strategies that curtail cigar sales and consumption. The scientific premise is based on (1) demonstrated efficacy of flavored cigar policies in limiting access to a widely appealing product, (2) research noting limitations in the implementation of flavored cigar policies that may impact outcomes, (3) implementation science theoretical frameworks indicating the importance of the implementation process when assessing policy outcomes, and (4) preliminary data indicating heterogeneity in policy implementation strategies across municipalities. This study will provide critical data on the implementation of flavored cigar policies in the US, to inform the knowledge base on how policies are implemented, and which strategies reduce cigar sales and use. More broadly, this study will advance the field of dissemination and implementation science by creating a policy implementation measure that accounts for differential implementation and can be used to inform more rigorous policy evaluations.