Impacts of Tax and Flavor Tobacco Policies on San Francisco Bay Area Tobacco Prices

Background: California Proposition 56 increased the state tobacco tax by $2 per cigarette pack effective April 1, 2017. Between 2015-2020 San Francisco (SF) and some cities in Alameda County enacted local flavored tobacco sales restrictions. SF also increased its Cigarette Litter Abatement Fee, from $0.20/pack in 2015 to $1.00 in 2020.Objectives: Compare the change in tobacco prices before (2015) and after (2019/20) the implementation of a $2 increase in tobacco excise tax and local flavored tobacco policies in SF and Alameda Counties.Research Design: Descriptive study of the pre-to-post policy analysis design. We drew a proportional random sample of retailers (N=463) in SF and Alameda Counties, by city. Using multivariable, single- and multiple-level linear regressions, we compared inflation-adjusted average tobacco prices in 2015 vs. 2019/20 by county and by flavor policy, accounting for socio-demographics.Measures: Change in inflation-adjusted average tobacco prices in 2015 vs. 2019/20 by county and flavor policy, accounting for socio-demographics.Results: Between 2015-2019/20, the increase in cigarette prices was higher than the $2 tax increase, and higher in SF than Alameda County (+$4.6 vs +$2.5). SF retailers stopped selling Newport menthol cigarettes and Blu brand menthol e-cigarettes in 2019/20. Adjusted average cigarette prices increased significantly more in SF and Alameda County cities with comprehensive or partial flavor policies versus cities without flavor policies (by $3.23 and $2.11).Conclusions: Local flavor policies affected menthol product availability and may have had positive spillover effects and indirectly increased pack prices.

Automated summary

California Proposition 56 increased tobacco tax, SF enacted local flavored tobacco sales restrictions, and the Cigarette Litter Abatement Fee was increased. This study compares the change in tobacco prices before and after the tax increase and local policies, and found that the price increase was higher in SF than Alameda County. Local flavor policies affected menthol product availability and increased pack prices.