College Students’ Awareness of California’s Law Prohibiting Sales of Flavored Tobacco

Abstract

Introduction:

Laws prohibiting sales of flavored tobacco are increasingly prevalent across the United States, with eight states and 402 localities that passed such laws between 2010 and 2024. California’s statewide law prohibiting sales of flavored tobacco products went into effect on December 21, 2022. It is unknown whether California college students are aware of this law.

Aims and Methods:

An online survey of California college students (ages 18–24) was conducted from April 4 to August 6, 2024 (n = 3919). Mixed models estimated associations between awareness of the state law and any tobacco product use (including nicotine vapes, cigarettes, cigars, hookah, and nicotine pouches), adjusting for sociodemographic characteristics.

Results:

Overall, only 20.8% of students were aware of the state law. Awareness differed by any tobacco use: 16.1% among never, 23.3% among ever (not current), and 24.4% among current. Compared to students who never used tobacco, students who reported ever use were more likely to be aware (aOR = 1.50, 95% CI: 1.19, 1.90), as were those who reported current use (aOR = 1.53, 95% CI: 1.24, 1.87). Among students who reported current use, those who used flavored tobacco were less likely to be aware compared to those who used unflavored tobacco (23.3% vs. 31.6%; aOR = 0.59, 95% CI: 0.42, 0.83).

Conclusions:

More than 15 months after California prohibited flavored tobacco sales, only one in five college students was aware of the law. Surprisingly, awareness was lower among students who used flavored tobacco than those who used unflavored tobacco. Students who use unflavored tobacco may have greater awareness as a result of challenges with purchasing flavored tobacco.

Implications:

This is the first study to examine awareness of California’s law prohibiting sales of flavored tobacco among young adults (ages 18–24). Only 20.8% of California college students were aware of the law. Notably, awareness was lower among students who reported current use of flavored tobacco compared to those who reported current use of unflavored tobacco. Some students may have faced difficulties purchasing flavored tobacco, which raised their awareness of the law. These results suggest the need for public health campaigns and retail signage to improve awareness of the law, particularly among young adults.

Introduction

Flavored tobacco products, such as menthol cigarettes and explicit-flavored nicotine vapes, are perceived as more appealing than unflavored tobacco products.¹ Previous evidence from US tobacco industry documents demonstrates that flavored tobacco has been purposely marketed to appeal to young people, women, and specific racial/ethnic groups.² Among young adults, 86% of those who ever used tobacco started with a flavored product.³

To curb flavored tobacco product use among youth and young adults, laws prohibiting sales of flavored tobacco are becoming more prevalent across the United States. As of March 2025, eight US states and 402 localities had passed restrictions on flavored tobacco.⁴ California’s law (SB 793) went into effect on December 21, 2022.⁵ SB 793 prohibits sales of flavored tobacco products, with exceptions for loose-leaf tobacco, premium cigars, and hookah in retailers that limit entry to those aged 21 and over.

Few studies examine awareness of state and local laws for flavored tobacco product sales, even though previous literature has shown that awareness of the minimal legal age of tobacco sales was inversely associated with intention to use tobacco.⁶ Awareness of flavored tobacco product laws appears to be high among adults but low among youth. In southern California, 88.5% of Black adults were aware of a Los Angeles County law banning the sale of menthol cigarettes.⁷ In New York, however, only 6.7% of adolescents correctly reported that flavored vapes were banned in all stores in their state.⁸ Nearly a year after SB 793 went into effect, only 22.0% of adolescents in California were aware of the state law.⁹

To our knowledge, there have been no studies examining awareness of local and state laws prohibiting sales of flavored tobacco among young adults (ages 18–24). Young adults are of particular concern because they have a high rate of tobacco use and because they were adolescents during the peak of flavored e-cigarette popularity and use.^10,11 This study sought to measure awareness of SB 793 among college-enrolled young adults in California, overall and by tobacco use status, more than a year after the law went into effect. Given the retail availability of tobacco products and compliance with sales restrictions also vary by neighborhood demographics,¹² we examined individual differences in awareness.

Materials and Methods

Study Sample

Students were recruited from Qualtrics Research Panels and eligible for the study if they were 18–24 years old, and attended a 2-year community college or 4-year public or private university with housing for at least 250 students in California. Students who only attended classes online were ineligible. With concern for surveying two independent samples, students who participated in a previous wave of this study survey were ineligible. The confidential, online survey was conducted between April 4 and August 6, 2024. The median survey completion time was 9.2 min (IQR = 7.2–12.1). Qualtrics excluded respondents who completed the 124-item survey in fewer than 4.2 min. Qualtrics also assessed the probability that a respondent was a bot (ReCAPTCHA score > 0.5), which was used to identify invalid cases.

Students (n = 4164) were clustered in 166 campuses, including both community colleges (n = 112) and 4-year colleges/universities (n = 54). The mean number of students per campus was 25.1 (SD = 27.6, range = 1–162). A cap of 100 students per campus was added to the recruitment protocol, but not until three campuses had exceeded this limit. All surveys from these three campuses were included in the analysis. Qualtrics provided compensation for survey completion in the form of points valued at $5.10–$6.38. This study was approved by the Stanford University Institutional Review Board, protocol #44275.

Measures

Awareness of State Law

Students were asked: “Is it legal for stores in California to sell cigarettes, nicotine vapes or other tobacco products that taste like mint/menthol, fruit, or other flavors?” Response options were “Yes,” “No,” and “I don’t know.” Students who responded “No” were categorized as being aware of the state law, and those who responded “Yes” or “I don’t know” were categorized as being unaware.

Tobacco Use

Two measures were created: (1) tobacco use status, categorized as never, ever (not current), and current (past 30 days), and (2) among the subgroup of those who reported current use, flavored tobacco product use (yes/no). Tobacco use assessed use of nicotine vapes, cigarettes, hookah, cigars, and nicotine pouches. Flavored tobacco use included the use of menthol cigarettes or explicit-flavored (e.g., mint, fruit) nicotine vapes, cigars, or nicotine pouches. Students who reported using both flavored and unflavored tobacco were included in the flavored tobacco use category. Friends’ tobacco use measured the number of different types of tobacco products (i.e., cigarettes, nicotine vapes, cigarillos, and nicotine pouches) used by at least one of the student’s five closest friends, ranging from 0 to 4.

Sociodemographics

Students reported their age, gender, sexual orientation, race, ethnicity, and whether they experienced food insecurity and housing instability. Gender and sexual orientation were combined to create four mutually exclusive categories: (1) heterosexual man, (2) heterosexual woman, (3) sexual and/or gender minority (SGM), and (4) decline to specify/unknown. The SGM category included anyone who responded “nonbinary” or “prefer to self-describe” and/or responded anything other than “heterosexual.” Race and ethnicity were combined to create a single variable with seven mutually exclusive categories: (1) non-Hispanic/Latinx (NHL) White, (2) NHL Black, (3) NHL Asian/Pacific Islander/Native Hawaiian, (4) NHL American Indian/Alaska Native, (5) NHL multiracial, (6) Hispanic/Latinx, and (7) Other. The Other category included students who specified other or unknown race or declined to answer. Food insecurity was assessed using the Hunger Vital Sign, a validated two-question food insecurity screening tool that measured whether the students worried about or experienced running out of food.¹³ Housing instability assessed whether the student experienced homelessness for a week or longer in the past 12 months.

Statistical Analyses

Recruited students with a high probability of being a bot (n = 182), who had inconsistencies in their reported age (n = 61), and who did not answer the question asking about awareness of the state law (n = 2) were excluded from all analyses, resulting in an analytic nonprobability sample of 3919 students. Descriptive statistics were computed overall and split by awareness of the state law for students’ sociodemographic characteristics as well as tobacco product use by students and their friends. Mixed models (3919 students within 166 colleges) were used to estimate associations between awareness of the state law and tobacco use status, adjusting for sociodemographic characteristics. Among the subset of students who reported current tobacco use, mixed models also examined awareness of the law and flavored tobacco product use, adjusting for sociodemographic characteristics. As sensitivity analyses, we (1) re-estimated the mixed model for tobacco use status excluding students who exclusively used hookah (n = 43), as it is exempt from the state law, and (2) re-estimated the mixed models for tobacco use status and flavored tobacco product use adjusting for campus type (community college or 4-year university). All analyses were performed using PROC GLIMMIX in SAS Version 9.4. The reference category for race/ethnicity was NHL White, and for gender/sexual orientation was heterosexual man. Because of sample size limitations, unknown gender and sexual orientation was combined with sexual and/or gender minority category and NHL American Indian/Alaska Native was combined with other race/ethnicity in the models.

Results

Overall, 20.8% of California college students in this sample were aware of the state law prohibiting sales of flavored tobacco. As shown in Table 1, awareness of the law was higher among students who reported current tobacco use (24.4%) and ever use (23.3%) than never use (16.1%). Among those who reported current tobacco use, awareness of the law was higher among those who used unflavored tobacco (31.6%) compared to those who used flavored tobacco (23.3%). Awareness of the law was highest among students whose gender and sexual orientation was unknown (26.8%), and NHL American Indian/Alaska Native students (29.7%). Awareness of the law was lowest among heterosexual women (17.7%) and students who identified as NHL Asian/Pacific Islander/Native Hawaiian (17.2%).

Table 1.

California College Students’ Demographics Overall and by Awareness of the State Flavored Tobacco Law (n = 3919)

	Overall sample	Is it legal for stores in California to sell flavored tobacco products?
		No (aware)	Yes/I don’t know (unaware)
	n (col %)	n (row %)	n (row %)
Overall	3919 (100.0)	814 (20.8)	3105 (79.2)
Age
mean (SD)	21.1 (2.0)	21.2 (1.9)	21.0 (2.0)
Gender and sexual orientation
Heterosexual man	1153 (29.4)	234 (20.3)	919 (79.7)
Heterosexual woman	1675 (42.7)	297 (17.7)	1378 (82.3)
Sexual and/or gender minority	1051 (26.8)	272 (25.9)	779 (74.1)
Unknown	41 (1.0)	11 (27.5)	29 (72.5)
Race and ethnicity
NHL White	952 (23.2)	211 (23.6)	685 (76.5)
NHL Black	554 (14.1)	107 (19.3)	447 (80.7)
NHL Asian/Pacific Islander/Native Hawaiian	482 (12.3)	83 (17.2)	399 (82.8)
NHL American Indian/Alaska Native	37 (0.9)	11 (29.7)	26 (70.3)
NHL multiracial	210 (5.4)	55 (26.2)	155 (73.8)
Hispanic/Latinx	1693 (43.2)	337 (19.9)	1356 (80.1)
Othera	57 (1.2)	10 (21.3)	37 (78.7)
Tobacco use
Never	1622 (41.4)	261 (16.1)	1361 (83.9)
Ever, not current	631 (16.1)	147 (23.3)	484 (76.7)
Current	1665 (42.5)	406 (24.4)	1259 (75.6)
Type of tobacco used c
Unflavored only	196 (11.8)	62 (31.6)	134 (68.4)
Flavored	1464 (88.2)	341 (23.3)	1123 (76.7)
Food insecurity	2275 (58.1)	497 (21.9)	1778 (78.2)
Housing instability	636 (16.2)	144 (22.6)	492 (77.4)
Friends’ tobacco use b
mean (SD)	1.9 (1.3)	2.1 (1.3)	1.9 (1.3)

NHL = non-Hispanic/Latinx.

^aOther included students who specified other or unknown race or declined to provide their race and ethnicity.

^bFriends’ tobacco use represents the number of types of products (ranging from 0 to 4) (i.e., cigarettes, nicotine vapes, cigarillos, and nicotine pouches) used by at least one of the student’s five closest friends.

^cType of tobacco used was only assessed among students who reported current tobacco use.

After adjusting for age, gender/sexual orientation, race/ethnicity, friends’ tobacco use, food insecurity, and housing instability students who reported ever tobacco use (aOR = 1.50, 95% CI = 1.19 to 1.90) or current tobacco use (aOR = 1.53, 95% CI = 1.24 to 1.87) were more likely to be aware of the law than those who never used tobacco (Table 2). After adjusting for age, race/ethnicity, tobacco use status, friends’ tobacco use, food insecurity, and housing instability, students who identified as SGM were more likely to be aware of the law than heterosexual men (aOR = 1.39, 95% CI= 1.14 to 1.71). Both sensitivity analyses, one that excluded students who used hookah exclusively and a second that adjusted for type of campus (community college vs. 4-year college/university) yielded similar results (results not shown).

Table 2.

Adjusted Associations between Awareness of the State Flavored Tobacco Law and Tobacco Use and Type of Tobacco Used Among California College Students

	All students (n = 3919)	Students reporting current tobacco use (n = 1665)
	aOR (95% CI)	aOR (95% CI)
Tobacco use status
Never	Ref
Ever, not current	1.50 (1.19–1.90)
Current	1.53 (1.24–1.87)
Type of tobacco used
Unflavored		Ref
Flavored		0.59 (0.42–0.83)
Age	1.02 (0.98–1.06)	1.01 (0.95–1.07)
Gender and sexual orientation
Heterosexual man	Ref	Ref
Heterosexual woman	0.89 (0.73–1.08)	0.85 (0.65–1.13)
Sexual and/or gender minority/unknown	1.39 (1.14–1.71)	1.33 (1.00–1.78)
Race and ethnicity
NHL White	Ref	Ref
NHL Black	0.80 (0.61–1.05)	0.69 (0.48–0.99)
NHL Asian/Pacific Islander/Native	0.78 (0.58–1.04)	1.03 (0.66–1.60)
Hawaiian
NHL multiracial	1.21 (0.85–1.71)	1.02 (0.58–1.80)
Hispanic/Latinx	0.87 (0.71–1.06)	0.91 (0.68–1.20)
Othera/NHL American Indian/Alaska	1.06 (0.63–1.79)	0.84 (0.38–1.85)
Native
Food insecurity	1.03 (0.87–1.23)	0.93 (0.71–1.22)
Housing instability	0.94 (0.78–1.13)	0.85 (0.64–1.12)
Friends’ tobacco use b	1.05 (0.98–1.13)	1.09 (0.97–1.22)

NHL = non-Hispanic/Latinx.

^aOther included students who specified other or unknown race or declined to provide their race and ethnicity.

^bFriends’ tobacco use represents the number of types of products (ranging from 0 to 4) (i.e., cigarettes, nicotine vapes, cigarillos, and nicotine pouches) used by at least one of the student’s five closest friends.

After adjusting for age, gender/sexual orientation, race/ethnicity, friends’ tobacco product use, food insecurity, and housing instability, among students who reported current tobacco use, those who used flavored tobacco products were less likely to be aware of the law compared to those who used unflavored tobacco products (aOR = 0.59, 95% CI = 0.42 to 0.83). Among those who reported current tobacco use, NHL Black students were less likely to be aware of the law than NHL White students (aOR = 0.69, 95% CI = 0.48 to 0.99).

Discussion

More than 15 months since California’s law prohibiting sales of flavored tobacco went into effect, only one in five college students in this sample were aware of the law. Awareness of the law was greater, although still very low, among students who reported current tobacco use, possibly because they are more directly affected by tobacco control policies. Concerningly, awareness was lower among students who reported using flavored tobacco, suggesting that they may not be encountering difficulty obtaining their flavored products. In addition, students who identified as SGM were more likely to be aware of the state law, perhaps because they are often targeted by public health campaigns to counteract efforts by tobacco industry marketing and are therefore more aware of policies governing tobacco sales.¹⁴ Among students who reported current tobacco use, NHL Black students had lower awareness than NHL White students, perhaps as a result of tobacco availability being greater in neighborhoods with a higher proportion of NHL Black residents.¹²

One possible explanation for low awareness is that tobacco specialty shops and other tobacco retailers, which are often clustered near college campuses,¹⁵ continue to sell flavored tobacco despite local and state prohibitions in California.^16,17 Students may believe that the flavor law only applies to certain localities or retailers. For example, following New York state’s sales restriction on flavored tobacco, nearly a quarter of adolescents in the state reported that the flavor ban only applied to some stores.⁸ Research is needed to examine the effect of the California’s law on flavored tobacco use among young adults, including college students.

Possible avenues to improve awareness of the state and local flavor laws exist. First, improved enforcement of the law may help reduce the availability of flavored tobacco, thereby increasing customer awareness of the law. Already, California has adopted measures to strengthen enforcement and close loopholes such as authorizing the seizure of prohibited flavored products and creating a list of unflavored tobacco products.¹⁸ Awareness may also be increased through “micro”-level activities such as requiring tobacco retailers to display signs about the state law, as previously required by the smoke-free workplace law in California.¹⁹

This study is the first to assess awareness of the California sales law among young adults. Another strength is the large sample of community college and university students. Study limitations include the use of a convenience sample and self-reported measures of tobacco use. In addition, the demographic characteristics of the sample differ from the general population of college-enrolled young adults in California, specifically with respect to a higher proportion of NHL Black respondents and those who use tobacco products. Given that those who use tobacco products are more likely to be aware of the flavor law and overrepresented in this study sample, awareness of the f lavor law among college students may be even lower. There may also be residual confounding by factors not assessed in the survey (e.g., household income).

We found that few college students, even those who report current use of flavored tobacco, were aware of California’s flavored tobacco law. While students who have never used tobacco may not be aware of laws governing its sale, the low level of awareness among those who currently use flavored tobacco is concerning. The continued availability of flavored tobacco in retail stores¹⁷ and the presence of products with “concept flavors” and “non-menthol” labels^20,21 may contribute to low awareness. Through educational efforts such as public messaging and strengthening enforcement, states and localities may be able to increase awareness of sales restrictions on flavored tobacco and make further progress toward the goal of reducing tobacco use.

Data Availability

The data underlying this article will be shared upon reasonable request to the corresponding author.