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. 2025 Apr 25:54:103080.
doi: 10.1016/j.pmedr.2025.103080. eCollection 2025 Jun.

Tobacco policy coverage in California jurisdictions before and after enactment of proposition 56

Dennis R Trinidad  1   2 , Candice D Donaldson  3 , Brian Dang  1 , Matthew D Stone  1   2 , Thet Nwe Myo Khin  1 , Sara B McMenamin  1 , Yuyan Shi  1 , Tam D Vuong  3   4 , Xueying Zhang  3 , Karen Messer  1   2 , John P Pierce  1   2
Affiliations

Tobacco policy coverage in California jurisdictions before and after enactment of proposition 56

Dennis R Trinidad et al. Prev Med Rep. .

Abstract

Objective: Proposition 56, a $2 tobacco tax enacted in California in 2016, led to increased funding to Local Lead Agencies which work to reduce tobacco use. We examined whether Proposition 56 was associated with increases in the population covered by local policies addressing four areas: 1) tobacco retail sales (TRS), 2) flavored tobacco products sales (FTP), 3) outdoor secondhand smoke (SHS) restrictions, and 4) smoking restrictions in multi-unit housing (MUH).

Methods: 2007-2023 data from the Policy Evaluation Tracking System in California were analyzed. The unit of analysis was the California jurisdiction, with outcome the time (in months) to policy enactment in a jurisdiction. Kaplan-Meier estimates and population coverage percentages were calculated by weighing each jurisdiction by its population size. Discrete-time survival models were fitted to test the effect of Proposition 56 on the rate of population coverage for each policy of interest.

Results: By January 2023, 79 % of the California population was covered by a local SHS policy but only 55 %, 47 % and 18 % was covered by a local TRS, FTP and MUH policy, respectively. The rate of increase in TRS and FTP policy coverage was greater post-Proposition 56 than pre-Proposition 56 (p < 0.001), while the rate of increase did not change significantly for MUH and SHS policies.

Conclusions: Proposition 56 was associated with marked increases in the enactment of TRS and FTP, but not SHS or MUH policies. Despite increases post-Proposition 56, additional efforts are needed to increase local adoption of TRS, FTP and MUH policies because coverage remains low.

Keywords: Flavored tobacco; Geographic areas; Multi-unit housing; Policy; Population studies; Secondhand smoke; Tobacco.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Percentage of California Jurisdictions Covered by Each of Four Tobacco Policies of Interest, 2007–2023. Notes Tobacco Retail Sales Policy refers to local policies that restrict free samples, discounts on tobacco products, and the sale of tobacco or electronic smoking devices. Flavored Tobacco Policy refers to local policies that restrict the sale of flavored tobacco products. Multi-Unit Housing Policy refers to local policies that require a minimum of two units be free from combustible tobacco smoke. Secondhand Smoke Policy refers to local policies that restrict smoking in public places.
Fig. 2
Fig. 2
Map of California Counties Showing Coverage for Each of Four Tobacco Policies of Interest, Pre- and Post-Proposition 56, 2007–2023. Notes Pre-Prop 56: Jan. 2007 – Jan. 2018. Post-Prop 56: Feb. 2018 – Jan. 2023. Tobacco Retail Sales Policy refers to local policies that restrict free samples, discounts on tobacco products, and the sale of tobacco or electronic smoking devices. Flavored Tobacco Policy refers to local policies that restrict the sale of flavored tobacco products. Multi-Unit Housing Policy refers to local policies that require a minimum of two units be free from combustible tobacco smoke. Secondhand Smoke Policy refers to local policies that restrict smoking in public places.
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References

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