Trends in youth use of non-cigarette tobacco products in England, Canada, and the US and the impact of England’s menthol cigarette ban on use
Bibliographic record
Abstract
Introduction: In England, non-cigarette tobacco products (e.g., cigarillos, cigars, waterpipes, bidis, smokeless tobacco, heated tobacco) are subject to fewer regulatory restrictions than cigarettes/rolling tobacco. This study assessed trends in youth use of these products in England, Canada, and the US, focussing on evaluating the impact of England's May 2020 ban on menthol in cigarettes but not non-cigarette tobacco. Methods: Data were from the ITC Youth Tobacco and Vaping Survey (16-19-year-olds; N=129,575) across ten waves (2017-2024). Segmented regressions assessed changes in trends of non-cigarette tobacco products before vs. after May 2020, adjusting for race/ethnicity/sex/age. Results: In England, non-cigarette tobacco use increased similarly before (aOR=1.16,1.02-1.31) and after (1.13,1.07-1.20) the ban (change in trend: 0.98,0.91-1.06), from 7.4% in 2017 and reaching in 11.6% in 2024. In contrast, non-cigarette tobacco use decreased similarly before and after the ban in both the US (pre-ban: 0.82, 0.73-0.93; post-ban: 0.84,0.80-0.89; change in trend: 1.02,0.94-1.11; from 10.2% reaching 7.1%), and Canada (pre-ban: 0.84,0.76-0.93; post-ban: 0.90,0.86-0.94; from 9.2% reaching 7.9%), although the decline in Canada after the ban was slightly slower (1.07,1.001-1.15). Cigarillo, cigar, and smokeless tobacco use specifically increased to a greater extent in England than Canada and the US. Conclusions: Between 2017 and 2024, youth non-cigarette tobacco product use increased in England and surpassed declining use in Canada and the US. There was little evidence that England's menthol cigarette ban accelerated increases, although increases highlight the need for comprehensive regulations encompassing all tobacco products in England.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".