Flavors play an important role in the initiation and use of tobacco products. The FDA, states, and cities have been implementing or considering banning flavored e-cigarettes or any flavored tobacco products. This study empirically assessed the impact of one of the first comprehensive bans of all flavored tobacco products other than tobacco-flavored e-cigarettes among young adults in San Francisco, California. Using Amazon Mechanical Turk, a sample of San Francisco residents aged 18-34 who previously used tobacco products (N = 247) were surveyed about their tobacco use both before and after the ban. Descriptive statistics and regression models were applied. The prevalence of overall flavored tobacco use decreased from 81% and 85% to 69% and 76% for 18-24 years and 25-34 years old, respectively. The prevalence of flavored e-cigarettes decreased from 57% and 56% to 45% and 48% for 18-24 years and 25-34 years old, respectively. The prevalence of cigars uses reduced as well. However, cigarette smoking increased, although not statistically significant among 25-34 years old. 66% of participants did not support the ban and 65% believed the ban had not been enforced completely. Most users reported being able to obtain flavored tobacco products in multiple ways despite the ban. These findings suggest that comprehensive local flavor bans, by themselves, cannot sharply reduce the availability or use of flavored tobacco products among residents. Nevertheless, local bans can still significantly reduce overall e-cigarette use and cigar smoking but may increase cigarette smoking.

Purpose: Studies on how the interaction of psychological and environmental characteristics influences walking are limited, and the results are inconsistent. Our aim is to examine how the attitude toward walking and neighborhood environments interacts to influence walking. Design: Cross-sectional phone and mail survey. Setting: Participants randomly sampled from 6 study sites including Los Angeles, Chicago, Baltimore, Minneapolis, Manhattan, and Bronx Counties in New York City, and Forsyth and Davidson Counties in North Carolina. Participants: The final sample consisted of 2621 persons from 2011 to 2012. Measures: Total minutes of walking for travel or leisure, attitude toward walking, and perceptions of the neighborhood environments were self-reported. Street Smart (SS) Walk Score (a measure of walkability derived from a variety of geographic data) was obtained for each residential location. Analysis: Linear regression models adjusting for age, gender, race/ethnicity, education, and income. Results: Attitude toward walking was positively associated with walking for both purposes. Walking for travel was significantly associated with SS Walk Score, whereas walking for leisure was not. The SS Walk Score and selected perceived environment characteristics were associated with walking in people with a very positive attitude toward walking but were not associated with walking in people with a less positive attitude. Conclusion: Attitudes toward walking and neighborhood environments interact to affect walking behavior.

We used an agent-based model to examine the impact of the walking school bus (WSB) on children’s active travel to school. We identified a synergistic effect of the WSB with other intervention components such as an educational campaign designed to improve attitudes toward active travel to school. Results suggest that to maximize active travel to school, children should arrive on time at “bus stops” to allow faster WSB walking speeds. We also illustrate how an agent-based model can be used to identify the location of routes maximizing the effects of the WSB on active travel. Agent-based models can be used to examine plausible effects of the WSB on active travel to school under various conditions and to identify ways of implementing the WSB that maximize its effectiveness.