State and regional gaps in coverage of ‘Tobacco 21’ policies

Leas, Eric C.; Schliecher, Nina; Recinos, Amanda; Mahoney, Margaret; Henriksen, Lisa

doi:10.1136/tobaccocontrol-2019-054942

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…We found significant inequalities in the coverage of state/local T21 by geographical distribution, rurality, demographics, SES factors, and tobacco control policies. These findings add to the growing literature 40,41 that state or local T21 policies were not uniformly adopted in the US. We further used the proxy measure of FDA retail inspections to inform potentially differential enforcement of T21 laws by region and other ecological factors.…”

Section: Discussionsupporting

confidence: 60%

Geographical distribution and social determinants of Tobacco 21 policy adoption and retail inspections in the United States, 2015–2019

Dai¹,

Tamrakar²,

Rathnayake³

et al. 2021

Tob. Induc. Dis.

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of tobacco product retailers have led to a decrease in the prevalence of youth buying cigarettes in a store [3][4][5] . However, social access to cigarettes has been increasing, with strong evidence indicating that youth aged <18 years can obtain their cigarettes from friends and young adults aged 18-20 years [6][7][8] .In 2015, the Institute of Medicine (IOM) examined existing literature on tobacco use initiation and ABSTRACT INTRODUCTION Tobacco control laws that raise the minimum age of tobacco sales to 21 years (T21) play a pivotal role in youth tobacco prevention, yet empirical data are sorely needed to inform enforcement, compliance efforts, and future legislation. METHODS Spatial analysis was conducted at the zip code level by geocoding the states and localities that adopted T21 ordinances from 2015 to 2019. A multi-level logistic regression model was conducted to examine disparities in neighborhood socioeconomic status (SES), FDA retail inspection, and state-level tobacco control policies associated with T21 adoption. RESULTS T21 adoption at the state and local level increased considerably from 1.4% of zip codes in 2015 to 40.2% in 2019. However, the T21 ordinances were disproportionally adopted in New England (82.6%) and Pacific (73.6%) regions with scarce coverage in East South Central (<0.1%), Mountain (1.6%), and West North Central regions (6.1%). The T21 policies were more likely to be adopted in areas with stronger tobacco control policies, urban areas (vs rural, adjusted odds ratio, AOR=1.25, p=0.005), areas with a larger Hispanic (AOR=1.19, p<0.0001) or Asian population (AOR=1.12, p<0.0001), and in areas where the population had higher levels of education (AOR=1.05, p<0.0001). It was less likely to be adopted in areas with larger proportions of American Indians, youths, and young adults. Nearly 40% of zip codes with tobacco retailers did not receive annual FDA tobacco retail inspections for underage sales in 2019. The average retail violation rate of underage sales of tobacco products in T21 regions was lower than in non-T21 regions. CONCLUSIONS Disparities in T21 adoption, retail inspections, and retail compliance may limit the policy impact. Unified enforcement of youth tobacco access restrictions with resources and interventions in vulnerable communities is needed to reduce tobacco-related health disparities.

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Section: Discussionsupporting

confidence: 60%

Geographical distribution and social determinants of Tobacco 21 policy adoption and retail inspections in the United States, 2015–2019

Dai¹,

Tamrakar²,

Rathnayake³

et al. 2021

Tob. Induc. Dis.

View full text Add to dashboard Cite

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“…Comprehensive tobacco control programs that reach both college attenders and non-attenders should be applied in all state and local jurisdictions (U.S. Department of Health and Human Services, 2014). Increasing the minimum age of tobacco sales to 21 could reduce both youth and young adult tobacco use regardless of college attendance; however, coverage of this policy remains low (Leas et al, 2019). Targeted interventions that focus on places where nonattending populations congregate should become a programmatic focus.…”

Section: Discussionmentioning

confidence: 99%

The effect of college attendance on young adult cigarette, e-cigarette, cigarillo, hookah and smokeless tobacco use and its potential for addressing tobacco-related health disparities

Leas

Trinidad

Pierce

et al. 2020

Preventive Medicine

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The goal of this study was to assess the effect of college attendance on tobacco use among young adults and across subpopulations with disparities in tobacco use. Using a cohort of US youth (< 18 years) who aged into young adulthood (18-24 years) in the Population Assessment of Tobacco and Health (2013-14, 2015-16, n = 3619) and propensity score matching we estimated the effect of college attendance on past 30-day use of cigarettes, e-cigarettes, cigarillos, hookah and smokeless tobacco. In unmatched analysis, college attenders (vs. nonattenders) had lower risk of using any form of tobacco (Risk Difference (RD): −10.

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“…Lacking a federal Tobacco 21 law, states and local jurisdictions have passed legislation, with regional differences in coverage. As of January 2019, most U.S. residents aged 18 to 20 were not covered by a Tobacco 21 policy, with the largest gaps in coverage in the South ( 195 ). As of 1 June 2019, 14 states and >400 local jurisdictions have passed Tobacco 21 legislation; 16 of the non-adopting states preempt lower levels of government from implementing these regulations.…”

Section: Tobacco Control Population-based and Policy Approachesmentioning

confidence: 99%

Current advances in research in treatment and recovery: Nicotine addiction

2019

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The health harms of combusted tobacco use are undeniable. With market and regulatory pressures to reduce the harms of nicotine delivery by combustion, the tobacco product landscape has diversified to include smokeless, heated, and electronic nicotine vaping products. Products of tobacco combustion are the main cause of smokinginduced disease, and nicotine addiction sustains tobacco use. An understanding of the biology and clinical features of nicotine addiction and the conditioning of behavior that occurs via stimuli paired with frequent nicotine dosing, as with a smoked cigarette, is important for informing pharmacologic and behavioral treatment targets. We review current advances in research on nicotine addiction treatment and recovery, with a focus on conventional combustible cigarette use. Our review covers evidence-based methods to treat smoking in adults and policy approaches to prevent nicotine product initiation in youth. In closing, we discuss emerging areas of evidence and consider new directions for advancing the field.

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State and regional gaps in coverage of ‘Tobacco 21’ policies

Cited by 7 publications

References 5 publications

Geographical distribution and social determinants of Tobacco 21 policy adoption and retail inspections in the United States, 2015–2019

Geographical distribution and social determinants of Tobacco 21 policy adoption and retail inspections in the United States, 2015–2019

The effect of college attendance on young adult cigarette, e-cigarette, cigarillo, hookah and smokeless tobacco use and its potential for addressing tobacco-related health disparities

Current advances in research in treatment and recovery: Nicotine addiction

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