Alesci Nina L, Forster Jean L, Erickson Darin J
Division of Epidemiology & Community Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, USA.
Nicotine Tob Res. 2009 Oct;11(10):1196-204. doi: 10.1093/ntr/ntp124. Epub 2009 Jul 24.
No previous studies document the effects of both comprehensive tobacco control and its defunding on youth smoking. This study tests the effect of the youth-focused Minnesota Youth Tobacco Prevention Initiative (MYTPI) and its shutdown on youth smoking and determines whether these effects differed by age.
The Minnesota Adolescent Community Cohort is a population-based, observational study designed to evaluate the MYTPI. The sample included cohorts of youth aged 12-16 years at baseline in Minnesota (N = 3,636) and a comparison group in six other Midwestern states (n = 605). Biannual surveys assessed youth smoking from October 2000, 5 months after the MYTPI launch, through October 2005, 2 years postshutdown. Adjusted piecewise linear trajectories predicted smoking stage (measured on a 1-6 continuum) comparing Minnesota with a comparison group during the MYTPI (Slope 1) and postshutdown (Slope 2) for each baseline age cohort. Analysis then compared baseline age cohorts with each other by centering their intercepts on age 16.
Neither slope of smoking stage differed between Minnesota and comparison groups, showing no period effects for the MYTPI or shutdown. However, younger cohorts, with early teen experience of MYTPI, smoked less than older cohorts by the same age. Mean smoking stage at age 16 differed by almost a half stage from the youngest (2.04) to the oldest (2.46) age cohort.
The study offers no evidence of period effects for the MYTPI or its shutdown. Design limitations, national or continued post-MYTPI statewide tobacco control efforts, or program flaws could explain the findings.
以往尚无研究记录全面烟草控制及其资金削减对青少年吸烟的影响。本研究测试了以青少年为重点的明尼苏达青少年烟草预防倡议（MYTPI）及其终止对青少年吸烟的影响，并确定这些影响是否因年龄而异。
明尼苏达青少年社区队列是一项基于人群的观察性研究，旨在评估MYTPI。样本包括明尼苏达州基线时年龄在12 - 16岁的青少年队列（N = 3636）以及其他六个中西部州的对照组（n = 605）。从2000年10月（MYTPI启动后5个月）至2005年10月（终止后2年），每半年进行一次调查，评估青少年吸烟情况。调整后的分段线性轨迹预测吸烟阶段（在1 - 6连续量表上测量），比较明尼苏达州与对照组在MYTPI实施期间（斜率1）和终止后（斜率2）各基线年龄队列的情况。然后通过将各基线年龄队列的截距以16岁为中心进行分析，比较彼此之间的差异。
明尼苏达州与对照组之间吸烟阶段的斜率均无差异，表明MYTPI或其终止没有阶段性影响。然而，在青少年时期有MYTPI经历的较年轻队列，到相同年龄时吸烟少于较年长队列。16岁时的平均吸烟阶段从最年轻队列（2.04）到最年长队列（2.46）相差近半个阶段。
该研究没有提供MYTPI或其终止存在阶段性影响的证据。设计局限性、全国性或MYTPI终止后全州持续的烟草控制努力，或项目缺陷可能解释了这些结果。
