Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and.
Colorado School of Public Health, University of Colorado Anschutz Medical Center, Aurora, Colorado.
Pediatrics. 2019 Feb;143(2). doi: 10.1542/peds.2017-3536. Epub 2019 Jan 7.
Restricting youth access to tobacco is a central feature of US tobacco regulatory policy, but impact of local tobacco retail licensing (TRL) regulation on cigarette smoking rates remains uncertain. Effects of TRL on other tobacco product use and use as adolescents reach the age to legally purchase tobacco products has not been investigated.
Prevalences of ever and past 30-day cigarette, electronic cigarette (e-cigarette), cigar, and hookah use were assessed in a survey of a cohort of 1553 11th- and 12th-grade adolescents (mean age: 17.3 years); rates of initiation were evaluated 1.5 years later. An American Lung Association (2014) youth access grade was assigned to each of 14 political jurisdictions in which participants lived on the basis of the strength of the local TRL ordinance.
At baseline, participants living in 4 jurisdictions with "A" grades (ie, with most restrictive ordinances) had lower odds of ever cigarette use (odds ratio [OR] 0.61; 95% confidence interval [CI] 0.41-0.90) and of past 30-day use (OR 0.51; 95% CI 0.29-0.89) than participants in 10 D- to F-grade jurisdictions. At follow-up at legal age of purchase, lower odds of cigarette use initiation (OR 0.67; 95% CI 0.45-0.99) occurred in jurisdictions with stronger TRL policy. Lower odds of e-cigarette initiation at follow-up (OR 0.74; 95% CI 0.55-0.99) and of initiation with past 30-day use (OR 0.45; 95% CI 0.23-0.90) were also associated with better regulation.
Strong local TRL ordinance may lower rates of cigarette and e-cigarette use among youth and young adults.
限制青少年接触烟草是美国烟草监管政策的核心特征,但地方烟草零售许可(TRL)法规对香烟吸烟率的影响仍不确定。TRL 对其他烟草制品使用的影响,以及青少年达到合法购买烟草产品年龄时的使用情况尚未得到调查。
在对 1553 名 11 至 12 年级青少年(平均年龄 17.3 岁)的队列进行调查中,评估了以往和过去 30 天内吸烟、电子烟(电子烟)、雪茄和水烟的使用情况;1.5 年后评估了起始率。根据参与者居住的 14 个政治司法管辖区的当地 TRL 条例的力度,为每个司法管辖区分配了美国肺脏协会(2014 年)的青少年准入等级。
在基线时,居住在 4 个 A 级司法管辖区(即具有最严格条例的司法管辖区)的参与者,以往吸烟(比值比 [OR] 0.61;95%置信区间 [CI] 0.41-0.90)和过去 30 天内吸烟(OR 0.51;95% CI 0.29-0.89)的可能性低于 10 个 D 至 F 级司法管辖区的参与者。在购买年龄的随访中,在 TRL 政策较强的司法管辖区,吸烟起始的可能性降低(OR 0.67;95% CI 0.45-0.99)。在随访中,电子烟起始的可能性降低(OR 0.74;95% CI 0.55-0.99)和过去 30 天内使用电子烟的起始可能性降低(OR 0.45;95% CI 0.23-0.90)也与更好的监管相关。
强有力的地方 TRL 条例可能会降低青少年和年轻人的香烟和电子烟使用率。