School of Social Work, Boston College, Chestnut Hill, Massachusetts, USA
Department of Counseling, Developmental, and Educational Psychology, Lynch School of Education, Boston College, Chestnut Hill, Massachusetts, USA.
Tob Control. 2022 Jul;31(4):576-579. doi: 10.1136/tobaccocontrol-2020-056159. Epub 2021 Jan 27.
In the USA, many states do not pre-empt municipalities from enacting stricter tobacco-control policies than state or federal laws. Several municipalities in Massachusetts have passed progressive local laws aimed at reducing adolescent tobacco use. We exploited this variability to examine the associations between county-level flavoured tobacco product restrictions, tobacco 21 policies and smoke-free laws prohibiting e-cigarettes with adolescent cigarette and e-cigarette use in Massachusetts, and to assess whether policy effects varied by age.
We conducted difference-in-differences models to link changes in county-level tobacco-control policies to changes in adolescents' use of cigarettes and e-cigarettes using 2011-2017 biennial Massachusetts Youth Health Surveys.
Counties with greater implementation of flavoured tobacco product restrictions were associated with a decrease in the level of cigarette use among users (Coefficient -1.56; 95% CI -2.54 to -0.58). A significant interaction (p=0.03) revealed the largest reductions among 14 and 18 year olds. Increasing flavoured tobacco product restrictions were also associated with reductions in the likelihood of e-cigarette use (Coefficient -0.87; 95% CI -1.68 to -0.06). Increasing tobacco 21 restrictions were associated with decreases in cigarette use only among 18 year olds, while there was no evidence of associations between smoke-free laws with use of either tobacco product.
Adolescents in Massachusetts decreased their use of cigarettes and e-cigarettes in response to local restrictions that limited the sale of flavoured tobacco products to adult-only retail tobacco stores. Local legislation can reduce adolescent tobacco use and municipalities should enact stricter tobacco-control policies when not pre-empted by state law.
在美国，许多州并没有预先阻止地方政府制定比州或联邦法律更严格的烟草控制政策。马萨诸塞州的几个城市已经通过了旨在减少青少年烟草使用的渐进式地方法律。我们利用这种可变性来研究县级调味烟草制品限制、烟草 21 政策和禁止电子烟的无烟法律与马萨诸塞州青少年吸烟和电子烟使用之间的关联，并评估政策效果是否因年龄而异。
我们使用 2011-2017 年马萨诸塞州青少年健康调查的两年期数据，通过差异中的差异模型将县级烟草控制政策的变化与青少年吸烟和电子烟使用的变化联系起来。
实施更严格的调味烟草制品限制的县与使用者吸烟水平的降低有关（系数-1.56；95%置信区间-2.54 至-0.58）。一项显著的交互作用（p=0.03）表明，14 岁和 18 岁的青少年降幅最大。增加调味烟草制品的限制也与电子烟使用的可能性降低有关（系数-0.87；95%置信区间-1.68 至-0.06）。烟草 21 限制的增加仅与 18 岁青少年的吸烟量减少有关，而无烟法律与任何一种烟草制品的使用之间均无关联。
马萨诸塞州的青少年对限制销售调味烟草制品到成人专用零售烟草店的地方限制做出了反应，减少了他们对香烟和电子烟的使用。地方立法可以减少青少年的烟草使用，而且在不受州法律预先阻止的情况下，地方政府应该制定更严格的烟草控制政策。
