Department of Clinical Pharmacy, School of Pharmacy, University of California San Francisco, San Francisco, California, United States of America.
Center for Health Analytics, Media, and Policy, RTI International, Berkeley, California, United States of America.
PLoS One. 2021 Feb 11;16(2):e0246321. doi: 10.1371/journal.pone.0246321. eCollection 2021.
Cigarette smoking patterns vary within the population, with some individuals remaining never smokers, some remaining occasional users, and others progressing to daily use or quitting. There is little research on how population-level tobacco control policy interventions affect individuals within different smoking trajectories. We identified associations between tobacco control policy interventions and changes across different smoking trajectories among adolescents and young adults. Using 15 annual waves of data drawn from the National Longitudinal Survey of Youth 1997 (NLSY97), we applied a group-based trajectory model to identify associations between days smoked per month, comprehensive smoke-free laws, cigarette tax rates, and known socio-demographic risk factors for membership in different smoking trajectories. Comprehensive smoke-free laws were associated with reduced risk of initiation and reductions in days smoked per month for all trajectories other than occasional users. Higher tax rates were associated with reduced risk of initiation and days smoked for all trajectories other than established users. Overall, population-based tobacco control policies, particularly comprehensive smoke-free laws, were associated with reduced smoking. Tobacco taxes primarily reduced risk of initiation and use among never smokers, experimenters, and quitters, consistent with previous research suggesting that tobacco manufacturers lower prices after tax increases to reduce the cost of continued smoking for established users. These results provide support for expanding smoke-free laws and establishing a minimum tobacco floor price, which could improve public health by reducing the risk of initiation as well as use among occasional and established smokers.
吸烟模式在人群中存在差异,有些个体始终不吸烟,有些个体偶尔吸烟,而有些个体则进展为每日吸烟或戒烟。关于人口层面的烟草控制政策干预如何影响不同吸烟轨迹中的个体,研究甚少。我们确定了烟草控制政策干预与青少年和年轻人不同吸烟轨迹之间变化的关联。我们使用来自国家青年纵向调查 1997 年(NLSY97)的 15 个年度数据波,应用基于群组的轨迹模型,确定了每月吸烟天数、全面无烟法律、香烟税率与不同吸烟轨迹中已知社会人口风险因素之间的关联。全面无烟法律与减少初始吸烟风险和除偶尔吸烟者以外的所有轨迹的每日吸烟量减少有关。更高的税率与除固定用户以外的所有轨迹的初始吸烟风险和每日吸烟量减少有关。总体而言,基于人群的烟草控制政策,特别是全面无烟法律,与吸烟减少有关。烟草税主要降低了从不吸烟者、实验者和戒烟者的初始吸烟风险和吸烟量,这与先前的研究一致,即烟草制造商在增税后降低价格,以降低固定用户继续吸烟的成本。这些结果为扩大无烟法律和建立最低烟草底价提供了支持,这可以通过降低偶尔吸烟者和固定吸烟者的初始吸烟风险以及使用量来改善公共卫生。