Division of Health Policy and Management, Department of Public Health Sciences, University of California Davis, Davis, CA, United States.
Division of Biostatistics, Department of Public Health Sciences, University of California Davis, Davis, CA, United States.
Prev Med. 2021 Jul;148:106553. doi: 10.1016/j.ypmed.2021.106553. Epub 2021 Apr 18.
In June 2016, California implemented a Tobacco 21 (T21) policy that increased the minimum sale age of tobacco products from 18 to 21. This study examined the association between California's T21 policy and smoking behavior (ever, current, daily, and nondaily) in 18-20 year-olds using data from the 2012-2019 Behavioral Risk Factor Surveillance System (n = 15,863). The annual change in odds of smoking among 18-20 year-olds post-policy (July 2016-December 2019) was compared with the pre-policy period (January 2012 - June 2016) 1) within California and 2) compared with states without a T21 policy. As a sensitivity analysis, 21-23 year-olds in California were used as the referent. Difference-in-difference estimates (D-I-D) were calculated using adjusted logistic regression and compared the post to pre-policy change in trends in California to the referent groups. Before California's T21 policy, there was an 11% annual decrease in the odds of ever smoking among 18-20 year-olds in California and a 6% decrease in the referent states. After the policy, these trends did not change significantly. Results for current smoking were similar. For daily smoking, there was an 8% annual decrease before the policy and a 26% annual decrease after the policy among 18-20 year-olds in California; D-I-D estimates were 0.80 (95% CI: 0.57, 1.14) using referent states as the comparison and 0.62 (95% CI: 0.41, 0.95) using 21-23 year-olds in California as the comparison. There was an association between California's T21 policy and a decrease in daily smoking among 18-20 year-olds, compared with 21-23 year-olds, more than three years post-implementation.
2016 年 6 月，加利福尼亚州实施了一项烟草 21 （T21）政策，将烟草产品的最低销售年龄从 18 岁提高到 21 岁。本研究使用 2012-2019 年行为风险因素监测系统的数据（n=15863），研究了加利福尼亚州 T21 政策与 18-20 岁青少年吸烟行为（曾吸烟、当前吸烟、每日吸烟和非每日吸烟）之间的关联。政策后（2016 年 7 月至 2019 年 12 月），与政策前（2012 年 1 月至 2016 年 6 月）相比，1）加利福尼亚州内和 2）与没有 T21 政策的州相比，18-20 岁青少年吸烟的几率每年变化情况。作为敏感性分析，将加利福尼亚州 21-23 岁青少年作为参照组。使用调整后的逻辑回归计算差异-差异估计值（D-I-D），比较加利福尼亚州政策前后吸烟趋势的变化与参照组。在加利福尼亚州 T21 政策实施之前，18-20 岁青少年中曾吸烟的几率每年下降 11%，而参照州则下降 6%。在该政策之后，这些趋势并没有显著变化。当前吸烟的结果相似。对于每日吸烟，在该政策之前，18-20 岁青少年中每年下降 8%，而在该政策之后，每年下降 26%；使用参照州作为比较，D-I-D 估计值为 0.80（95%CI：0.57，1.14），使用加利福尼亚州 21-23 岁青少年作为比较，D-I-D 估计值为 0.62（95%CI：0.41，0.95）。加利福尼亚州 T21 政策的实施与 18-20 岁青少年每日吸烟率的下降有关，与 21-23 岁青少年相比，这一关联在实施三年多后显现出来。
