Wilhelm April K, Kingsbury John H, Eisenberg Marla E, Shyne Michael, Helgertz Sharrilyn, Borowsky Iris W
Department of Pediatrics, Division of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, MN, USA.
Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
Nicotine Tob Res. 2022 Mar 1;24(4):478-483. doi: 10.1093/ntr/ntab200.
Tobacco 21 (T21) policies have shown promise in reducing cigarette use among adolescents. This study examined whether local T21 policies affected adolescent use of a variety of tobacco products and whether results differed by grade level.
We used repeated cross-sectional data from eighth, ninth, and eleventh-grade respondents to the 2016 (n = 107 981) and 2019 (n = 102 196) Minnesota Student Surveys. Generalized estimating equations modeled eight adolescent tobacco use outcomes in 2019 (past 30-day use of any tobacco, cigarettes, cigars, e-cigarettes, hookah, chewing tobacco, flavored tobacco, and multiple products) by T21 exposure, defined as respondents' attendance at a school within a jurisdiction with T21 policy implementation between the two surveys. Models controlled for demographic characteristics and product-specific baseline tobacco use at the school level in 2016 and were stratified by grade.
After adjusting for baseline tobacco use and other demographics, T21-exposed eighth and ninth-grade students had significantly lower odds of tobacco use than unexposed peers in five of eight models, i.e. any tobacco (aOR = 0.80, 95% CI: 0.74, 0.87), cigarettes (aOR = 0.81, 95% CI: 0.67, 0.99), e-cigarettes (aOR = 0.78, 95% CI: 0.71, 0.85), flavored tobacco (aOR = 0.79, CI: 0.70, 0.89), and dual/poly tobacco (aOR = 0.77, 95% CI: 0.65, 0.92). T21-exposed eleventh-grade students did not differ significantly in their odds of any tobacco use outcomes relative to their unexposed peers.
T21 exposure is associated with lower odds of multiple forms of tobacco use, particularly among younger adolescent populations, supporting the implementation of T21 policies to reduce tobacco use in this population.
21岁及以上购烟限制政策（T21）在减少青少年吸烟方面已初见成效。本研究调查了地方T21政策是否会影响青少年对各种烟草制品的使用，以及结果是否因年级不同而有所差异。
我们使用了2016年（n = 107981）和2019年（n = 102196）明尼苏达学生调查中八年级、九年级和十一年级受访者的重复横断面数据。广义估计方程通过T21暴露情况对2019年青少年的八种烟草使用结果进行建模（过去30天内使用过任何烟草、香烟、雪茄、电子烟、水烟、嚼烟、调味烟草以及多种烟草制品），T21暴露定义为受访者就读于在两次调查期间实施了T21政策的辖区内的学校。模型对2016年学校层面的人口统计学特征和特定产品的基线烟草使用情况进行了控制，并按年级分层。
在对基线烟草使用情况和其他人口统计学因素进行调整后，在八个模型中的五个模型中，接触T21政策的八年级和九年级学生使用烟草的几率显著低于未接触的同龄人，即任何烟草（调整后比值比[aOR]=0.80，95%置信区间[CI]：0.74，0.87）、香烟（aOR = 0.81，95% CI：0.67，0.99）、电子烟（aOR = 0.78，95% CI：0.71，0.85）、调味烟草（aOR = 0.79，CI：0.70，0.89）以及双重/多种烟草使用（aOR = 0.77，95% CI：0.65，0.92）。接触T21政策的十一年级学生在任何烟草使用结果方面的几率与未接触的同龄人相比没有显著差异。
接触T21政策与多种形式烟草使用几率较低相关，尤其是在较年轻的青少年人群中，这支持实施T21政策以减少该人群的烟草使用。
