最低法定年龄法律与加拿大、英国和美国青少年对香烟、电子烟和其他物质的感知获取：2017-2021 年。
Minimum legal age laws and perceived access to cigarettes, e-cigarettes, and other substances among youth in Canada, England, and the United States: 2017-2021.
机构信息
School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1.
Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY 14263, USA.
出版信息
Int J Drug Policy. 2023 May;115:104003. doi: 10.1016/j.drugpo.2023.104003. Epub 2023 Mar 23.
BACKGROUND
Minimum legal age (MLA) restrictions are a core policy to reduce youth use of tobacco, e-cigarettes, and other substances. We examined trends in perceived ease of access to tobacco and other substances across three countries with differing MLA policies, including the United States (US), which increased the federal MLA for tobacco products from 18 to 21 in 2019.
METHODS
Repeat cross-sectional data were analyzed from seven waves of the International Tobacco Control (ITC) Youth Tobacco and Vaping Survey conducted between 2017 and 2021. Online surveys were conducted with non-probability samples of 91,647 youth aged 16-19 in Canada, England, and the US. Regression models were used to examine differences in perceived ease of accessing each of 7 substances (analyzed as "very easy" or "fairly easy" versus else), and differences between countries and over time (including before and after any MLA changes) for cigarettes, e-cigarettes, cannabis, and alcohol; additional models examined sub-national variation in MLA.
RESULTS
Perceived access varied by substance and across countries: in August/September 2021, perceived ease of accessing cigarettes and e-cigarettes was greater in Canada where MLA was 18-19 (61.7% cigarettes, 66.4% e-cigarettes) and England where MLA was 18 (66.9%, 69.6%), compared to the US where MLA was 21 (48.0%, 60.9%; p < 0.001 for all). Perceived ease of accessing cannabis was greatest in Canada (53.3%), followed by the US (44.1%) and England (34.0%; p < 0.001 for all). Following the federal MLA increase for tobacco products in the US, perceived ease of access decreased significantly for cigarettes (65.1% in 2019 to 59.7% in 2020; aOR=0.80 (95%CI=0.71-0.89)) and e-cigarettes (72.4% in 2019 to 69.4% in 2020; aOR=0.87 (95%CI=0.77-0.98)).
CONCLUSIONS
Higher MLA was strongly associated with fewer youth perceiving easy access to substances: perceived access varied between countries with differing MLA, as well as within-country before and after changes to MLA.
背景
最低法定年龄（MLA）限制是减少青少年使用烟草、电子烟和其他物质的核心政策。我们研究了三个国家在不同的 MLA 政策下，烟草和其他物质的可及性感知趋势，这三个国家包括美国，美国在 2019 年将联邦烟草产品 MLA 从 18 岁提高到 21 岁。
方法
对 2017 年至 2021 年期间进行的七轮国际烟草控制（ITC）青年烟草和电子烟调查的重复横断面数据进行了分析。在线调查是对加拿大、英国和美国的 91647 名 16-19 岁的非概率青少年样本进行的。回归模型用于检验对 7 种物质（分析为“非常容易”或“相当容易”与其他）的每种物质的可及性感知差异，以及不同国家和不同时间（包括任何 MLA 变化之前和之后）的香烟、电子烟、大麻和酒精的差异；此外的模型还检验了 MLA 的次国家差异。
结果
不同物质和国家的可及性感知存在差异：2021 年 8 月/9 月，加拿大（MLA 为 18-19 岁）和英国（MLA 为 18 岁）的青少年认为更容易获得香烟和电子烟，而美国（MLA 为 21 岁）则较低，在加拿大（61.7%的香烟，66.4%的电子烟）和英国（66.9%，69.6%），而美国（48.0%，60.9%；所有差异均 p<0.001）。大麻的可及性感知在加拿大最高（53.3%），其次是美国（44.1%）和英国（34.0%；所有差异均 p<0.001）。在美国提高烟草产品的联邦 MLA 后，香烟（2019 年为 65.1%，2020 年为 59.7%；aOR=0.80（95%CI=0.71-0.89））和电子烟（2019 年为 72.4%，2020 年为 69.4%；aOR=0.87（95%CI=0.77-0.98））的可及性感知显著下降。
结论
较高的 MLA 与青少年对物质的可及性感知减少密切相关：不同 MLA 国家之间以及 MLA 变化前后的国家内部的可及性感知存在差异。
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