Tobacco 21 laws may reduce smoking and tobacco-related health disparities among youth in the U.S

David C Colston; Yanmei Xie; Megan E Patrick; James F Thrasher; Andrea R Titus; Michael R Elliott; David T Levy; Nancy L Fleischer

doi:10.1016/j.pmedr.2022.101762

Tobacco 21 laws may reduce smoking and tobacco-related health disparities among youth in the U.S

Prev Med Rep. 2022 Mar 19:27:101762. doi: 10.1016/j.pmedr.2022.101762. eCollection 2022 Jun.

Authors

David C Colston¹, Yanmei Xie^{1

2}, Megan E Patrick³, James F Thrasher^{4

5}, Andrea R Titus⁶, Michael R Elliott^{7

8}, David T Levy⁹, Nancy L Fleischer¹

Affiliations

¹ Department of Epidemiology, Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
² Biostatistics Core of the Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.
³ Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
⁴ Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
⁵ Department of Tobacco Research, Center for Population Health Research National Institute of Public Health, Cuernavaca, Mexico.
⁶ Department of Population Health, NYU Langone School of Medicine, New York, NY, USA.
⁷ Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
⁸ Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
⁹ Lombardi Cancer Center, Georgetown University, Washington, DC, USA.

Abstract

The goal of our study is to understand the impact of Tobacco 21 (T21) laws on youth smoking and health equity. We conducted modified Poisson regression models using 2014-2019 Monitoring the Future data to measure the impact of attending school in a county 100% covered by a T21 law versus counties with <100% T21 coverage on past 30-day smoking participation (n = 262,632), first cigarette smoking initiation (n = 189,698), and daily smoking initiation among 8th, 10th, and 12th graders (n = 214,496), separately. Additive interactions were tested between T21 coverage and sex, race/ethnicity, parental education, and college plans. T21 coverage was associated with a lower likelihood of smoking participation among 12th graders. T21 coverage was most strongly associated with a lower likelihood of smoking participation among: Hispanic and NH (Non-Hispanic) Other/Multiracial individuals; respondents with parents who had less than a college education; and respondents who were not definitely planning on attending college. T21 laws were associated with a lower likelihood of smoking participation among 12th graders. T21 policies were most impactful for individuals disproportionately impacted by tobacco, indicating T21 laws might help reduce tobacco-related health disparities.

Abstract

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