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Area-Level Predictors of Tobacco 21 Coverage in the U.S. Before the National Law: Exploring Potential Disparities

  • David C. Colston
    Correspondence
    Address correspondence to: David C. Colston, MPH, Department of Epidemiology, Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor MI 48109.
    Affiliations
    Department of Epidemiology, Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, Michigan
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  • Andrea R. Titus
    Affiliations
    Department of Epidemiology, Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, Michigan
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  • James F. Thrasher
    Affiliations
    Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
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  • Michael R. Elliott
    Affiliations
    Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan

    Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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  • Nancy L. Fleischer
    Affiliations
    Department of Epidemiology, Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, Michigan
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Published:November 04, 2020DOI:https://doi.org/10.1016/j.amepre.2020.06.026

      Introduction

      The goal of the paper is to characterize the geographic and sociodemographic patterns of policies prohibiting tobacco sales to people aged <21 years (i.e., Tobacco 21) at the local, county, and state levels in the U.S. before the national law.

      Methods

      This study assessed area-level markers for region, race/ethnicity, education, poverty status, and smoke-free law coverage as predictors of Tobacco 21 passage as of December 20, 2019, using modified Poisson and negative binomial regression models with robust SEs. Data were analyzed in 2020.

      Results

      Before the passage of the national policy, 191 million people were covered by Tobacco 21 laws. Counties with higher percentages of non-Hispanic Blacks and individuals living below the poverty line had a lower probability of coverage, whereas counties with higher percentages of Hispanics/Latinxs and individuals with a college degree had a higher probability of coverage. Tobacco 21 coverage also varied by region, with far greater coverage in the Northeast than in the Midwest and South.

      Conclusions

      The national Tobacco 21 law may address disparities in coverage by SES, race/ethnicity, and region that could have lasting implications with regard to health equity.
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      REFERENCES

        • National Center for Chronic Disease Prevention and Health Promotion (U.S.) Office on Smoking and Health
        The health consequences of smoking—50 years of progress: a report of the surgeon general.
        Centers for Disease Control and Prevention (U.S.), Atlanta, GAPublished 2014 (Accessed XXX)
        • Institute of Medicine
        Public health implications of raising the minimum age of legal access to tobacco Products.
        The National Academies Press, Washington, DC2015
        • Winickoff JP
        • McMillen R
        • Tanski S
        • Wilson K
        • Gottlieb M
        • Crane R
        Public support for raising the age of sale for tobacco to 21 in the United States.
        Tob Control. 2016; 25: 284-288
        • King BA
        • Jama AO
        • Marynak KL
        • Promoff GR
        Attitudes toward raising the minimum age of sale for tobacco among U.S. adults.
        Am J Prev Med. 2015; 49: 583-588
        • Lee JGL
        • Boynton MH
        • Richardson A
        • Jarman K
        • Ranney LM
        • Goldstein AO
        Raising the legal age of tobacco sales: policy support and trust in government, 2014-2015, U.S.
        Am J Prev Med. 2016; 51: 910-915
        • Friedman AS
        • Buckell J
        • Sindelar JL
        Tobacco‐21 laws and young adult smoking: quasi‐experimental evidence.
        Addiction. 2019; 114: 1816-1823
        • Friedman AS
        • Wu RJ
        Do local tobacco-21 laws reduce smoking among 18 to 20 year-olds.
        Nicotine Tob Res. 2020; 22: 1195-1201
        • Kessel Schneider S
        • Buka SL
        • Dash K
        • Winickoff JP
        • O'Donnell L
        Community reductions in youth smoking after raising the minimum tobacco sales age to 21.
        Tob Control. 2016; 25: 355-359
        • Public Law: Further Consolidated Appropriations Act
        2020, H.R. 1865 § 603 et. Seq.
        2019 (Accessed XXX)
        • U.S. National Cancer Institute
        A Socioecological Approach to Addressing Tobacco-Related Health Disparities. National Cancer Institute Tobacco Control Monograph 22. NIH Publication No. 17-CA-8035A.
        HHS, NIH, National Cancer Institute, Bethesda, MDPublished 2017 (Accessed XXX)
        • Delnevo CD
        • Hrywna M
        • Lewis MJ
        Predictors of smoke-free workplaces by employee characteristics: who is left unprotected?.
        Am J Ind Med. 2004; 46: 196-202
        • Cook DM
        • Lee WL
        • Yang W
        Factors associated with total restrictions on smoking at work and at home: a study among populations in multiple U.S. states and the U.S. Virgin Islands.
        Int J Occup Environ Health. 2009; 15: 392-401
        • Ferketich AK
        • Liber A
        • Pennell M
        • Nealy D
        • Hammer J
        • Berman M
        Clean indoor air ordinance coverage in the Appalachian region of the United States.
        Am J Public Health. 2010; 100: 1313-1318
        • Gonzalez M
        • Sanders-Jackson A
        • Song AV
        • K-w Cheng
        • Glantz SA
        Strong smoke-free law coverage in the United States by race/ethnicity 2000-2009.
        Am J Public Health. 2013; 103: e62-e66
      1. T21 cities as of Dec 31, 2019. University of Missouri Tobacco Control Research Center; 2019. https://drive.google.com/file/d/1ui41tABh6hV7EoEiycdWNsVA19do6Mlv/view. Updated January 2. Accessed August 3, 2020.

      2. City and Town population totals: 2010–2018: subcounty resident population estimates: April 1, 2010 to July 1, 2018 (SUB-EST2018). United States Census Bureau.https://www.census.gov/data/tables/time-series/demo/popest/2010s-total-cities-and-towns.html. Updated 2019. Accessed January 2, 2020

      3. American Community Survey. ACS demographic and housing estimates. United States Census Bureau.https://data.census.gov/cedsci/table?q=dp05&hidePreview=true&table=DP05&tid=ACSDP5Y2018.DP05&lastDisplayedRow=25&vintage=2018. Updated 2018. Accessed August 3, 2020.

      4. American community survey. Poverty status in the past 12 months. United States Census Bureau.https://data.census.gov/cedsci/table?q=s1701&table=S1701&tid=ACSST5Y2018.S1701&lastDisplayedRow=24&vintage=2018&hidePreview=false&g=. Updated 2018. Accessed August 3, 2020.

      5. American community survey. Educational attainment. United States Census Bureau.https://data.census.gov/cedsci/table?q=s1501&g=&table=S1501&tid=ACSST5Y2018.S1501&lastDisplayedRow=67&vintage=2018. Updated 2018. Accessed August 3, 2020.

      6. Tobacco control laws database: a tool for researchers. American Nonsmokers’ Rights Foundation.https://no-smoke.org/tobacco-control-laws-database-tool-researchers/. Updated March 5, 2018. Accessed July 16, 2020.

      7. U.S. Census Bureau; U.S. Department of Commerce; Economics and Statistics Administration. Census regions and divisions of the United States. Suitland-Silver Hill, MD: U.S. Census Bureau; U.S. Department of Commerce; Economics and Statistics Administration.https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf. Published September 16, 2016. Accessed January 28, 2020.

        • Zou G.
        A modified Poisson regression approach to prospective studies with binary data.
        Am J Epidemiol. 2004; 159: 702-706
        • Barros AJ
        • Hirakata VN.
        Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio.
        BMC Med Res Methodol. 2003; 3: 21
        • Donahoe JT
        • Titus AR
        • Fleischer NL
        Key factors inhibiting legislative progress toward smoke-free coverage in Appalachia.
        Am J Public Health. 2018; 108: 372-378
        • Bartosch WJ
        • Pope GC.
        Local enactment of tobacco control policies in Massachusetts.
        Am J Public Health. 2002; 92: 941-943
        • Skeer M
        • George S
        • Hamilton WL
        • Cheng DM
        • Siegel M
        Town-level characteristics and smoking policy adoption in Massachusetts: are local restaurant smoking regulations fostering disparities in health protection?.
        Am J Public Health. 2004; 94: 286-292
        • Trinidad DR
        • Pérez-Stable EJ
        • White MM
        • Emery SL
        • Messer K
        A nationwide analysis of U.S. racial/ethnic disparities in smoking behaviors, smoking cessation, and cessation-related factors.
        Am J Public Health. 2011; 101: 699-706
        • Lipperman-Kreda S
        • Grube JW
        • Friend KB
        Contextual and community factors associated with youth access to cigarettes through commercial sources.
        Tob Control. 2014; 23: 39-44
        • Harrell JS
        • Bangdiwala SI
        • Deng S
        • Webb JP
        • Bradley C
        Smoking initiation in youth: the roles of gender, race, socioeconomics, and developmental status.
        J Adolesc Health. 1998; 23: 271-279
        • Dutra LM
        • Farrelly MC
        • Nonnemaker J
        • et al.
        Differential relationship between tobacco control policies and U.S. adult current smoking by poverty.
        Int J Environ Res Public Health. 2019; 16: 4130
        • Fryar CD
        • Merino MC
        • Hirsch R
        • Porter KS
        Smoking, alcohol use, and illicit drug use reported by adolescents aged 12-17 years: United States, 1999-2004.
        Natl Health Stat Report. 2009; 15: 1-23
      8. Federal Tobacco 21: the law of the land. Tobacco 21. https://tobacco21.org/federal-tobacco-21-faq/. Updated 2020. Accessed August 3, 2020.

        • Astor RL
        • Urman R
        • Barrington-Trimis JL
        • et al.
        Tobacco retail licensing and youth product use.
        Pediatrics. 2019; 143e20173536
        • Whyte LE
        • Náñez D.
        Big Tobacco's surprising new campaign to raise the smoking age.
        The Center of Public Integrity. May 23, 2019;
        • Glenza J
        Why do e-cigarette makers suddenly want to be regulated?.
        The Guardian. September 20, 2019; (Accessed July 16, 2020)
      9. Sales of tobacco products, Chapter 262-A Subchapter 2 § 1555-B et seq.: Maine Legislature. https://legislature.maine.gov/statutes/22/title22sec1555-B.html. Accessed August 3, 2020.

      10. Prohibiting purchase or possession of tobacco products, nicotine vapor products, and alternative nicotine products by a person under 21 years of age or sale of tobacco products, nicotine vapor products, and alternative nicotine products to persons under 21 years of age, Code of Virginia. §:18.2–371.2 et seq.https://law.lis.virginia.gov/vacode/title18.2/chapter8/section18.2-371.2/. Accessed August 3, 2020.

        • Gottlieb NH
        • Loukas A
        • Corrao M
        • McAlister A
        • Snell C
        • Huang PP
        Minors’ tobacco possession law violations and intentions to smoke: implications for tobacco control.
        Tob Control. 2004; 13: 237-243
        • Berman ML.
        Raising the tobacco sales age to 21: surveying the legal landscape.
        Public Health Rep. 2016; 131: 378-381
        • Jones JM.
        Conservatives greatly outnumber liberals in 19 U.S. states.
        Gallup. 2019; (February 22.) (Accessed July 16, 2020)