Tobacco Retail Licensing and Youth Product Use

• Published in: Pediatrics (Evanston) 2019-02, Vol.143 (2), p.1
• Main Authors: Astor, Roee L, Urman, Robert, Barrington-Trimis, Jessica L, Berhane, Kiros, Steinberg, Jane, Cousineau, Michael, Leventhal, Adam M, Unger, Jennifer B, Cruz, Tess, Pentz, Mary Ann, Samet, Jonathan M, McConnell, Rob
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Age; Cigarette smoking; Cohort Studies; Commerce - economics; Commerce - legislation & jurisprudence; Electronic cigarettes; Electronic Nicotine Delivery Systems - economics; Female; Follow-Up Studies; Humans; Licensing; Licensing, certification and accreditation; Licensure - economics; Licensure - legislation & jurisprudence; Lungs; Male; Ordinances; Pediatrics; Smoking; Smoking Water Pipes - economics; Surveys; Tobacco; Tobacco products; Tobacco Products - economics; Tobacco Products - legislation & jurisprudence; Vaping - economics; Vaping - epidemiology; Vaping - legislation & jurisprudence; Young adults
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2017-3536

Restricting youth access to tobacco is a central feature of US tobacco regulatory policy, but impact of local tobacco retail licensing (TRL) regulation on cigarette smoking rates remains uncertain. Effects of TRL on other tobacco product use and use as adolescents reach the age to legally purchase tobacco products has not been investigated. Prevalences of ever and past 30-day cigarette, electronic cigarette (e-cigarette), cigar, and hookah use were assessed in a survey of a cohort of 1553 11th- and 12th-grade adolescents (mean age: 17.3 years); rates of initiation were evaluated 1.5 years later. An American Lung Association (2014) youth access grade was assigned to each of 14 political jurisdictions in which participants lived on the basis of the strength of the local TRL ordinance. At baseline, participants living in 4 jurisdictions with "A" grades (ie, with most restrictive ordinances) had lower odds of ever cigarette use (odds ratio [OR] 0.61; 95% confidence interval [CI] 0.41-0.90) and of past 30-day use (OR 0.51; 95% CI 0.29-0.89) than participants in 10 D- to F-grade jurisdictions. At follow-up at legal age of purchase, lower odds of cigarette use initiation (OR 0.67; 95% CI 0.45-0.99) occurred in jurisdictions with stronger TRL policy. Lower odds of e-cigarette initiation at follow-up (OR 0.74; 95% CI 0.55-0.99) and of initiation with past 30-day use (OR 0.45; 95% CI 0.23-0.90) were also associated with better regulation. Strong local TRL ordinance may lower rates of cigarette and e-cigarette use among youth and young adults.