Clean Indoor Air Laws, Cigarette Taxes, and Use of Smoking Cessation Treatments

清洁室内空气法、香烟税和戒烟治疗的使用 在美国，吸烟是可预防的死亡的主要原因，美国有4200万成年人吸烟。而当 70%-85%的吸烟者在没有接受治疗的情况下戒烟，研究证实治疗是有效的，并有帮助 个人仍保持节制。非处方药、处方治疗和咨询服务是 可帮助近70%想要戒烟的吸烟者。截至2014年，患者保护和 《平价医疗法案》(ACA)为许多美国人提供了更多的戒烟治疗机会。虽然这件事 前所未有的覆盖范围提高了治疗的可得性，但它没有解决利用率问题。换句话说， 戒烟治疗的覆盖面不会有什么效果，除非吸烟者真正使用它们。然而，并不是很多 知道是什么驱使吸烟者使用这些治疗方法。因为各州和地方的资金有限， 为了在烟草控制方面投入更多资金，这些地方司法管辖区可以通过以下方式加强烟草控制工作： 成本政策的变化。如果清洁室内空气法和更高的烟草税等政策增加 通过促进戒烟治疗的使用，各州和地方可以利用 ACA对戒烟治疗的报道，通过制定或加强自己的戒烟治疗来增加戒烟 政策。几乎没有研究调查国家和地方的烟草控制政策是否相关 随着戒烟治疗的使用增加。拟议的研究将提供这一关键信息 考虑到ACA正在大幅增加戒烟治疗的可获得性，这是一个幸运的时刻。 我们建议使用州和地方烟草控制法律的数据和当前 人口调查-烟草使用补充剂(CPS-TUS)，以确定国家和地区 当地清洁的室内空气法规和香烟税可能会通过促进 与戒烟相关的卫生服务使用情况，以及这种情况在特定人群分组中是否有所不同。 我们建议：1)审查州和地方清洁室内空气法律和卷烟税与 2002/2003年和2010/2011年戒烟和治疗使用情况；2)检查是否使用 戒烟治疗调解了州和地方清洁室内空气法律和香烟税与 戒烟；以及3)检查州和地方清洁室内空气法规和 使用温和的调解模型在人群亚组中使用香烟税和戒烟治疗。 清洁室内空气法和香烟税是为数不多的低成本、人口层面的干预措施之一。 这可能会推动戒烟治疗的使用。对于缺乏清洁室内空气法规或较低的州和地区 香烟税，调查结果可能会鼓励制定或加强这些法律，以促进治疗的使用 和戒烟，利用ACA的戒烟治疗覆盖范围。研究结果也可能鼓励各州 更全面的清洁室内空气法规和更高的香烟税，以更广泛地覆盖戒烟 医疗补助下的服务，超出ACA的要求，以增强其烟草控制法律的效果。

Clean Indoor Air Laws, Cigarette Taxes, and Use of Smoking Cessation Treatments Smoking is the leading cause of preventable death in the U.S., and 42 million U.S. adults are smokers. While 70-85% of smokers who quit do so without treatment, studies confirm that treatment is effective and helps individuals remain abstinent. Over-the-counter and prescription treatments and counseling services are available to assist the nearly 70% of smokers who want to quit. As of 2014, the Patient Protection and Affordable Care Act (ACA) grants many Americans greater access to cessation treatments. While this unprecedented coverage improves treatments' availability, it does not address utilization. In other words, coverage of cessation treatments will have little effect unless smokers actually use them. Yet, not much is known about what drives smokers to use these treatments. Because states and localities have limited funds to spend on tobacco control, these sub-national jurisdictions can augment their tobacco control efforts via low- cost policy changes. If policies such as clean indoor air laws and higher tobacco taxes increase smoking cessation by promoting cessation treatment use, states and localities could capitalize on the ACA's coverage of cessation treatments to increase cessation by enacting or strengthening their own policies. Virtually no studies have investigated whether state and local tobacco control policies are associated with increased use of cessation treatments. The proposed study would provide this critical information at an auspicious time, given that the ACA is dramatically increasing the availability of cessation treatment. We propose to use data on state and local tobacco control laws and data from the Current Population Survey-Tobacco Use Supplements (CPS-TUS) to determine the extent to which state and local clean indoor air laws and cigarette taxes might increase rates of cessation by promoting cessation-related health service use, and whether this differs across specific population sub-groups. We propose to: 1) examine the association of state and local clean indoor air laws and cigarette taxes with smoking cessation and treatment use in 2002/2003 and again in 2010/2011; 2) examine whether use of cessation treatment mediates the association of state and local clean indoor air laws and cigarette taxes with smoking cessation; and 3) examine differences in the association of state and local clean indoor air laws and cigarette taxes with cessation treatment use among population sub-groups using moderated mediation models. Clean indoor air laws and cigarette taxes are among a small number of low-cost, population-level interventions that may drive use of cessation treatments. For states and localities lacking clean indoor air laws or with lower cigarette taxes, findings may encourage the creation or strengthening of these laws to promote treatment use and cessation, capitalizing on the ACA's cessation treatment coverage. Findings may also encourage states with more comprehensive clean indoor air laws and higher cigarette taxes to more broadly cover cessation services under Medicaid, beyond the ACA requirements, to augment their tobacco control laws' effects.