Effects of State Preemption of Local Tobacco Control Legislation on Disparities in Tobacco Use, Exposure and Retail

项目摘要 2030年健康人口烟草使用目标的一个关键是消除国家对地方烟草控制的优先权。 然而，很少有已发表的研究严格量化了国家优先购买当地烟草的影响 控制，特别是：1）跨州和随着时间的推移; 2）广泛的烟草控制工作（例如， 限制广告，青年访问）; 3）在一系列关键成果（例如，青少年和成人烟草 使用，二手烟暴露[SHSe]，烟草零售）;以及4）关于潜在的不成比例 在面临烟草相关差异的某些亚群体中的影响（例如，少数种族/族裔，较低 社会经济地位[SES]，农村环境中的人）。作为为这一提议提供基础的初步证据，我们的 RWJF资助的研究得出结论，州无烟空气优先权与吸烟率增加有关。 成人吸烟率和影响不同的县。这项建议将在这项工作的基础上， 通过填补现有研究中的上述空白来填补文献。这项研究的长期目标是 为减少烟草使用和相关健康差距的政策提供信息，并为政策努力提供更多信息 广泛地说，特别是作为公共卫生问题，如枪支安全，营养政策和COVID-19缓解 措施，越来越多地受到国家先发制人。我们的目标是增进我们对 是否-以及在多大程度上-颁布或废除州对地方烟草控制的优先权 在烟草使用、SHSe和零售（销售、零售商密度）方面存在差异。我们的中心假设是 抢占导致不成比例的高烟草使用，SHSe和零售在社区与更大的 种族/少数民族，社会经济地位较低，和/或在农村环境中。我们的理由是，通过抢占当地 烟草控制，州政府剥夺了地方政府减少烟草负担的重要工具， 社区，可能扩大差距。我们将分析1999年至2021年的国家数据， 颁布或废除5个州烟草优先权的州优先权的影响（即，无烟政策， 广告、许可证、青年准入和税收）。我们的具体目标是研究国家优先购买权， 烟草控制与以下变化有关：1）青少年个人烟草使用（包括电子烟）， 成年人和非吸烟者的SHSe，以及某些亚群个体的潜在不成比例的影响; 以及2）烟草产品销售和烟草零售密度随时间的变化，以及潜在的不成比例的影响 在代表那些面临与烟草有关的不平等的社区。我们将采用多层次模型 和人行横道/合并（州/地方法律，结果，社会人口统计学）数据从各种来源，在不同的 地理水平。这项研究将产生很大的影响，因为它将：1）增加关于国家的证据基础 先发制人对人口成果的影响和影响机制; 2）为减少烟草使用的努力提供信息 以及相关的差距;以及3）让关键的烟草控制和政策专家参与研究传播。

PROJECT SUMMARY A key Healthy People 2030 Tobacco-Use Objective is to eliminate state preemption of local tobacco control. However, little published research has rigorously quantified the impacts of state preemption of local tobacco control, particularly: 1) across states and over time; 2) across a broad range of tobacco control efforts (e.g., restrictions on advertising, youth access); 3) across a range of key outcomes (e.g., youth and adult tobacco use, secondhand smoke exposure [SHSe], tobacco retail); and 4) with regard to potential disproportionate impacts among certain subgroups that face tobacco-related disparities (e.g., racial/ethnic minorities, lower socioeconomic status [SES], those in rural settings). As initial evidence providing a basis for this proposal, our RWJF-funded research concluded that state smoke-free air preemption was associated with an increase in adult smoking prevalence and affect counties differently. This proposal will build on this work and advance the literature by filling the aforementioned gaps in the existing research. The long-term goal of this research is to inform policies to reduce tobacco use and related health disparities, as well as to inform policy efforts more broadly, particularly as public health issues, like firearm safety, nutrition policies, and COVID-19 mitigation measures, are increasingly subject to state preemption. Our objective is to advance our understanding of whether—and to what extent—enactment or repeal of state preemption on local tobacco control is associated with disparities in tobacco use, SHSe, and retail (sales, retailer density). Our central hypothesis is that state preemption results in disproportionately high tobacco use, SHSe, and retail in communities with greater racial/ethnic minorities, of lower SES, and/or in rural settings. Our rationale is that, by preempting local tobacco control, state governments deprive localities of a crucial tool for reducing the burden of tobacco in their communities, potentially widening disparities. We will analyze national data from 1999 to 2021 to examine the impacts of enactment or repeal of state preemption of 5 state tobacco preemption (i.e., smoke-free policy, advertising, licensure, youth access, and taxation). Our specific aims are to examine state preemption on tobacco control in relation to changes in: 1) individual-level tobacco use (including e-cigs) in adolescents and adults and nonsmokers' SHSe, and potential disproportionate impacts among certain subgroups of individuals; and 2) sales of tobacco products and tobacco retail density over time, and potential disproportionate impacts among communities representing those facing tobacco-related disparities. We will employ multilevel models and crosswalk/merge (state/local laws, outcomes, sociodemographics) data from various sources at different geographic levels. This study will have high impact, as it will: 1) add to the evidence base regarding state preemption impact on population outcomes and mechanisms of impact; 2) inform efforts to reduce tobacco use and related disparities; and 3) engage key tobacco control and policy experts in research dissemination.