Tobacco Control Policies and Individual-Level Trajectories of Youth Cigarette Use

描述（由申请人提供）：虽然对烟草控制政策和吸烟率的宏观层面和反复的横断面研究，以及对特定地理区域的新政策的评估研究，提供了一些政策有效性的证据，但很少有研究检查各级政策的实施（例如地方、县和州）如何影响青少年和青年关键时期的个人内部吸烟轨迹（开始吸烟、流行、持续时间和戒烟）。如果没有一种方法，在全国范围内对同一个人同时进行全面的政策审查，政策制定者就无法充分评估特定烟草控制政策的效力，从而无法对无效法规进行风险投资。该项目的目标是利用具有全国代表性的纵向数据、烟草控制条例的完整记录和创新的统计方法，为政策制定者和卫生研究人员提供工具，以便在青少年吸烟预防和干预方面做出最明智的烟草控制政策决定，包括哪些个人或地区最不容易受到政策实施导致的行为变化的影响。为了充分了解控烟政策是如何影响青少年吸烟模式的，我们需要一个地理编码的、重复的青少年卷烟使用和预测风险因素的观察数据集，一个全面的控烟法规数据库，以及一种能够处理复杂分层数据结构的统计方法。为了满足这些需求，我们将1997年全国青年纵向调查（NLSY97）的年度收集数据与美国非吸烟者权利组织（ANR）全国烟草条例和法规库的数据合并，并使用分层交叉分类模型的最新发展。为了确定烟草政策对青少年卷烟使用轨迹的主要影响，我们将结合两个地理编码数据集，并使用最近开发的分层交叉分类模型进行分析。在控制了众所周知的风险因素和当地结构条件之后，特定烟草政策的有效性将证明这一点

DESCRIPTION (provided by applicant): While macro-level and repeated cross-sectional studies of tobacco control policies and smoking rates, as well as evaluative studies of new policies in specific geographic areas, provide some evidence of policy effectiveness, little research has examined how policies at various levels implementation (e.g. local, county, and state) affect within-individual trajectories (initiation, prevalence, duration, and cessation) of smoking during the critical teenage and young adult years. Without an approach that examines the full range of policies simultaneously nationwide on the same individuals over time, policymakers cannot adequately assess the efficacy of particular tobacco control policies and, thus, risk investment in non-effective regulations. Using nationally representative longitudinal data, a complete record of tobacco control ordinances, and innovative statistical methods, the goal of this project is to provide policymakers and health researchers with the tools to make the most informed tobacco control policy decisions regarding youth smoking prevention and intervention, including which individuals or locales are least susceptible to changes in behavior resulting from policy implementation. To fully understand how tobacco control policy affects youth smoking patterns over time, we require a geocoded, repeated observations dataset of youth cigarette use and predictive risk factors, a comprehensive database of tobacco control regulations, and a statistical method capable of handling a complex hierarchical data structure. We address those needs by merging data from the annually collected National Longitudinal Survey of Youth 1997 (NLSY97) with the Americans for Nonsmokers' Rights (ANR) national repository of tobacco ordinances and regulations, and using recent developments in hierarchical cross-classification models. To identify the main effect of tobacco policies on trajectories of youth cigarette use, we will combine the two geocoded datasets and analyze them with recently developed hierarchical cross- classification models. After controlling for well-known risk factors and local structural conditions, the efficacy of particular tobacco policies will demonstrate which policies should be adopted on a wider basis, ultimately impacting health and mortality and reducing costs to health care and society. To assess whether the effect of policy varies by characteristics of the individual or context, we will analyze interaction effects between individua-level characteristics and policy measures and local-level characteristics and policy measures, which will reveal if a given policy is more effective for certain types of individuals or those residing in similar areas. The lack of effectiveness of policies on certain individuals will expose the need for those policies to incorporate a component that addresses particular groups or areas. This proposal's innovation lies in both its examination of within-youth changes in smoking behavior over time as it relates to both previously examined and unexamined tobacco restrictions at various levels of implementation and in the development and furthering of innovative statistical approaches necessary for datasets that contain repeated observations on multiple levels.