Assessing the Impact of State Preemption Laws

项目摘要/摘要 烟草使用仍然是可预防的死亡的主要原因，在美国造成48万人死亡。 每年一次。仅吸烟一项就导致了90%的肺癌相关死亡和80%的慢性阻塞性肺疾病 与肺部疾病相关的死亡。在美国，另有1600万人患有由 抽烟。尽管对健康的长期影响未知，但电子烟的日益普及(1080万 成年人是目前的吸烟者)是一个日益令人担忧的问题，特别是考虑到这是最受欢迎的烟草形式 在年轻人中间。近年来，先发制人的法律越来越多，种类也越来越多 公共政策。当更高级别的政府限制或撤回一国政府的权力时，就会发生抢占 下级政府对某一特定问题采取行动，从而禁止下级政府 制定更严格的法律。在包括烟草在内的各种健康问题上，先发制人的法律很常见。 例如，大约有32个州至少有一种形式的抢占当地烟草控制条例的形式 2018年9月30日。这些法律在许多方面因州而异，包括电子烟是否包括在内。 许多利益攸关方对这些法律的潜在负面影响表示担忧。例如， 美国医学协会、医学研究所和健康人2020年已经认可 优先购买法(S)作为公共健康的障碍。然而，到目前为止，还没有现有的严格的经验证据 关于这些优先购买法如何或是否影响当地政策创新和关键健康结果的证据。这个 拟议的研究将通过使用严格的准实验设计来解决这些关键的知识差距 评估国家抢占法对烟草和电子烟使用的影响。具体地说，我们提出了一个 原创系统的法律分析，以表征和编码国家烟草优先购买法及其 层面(目标1)，评估国家优先购买法对县无烟室内政策的影响(目标2)， 吸烟(目标3)和电子烟使用(目标4)。目标3和目标4也将评估异构性 国家优先购买法对(A)分组(根据性别和种族/族裔界定)和 (B)农村社区和城市社区之间这些法律的影响是否不同。我们的跨学科团队已经 在药物滥用流行病学、定量分析、政策和法律研究方面有丰富的经验。这个 拟议的研究将解决一个严重不足的具有高度公共卫生意义的领域：国家 优先购买法是公共健康的重大障碍。这是一个至关重要的领域，因为 在美国，优先购买法的数量和种类正在增加。这项高度创新的研究的结果 将提供及时的经验证据，并对未来的决策产生持续的影响 先发制人的政策和法律。

Project Summary/Abstract Tobacco use remains the leading cause of preventable death, contributing to 480,000 deaths in the U.S. annually. Smoking alone causes 90% of all lung cancer-related deaths and 80% of all chronic obstructive pulmonary disease-related deaths. Another 16 million people in the U.S. live with a disease caused by smoking. Despite unknown long-term health effects, the increasing popularity of e-cigarettes (10.8 million adults are current users) is a growing concern, especially given that this is the most popular form of tobacco among youth. In recent years, there has been an increase in the number and variety of laws that preempt local public policies. Preemption occurs when a higher level of government restricts or withdraws the authority of a lower level of government to act on a particular issue, thereby prohibiting lower levels of government from enacting more stringent laws. Preemptive laws are common on a variety of health issues, including tobacco. For example, about 32 states had at least one form of preemption of local tobacco control ordinances as of September 30, 2018. The laws vary by states in many aspects, including whether e-cigarettes are included. Numerous stakeholders have concerns about the potential negative impacts of these laws. For instance, the American Medical Association, the Institute of Medicine, and Healthy People 2020 have recognized preemption law(s) as a barrier to public health. However, to date, there is no existing rigorous empirical evidence on how, or if, these preemption laws affect local policy innovation and key health outcomes. The proposed study will address these critical knowledge gaps by using a rigorous quasi-experimental design to assess the impact of state preemption laws on tobacco and e-cigarette use. Specifically, we propose an original systematic legal analysis to characterize and code state tobacco preemption laws as well as their dimensions (Aim 1), assess the impact of state preemption laws on county smoke-free indoor policy (Aim 2), cigarette smoking (Aim 3) and e-cigarette use (Aim 4). Aims 3 and 4 will also assess the heterogeneous impact of state preemption laws among (a) subgroups (defined based on gender and race/ethnicity) and whether the effects of these laws vary between (b) rural and urban communities. Our interdisciplinary team has extensive experience in substance abuse epidemiology, quantitative analysis, policy and legal research. The proposed research will address a severely understudied area with high public health significance: state preemption laws functioning as a significant barrier to public health. This is an area of critical importance, as the number and variety of preemption laws are increasing in the U.S. The results of this highly innovative study will provide timely empirical evidence and have a sustained impact in informing future decision making on preemptive policies and laws.