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

项目总结 2030年健康人烟草使用的一个关键目标是消除国家对地方烟草控制的抢占。 然而，几乎没有发表的研究严格量化国家抢占地方烟草的影响。 控制，特别是：1)跨州和随着时间的推移；2)广泛的烟草控制努力(例如， 限制广告、青少年进入)；3)涉及一系列关键成果(例如，青少年和成人烟草 使用、二手烟暴露、烟草零售)；以及4)关于潜在的不成比例 面临与烟草有关的差异的某些亚群的影响(例如，较低的种族/族裔少数群体 社会经济地位[社会经济地位]，那些在农村环境中的人)。作为支持这项提议的初步证据，我们的 RWJF资助的研究得出结论，州无烟空气抢占与 成人吸烟患病率和影响县市不同。这项提案将在这项工作的基础上再接再厉，推进 通过填补现有研究中的上述空白进行文献综述。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、营养政策和新冠肺炎缓解 这些措施越来越多地受到国家优先购买权的制约。我们的目标是增进我们对 是否--以及在多大程度上--制定或废除国家对地方烟草控制的优先购买权 在烟草使用、SHSE和零售(销售、零售商密度)方面存在差异。我们的中心假设是国家 抢占导致烟草使用量、SHSE和零售量在以下社区不成比例地高 少数族裔、社会经济地位较低的和/或农村环境中的少数族裔。我们的理由是，通过先发制人 在烟草控制方面，州政府剥夺了地方政府减轻地方烟草负担的重要工具 社区，有可能扩大差距。我们将分析1999年至2021年的国家数据，以检查 颁布或废除5个州烟草优先购买权的影响(即无烟政策， 广告、执照、青少年准入和税收)。我们的具体目标是研究国家在 烟草控制与以下方面的变化有关：1)青少年个人水平的烟草使用(包括电子烟)和 成年人和非吸烟者的健康状况，以及某些个体亚群之间潜在的不成比例的影响； 2)随时间推移的烟草产品销售和烟草零售密度，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差异的社区中。我们将采用多层次模型 和十字路口/合并(州/地方法律、结果、社会人口统计)来自不同来源的不同数据 地理级别。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 先发制人对人口结果的影响和影响机制；2)为减少烟草使用提供信息 以及3)让主要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.