Measuring the Public Health Impact of State-Level Flavored Tobacco Bans on Youth and Adult Tobacco Use

项目摘要。马萨诸塞州是美国第一个限制所有口味的零售的州 烟草产品，包括电子烟，可燃和无烟烟草到21岁及以上的吸烟商店。 新的《千年评估法》提供了一个有时限的机会，以获得关于《千年评估法》最初影响的基线信息。 关于青年和成年人吸烟以及法律实施后成年人戒烟尝试的法律。也是 在此期间，审查在全州范围内实施法律规定的障碍和促进因素至关重要。 初期。从这项研究中获得的知识将提供急需的和时间敏感的证据， 向其他国家通报额外限制的好处或意外影响。我们的长期目标是 防止青少年使用各种形式的烟草制品，并以证据帮助青少年和成年烟草使用者- 基于停止治疗。本研究的目的是估计新的MA法的初步影响 青年和成年人的烟草使用行为以及成年人的戒烟尝试， 邻近的新英格兰州，并确定在初始阶段的障碍和促进因素， 贯彻《马法》。我们的科学理论基础是《综合执行和调解 烟草控制政策模式。我们将获得烟草使用和戒烟尝试的法律前数据（2019年青年 风险行为调查和行为风险因素监测系统），并通过 在13-17岁青年（n=1800）和成人中进行每月重复的横断面在线调查， 18岁以上的使用者（n=1800）。使用准实验设计，我们将进行倾向评分差异， 差异（DID）分析，以估计参与者在法律实施前后研究结果的变化， MA和4个对照状态（NH、VT、RI和CT）。我们将研究法律颁布后的每月研究结果趋势 在MA和4个控制状态中。我们将与MA（学区）的32个利益相关者进行关键的线人访谈 监督员、负责人、保健提供者、卫生部门官员、烟草零售商）进行评估， 促进者和执行新法律的障碍。我们的具体目标是：1）估计前和后的法律 MA与4个对照组相比，青少年和成人使用烟草制品和成人戒烟尝试的变化 州（新罕布什尔州、佛蒙特州、罗德岛州和康涅狄格州），2）审查青年和成人使用烟草制品的法律后趋势， 在MA和4个对照状态（NH、VT、RI和CT）中的成人戒烟尝试，3）确定政策执行情况 千年生态系统评估主要利益攸关方之间的促进因素和障碍。影响：本研究将提供时间敏感的数据， 评估新的MA法律对烟草使用和戒烟尝试的初步影响，与限制较少的法律相比， 新英格兰控制州的政策。研究结果将有助于实施循证医学。 各州的烟草控制条例，以防止青少年吸烟，减少人口健康危害， 烟草使用。

PROJECT SUMMARY. Massachusettsis the first state inthe nation to restrict retail sales of all flavored tobacco products including e-cigarettes, combustible and smokeless tobacco to 21-and over smoke shops. The new MA law presents a time-limited opportunity to obtain baseline information on the initial impacts of the law on youth and adults' tobacco use and adults' quit attempts following the law's implementation. It is also critical to examine barriers and facilitators of implementing the law's provisions across the state during this initial period. Knowledge gained from this research would provide much needed and time-sensitive evidence to inform other states on the benefits or unintended effects of additional restrictions. Our long-term goals are to prevent all forms of tobacco product use among youth and assist youth and adult tobacco users with evidence- based cessation treatments. The objectives of this study are to estimate the initial impacts of the new MA law on tobacco use behaviors among youth and adults and quit attempts among adults in MA compared with four adjacent New England states and to identify the barriers and facilitators during the initial period of implementing the MA law. Our scientific rationale is based on the Integrated Implementation and Mediation Model of Tobacco Control Policy. We will obtain pre-law data of tobacco use and quit attempts (2019 Youth Risk Behavioral Survey and Behavioral Risk Factor Surveillance System) and collect post-law data through monthly repeated cross-sectional online surveys among youth ages 13-17 (n=1800) and adult current tobacco users ages 18+ (n=1800). Using a quasi-experimental design, we will perform propensity score difference-in- differences (DID) analyses to estimate changes in the study outcomes pre- and post-law among participants in MA and 4 control states (NH, VT, RI, and CT). We will examine the post-law monthly trends in study outcomes in MA and 4 control states. We will conduct key informant interviews with 32 stakeholders in MA (school district superintendents, principals, health providers, health department officials, tobacco retailers) to assess facilitators and barriers of implementing the new law. Our specific aims are: 1) Estimate the pre- and post-law changes in youth and adult use of tobacco products and adult quit attempts in MA compared with 4 control states (NH, VT, RI, and CT), 2) Examine the post-law trends in youth and adult use of tobacco products and adult quit attempts in MA and 4 control states (NH, VT, RI, and CT), 3) Identify policy implementation facilitators and barriers among key stakeholders in MA. Impact: This study will provide time-sensitive data to evaluate the initial impacts of the new MA law on tobacco use and quit attempts compared with less restrictive policies in control states in New England. The study findings will aid in implementing evidence-informed tobacco control regulations in states to prevent youth tobacco use and reduce the population health harms of tobacco use.