Associations between tobacco 21 and state flavour restrictions with young adult tobacco use.

BACKGROUND: States have recently enacted tobacco-related age and flavour restrictions in addition to federal T21 laws. Little is known about the independent effects of these policies on young adult tobacco use. METHODS: Linking 2011-2022 Behavioural Risk Factor Surveillance System data on 2 696 870, 18-59 years from 50 states and DC with policy data, we conducted probit regression models to evaluate the associations between state and federal T21 laws and state flavour restrictions with cigarettes, electronic nicotine delivery system (ENDS) and smokeless tobacco use. Models were adjusted for sociodemographics, additional tobacco policies, COVID-19-related factors, year and state. We tested two-way and three-way interactions between age, state T21 and federal T21 laws. RESULTS: Although we did not find evidence that state T21 laws were associated with cigarette, smokeless tobacco or ENDS use overall, the federal T21 law was associated with lower use of all three tobacco products by 0.39-0.92 percentage points. State flavour restrictions were associated with lower use of cigarettes by 0.68 (-1.27 to -0.09) and ENDS by 0.56 (-1.11 to -0.00) percentage points, but not with smokeless tobacco. A three-way interaction revealed that state and federal T21 laws together were associated with a lower prevalence of ENDS use among 18-20 years, but there were no differences in cigarette use from both policies combined versus either alone. CONCLUSION: State and federal T21 laws are broadly effective at reducing adult tobacco use, while state flavour restrictions specifically lower use of cigarettes and ENDS.

Flavoured tobacco product restrictions in Massachusetts associated with reductions in adolescent cigarette and e-cigarette use.

BACKGROUND: In the USA, many states do not pre-empt municipalities from enacting stricter tobacco-control policies than state or federal laws. Several municipalities in Massachusetts have passed progressive local laws aimed at reducing adolescent tobacco use. We exploited this variability to examine the associations between county-level flavoured tobacco product restrictions, tobacco 21 policies and smoke-free laws prohibiting e-cigarettes with adolescent cigarette and e-cigarette use in Massachusetts, and to assess whether policy effects varied by age. METHODS: We conducted difference-in-differences models to link changes in county-level tobacco-control policies to changes in adolescents' use of cigarettes and e-cigarettes using 2011-2017 biennial Massachusetts Youth Health Surveys. RESULTS: Counties with greater implementation of flavoured tobacco product restrictions were associated with a decrease in the level of cigarette use among users (Coefficient -1.56; 95% CI -2.54 to -0.58). A significant interaction (p=0.03) revealed the largest reductions among 14 and 18 year olds. Increasing flavoured tobacco product restrictions were also associated with reductions in the likelihood of e-cigarette use (Coefficient -0.87; 95% CI -1.68 to -0.06). Increasing tobacco 21 restrictions were associated with decreases in cigarette use only among 18 year olds, while there was no evidence of associations between smoke-free laws with use of either tobacco product. CONCLUSIONS: Adolescents in Massachusetts decreased their use of cigarettes and e-cigarettes in response to local restrictions that limited the sale of flavoured tobacco products to adult-only retail tobacco stores. Local legislation can reduce adolescent tobacco use and municipalities should enact stricter tobacco-control policies when not pre-empted by state law.

Changes in health risk behaviors for males and females from early adolescence through early adulthood.

OBJECTIVE: We sought to identify (a) the course of changes in smoking, alcohol and marijuana use, violence, and sexual behavior from early adolescence through young adulthood for males and females, (b) points of divergence and convergence for 5 health risk behaviors between males and females, and (c) whether the trajectories of change in health risk behaviors differed for males and females. METHOD: Data from four waves of the nationally representative National Longitudinal Study of Adolescent Health (Add Health) followed 18,911 youth from early adolescence through the transition to adulthood (ages 13 through 31 years) and were analyzed using zero-inflated negative binomial growth models and logistic growth models. RESULTS: Generally, health risk behaviors steadily increased through adolescence into the early 20s, subsequently leveling off or decreasing. Results indicated early adolescent females were more likely to smoke and have more sexual partners, and 14- and 18-year-old females had higher rates of increase for getting drunk. The majority of findings, however, indicated that adolescent and young adult males engaged in more risk behaviors and were increasingly likely to engage over time. Among youth engaged in health risk behaviors, males reported greater frequency and increases in rates over time for most risk behaviors. CONCLUSIONS: We identify several critical groups for health professionals to address: early adolescent females not previously identified as more engaged in health risks; adolescent females "catching up" to male health risks; early and mid-adolescent males shifting into adult patterns of heightened health risk behaviors; and the group of risk-taking males across age groups.

Maternal, family, and work correlates of role strain in low-income mothers.

Welfare reform brought large numbers of low-income mothers into the labor force, yet little research has examined how low-income mothers manage the multiple demands of parenthood and employment. Using Hobfoll's conservation of resources (COR) theory (Hobfoll, 1989, 2001) to guide hypotheses, the authors examined correlates of role strain in a racially diverse sample of low-income mothers (N = 276) combining work/school with family responsibilities. Results from regression analyses indicate that characteristics that deplete resources, particularly family factors (e.g., more young children, having a child with a disability) and work characteristics (e.g., long work hours, work transitions), related to higher maternal role strain, whereas greater work flexibility predicted lower role strain. Findings suggest that interventions directed toward increasing women's resources may help reduce role strain.