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Tobacco Retail Licensing
<br />and Youth Product Use
<br />Roee L. Astor, MPH o Robert Urman, PhD,a Jessica L. Barrington -Trim is, PhD? Kites Berhane, PhD?
<br />Jane Steinberg, PhD,- Michael Cousineau, PhD, -Adam M. Leventhal, PhD, -Jennifer B. Unger, PhD, -
<br />Tess Cruz, PhD,- Mary Ann Portz, PhDo Jonathan M. Samet, MD, MS,b Rob McConnell, MOO
<br />BACKGROUND: Restricting youth access to tobacco is a central feature of US tobacco regulatory
<br />policy, but impact of local tobacco retail licensing (TRL) regulation on cigarette smoking
<br />rates remains uncertain. Effects of TRL on other tobacco product use and use as adolescents
<br />reach the age to legally purchase tobacco products has not been investigated.
<br />METHODS: Prevalences of ever and past 30-day cigarette, electronic cigarette (e-cigarette),
<br />cigar, and hookah use were assessed in a survey of a cohort of 1553 11th- and 12th-grade
<br />adolescents (mean age: 17.3 years); rates of initiation were evaluated 1.5 years later. An
<br />American Lung Association (2014) youth access grade was assigned to each of 14 political
<br />jurisdictions in which participants lived on the basis of the strength of the local TRL
<br />ordinance.
<br />RESULTS: At baseline, participants living in 4 jurisdictions with "A" grades (ie, with most
<br />restrictive ordinances) had lower odds of ever cigarette use (odds ratio [OR] 0.61; 95%
<br />confidence interval [Cl] 0.41-0.90) and of past 30-day use (OR 0.51; 95% Cl 0.29-0.59)
<br />than participants in 10 D- to F-grade jurisdictions. At follow-up at legal age of purchase,
<br />lower odds of cigarette use initiation (OR 0.67; 95% Cl 0.45-0.99) occurred in jurisdictions
<br />with stronger TRL policy. Lower odds of e-cigarette initiation at follow-up (OR 0.74; 95%
<br />Cl 0.55-0.99) and of initiation with past 30-day use (OR 0.45; 95% Cl 0.23-0.90) were also
<br />associated with better regulation.
<br />CONCLUSIONS: Strong local TRL ordinance may lower rates of cigarette and e-cigarette use
<br />among youth and young adults. 0
<br />V
<br />WHAT'S KNOWN ON THIS SUBJECT: Restricting youth
<br />access to tobacco has long been a central feature of
<br />"Department of Preventive Medicine, Keck School of Medicine, UnivenutyofSouthern California Los Angeles,
<br />US tobacco regulatory policy, butthe Impact of local
<br />California; and °Colorado School of Public Health, University ofColomdo Anschutz Medical Center, Aurora,
<br />Colorado
<br />tobacco retail licensing regulation on electronic
<br />cigarette use rates remains uncertain.
<br />Or McConnell conceptualized and designed the study and reviewed and revised the manuscript;
<br />Mr Astor collected data on tobacco retail licensing in study communities, conducted a literature
<br />WHAT THIS STUDY ADDS: Strong local tobacco retail
<br />review, and drafted the manuscript; Or Urman conducted all data analyses; Drs Barrington-Trimis,
<br />licensing ordinances may lower rates of cigarette
<br />Berhane, Steinberg, Cousineau, Leventhal, Unger, Cruz, Pentz, and Samet provided advice on the
<br />and electronic Cigarette use among youth and
<br />analysis and interpretation of results and reviewed and provided guidance on the development of
<br />young adults. Success of regulations restricting
<br />the manuscript; and all authors approved the final manuscript as submitted
<br />youth access to Cigarettes and alternative tobacco
<br />001: https://doi.org/10.1542/peds.2017-3536
<br />products may depend on ensuring a robust
<br />Accepted for publication Oct 31, 2018
<br />enforcement scheme.
<br />Address correspondence to Rob McConnell, MD, Department of Preventive Medicine, Keck School
<br />of Medicine, University of Southern California, 2001 N Soto St, 230-1), Los Angeles, CA 90089. E-mail:
<br />rmcconne@usc.edu
<br />PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
<br />Copyright 0 2019 by the American Academy of Pediatrics To cite: Astor RL, Urman R, Barrington-Trimis JL, at al.
<br />Tobacco Retail Licensing and Youth Product Use. Pediatrics.
<br />2019;143(2):e20173536
<br />Downloaded from www.aappublications.org/news by guest
<br />PEDIATRICS Volume 143, number 2, February 2019:e20173536
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