Laserfiche WebLink
3.0 found reduced smoking rates in <br /> communities with youth access <br /> • Lifetime use♦ Past 30-day use restrictions,but it was not clear <br /> 15 that reduced access mediated the <br /> reduction in smoking rates.19,23 For <br /> example,sustained reductions in <br /> 2.0 adolescent daily smoking rates were <br /> U <br /> a° observed in Minnesota communities <br /> that were randomly assigned to <br /> s intervention supporting community <br /> organizers to develop and promote <br /> 10 <br /> a.° <br /> good TLR ordinances,compared <br /> with nonintervention communities.20 <br /> However,it was not clear whether <br /> 0.5 the observed reductions in <br /> smoking rates were due to youth <br /> access restrictions and improved <br /> o° vendor compliance or to other <br /> Cigarettes E-cigarettes Hookah Cigars Anytobacco regulatory features resulting from <br /> FIGURE 1 the intervention,such as bans on <br /> Associations of prevalent lifetime and current(last 30-day)use of each tobacco product at baseline vending machines and requirements <br /> with residence in ALA Reduced Tobacco Sales grade A jurisdictions, compared with residence for posted signs reporting age of <br /> in grade D or F jurisdictions. Models were adjusted for sex, ethnicity, parental education, age at sale policies,or for storing cigarettes <br /> baseline, and for any other tobacco product use at baseline (except for any tobacco product use behind the sales counter.17 <br /> prevalence,which was compared with never users of any tobacco product) and included a random <br /> effect for jurisdiction. <br /> Our results are broadly consistent <br /> with findings of a comprehensive <br /> 3.0 review in which authors concluded <br /> • Initiation that lower smoking rates occur if <br /> 2.5 ♦ Initiationwith past30 day use local TRL requires yearly compliance <br /> checks with effective enforcement.? <br /> Our study is 1 of the few that <br /> o assessed associations of TRL with <br /> v both prevalence and initiation <br /> rates in a prospective assessment <br /> e of the same participants during <br /> an adolescent period of known <br /> o high incidence of initiation.The <br /> 1° prospective cohort design of the <br /> study also provided the opportunity <br /> to examine the impact of TRL on <br /> a 5 legal tobacco product use by young <br /> adults.The reduced risk of initiation <br /> 0.0- <br /> of cigarette and e-cigarette use <br /> at follow-up in jurisdictions with <br /> Cigarettes E-cigarettes Hookah Cigars Anytobacco better TRL regulation(with effect <br /> FIGURE 2 estimates that were unaffected by <br /> Associations of initiation of use of each tobacco product between baseline and follow-up and of adjusting for time since turning 18 at <br /> initiation and current (last 30-day) use, with residence in ALA Reduced Tobacco Sales grade A follow-up)suggests that regulation <br /> jurisdictions, compared with residence in grade D or F jurisdictions. Each model was restricted may have lowered initiation rates <br /> to nonusers of product at baseline. Models were adjusted for sex, ethnicity, parental education, <br /> age at baseline,and for any other tobacco product use at baseline(except for any tobacco product even after participants reached the <br /> use initiation,which was compared with never users of any tobacco product at either baseline or age for legal purchase.Although most <br /> follow-up)and included a random effect for jurisdiction. adult smokers historically first use <br /> cigarettes before age 18,12 in our <br /> cohort,rates of initiation of tobacco <br /> Downloaded from www.aappublications.org/news by guest on May 7,2019 <br /> PEDIATRICS Volume 143,number 2,February 2019 5 <br />