A Rapid Evaluation of the US Federal Tobacco 21 (T21) Law and Lessons from Statewide T21 Policies: F
Thursday, June 16, 2022
Posted by: Natalia Gromov
Agaku IT, Nkosi L, Agaku
QD, Gwar J, Tsafa T.
A Rapid Evaluation of the
US Federal Tobacco 21 (T21) Law and Lessons from Statewide T21 Policies:
Findings from Population-level Surveys.
Prev Chronic Dis. 2022;19:E29. Published 2022 Jun 2. doi:10.5888/pcd19.210430
Background.
On December 20, 2019, the minimum age for purchasing tobacco in the US was
raised nationally to 21 years. We evaluated this law (Tobacco 21 [T21]) 1 year
after implementation. We also compared states with versus without T21 policies
during 2019 to explore potential equity impacts of T21 policies.
Methods.
We examined shifts in tobacco access among 6th through 12th graders using the
National Youth Tobacco Survey. To explore equity of state T21 policies among
youths and young adults, the associations with tobacco use were explored
separately for race and ethnicity by using data from the 2019 Behavioral Risk
Factor Surveillance System (for persons aged 18 to 20 years) and the 2019 Youth
Risk Behavior Survey (for high school students).
Results.
The overall percentage of 6th to 12th graders perceiving that it was easy to
buy tobacco products from a store decreased from 2019 (67.2%) to 2020 (58.9%).
However, only 17.0% of students who attempted buying cigarettes in 2020 were
unsuccessful because of their age. In the 2019 BRFSS, those aged 18 to 20 years
living in a state with T21 policies had a lower likelihood of being a current
cigarette smoker (adjusted prevalence ratio [APR], 0.58) or smoking cigarettes
daily (APR, 0.41). Similar significant associations were seen when analyses
were restricted to only non-Hispanic White participants but not for
participants who were non-Hispanic Black, non-Hispanic Asian, Hispanic, or of
other races or ethnicities. Consistent findings were seen among high school
students.
Conclusion.
Greater compliance with the federal T21 law is needed as most youth who
attempted buying cigarettes in 2020 were successful. Comparative analysis of
states with versus states without statewide T21 policies in 2019 suggest the
policies were differentially more protective of non-Hispanic White participants
than other participants. Equitable and intensified enforcement of T21 policies
can benefit public health.
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