In AIDS Bulletins Nos. 1 to 4 the Institute of Actuaries AIDS Working Party presented projections of HIV infection and AIDS based on a model developed by Wilkie. This paper explores the sensitivity of those projections to the various different assumptions which have to be made and presents results on a number of alternative sets of assumptions.
1.1 In March 1987 the Futures Committee of the Institute considered a preliminary report (Daykin, 1987) on the possible impact of AIDS in the United Kingdom and the consequences for life insurance. The Committee recommended the setting up of a Working Party to study the problem. The Working Party on AIDS was accordingly established, under the auspices of the Research Committee. The authors of this paper formed the membership of the Working Party, under the chairmanship of C. D. Daykin.
Purpose: Determine associations of strength of local smoke-free laws and urban/rural location with cigarette and smokeless tobacco use among high school students in grades 10 and 12.
Design: Secondary data analysis from the 2004-2018 biennial Kentucky Incentives for Prevention Survey
Setting: Public high schools in Kentucky
Sample: N = 353,502 10th/12th graders
Measures: County-level smoke-free law status from the Kentucky Center for Smoke-free Policy; Rural Urban Continuum Codes; self-reported last 30-day alcohol, marijuana, cigarette and smokeless tobacco use
Analysis: Generalized estimating equations modeling assessed the association of law status and urban/rural location with tobacco use across cohorts, controlling for demographics and other substance use.
Results: Students in counties with a comprehensive smoke-free law were 23% less likely to smoke cigarettes and 16% less likely to use smokeless, compared to those in counties without a law. Students in counties with moderate/weak laws did not differ in likelihood of use for either product, compared to those in counties without a law. Students in urban counties were 14% less likely to smoke, but there was no difference in likelihood of smokeless use by urban/rural location.
Conclusion: Comprehensive smoke-free laws are associated with a lower likelihood of youth cigarette and smokeless use. Rural youth may be at increased risk of cigarette smoking relative to youth in urban areas.
Key Words: smoke-free policy; adolescent; tobacco use; outcome assessment; cigarettes; smokeless tobacco
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