Evaluation of Restrictions on Tobacco Sales to Youth Younger Than 21 Years in Cleveland, Ohio, Area

Trapl, Erika S.; Moore, Stephanie Pike; Osborn, Catherine; Gupta, Neha; Love, Thomas E.; Kinzy, Tyler G.; Kinsella, Audrey E.; Frank, Scott

doi:10.1001/jamanetworkopen.2022.22987

Cited by 9 publications

(6 citation statements)

References 38 publications

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“…FRIEDMAN and WU [15] examined smoking rates among 18-to 20-year-olds in US metropolitan areas and found a 1.2% reduction post introduction of T21 laws. Survey data from Cleveland, Ohio reported a reduction in tobacco use among high-school children once T21 legislation was introduced [16]. After implementation of T21 law in California in 2016, a purchase survey demonstrated a reduction in tobacco products sales among 15-to 16-year-olds [17].…”

Section: What Is the Evidence For Effectiveness Of T21?mentioning

confidence: 99%

Statement on Tobacco 21 from the European Respiratory Society Tobacco Control Committee

2023

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Section: What Is the Evidence For Effectiveness Of T21?mentioning

confidence: 99%

Statement on Tobacco 21 from the European Respiratory Society Tobacco Control Committee

2023

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“…26 estimates of association of the policy with current smoking or cigarette sales were extracted from the 19 remaining studies. [23–41] (Table 1). Full data extraction is available in Supplementary File 3.…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies considered differential associations of T21 by ethnicity or race. Studies defined ethnicity and race differently, making synthesis difficult; most notably, five analyses found a more pronounced association with T21 in Hispanic/Latinx groups than in White groups [25,27,29,41] with two analyses finding the opposite. [33,40]…”

Section: Resultsmentioning

confidence: 99%

“…This may have prevented useful further context on product type; for example, Trapl et al’s paper found a significant reduction in cigar use in Cleveland compared to surrounding areas, though not cigarettes. [41] However, given a proliferation of estimates across product types, a focus on cigarette smoking enabled systematic, transparent approach to synthesising data for the outcome of greatest global relevance, given cigarette smoking is most common form of tobacco use in this age group. [1]…”

Section: Discussionmentioning

confidence: 99%

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What is the relationship between raising the minimum legal sales age of tobacco above 20 and cigarette smoking? A systematic review

Davies,

Bogdanovica,

McGill

et al. 2023

Preprint

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Objectives To determine whether raising the minimum legal sales age of tobacco (MLSA) to 20 or above is associated with reduced prevalence of smoking compared to an MLSA set at 18 or below through systematic review. Design Following a pre-registered protocol on PROSPERO (ref: CRD42022347604), six databases were searched for studies that assessed the association between MLSAs of 20 and above and tobacco smoking or tobacco sales. Assessments on e-cigarettes were excluded. Two reviewers independently extracted study data and used ROBINS-I to assess the risk of bias. Narrative methods were used to synthesise findings. Setting Global, with no language restrictions. Subjects Children and young people aged 11-20. Main outcome measures Current cigarette smoking and cigarette sales. Results 19 studies were reviewed, from which 26 effect estimates were extracted. All studies evaluated Tobacco 21 laws in the United States. Just under half of estimates found a statistically significant association with reduced current cigarette smoking or sales, just over half found no statistically significant association and one estimate found an association with increased cigarette smoking. The positive association appeared to be stronger for older age groups, those from a Hispanic/Latinx background and those with lower education. The degree of study bias was variable. Conclusions There is evidence that raising the MLSA for tobacco to 21 reduces cigarette sales and current cigarette smoking amongst those aged 11-20. It may have the potential to reduce health inequalities. Further research beyond the United States would support generalisability to other settings.

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“…Innovative strategies to improve cardiovascular health in redlined neighborhoods are urgently needed. These may include improving neighborhood designs by increasing greenspace, 8 , 26 reducing access to tobacco via increasing taxes and elevating the legal age for purchasing, 27 increasing access to healthy food, 28 and implementing novel health care delivery models (eg, mobile health units) 29 to improve cardiovascular outcomes.…”

Section: Discussionmentioning

confidence: 99%

Association Between Historical Neighborhood Redlining and Cardiovascular Outcomes Among US Veterans With Atherosclerotic Cardiovascular Diseases

et al. 2023

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ImportanceIn the 1930s, the government-sponsored Home Owners’ Loan Corporation (HOLC) established maps of US neighborhoods that identified mortgage risk (grade A [green] characterizing lowest-risk neighborhoods in the US through mechanisms that transcend traditional risk factors to grade D [red] characterizing highest risk). This practice led to disinvestments and segregation in neighborhoods considered redlined. Very few studies have targeted whether there is an association between redlining and cardiovascular disease.ObjectiveTo evaluate whether redlining is associated with adverse cardiovascular outcomes in US veterans.Design, Setting, and ParticipantsIn this longitudinal cohort study, US veterans were followed up (January 1, 2016, to December 31, 2019) for a median of 4 years. Data, including self-reported race and ethnicity, were obtained from Veterans Affairs medical centers across the US on individuals receiving care for established atherosclerotic disease (coronary artery disease, peripheral vascular disease, or stroke). Data analysis was performed in June 2022.ExposureHome Owners’ Loan Corporation grade of the census tracts of residence.Main Outcomes and MeasuresThe first occurrence of major adverse cardiovascular events (MACE), comprising myocardial infarction, stroke, major adverse extremity events, and all-cause mortality. The adjusted association between HOLC grade and adverse outcomes was measured using Cox proportional hazards regression. Competing risks were used to model individual nonfatal components of MACE.ResultsOf 79 997 patients (mean [SD] age, 74.46 [10.16] years, female, 2.9%; White, 55.7%; Black, 37.3%; and Hispanic, 5.4%), a total of 7% of the individuals resided in HOLC grade A neighborhoods, 20% in B neighborhoods, 42% in C neighborhoods, and 31% in D neighborhoods. Compared with grade A neighborhoods, patients residing in HOLC grade D (redlined) neighborhoods were more likely to be Black or Hispanic with a higher prevalence of diabetes, heart failure, and chronic kidney disease. There were no associations between HOLC and MACE in unadjusted models. After adjustment for demographic factors, compared with grade A neighborhoods, those residing in redlined neighborhoods had an increased risk of MACE (hazard ratio [HR], 1.139; 95% CI, 1.083-1.198; P &lt; .001) and all-cause mortality (HR, 1.129; 95% CI, 1.072-1.190; P &lt; .001). Similarly, veterans residing in redlined neighborhoods had a higher risk of myocardial infarction (HR, 1.148; 95% CI, 1.011-1.303; P &lt; .001) but not stroke (HR, 0.889; 95% CI, 0.584-1.353; P = .58). Hazard ratios were smaller, but remained significant, after adjustment for risk factors and social vulnerability.Conclusions and RelevanceIn this cohort study of US veterans, the findings suggest that those with atherosclerotic cardiovascular disease who reside in historically redlined neighborhoods continue to have a higher prevalence of traditional cardiovascular risk factors and higher cardiovascular risk. Even close to a century after this practice was discontinued, redlining appears to still be adversely associated with adverse cardiovascular events.

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Evaluation of Restrictions on Tobacco Sales to Youth Younger Than 21 Years in Cleveland, Ohio, Area

Cited by 9 publications

References 38 publications

Statement on Tobacco 21 from the European Respiratory Society Tobacco Control Committee

Statement on Tobacco 21 from the European Respiratory Society Tobacco Control Committee

What is the relationship between raising the minimum legal sales age of tobacco above 20 and cigarette smoking? A systematic review

Association Between Historical Neighborhood Redlining and Cardiovascular Outcomes Among US Veterans With Atherosclerotic Cardiovascular Diseases

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