A Comprehensive Examination of the Influence of State Tobacco Control Programs and Policies on Youth Smoking

Matthew C. Farrelly, Brett R. Loomis, and G. Lance Couzens are with RTI International, Research Triangle Park, NC. Beth Han and Joe Gfroerer are with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD. Nicole Kuiper, Shanta Dube, and Ralph S. Caraballo are with the Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA.
American Journal of Public Health (Impact Factor: 4.55). 01/2013; 103(3). DOI: 10.2105/AJPH.2012.300948
Source: PubMed


We examined the influence of tobacco control policies (tobacco control program expenditures, smoke-free air laws, youth access law compliance, and cigarette prices) on youth smoking outcomes (smoking susceptibility, past-year initiation, current smoking, and established smoking).

We combined data from the 2002 to 2008 National Surveys on Drug Use and Health with state and municipality population data from the US Census Bureau to assess the associations between state tobacco control policy variables and youth smoking outcomes, focusing on youths aged 12 to 17 years. We also examined the influence of policy variables on youth access when these variables were held at 2002 levels.

Per capita funding for state tobacco control programs was negatively associated with all 4 smoking outcomes. Smoke-free air laws were negatively associated with all outcomes except past-year initiation, and cigarette prices were associated only with current smoking. We found no association between these outcomes and retailer compliance with youth access laws.

Smoke-free air laws and state tobacco control programs are effective strategies for curbing youth smoking.

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Available from: Ralph S Caraballo, Jul 25, 2014
    • "Finally, indoor clean air laws have been long discussed as a determinant factor of youth smoking (Tauras et al., 2005; Farrelly et al., 2013). These regulations have been in place in various cities, counties, and states since early 1990s by restricting smoking in workplaces, restaurants, or bars. "
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    • "This suggests that substance use prevention programmes and tobacco control programmes should target young people, as they are most at risk for smoking. Indeed, in the U.S., state-level tobacco control programmes were associated with substantial declines in several smoking-related behaviours among youth, including susceptibility, initiation, current smoking, and established smoking (Farrelly et al., 2013). Other effective strategies to reduce smoking among young people include web-based interventions (Simmons et al., 2013), technology-assisted interventions (Newman et al., 2011), and school/university-based interventions (Hutton et al., 2011; Lechner et al., 2012). "
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