Do tobacco 21 laws work?

The effect of vertical identification card laws on teenage tobacco and alcohol use

We study the impact of vertical identification card laws, which changed the orientation of driver's licenses and state identification cards from horizontal to vertical for those under 21 years, on teenage tobacco and alcohol use. We study this question using four national datasets (pooled national and state Youth Risk Behavior Surveillance System, National Youth Tobacco Survey, Current Population Survey to Tobacco Use Supplements, and Behavioral Risk Factor Surveillance System). We improve previous databases of vertical ID law implementation by using original archival research to identify the exact date of the law change. We estimate models using standard two-way fixed effects and stacked difference-in-differences that avoid bias from dynamic and heterogeneous treatment effects. Using data through 2021, we do not find evidence of reductions in teenage tobacco and alcohol use. While these laws reduce retail-based purchasing, they also increase social sourcing, thus leading to no net impact on use.

Estimating Young Adult Uptake of Smoking by Area Across the United Kingdom

INTRODUCTION

There is majority support in parliament and across the United Kingdom to implement a "smoke-free generation" policy which would mean people born on or after January 1, 2009, could never legally be sold tobacco. To explore the potential impact this policy could have, we estimated the number of young adults (18-25 years) currently taking up smoking each year by area across the United Kingdom.

METHODS

Using data from the Office for National Statistics (ONS), Annual Population Survey (APS), and Smoking Toolkit Study (STS), we estimated the total number of 18- to 25-year-olds taking up smoking each year, based on national estimates of population size (ONS) and the proportion who reported ever having regularly smoked (STS). We used local data on adult smoking rates (APS) to apportion the national estimated number of young adults taking up smoking to specific areas.

RESULTS

Around 127 500 18- to 25-year-olds in the United Kingdom start smoking regularly each year (~350 each day); 105 700 each year in England, 11 500 in Scotland, 6500 in Wales, and 3800 in Northern Ireland. Uptake estimates varied across localities: for example, North East Lincolnshire had the highest proportion of young adults taking up smoking each year (3.9%) and Wokingham had the lowest (0.9%).

CONCLUSIONS

Despite reductions in smoking prevalence over recent decades, hundreds of young adults in the United Kingdom start smoking every day.

IMPLICATIONS

Data on rates of uptake among individual local authorities can be used to focus attention locally prior to the introduction of new age of sale laws.

Gaps in Awareness of the United States Minimum Legal Age of E-Cigarette and Cigarette Sales: Implications for Public Health Messaging

PURPOSE

In 2019, the United States raised the minimum legal age (MLA) of sales for all tobacco products from 18 to 21. Public awareness of the federal MLA of tobacco sales overall and by demographics is understudied.

METHODS

A national, cross-sectional 2023 survey in which 6,098 participants aged 13-40 years responded to the question, "at which age is it legal to purchase [e-cigarettes; cigarettes; alcohol] in the United States?" Participants also reported age, sex, race/ethnicity, and prior use of each substance.

RESULTS

Sixty-one percent, 64.6%, and 88.7% correctly identified the MLA of sales for e-cigarettes, cigarettes, and alcohol, respectively. Differences in awareness of the MLA were found by age, sex, race/ethnicity, and prior use status.

DISCUSSION

Gaps in awareness of the MLA of tobacco sales, particularly among adolescents and adults, suggest messaging regarding the federal Tobacco 21 law is needed.

Public Perception of the Tobacco 21 Amendment on Twitter in the United States: Observational Study

BACKGROUND

Following the signing of the Tobacco 21 Amendment (T21) in December 2019 to raise the minimum legal age for the sale of tobacco products from 18 to 21 years in the United States, there is a need to monitor public responses and potential unintended consequences. Social media platforms, such as Twitter (subsequently rebranded as X), can provide rich data on public perceptions.

OBJECTIVE

This study contributes to the literature using Twitter data to assess the knowledge and beliefs of T21.

METHODS

Twitter data were collected from November 2019 to February 2021 using the Twitter streaming application programming interface with keywords related to vaping or e-cigarettes, such as "vape," "ecig," etc. The temporal trend of the T21 discussion on Twitter was examined using the mean number of daily T21-related tweets. Inductive methods were used to manually code the tweets into different sentiment groups (positive, neutral, and negative) based on the attitude expressed toward the policy by 3 coders with high interrater reliability. Topics discussed were examined within each sentiment group through theme analyses.

RESULTS

Among the collected 3197 tweets, 2169 tweets were related to T21, of which 444 tweets (20.5%) showed a positive attitude, 736 (33.9%) showed a negative attitude, and 989 (45.6%) showed a neutral attitude. The temporal trend showed a clear peak in the number of tweets around January 2020, following the enactment of this legislation. For positive tweets, the most frequent topics were "avoidance of further regulation" (120/444, 27%), "Enforce T21" (110/444, 24.8%), and "health benefits" (81/444, 18.2%). For negative tweets, the most frequent topics were "general disagreement or frustration" (207/736, 28.1%) and "will still use tobacco" (188/736, 25.5%). Neutral tweets were primarily "public service announcements (PSA) or news posts" (782/989, 79.1%).

CONCLUSIONS

Overall, we find that one-third of tweets displayed a negative attitude toward T21 during the study period. Many were frustrated with T21 and reported that underage consumers could still obtain products. Social media data provide a timely opportunity to monitor public perceptions and responses to regulatory actions. Continued monitoring can inform enforcement efforts and potential unintended consequences of T21.

Do e-cigarette retail licensure laws reduce youth tobacco use?

E-cigarette licensure laws (ELLs) require retailers to obtain a state license to sell e-cigarettes over the counter. This study is the first to comprehensively explore the effect of ELL adoption on youth tobacco product use. Using data from the State Youth Risk Behavior Survey (YRBS) and a difference-in-differences approach, we find no evidence that ELL adoption reduces youth ENDS use. The precision of our estimates allows us to rule out, with 95 % confidence, ELL-induced declines in prior-month, frequent, and everyday youth ENDS use of more than 0.7, 0.3, and 0.4 percentage points, respectively. The pattern of null findings persists when we examine ELLs that impose higher penalties for retailer non-compliance, higher renewable licensure fees, and criminal in addition to civil penalties. We conclude that ELLs have only limited success in curbing access to ENDS among youths.

Estimating the effects of tobacco-21 on youth tobacco use and sales

We examine the effect of raising the minimum legal sale age of tobacco to 21 (i.e., "T21"). We estimate difference-in-differences models using the Monitoring the Future (MTF) survey data and Nielsen Retail Scanner data from 2012 to 2019. Outcomes include cigarette and e-cigarette use and sales. We find sizable reductions in e-cigarette and cigarette use for 12th graders. T21 also reduced cigarette sales by 12.4 % and e-cigarette sales by 69.3 % in counties with the highest percent quartile of individuals under 21 years of age. In terms of mechanisms, we find that T21 increases ID checking and perceived risks of using both products.