Grant Number:	5R01CA275066-02 Interpret this number
Primary Investigator:	Yang, Tony
Organization:	George Washington University
Project Title:	Effects of State Preemption of Local Tobacco Control Legislation on Disparities in Tobacco Use, Exposure and Retail
Fiscal Year:	2024

PROJECT SUMMARY A key Healthy People 2030 Tobacco-Use Objective is to eliminate state preemption of local tobacco control. However, little published research has rigorously quantified the impacts of state preemption of local tobacco control, particularly: 1) across states and over time; 2) across a broad range of tobacco control efforts (e.g., restrictions on advertising, youth access); 3) across a range of key outcomes (e.g., youth and adult tobacco use, secondhand smoke exposure [SHSe], tobacco retail); and 4) with regard to potential disproportionate impacts among certain subgroups that face tobacco-related disparities (e.g., racial/ethnic minorities, lower socioeconomic status [SES], those in rural settings). As initial evidence providing a basis for this proposal, our RWJF-funded research concluded that state smoke-free air preemption was associated with an increase in adult smoking prevalence and affect counties differently. This proposal will build on this work and advance the literature by filling the aforementioned gaps in the existing research. The long-term goal of this research is to inform policies to reduce tobacco use and related health disparities, as well as to inform policy efforts more broadly, particularly as public health issues, like firearm safety, nutrition policies, and COVID-19 mitigation measures, are increasingly subject to state preemption. Our objective is to advance our understanding of whether—and to what extent—enactment or repeal of state preemption on local tobacco control is associated with disparities in tobacco use, SHSe, and retail (sales, retailer density). Our central hypothesis is that state preemption results in disproportionately high tobacco use, SHSe, and retail in communities with greater racial/ethnic minorities, of lower SES, and/or in rural settings. Our rationale is that, by preempting local tobacco control, state governments deprive localities of a crucial tool for reducing the burden of tobacco in their communities, potentially widening disparities. We will analyze national data from 1999 to 2021 to examine the impacts of enactment or repeal of state preemption of 5 state tobacco preemption (i.e., smoke-free policy, advertising, licensure, youth access, and taxation). Our specific aims are to examine state preemption on tobacco control in relation to changes in: 1) individual-level tobacco use (including e-cigs) in adolescents and adults and nonsmokers' SHSe, and potential disproportionate impacts among certain subgroups of individuals; and 2) sales of tobacco products and tobacco retail density over time, and potential disproportionate impacts among communities representing those facing tobacco-related disparities. We will employ multilevel models and crosswalk/merge (state/local laws, outcomes, sociodemographics) data from various sources at different geographic levels. This study will have high impact, as it will: 1) add to the evidence base regarding state preemption impact on population outcomes and mechanisms of impact; 2) inform efforts to reduce tobacco use and related disparities; and 3) engage key tobacco control and policy experts in research dissemination.





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