||1R03CA228909-01A1 Interpret this number
||University Of Nebraska Medical Center
||Effects of the FDA Compliance Inspections of Tobacco Retailers on Youth E-Cigarette and Cigar Use: a National Study
The use of emerging tobacco products is gaining popularity among youth. Among U.S. high school students,
current use of e-cigarettes has outpaced the use of traditional cigarettes. E-cigarettes contain varying levels of
nicotine and a number of potentially toxic substances and youth use of e-cigarettes might serve as a gateway
for future cigarette use. Cigars currently rank third among the tobacco products most commonly used by youth
and also pose serious threats to health; cigar smoke is possibly more toxic than cigarette smoke. The recently
finalized ?Deeming Rule? from the Food and Drug Administration (FDA) expanded the agency's regulatory
authority over tobacco to include e-cigarettes, cigars, and other newly deemed tobacco products. The first round
of new requirements on ?retailer environment? for ?covered tobacco products,? including mandatory age and
photo ID checks to prevent illegal sale of these products to minors, was implemented on August 8, 2016. Early
studies that were primarily based on community data have shown mixed results regarding the effectiveness of
youth access laws to reduce youth cigarette smoking. Recent studies using national probability samples have
shown that retail compliance of underage sales laws and restricting tobacco sales to minors are important
tobacco prevention strategies. Over the decades, the prevalence of youth cigarette smoking and youth
commercial access to cigarettes has been significantly reduced. Despite this progress, the tobacco industry has
been promoting alternative tobacco products, such as e-cigarettes, cigars, to entice a new generation of users.
The overarching goal of this study is to conduct a quasi-experimental design to assess the impacts of the FDA
retail compliance inspections on youth cigar and e-cigarette use behaviors (e.g., ever, current, and frequency of
use). This study is innovative in its focus on developing propensity models to predict the violation rate for
underage retail sales of e-cigarettes and cigars at the zip code level, and on linking the compliance inspection
data with multiple years of national youth survey data in order to assess the potential impacts of regulatory
actions. This research will address two of the FDA Center for Tobacco Products (CTP) scientific interest areas:
#4 (behavior) and #7 (impact analysis). Results from this study are expected to inform appropriate retail
compliance inspection strategies and further expand our knowledge of the potential impacts of regulatory actions
on youth e-cigarette and cigar use behaviors.
Trends in Single, Dual, and Poly Use of Alcohol, Cigarettes, and Marijuana Among US High-School Students: 1991-2017.
American journal of public health, 2019 Aug; 109(8), p. 1138-1140.
Changes in Flavored Tobacco Product Use Among Current Youth Tobacco Users in the United States, 2014-2017.
JAMA pediatrics, 2019-03-01; 173(3), p. 282-284.