Rutgers School of Public Health has been awarded a National Cancer Institute (NCI) R01 grant (1R01CA231139) titled, “Adoption, diffusion, and implementation of Tobacco 21 policies to address health.” The 5-year, $3,157,179, grant will use a mixed methods approach to understand the adoption, implementation, and maintenance of policies that raise the minimum legal age for tobacco sale to 21 and considers the impact of “Tobacco 21” on racial/ethnic tobacco disparities in the context of a diverse tobacco environment.
More than three years ago, an Institute of Medicine (IOM) report concluded that raising the tobacco age of sale to 21 would reduce tobacco use initiation among young people and reduce morbidity and mortality. Subsequently, Tobacco 21 age of sale laws have rapidly diffused as a tobacco control strategies with five states, including New Jersey, and numerous cities implementing Tobacco 21. However, little is known about factors associated with adoption or rejection of Tobacco 21 legislation nor which policy elements are most effective. In all cases, the degree of enforcement of Tobacco 21 laws will likely impact short and long-term public health outcomes such as access to tobacco for young people and patterns of use. In addition, it is not known how Tobacco 21 laws may impact the trends in tobacco product use across different tobacco products, demographic groups, or regions of the U.S.
The study, led by principal investigators, Dr. Cristine Delnevo, director of the Center for Tobacco Studies at Rutgers School of Public Health, and Dr. Shawna Hudson, professor and research division chief, department of family medicine and community health at the Rutgers Robert Wood Johnson Medical School, will be the first to gather multi-level data to examine the process, content, and outcome of Tobacco 21 laws, particularly with regard to racial/ethnic disparities in tobacco use. “While there has been a rapid diffusion of Tobacco 21 laws in the last few years, it is important to note that early adopters of health policies are often communities with the lowest risk of chronic disease and so where Tobacco 21 laws are passed is important,” says Dr. Hudson.
“As momentum for Tobacco 21 laws builds, given the diversity in tobacco product availability, regulation, and use, there is an urgent need to expand the evidence base for Tobacco 21 beyond the IOM report which focused primarily on cigarettes,” says Dr. Delnevo. “Modern tobacco use among young people is increasingly complex and characterized by decreased cigarette use, increased use of non-cigarette tobacco product use and poly tobacco use and so the extent to which Tobacco 21 laws will be effective depends on how they are enfo