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Principal Investigator: Carla J Berg
Organization: GEORGE WASHINGTON UNIVERSITY
Fiscal Year: 2024
Award: $454,860
Funding agency: National Cancer Institute
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.
Terms: <21+ years old><Address><Adolescent><Adolescent Youth><Adult><Adult Human><Advertisement><Advertisements><Advertising><Affect><Air><American><Attention><COVID-19><CV-19><Categories><Classification><Code><Coding System><Communities><Community Surveys><Consensus><Coronavirus Infectious Disease 2019><County><Data><Data Bases><Databases><Disparities><Disparity><Disparity population><Electronic cigarette><Empirical Research><Ethnic Origin><Ethnicity><Face><Firearms><Foundations><Funding><Geography><Goals><Health><Individual><Individuals from minority><Individuals of minority><Industry><Laws><Lead><Legislation><Licensing><Licensure><Link><Literature><Location><Measures><Minority Groups><Minority People><Minority Population><Minority individual><NHANES><National Health Interview Survey><National Health and Nutrition Examination Survey><Nutrition Policy><Outcome><Outcome Measure><Passive Smoke Exposure><Pb element><Persons><Policies><Population><Provincial Government><Public Health><Publishing><Race><Races><Research><Rights><Rural><Rural Population><Rural group><Rural people><Safety><Sales><Sampling><Smoke><Socio-economic status><Socioeconomic Status><Source><State Government><Statutes and Laws><Subgroup><Survey Instrument><Surveys><System><Systematics><Taxation><Taxes><Time><Tobacco><Tobacco Consumption><Tobacco Industry><Tobacco use><Translational Research><Translational Science><Vulnerable Populations><Walking><Work><Youth><Youth 10-21><adulthood><clean indoor air law><coronavirus disease 2019><coronavirus disease-19><coronavirus infectious disease-19><data base><density><disadvantaged group><disadvantaged individual><disadvantaged people><disadvantaged population><disadvantaged subgroup><disparities across groups><disparity across subgroups><disparity among groups><disparity among subgroups><disparity between groups><disparity between subgroups><disparity in health><e-cig><e-cigarette><ecig><ecigarette><environmental tobacco smoke exposure><ethnic minority><evidence base><experience><exposure to ETS><exposure to SHS><exposure to environmental tobacco smoke><exposure to secondhand smoke><exposure to tobacco smoke><faces><facial><group disparity><group inequality><group inequity><health disparity><heavy metal Pb><heavy metal lead><improved><indexing><inequalities among populations><inequalities between populations><inequalities in populations><inequality across populations><inequality among groups><inequality between groups><inequality in groups><inequities among populations><inequities between populations><inequities in populations><inequity across groups><inequity across populations><inequity between groups><inequity in groups><information processing><juvenile><juvenile human><low SES><low socio-economic position><low socio-economic status><low socioeconomic position><low socioeconomic status><measurable outcome><methods to study multiple-level influences><multi-level analysis><multi-level model><multilevel analysis><multilevel model><multilevel modeling><non-smoker><nonsmoker><novel><outcome measurement><population inequality><population inequity><preempt><public policy on tobacco><racial><racial background><racial minority><racial origin><reduce tobacco use><reduction in tobacco use><research data dissemination><research dissemination><rural dwellers><rural individual><rural locality><rural place><rural resident><rural setting><second hand smoke exposure><secondhand smoke exposure><secondhand tobacco smoke exposure><smoke-free air law><smoke-free air policy><smoke-free indoor policy><smoke-free law><smoke-free policy><smokefree air law><smokefree policy><smoking prevalence><socio-demographics><socio-economic position><sociodemographics><socioeconomic position><subgroup disparity><tobacco company><tobacco control><tobacco control policy><tobacco policy><tobacco product use><tobacco products><tobacco use reduction><tool><translation research><translational investigation><unequal group><unequal population><vulnerable group><vulnerable individual><vulnerable people>