title: Statewide evaluation of youth access ordinances in practice: effects of the implementation of community-level regulations in Massachusetts.
abstract: The objectives of the study described in this article were to test whether community-level youth access ordinances reduce adolescents' perceived access to tobacco, purchase attempts, and tobacco use. A telephone survey was performed of a random sample of 3,831 Massachusetts adolescents linked to a database of all town-level youth access ordinances in the state. Respondents' perceived ease of access to tobacco, attempts to purchase tobacco, and tobacco use (ever smoking and current [past 30-day] smoking) were assessed. The association of these outcomes with the characteristics of youth access ordinances in the respondents' town of residence (n = 314) was tested in multilevel analyses that included town-level clustering, controlled for multiple individual and environmental characteristics, including a measure of community-level anti-smoking sentiment. Community-level youth access ordinances were not associated with adolescents' perceived access to tobacco, purchase attempts, or tobacco use, with two exceptions: (1) banning free-standing displays was associated with a 40% reduction in perceived access to tobacco (OR = 0.6; 95% CI, 0.4-0.9) and (2) a vending machine ban was associated a 30% higher report of perceived access to tobacco (OR = 1.3; 95% CI, 1.1-1.5). This study found no consistent associations between community-level youth access ordinances and adolescents' perceived access to tobacco, purchase attempts, or smoking prevalence.
authors.affiliation: Pulmonary and Critical Care Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA. cthomson@partners.org
authors.forename: Carey Conley
authors.initials: CC
authors.lastname: Thomson
authors.forename: Manjusha
authors.initials: M
authors.lastname: Gokhale
authors.forename: Lois
authors.initials: L
authors.lastname: Biener
authors.forename: Michael B
authors.initials: MB
authors.lastname: Siegel
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Rigotti
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000329:Advertising; D002648:Child; D003256:Community Participation / Q000331:legislation & jurisprudence*; D005260:Female; D006291:Health Policy / Q000331:legislation & jurisprudence; D006801:Humans; D008297:Male; D008404:Massachusetts; D012907:Smoking / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D012926:Social Control, Formal; D012959:Socioeconomic Factors; D014026:Nicotiana