TY - JOUR
T1 - Characteristics and Reach Equity of Policies Restricting Flavored Tobacco Product Sales in the United States
AU - Rose, Shyanika W.
AU - Amato, Michael S.
AU - Anesetti-Rothermel, Andrew
AU - Carnegie, Brittany
AU - Safi, Zeinab
AU - Benson, Adam F.
AU - Czaplicki, Lauren
AU - Simpson, Randall
AU - Zhou, Yitong
AU - Akbar, Maham
AU - Younger Gagosian, Stacey
AU - Chen-Sankey, Julia Cen
AU - Schillo, Barbara A.
N1 - Publisher Copyright:
© 2019 Society for Public Health Education.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - In 2009, flavored cigarettes (except menthol) were banned in the United States, but other flavored tobacco products (FTPs) were allowed. Women, populations of color, youth, sexual minority, and low–socioeconomic status populations disproportionately use FTPs. Localities have passed sales restrictions on FTPs that may reduce disparities if vulnerable populations are reached. This study assessed the extent to which FTP restrictions reached these subgroups (“reach equity”). We identified 189 U.S. jurisdictions with FTP policies as of December 31, 2018. We linked jurisdictions with demographics of race/ethnicity, gender, age, partnered same-sex households and household poverty, and stratified by policy strength. We calculated Reach Ratios (ReRas) to assess reach equity among subgroups covered by FTP policies relative to their U.S. population representation. Flavor policies covered 6.3% of the U.S. population (20 million individuals) across seven states; 0.9% were covered by strong policies (12.7% of policies). ReRas indicated favorable reach equity to young adults, women, Hispanics, African Americans, Asians, partnered same-sex households, and those living below poverty. Youth, American Indians/Alaska Natives (AIAN) and Native Hawaiians/Pacific Islanders (NHPI) were underrepresented. Strong policies had favorable reach equity to young adults, those living below poverty, Asians, NHPIs, individuals of 2+ races, and partnered same-sex households, but unfavorable reach equity to women, youth, Hispanic, AIAN, and African American populations. U.S. flavor policies have greater reach to many, but not all, subgroups at risk of FTP use. Increased enactment of strong policies to populations not covered by flavor policies is warranted to ensure at-risk subgroups sufficiently benefit.
AB - In 2009, flavored cigarettes (except menthol) were banned in the United States, but other flavored tobacco products (FTPs) were allowed. Women, populations of color, youth, sexual minority, and low–socioeconomic status populations disproportionately use FTPs. Localities have passed sales restrictions on FTPs that may reduce disparities if vulnerable populations are reached. This study assessed the extent to which FTP restrictions reached these subgroups (“reach equity”). We identified 189 U.S. jurisdictions with FTP policies as of December 31, 2018. We linked jurisdictions with demographics of race/ethnicity, gender, age, partnered same-sex households and household poverty, and stratified by policy strength. We calculated Reach Ratios (ReRas) to assess reach equity among subgroups covered by FTP policies relative to their U.S. population representation. Flavor policies covered 6.3% of the U.S. population (20 million individuals) across seven states; 0.9% were covered by strong policies (12.7% of policies). ReRas indicated favorable reach equity to young adults, women, Hispanics, African Americans, Asians, partnered same-sex households, and those living below poverty. Youth, American Indians/Alaska Natives (AIAN) and Native Hawaiians/Pacific Islanders (NHPI) were underrepresented. Strong policies had favorable reach equity to young adults, those living below poverty, Asians, NHPIs, individuals of 2+ races, and partnered same-sex households, but unfavorable reach equity to women, youth, Hispanic, AIAN, and African American populations. U.S. flavor policies have greater reach to many, but not all, subgroups at risk of FTP use. Increased enactment of strong policies to populations not covered by flavor policies is warranted to ensure at-risk subgroups sufficiently benefit.
KW - health disparities
KW - health equity
KW - public policy
KW - tobacco control
KW - vulnerable populations
UR - http://www.scopus.com/inward/record.url?scp=85077637230&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85077637230&partnerID=8YFLogxK
U2 - 10.1177/1524839919879928
DO - 10.1177/1524839919879928
M3 - Article
C2 - 31908207
AN - SCOPUS:85077637230
SN - 1524-8399
VL - 21
SP - 44S-53S
JO - Health Promotion Practice
JF - Health Promotion Practice
IS - 1_suppl
ER -