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Quantifying the Effect of Changes in State-Level Adult Smoking Rates on Youth Smoking

Farrelly, Matthew C. PhD; Arnold, Kristin Y. MSPH; Juster, Harlan R. PhD; Allen, Jane A. MA

Journal of Public Health Management & Practice:
doi: 10.1097/PHH.0b013e31829aa28e
Original Articles
Abstract

Objective: Quantify the degree to which changes in state-level adult smoking prevalence subsequently influence youth smoking prevalence.

Design: Analysis of data from the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) collected from 1995 to 2006 and the National Youth Tobacco Survey (NYTS) collected from 1999 to 2006.

Setting and Participants: Adults 25 years or older who completed the TUS-CPS and youth in middle and high school who completed the NYTS.

Main Outcome Measures: Current smoking among middle and high school students as a function of the change in state-level adult smoking, controlling for individual-level sociodemographic characteristics and state-level tobacco control policy variables.

Results: Among middle school students, declines in state-level adult smoking rates are associated with lower odds of current smoking (P < .05), and each doubling of the decline in adult smoking rates is associated with a 6.0% decrease in youth smoking. Among high school students, declines in state-level adult smoking rates are not associated with current smoking. Higher cigarette prices were associated with lower odds of smoking among middle and high school students. Greater population coverage by smoke-free air laws and greater funding for tobacco control programs were associated with lower odds of current smoking among high school students but not middle school students. Compliance with youth access laws was not associated with middle or high school smoking.

Conclusion: By quantifying the effect of changes in state-level adult smoking rates on youth smoking, this study enhances the precision with which the tobacco control community can assess the return on investment for adult-focused tobacco control programs.

In Brief

This article discusses the degree to which changes in state-level adult smoking prevalence subsequently influence youth smoking prevalence. Quantification of the effect of these changes enhances the precision with which the tobacco control community can assess the return on investment for adult-focused tobacco control programs.

Author Information

Public Health Policy Research Program, RTI International, Research Triangle Park, North Carolina (Dr Farrelly and Mss Arnold and Allen); and Tobacco Surveillance, Evaluation and Research, Bureau of Chronic Disease Evaluation and Research, New York State Department of Health, Albany (Dr Juster).

Correspondence: Matthew C. Farrelly, PhD, Public Health Policy Research Program, RTI International, 3040 Cornwallis Rd, PO Box 12194, Research Triangle Park, NC 27709 (mcf@rti.org).

This study was funded by the New York State Department of Health Tobacco Control Program. The conclusions in this article are those of the authors and do not represent the views of the New York State Department of Health. The authors thank Kelsey Campbell and Susan Murchie, both of RTI International, for their assistance with this project.

The authors declare no conflicts of interest.

© 2014 Lippincott Williams & Wilkins, Inc.