{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T04:54:34Z","timestamp":1785732874303,"version":"3.56.0"},"reference-count":43,"publisher":"BMJ","issue":"5","funder":[{"DOI":"10.13039\/100010628","name":"Center for Tobacco Products","doi-asserted-by":"publisher","award":["R21CA268199"],"award-info":[{"award-number":["R21CA268199"]}],"id":[{"id":"10.13039\/100010628","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2024,3,13]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>States have recently enacted tobacco-related age and flavour restrictions in addition to federal T21 laws. Little is known about the independent effects of these policies on young adult tobacco use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Linking 2011\u20132022 Behavioural Risk Factor Surveillance System data on 2 696 870, 18\u201359\u2009years from 50 states and DC with policy data, we conducted probit regression models to evaluate the associations between state and federal T21 laws and state flavour restrictions with cigarettes, electronic nicotine delivery system (ENDS) and smokeless tobacco use. Models were adjusted for sociodemographics, additional tobacco policies, COVID-19-related factors, year and state. We tested two-way and three-way interactions between age, state T21 and federal T21 laws.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Although we did not find evidence that state T21 laws were associated with cigarette, smokeless tobacco or ENDS use overall, the federal T21 law was associated with lower use of all three tobacco products by 0.39\u20130.92\u2009percentage points. State flavour restrictions were associated with lower use of cigarettes by 0.68 (\u22121.27 to \u20130.09) and ENDS by 0.56 (\u22121.11 to \u20130.00)\u2009percentage points, but not with smokeless tobacco. A three-way interaction revealed that state and federal T21 laws together were associated with a lower prevalence of ENDS use among 18\u201320\u2009years, but there were no differences in cigarette use from both policies combined versus either alone.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>State and federal T21 laws are broadly effective at reducing adult tobacco use, while state flavour restrictions specifically lower use of cigarettes and ENDS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/tc-2023-058448","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T13:21:26Z","timestamp":1711372886000},"page":"571-578","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Associations between tobacco 21 and state flavour restrictions with young adult tobacco use"],"prefix":"10.1136","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1099-362X","authenticated-orcid":false,"given":"Summer Sherburne","family":"Hawkins","sequence":"first","affiliation":[{"name":"School of Social Work, Boston College, Chestnut Hill, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoka","family":"Carey","sequence":"additional","affiliation":[{"name":"Lynch School of Education & Human Development, Boston College, Chestnut Hill, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebekah","family":"Levine Coley","sequence":"additional","affiliation":[{"name":"Department of Counseling, Developmental, and Educational Psychology, Boston College Lynch School of Education, Chestnut Hill, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher F","family":"Baum","sequence":"additional","affiliation":[{"name":"School of Social Work, Boston College, Chestnut Hill, Massachusetts, USA"},{"name":"Department of Economics, Boston College, Chestnut Hill, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"2025100305400837000_34.5.571.1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6806e1"},{"key":"2025100305400837000_34.5.571.2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7244a1"},{"key":"2025100305400837000_34.5.571.3","unstructured":"Schoenborn CA , Gindi RM . Electronic cigarette use among adults: United States, 2014. NCHS Data Brief 2015:1\u20138."},{"key":"2025100305400837000_34.5.571.4","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7218a1"},{"key":"2025100305400837000_34.5.571.5","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1001\/jamapediatrics.2017.3209","article-title":"Associations of electronic cigarette nicotine concentration with subsequent cigarette smoking and vaping levels in adolescents","volume":"171","author":"Goldenson","year":"2017","journal-title":"JAMA Pediatr"},{"key":"2025100305400837000_34.5.571.6","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.13804","article-title":"Association of flavored tobacco use with tobacco initiation and subsequent use among US youth and adults, 2013-2015","volume":"2","author":"Villanti","year":"2019","journal-title":"JAMA Netw Open"},{"key":"2025100305400837000_34.5.571.7","unstructured":"Centers for Disease Control and Prevention . 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