{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T07:58:33Z","timestamp":1780905513088,"version":"3.54.1"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The rise in popularity of electronic cigarettes (e-cigarettes) among adolescents in the United States during the past decade is concerning because of the device\u2019s novelty and potential long-term health effects. In response, a federal Tobacco 21 (T21) law was enacted in 2019 to raise the minimum age for purchasing tobacco products and e-cigarettes from 18 to 21 years. We examined changes in adolescent e-cigarette use after implementation of T21 during a period of broader federal tobacco control activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We analyzed data from the 2019 and 2020 National Youth Tobacco Survey (NYTS) to assess changes in e-cigarette use among middle and high school students aged 9 to 19 years (most aged 13-17 y) following implementation of the federal T21 law. Weighted logistic regression models examined associations between policy implementation and current e-cigarette use, controlling for demographic characteristics and perceived harm and addictiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The prevalence of current e\u2011cigarette use declined from 16% (95% CI, 15%-18%) in 2019 to 11% (95% CI, 10%-13%) in 2020. After implementation of the federal T21 law in December 2019, adolescents were significantly less likely to use e\u2011cigarettes, with a 24% reduction in the odds of current use (odds ratio\u2009=\u20090.76; 95% CI, 0.64-0.91;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Federal legislation such as increasing the minimum age for purchasing tobacco and nicotine products may be an effective strategy in reducing and preventing e-cigarette use among adolescents. Future research should assess the sustainability of the effects of T21 legislation over time and examine how federal policies interact with other public health interventions to influence adolescent e-cigarette use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00333549261446258","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T06:32:46Z","timestamp":1780641166000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Impact of the Federal Tobacco 21 Legislation on Adolescent E-Cigarette Use and Risk Perceptions"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8356-954X","authenticated-orcid":false,"given":"Karen W.","family":"Geletko","sequence":"first","affiliation":[{"name":"Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Mills","sequence":"additional","affiliation":[{"name":"Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Dix","sequence":"additional","affiliation":[{"name":"Florida State University College of Medicine, Tallahassee, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghana","family":"Bomma","sequence":"additional","affiliation":[{"name":"Florida State University College of Medicine, Tallahassee, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidan","family":"Price","sequence":"additional","affiliation":[{"name":"Florida State University College of Medicine, Tallahassee, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1125-7704","authenticated-orcid":false,"given":"Jeffrey","family":"Harman","sequence":"additional","affiliation":[{"name":"Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6745a5"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6950a1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7341a2"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2023.109834"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09572-x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2016.11.013"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2019.7.41661"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a012120"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2016.12.034"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2023.106716"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-3652"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pbb.2022.173343"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12012-019-09516-x"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19063237"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00448.2020"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2300229"},{"key":"e_1_3_2_18_2","volume-title":"The Health Consequences of Smoking\u201450 Years of Progress: A Report of the Surgeon General","author":"National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health","year":"2014","unstructured":"National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. The Health Consequences of Smoking\u201450 Years of Progress: A Report of the Surgeon General. Centers for Disease Control and Prevention; 2014."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.2285"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2013.09.015"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2023.07.010"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2022.107238"},{"key":"e_1_3_2_23_2","unstructured":"US Food and Drug Administration. Spotlight on science\u2014winter 2020: FDA finalizes policy on unauthorized flavored cartridge-based e-cigarettes that appeal to children. Published January 2020. Accessed May 31 2025. https:\/\/www.fda.gov\/tobacco-products\/ctp-newsroom\/spotlight-science-winter-2020#policy"},{"key":"e_1_3_2_24_2","unstructured":"US Food and Drug Administration. Tobacco 21. Published August 2024. Accessed May 31 2025. https:\/\/www.fda.gov\/tobacco-products\/retail-sales-tobacco-products\/tobacco-21"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11166-022-09402-y"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.5888\/pcd19.210430"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2023.307447"},{"key":"e_1_3_2_28_2","unstructured":"US Department of Health and Human Services Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Office on Smoking and Health. 2022 National Youth Tobacco: About Historical NYTS Data and Documentation. Accessed May 31 2023. https:\/\/www.cdc.gov\/tobacco\/about-data\/surveys\/historical-nyts-data-and-documentation.html"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2014-052207"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2018.04.043"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40429-020-00340-w"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.11336"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2022.03.018"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1916171"}],"container-title":["Public Health Reports\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549261446258","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00333549261446258","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549261446258","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T07:16:52Z","timestamp":1780903012000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00333549261446258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,4]]},"references-count":33,"alternative-id":["10.1177\/00333549261446258"],"URL":"https:\/\/doi.org\/10.1177\/00333549261446258","relation":{},"ISSN":["0033-3549","1468-2877"],"issn-type":[{"value":"0033-3549","type":"print"},{"value":"1468-2877","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,4]]},"article-number":"00333549261446258"}}