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Objectives. To examine the independent and joint effects of state legislation on minimum age for purchasing handguns and background checks on the suicide of young adults aged 18 to 20 years. Methods. We used negative binomial regressions with fixed effects for year and generalized estimating equations for state to estimate the effects of state legislation on annual counts of firearm, nonfirearm, and total young adult suicides in all 50 US states from 1991 to 2020. Results. Minimum age laws decreased the incidence rate of firearm suicide among young adults, an effect that was amplified in states with permit to purchase laws; there was no effect on the nonfirearm or total suicide rate. Permit to purchase laws significantly decreased the young adult firearm suicide incidence rate by 39% (incidence rate ratio [IRR] = 0.61; 95% confidence interval [CI] = 0.51, 0.74) and the overall suicide incidence rate by 14% (IRR = 0.86; 95% CI = 0.75, 0.99), with no effect on the nonfirearm suicide rate. Conclusions. Permit to purchase laws are a more promising avenue for reducing young adult suicides than are age-based restrictions. (Am J Public Health. 2024;114(8):805–813. https://doi.org/10.2105/AJPH.2024.307689) [ABSTRACT FROM AUTHOR]

Aims: From 1 January 2018, the number of retail hours for the sale of alcohol was reduced from 14 to 5 hours on Sundays and from 14 to 10 hours on the other days of the week in Lithuania. The significant reduction of hours for the sale of alcohol on Sundays may have affected the distribution of alcohol-attributable deaths during the week. This study aimed to examine the change in the weekly pattern of alcohol-attributable male mortality before and after imposing limits on the hours when alcohol can be sold. Methods: Age-standardised male death rates by days of the week were calculated for four groups according to cause of death: alcohol poisoning (X45), all external causes of death (V01–Y98), diseases of the circulatory system (I00–I99) and all other causes of death. We compared age-standardised death rates for two periods: before (2015–2017) and after (2018–2019) the intervention. Mortality and population data were obtained from the Lithuanian Institute of Hygiene and Human Mortality Database. Results: We found that during 2018–2019, earlier observed peak in age-standardised death rates for external causes of death on Sunday diminished, and this day no longer differed from the weekly average. The same tendency was also observed for the Monday excess mortality due to circulatory diseases. Conclusions: The reduction of the hours when alcohol can be sold from the beginning of 2018 was associated with a change in a weekly pattern of alcohol-attributable male mortality. However, more studies are needed to examine the causes of the change in mortality pattern. [ABSTRACT FROM AUTHOR]

In 2020, California passed a flavored tobacco sales restriction (FTSR), but the tobacco companies filed a referendum, and the ban will not be implemented unless approved by voters in November 2022. This study examined the percentage of the California population covered by a city FTSR and identified groups more likely to be covered. Mean demographics as well as tobacco use and control measures were compared for California cities with (n = 93) and without (n = 389) a FTSR, and t tests were used to examine the differences. We calculated adjusted odds ratios using logistic regression models. City FTSR policies covered 20.7% of the California population. Adjusted predictors of having a FTSR included the American Lung Association tobacco control score (odds ratio [OR] = 1.27, 95% confidence interval [CI]: [1.17, 1.38]), voting democratic (OR = 1.06, 95% CI: [1.02, 1.10]). and having a lower adult smoking prevalence (OR = 0.84, 95% CI: [0.72, 0.99]). A state-level policy would cover all populations in California. [ABSTRACT FROM AUTHOR]

To assess whether and how beverage companies incentivize universities to maximize sugar-sweetened beverage (SSB) sales through pouring rights contracts. Cross-sectional study of contracts between beverage companies and public U.S. universities with 20,000 or more students active in 2018 or 2019. We requested contracts from 143 universities. The primary measures were presence of financial incentives and penalties tied to sales volume. 124 universities (87%) provided 131 unique contracts (64 Coca-Cola, 67 Pepsi). 125 contracts (95%) included at least one provision tying payments to sales volume. The most common incentive type was commissions, found in 104 contracts (79%). Nineteen contracts (15%) provided higher commissions or rebates for carbonated soft drinks compared to bottled water. Most contracts between universities and beverage companies incentivized universities to market and sell bottled beverages, particularly SSBs. Given the health risks associated with consumption of SSBs, universities should consider their role in promoting them. [ABSTRACT FROM AUTHOR]

Background: Research is needed to identify the determinants of motivation to quit smoking among non-Hispanic Black (NHB) adults who smoke menthol cigarettes and reside in communities covered by menthol cigarette bans. Objectives: This study examined the associations between motivation to quit smoking and a range of individual-level predictors, including measures of demographics, harm/risk perception of menthol cigarettes, and awareness of a ban on menthol cigarettes in Los Angeles County unincorporated communities. Self-identified NHB adults who currently smoke menthol cigarettes (N=50; M=47.2 years; SD=13.7; 46% female) were recruited in Los Angeles County unincorporated communities. Participants completed an interviewer-administered cross-sectional survey between January to September 2021. Results: Participants (74%) reported an annual household income of less than $25,000. Participants' mean age at cigarette initiation was 15.7 years old (SD=5.68). Most (88%) were aware of the ordinance banning menthol cigarette sales. Employing multivariable linear regression analysis, harm/risk perception of menthol cigarettes (B=14.69, p<0.01) and awareness of the local menthol ban (B=26.18, p<0.05) were found to be independently associated with motivation to quit smoking. Conclusions: Findings from this community-based sample suggest that among NHB adults who smoke menthol cigarettes, motivation to quit smoking is influenced by their perception of menthol cigarettes as harmful and awareness of local policy banning the sale of menthol cigarettes. Findings underscore the need for community-centered and culturally grounded interventions to facilitate quitting among NHB adults who smoke in order for communities covered by menthol bans to achieve health equity in reducing preventable racial inequities due to menthol cigarettes. [ABSTRACT FROM AUTHOR]

INTRODUCTION In January 2006, the Spanish government enacted a tobacco control law that banned the advertising, promotion and sponsorship of tobacco. In January 2011, further legislation on this matter was adopted to provide a more restrictive specification of the ban. In this study, we analyze the effect produced on cigarette sales by these two prohibitions. We address this problem using a cluster time-series analysis to test whether the sales of cigarettes by brands have been homogenized with the prohibition of advertising, promotion, and sponsorship. METHODS The data source used was the official data on legal sales of cigarettes by brands in Spain, from January 2005 to December 2021 (excluding the Canary Islands and the Autonomous Communities of the cities of Ceuta and Melilla). To achieve our objective, we used log(t) test statistics to check if there is global convergence in the three selected periods according to the regulatory changes that have occurred in Spain (2005-2021, 2005-2010 and 2011-2021). Second, once absolute convergence is rejected, we applied a clustering algorithm to test for the existence of subgroup convergence. RESULTS The cigarette brands that have been marketed during the period 2005- 2021 (n=40), can only be grouped into three groups according to the behavior of their sales. When we focus on the period 2005-2010 (n=74), cigarette brands are grouped into five groups according to their sales behavior. Finally, the cigarette brands marketed during the period 2011-2021 (n=67) are grouped into three groups according to the temporal evolution of their sales. These results suggest a greater homogenization of cigarette sales after the application of the law of January 2011. CONCLUSIONS Act 42/2010 (total ban on tobacco advertising, promotion, and sponsorship actions) was associated with greater homogenization of cigarette sales than the application of Act 28/2005 (partial ban). This finding supports what is established in the previous literature that indicates that Act 42/2010 provided a more restrictive specification of the ban than Act 28/2005. [ABSTRACT FROM AUTHOR]

Background: Prohibiting the purchase and possession of firearms by those at risk of violence is an established approach to preventing firearm violence. Prior studies of legal purchasers have focused on convictions for specific crimes, such as violent misdemeanors and driving under the influence (DUI). We broaden that line of inquiry by investigating and comparing the associations between prior arrests for most categories of crime and subsequent arrest for violent offenses among legal handgun purchasers in California. Methods: In this longitudinal cohort study of 79,678 legal handgun purchasers in California in 2001, we group arrest charges prior to their first purchases in 2001 according to categories defined by the Uniform Crime Report (UCR) Handbook. We use a gradient boosting machine to identify categories of offenses that are most important for predicting arrest for violent crime following firearm purchase. For each category identified, we then estimate the difference in risk of subsequent arrest for a violent offense using survival regression models. Results: We identified eight crime categories with high predictive importance: simple assaults, aggravated assaults, vehicle violations, weapon, other crimes, theft, drug abuse, and DUI. Compared to purchasers with no prior arrests, those with a prior arrest for any one of the eight important categories and no other categories were found to be at increased risk of arrest for a Crime Index-listed violent crime (murder, rape, robbery, aggravated assault), with the greatest estimated risk corresponding to the simple assault UCR category (adjusted hazard ratio 4.0; 95% CI 2.8–5.9). Simple assault was also associated with the greatest risk for subsequent arrest for firearm violence (adjusted hazard ratio 4.6; 95% CI 2.4–9.0) and any violent offense (adjusted hazard ratio 3.7; 95% CI 2.7–5.0). Conclusion: The findings of this study suggest that prior arrests for a broad array of crimes, both violent and non-violent, are associated with risk of subsequent violent crimes, including Crime Index-listed violent crimes and firearm violence, among legal purchasers of firearms. Current policies aimed at restricting access to firearms for individuals at increased risk of violence should be re-examined considering these findings. [ABSTRACT FROM AUTHOR]

Objective: two-thirds of U.S. colleges are near vape shops, where higher rates of underage sales exist. this study examined vape shop compliance with state-mandated age-of-sale signs, the presence of age-of-entry signs and the tobacco industry's "We Card" sign. Participants: Random sample of 614 California vape shops, stratified by distance to community colleges or 4-year universities/colleges; visited June--August, 2019. Methods: Logistic regressions examined whether signage varied by distance to colleges and whether stores sold other tobacco products (otp). Results: Compliance with the state-mandated age-of-sale sign was 69.4%; vape-only stores were less compliant than vape + otp (AoR = 0.39, 95% CI = 0.22,0.70). Age-of-entry signs were more common in vape-only (AoR = 1.87, 95% CI = 1.07,3.28) than vape + otp stores. However, this difference was greater for vape-only stores near community colleges and attenuated for vape-only stores near 4-year universities/colleges. Conclusion: Improved enforcement and retailer education regarding age-of-sale signage are needed, particularly near colleges where greater potential for underage sales presumably exists. [ABSTRACT FROM AUTHOR]

Background: Tobacco usage has been identified as a leading preventable cause of mortality and is responsible for six million fatalities per year globally. India had enacted COTPA in 2003. Tobacco vendors are one of the key stakeholders for Cigarettes and Other Tobacco Products Act (COTPA) implementation. Objective: To assess the knowledge gap on COTPA and to explore the perceived factors influencing implementation of COTPA among tobacco vendors in Puducherry. Materials and Methods: A mixed-method study was conducted among tobacco vendors from Point of Sale (PoS) around 230 educational institutions (schools and degree colleges) in Puducherry for three months. Simple random sampling was applied to select educational institutions and the tobacco vendors from PoS located around these institutions were included. Data capture was done using a pretested, face-validated questionnaire incorporated in Epicollect software 5 and data analysis by SPSSv24. Purposive sampling was employed to conduct in-depth interviews among tobacco vendors till the point of saturation and manual content analysis performed. Written informed consents were sought. Institutional Ethical Committee approval was obtained. Results: Majority (95.7%) reported that they were aware of tobacco control legislation, but only one person had heard of COTPA. Awareness about the display of signage boards at PoS was observed in 75.7% vendors. Around 41.7% reported that they should not advertise any kind of tobacco products. Three major themes were identified: facilitators, barriers, and suggested measures for COTPA implementation. Conclusion: Tobacco vendors in Puducherry were aware of tobacco control legislations but not familiar with the COTPA and its provisions. It is necessary to put forth efforts to educate these important stakeholders to be more cognizant of COTPA and to effectively include them in anti-tobacco programs. [ABSTRACT FROM AUTHOR]

We examined how legalization of Sunday alcohol sales relates to attitudes towards Sunday sales, and how both attitudes and alcohol consumption patterns relate to Sunday alcohol purchasing. A total of 1,384 adults of legal drinking age completed a survey one year post-legalization of Sunday sales. A majority of respondents (51%) were supportive of Sunday sales legalization both before and after legalization. People were more likely to support Sunday sales legalization if they reported binge drinking (PR: 2.19; CI: 1.51 3.18). Following Sunday sales legalization, 59% of participants reported purchasing alcohol in Minnesota on Sunday. Binge drinking (PR: 1.39; CI: 1.27, 1.52) or supporting Sunday sales legalization (PR: 1.85; CI: 1.56, 2.17) were associated with higher likelihood of purchasing alcohol on Sunday. Legalizing Sunday sales may have increased access to alcohol for people with more unhealthy drinking behaviors. [ABSTRACT FROM AUTHOR]

INTRODUCTION In response to COVID-19, the South African government banned the sale of tobacco products for 20 weeks. Before the ban, the illicit cigarette market was well-entrenched and smoking cessation services were not widely available. Several surveys conducted to ascertain cigarette smokers' responses to the ban reported substantial differences in the proportion of smokers who quit. This study provides a broadly nationally representative ex-post investigation into cigarette smokers' quitting behavior related to the sales ban. METHODS We used data from wave three of NIDS-CRAM (the National Income Dynamics Study-Coronavirus Rapid Mobile Survey) conducted in November-- December 2020. We first investigated the proportion of people who quit and who continued smoking during and after the sales ban. We subsequently linked the NIDS-CRAM survey to the fifth wave of NIDS (2017) to identify a subset of established smokers, and considered whether their quitting behavior differed from that of all smokers who smoked at the start of the sales ban. RESULTS The cross-sectional analysis showed that 7.8% of cigarette smokers quit during the sales ban, but that 55% of these quitters relapsed after it was lifted. Of the pre-ban smokers, 3.5% indicated that they did not smoke both during and after the sales ban, and 3.7% quit after the ban was lifted. The longitudinal analysis showed that 7% of people who were smoking in 2017, quit smoking cigarettes during the tobacco sales ban, but that >70% of quitters relapsed after it was lifted. Only 2% of pre-ban established smokers indicated that they did not smoke during or after the ban. CONCLUSIONS The sales ban did not have the intended objective of encouraging large-scale smoking cessation. This reflects policy failures to provide smokers with appropriate cessation support and to effectively control the illicit market both prior to and during the sales ban. [ABSTRACT FROM AUTHOR]

The article focuses on the FDA's concerns about probiotic products containing live bacteria or yeast, commonly known as probiotics, being sold illegally for use in treating or preventing diseases in hospitalized preterm infants. Topics include the FDA issuing warning letters to companies, the potential risks of these unapproved probiotic products to preterm infants, and the agency's investigation into adverse events.

In response to the COVID-19 pandemic, South Africa implemented a national lockdown including a ban on the sale of alcohol. This paper describes adults' perspectives on this alcohol ban, focusing on whether they support or oppose this regulation. As part of a longitudinal study that documents South African's experiences of the COVID-19 lockdown, qualitative data were collected from 49 adults and analyzed thematically. Perspectives are framed around the overarching theme of "lives versus livelihoods," presented as support and/or opposition to the ban. Participants who endorsed the ban, as preserving "lives," thought that it facilitated social distancing and therefore limited the spread of COVID-19. Those who opposed the ban suggested that it undermined the "livelihoods" of South Africans, in the context of an already-strained economy. Our findings show that decisions around whether to support or oppose the alcohol ban were informed by critical reflections on the wider socio-behavioral and health implications of such regulations. Further implications are discussed. [ABSTRACT FROM AUTHOR]

Objectives. To comprehensively catalog and review state e-cigarette delivery sales laws as well as capture their scope and dimensions. Methods. We conducted an in-depth review to determine whether states had at least 1 form of e-cigarette delivery sales law. We coded laws for 5 key policy domains: (1) delivery terminology used in laws, (2) age verification requirements, (3) packaging label requirements, (4) permit or registration requirements, and (5) fines and penalties for violations. Results. Overall, 34 states had e-cigarette delivery sales laws with varying scopes and dimensions. In 27 states, these laws required at least 1 form of age verification requirements. We identified mandatory packaging labels in 12 states, and 7 states where permits were required. There were considerable differences among states on the scale of fines and penalties for violations. Conclusions. Our findings reveal extensive heterogeneity in e-cigarette delivery sales laws among states, particularly regarding the scope and dimensions of these laws. Public Health Implications. The mapping of e-cigarette delivery sales policies showed several potential loopholes that may diminish their effectiveness. (Am J Public Health. 2023;113(5):568–576. https://doi.org/10.2105/AJPH.2023.307228) [ABSTRACT FROM AUTHOR]

Background: In June 2016, a comprehensive food policy was implemented in Chile that included front-of-package warning labels on key nutrients of concern (total sugars, added saturated fats, sodium, and calories), child-directed food advertisement bans, and school regulations. The policy was implemented in 3 phases from 2016 to 2019 and the primary objective was to improve children's food environments. This study's objective was to assess changes in child and adolescent intake of key nutrients of concern (total sugars, saturated fats, and sodium) at school after the initial implementation of Chile's Law of Food Labeling and Advertisement. Methods: Longitudinal study of 349 children from the Food Environment Chilean Cohort (FECHIC) and 294 adolescents from the Growth and Obesity Cohort Study (GOCS). Data were from single 24-hour dietary recalls collected from 2016 to 2019. Fixed-effects models stratified by school, home, and other locations compared nutrient consumption in each year to consumption at the pre-policy 2016 baseline. Nutrient intakes are expressed as percent of total energy. Results: Compared to 2016 (pre-policy), total sugars consumed by children at school decreased 4.5 [-8.0, -0.9] percentage points (pp) and 11.8 [-15.4, -8.3] pp in 2018 and 2019 respectively. In 2019, children's saturated fats and sodium intake at school also decreased (1.1 [-1.9, -0.2] pp and 10.3 [-18.1, -2.5] mg/100 kcal respectively). Likewise, in adolescents, total sugars and saturated fats consumed at school decreased in 2018 (5.3 [-8.4, -2.2] pp and 1.5 [-2.7, -0.3] pp respectively). However, consumption of key nutrients of concern at other locations increased after implementation of the policy. Conclusions: After initial implementation of Chile's Labeling Law, intake of most key nutrients of concern significantly declined at school. However, we found evidence of compensatory behavior in out-of-school settings. Further research is needed to evaluate what other actions are needed to impact overall diets in the long term both at schools and out of school. [ABSTRACT FROM AUTHOR]

Background and Objective: Organ transplant is the treatment of choice for end-stage organ failure but there is a shortage of donor organs worldwide. Situation in India is even worse. There is a worldwide shortage of donor organs in comparison to the need for transplantation. The present study was designed with the aim to assess knowledge and attitude regarding organ donation among medical students and students pursuing courses other than medical and compare among both groups. Materials and Methods: The study included 200 medical students and 200 students pursuing courses other than medical. After taking informed consent, the students were given a prevalidated self-designed questionnaire having three sections to assess knowledge and attitude regarding organ donation. Data were collected, compiled, and analyzed. Results: On average, 98.75% of students were aware that organ donation can save life but a significantly higher number of medical students (P < 0.0001) knew brain death and that organ donation can be done during life and after death. However, willingness to donate their own organs or organs of the relative was seen among a greater number of students pursuing other courses (P < 0.001). To save someone's life was the reason to will for organ donation among 70% of medical students. Conclusion: It was observed that the medical students had better awareness regarding organ donation but students pursuing other courses had a better attitude toward organ donation. [ABSTRACT FROM AUTHOR]

In April, the Center for Tobacco Products of the U.S. Food and Drug Administration (FDA) recently reviewed our inspection records and determined that Ram Goods LLC sells and/or distributes electronic nicotine delivery system (ENDS) products to customers in the United States. [ABSTRACT FROM AUTHOR]

Global health policymakers have identified Myanmar as a source of high drug resistance and informal pharmaceutical markets in need of tighter state regulation. The World Health Organization drafted a Global Action Plan on antibiotic resistance (often referred to as antimicrobial resistance) that seeks to address it. Myanmar is one of over a hundred countries that has followed the World Health Organization's prescription and drafted its own National Action Plan. Through participating in the everyday life of a family pharmacy, we observed that in practice the outcomes of global plans for AMR, such as regulating access to antibiotics, are shaped by people's limited access to affordable health care, low salaries, and the military's authoritarian role in Myanmar politics. We followed how negotiations between state officials and drug vendors evolved towards a mutual understanding (as opposed to following written rules) after a Food and Drug Administration raid, intended to enforce the regulation of the sales of illegal medicines. Rather than uncritically pushing state-centric action, those working to promote the regulation of medicines must attend more carefully to how different modes of political authority and governance, combined with histories of health provision, shape drug policy in practice. Otherwise, they risk contributing, if not intensifying, already existing health and social injustices, whilst also failing to generate their intended outcomes, such as meaningful changes to antibiotic sales and reductions in resistance. [ABSTRACT FROM AUTHOR]

Background and Aims: Existing research on mental health comorbidities of youth e‐cigarette use is subject to confounding bias and reverse causality. This study aimed to measure the effects of e‐cigarette use on youth mental health, using e‐cigarette minimum legal age (MLA) law in Canada as a natural experiment. Design: We used difference‐in‐differences (DD), difference‐in‐differences‐in‐differences (DDD) and two‐sample instrumental variables (TSIV) methods. Setting: Data were from nationally representative Canadian Community Health Surveys 2008–2019 and Canadian Student Tobacco Alcohol and Drugs Surveys 2008–2019. Participants: The study sample comprised of respondents aged 15 to 18 (in DD analysis; n = 33 858) and aged 15 to 24 (in DDD analysis; n = 78 689). Measurements Primary outcomes were self‐reported mood disorders and anxiety disorders. Secondary outcomes were cannabis use, illicit drug use, cigarette use and strength of peer relationships at schools. Findings After the e‐cigarette MLA laws, risks of mood disorders declined by 1.9 percentage points (95% CI, 0.0–3.8; P = 0.05) in the DD analysis and by 2.6 percentage points (95% CI, 0.2–5.0; P = 0.03) in the DDD analysis. For anxiety disorders, while the DD estimate was negative but imprecisely estimated, the MLA law reduced risks of anxiety disorder by 3.6 percentage points (95% CI, 0.9–6.2; P = 0.01) in the DDD analysis. Youths in provinces with MLA laws were also less likely to report cannabis use and illicit drug use and more likely to feel being part of schools. TSIV analysis indicates that youth e‐cigarette use increased the likelihood of mood and anxiety disorders by 44% and 37%, respectively. Conclusion and Relevance: In Canada, the e‐cigarette minimum legal age law appears to have reduced risks of mood and anxiety disorders, lowered substance use and improved peer relationships at schools. Combined with previous evidence of lower e‐cigarette use following the minimum legal age law, our findings indicate that youth e‐cigarette use increases risks of mood and anxiety disorders. [ABSTRACT FROM AUTHOR]

The article offers information that the American Heart Association's Hypertension Scientific Sessions 2022 suggests that these foods might act as a "gateway" causing teenagers to eat higher quantities of unhealthy foods. It also discusses that oral health which has always been a correlation between sugary or ultra-processed foods and negative impacts on the same.

This article covers the legal issues that arise when human organs are bought or sold in the UK. What this means for kidney care professionals is also considered, and how they may need to practice more defensively if they have concerns about a potential donor [ABSTRACT FROM AUTHOR]

The article presents the discussion on raising the age of the sale of tobacco by one year. Topics include smokefree generation' by phasing out the sale of tobacco by bringing forward legislation that would make it an offence to sell tobacco products to anyone born on or after 1 January; and Vaping is less harmful than smoking as vapes do not contain tobacco, and they are used to support people.

There is a growing emphasis on reducing alcohol fueled violence. We do not know whether legislation to close nighttime entertainment districts (NEDs) earlier leads to decreased intoxication and fear of violence within the NED. We collected data before restrictive alcohol legislation (n = 2,670 participants) and again after legislation was introduced (n = 1,926 participants). Patrons were systematically assessed with surveys and breathalyzers as they exited Brisbane NEDs. Consistent with a 2-hour reduction in closing times, people left the NED substantially earlier. The exit intoxication levels of people did not change between pre- and post-legislation. After the legislation was introduced perceived risk of violence increased. Perceived alcohol scarcity leads to increased preloading. With only restrictive legislation on alcohol sales, people do not drink to lower levels of inebriation. [ABSTRACT FROM AUTHOR]

Electronic nicotine delivery system use contributes to the epidemic of youth vaping. Regulations to curtail or prohibit the sale of flavored nicotine products aim to disrupt initiation of child nicotine use by reducing access to enticing nicotine flavorings. A total of 6 states and >300 localities have restricted or banned flavored nicotine product sales. In this case study, we outline the use of a localized town-based strategy, which offered 2 potential bills to incrementally restrict or prohibit sale of flavored vape products when county or state legislation was not politically feasible. Over the course of 18 months, these bills reduced the number of municipalities where these products could be sold or advertised until county, city, and statewide bans were effectively in place, ultimately making the passage of a bill in the statehouse palatable. Strong partnerships with officials who had expertise in local town government, local American Academy of Pediatrics chapter physician champions, and a diverse coalition were instrumental in motivating smaller governments, which often pass legislation faster than larger legislatures, to create child-protective tobacco policies. [ABSTRACT FROM AUTHOR]

Objective: To determine compliance with North Dakota's smoke‐free law in vape shops and other tobacco specialty shops selling electronic nicotine delivery systems (ENDS) or e‐liquids. Design: In this 2019 descriptive study, shops (n = 35) were assessed for compliance with the smoke‐free law by observation of indoor and outdoor areas for smoking or vaping, or evidence of such activity in prohibited areas, and the presence of required no‐smoking signs. Results: Only two shops (5.7%) were fully compliant with the smoke‐free law. Full compliance for indoor and outdoor environments was 8.5% and 42.8%, respectively. Vaping occurred inside five shops (14.3%), and smoking occurred outdoors within required smoke‐free areas in two (5.7%) shops. Four (11.4%) and 17 (48.6%) shops complied with indoor and outdoor signage requirements, respectively. Conclusions: Overall compliance remained low, although much of the noncompliance was related to signage. Use or evidence of ENDS use occurred both indoors and outdoors where prohibited by law. Classifying ENDS as tobacco products would require tobacco licensure of shops selling ENDS and e‐liquids, aiding in identification of the shops for education and enforcement efforts to ensure compliance with the law and to improve public health protection. [ABSTRACT FROM AUTHOR]

INTRODUCTION Tobacco control laws that raise the minimum age of tobacco sales to 21 years (T21) play a pivotal role in youth tobacco prevention, yet empirical data are sorely needed to inform enforcement, compliance efforts, and future legislation. METHODS Spatial analysis was conducted at the zip code level by geocoding the states and localities that adopted T21 ordinances from 2015 to 2019. A multi-level logistic regression model was conducted to examine disparities in neighborhood socioeconomic status (SES), FDA retail inspection, and state-level tobacco control policies associated with T21 adoption. RESULTS T21 adoption at the state and local level increased considerably from 1.4% of zip codes in 2015 to 40.2% in 2019. However, the T21 ordinances were disproportionally adopted in New England (82.6%) and Pacific (73.6%) regions with scarce coverage in East South Central (<0.1%), Mountain (1.6%), and West North Central regions (6.1%). The T21 policies were more likely to be adopted in areas with stronger tobacco control policies, urban areas (vs rural, adjusted odds ratio, AOR=1.25, p=0.005), areas with a larger Hispanic (AOR=1.19, p<0.0001) or Asian population (AOR=1.12, p<0.0001), and in areas where the population had higher levels of education (AOR=1.05, p<0.0001). It was less likely to be adopted in areas with larger proportions of American Indians, youths, and young adults. Nearly 40% of zip codes with tobacco retailers did not receive annual FDA tobacco retail inspections for underage sales in 2019. The average retail violation rate of underage sales of tobacco products in T21 regions was lower than in non-T21 regions. CONCLUSIONS Disparities in T21 adoption, retail inspections, and retail compliance may limit the policy impact. Unified enforcement of youth tobacco access restrictions with resources and interventions in vulnerable communities is needed to reduce tobacco-related health disparities. [ABSTRACT FROM AUTHOR]

Aims: To establish the number of smokers in England who would be targeted by increasing the age of sale of cigarettes from 18 to 21 years and to assess the smoking and socio‐demographic profile of those smokers. Design and setting: Nationally representative cross‐sectional survey of adults in England conducted between January 2009 and July 2019. Participants: A total of 219 720 adults. Measurements All participants reported their current smoking status and socio‐demographic characteristics (i.e. age, gender, home ownership, social grade and ethnicity). Smokers reported motivation to quit, urges to smoke and the Heaviness of Smoking Index (HIS). Weighted prevalence statistics were calculated. Multinomial regression and logistic regression were used to assess differences in smoking characteristics among smokers and socio‐demographic characteristics relative to non‐smokers. Findings The prevalence of smoking between January 2009 and July 2019 was highest among those aged 21–30. In 2019, 15.6% [95% confidence interval (CI) = 12.8–18.8%] of 18–20‐year‐olds reported smoking, which is estimated to represent 364 000 individuals in England. Relative to smokers aged 18–20, older smokers (aged 21+) had a higher motivation to quit smoking [odds ratios (ORs) = 1.40–1.45 range] and higher nicotine dependency as measured by urges to smoke (ORs = 1.06–1.24 range) and HSI (ORs = 1.05–2.85 range). Compared with non‐smokers aged 18–20, smokers in this age group had lower odds of being female (OR = 0.89) and higher odds of being of white ethnicity (OR = 2.78) and from social grades C1–E (lower social grades) compared with AB (higher social grades) (OR = 1.19–1.83 range). Conclusion: Increasing the age of sale of cigarettes to 21 years in England would currently target approximately 364 000 lower dependent smokers from more disadvantaged backgrounds aged 18–20, who have less motivation to quit. [ABSTRACT FROM AUTHOR]

Aim Kingdon [(2014) Agendas, Alternatives, and Public Policies. Essex. United Kingdom: Pearson Education Limited] argues that windows of opportunity to pass policies emerge when problems, solutions and policy support co-occur. This study aims to identify a set of alcohol policies with the potential to reduce alcohol-related disparities given high levels of support from marginalized groups, such as racial/ethnic minorities and lower-income groups. Methods This study used data from five US National Alcohol Surveys, which were based on household probability samples of adults in 1995 (n  = 4243), 2000 (n  = 5736), 2005 (n  = 1445), 2010 (n  = 4164) and 2015 (n  = 4041). We used multiple logistic regression to determine the odds of policy support by racial/ethnic group and income level, considering price, place and marketing policies as well as individual-level interventions. Results Overall a majority of Americans supported banning alcohol sales in corner stores (59.4%), banning alcohol advertisements on television (55.5%), and establishing universal health coverage for alcohol treatment (80.0%). Support was particularly high among Blacks, Hispanics/Latinos and lower-income persons. Multivariate models showed that compared with White people, foreign-born Hispanics/Latinos had the most robust levels of support, including raising alcohol taxes (aOR  = 2.40, 95% CI: 2.00, 2.88, P  < 0.0001), banning alcohol sales in corner stores (aOR  = 2.85, 95% CI: 2.22, 3.65, P  < 0.0001) and reducing retail sales hours (aOR  = 2.91, 95% CI: 2.38, 3.55, P  < 0.0001). Conclusion Of the policies examined, banning alcohol sales at corner stores is most likely to be in a "window of opportunity" for reducing alcohol-related disparities. By simultaneously reducing population-level consumption and harms from others' drinking, place-based policies have the potential to reduce harms experienced by marginalized groups. [ABSTRACT FROM AUTHOR]

College student drinking in on-premises establishments has been associated with heavy alcohol consumption and a range of problems including assault, fighting, risky sex, and drinking and driving. Although more strictly enforcing overservice laws might reduce heavy drinking in on-premises establishments, law enforcement agencies have few resource-efficient tools for doing so, resulting in these laws seldom being enforced. In this paper, we report the results of an evaluation of the Stop Service to Obviously-impaired Patrons (S-STOP) program that was implemented in 303 bars and restaurants in 18 university communities in California using a randomized cross-over design (early vs. delayed implementation). The S-STOP program: (a) deployed pseudo-intoxicated patrons who attempted to purchase a drink when showing obvious signs of intoxication; (b) provided feedback to owners and managers on staff performance; and (c) offered free online refresher training for staff. Overall, alcohol servers in bars and restaurants in these college communities were willing to serve a pseudo-intoxicated mystery shopper 90% of the time. The study found no evidence that S-STOP reduced the prevalence of alcohol sales to apparently impaired patrons during the two intervention stages of the study. The findings highlight the need for developing effective interventions to prevent overservice and should prompt college and university leaders to take the lead in addressing the problem of alcohol overservice at on-premises establishments by working with community leaders, law enforcement, and retailers. [ABSTRACT FROM AUTHOR]

Objectives: Those underage should not use tobacco products, including electronic nicotine delivery systems. A technologically-based solution developed by Juul Labs Inc to restrict underage access seeks to automate transactions, structurally mandate age-verification, and limit the quantity of JUUL products purchased per transaction. A pilot of this standards-based approach, referred to as RACS™ (Retail Access Control Standards), was conducted to assess efficacy. Methods: RACS was implemented at 171 stores within 3 retail chains selling tobacco products in 3 states. "Secret shopper" compliance audits, in which a mystery shopper attempted to purchase JUUL products, were conducted at participating stores before and after implementation of RACS, to test compliance with age-verification and product-quantity limits. Audit failure rates were compared pre- and post-RACS implementation to assess effectiveness. Comparisons were made overall, by chain, state, and failure type. Results: A total of 3990 audits were conducted. We found large, statistically significant reductions (p < .001) in failure rates for age-verification and compliance with product-quantity limits after implementing RACS, as compared to pre- RACS rates, declining to near zero. Conclusions: Utilizing enhanced access controls can be part of a comprehensive, evidence-based tobacco-control strategy to address underage use of all tobacco products, including JUUL. ACKNOWLEDGMENT & CONFLICT OF INTEREST STATEMENT: Funding for this study was provided by Juul Labs Inc. Through Pinney Associates, Saul Shiffman provides consulting services on tobacco harm reduction on an exclusive basis to Juul Labs Inc. In that role, he acted as internal editor and coordinator for the papers in this special issue. Erik Augustson is a full-time employee of Juul Labs Inc. As Senior Director of Behavioral Affairs at JLI, he oversaw the conduct of the behavioral research reported in this special issue. [ABSTRACT FROM AUTHOR]