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“I think we can do without [tobacco]”: support for policies to end the tobacco epidemic among California adolescents
  1. Benjamin W Chaffee1,
  2. Candice D Donaldson2,
  3. Elizabeth T Couch1,
  4. Elizabeth Andersen-Rodgers2,
  5. Claudia Guerra1,
  6. Nancy F Cheng1,
  7. Niloufar Ameli1,
  8. David Stupplebeen2,
  9. Omara Farooq2,
  10. Monica Wilkinson2,
  11. Stuart Gansky1,
  12. Xueying Zhang2,
  13. Kristin Hoeft1
  1. 1Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, USA
  2. 2California Tobacco Prevention Program, California Department of Public Health, Sacramento, California, USA
  1. Correspondence to Dr Benjamin W Chaffee, Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, CA 94143, USA; benjamin.chaffee{at}ucsf.edu

Abstract

Introduction The tobacco endgame, policies aiming to end the commercial tobacco epidemic, requires sustained public support, including among youth. We assessed endgame support among California (USA) adolescents, including their reasons and associated participant and policy-specific factors.

Methods Teens, Nicotine and Tobacco Project online surveys (n=4827) and focus groups were conducted in 2021 and 2022 among California residents aged 12–17 years. Cross-sectional survey participants were asked their agreement level with eight policy statements related to tobacco and/or cannabis sales restrictions, use in public places and use in multiunit housing. Ordered logistic regression modelled level of agreement according to respondent characteristics, behaviours and statement content. Qualitative data were collected through focus groups (n=51 participants), which were analysed to provide insight into support for different policies.

Results Most survey participants agreed or strongly agreed with tobacco product sales restrictions (72%–75%, depending on the policy), bans on use in public spaces (76%–82%) and smoke-free (79%) and vape-free (74%) apartment buildings. Support was stronger among younger, female, Asian and tobacco non-using participants and for policies directed at ‘tobacco’ (vs ‘vapes’ or cannabis), at flavoured tobacco (compared with all tobacco), and when statements featured ‘should end’ (vs ‘not allowed’). Focus group participants who were supportive viewed policies as protecting children from harmful products, while those less supportive cited concerns about limiting adults’ freedoms and unintended consequences.

Conclusions Most participants supported strong tobacco control policies. Public communication that promotes broader endgame benefits besides protecting youth and accelerates industry denormalisation may counter youth concerns and further bolster their support.

  • end game
  • public opinion
  • non-cigarette tobacco products

Data availability statement

Data are available on reasonable request. Additional data available at https://escholarship.org/uc/item/6qf8f8x1.

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Data availability statement

Data are available on reasonable request. Additional data available at https://escholarship.org/uc/item/6qf8f8x1.

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Footnotes

  • Contributors BWC: conceptualisation, methodology, formal analysis, writing—original draft, project administration, funding acquisition; CDD: conceptualisation, writing—review and editing, project administration; ETC: conceptualisation, writing—review and editing, project administration; EA-R: writing—review and editing; CG: formal analysis, writing—review and editing; NFC: data curation, writing—review and editing; NA: data curation, writing—review and editing; DS: writing—review and editing; OF: writing—review and editing, project administration; MW: writing—review and editing; SG: conceptualisation, methodology, writing—review and editing; XZ: conceptualisation, writing—review and editing, project administration; KH: conceptualisation, methodology, formal analysis, writing—review and editing. BWC accepts full responsibility for the finished work and/or the conduct of the study, had access to the data, and controlled the decision to publish. All authors have approved the final article.

  • Funding This work was supported by the California Department of Public Health (contract number: CDPH-20-10026) and by the National Center for Advancing Translational Sciences, National Institutes of Health (grant number: UL1 TR001872).

  • Disclaimer The findings and conclusions in this article are those of the author(s) and do not necessarily represent the views or opinions of the National Institutes of Health, the California Department of Public Health or the California Health and Human Services Agency.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.