Evaluating implementation of Tobacco 21 laws in the U.S.

ABSTRACT Increasing the retail age of sales of commercial tobacco products from 18 to 21 (known as Tobacco 21 or T21) has been shown to decrease youth and young adult tobacco access and use. However, underage sales are widespread despite the enactment of T21, and retailer characteristics may contribute to underage sales rates. In addition, the tobacco retail and regulatory environment has changed considerably since federal T21 became effective in December 2019 (e.g., temporary suspension of T21 enforcement during COVID, tobacco product diversity, regulatory actions, electronic identification [ID] verification technology). Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework and Purtle’s conceptualization framework of policy in implementation science research, we seek to better understand compliance and enforcement of T21 over time and how T21 implementation can be improved, including identifying modifiable factors that affect key implementation outcomes (i.e., ID check and sales to underage purchasers) and may lead to differential implementation outcomes across social groups and neighborhoods. This competing renewal application intends to examine how tobacco product types, retailer characteristics, and neighborhood-level factors, contribute to T21 implementation in a longitudinal sample of tobacco retailers in three states: New Jersey, the focus of our original application; North Carolina, a state added after federal T21; and now Nevada, the first state to require electronic ID verification. Specifically, by conducting underage purchase attempts in a longitudinal sample of retailers (at least 4 Waves of data collection), we aim to 1) Examine T21 implementation (i.e., ID checks, sales to underaged buyers) over time by tobacco product types to determine the propensity of tobacco retailers to check IDs and sell cigarettes, cigars, electronic cigarettes, smokeless tobacco, and nicotine pouches to underage purchasers; 2) Identify the extent to which retailer-level characteristics (i.e., store type, tobacco industry contracts, electronic ID verification) contribute to tobacco product ID checks and underage sales over time; 3a) Determine how neighborhood-level factors (i.e., sociodemographic characteristics, tobacco retailer availability) are associated with tobacco product ID checks and underage sales over time and finally, 3b) Test whether neighborhood sociodemographic characteristics and tobacco retailer availability moderate associations between tobacco product types (Aim 1) and retailer-level characteristics (Aim 2) and tobacco product ID checks and underage sales. Results from this project will provide a longitudinal evaluation of T21 implementation and identify modifiable characteristics that can inform regulatory efforts, retailer education programs, and overall T21 compliance and enforcement.