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Impact of new policies on young adult tobacco and marijuana

Institution: University of California, San Francisco
Investigator(s): Pamela Ling, M.D., M.P.H.
Award Cycle: 2018 (Cycle 27) Grant #: 27IR-0042 Award: $908,748
Subject Area: State and Local Tobacco Control Policy Research
Award Type: High Impact Research Project Award

Initial Award Abstract

Research Question: How do changes in tobacco and marijuana policy impact disparities in young adult tobacco and marijuana use?

Background:  Tobacco use in California is rapidly transforming with new products and policies that may decrease tobacco use (such as raising the purchase age to 21) but may increase marijuana use (such as marijuana legalization). Young adults are the most likely group to adopt new tobacco products, to use multiple products, and to co-use tobacco and marijuana. Research is needed to address new and diverse tobacco and nicotine products, and the impact of the new tobacco and marijuana policies on young adult tobacco and marijuana use.  The overall goal of this research project is to describe changes in differential tobacco and marijuana use patterns among young adults in the San Francisco Bay Area.  We will specifically examine racial/ethnic and socioeconomic differences that may result in health disparities.  We will also identify variations in impacts of tobacco and marijuana marketing policies by neighborhood that may exacerbate or contribute to health disparities.

We conducted the first representative population-based study of young adults in the San Francisco Bay Area in 2014.  We propose to re-contact our participants to address these three specific aims:  (1) Describe changing patterns of differential tobacco use and marijuana co-use with tobacco over time among diverse Bay Area young adults to characterize tobacco and marijuana use disparities (2) Identify the impacts of neighborhood-level variations in tobacco and marijuana policy implementation and product marketing on policy awareness, perceived tobacco and marijuana availability, and use (3) Describe the potential mechanisms for how tobacco and marijuana policy implementation may impact tobacco and marijuana-related attitudes and use among diverse young adults

Approach: In 2014, we conducted the San Francisco Bay Area Young Adult Health Survey (BAYAHS), a population survey of 1363 young adults living in Alameda and San Francisco Counties.  The survey used mail, telephone, and face-to-face interviews to collect representative samples of Hispanic (24%), White (32%), Black (10%) Asian (28%) and Multiracial (6.5%) participants.  We also visited tobacco stores in neighborhoods where our survey respondents lived to record their advertising, prices, and availability of different tobacco products.  These data will serve as the baseline for the proposed study, where we will re-contact BAYAHS participants (75% consented to be re-contacted) for follow up surveys, with an additional replenishment sample to achieve similar numbers.  The new survey will include questions about the new tobacco and marijuana policies implemented in the Bay Area, changes in tobacco and marijuana advertising and perceived availability, and how variation between different neighborhoods influences disparities in tobacco and marijuana use.

Impact:  Young adults are early adopters of new products, they are aggressively targeted by marketing, and they report high rates of tobacco and marijuana use.  This is seen more frequently among nonwhite and lower socioeconomic status populations.  This study will increase our understanding of how new market forces, policies and programs impact these young adult tobacco disparities, so that new policies and programs can be implemented more equitably.