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Introduction: The goal of the paper is to characterize the geographic and sociodemographic patterns of policies prohibiting tobacco sales to people aged <21 years (i.e., Tobacco 21) at the local, county, and state levels in the U.S. before the national law.Methods: This study assessed area-level markers for region, race/ethnicity, education, poverty status, and smoke-free law coverage as predictors of Tobacco 21 passage as of December 20, 2019, using modified Poisson and negative binomial regression models with robust SEs. Data were analyzed in 2020.Results: Before the passage of the national policy, 191 million people were covered by Tobacco 21 laws. Counties with higher percentages of non-Hispanic Blacks and individuals living below the poverty line had a lower probability of coverage, whereas counties with higher percentages of Hispanics/Latinxs and individuals with a college degree had a higher probability of coverage. Tobacco 21 coverage also varied by region, with far greater coverage in the Northeast than in the Midwest and South.Conclusions: The national Tobacco 21 law may address disparities in coverage by SES, race/ethnicity, and region that could have lasting implications with regard to health equity. [ABSTRACT FROM AUTHOR]

Racial/ethnic discrimination (hereafter, discrimination) is associated with use of individual tobacco and cannabis products. However, we know little about how discrimination affects dual/polytobacco and cannabis use and associated use disorders. We used cross-sectional data on adults (18+) from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 35,744). We defined past-year discrimination as a summary scale (range: 0–24) based on six scenarios. We created a mutually exclusive six-category use variable: noncurrent, individual tobacco and noncannabis, individual tobacco and cannabis, individual cannabis and nontobacco, dual/polytobacco and noncannabis, and dual/polytobacco and cannabis based on past 30-day tobacco use of four products (i.e., cigarettes, electronic nicotine delivery systems, other combustibles (cigars, pipe), smokeless tobacco) and cannabis use. We also examined past-year tobacco use disorder (TUD) and cannabis use disorder (CUD) as a four-level variable: no disorders, TUD only, CUD only, and TUD and CUD. We estimated associations between discrimination and each outcome using adjusted multinomial logistic regression and assessed effect modification by stratifying adjusted models by race/ethnicity (i.e., Hispanic, non-Hispanic (NH) White, NH Black, and another race/ethnicity). Experiencing more discrimination was associated with each outcome but was most strongly associated with dual/polytobacco and cannabis use (OR: 1.13, 95 % CI: 1.07–1.19) and joint TUD and CUD (OR: 1.16, 95 % CI: 1.12–1.20). Models stratified by race/ethnicity showed that discrimination was associated with dual/polytobacco and cannabis only among NH White adults, and with joint TUD and CUD only among NH Black and NH White adults. Discrimination was associated with tobacco and cannabis use outcomes among multiple adult racial/ethnic populations, but associations were more profound for NH White and NH Black adults than adults from other racial/ethnic populations. • Experiencing more discrimination was linked to dual/polytobacco and cannabis use. • Discrimination was also associated with joint tobacco and cannabis use disorders. • For each race/ethnicity, discrimination was linked to at least one use outcome. • Associations with more severe outcomes were stronger for White and Black adults. [ABSTRACT FROM AUTHOR]

Background: It is unknown whether increasing attention to police brutality is a source of stress associated with substance use risk among young people.Methods: A longitudinal racially/ethnically diverse cohort from Los Angeles, California (n = 1797) completed baseline (2017; mean age: 17.9) and follow-up (2020; mean age: 21.2) surveys assessing level of concern, worry, and stress about police brutality (range: 0 'not at all' - 4 'extremely') and past 30-day nicotine, cannabis, alcohol, other drug, and number of substances used (0-19). Regression models, adjusted for demographic characteristics and baseline substance use, evaluated whether changes in distress about police brutality from 2017 to 2020 were associated with substance use in 2020 overall and stratified by race/ethnicity.Results: Distress about police brutality increased between 2017 (mean: 1.59) and 2020 (mean: 2.43) overall. Black/African American and Hispanic/Latino respondents consistently had the highest mean distress levels at both timepoints. In the full sample, each one-unit greater increase in distress about police brutality from 2017 to 2020 was associated with 11% higher odds of cannabis use, 13% higher odds of alcohol use, and 8% higher risk of using an additional substance for the number of substances used outcome. Race/ethnicity-stratified models indicated that greater increases in distress from 2017 to 2020 was associated with substance use among Black/African American, Hispanic, and multiracial respondents in 2020, but not Asian American/Pacific Islander and White respondents.Conclusions: Distress about police brutality may be associated with substance use, particularly among certain racial/ethnic minority young people. Further investigation of whether police brutality affects health in disparity populations is needed. [ABSTRACT FROM AUTHOR]

Introduction: Waterpipe tobacco smoking is prevalent among college students in the U.S. and increasing in popularity. Waterpipe smoking establishments are almost completely unregulated, and limited information exists documenting the expansion of this industry. The objective of this study was to identify U.S.-based waterpipe establishments and measure their proximity to colleges/universities.Methods: Waterpipe establishments and their addresses were compiled using five Internet-based directories during 2014 and analyzed in 2015. Addresses were geocoded and overlaid on a U.S. map of accredited colleges/universities. Proximity of colleges/universities to the nearest waterpipe establishment was measured in 3-mile increments. Multinomial logistic regression was used to model the factors associated with proximity of waterpipe establishments to colleges/universities.Results: A total of 1,690 waterpipe establishments and 1,454 colleges/universities were included in the study. Overall, 554 colleges/universities (38.1%) were within 3 miles of a waterpipe establishment. Proximity of waterpipe establishments to colleges/universities was associated with higher full-time student enrollment. Public colleges/universities and those with a smoke-free campus policy were at lower odds of having waterpipe establishments within 3 miles of their campuses.Conclusions: Waterpipe smoking establishments are more likely to be located near large colleges/universities. This study should inform initiatives aimed at reducing retail tobacco establishment exemptions. [ABSTRACT FROM AUTHOR]