Tobacco use is the leading cause of preventable death, accounting for more than 480,000 deaths each year in the United States. Smoking at a young age increases the likelihood of becoming an addicted daily smoker. While the cigarette smoking rate among youth has been declining over the last several decades, the use of emerging tobacco products is gaining popularity among youth. Among U.S. high school students, current use of electronic cigarettes (e-cigarettes) has outpaced the use of traditional cigarettes. The recently finalized “Deeming Rule” from the Food and Drug Administration (FDA) expanded the agency’s regulatory authority over tobacco to include e-cigarettes, cigars, and other emerging tobacco products. Studies using national probability samples have shown that retail compliance with underage sales laws and restricting tobacco sales to minors are important tobacco prevention strategies. No study has examined the effectiveness of FDA inspections of retailers selling e-cigarettes and cigars. Also, the relationship between compliance inspections of tobacco retailers and youth use behaviors (e.g., ever, current, and frequency of use) is unknown.
Dr. Hongying Dai has recently received funding from the National Institutes of Health (NIH) to conduct a two-year national study to assess the impacts of the FDA retail compliance inspections on youth e-cigarette and cigar use behaviors. Dr. Dai is an associate professor in the University of Nebraska Medical Center (UNMC) College of Public Health – department of biostatistics. Her research interests include the development of statistical methodology and application of advanced statistical methods in public health research, such as mixture modeling, high dimensional data, public health research on tobacco use and health disparities, and social media research for public health surveillance.
This NIH-funded study will be the first population study using a quasi-experimental design to examine the effects of FDA compliance inspections on youth e-cigarette and cigar use behaviors. Dr. Dai’s research team will develop advanced statistical models in analyzing the big data from the FDA compliance inspection program (n>300,000 inspections) and national youth behavior survey data (n≈45,000 adolescents/year). The team will first develop an innovative machine learning method to identify violations related to e-cigarettes and cigars from the FDA decision letters and then build propensity models and small area estimation models to predict the violation rate for underage retail sales of e-cigarettes and cigars at the zip code level. The study results will assess whether the FDA regulatory actions (e.g., compliance inspection) will serve as an environmental factor that interacts with other factors (e.g., age, race/ethnicity, sex, and other tobacco policies) to impact youth smoking behaviors.
Findings from this study are expected to inform appropriate retail compliance inspection strategies and further expand our knowledge of the potential impacts of regulatory actions on youth e-cigarette and cigar use behaviors.