 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Kim Hutchinson, EdD, MS, MSN, Public Health Sciences, Wake Forest University School of Medicine, 2000 West First Street, Suite 244, Winston-Salem, NC 27157, 336-713-5260, khutchin@wfubmc.edu
Background:
Most cigarette smokers initiate tobacco use around age 12 – 13 years and studies show that youth have relatively easy access. Despite the illegality, prevalence remains a fundamental public health concern. High rates of tobacco use among youth lend support for improved precision in looking at community dynamics which potentially undermines tobacco restriction efforts. Urban ghetto life or rural poverty existence epitomizes resource-poor communities and many residents experience greater health adversity. The Institute of Medicine acknowledges that healthcare is a resource tied to social justice, and basic differences arise as the result of variations in social, socioeconomic, behavioral risk factors, and environmental living conditions. That said, tobacco enforcement activities designed to curtail underage access and availability needs exploration in relation to demographic and community factors since basic health service access and information may be disproportionately disseminated. Reports that law enforcement efforts are “uneven and fragile” in different cities supports the need for studies that use large city/community samples to clarify tobacco enforcement efforts. Key initiatives such as tobacco age-of-sale enforcement activities may be weak or neglected in diverse communities.
Methods: This cross sectional study examined the relationship between two tobacco-age-of-sale law enforcement activities – performance of compliance checks and issuance of citations to youth violators - in 1999 in a national sample of 694 cities which were stratified as either an African American city or a Non-African American city. Known covariates (size, income, crimes, region, and presence of a Drug Abuse Resistance Officer) were adjusted for in regression models.
Results: Findings indicate a lower probability of citations issued in African American cities compared to non-African American cities (OR= 0.57 [95% CI: 0.37, 0.86]. Similarly, in cities where citations were issued to minors, African American cities had 34.2% lower number of citations, compared to the non-African American cities (p < 0.05). No differences were seen between cities with regards to compliance checks.
Conclusions: Findings of differential tobacco restriction efforts in diverse communities is concerning on constitutional and moral grounds. Future research needs to focus on the enforcement-prevalence continuum in disparate communities to lend validation to these early findings.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.