Hongying Dai1, Jianqiang Hao2, Delwyn Catley3. 1. College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States. Electronic address: daisy.dai@unmc.edu. 2. Bellevue University, College of Business, Omaha, NE, United States. 3. The Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, United States.
Abstract
OBJECTIVES: The finalized 'Deeming Rule' extended the Food and Drug Administration (FDA) authority to regulate e-cigarettes, cigars, and other newly deemed tobacco products. We seek to assess the neighborhood characteristics associated with retail violations of sales to minors (RVSM) by tobacco product. STUDY DESIGN: We collected national inspection data on tobacco retailers during August 8, 2016, and May 31, 2018, from the FDA compliance check database. METHODS: A web scraping tool was applied to text mine the FDA decision letters and extract information on the tobacco product involved in RVSM. Separate logistic regression models with random effects were performed to examine the association between zip code-level neighborhood characteristics and RVSM by tobacco product. RESULTS: Of 268,317 minor-involved compliance inspections, 35,403 (13.2%) were identified as RVSM. Among 23,352 warning letters included in the final analysis, e-cigarettes, cigars, cigarettes, and smokeless tobacco accounted for 20.0% (n = 4673), 40.4% (9439), 35.6% (8303), and 4.0% (937) of RVSM, respectively. Flavored tobacco products were abundant among underage sales. For e-cigarettes, RVSM were more likely to occur in zip codes with a larger proportion of youth population aged 10-17 years (adjusted odds ratio [AOR] = 1.17 [1.02-1.34]). A larger proportion of African Americans was associated with a higher risk of RVSM for cigars (AOR = 1.09 [1.07-1.11]) but a lower risk of RVSM for e-cigarettes (AOR = 0.90 [0.87-0.93]). CONCLUSIONS: Retail violations of underage sales for cigars and e-cigarettes are prevalent and neighborhood characteristics associated with violations differ by tobacco product. Continued inspections with tailored strategies to reduce RVSM of all tobacco products are needed.
OBJECTIVES: The finalized 'Deeming Rule' extended the Food and Drug Administration (FDA) authority to regulate e-cigarettes, cigars, and other newly deemed tobacco products. We seek to assess the neighborhood characteristics associated with retail violations of sales to minors (RVSM) by tobacco product. STUDY DESIGN: We collected national inspection data on tobacco retailers during August 8, 2016, and May 31, 2018, from the FDA compliance check database. METHODS: A web scraping tool was applied to text mine the FDA decision letters and extract information on the tobacco product involved in RVSM. Separate logistic regression models with random effects were performed to examine the association between zip code-level neighborhood characteristics and RVSM by tobacco product. RESULTS: Of 268,317 minor-involved compliance inspections, 35,403 (13.2%) were identified as RVSM. Among 23,352 warning letters included in the final analysis, e-cigarettes, cigars, cigarettes, and smokeless tobacco accounted for 20.0% (n = 4673), 40.4% (9439), 35.6% (8303), and 4.0% (937) of RVSM, respectively. Flavored tobacco products were abundant among underage sales. For e-cigarettes, RVSM were more likely to occur in zip codes with a larger proportion of youth population aged 10-17 years (adjusted odds ratio [AOR] = 1.17 [1.02-1.34]). A larger proportion of African Americans was associated with a higher risk of RVSM for cigars (AOR = 1.09 [1.07-1.11]) but a lower risk of RVSM for e-cigarettes (AOR = 0.90 [0.87-0.93]). CONCLUSIONS: Retail violations of underage sales for cigars and e-cigarettes are prevalent and neighborhood characteristics associated with violations differ by tobacco product. Continued inspections with tailored strategies to reduce RVSM of all tobacco products are needed.