A systematic review and meta-analysis of Tobacco 21 policies and youth tobacco use: implications for future policy research.

ABSTRACT:

Background

Raising the sales age to 21 is among the most important steps to curb tobacco/nicotine use in youth in the past two decades. The study aims to systematically review and perform meta-analyses on the impact of Tobacco 21 (T21) policies on tobacco use among 11-to-20-year-olds in the United States, encompassing T21s at local, state, and national levels.

Methods

We screened 14 databases following PRISMA and PICOS criteria, applying standardized abstraction forms and quality assessment tools. Inverse-variance-weighted random-effects models estimated pooled, fully adjusted odds ratios (ORs) for tobacco use outcomes, with moderation analyses by T21-level, gender, age, and race/ethnicity proportions. Sensitivity analyses considering study quality and study-level clusters w

SUBMITTER: Li D 

PROVIDER: S-EPMC12356382 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature