This application proposes continued longitudinal research on the impact of three major types of public health interventions used by many states to reduce the use of tobacco and the health risks of second-hand smoke: local clean indoor air policies, local policies to restrict youth access to tobacco products and televised anti- tobacco media campaigns. The data come from two sources: 1) three waves of telephone interviews with a population based sample of Massachusetts adults and youth who were first interviewed in 2001/2002; and 2) a linked set of town-level data on the tobacco control regulations, activities, funding, and demographic characteristics of the 351 cities and towns in Massachusetts in which the respondents resided at baseline. The interim period between the first and last survey includes one in which important changes have occurred in Massachusetts: State funding for the tobacco control program has been cut by 90% necessitating cessation of the mass media campaign and drastically reduced funding for other local programs. At the same time, the adoption of local smokefree workplace ordinances has proliferated, increasing what some see as the most effective intervention for reducing smoking at the population level. In addition to continued examination of the relative impact of policy and media interventions, this project will take advantage of the multiple longitudinal measurement of a population-based sample to study the smoking trajectories of youth, young adults, and older adults. The project has three specific aims: 1) To investigate youth cigarette smoking trajectories and elucidate the individual, family and community level predictors of transitions from abstinence to experimental or occasional use to regular, established use; 2) To investigate smoking trajectories of adult smokers and recent quitters and elucidate the individual, family and community level predictors of extended cessation, versus relapse, versus sustained or increased smoking.3) To provide descriptive information about the relationship between reductions in funding for the Massachusetts Tobacco Control Program and changes in youth and adult reports of a) exposure to anti-tobacco media messages; b) teenagers' ease of access to tobacco products; c) perceptions of the tobacco industry.
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