Publications by authors named "Michael Pesko"

Importance: More than one-quarter of US residents live in states or localities that restrict sales of flavored electronic nicotine delivery systems (ENDS), often as a means to reduce youth vaping. Yet, how these policies affect young adult vaping and smoking remains unclear.

Objective: To estimate the effects of ENDS flavor restrictions on ENDS use and cigarette smoking among young adults (age 18-29 years) in the US.

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Introduction: 30 states enacted e-cigarette taxes by the end of 2023. E-cigarette tax schema in the USA vary, in contrast to cigarette taxes that are standardised as an excise tax amount per pack. Some states use excise taxes on liquid and containers, others wholesale sales taxes and others retail sales taxes.

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Article Synopsis
  • The study analyzes the impact of county-level e-cigarette indoor vaping restrictions on infant mortality using birth certificate data from 2010 to 2015.
  • The findings show that these restrictions led to an increase in infant mortality rates by 0.39 per 1,000 live births, equating to a 12.9% increase.
  • This rise was notably higher among infants born to younger mothers and in areas with higher rates of prenatal smoking, with significant increases in mortality from infections and neoplasms observed between 100 days to 1 year after the restrictions.
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We study the impact of vertical identification card laws, which changed the orientation of driver's licenses and state identification cards from horizontal to vertical for those under 21 years, on teenage tobacco and alcohol use. We study this question using four national datasets (pooled national and state Youth Risk Behavior Surveillance System, National Youth Tobacco Survey, Current Population Survey to Tobacco Use Supplements, and Behavioral Risk Factor Surveillance System). We improve previous databases of vertical ID law implementation by using original archival research to identify the exact date of the law change.

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Background And Aims: The use of e-cigarettes may influence later smoking uptake in young people. Evidence and gap maps (EGMs) are interactive on-line tools that display the evidence and gaps in a specific area of policy or research. The aim of this study was to map clusters and gaps in evidence exploring the relationship between e-cigarette use or availability and subsequent combustible tobacco use in people aged < 30 years.

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Article Synopsis
  • Secondhand smoke and e-cigarette aerosol exposure pose health risks, prompting many states to implement indoor smoking and vaping restrictions (ISR and IVR).
  • Data from 1990 to 2021 showed significant increases in comprehensive ISR for bars, restaurants, and workplaces but highlighted that less than half of the population in many states is fully protected.
  • While coverage has improved, the existing gaps in these policies may lead to ongoing health disparities related to tobacco use.
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To produce a database of private insurance hearing aid mandates in the United States and quantify the share of privately insured individuals covered by a mandate. We used health-related policy surveillance methods to create a database of private insurance hearing aid mandates through January 2023. We coded salient features of mandates and combined policy data with American Community Survey and Medicare Expenditure Panel Survey-Insurance Component data to estimate the share of privately insured US residents covered by a mandate from 2008 to 2022.

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Background: The magnitude of the relationship between ambulatory care fragmentation and subsequent total health care costs is unclear.

Objective: To determine the association between ambulatory care fragmentation and total health care costs.

Research Design: Longitudinal analysis of 15 years of data (2004-2018) from the national Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, linked to Medicare fee-for-service claims.

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  • The study investigates the impact of raising the minimum legal age for tobacco sales to 21 (T21) using data from 2012 to 2019.
  • The research shows significant decreases in e-cigarette and cigarette usage among 12th graders, with cigarette sales falling by 12.4% and e-cigarette sales dropping by 69.3% in areas with a high percentage of individuals under 21.
  • Findings indicate that T21 leads to more frequent ID checks and a heightened perception of the risks associated with using tobacco products.
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E-cigarette taxes are an active area of legislation and have important regulatory implications by proxying e-cigarette accessibility. We examine the effect of e-cigarette taxes on prepregnancy and prenatal smoking using the near-universe of births to mothers conceiving between 2013 and 2019 in the United States. Using fixed effect regressions, we show that e-cigarette taxes increase prepregnancy and prenatal smoking.

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Article Synopsis
  • The study analyzes the impact of Tobacco-21 (T21) policies on cigarette, cigar, and electronic nicotine delivery system (ENDS) use among 18- to 20-year-olds.
  • Increased coverage of T21 laws shows a significant decrease in tobacco use among this age group, particularly when policies do not include possession, use, or purchase (PUP) penalties.
  • The findings suggest that state policymakers should consider enacting T21 laws that omit PUP penalties to more effectively reduce underage tobacco and nicotine use.
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Objective: To use a standardised e-cigarette tax measure to examine the impact of e-cigarette taxes on the price and sales of e-cigarettes and cigarettes in the USA.

Design: We used State Line versions of NielsenIQ Retail Scanner data from quarter 4 of 2014 through quarter 4 of 2019 to calculate e-cigarette and cigarette prices and sales in 23 US states. We then estimated how these outcomes are associated with standardised state-level e-cigarette taxes, controlling for state fixed effects, quarter-by-year fixed effects, cigarette taxes, other tobacco control policies and other state-level time-varying characteristics.

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Article Synopsis
  • The 2009 Tobacco Control Act allows the FDA to regulate tobacco products, and in 2019, General Snus became the first modified-risk tobacco product to be authorized, potentially increasing its usage in the U.S.
  • A study analyzing sales data revealed that while absolute sales of General Snus declined, it experienced a relative increase in sales compared to non-snus smokeless products after the MRTP authorization.
  • The study suggests that MRTP designation for General Snus may have positively influenced the entire snus category, indicating that consumers evaluate risk based on product categories rather than single items.
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Objective: To examine the association between state Medicaid and private telemedicine coverage requirements and telemedicine use. A secondary objective was to examine whether these policies were associated with health care access.

Data Sources And Study Setting: We used nationally representative survey data from the 2013-2019 Association of American Medical Colleges Consumer Survey of Health Care Access.

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Public health experts caution that legalization of recreational marijuana may normalize smoking and undermine the decades-long achievements of tobacco control policy. However, very little is known about the impact of recreational marijuana laws (RMLs) on adult tobacco use. Using newly available data from the Population Assessment of Tobacco and Health (PATH) and dynamic difference-in-differences and discrete-time hazard approaches, we find that RML adoption increases prior-month marijuana use among adults ages 18-and-older by 2-percentage-points, driven by an increase in marijuana initiation among prior non-users.

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Article Synopsis
  • The study looks at how changes in air quality, specifically fine particulate matter (PM 2.5), affect COVID-19 cases and deaths.
  • An increase of 1 g/m in PM 2.5 correlates with a 1.8% rise in daily confirmed cases and over 4% in death rates.
  • The negative impact of PM 2.5 on COVID-19 severity grows over time, affecting hospitalizations and increasing risks of mechanical ventilation and mortality.
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We study the impact of a temporary U.S. paid sick leave mandate that became effective April 1st, 2020 on self-quarantining, proxied by physical mobility behaviors gleaned from cellular devices.

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Background: By the end of 2022, nearly 20 million workers in the United States have gained paid-sick-leave coverage from mandates that require employers to provide benefits to qualified workers, including paid time off for the use of preventive services. Although the lack of paid-sick-leave coverage may hinder access to preventive care, current evidence is insufficient to draw meaningful conclusions about its relationship to cancer screening.

Methods: We examined the association between paid-sick-leave mandates and screening for breast and colorectal cancers by comparing changes in 12- and 24-month rates of colorectal-cancer screening and mammography between workers residing in metropolitan statistical areas (MSAs) that have been affected by paid-sick-leave mandates (exposed MSAs) and workers residing in unexposed MSAs.

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We study the effects of changing Medicaid reimbursement rates for primary care services on behavioral health outcomes-defined here as mental illness and substance use disorders. Medicaid enrollees are at elevated risk for these, and other, chronic conditions and are likely to have unmet treatment needs. We apply two-way fixed-effects regressions to survey data specifically designed to measure behavioral health outcomes over the period 2010-2016.

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Over the past decade, rising youth use of e-cigarettes and other electronic nicotine delivery systems (ENDS) has contributed to aggressive regulation by state and local governments. Between 2010 and mid-2019, ten states and two large counties adopted ENDS taxes. We use two large national surveys (Monitoring the Future and the Youth Risk Behavior Surveillance System) to estimate the impact of ENDS taxes on youth tobacco use.

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Objective: To test the effect of cigarette and e-cigarette taxes on prescriptions for smoking cessation medications.

Data Source: Symphony Health, IDV all-payer prescription claims data for the United States over the period 2009-2017. Prescription fills for smoking cessation products were provided at the patient's age, patient's sex, brand/generic, payment type, year, and quarter levels.

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We estimate the effect of e-cigarette tax rates on e-cigarette prices, e-cigarette sales, and sales of other tobacco products using NielsenIQ Retail Scanner data from 2013 to 2019. We find that 90% of e-cigarette taxes are passed on to consumer retail prices. We then estimate reduced form and instrumental variables regressions to examine the effects of e-cigarette and cigarette taxes and prices on sales.

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Aims: To estimate whether and to what extent extending indoor smoking restrictions to include electronic cigarettes (ECs) impact the use of ECs and cigarette smoking among adults in the United States.

Design: Observational study using a linear probability model and applying a difference-in-differences analysis.

Setting: United States.

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