Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Manoj Sharma


The study is an investigation of the association between the Tobacco 21 Law and youth tobacco usage rates in Hawaii. Researchers have documented a gap in the research regarding the effectiveness of such laws. Several studies that have been conducted have shown mixed results. The purpose of this study was to better understand any association that may exist in Hawaii. The social ecological model (SEM) of health is the theoretical foundation for the study. The SEM of health includes five sources which influence health, and these consist of intrapersonal factors, interpersonal factors, institutional factors, community factors, and public policy. Tobacco use can be influenced via all five sources. The research questions focused on the relationship between the Tobacco 21 Law and youth tobacco usage rates and how usage rates differ between male and female youth as well as varied races. The effects of obesity, overweight, and alcohol use were also analyzed in relationship to tobacco use. The research design for the study was causal comparative. Data were obtained from the Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Survey (YRBS) completed in 2015 and 2017. The target population was youth between the ages of 14 and 18. Data were analyzed using the Chi Square test and Logistic Regression. Results indicate that tobacco use among youth decreased after the passage of the Tobacco 21 law. Results also show that White and Asian participants were less likely to use tobacco compared to other races. The findings on the Tobacco 21 Law has the capability to create positive social change by decreasing the number of youth who use tobacco and the secondary effects that tobacco use will eventually have on youth as they age into adulthood.