A baseline assessment of cigarette sales to minors in San Diego,California

This study reports the sales rate of cigarettes to minors in San Diego County, and investigates factors associated with cigarette sales to minors. Two hundred and ninety-four stores were identified and recruited to participate in a retailer education effort. To assess the baseline illegal sales rate of cigarettes to minors, selected stores were surveyed by 70 volunteer teams of adults and minors. Questionnaires were also administered to participating store owners or managers to assess retailers' knowledge about laws regulating minors' access to tobacco. Survey results indicated that minors were able to successfully purchase cigarettes in 68% of attempts. In addition, teen gender, community sociodemographics and cashier characteristics were associated with sales to minors. Analyses of the retailer questionnaire indicated retailers knew the legal age to purchase cigarettes, but few knew of the specific penalties associated with sales to minors. These findings indicate that minors have easy access to cigarettes and underscore the need for intensive tobacco sales education for retailers and enforcement of sales to minors laws.Ann D. Erickson is Assistant Intervention Coordinator, Susan I. Woodruff is Evaluation Coordinator, Marianne B. Wildey is Intervention Coordinator, and Erin Kenney is Principal Investigator, all at the Graduate School of Public Health, San Diego State University, Behavioral and Community Health Studies, 6363 Alvarado Ct. Ste. 225, San Diego, CA 92120.Funding was provided by the Tobacco Tax Health Protection Act of 1988-Proposition 99, under grant number 90-10960. The authors gratefully acknowledge the contributions of Felipe Castro, PhD, MSW and Nadia Campbell, MPH.     

Laying down the law: reducing illegal tobacco sales to minors in central Harlem.

OBJECTIVES: This study compared the impact of educational and enforcement interventions on retailers' sale of tobacco to minors in Central Harlem, New York. METHODS: In a randomized trial with repeated measures, 152 stores were randomly divided into control, education, and enforcement groups. RESULTS: Overall tobacco sales to 12- and 13-year-old minors at baseline (98%) were among the highest in the nation. At 6-month and 1-year follow-ups, decreases in rates of tobacco sales to minors were modest among education stores and substantial among enforcement stores. CONCLUSIONS: Effective reduction of tobacco sales to minors may require ongoing enforcement measures, including fines for retailers who violate state and local laws.     

Evaluation of an enforcement program to reduce tobacco sales to minors.

OBJECTIVES: This study evaluated an active enforcement program to increase retailers' compliance with the law prohibiting tobacco sales to minors. METHODS: Tobacco sales to minors were monitored in 319 outlets in 6 pairs of communities in Erie County, New York. One community in each pair was randomly assigned to an enforcement intervention. RESULTS: Retailers' compliance with the law increased from 35% in 1994 to 73% in 1995. However, the change in compliance rates was roughly the same for stores in the enforcement and nonenforcement communities. CONCLUSIONS: Active compliance checking of retail outlets as a strategy to reduce illegal tobacco sales to minors may only be necessary insofar as it contributes to an increase in retailers' perception that the threat of enforcement is real.     

Impact of a local ordinance banning tobacco sales to minors.

Most addictions to tobacco begin when a person is younger than age 18. Although the sale of tobacco to minors is illegal in most jurisdictions, there is often little enforcement of these laws, and minors can usually purchase tobacco easily. The impact of a local ordinance designed to prevent tobacco sales to minors was assessed by surveys of 10th grade students before and after the implementation of the ordinance. Tobacco use declined from 25.3 percent to 19.7 percent overall, with a significant (P = 0.004) decline from 26.4 percent to 11.5 percent among girls. There was also a significant (P = 0.008) increase from 29.3 percent to 61.5 percent in the proportion of students reporting they were asked for proof of age when they attempted to purchase tobacco. Local ordinances may be an effective tool for reducing tobacco use by adolescents.     

Evaluating the effects of a community coalition's efforts to reduce illegal sales of alcohol and tobacco products to minors

Minors' access to alcohol and tobacco is a major public health concern because of the many deaths and disabilities associated with use and the ease with which minors purchase these products. We evaluated the effects of a community-based substance abuse coalition's efforts to reduce alcohol and tobacco products to minors. The intervention —implemented entirely by coalition members—consisted of adults and minors issuing citations to clerks in supermarkets, convenience stores and liquor stores, who were willing to sell alcohol and tobacco products to minors and issuing commendations to clerks who refused to sell. For those liquor stores receiving the citizen's surveillance, there was a marked decrease in alcohol sales to minors, from 83% to 33%; and in those liquor stores not experiencing the intervention, there was a smaller decrease in alcohol sales, from 45% to 36%. This study's findings suggest that citizen surveillance and feedback may be effective in reducing alcohol sales to minors when the intervention is fully implemented, but may be ineffective, at least in these doses, with tobacco sales.     

Availability of tobacco products to minors

Availability of tobacco products is a key factor in the initiation of smoking or use of smokeless tobacco by minors. Existing laws limiting such use are usually not enforced. The ability of minors to purchase tobacco products in Wichita, Kansas, was compared with results in previous reports. In a variety of retail stores, access to both cigarettes and smokeless tobacco was found to be significantly less than that found in other studies. Vending machines, however, were universally accessible. Sufficient retail outlets allowed purchase to ensure that minors who are determined to buy could supply themselves with tobacco. Strategies to limit the access of tobacco to minors are discussed.     

Usual sources of cigarettes for middle and high school students--Texas, 1998-1999

Persons often begin smoking when they are minors (aged <18 years), and easy access to cigarettes might contribute to this behavior. Laws and regulations were in place in Texas during 1998-1999 to reduce minors' access to cigarettes by 1) prohibiting the sale and distribution of tobacco products to minors; 2) imposing fines against retailers caught selling cigarettes to minors; 3) prohibiting minors from purchasing, possessing, or using tobacco products; 4) limiting vending machines to adult-only locations; and 5) requiring tobacco retailers to ask for proof of identification from anyone attempting to purchase tobacco who appeared to be aged <27 years. To measure progress in reducing access to cigarettes among middle and high school students in Texas, CDC analyzed self-reported data from the 1998 and 1999 Texas Youth Tobacco Survey (TYTS). This report summarizes the results of that survey, which indicate that during 1998-1999, reported access to cigarettes from stores and vending machines (commercial sources) decreased among middle school students from 13.2% to 5.3% and from 7.6% to 1.7%, respectively, but access from noncommercial and other sources (e.g., stealing cigarettes and "getting them some other way") increased from 8.3% to 12.3% and from 16.6% to 23.3%, respectively. Among high school students, most sources did not change. Educating retailers and actively enforcing laws governing youth access to tobacco as part of a comprehensive tobacco-control approach are required to reduce youth access to cigarettes.     

广州市201名小学生尝试买烟成功率及其影响因素

目的了解广州地区未成年人的烟草可及性以及影响因素。方法组织201名六年级小学生参加尝试买烟模拟试验,以是否买烟成功为因变量,商店、销售商和学生的特征为自变量进行因素分析。结果共有165名学生成功买到香烟,买烟失败36人,成功率为82.1%。学生年龄、学生身高、商店类型、售烟者的性别、售烟者的年龄、是否张贴有烟草广告、是否放置"禁止向未成年人售烟"警示牌、售烟者有无询问学生具体年龄、售烟者有无询问学生买烟给谁吸等9个变量与尝试买烟成功有统计学意义的关联。多因素分析筛选3个有意义的变量:学生年龄、商店类型和放置"禁止向未成年人售烟"警示牌。结论未成年人很容易通过自己购买而获得香烟,杂货店和小超市是重点,应加强对烟草零售商向未成年人售烟的监督和管制工作。     

Reducing minors' access to tobacco: eight years' experience in Hawaii

OBJECTIVE: This paper reports the findings of annual Synar inspections to assess compliance with federal and state legislation to limit minors' access to tobacco products in Hawaii. We also report on factors associated with selling tobacco to minors for the most recent year of inspections (2003). METHODS: Annual, random, unannounced inspections were conducted by minors (ages 14-17 years) over an 8-year period (1996-2003). Stores were randomly selected from a list of stores that sell tobacco products in Hawaii. RESULTS: There was a significant decrease in the percent of successful purchases made over the period from 1996 (44.5%) to 2003 (6.2%). Based on multivariate analyses, only two variables were associated with whether a successful purchase was made in 2003: whether the minor's identification or age was requested. CONCLUSION: Findings suggest that surveillance, education, and enforcement efforts in Hawaii have been successful at making substantial reductions in noncompliance rates. Even with the current low rate of sales to minors, failing to request the minor's identification or age was associated with making a successful purchase, while characteristics of the minor and retail environment were not.     

Availability of cigarettes to underage youth in three communities.

BACKGROUND. Underage youth report that they primarily obtain cigarettes from commercial sources. Thus policies that effectively prevent purchase by minors could have an effect on the prevalence of young people's cigarette use. METHODS. In this study, 12- to 15-year-old male and female confederates attempted to purchase cigarettes from all cigarette outlets in three communities. RESULTS. A success rate of 53% over the counter and 79% from vending machines was achieved. These results show that minors can purchase cigarettes in all types of businesses, even those characterized as "adult" locations. Boys in this study had more difficulty than girls in purchasing cigarettes over the counter, and younger individuals had more difficulty than 15-year-olds. However, these differences were not found in vending machine sales. Similarly, over-the-counter sales of cigarettes were significantly reduced following a state-wide increase in the penalty for tobacco sales to minors, but vending machine sales were not affected. CONCLUSIONS. These results support stringent and universal controls over the sale of cigarettes as an essential part of any tobacco use prevention strategy.     

Cigarette sales to African-American and white minors in low-income areas of Baltimore.

OBJECTIVES: This study documented illegal sales of cigarettes to minors in low-income African-American and White urban areas in East Baltimore. METHODS: Six youths, aged 14 through 16 years, were sent to a random sample of 83 corner stores to attempt to purchase cigarettes. The youths provided the investigators with data on merchant, store, and purchase characteristics. RESULTS: The youths successfully purchased cigarettes in 85.5% of the stores; 58% of the stores displayed five or more cigarette advertisements outside their premises. CONCLUSIONS: Cigarette sales to minors and associated advertising remain prevalent in this urban community.     

The relationship of point-of-sale tobacco advertising and neighborhood characteristics to underage sales of tobacco

Our objective was to determine how point-of-sale tobacco marketing may relate to sales to minors. The authors used data from a 2007 cross-sectional study of the retail tobacco marketing environments in the St. Paul, MN metropolitan area matched with a database of age-of-sale compliance checks (random, covert test purchases by a minor, coordinated by law enforcement) of tobacco retailers and U.S. Census data to test whether certain characteristics of advertising or neighborhoods were associated with compliance check failure. The authors found that tobacco stores were the most likely type of store to fail compliance checks (44% failure), supermarkets were least likely (3%). Aside from a marginally significant association with Hispanic population proportion, there was no other association between either store advertising characteristics or neighborhood demographics and stores' compliance check failure. Though our findings were null, the relationship between advertising and real youth sales may be more nuanced as compliance checks do not perfectly simulate the way youth attempt to purchase cigarettes.     

Accessibility of Cigarettes to Minors in Suburban Cook County, Illinois

This study assessed the problem of under age sale of cigarettes, educated vendors about the law restricting the sale of tobacco to minors, and determined the effectiveness of a vendor education intervention. Twenty-one teen volunteers, 14 to 17 years in age, attempted to purchase cigarettes in suburban Cook County from over-the-counter merchants and vending machines. Of the 347 vendors that were checked, the minors were successful in 37.2% of their attempts to purchase cigarettes. After information was sent to each vendor about the State of Illinois law, follow up visits were made to all the vendors who were willing to sell cigarettes to the minors during the first visits. Approximately 50% of the vendors were again willing to sell cigarettes to minors. This study's findings suggest that minors can easily purchase cigarettes in suburban Cook County. The education intervention component of the study had a limited but promising effect on compliance rates of the vendors.     

Measuring statewide merchant compliance with tobacco minimum age laws: the Massachusetts experience.

OBJECTIVES: This study evaluated merchant compliance with laws prohibiting the sale of tobacco to minors in Massachusetts. METHODS: Stratified cluster sampling was used to select outlets from which youths aged 13 to 17 years attempted to purchase tobacco. RESULTS: Illegal sales were more common when the youth purchasing the tobacco was older, when the clerk was male, and when tobacco was obtained from a self-service display or unlocked vending machine. Failure to request proof of age was the strongest predictor of illegal sales. CONCLUSIONS: Measured compliance rates are strongly influenced by the age of the youths used to purchase tobacco.     

Sustained effects of an educational program to reduce sales of cigarettes to minors.

We report 1-year follow-up data from a sample of stores participating in a 6-month community-wide educational effort to reduce cigarette sales to minors in Santa Clara County, California. The proportion of over-the-counter sales to minors at the 1-year follow-up illustrated that although statistically significant reductions were maintained 6 months after the intervention ended, recidivism occurred. Suggestions for achieving long-term reductions in sales to minors are offered.     

烟草商店向未成年人售烟情况及影响因素分析

目的了解烟草销售店向未成年人售烟情况及其影响因素。方法利用自填式问卷调查281名烟草销售人员向未成年人售烟的相关情况并分析影响因素。结果有效问卷共268份。烟草销售人员167人（62．3％）报告所工作的商店持有烟草专卖证，181人（67．5％）报告放置了“禁止向未成年人售烟”的标志。116人（43．3％）回答会询问或判断买烟者的年龄，146人（53．4％）表示会把香烟卖给中小学生或未成年人。以销售率较低的烟草专卖店和大超市为参照，小超市最高（0R=3．60），其次为杂货店（OR=2．52）；询问或判断买烟者年龄的销售率较低（0R=0．22）；认同青少年控烟责任的销售率较低（OR=0．85）。如商店类型不纳入方程，放置了禁止向未成年人售烟之类标志的销售率低（OR=0．52）。结论有烟草销售的商店非法向未成年人售烟的比例较高，尤其是小超市和杂货店。询问或判断买烟者的年龄、放置标志牌能降低向未成年人售烟的销售率。应制定非法向未成年人售烟的具体处罚措施。加强监督和管理力度，并对烟草销售人员进行法制教育。     

Long-term findings from Woodridge in reducing illegal cigarette sales to older minors

The purpose of the present study is to assess the effectiveness of an enforcement program in reducing cigarette sales to older minors in a community that had been successful in reducing illegal sales of cigarettes to younger minors. Cigarette sales rates were monitored over a 3-year period with quarterly compliance testing in Woodridge, Illinois. Sales rates for older minors were found to be only slightly higher than those of younger minors with one exception. These findings suggest that the enforcement of cigarette control laws is an effective means by which access to cigarettes can be reduced for both younger and older minors.     

Reducing cigarette sales to minors in an urban setting: Issues and opportunities for merchant intervention

Introduction: Intervention studies to reduce cigarette sales to minors have been conducted primarily in suburban settings. Little is known about sociocultural factors influencing cigarette sales to minors in urban settings. This study sought to determine sociodemographic and cultural factors that may play a role in cigarette sales and in efforts to reduce sales to minors in urban areas.Methods: Merchant education and follow-up surveys were conducted in small local stores in predominantly African-American urban census tracts in Baltimore. The stores had prior evidence of cigarette sales to minors.Results: Merchants reported hostility (66%) and foul language (64%) when they requested youth identification. Youthful-oriented advertising of cigarettes was highly prevalent in all stores and moreso in stores owned and staffed by Asian merchants. Advertising with specific youthful content was predictive (OR = 3.97; 95% CI = 1.70, 9.23; P = .0014) of higher requests for cigarettes from minors.Conclusions: Youth-oriented cigarette advertising is a prevalent environmental risk for urban youth. Differences between Asian and African-American merchants suggest socioethnic factors may be an influential component of illegal sales and educational campaigns to reduce smoking among minors.     

An experimental analysis of sociocultural variables in sales of cigarettes to minors.

OBJECTIVES: This study assessed the role of age, racial/ethnic group, and gender, as well as that of other sociocultural variables, in minors' access to tobacco. METHODS: Thirty-six minors attempted to purchase cigarettes once in each of 72 stores (2592 purchase attempts). The minors represented equal numbers of girls and boys; 10-year-olds, 14-year-olds, and 16-year-olds; and Whites, Blacks, and Latinos. Equal numbers of stores were in Black, White, and Latino neighborhoods. RESULTS: Older children were more likely than younger ones to be sold cigarettes, and Latino children were more likely than Whites to be sold cigarettes. Older Black children (irrespective of gender) were the single most likely group to be sold cigarettes. Cigarettes were significantly more likely to be sold to children by male than female clerks and in specific sociocultural contexts. CONCLUSIONS: Interventions with retailers must address sociocultural variables to improve effectiveness in reducing minors' access to tobacco.     

The relationship between tobacco access and use among adolescents: a four community study

The objective of this study was to examine the effectiveness of a longitudinal community intervention on the reduction of tobacco sales to minors and subsequent effects on tobacco consumption by youths. The study was conducted in Monterey County, CA. Four rural communities were randomized into treatment and comparison arms of the study and middle and high school students in each of these communities completed surveys assessing knowledge, attitude, and behavior. The main outcome measures were retail tobacco sales to minors as measured through store visits (tobacco purchase surveys) and self-reported consumption of tobacco. Over a three-year period, a diverse array of community interventions were implemented in the intervention communities. These included community education, merchant education, and voluntary policy change. In the treatment communities, the proportion of stores selling tobacco to minors dropped from 75% at baseline to 0% at the final post-test. In the comparison communities, the proportions were 64% and 39%, respectively. Although the availability of tobacco through commercial outlets was reduced substantially in intervention communities, youths reported still being able to obtain tobacco from other sources. Predicted treatment effects on reported use of tobacco among youths were observed cross-sectionally and longitudinally for younger students (7th graders). The intervention did not impact tobacco use among older students (9th and 11th graders) although the trends were in the predicted direction for 9th graders. A significant intervention effect was found for sex--females in the intervention communities were less likely to use tobacco post-intervention than females in the comparison communities. Tobacco sales to minors can be reduced through a broad-based intervention. To prevent or reduce tobacco use by youths, however, multiple supply-and demand-focused strategies are needed.