Sustained effects of educating retailers to reduce cigarette sales to minors.

Despite state laws prohibiting the purchase of tobacco by minors, the ease with which underage youth can purchase cigarettes has been documented nationwide. The public health community as well as policy makers have called for a combination of retailer education and enforcement of laws prohibiting tobacco sales to minors. Enforcement activity may not be feasible in many communities, however, and an educational intervention may be the only option. This paper reports results of a 6-month followup assessment following a face-to-face education intervention with retailers to reduce cigarettes sales to minors in San Diego County, CA. A control-experimental group, pre-post design was employed to study the sustained effects of the program on the illegal sale of cigarettes to minors. A total of 236 stores were visited by minors, ages 14-17 years, with the intent of purchasing cigarettes. Information was collected three times: pre-test, immediately following the intervention, and 6 months after the intervention ended. The groups included a no-treatment control group of 108 stores and an intervention group of 128 that received three educational visits from project staff over a 1-year period. Community education via media and informational presentations was also conducted. As previously reported, a 68-percent pretest sales rate was found for stores overall. Immediately following the intervention, 32 percent of the intervention group and 59 percent of the control group sold cigarettes to minors. These results were maintained 6 months following the conclusion of the intervention. Results are discussed in terms of education versus use of enforcement.     

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.     

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.     

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.     

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。     

Measuring feeding in low-income African-American and Hispanic parents

Current feeding measures have been developed based on the premise that a child's obesity risk is increased when parents exert high levels of control over feeding. Although these measures provide useful ways to assess parental restrictiveness in feeding, they do not capture other important aspects of feeding that describe the behavior of parents not overly concerned about child obesity. Alternative measures are important to develop, especially for minority populations where concerns about child obesity are often not a significant determinant of parental feeding practices. The current study describes a culturally informed method used to develop a broader assessment of parental feeding strategies across two low-income ethnic groups. To be able to accurately measure cultural differences associated with feeding, qualitative and quantitative methods were used to assure conceptual, linguistic, and measurement equivalency across African-American and Hispanic parents. Based on responses from 231 parents, mean differences in feeding strategies were found with Hispanic parents reporting significantly more parent-centered/high control and child-centered feeding strategies compared to African-Americans. Furthermore, the relationship between children's weight status and parental feeding strategies varied by the two ethnic groups and child gender. Implications of these results for understanding the role of parental socialization in the development of child obesity are discussed.     

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.     

Blood pressure measurement and antihypertensive treatment in a low-income African-American population.

OBJECTIVES: The purpose of this study was to describe blood pressure measurement and hypertension treatment in an inner-city African-American community. METHODS: A random-digit dialing telephone survey of adults more than 18 years of age was carried out in 12 predominantly African-American zip code areas in Houston, Texas. RESULTS: More than 90% of subjects reported a blood pressure measurement within the past 2 years, and 87% of known hypertensives reported current medication use. CONCLUSIONS: Further improvements in hypertension control among African Americans in this country are likely to depend primarily on changes in diagnosis and management practices of health care providers and on maintaining primary care access for all socioeconomic groups.     

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.     

Effects of publicity and a warning letter on illegal cigarette sales to minors

Abstract: The study aimed to assess rates of illegal cigarette sales to children and the impact on these rates of publicity and a warning letter threatening prosecution. Children aged 12 and 13 made two repeat purchasing attempts, three months apart, at 255 randomly selected tobacco retail outlets in Sydney. A randomly selected 50 per cent of retail outlets which sold cigarettes illegally at the first attempt were sent warning letters threatening prosecution. Publicity about the undercover buying operation was organised between the attempts. At the first attempts, 39 per cent of shops sold cigarettes to the children and 32 per cent sold them at the second attempt. Shops which sold on the first occasion and received warning letters reduced selling by 69 per cent compared to the 40 per cent reduction in shops which sold cigarettes on the first attempt and were not sent warning letters, a net reduction of 29 per cent seemingly attributable to the warning letters (95 per cent confidence interval 8 per cent to 50 per cent). It is extremely easy for children as young as 12 to buy cigarettes. The combined effects of publicity about undercover buying operations and warning letters threatening prosecution seem capable of reducing selling by about 29 per cent. Because of inconsistencies in selling or refusals, future attempts to measure selling rates to children should use repeat purchasing attempts and classify outlets as ‘selling’, ‘not selling’ or ‘sometimes selling’.     

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.     

Bans on electronic cigarette sales to minors and smoking among high school students

Many states have banned electronic cigarette sales to minors under the rationale that using e-cigarettes leads to smoking traditional combustion cigarettes. Such sales bans would be counterproductive, however, if e-cigarettes and traditional cigarettes are substitutes, as bans might push teenagers back to smoking the more dangerous combustion cigarettes. We provide evidence that these sales bans reduce the incidence of smoking conventional cigarettes among high school seniors. Moreover, we provide evidence suggesting that sales bans reduced e-cigarette usage as well. This evidence suggests that not only are e-cigarettes and smoking regular cigarettes positively related and not substitutes for young people, banning retail sales to minors is an effective policy tool in reducing tobacco use.     

Deterring sales and provision of alcohol to minors: a study of enforcement in 295 counties in four states.

The authors analyzed patterns of criminal and administrative enforcement of the legal minimum age for drinking across 295 counties in four States. Data on all arrests and other actions for liquor law violations from 1988 through 1990 were collected from the Federal Bureau of Investigation Uniform Crime Reporting System, State Uniform Crime Reports, and State Alcohol Beverage Control Agencies. Analytic methods used include Spearman rank-order correlation, single-linkage cluster analysis, and multiple regression modeling. Results confirmed low rates of enforcement of the legal drinking age, particularly for actions against those who sell or provide alcohol to underage youth. More than a quarter of all counties examined had no Alcoholic Beverage Control Agency actions against retailers for sales of alcohol to minors during the three periods studied. Analyses indicate that 58 percent of the county-by-county variance in enforcement of the youth liquor law can be accounted by eight community characteristics. Rate of arrests for general minor crime was strongly related to rate of arrests for violations of the youth liquor law, while the number of law enforcement officers per population was not related to arrests for underage drinking. Raising the legal age for drinking to 21 years had substantial benefits in terms of reduced drinking and reduced automobile crashes among youths, despite low level of enforcement. Potential benefits of active enforcement of minimum drinking age statutes are substantial, particularly if efforts are focused on those who provide alcohol to youth.