Reducing underage cigarette sales in an isolated community: the effect on adolescent cigarette supplies

OBJECTIVE: The current study explored the practicality of preventing underage retail cigarette sales and the relationship to cigarette supplies among adolescents. METHOD: In Fort Morgan, Colorado, an isolated rural community with below-average socioeconomic status and a large Latino population, supervised teenaged employees repeatedly attempted to buy cigarettes from every store over a 9-month period in 2005. Repeated violations were penalized. Cigarette acquisition and exchange among community adolescents were assessed before and after intervention using a high school student survey. RESULTS: The measured violation rate declined from 47% in the first week to 3.4% during the final three months, and high school student reliance on retail cigarette purchases declined. Adolescent cigarette supplies declined by approximately 15%. CONCLUSION: Isolated rural communities can reduce adolescent cigarette supplies by conducting consistent enforcement against retail cigarette sales to minors. Previous research suggests that reducing these sales may help reduce adolescent smoking. The current study demonstrates that enforcement is practical and effective.     

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.     

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.     

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.     

How does electronic cigarette access affect adolescent smoking?

Understanding electronic cigarettes’ effect on tobacco smoking is a central economic and policy issue. This paper examines the causal impact of e-cigarette access on conventional cigarette use by adolescents. Regression analyses consider how state bans on e-cigarette sales to minors influence smoking rates among 12 to 17 year olds. Such bans yield a statistically significant 0.9 percentage point increase in recent smoking in this age group, relative to states without such bans. Results are robust to multiple specifications as well as several falsification and placebo checks. This effect is both consistent with e-cigarette access reducing smoking among minors, and large: banning electronic cigarette sales to minors counteracts 70 percent of the downward pre-trend in teen cigarette smoking for a given two-year period.     

Availability of cigarettes to minors

Abstract: Legislation banning the sale of cigarettes to minors is potentially a cost-effective means of reducing smoking rates among adolescents. Such legislation has been in existence in Australia for over 80 years. Two studies examined the retail industry's adherence to the sales ban in two regions of New South Wales in 1990. The first study was a survey of 1 849 12- to 15-year-old adolescents from 12 high schools in New South Wales, providing data on self-reported purchasing of cigarettes from retail outlets by minors. In all, 38 per cent reported having purchased cigarettes illegally. A second study was undertaken to determine the proportion of retail shops which sell cigarettes to apparently underage youth. Two 16-year-olds who looked young for their age attempted to purchase cigarettes from 101 different retail outlets in one region of New South Wales. No challenge about age was made for 70 per cent of purchases, and proof of age was requested on only 15 per cent of occasions. The results suggest that legislation banning sales of cigarettes to minors requires strong enforcement procedures to be effective.     

Reducing underage cigarette sales in an isolated community: The effect on adolescent cigarette supplies

Objective.The current study explored the practicality of preventing underage retail cigarette sales and the relationship to cigarette supplies among adolescents.Method.In Fort Morgan, Colorado, an isolated rural community with below-average socioeconomic status and a large Latino population, supervised teenaged employees repeatedly attempted to buy cigarettes from every store over a 9-month period in 2005. Repeated violations were penalized. Cigarette acquisition and exchange among community adolescents were assessed before and after intervention using a high school student survey.Results.The measured violation rate declined from 47% in the first week to 3.4% during the final three months, and high school student reliance on retail cigarette purchases declined. Adolescent cigarette supplies declined by approximately 15%.Conclusion.Isolated rural communities can reduce adolescent cigarette supplies by conducting consistent enforcement against retail cigarette sales to minors. Previous research suggests that reducing these sales may help reduce adolescent smoking. The current study demonstrates that enforcement is practical and effective.     

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.     

Smoking by adolescents: large revenue but little for prevention

Abstract: The purpose of this paper is to report on the government revenue gained from the sale of cigarettes to minors and the proportion of this revenue that is spent on attempting to prevent adolescents from taking up this habit Prevalence of smoking by minors was extrapolated for the individual states using Australian prevalence data; estimates of annual cigarette consumption were coupled with the respective cost of cigarettes in each state to derive an estimate of the total revenue accumulating from cigarette consumption by minors. From our analysis, approximately 211 000 Australian children under the legal age to purchase cigarettes consumed approximately 11.5 million packets of cigarettes in 1990. The estimated tax revenues to the federal and state governments from these sales were $8.42 million and $12.78 million respectively. While the average state revenue from cigarette consumption by minors during 1990 was just over $60 per under-age smoker, only $0.11 per under-age smoker was spent on anti-smoking campaigns in 1990. This is equivalent to approximately 0.002 per cent of state revenue from cigarette smoking by those under the legal purchase age being spent on discouraging adolescents from taking up this habit Clearly, there is an inequitable expenditure on antismoking activities, given the enormous resources obtained from sales to minors.     

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.     

The illegal sale of cigarettes to US minors: estimates by state.

Data available from recent national surveys on the cigarette consumption and purchasing practices of teenage smokers were used to generate state-specific estimates of the number of teenage smokers and cigarette sales to minors. In 1991, approximately 2.7 million teenage cigarette smokers consumed an average of 28.3 million cigarettes per day (516 million packs per year). An estimated 255 million packs of cigarettes were sold illegally to minors in 1991. To make cigarettes and other tobacco products less accessible to minors, policymakers should consider implementing various legislative and economic measures such as banning cigarette vending machines and raising tobacco excise taxes.     

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。     

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.     

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.     

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.     

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 enforcements and fines on youth smoking

Restricting access to retail sources of tobacco and fining minors for possession of tobacco products were evaluated as possible strategies to reduce the rising rates of teenage smoking. Four towns were assigned to enforce both tobacco minimum-age-of sales laws and tobacco possession laws (P). The remaining four towns were assigned to enforce only tobacco minimum-age-of sales laws (NP). Tobacco use among sixth-, seventh- and eighth-grade students was assessed. White youth who lived in communities with strict enforcement of tobacco sales and possession laws had significantly fewer increases in tobacco use than those living in communities with only moderate enforcement of tobacco sales laws. Public health interventions that involve police fining minors along with very high merchant compliance rates might decrease rates of tobacco use of white youth during a developmental time when they are susceptible to experimentation and use of tobacco products.     

Purchasing of cigarettes by New Zealand secondary students in 2000

OBJECTIVE: To examine the prevalence of under-age sales of cigarettes to New Zealand secondary school students in 2000 and to identify correlates of buying cigarettes. METHOD: A randomly selected sample of 53 secondary schools from five geographic regions took part, and 2,896 Year 10 and Year 12 students completed a self-report questionnaire. RESULTS: Some 30.3% reported smoking during the past 30 days and 61.8% of these students usually obtained cigarettes by purchasing from shops, from other students or from someone else buying them on their behalf. Local corner stores and service stations were the most popular source. Buying cigarettes was associated with more frequent smoking, more money to spend, a higher school decile rating and higher proportion of schoolmates also purchasing. CONCLUSIONS: Prohibition of cigarette sales to minors needs much greater attention in NZ than it is receiving at present if smoking among young people is to be reduced.     

北京市朝阳区普通中学校外烟草售卖点情况调查

目的：了解北京市朝阳区普通中学校门周边100米范围内烟草售卖点的分布情况及其向中学生售烟情况。方法采取单纯随机抽样的方法,抽取朝阳区32所普通中学,对校门周边100米范围内烟草售卖点的分布情况和对学生售烟情况进行调查。结果71.9%(23/32)的普通中学校门口100米范围内存在烟草售卖点,平均每所中学校外有1.50±1.37家烟草售卖点。烟草售卖点离校门的平均距离为45.8±27.2米,所售烟草的最低价格为4.19±1.50元/包。56.3%(27/48)的烟草售卖点悬挂有烟草专卖零售许可证,35.4%(17/48)烟草售卖点的工作人员知晓禁止向未成年人售烟和禁止在校门口100米内设立卷烟零售点的政策,25.0%(12/48)的烟草售卖点张贴禁止向未成年人售烟的标识,72.9%(35/48)的烟草售卖点向中学生售烟。有烟草专卖零售许可证的正规烟草售卖点对禁售政策知晓率、标识的张贴率和向中学生拒售烟草的比例,显著高于非正规烟草售卖点。结论北京市朝阳区中学生烟草易得性较高,有必要加强控烟政策法规的宣传和执法力度。     

Trends in Underage Tobacco Sales: An Update on the Past Decade of Compliance Checks in Hawai‘i

Tobacco use remains the leading cause of preventable death in the United States and is a major concern in the adolescent population. Preventing youth from starting to smoke is a key public health priority, as a majority of adult smokers started smoking by age 18. Controlling access to tobacco in retail outlets has been shown to be an effective measure for reducing the use of tobacco among minors. In order to control the sales of tobacco to minors in the retail environment, the Synar Amendment requires states to conduct annual, random, and unannounced tobacco sales compliance inspections. Synar compliance inspections started in Hawai‘i in 1996, reducing the sales of tobacco to minors almost 40.0% by 2003. The current paper aims to expand on past surveillance findings to examine the Synar compliance inspection results in Hawai‘i from 2004 to 2013 and to identify factors associated with minors'' successfully purchasing tobacco. Surveillance of the past ten years showed that noncompliance rates remained low, ranging from a high of 11.2% in 2008 to a low of 4.3% in 2012; this number was 7.5% in 2013. Three factors were significantly associated with successful tobacco purchases by a minor in 2013: whether a clerk requested a minor''s identification, the gender of the minor, and whether self-service of tobacco products was available. Other significant factors varied by year. Findings from this study are needed for continued surveillance, to implement effective anti-tobacco policies, and to develop policies aimed at emerging tobacco products, such as electronic cigarettes.