Tobacco Sales to Minors

Landrine and Klonoff1 have revealed a major flaw in the way we measure underage tobacco sales. In most “compliance checks,” a supervised youngster visits a store and tries to buy cigarettes. The weighted proportion of sales in a random sample of stores estimates the violation rate for an area. The known problem with this method is that compliance checks are unreliable. Results vary with the minor’s age and appearance,2 presentation (or not) of valid identification,3 honesty,4 and other elements. Thus, even when compliance checks produce single-digit violation rates, adolescent tobacco use often fails to decline.5 The disconnect is certainly an artifact of underestimation of underage sales, but null findings have fueled doubt that anything practical can be done about youth access to cigarettes.6 Some attention has shifted to kids giving kids cigarettes,7 and some advocates have intensified8 longstanding calls9 to abandon youth access interventions altogether. However, retail purchase remains the usual way that addicted adolescents get their cigarettes10—as well as the cigarettes they give experimenting peers headed for addiction. Abandonment of youth access interventions would only expand the social-source problem, which may prove as hard to control as retail underage sales have been. US regulations require tobacco-sales compliance checks, and results are reviewed before states can be funded for substance abuse prevention and treatment. The rules have withstood previous findings that compliance checks are unreliable, but Landrine and Klonoff document a more fundamental problem. Currently, we send underage strangers into randomly chosen stores to attempt a single purchase each time. But in the real world, addicted adolescent smokers choose their stores nonrandomly, establish familiarity by making noncigarette purchases, then return repeatedly as regular cigarette customers. Put simply, we simply aren’t measuring youths’ access to retail cigarettes. However, Landrine and Klonoff may have illustrated a better method. Adolescents in tobacco control programs could establish familiarity at retail tobacco outlets across their communities, then conduct compliance checks with penalties for violators. Clerks already warn one another when “stings” are under way—maybe they would spread the word that familiarity with young customers doesn’t provide safety when selling cigarettes. A feasibility study of this strategy is being developed. If it proves effective and practical, it might really reduce youth access to cigarettes. Only then will we be able to determine whether and to what extent adolescent smoking depends on underage retail tobacco sales

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  J Forster, Jean L Forster et al.•Tobacco Control•2003

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• Is the standard compliance check protocol a valid measure of the accessibility of tobacco to underage smokers

  Joseph R DiFranza, Judith A Savageau et al.•Tobacco Control•2001

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• Preventing tobacco use--the youth access trap

  Stanton A Glantz•American Journal of Public Health•1996

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• Validity of Assessments of Youth Access to Tobacco

  Hope Landrine, Elizabeth A Klonoff•American Journal of Public Health•2003

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