FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 337:1044-1051 October 9, 1997 Number 15 Next

	Full Text PDF Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Enforcing laws banning tobacco sales to minors is widely advocated as a way to reduce young people's access to tobacco and tobacco use. Whether this approach is successful is not known.

Methods In a two-year controlled study, we assessed sales of tobacco to minors and young people's access to and use of tobacco in six Massachusetts communities. Three communities (the intervention group) enforced tobacco-sales laws, whereas three matched communities (the control group) did not. To assess compliance with the law, minors working for the study investigators attempted to purchase tobacco from all retail vendors in each community every six months. Three annual anonymous surveys of a total of 22,021 students in grades 9 through 12 (response rate, 84 percent) measured access to tobacco and smoking behavior.

Results At base line, 68 percent of 487 vendors sold tobacco to minors. Compliance with the law improved significantly faster in the intervention communities than in the controls (P<0.001). By the study's end, 82 percent of the merchants in the intervention communities complied with the law, as compared with 45 percent in the control communities (P<0.001). However, adolescents under 18 years old reported only a small drop in their ability to purchase tobacco and no decline in its use. Communities with and those without enforcement programs did not differ with respect to these outcomes.

Conclusions Enforcing tobacco-sales laws improved merchants' compliance and reduced illegal sales to minors but did not alter adolescents' perceived access to tobacco or their smoking. Test purchases of tobacco do not accurately reflect adolescents' self-reported access to tobacco, and reducing illegal sales to less than 20 percent of attempts — the goal of a new federal law — may not decrease young people's access to or use of tobacco.

Source Information

From the Tobacco Research and Treatment Center (N.A.R., T.T., B.K.) and the General Internal Medicine Unit (N.A.R., Y.C., T.T., D.E.S.), Massachusetts General Hospital, Harvard Medical School, Boston; and the Department of Family and Community Medicine, University of Massachusetts Medical Center, Worcester (J.R.D.).

Address reprint requests to Dr. Rigotti at the General Internal Medicine Unit, 50 Staniford St., 9th Fl., Massachusetts General Hospital, Boston, MA 02114.

Full Text of this Article

Related Letters:

Smoking in the Young
Moskowitz J. M., Malvin J., Rigotti N. A., Singer D. E., DiFranza J. R.
Extract | Full Text  
N Engl J Med 1998; 338:472-473, Feb 12, 1998. Correspondence

This article has been cited by other articles:

• Jason, L. A., Pokorny, S. B., Adams, M., Hunt, Y., Gadiraju, P., Morello, T., Schoeny, M., Dinwiddie, C. (2007). Youth Caught in Violation of Tobacco Purchase, Use, and Possession Laws: Education Versus Fines. Behav Modif 31: 713-731 [Abstract]  
• Ng, N., Prabandari, Y. S., Padmawati, R. S., Okah, F., Haddock, C K., Nichter, M., Nichter, M., Muramoto, M., Poston, W. S C, Pyle, S. A, Mahardinata, N., Lando, H. A (2007). Physician assessment of patient smoking in Indonesia: a public health priority. Tobacco Control 16: 190-196 [Abstract] [Full Text]  
• Hahn, E. J., Riker, C., Butler, K. M., Cavendish, S., Lewis, P., Army, U.S., Greathouse Maggio, L. W., Nunley, V. (2007). Enforcement of Tobacco Purchase, Use, and Possession Laws in Four Kentucky Communities. Policy Politics Nursing Practice 8: 140-147 [Abstract]  
• Niederdeppe, J., Farrelly, M. C, Wenter, D. (2007). Media advocacy, tobacco control policy change and teen smoking in Florida. Tobacco Control 16: 47-52 [Abstract] [Full Text]  
• Craig, M. J., Boris, N. W. (2007). Youth Tobacco Access Restrictions: Time to Shift Resources to Other Interventions?. Health Promot Pract 8: 22-27 [Abstract]  
• Webster, D W, Bulzacchelli, M T, Zeoli, A M, Vernick, J S (2006). Effects of undercover police stings of gun dealers on the supply of new guns to criminals.. Inj. Prev. 12: 225-230 [Abstract] [Full Text]  
• Turner, K. M., Gordon, J., Young, R. (2004). Cigarette access and pupil smoking rates: a circular relationship?. HEALTH PROMOT INT 19: 428-436 [Abstract] [Full Text]  
• Dent, C, Biglan, A (2004). Relation between access to tobacco and adolescent smoking. Tobacco Control 13: 334-338 [Abstract] [Full Text]  
• Siegel, M (2004). Food and Drug Administration regulation of tobacco: snatching defeat from the jaws of victory. Tobacco Control 13: 439-441 [Full Text]  
• Kandel, D. B., Kiros, G.-E., Schaffran, C., Hu, M.-C. (2004). Racial/Ethnic Differences in Cigarette Smoking Initiation and Progression to Daily Smoking: A Multilevel Analysis. Am. J. Public Health 94: 128-135 [Abstract] [Full Text]  
• Landrine, H., Klonoff, E. A. (2003). Validity of Assessments of Youth Access to Tobacco: The Familiarity Effect. Am. J. Public Health 93: 1883-1886 [Abstract] [Full Text]  
• Andersen, B. S., Begay, M. E., Lawson, C. B. (2003). Breaking the Alliance: Defeating the Tobacco Industry's Allies and Enacting Youth Access Restrictions in Massachusetts. Am. J. Public Health 93: 1922-1928 [Abstract] [Full Text]  
• Mercer, S. L, Green, L. W, Rosenthal, A. C, Husten, C. G, Khan, L. K., Dietz, W. H (2003). Possible lessons from the tobacco experience for obesity control. Am. J. Clin. Nutr. 77: 1073S-1082 [Abstract] [Full Text]  
• Jason, L. A., Pokorny, S. B., Schoeny, M. E., Fichtenberg, C. M., Glantz, S. A. (2003). It Is Premature to Abandon Youth Access to Tobacco Programs. Pediatrics 111: 920-921 [Full Text]  
• Sargent, J. D., DiFranza, J. R. (2003). Tobacco Control for Clinicians Who Treat Adolescents. CA Cancer J Clin 53: 102-123 [Abstract] [Full Text]  
• Levinson, A H, Hendershott, S, Byers, T E (2002). The ID effect on youth access to cigarettes. Tobacco Control 11: 296-299 [Abstract] [Full Text]  
• Donovan, R J, Jancey, J, Jones, S (2002). Tobacco point of sale advertising increases positive brand user imagery. Tobacco Control 11: 191-194 [Abstract] [Full Text]  
• DiFranza, J R, Fichtenberg, C M, Glantz, S A, Ling, P, Landman, A, Glantz, S A (2002). Is it time to abandon youth access programmes? * Authors' replies. Tobacco Control 11: 282-284 [Full Text]  
• Krevor, B S, Lieberman, A, Gerlach, K (2002). Application of consumer protection authority in preventing tobacco sales to minors. Tobacco Control 11: 109-111 [Abstract] [Full Text]  
• Ling, P M, Landman, A, Glantz, S A (2002). It is time to abandon youth access tobacco programmes. Tobacco Control 11: 3-6 [Full Text]  
• Jones, S E., Sharp, D J, Husten, C G, Crossett, L S (2002). Cigarette acquisition and proof of age among US high school students who smoke. Tobacco Control 11: 20-25 [Abstract] [Full Text]  
• Livingood, W. C., Woodhouse, C. D., Sayre, J. J., Wludyka, P. (2001). Impact Study of Tobacco Possession Law Enforcement in Florida. Health Educ Behav 28: 733-748 [Abstract]  
• DiFranza, J. R, Coleman, M. (2001). Sources of tobacco for youths in communities with strong enforcement of youth access laws. Tobacco Control 10: 323-328 [Abstract] [Full Text]  
• Ringel, J. S., Evans, W. N. (2001). Cigarette Taxes and Smoking During Pregnancy. Am. J. Public Health 91: 1851-1856 [Abstract] [Full Text]  
• DiFranza, J. R, Savageau, J. A, Bouchard, J. (2001). Is the standard compliance check protocol a valid measure of the accessibility of tobacco to underage smokers?. Tobacco Control 10: 227-232 [Abstract] [Full Text]  
• Levy, D. T, Friend, K., Holder, H., Carmona, M. (2001). Effect of policies directed at youth access to smoking: results from the SimSmoke computer simulation model. Tobacco Control 10: 108-116 [Abstract] [Full Text]  
• DiFranza, J. R. (2001). State and Federal Compliance With the Synar Amendment: Federal Fiscal Year 1998. Arch Pediatr Adolesc Med 155: 572-578 [Abstract] [Full Text]  
• Levy, D. T., Friend, K. B. (2000). A Simulation Model of Tobacco Youth Access Policies. Journal of Health Politics, Policy and Law 25: 1023-1050 [Abstract]  
• DiFranza, J. R. (2000). State and Federal Compliance With the Synar Amendment: Federal Fiscal Year 1997. Arch Pediatr Adolesc Med 154: 936-942 [Abstract] [Full Text]  
• Clark, P. I., Natanblut, S. L., Schmitt, C. L., Wolters, C., Iachan, R. (2000). Factors Associated With Tobacco Sales to Minors: Lessons Learned From the FDA Compliance Checks. JAMA 284: 729-734 [Abstract] [Full Text]  
• DIFRANZA, J. R (2000). Youth access: the baby and the bath water. Tobacco Control 9: 120-121 [Full Text]  
• Stead, L. F, Lancaster, T. (2000). A systematic review of interventions for preventing tobacco sales to minors. Tobacco Control 9: 169-176 [Abstract] [Full Text]  
• Wakefield, M., Chaloupka, F. (2000). Effectiveness of comprehensive tobacco control programmes in reducing teenage smoking in the USA. Tobacco Control 9: 177-186 [Abstract] [Full Text]  
• Lantz, P. M, Jacobson, P. D, Warner, K. E, Wasserman, J., Pollack, H. A, Berson, J., Ahlstrom, A. (2000). Investing in youth tobacco control: a review of smoking prevention and control strategies. Tobacco Control 9: 47-63 [Abstract] [Full Text]  
• Bidell, M. P, Furlong, M. J, Dunn, D. M, Koegler, J. E (2000). Case study of attempts to enact self service tobacco display ordinances: a tale of three communities. Tobacco Control 9: 71-77 [Abstract] [Full Text]  
• DiFranza, J. R. (1999). Are the Federal and State Governments Complying With the Synar Amendment?. Arch Pediatr Adolesc Med 153: 1089-1097 [Abstract] [Full Text]  
• O'Grady, B., Asbridge, M., Abernathy, T. (1999). Analysis of factors related to illegal tobacco sales to young people in Ontario. Tobacco Control 8: 301-305 [Abstract] [Full Text]  
• DiFranza, J. R, Rigotti, N. A (1999). Impediments to the enforcement of youth access laws. Tobacco Control 8: 152-155 [Abstract] [Full Text]  
• Emery, S., Gilpin, E. A., White, M. M., Pierce, J. P. (1999). How Adolescents Get Their Cigarettes: Implications for Policies on Access and Price. JNCI J Natl Cancer Inst 91: 184-186 [Full Text]  
• Nathanson, C. A. (1999). Social Movements as Catalysts for Policy Change: The Case of Smoking and Guns. Journal of Health Politics, Policy and Law 24: 421-488 [Abstract]  
• Jacobson, P. D., Wasserman, J. (1999). The Implementation and Enforcement of Tobacco Control Laws: Policy Implications for Activists and the Industry. Journal of Health Politics, Policy and Law 24: 567-598 [Abstract]  
• WAKEFIELD, M. A, CHALOUPKA, F. J (1998). Improving the measurement and use of tobacco control "inputs". Tobacco Control 7: 333-335 [Full Text]  
• Alciati, M. H, Frosh, M., Green, S. B, Brownson, R. C, Fisher, P. H, Hobart, R., Roman, A., Sciandra, R. C, Shelton, D. M (1998). State laws on youth access to tobacco in the United States: measuring their extensiveness with a new rating system. Tobacco Control 7: 345-352 [Abstract] [Full Text]  
• Robinson, L. A, Klesges, R. C, Zbikowski, S. M (1998). Gender and ethnic differences in young adolescents' sources of cigarettes. Tobacco Control 7: 353-359 [Abstract] [Full Text]  
• Moskowitz, J. M., Malvin, J., Rigotti, N. A., Singer, D. E., DiFranza, J. R. (1998). Smoking in the Young. NEJM 338: 472-473 [Full Text]