The Rest of the Story
Ten years is long enough for an experiment that as early as 1996, Dr. Stan Glantz suggested to us was an unfortunate diversion of resources (see: Glantz SA. Preventing tobacco use--the youth access trap. American Journal of Public Health 1996; 86(2):156-158). No matter how reluctant we are, it is time to conclude that the experiment has failed.
There simply is not evidence that as implemented in widespread practice, youth access laws and their enforcement have any significant effect on youth smoking. While there have been a few studies that found an effect, these were generally in specific communities that implemented an unusually aggressive program that cannot likely be sustained or easily replicated elsewhere. The totality of the evidence, in my opinion, documents that youth access interventions do not significantly decrease youth smoking (see, in particular: Fichtenberg CM. Glantz SA. Youth access interventions do not affect youth smoking. Pediatrics 2002; 109(6):1088-1092).
Research conducted here in Massachusetts, where a heavily-funded statewide tobacco control program with a huge emphasis on youth access interventions (including enforcement) was in place for a decade (from 1993-2003), revealed that these initiatives had no effect on youth smoking behavior (see: Thomson CC, Gokhale M, Biener L, Siegel MB, Rigotti NA. Statewide evaluation of youth access ordinances in practice: Effects of the implementation of community-level regulations in Massachusetts. Journal of Public Health Management and Practice 2004; 10:481-489).
There are a number of reasons why widespread efforts to restrict the sale of tobacco products to minors would not be expected to be effective in reducing youth smoking:
- Youths have a wide variety of sources of access to cigarettes, and half of youth smokers do not even rely on purchasing their own cigarettes. If youths want to smoke, they can obtain cigarettes even if unable to purchase for themselves.
- Compliance checks as conducted by tobacco control groups are essentially meaningless exercises, because they do not simulate real-life conditions, in which youths are able to lie about their age or present false identification.
- Even if there were no alternate sources of cigarettes other than purchasing in a store, compliance would have to reach extremely high levels to reduce youth access to cigarettes. If even one store in a community sells to minors, youths have ready access to cigarettes.