Na. Rigotti et al., THE EFFECT OF ENFORCING TOBACCO-SALES LAWS ON ADOLESCENTS ACCESS TO TOBACCO AND SMOKING-BEHAVIOR, The New England journal of medicine, 337(15), 1997, pp. 1044-1051
Background Enforcing laws banning tobacco sales to miners is widely ad
vocated as a way to reduce young people's access to tobacco and tobacc
o use. Whether this approach is successful is not known. Methods In a
two-year controlled study, we assessed sales of tobacco to miners and
young people's access to and use of tobacco in six Massachusetts commu
nities. Three communities (the intervention group) enforced tobacco-sa
les laws, whereas three matched communities (the control group) did no
t. To assess compliance with the law, miners working for the study inv
estigators attempted to purchase tobacco from all retail vendors in ea
ch community every six months. Three annual anonymous surveys of a tot
al of 22,021 students in grades 9 through 12 (response rate, 84 percen
t) measured access to tobacco and smoking behavior.Results At base lin
e, 68 percent of 487 vendors sold tobacco to miners. Compliance with t
he law improved significantly faster in the intervention communities t
han in the controls (P<0.001). By the study's end, 82 percent of the m
erchants in the intervention communities complied with the law, as com
pared with 45 percent in the control communities (P<0.001). However, a
dolescents under 18 years old reported only a small drop in their abil
ity to purchase tobacco and no decline in its use. Communities with an
d those without enforcement programs did not differ with respect to th
ese outcomes. Conclusions Enforcing tobacco-sales laws improved mercha
nts' compliance and reduced illegal sales to miners but did not alter
adolescents' perceived access to tobacco or their smoking. Test purcha
ses of tobacco do not accurately reflect adolescents' self-reported ac
cess to tobacco, and reducing illegal sales to less than 20 percent of
attempts - the goal of a new federal law - may not decrease young peo
ple's access to or use of tobacco. (C) 1997, Massachusetts Medical Soc
iety.