Pi. Clark et al., Factors associated with tobacco sales to minors - Lessons learned from theFDA compliance checks, J AM MED A, 284(6), 2000, pp. 729-734
Citations number
33
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Context. Tobacco products continue to be widely accessible to miners. Betwe
en 1997 and 1999, the US Food and Drug Administration (FDA) conducted more
than 150000 tobacco sales age-restriction compliance checks. Data obtained
from these checks provide important guidance for curbing illegal sales.
Objective To determine which elements of the compliance checks were most hi
ghly associated with illegal sales and thereby inform best practices for co
nducting efficient compliance check programs.
Design and Setting Cross-sectional analysis of FDA compliance checks in 110
062 unique establishments in 36 US states and the District of Columbia.
Main Outcome Measure Illegal sales of tobacco to miners at compliance check
s; association of illegal sales with variables such as age and sex of the m
inor.
Results The rate of illegal sales for all first compliance checks in unique
stores was 26.6%. Clerk failure to request proof of age was strongly assoc
iated with illegal sales (uncorrected sales rate, 10.5% compared with 89.5%
sales when proof was not requested; multivariate-adjusted odds ratio [OR],
0.03; 95% confidence interval [CI], 0.03-0.04). Other factors associated w
ith increased illegal sales were employment of older miners to make the pur
chase attempt (adjusted ORs for 16- and 17-year-old miners compared with 15
-year-olds were 1.52 [95% CI, 1.46-1.63] and 2.43 [95% CI, 2.31-2.59], resp
ectively), attempt to purchase smokeless tobacco (adjusted OR, 2.16 [95% CI
, 1.90-2.45] vs cigarette purchase attempts), and performing checks at or a
fter 5 PM (adjusted OR, 1.28 [95% CI, 1.21-1.35] vs before 5 PM). Female se
x of clerk and minor, Saturday checks, type of store (convenience store sel
ling gas, gas station, drugstore, supermarket and general merchandise), and
rural store locations also were associated with increased illegal sales.
Conclusions This analysis found that a request for age verification strongl
y predicted compliance with the law. The results suggest several ways in wh
ich the process of compliance checks might be optimized.