What is the potential cost-effectiveness of enforcing a prohibition on thesale of tobacco to minors?

Background, Enforcement programs to halt the sale of tobacco to youths have been implemented across the United States. The potential cost-effectivenes s of enforcement mas evaluated under a range of assumptions regarding cost and impact. Methods. An enforcement model was constructed incorporating quarterly inspe ctions of all tobacco vendors. The cost of discounted years of life saved w as calculated using reported values regarding cost and a range of assumptio ns regarding the impact on youth tobacco use. Results. Inspecting an estimated 543,000 tobacco outlets would cost up to $ 190 million annually Costs range from $44 to $8,200 per year of life saved depending on the discount rate and assumptions regarding cost, and efficacy To compete in cost-effectiveness with implementing smoking cessation guide lines, enforcement would hare to produce a 5% reduction in adolescent smoki ng at a cost of no more than $250 per vendor. Conclusion. At this level of cost and effectiveness an enforcement program could save 10 times as many Lives as the same amount spent on mammography o r screening for colorectal carcinoma. A one-cent per pack cigarette tax cou ld fully fund enforcement. Enforcement of tobacco sales laws deserves furth er study as one component of a multifaceted approach to tobacco use prevent ion. (C) 2001 American Health Foundation and Academic Press.