Effect of policies directed at youth access to smoking: results from the SimSmoke computer simulation model

Objectives-To develop a simulation model to predict the effects of youth ac cess policies on retail compliance, smoking rates, and smoking attributable deaths. Methods-A model of youth access policies is developed based on empirical re search and a theory of perceived risk. The model incorporates substitution into other sources as retail sales are restricted, and is used to project t he number of smokers and smoking related deaths. Various policies to limit youth access to cigarettes are evaluated, and we explore how efficient poli cies may be developed. Results-The model predicts that a well designed and comprehensive policy th at includes sufficient compliance checks, penalties, and community involvem ent has the potential to reduce the number of young smokers. Because smokin g related deaths occur later in life, the effects on health are largely del ayed. Conclusions-A well designed youth access policy has the ability to affect y outh smoking rates in the short term, and will lead to savings in lives in future years. The ability of retail oriented policies to reduce youth smoki ng, however, is limited. Other tobacco control policies, including those di rected at non-retail sources of cigarettes, are also needed.