The American Nonsmokers' Rights (ANR) Foundation will collect and code local tobacco control laws nationwide related to youth access to tobacco products, tobacco advertising, and conditional use permits. The final dataset is expected to include as many as 70 variables for the youth access laws (eg. vending machines, single cigarettes, and penalties), 20 variables for tobacco advertising laws (eg. location restrictions, point of sale requirements, and tombstone exemptions), and an undetermined number of variables for conditional use permit laws. The dataset of tobacco control laws, in combination with other existing data on public health behavior and outcomes, will enable researchers to determine the impact and value of such laws on public health.
Grant Number: 69741
Funding Date: Sun, 01/01/2012
Researching Institution: Americans for Nonsmokers' Rights Foundation
Researcher: Cynthia Hallett, MPH
ORIGIN: Peer-Reviewed Systematic Review
Tobacco use is a source of chronic and fatal illnesses for users and persons with secondary exposure. In the United States, cigarette smoking contributes to one in five deaths and costs more than $193 billion in annual lost productivity and healthcare expenditures. CDC: Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004. Initiation of smoking and other tobacco use generally starts in adolescence; more than 80% of adult smokers started smoking as young children or teenagers. CDC: Youth Tobacco Use Fact Sheet.
Pursuant to the 1997 federal “Synar law” states must prohibit the sale of tobacco products to children and take steps to ensure effective enforcement. 42U.S.C. 300x-26, 45 C.F.R. 96.130. States and localities have adopted numerous legal interventions to increase compliance with this prohibition. For example, some states prohibit the handling of tobacco products by minors working in retail and require posting of signs explicitly prohibiting sale of tobacco products to minors (Oklahoma, 37 O.S. §600.1-§600.12). Under age purchasers of tobacco face fines and community service (Washington, RCW 70.155.080). To increase compliance with youth access laws, localities and states also conduct compliance investigations (Missouri: Restricting Youth Access to Tobacco).
Stead and Lancaster systematically reviewed studies assessing the effect of laws restricting youth access to tobacco and interventions aimed at increasing compliance with youth access laws. Lindsay F Stead and Tim Lancaster. A systematic review of interventions for preventing tobacco sales to minors. Tob Control 2000 9: 169-176. The reviewers identified 27 studies that fit their criteria of employing either experimental or observational designs with data both before and after the adoption of a law or compliance intervention. The studied laws included requirements for compliance checks; the evaluated interventions included experiments with compliance checks and education campaigns with retailers about fines and enforcement of youth access laws. Most of the included studies found reductions in prevalence of smoking among youths or decreases in reported ease of purchasing tobacco for minors. Although the reviewers were cautious because of methodological limitations in the studies such as the inability to control for potentially confounding effects from other youth smoking prevention programs and the possibility that effects wane over time, they view the collective body of studies as sufficient evidence to conclude that laws restricting youth access and interventions aimed at increasing compliance do indeed reduce access to tobacco for minors. The reviewers observed that greater levels of compliance activity – such as personal visits to retailers – were more likely to result in greater reductions in smoking or access.