When blocked from buying cigarettes over the counter, teen smokers turn to friends and family members to obtain cigarettes, according to the study, which examined ninth-graders in Erie County, N.Y.
Results of the study by K. Michael Cummings, Ph.D., M.P.H., and colleagues from the Roswell Park Cancer Institute in Buffalo appear in the July issue of Nicotine & Tobacco Research.
Cummings and his colleagues tested enforcement by monitoring tobacco sales to minors in 12 communities in Erie County. In six communities randomly designated for enforcement, police hired teens aged 14 to 16 to go into the stores one to four times a year and attempt to buy cigarettes. The other six communities saw no enforcement action.
Researchers found that average retailer compliance with laws prohibiting tobacco sales to minors more than doubled, from 35 percent in 1994 to 73 percent in 1995. Six of the 12 communities got above the 80 percent mark, considered the minimum level of compliance by federal agencies.
But those improvements were apparently unrelated to whether or not police in those communities carried out the targeted enforcement program. The researchers surveyed retailers at the end of the study and found almost total awareness of the law and the police enforcement operation in both types of communities.
"The improved retailer compliance occurred because of efforts made to educate and inform retailers throughout Erie County that illegal tobacco sales to minors would not be tolerated," Cummings says, not necessarily because they were targeted by the enforcement teams.
Cummings had investigated student smoking patterns in 1992 using a survey of 4,055 ninth-graders. In 1996, after the enforcement experiment, another group of 4,741 students responded to the questionnaire. Between 1992 and 1996, indicators of smoking in the previous 30 days (27 percent) and frequent smoking (10 percent) remained about the same in all 12 communities.
In the six communities that did not achieve the 80 percent retailer compliance, prevalence of smoking in the previous 30 days increased from 26 percent to 30 percent and frequent smoking increased from 10 percent to 13 percent. However, the 30-day prevalence stayed the same and frequent smoking fell slightly (from 9 percent to 8 percent) in the six communities that reached the 80 percent retailer compliance mark.
"The difference in smoking behavior seen in students from high and low compliance communities shows an impact of retailer compliance on youth smoking," says Cummings. "However, the differences are small and in most cases are not statistically significant."
He cautioned that results of the study have to be interpreted cautiously, because the communities with 80 percent compliance include the smallest and most isolated towns in the group. He speculates that youths there may have had fewer options about where to buy tobacco, which might explain the effects seen.
The study offers only modest support for the idea that increasing compliance to more than 80 percent can cut teen smoking, says Cummings.
"One has to question whether such a strategy is even feasible in all communities because of factors likes cost, competing use of law enforcement resources, community sentiment, political leadership, and business interests," he says.
Funding for this study was provided by a grant from the Association of Teachers of Preventive Medicine.
BY AARON LEVIN, STAFF WRITER
HEALTH BEHAVIOR NEWS SERVICE
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Nicotine & Tobacco Research