It is time to abandon youth access tobacco programmes
- Center for Tobacco Control Research and Education, Institute for Health Policy Studies, Cardiovascular Research Institute, Center for AIDS Prevention Studies, University of California, San Francisco, California, USA
- Correspondence to: Stanton A Glantz, PhD, Professor of Medicine, Box 0130, University of California, San Francisco, CA 94143, USA; glantz{at}medicine.ucsf.edu
Youth access has benefited the tobacco industry
The most widespread and popular strategy for reducing tobacco use has been “youth access” laws, which make it illegal to sell cigarettes to teenagers. In the USA, youth access controls have been part of tobacco control policies required by the federal government in order to obtain funding for substance abuse programmes1; they were at the core of the tobacco regulation proposed by the Food and Drug Administration2 and struck down by the US Supreme Court. Both the US Centers for Disease Control and Prevention3 and the Institute of Medicine4 recommend youth access controls as part of a comprehensive tobacco control program. By August 2001, in the USA all 50 states and 1139 local governments had passed youth access laws (American Nonsmokers' Rights Foundation database, 24 August 2001).
Unfortunately, while these programmes do make it difficult for teens to purchase cigarettes,5–7 on the whole they do not affect teen smoking prevalence8 (fig 1). Proponents of youth access programmes have argued that this approach would be effective, if only the programmes were “done right” and successfully prevented a high proportion of youth from using commercial sources to buy cigarettes,9 and that exceeding a high “threshold” level of merchant compliance9–14 is necessary to affect youth smoking. There is no consistent empirical evidence to support the existence of this hypothesised threshold8 (fig 1).
This graph shows the relation between 30 day teen smoking prevalence and the level of merchant compliance with youth access regulations in different communities. There is no relation between teen smoking prevalence and the level of merchant compliance with youth access policies. There is no evidence of a threshold effect. From Fichtenberg and Glantz8, with permission of the publisher. (See …
