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Is it time to abandon youth access programmes?
  1. J R DiFranza1
  1. 1Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue, Worcester, MA 01655, USA;

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    In their editorial “It is time to abandon youth access tobacco programmes”, Ling et al1 base their argument on an in press meta-analysis of youth access interventions by Fichtenberg and Glantz.2 These authors conclude that there is no proof that youth access interventions work to reduce youth smoking rates. Sadly, this analysis includes 10 methodological flaws, each one of which individually renders the conclusions scientifically invalid.2 One of the invalid figures from the Fichtenberg analysis has been reprinted in Tobacco Control.1

    Three of the eight studies included in the meta-analysis did not involve any actual enforcement of the law, and the authors of a fourth study concluded that enforcement was inadequate because of a political backlash from merchants.3–7 The inclusion of at least three of these studies is scientifically unjustifiable as it has been established for over a decade that merchant education programmes alone are ineffective at attaining the levels of merchant compliance that can be expected to reduce youth access to tobacco.8,9 Three out of the five studies included in the analysis of the effects of youth access restrictions on past 30 day smoking did not involve enforcement. The authors inappropriately list the Baggot study as including enforcement and fines when in fact the inspection method was so flawed that no merchant was ever caught and none were prosecuted.4

    In the Baggot study, merchant compliance is reported as 100%.4 None of the stores sold to youths aged 13 years or under during enforcement checks, yet 100% of smokers among the community youths surveyed reported that they regularly bought tobacco from stores and only rare subjects reported ever having been turned down. The study's authors correctly concluded that the compliance inspections were an invalid measure of youth access. Yet …

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