Elsevier

Addictive Behaviors

Volume 26, Issue 5, September–October 2001, Pages 677-687
Addictive Behaviors

The effects of licensing and inspection enforcement to reduce tobacco sales to minors in Greater Philadelphia, 1994–1998

https://doi.org/10.1016/S0306-4603(00)00150-7Get rights and content

Abstract

This study examined the changes in tobacco sales to minors after active enforcement of merchant compliance to the Synar regulation and the city of Philadelphia Youth Access to Tobacco Ordinance 732. Data for the present study were obtained through Tobacco-free Education and Action Coalition for Health (TEACH) Program in a 5-year, follow-up retail compliance check surveys of 1649 stores in 14 cluster areas of Philadelphia, PA. Trend analysis was conducted of the sales of tobacco to minors by type of retail outlet, gender, and age of the buyer, and gender, age, and race of the store clerk, and whether restriction policy signs were posted. Analysis indicates that there was a reduction in tobacco sales to minors after implementation of enforcement; sales dropped from 85% in 1994 to 43% in 1998. There were less sales to minors when signs were posted. There were differences in sales if the buyer was asked his or her age and whether the minor was asked to show identification. In addition, the age of the buyer and the brand of cigarettes were associated with sales. Future research should focus on both commercial and social availability and provision of tobacco to minors.

Introduction

Tobacco use accounts for the most preventable cause of disease and premature death in the United States (McGinnis & Foege, 1993). It is estimated that 20% or 431,000 of the preventable deaths in the United States each year are attributed to tobacco use (Centers for Disease Control and Prevention, 1999). The efforts by public health personnel to prevent teen tobacco use by reducing the supply to minors were assisted with the passage of the Synar Amendment (42 USC 300x-26) in 1992. The amendment required that states enact and enforce laws prohibiting the sale and distribution of tobacco products to persons under 18 years of age (Jacobson, Wasserman, & Anderson, 1997). Studies indicated that success rates for over-the-counter purchases by minors ranged from 43% to 70% depending on the community. Success rates for purchases from vending machines ranged from 77% to 98% Centers for Disease Control and Prevention, 1994, Centers for Disease Control and Prevention, 1996, Cismoski & Sheridan, 1993, Forster et al., 1992. The Tobacco Policy Options for Prevention (TPOP) study conducted in Minnesota found that overall purchase success rate was 40.8% after adjusting for buyer and community. Success rates for over-the-counter purchases were 38.8%. Of 283 outlets in which purchase attempts were made by 15-year-old female confederates, 56.5% sold at least once to the minors who participated in the study (Forster, Wolfson, Murray, Wagenaar, & Claxton, 1997).

One type of intervention designed to reduce commercial sources of tobacco products to minors has been to fine merchants for noncompliance with state laws and local ordinances. A survey was administered to students residing in Everett, WA, a community that adopted a tobacco youth access restriction ordinance. The survey was conducted pre- and post-implementation of the ordinance. As a result of the enforcement of this ordinance, there was a reduction in reported commercial sources of tobacco products by students from 82% to 76% (Hinds, 1992). Jason, Billows, Schnopp-Wyatt, and King (1996) conducted an experimental design in which 40 stores in each of three ethnic geographical areas of Chicago were randomly assigned to one of four groups: (1) a control condition, (2) a 2-month, (3) a 4-month, and (4) a 6-month enforcement schedule. Illegal sales of tobacco remained high (84%) in the control group (Jason et al., 1996). There was a reduction in illegal tobacco sales in the 2-month (from 86% to 19%), 4-month (from 87% to 34%), and 6-month (from 87% to 42%) enforcement schedule groups. These results indicated that more frequent enforcement led to greater reductions in sales of tobacco to minors.

Rigotti et al. (1997) conducted a quasi-experimental study in six Massachusetts communities in which three communities were assigned to a law enforcement intervention and three to a control group that received no enforcement. Findings indicated that after 2 years, 82% of merchants complied with the law in the experimental group and 45% complied in the control group. Gemson et al. (1998) conducted a study using a randomized trial with repeated measures design in Central Harlem. The 152 stores were randomly assigned to one of three types: control, education, or enforcement. At baseline, 98% of the stores sold cigarettes to 12- to 13-year-old minors. After 6 months, the following percentage sales were reported: control (87%), education (90%), and enforcement (55%). After 1 year, the following percentage sales were reported: control (89%), education (77%), and enforcement (47%). The control group showed little or no increase in compliance, education of merchants showed some compliance, and law enforcement showed the largest increase in compliance. These are some examples of the studies, which showed a reduction in merchant sales of tobacco products to minors as a result of compliance check enforcement.

The Tobacco-free Education and Action Coalition for Health (TEACH) Program that we evaluated in this article has been active in prevention of tobacco use among youth in greater Philadelphia. The TEACH Program is sponsored by the Health Promotion Council (HPC) of Southeastern Philadelphia. Since 1992, TEACH has participated in legislative action, provided educational programs for children, teens, and adults, empowered youth to take action against the tobacco industry, conducted campaigns to educate schools, communities, and merchants about tobacco sale ordinances, and is responsible for monitoring compliance checks of local merchants. The TEACH Program's efforts assisted in the passage of Philadelphia City Ordinances 732 and 960367, which require merchants to comply with: (a) the prohibition of selling cigarettes, cigars, chew, or pipe tobacco, or any single cigarettes (loosies) to minors under 18 years of age, (b) ask for a photo ID of anyone who appears to be under 25 years old, (c) post an age-of-sale warning sign near the cash register, (d) place tobacco behind the counter or in a locked case, and (e) equip vending machines with a remote control lock-out device. The rationale for this study was based on unique features that are different from previous studies. For example, the use of the Department of Licenses and Inspections to process violation fines, instead of the use of criminal prosecution as in most states, is a unique enforcement approach used in Philadelphia. In addition, this youth access policy enforcement intervention, primarily carried out in culturally diversified ethnic minority communities, has rarely been published and little is known about its effectiveness.

The present study investigated the trends in the effects of using the Department of Licenses and Inspections as the method of compliance check enforcement of merchants to reduce illegal sales of tobacco to minors in greater Philadelphia from 1994 to 1998. A secondary purpose of the study was to determine the trends in the sale of tobacco to minors by clerk race/ethnicity, age, and gender, posted warning signs, type of outlet, and buyer gender and age. It was hypothesized that more frequent enforcement would lead to lower illegal sales of cigarettes to minors.

Section snippets

Data collection and enforcement procedures

Compliance checks were conducted in 1655 stores. Stores were selected in one of three ways, randomly, targeted, or selected. Random stores were selected from a random data set computer generated by the Pennsylvania State Department of Statistics. A targeted store was one reported to the TEACH hotline or the Department of Licenses and Inspections as selling tobacco to minors. Selected stores were chosen as surveyors conducted compliance checks in local neighborhoods.

The standard approach used by

Results

Overall, the percentage of sales of tobacco products to minors decreased from the baseline data, 85% in 1994 to 52% in 1998 (n=1633). There was an increase from 70% in 1995 to 84% in 1996 (Fig. 1).

As shown in Fig. 2, trends in the characteristics of clerks who sold tobacco to minors showed that there was a decrease in sales by both genders from 1994 to 1998 (n=1611). In addition, male clerks were consistently more likely to sell tobacco to minors than female clerks (OR=1.21, 95% CI=0.99, 1.49; χ

Discussion

The overall trend toward a reduction in merchant sales of tobacco to minors from 1994 to 1998 supports the use of the Department of Licenses and Inspections as a method to reduce sales of tobacco products to minors. The increase in sales to minors in 1996 may be the result that more targeted stores were inspected due to the success of educational awareness campaigns that encouraged people in the general population to use a hotline to identify those merchants who were selling to minors. As a

Acknowledgements

This study is supported by a grant from the William Penn Foundation. We would like to thank the Philadelphia Department of Public Health, the Philadelphia Department of Licenses and Inspection, and the Philadelphia Bureau of Administrative Adjudication.

References (13)

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