Aims
To estimate relationships of tobacco outlet density, cigarette sales without ID checks, and local enforcement of underage tobacco laws with youth’s lifetime cigarette smoking, perceived availability of tobacco and perceived enforcement of underage tobacco laws and changes over time.
Design
The study involved: (a) three annual telephone surveys, (b) two annual purchase surveys in 2,000 tobacco outlets, and (c) interviews with key informants from local law enforcement agencies. Analyses were multilevel models (city, individual, time).
Setting
A sample of 50 mid-sized non-contiguous cities in California, USA.
Participants
1,478 youths (aged 13–16 at Wave 1, 52.2% male). 1,061 participated in all waves.
Measurements
Measures at the individual-level included lifetime cigarette smoking, perceived availability, and perceived enforcement. City-level measures included tobacco outlet density, cigarette sales without ID checks, and compliance checks.
Findings
Outlet density was positively associated with lifetime smoking (OR=1.12, p<.01). An interaction between outlet density and wave (OR=0.96, p<.05) suggested that higher density was more closely associated with lifetime smoking at the earlier waves when respondents were younger. Greater density was positively associated with perceived availability (β=0.02, p<.05) and negatively associated with perceived enforcement (β=−0.02, p<.01). Sales rate without checking IDs was related to greater perceived availability (β=0.01, p<.01) and less perceived enforcement (β=−0.01, p<.01). Enforcement of underage tobacco laws was positively related to perceived enforcement (β=0.06, p<.05).
Conclusions
Higher tobacco outlet density may contribute to lifetime smoking among youths. Density, sales without ID checks and enforcement levels may influence beliefs about access to cigarettes and enforcement of underage tobacco sales laws.