Restricting the retail supply of tobacco to minors

Abstract

To examine the impact of enforcement of age-restricted tobacco sales on adolescent tobacco purchasing and smoking, we compared the Central Coast intervention area to the rest of New South Wales (NSW) and Australia. We collected data on students in school years 7-12 from triennial health surveys at baseline in 1993 through 2002. Attempts by minors to purchase tobacco in the intervention area declined by 73.6 per cent between 1993 and 2002. Between 1993 and 1996 the prevalence of smoking declined in the Central Coast intervention area, while remaining unchanged in NSW as a whole and nationally (P<0.0001). Between 1993 and 2002, the prevalence of current smoking in the intervention area was reduced by half. Effective enforcement of an age-restricted tobacco sales law was accompanied by a substantial reduction in attempted purchases of tobacco and of smoking by youth. The long-term follow-up in this study allows us to observe that the impact of the intervention was not only sustained but also increased with time.

Which interventions against the sale of tobacco to minors can be expected to reduce smoking?: Table 1

“…Surveys conducted every 3 years from 1993 to 2002, revealed that the proportion of all youth who had recently attempted to purchase cigarettes fell from 21.6% to 5.7%, a reduction of 73.6%. The prevalence of current smoking among youth was reduced by 50% (from 26% in 1993 to 13% in 2002) 38. Initially, a decrease in smoking was evident only in the youngest adolescents, with declines among the older adolescents being evident only as a birth cohort effect as youths who did not initiate smoking during early adolescence did not take it up later.…”

“…The Health Promotion Unit of the Central Coast region of New South Wales, Australia initiated an effort to curtail the sale of tobacco to children by conducting test purchases and issuing $1000 fines to violators 37 38. Subsequent rounds of compliance tests and prosecutions revealed violation rates of 10%, 8% and by 1997, 0%.…”

“…Reductions in national adolescent smoking rates of 50% or more have been reported in the USA, Canada, Australia and The Netherlands following the implementation of enforcement programmes 38 50 58 60. In The Netherlands, the proportion of youth that smoked and bought their own tobacco fell by 53%, from 13.5% to 6.4%, while the prevalence of smoking among youth 13–15 years old fell by 64%, from 20.3% to 7.4% 58…”

“…Some of the studies documenting this effect had strong designs with long follow-up periods and these studies had the strongest measured outcomes 36 38 42. The positive studies include non-controlled studies,33 41 49 non-randomised controlled studies,39 42 and randomised controlled studies 36 51 53.…”

“…The positive studies include non-controlled studies,33 41 49 non-randomised controlled studies,39 42 and randomised controlled studies 36 51 53. Positive effects were seen in rural communities,36 39 suburban communities,41 42 53 55 across large regions or states,37 38 40 and countrywide 50 58. Positive effects remained in all studies in which it was possible to adjust for other tobacco control initiatives 47 50 56.…”