Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA) National Conference on Tobacco or Health December 10-12, 2003 Boston, MA U.S DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Prevention

Preventing Early Tobacco Use Approximately 75% of smokers begin smoking daily before the age of 20 Most adolescent smokers will continue to smoke when they become adults About 1 in 3 teens who presently smoke cigarettes daily will die due to smoking Source: Surgeon Generals Report, 2000

Retail outlets are key source of cigarettes for youth In 2001, of students less than 18 years of age who were current smokers: –19.1% reported having purchased cigarettes at a store or gas station during the past 30 days –67.2% reported having purchased cigarettes without being asked to show proof of age during the past 30 days. Source: Youth Risk Behavioral Survey, 2001

The Synar Legislation Enact and enforce laws prohibiting the sale or distribution of tobacco products to individuals under the age of 18; Conduct random, unannounced inspections of tobacco outlets; and Report findings to the Secretary of HHS annually.

The Synar Regulation* Conduct random, unannounced inspections to measure compliance with the law; Report annually to the Secretary on the progress in meeting overall Synar requirements; and Negotiate interim performance targets and timeline to achieve a retailer violation rate of 20 percent or below. *Proposed rule issued in August Final rule issued in January Failure to meet the requirements of the Synar Legislation/Regulation could result in penalties against a State’s Substance Abuse Prevention and Treatment (SAPT) Block Grant.

States Achieving Retailer Violation Rates of 20 Percent or Lower for FY97-FY03* † *All years include data from the 50 States and the District of Columbia. † In FY03, 49 States and D.C. were found in compliance with the Synar goal of 20%, with a 3% margin of error

National Weighted* Average Retailer Violation Rate: FY97-FY03 † *Weighted by the State population † All years include data from the 50 States and the District of Columbia.

Synar Compliance Rate and Perceived Availability of Cigarettes by 8 th /10 th Graders, USA, FY96-FY03 Source: Monitoring the Future, 2002

Synar Compliance Rate and 30 day Cigarette Use by 8 th, 10 th, and 12 th Graders, USA, FY96-FY03 Source: Monitoring the Future, 2002

Key Youth Access Laws Ban sales of tobacco to youth under 18 years of age Ban tobacco vending machines Ban self-service displays Create a graduated system of civil or criminal penalties for owners of establishments selling to youth Require sign postage of age of sales

Enforcement-Related Laws for Youth Tobacco Access Specify State enforcement authority Require random, unannounced inspections License tobacco retailers Allow minors (<18) to conduct compliance checks Provide immunity to youth who conduct compliance checks (possession laws)

Synar Requirements: Changes in States Laws All States now prohibit the sale or distribution of tobacco to minors. All States now allow for the levying of either civil or criminal penalties for violations of youth access laws. All States now enforce laws restricting youth access to tobacco.

Other Key Youth Access Provisions 45 States ban the use of vending machines or restrict their accessibility 26 States allow the revocation or suspension of licenses if retailer sells to minors 38 States require age sign posting at point of sale

Enforcement-Related Laws, 2002 Some States have, by law, a designated enforcement agency Some States require random, unannounced inspections of tobacco outlets in State law Some States require licensing of retailers All States allow minors to conduct compliance checks Some States ban youth tobacco possession

Case Study: Indiana

Indiana Legal Structure for Youth Tobacco Access, 2002 Enforcement of Youth Tobacco Access Laws primarily a State function Illegal to sell to youth under <18 years of age Designated enforcement authority Allow progressive penalties to vendors selling tobacco products to underage No licensing required Allow police to use youth under 18 years in enforcement activities. Possession by youth illegal but provide immunity to youth for tobacco possession during inspections

Indiana Tobacco Retailer Inspection Program (TRIP) Originally funded by the FDA, now funded by the State of Indiana Established partnership with Alcohol and Tobacco Commission (ATC) to conduct compliance checks and enforce youth access laws 1999 State law established –progressive penalties to retailers who sell to underage youth –Authority of ATC to prosecute violators of underage laws and signage law

In 2002, TRIP Approved budget for enforcement of State tobacco laws Contracts with off-duty police, adult monitors and youth Conducted 4,766 inspections and imposed $85,000 in fines Sent letters to all inspected vendors with outcomes of inspections Posted results of inspections on ATC website as way to bring attention to retailers who are or are not complying with law ATC prosecutors issue notices of civil penalties and handle prosecution of violators

Indiana Retailer Violation Rates, FY97-FY03

Case Study: Iowa

Iowa Legal Structure for Youth Tobacco Access, 2002 Enforcement of youth access laws primarily a local function Illegal to sell to youth under <18 years of age Allow progressive penalties to retailers selling tobacco products to underage Permit system for tobacco retailers Allows suspension or revocation of permit Allows police to use youth under 18 years in enforcement activities. Provide immunity to youth for tobacco possession during inspections

Enforcement System The Department of Public Health (IDPH) is responsible for: –Synar inspections –Enforcement of tobacco access laws In 2002, IDPH established agreement with State Alcohol and Beverage Commission (ABC) to conduct compliance checks of tobacco retailers –ABC contracts with local law enforcement agencies –Local law enforcement agencies cite and fine violators of youth tobacco laws –ABC issues citations if local enforcement fails to cite violators

Iowa Tobacco Permit System State law* requires: –Annual tobacco retail permit, set fees for permits and authorizes local government to collect fees –Cities and counties to submit copies of permits to State Division on Tobacco Since ABD pays local entities to conduct enforcement checks, it is to locals’ advantage to report permits *State law was implemented in 2000.

ABC Enforcement Efforts In 2002, the agency conducted 9,399 inspections and issued 1047 citations The agency partnered with: –136 police departments –74 sheriff’s offices, –the state patrol, –the Attorney General’s Office, and –local prosecutors

Iowa Retailer Violation Rates, FY97-FY03

Enforcement Challenges Perception that youth access is not important making enforcement of the law a low priority Need for interagency collaboration Need for accurate/complete lists of vendors Limited resources for enforcement Penalty structure Prosecutors/judges may be reluctant to prosecute/penalize Retailer complaints State budgets

Conclusions The Synar Legislation has had important effects on youth access to tobacco products: –Higher retailer compliance with tobacco access laws over the last decade; –Improved tobacco access laws; and –Greater enforcement efforts nationwide resulting in: Higher Synar compliance rates; and Reductions in youths’ perceptions of availability and youth tobacco use.