Strategies for reducing youth access to tobacco: a framework for understanding empirical findings on youth access policies

The purpose of this paper is to review empirical studies of youth access policies, to understand components of successful and unsuccessful interventions to help to formulate future policies, and to provide a framework for additional research. Studies of the effects of US youth access policies on retail compliance and youth smoking rates were collected using Internet searches, including Medline and other computerized databases, references identified from bibliographies of pertinent articles and books, and suggestions from tobacco control experts. Results suggested that a successful policy that reduces retail sales is likely to involve a multicomponent approach that includes strong enforcement and penalties, as well as community education and mobilization. The effects of youth access policies on youth smoking rates, however, are mixed and inconclusive. In addition to commercial sales, attention should also be paid to non-retail sources of tobacco, such as parents, older siblings and peers, and black markets. Additional research is warranted to understand better the elements of successful retail policies, their impact on youth smoking rates, how non-retail availability may limit the effectiveness of reduced retail access, and strategies to reduce non-retail access.