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Experimental evaluation of minors' access to tobacco

Institution: San Diego State University Research Foundation
Investigator(s): Hope Landrine, Ph.D.
Award Cycle: 2000 (Cycle 9) Grant #: 9RT-0043 Award: $655,347
Subject Area: Public Health, Public Policy, and Economics
Award Type: Research Project Awards
Abstracts

Initial Award Abstract
In the 1980's and early 1990's, children ages 12-17 were successful at purchasing cigarettes 60-90% of the time and purchased 1 billion pack of cigarettes each year despite laws prohibiting such sales. In response, the federal Synar Regulation and the California STAKE Act (California’s implementation of Synar) were passed in 1994. These require California to enforce youth access laws and to reduce youth access to tobacco to 20% or lose a portion of its federal drug abuse funds. The California Department of Health Services Tobacco Control Section (TCS) and Food & Drug Branch (FDB) enforce the STAKE Act, conduct “sting operations” with youth who attempt to purchase cigarettes, and assess fines against merchants who sell in order to reduce youth access to the required 20%. Statewide data collected by TCS-FDB indicate that these efforts have been successful: Minors’s access to tobacco in the state has steadily declined from 60-90% pre-STAKE Act, to 37% (1995), to 21.7% (1997), to 13.1% (1998). Simultaneously however, youth report that it is still easy to buy cigarettes despite TCS data indicating that it is not; youth report that their access is 60% or higher even though TCS data indicate that it is only 13%; youth smoking has not decreased (and indeed, has increased among minorities) despite the (ostensible) decrease in their access; and youth still purchase 1 billion packs of cigarettes each year. How do we explain these contradictory findings?

Our two, small pilot studies suggest that methodology is the explanation: In state and national studies of youth access, youth are sent to stores where no one knows them to purchase cigarettes only (Research Purchase Protocol). But real-world youth report that they purposefully select stores where they are recognized by clerks (Familiarity Purchase Protocol) as “good customers” who buy other items in addition to cigarettes (Foot-in-the-Door Purchase Protocol). In our pilot studies, youth who appeared once to request cigarettes (Research Purchase Protocol) had access rates of 6-11%, but those who appeared repeatedly at the same store to purchase cigarettes (Familiarity), and those who bought other items that act as a foot-in-the-tobacco door (Foot-in-the-Door) had access rates as high as 63%. Thus, how researchers assess youth’s ability to purchase cigarettes bears little resemblance to how youth in the real world actually do so, and hence, youth in studies have low access but those in the real world may continue to have high access. California youth’s rate of access to tobacco therefore remains unknown.

The purpose of the proposed studies is to acquire accurate data on youth access to tobacco in the state by having youth systematically attempt to purchase cigarettes using three purchase protocols: the standard research protocol used by TCS-FDB, and the strategies that real-world youth say that they use to obtain cigarettes (Familiarity and the Foot-in-the-Door). These purchase attempts will be made by White, Black, Latino, and Asian youth in White, Black, Latino, and Asian communities. We hypothesize that minors’s access when using real-world youth’s purchase-strategies will be high (50-90%) and will significantly exceed their access when using the standard research purchase-protocol (10-20%). We also hypothesize that access will be higher for minority youth than for White youth, and in minority communities than in White ones. Such findings would mean that how the state and nation assess minors’ access to tobacco yields false-low access rates; that minors’ access in California remains high and unchanged; that California is in violation of Synar and STAKE; and that primary prevention efforts to reduce youth access are still badly needed.
Publications

ID cards increase cigarette sales to underage youth
Periodical: JAMA: Journal of the American Medical Association Index Medicus:
Authors: Landrine H, Klonoff EA, Lang D, Alcaraz R ART
Yr: 2001 Vol: 285 Nbr: Abs: Pg: 2329

Adults buy cigarettes for underage youth
Periodical: American Journal of Public Health Index Medicus:
Authors: Klonoff EA, Landrine H, Lang D, Alcaraz R, Figueroa-Moseley C ART
Yr: 2001 Vol: 91 Nbr: 7 Abs: Pg: 1138-1139

Validity of assessments of youth access to tobacco: the familiarity effect.
Periodical: American Journal of Public Health Index Medicus:
Authors: Landrine H, Klonoff E ART
Yr: 2003 Vol: 93 Nbr: 11 Abs: Pg: 1883-1886

Experimental analysis of monors' access to tobacco: access is low in studies but high outside of them.
Periodical: TRDRP Annual Report to the State of California Legislature Index Medicus:
Authors: Landrine H, Klonoff EA, Parekh B ABS
Yr: 2002 Vol: Nbr: Abs: Pg:

Predicting youth access to tobacco: The role of youth versus store clerk behavior and issues of ecological validity.
Periodical: Health Psychology Index Medicus:
Authors: Klonoff EA, Landrine H ART
Yr: 0 Vol: Nbr: Abs: Pg:

Culture change and ethnic minority health-behavior: An operant theory of acculturation.
Periodical: Journal of Behavioral Medicine Index Medicus:
Authors: Landrine H, Klonoff EA ART
Yr: 0 Vol: Nbr: Abs: Pg:

Cigarette advertising in Black, Latino, and White magazines, 1998-2002
Periodical: Ethnicity and Disease Index Medicus:
Authors: Landrine H, Klonoff EA, Fernandez S, Hickman N, Kashima K, Parekh B, Thomas K, et al ART
Yr: 0 Vol: Nbr: Abs: Pg:

Preliminary investigation of the advertising and availability of PREPS, the new safe tobacco products.
Periodical: Journal of Behavioral Medicine Index Medicus:
Authors: Hickman N, Klonoff EA, Landrine H, Kashima K, Parekh B, Fernandez S, Thomas K, et al ART
Yr: 0 Vol: Nbr: Abs: Pg:

Cigarette advertising in magazines for Latinas, White women and Men, 1998-2002
Periodical: Journal of Community Health Index Medicus:
Authors: Fernandez S, Hickman N, Klonoff EA, Landrine H, Kashima K, Parekh B, Brouillard C, et al ART
Yr: 0 Vol: Nbr: Abs: Pg:

Youth access to tobacco via the internet.
Periodical: JAMA: Journal of the American Medical Association Index Medicus:
Authors: Jensen JJ, Hichman N, Landrine H, Klonoff EA ART
Yr: 2004 Vol: 291 Nbr: 15 Abs: Pg: 1837

Depressive symptoms and smoking among Black adults: Absence of a relationship?
Periodical: Journal of Health Psychology Index Medicus:
Authors: Klonoff EA, Landrine H ART
Yr: 2001 Vol: 6 Nbr: 6 Abs: Pg: 645-649

Sociocultural variables in minors' access to tobacco: Replication five years later.
Periodical: Preventive Medicine Index Medicus:
Authors: Landrine H, Klonoff EA, Campbell R, Reina-Patton AM ART
Yr: 2000 Vol: 30 Nbr: 5 Abs: Pg: 433-437

Minors' access to tobacco before and after the California STAKE act.
Periodical: Tobacco Control Index Medicus:
Authors: Landrine H, Klonoff EA, Reina-Patton AM ART
Yr: 2000 Vol: 9 Nbr: Suppl ll Abs: Pg: ii15 - ii17

The science and politics of youth smoking.
Periodical: Contemporary Psychology Index Medicus:
Authors: Landrine H, Klonoff EA ART
Yr: 2000 Vol: 45 Nbr: 6 Abs: Pg: 648-650

Racial discrimination and smoking among Blacks: Findings from two studies.
Periodical: Ethnicity and Disease Index Medicus:
Authors: Landrine H, Klonoff EA ART
Yr: 2000 Vol: 10 Nbr: 2 Abs: Pg: 195-202

Racial segregation and cigarette smoking amont Blacks: Findings at the individual level.
Periodical: Journal of Health Psychology Index Medicus:
Authors: Landrine H, Klonoff EA ART
Yr: 2000 Vol: 5 Nbr: 2 Abs: Pg: 211-219