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Reducing provision of tobacco to minors from social sources

Institution: Stanford University
Investigator(s): Stephen Fortmann, M.D.
Award Cycle: 1998 (Cycle 7) Grant #: 7RT-0156 Award: $639,838
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Research Project Awards

Initial Award Abstract
California has launched aggressive efforts to prevent youth from getting access to tobacco products. These programs have led to impressive reductions in the rate of illegal tobacco sales to minors. For instance, three years ago more than half of all retail outlets in California would sell tobacco illegally to minors. However, last year only one in five outlets sold to minors. California teens still report that it is very easy for them to obtain cigarettes and teens are still smoking in record numbers. This is because teen smokers are relying less on retail sources of cigarettes and more on non-retail or social sources to get their cigarettes. Our preliminary studies suggest that in California most teen smokers are not buying their own cigarettes, but that they are getting their cigarettes from what are called social sources. These include friends, parents and relatives and strangers. Specifically, friends tend to be slightly older smoking peers; parents and relatives consist of those who knowingly provide cigarettes and others who unintentionally leave their cigarettes accessible to youth; adult strangers are approached by youth asking them to share or buy tobacco. Unfortunately, California's impressive progress in getting stores to stop selling tobacco to minors has been severely compromised by the willingness of friends, family members and strangers to give youth tobacco. Social sources are also important to target because children's first cigarettes are usually provided by friends and family. Therefore, interventions to reduce social source provision have the potential to prevent children from starting smoking.

We propose to develop a strategy to reduce the provision of tobacco to minors from social sources by using print materials, such as newspaper ads, school materials, posters placed at tobacco outlets and postcards mailed to community residents. We will test out this intervention in one community, Half-Moon Bay, CA, and have Healdsburg, CA, serve as a control. The campaign will be delivered via print channels with both an English and an ethnically tailored Spanish version. We will evaluate the program by conducting surveys of all 9-12th grade students and their parents in both communities. With police permission, we will have closely supervised minors ask strangers to buy them tobacco outside of tobacco outlets. One year after making the initial assessments, we expect that our intervention will lead to: (a) increased difficulty in obtaining cigarettes from social sources and reduced number of packs of cigarettes from social sources, as reported by teen smokers; (b) reduced cigarette provision, increased caution in storing cigarettes and increased social disapproval of social source provision of tobacco to minors, as reported by parents of high school students; and (c) that fewer adult strangers will agree to buy cigarettes when asked by our supervised minors outside of retail outlets. This approach has the potential to stem the easy access of tobacco products to minors as part of a broader effort to reduce youth smoking.