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Lee JGL, Sesay M, van de Venne J, Kong AY, Hrywna M, Rose SW, Delnevo CD. Retailers' Compliance with Federal Age of Cigarette Sales Policies -- Pitt County, North Carolina, January-March 2022. N C Med J 2024; 85:49-53. [PMID: 38932935 PMCID: PMC11208035 DOI: 10.18043/001c.117074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
BACKGROUND Tobacco use remains a leading cause of preventable morbidity and premature mortality. In December 2019, the federal age of sale for tobacco products increased from 18 to 21 years of age. This study aimed to evaluate the implementation of federal tobacco 21 policies in Pitt County, North Carolina (NC), by conducting multiple purchase attempts for cigarettes. METHOD Stores in Pitt County that sold cigarettes were randomly sampled and visited by up to six different underage (18-20) buyers who attempted to buy cigarettes from January-March 2022. Buyers made a total of 217 cigarette purchase attempts from 49 Pitt County retailers. Analyses were conducted using SPSS Complex Samples (v.28/Macintosh) and estimate retailer prevalence of requesting identification (ID) and selling to underage buyers across multiple purchase attempts. RESULTS On average, retailers failed to request ID in 15.4% of purchase attempts (95% CI: 9.4%-21.3%) and sold to an underage buyer 34.2% of the time (95% CI: 27.0-41.4%). Additionally, 75.5% (95% CI: 63.4%-84.6%) of retailers sold to an underage buyer at least once. LIMITATIONS This study is limited to a single county in NC and to underage buyers aged 18 to 20. CONCLUSION There is widespread non-compliance with federal age of sale policies for tobacco products in Pitt County, NC. State enforcement is warranted, and NC's youth access law should be amended to match the federal age of sale. Changes to the law should allow research involving underage purchases.
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Affiliation(s)
- Joseph G. L. Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, USA
- Cancer Prevention and Control, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Mahdi Sesay
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, USA
| | - Judy van de Venne
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA
| | - Amanda Y. Kong
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Mary Hrywna
- Rutgers Center for Tobacco Studies, Rutgers University, New Brunswick, NJ, USA
| | - Shyanika W. Rose
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA
| | - Cristine D. Delnevo
- Rutgers Center for Tobacco Studies, Rutgers University, New Brunswick, NJ, USA
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Michalek IM, Koczkodaj P, Durzynska M, Caetano Dos Santos FL, Manczuk M. Tobacco products and electronic cigarettes' legislation violations - observational study in 31 European countries, 2005-2022. ENVIRONMENTAL RESEARCH 2023; 233:116429. [PMID: 37329947 DOI: 10.1016/j.envres.2023.116429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/23/2023] [Accepted: 06/14/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND European Union (EU) law regulates the manufacture, presentation, and sale of tobacco and related products in all member states. This study examined whether legislation non-compliant tobacco products and electronic cigarettes were available for sale in the European market. METHODS We queried the EU Rapid Information System for dangerous non-food products, covering 28 current and former EU member states and 3 associated countries, also known as Rapex, for non-compliant tobacco and related products reported between 2005 and 2022. FINDINGS During the operation of the Rapex system, 183 violations were reported (six on tobacco, three on traditional cigarettes, and 174 on e-cigarettes). Insufficient product safety information was found in 86% of the reports on e-cigarettes and 74% of the refills. Violations regarding the volume of the liquid container were observed in 26% of the e-cigarette reports and 20% of the refill reports. Approximately 15% of the reported e-cigarettes and 17% of refill liquids exceeded permissible nicotine levels. More serious standard violations were recorded for refills than for e-cigarettes. Approximately one-third of Rapex system countries submitted no notifications. INTERPRETATION E-cigarettes were the most frequently reported items in the European market of tobacco and non-tobacco nicotine products. The most common concerns were inadequate product safety information, incorrect liquid container volume, and excessive nicotine concentration. Identifying the most recognized legal infringements did not require laboratory tests and was based only on packaging and the manufacturer's declaration analysis. Further studies are necessary to corroborate whether products available in countries where no violations have been reported meet EU safety standards.
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Affiliation(s)
- Irmina Maria Michalek
- Department of Cancer Epidemiology and Primary Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
| | - Pawel Koczkodaj
- Department of Cancer Epidemiology and Primary Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Monika Durzynska
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Marta Manczuk
- Department of Cancer Epidemiology and Primary Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Raskind IG, Lee JGL, Henriksen L. Underage Sales of Tobacco in Dollar Stores and Top Grocery Stores, 2015-2020, U.S. Am J Prev Med 2023; 65:313-316. [PMID: 37479422 PMCID: PMC10363749 DOI: 10.1016/j.amepre.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 07/23/2023]
Abstract
INTRODUCTION Youth access to tobacco in retail settings remains a pressing public health concern and may vary across retail corporations. This study compares underage sales violation rates in tobacco-selling dollar store corporations-a rapidly growing retail segment where cheaper tobacco prices may appeal to youth-with rates in other major grocery corporations. METHODS In 2021, U.S. Food and Drug Administration data (N=64,059 inspections) from January 2015 to March 2020 were used to compare underage tobacco sales in the two major tobacco-selling dollar store corporations, Dollar General and Family Dollar, with sales in major grocery corporations: Albertsons, Delhaize, Kroger, Publix, and Walmart. Generalized linear mixed models controlled for neighborhood characteristics. Post hoc analyses examined whether the corporation with the highest violation rate was more likely to be in neighborhoods with higher proportions of racially minoritized residents, socioeconomic disadvantage, or rural status. RESULTS Family Dollar failed 12.1% of underage sales inspections. All other corporations had a significantly lower likelihood of selling tobacco to an underage buyer than Family Dollar. This significant association persisted after controlling for neighborhood characteristics. Family Dollar locations were associated with being in neighborhoods with higher proportions of racially minoritized residents and greater socioeconomic disadvantage. CONCLUSIONS Regulating corporate behavior is necessary to reduce underage access to tobacco in dollar stores and address place-based inequities in youth tobacco access. Increasing the use of U.S. Food and Drug Administration no-tobacco-sale orders and Assurances of Voluntary Compliance, which provide a mechanism for state attorneys general to engage with tobacco retailers regarding enforcement of minimum legal sales age laws, may help to reduce youth tobacco access in retail settings.
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Affiliation(s)
- Ilana G Raskind
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, California.
| | - Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina; Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, California
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Romm KF, Wang Y, Schleicher NC, Pannel A, Williams R, Berg CJ, Henriksen L. Rates of Age Verification for Cigarette and E-cigarette Purchases as a Function of State T21 Laws Before and After Implementation of the Federal T21 Law in the United States. Nicotine Tob Res 2023; 25:1386-1390. [PMID: 36943250 PMCID: PMC10256877 DOI: 10.1093/ntr/ntad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/08/2023] [Accepted: 03/17/2023] [Indexed: 03/23/2023]
Abstract
INTRODUCTION In the US, having a 21 minimum legal sales age for tobacco (T21) at the state level may have impacted age verification of cigarette and e-cigarette purchases among U.S. young adults (ages 18-26), before and/or after federal T21 implementation. AIMS AND METHODS This study examined this by analyzing data from cigarette and/or e-cigarette users (n = 618 and n = 864) in six metropolitan areas in six states. Participants reported frequency of being age verified ("almost always" vs. less frequently) for cigarette and/or e-cigarette purchases across 3 timepoints (ie, wave 1 [w1]: September-December 2018, w2: September-December 2019, and w3: September-December 2020). Multilevel modeling examined time-varying state T21 status and time (reflecting federal T21 implementation) in relation to age verification of cigarette and e-cigarette purchases, respectively. RESULTS The proportions almost always age verified for cigarette purchases in states with T21 versus without were: W1: 38.5% versus 37.7%, w2: 33.0% versus 39.1%, and w3: 45.4% versus 30.6%. For e-cigarettes, the proportions were: W1: 30.6% versus 40.3%, w2: 42.3% versus 50.5%, and w3: 56.0% versus 58.3%. In multilevel modeling, state T21 status was associated with greater likelihood of age verification for e-cigarettes (aOR = 1.67, CI = 1.13 to 2.45), but not for cigarettes. Age verification increased over time for e-cigarettes-both accounting for and not accounting for state T21 status. There were no changes for cigarettes. CONCLUSIONS State T21 status and time correlated with age verification for e-cigarettes, but not cigarettes. These self-reported age verification data contribute to evidence from compliance checks, indicating that retailers require additional prompts and enforcement to enhance compliance with T21 laws. IMPLICATIONS Current findings suggest that variations in regulations and gaps in enforcement may hinder the potential impact of increasing the minimum legal sales age, which ultimately may undermine the promise of such policies, specifically with regard to preventing tobacco use among the underage. Therefore, it is crucial to monitor retailer compliance with T21 laws and evaluate their efficacy to increase ID checks, minimize illegal sales, and curb underage use of tobacco. Relatedly, particular attention to enforcement efforts that may promote compliance is warranted.
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Affiliation(s)
- Katelyn F Romm
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Nina C Schleicher
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Alexandria Pannel
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - River Williams
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
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Henriksen L. Retail-focused tobacco control: equity and endgame implications. Tob Control 2022; 31:e96-e98. [DOI: 10.1136/tc-2022-057771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Dai H, Henriksen L, Xu Z, Rathnayake N. Using place-based characteristics to inform FDA tobacco sales inspections: results from a multilevel propensity score model. Tob Control 2022; 31:e148-e155. [PMID: 34697089 PMCID: PMC9726945 DOI: 10.1136/tobaccocontrol-2021-056742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 10/01/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Conducting routine inspections for compliance with age-of-sale laws is essential to reducing underage access to tobacco. We seek to develop a multilevel propensity score model (PSM) to predict retail violation of sales to minors (RVSM). METHODS The Food and Drug Administration compliance check of tobacco retailers with minor-involved inspections from 2015 to 2019 (n=683 741) was linked with multilevel data for demographics and policies. Generalised estimating equation was used to develop the PSM using 2015-2016 data to predict the 2017 RVSM. The prediction accuracy of the PSM was validated by contrasting PSM deciles against 2018-2019 actual violation data. RESULTS In 2017, 44.3% of 26 150 zip codes with ≥1 tobacco retailer had 0 FDA underage sales inspections, 11.0% had 1 inspection, 13.5% had 2-3, 15.3% had 4-9, and 15.9% had 10 or more. The likelihood of having an RVSM in 2017 was higher in zip codes with a lower number of inspections (adjusted OR (aOR)=0.988, 95% CI (0.987 to 0.990)) and penalties (aOR=0.97, 95% CI (0.95 to 0.99)) and a higher number of violations (aOR=1.07, 95% CI (1.06 to 1.08)) in the previous 2 years. Urbanicity, socioeconomic status, smoking prevalence and tobacco control policies at multilevels also predicted retail violations. Prediction accuracy was validated with zip codes with the highest 10% of the PSM 3.4 times more likely to have retail violations in 2019 than zip codes in the bottom decile. CONCLUSION The multilevel PSM predicts the RVSM with a good rank order of retail violations. The model-based approach can be used to identify hot spots of retail violations and improve the sampling plan for future inspections.
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Affiliation(s)
- Hongying Dai
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford UniversitySchool of Medicine, Stanford, California, USA
| | - Zheng Xu
- Department of Mathematics and Statistics, Wright State University, Dayton, Ohio, USA
| | - Nirosha Rathnayake
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Feltmann K, Gripenberg J, Elgán TH. Compliance Checks Decrease Cigarette Sales Rates to Pseudo-Underaged Mystery Shoppers: A Quasi-Experimental Control Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13161. [PMID: 36293737 PMCID: PMC9602829 DOI: 10.3390/ijerph192013161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/08/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
To control adherence to age limits regarding sales of tobacco products, Swedish authorities can conduct compliance checks. Compliance checks involve prior information to all retailers, mystery shopping, and subsequent feedback to the retailers. This study investigated whether compliance checks can decrease the rates of cigarette sales to underaged adolescents. Test purchases of cigarettes were conducted using pseudo-underaged mystery shoppers, i.e., 18-year-old adolescents with a younger appearance not carrying ID, to measure the refusal rate and rate of ID checks. Test purchases were conducted at 257 retail outlets in 13 municipalities in Stockholm County at baseline 2017 and follow-up 2019, respectively. In between the measurements, six municipalities (intervention area) conducted compliance checks, and seven municipalities were used as a comparison. Comparing baseline and follow-up, rates of refusal (70.4 to 95.8%) and ID checks (80.3 to 95.8%) improved in the intervention area. In the comparison area, refusal rates increased (80.9 to 85.2%), and ID check rates remained stable (at 86.1%). Significant group × time interaction effects reveal that the rates of refusal and ID checks differently changed in the study areas over time. These results indicate that compliance checks are an effective method to decrease cigarette sales to underaged adolescents.
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Combs TB, Ornstein JT, Chaitan VL, Golden SD, Henriksen L, Luke DA. Draining the tobacco swamps: Shaping the built environment to reduce tobacco retailer proximity to residents in 30 big US cities. Health Place 2022; 75:102815. [PMID: 35598345 PMCID: PMC10288515 DOI: 10.1016/j.healthplace.2022.102815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/14/2022] [Accepted: 04/27/2022] [Indexed: 11/17/2022]
Abstract
Combining geospatial data on residential and tobacco retailer density in 30 big US cities, we find that a large majority of urban residents live in tobacco swamps - neighborhoods where there is a glut of tobacco retailers. In this study, we simulate the effects of tobacco retail reduction policies and compare probable changes in resident-to-retailer proximity and retailer density for each city. While measures of proximity and density at baseline are highly correlated, the results differ both between effects on proximity and density and across the 30 cities. Context, particularly baseline proximity of residents to retailers, is important to consider when designing policies to reduce retailer concentration.
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Affiliation(s)
- Todd B Combs
- Center for Public Health Systems Science, Brown School at Washington University in St. Louis, 1 Brookings Drive, MSC 1196-0251-46, St. Louis, MO, 63130, USA.
| | - Joseph T Ornstein
- School of Public and International Affairs, The University of Georgia, 180 Baldwin Hall, Athens, GA, 30602, USA
| | - Veronica L Chaitan
- Center for Public Health Systems Science, Brown School at Washington University in St. Louis, 1 Brookings Drive, MSC 1196-0251-46, St. Louis, MO, 63130, USA
| | - Shelley D Golden
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7440, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, Chapel Hill, NC, 27599-7295, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, 3300 Hillview Ave, Mail Code 5537, Palo Alto, CA, 94304-1334, USA
| | - Douglas A Luke
- Center for Public Health Systems Science, Brown School at Washington University in St. Louis, 1 Brookings Drive, MSC 1196-0251-46, St. Louis, MO, 63130, USA
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Jenson D. Success from failure: US federal commercial tobacco regulation. Tob Control 2022; 31:212-215. [PMID: 35241590 DOI: 10.1136/tobaccocontrol-2021-056918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/09/2021] [Indexed: 11/03/2022]
Abstract
The history of the US Food and Drug Administration's (FDA) regulation of tobacco products is fraught with failures. A first effort to regulate tobacco products was completely dismantled. Despite robust authority to act, the current iteration of the FDA has also struggled to succeed. While the public health community may be frustrated by the lack of progress to date, recent developments have potentially shown advocates a pathway for success.
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