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A Study of Four Northern California Communities

Ellen Feighery, MS; David G. Altman, PhD; Gregory Shaffer, MA

JAMA. 1991;266(22):3168-3171.

Abstract
Objective.
—To examine the effects of a community education and law enforcement intervention on illegal tobacco sales to minors.

Design.
—A 2-year, before and after trial with retail stores as the unit of analysis.

Setting.
—Implementation occurred in four suburban California communities with populations of 25000 to 100000.

Participants.
—All the retail stores in one intervention community and half the retail stores, randomly selected, in the other three intervention communities (n = 169) were visited by minors aged 14 to 16 years with the intent to purchase tobacco.

Intervention.
—Ongoing community and merchant education and four law enforcement operations were conducted.

Main Outcome Measures.
—Over-the-counter and vending machine sales of tobacco to minors were the primary outcomes.

Results.
—Among a cohort of stores visited by minors at the pretest (n = 104) in June 1988,71% sold tobacco over the counter and 92% sold tobacco through vending machines. At posttest 2 in May 1990,24% sold tobacco over the counter and 93% sold tobacco through vending machines. Of the 31 stores issued citations, 16 were followed into the courts where the fines were dismissed or reduced.

Conclusions.
—Education alone had a limited effect on reducing illegal tobacco sales to minors. It did promote community support for more aggressive enforcement strategies. Education plus enforcement decreased significantly over-the-counter sales; vending machine sales were unaffected by these interventions. The lack of support at the judicial level may temper the effectiveness of enforcement. Legislative remedies addressing judicial obstacles and vending machine sales are needed.

(JAMA. 1991;266:3168-3171)

Author Affiliations
From the Center for Research in Disease Prevention, Stanford University School of Medicine, Palo Alto, Calif (Ms Feighery and Dr Altman) and the North Bay Health Resources Center, Petaluma, Calif (Mr Shaffer).

Footnotes
Reprint requests to the Center for Research in Disease Prevention, Stanford University School of Medicine, 1000 Welch Rd, Palo Alto, CA 94303 (Ms Feighery).

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