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To the Editor: The number of Internet tobacco vendors continues to increase,^1-4 with 195 such Web sites identified in 2003.² Because teenagers and other minors frequently use the Internet¹ and online tobacco vendors rarely verify purchasers' age,^1-4 it is possible that minors can readily purchase tobacco products from the Internet.

Methods
We recruited 36 minors aged 15 to 16 years. All were interviewed by a licensed clinical psychologist who established that they understood the study, did not smoke, and did not appear at risk for smoking. Additional procedures for selecting and training them (eg, antitobacco workshops) have been detailed elsewhere.^5-6 Immunity from prosecution for youth and researchers was obtained from the State Attorney General, and the study was approved by the San Diego State University institutional review board.

The authors established an Internet account on a laptop computer and created e-mail addresses for youth. The laptop and a printer were taken to each child's home and connected to the home phone line. Youth were instructed to find an Internet tobacco vendor on their own; purchase 1 carton of cigarettes using their parents' credit card; lie about their age and birth date when asked; and have the carton delivered to their home. Based on the assumption that youth outside of studies would purchase tobacco online quickly to avoid being caught by parents, youth were instructed to do follow the above instructions as quickly as possible. We provided no additional assistance, but timed how long it took them to make a purchase. Youth printed every page from their purchases, revealing vendor name and age verification procedures. Prior to their purchase attempts, youth completed a survey on their Internet use and skills.

Results
Most used a single search word—"cigarettes"—usually spelled incorrectly. Nonetheless, 29 of the 30 (96.7%) found a tobacco vendor and placed an order. The mean (SD) time needed to do so was 25.8 (20.8) minutes, with many finding a site and placing an order in 7 minutes (mode, 7 minutes; median, 20 minutes). Fourteen sites were used; 13 (92.9%) required youth to click a box indicating that they were old enough to make the purchase, whereas 1 required entering a birth date. Twenty-three of the 30 youth (76.7%) received tobacco in the mail, with 91% of these cartons delivered without requests for proof of age. The average cost of a carton online was $22.91 (range, $10.50-$30.65). Delivery (vs no delivery) was unrelated to youth age (15 vs 16 years: ² = 1.02, P = .31), ethnicity (white vs minority: ² = 0.95, P = .95), sex (² = 0.68, P = .41), time to complete the purchase (t = 0.855, P = .40), or frequency of using the Internet (² = 1.15, P = .28) and skill in its use (rated from "first-time user" to "expert") (² = 1.17, P = .56).

Comment
To our knowledge, this is the first study in which underage youth (rather than adult researchers³ or adult college students⁴) attempted to locate Internet vendors of tobacco products and to order tobacco on their own, without adult assistance. That 96.7% did so suggests that youth indeed can easily purchase tobacco online. Youths' online access (76.7% delivery) significantly exceeded their access to tobacco from other commercial sources statewide (12%-17%),^5-6 and far exceeds the federal goal of 20% commercial access.^5-6 In addition, a carton of cigarettes online was significantly cheaper ($23) than in a California store ($43). Such results strongly suggest that it is easier and cheaper for youth to purchase tobacco online than from other commercial sources.

Funding/Support: This study was funded by the Office of the California State Attorney General.

Jennifer A. Jensen, MPH; Norval J. Hickman III, BA; Hope Landrine, PhD; Elizabeth A. Klonoff, PhD
eklonoff{at}sunstroke.sdsu.edu
Behavioral Health Institute and Department of Psychology
San Diego State University
San Diego, Calif

1. Connolly GN. Smokes in cyberspace: a public health disaster in the making. Tob Control. 2001;10:364-367. FREE FULL TEXT 2. Ribisl KM, Kim AE, Williams RS. Web sites selling cigarettes: how many are there in the USA and what are their sales practices? Tob Control. 2001;10:352-359. FREE FULL TEXT 3. Ribisl KM, Williams RS, Kim AE. Internet sales of cigarettes to minors. JAMA. 2003;290:1356-1359. FREE FULL TEXT 4. Bryant JA, Cody MJ, Murphy ST. Online sales: profit without question. Tob Control. 2002;11:226-227. FREE FULL TEXT 5. Landrine H, Klonoff EA. Validity of assessments of youth access to tobacco. Am J Public Health. 2003;93:1883-1886. FREE FULL TEXT 6. Klonoff EA, Landrine H. Predicting youth access to tobacco. Health Psychol. In press.

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291:1837.

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