Journal of Rural Community Psychology, Vol. E3(1), 2000
YOUTH ACCESS TO TOBACCO LAWS:
A Survey of Municipality Government Officials
Attitudes About Youth Access to Tobacco Laws
Richard Katz and Leonard A. Jason
Smoking cigarettes is the single most preventable cause of death in
the United States. Smokers typically begin smoking as minors and become addicted to
nicotine by late adolescence. One of the ways to reduce this addiction is to simply limit
minors access to cigarettes. Most states have laws prohibiting the sales of
cigarettes to minors, but they are not uniformly enforced. Recent federal
legislation has mandated that states limit sales or face financial consequences. This
article examines the state and federal legislation and how that effects town managers and
police officials within one county in Illinois in relation to the enforcement of minor
access to tobacco laws. A case study is provided for one town, where a police officer was
actively pursuing a solution, which possibly contributed to this town's minors
having smoking prevalence rates below the national averages.
A Qualitative Survey of Municipality Government Officials'
Attitudes Towards Youth Access to Tobacco Laws
Cigarette smoking is the leading cause of preventable death in the United States, killing an estimated 434,000 people each year (United States Department of Health and Human Services, 1994). Smoking accounts for 85% of all lung cancer deaths, 80% of all chronic obstructive pulmonary disease deaths, and 30% of all heart disease deaths. (Schultz, 1991). The direct medical cost of treating these diseases is estimated to be $50 billion a year (CDC, 1996).
The course of becoming addicted to nicotine usually begins during a child's adolescent years, when that child first tries cigarettes, progresses to when that child begins using cigarettes in the company of friends and peers, finally becoming firmly established when that child uses cigarettes on a regular daily basis. (United States Department of Health and Human Services,1994). One of the contributing factors enabling children and adolescents to smoke is that cigarettes are readily available to them (DiFranza, Carlson & Caisse, 1992; Jason, Ji, Anes, & Birkhead, 1991; Stanton, Mahalski, McGee, & Silva, 1993). Adolescents typically have little difficulty, if any, purchasing cigarettes, even though laws prohibit this (Jason, Ji, & Anes, 1992; Forster, Komro, & Wolfson, 1996; United States Department of Health and Human Services, 1994; Radecki & Zdunich, 1993).
Programs that offer extensive education to minors and merchants have frequently failed to reduce long term sales rates of cigarettes to minors (Nutbeam,Macaskill, Smith, Simpson, & Catford, 1993). An example of this occurred in Santa Clara, California, where a comprehensive merchant and community education program was put into effect. Prior to the program, sales rates to minors were measured to be 76%. Following six months, the rate declined to 39%, but a year later the rate increased back up to 59% (Altman, Rasenick-Douss,Foster,& Tye, 1991). In another study, over a three year period two communities received a diverse array of interventions including community education, merchant education, and voluntary policy changes. In the treatment community the percent of stores selling to minors dropped from 75% at baseline to 0% at the final assessment, whereas in the control community, the percent of stores selling to minors dropped from 64% to 39%. However, these communities were very small and they achieved these results only after three years of considerable educational efforts that might be difficult to duplicate in other settings.
In contrast to educational approaches, some investigators have argued for the use of enforcements that involve sending minors into stores to purchase cigarettes. If the minor is successful, then the merchant is notified and given a citation for not complying with the law. This method developed in Woodridge produced dramatic reductions in illegal sales rates within six months (Jason Ji, Anes, & Birkhead, 1991). The Woodridge plan rests upon a law that has four components: 1) noncompliance is addressed administratively through civil penalties assessed against the owners of the retail sites in addition to penalties assessed against their employees; 2) fines increase progressively, leading ultimately to license revocation; 3) enforcement is done quarterly by unannounced compliance checks using minors attempting to make actual purchases; and, 4) minors caught in possession of tobacco products are subject to a fine. Prior to the plan's adoption, 70% of stores illegally sold cigarettes to minors. After the plan was put in place, illegal sales to minors dropped to 5%. (Jason Ji, Anes, & Birkhead, 1991).
In the last few years, more public attention has been focused on the issue of illegal sales of cigarettes to minors. Two federal legislative initiatives designed to limit smoking among youth have become law. The first is the Synar amendment, enacted in 1992 and implemented in 1996, which stipulates that states must conduct annual surveys of their retail cigarette vendors to determine the percentage of stores that are selling to minors. The goal of this legislation is to reduce the sales rate to minors to 20%. States that cannot demonstrate that the percent of stores selling to minors is declining will have their drug abuse block grants curtailed. The second law is the FDA Rule of 1996 which went into effect in August, 1997, which prohibits sales to minors as well, but this policy was overturned by the Superme Court in 2000.
A key question is how these policies at the federal level impact what occurs at the state level. Examining what has been happening in Illinois might be instructive. In Illinois, the Illinois Liquor Control Commission (ILCC) was chosen as the agency to direct a statewide program to comply with the Synar amendment. The ILCC's plan, called "The Kids Can't Buy 'Em Here Campaign" created an ad-hoc group with the Illinois State Police, the Illinois Department of Human Services Office of Alcohol and Substance Abuse and Illinois Department of Public Health. Under this plan the ILCC conducts surveys of the state to determine levels of illegal sales of cigarettes to minors and promotes 'The Kids Can't Buy 'Em Here Campaign". The purpose of the program is to further the education of merchants about how not to sell to minors through public relations, the distribution of a manual, and a video which offers an account of what Woodridge has accomplished over the past 10 years.
In addition, the Illinois Department of Health assists local health departments with educational programs and the IMPACT Initiative to Mobilize for the Prevention And Control of Tobacco use program. The Illinois Department of Health directs 19 small grants, of $2,000 per year to selected local health departments to aid their educational efforts. The Illinois Office of Drugs and Substance Abuse offers drug education programs to high schools.
One county within Illinois further provides a glimpse of what is occurring regarding the initiative to reduce sales of cigarettes to minors. DuPage County is the county in which Woodridge is located. Woodridge initiated the regular enforcement of tobacco sales to minors and minors possession of tobacco in 1989. Shortly after Woodridge passed its law it shared that legislation with other communities in an attempt to get them to pass similar laws. Recently, the ILCC in its attempt to comply with the Synar amendment chose the country of DuPage as a demonstration site. The ILCC enlisted the efforts of the County Sheriff to coordinate the "The Kids Can't Buy 'Em Here Campaign" by hosting monthly meetings to which retailers, retailers associations, city government officials, police officials, county government officials, police associations, not for profit community agencies, and not for profit health promotion agencies (such as the American Lung Association) are invited. In 1996, the purpose of these meetings was to carry out the ILCC's plan to encourage independent municipalities to adopt laws that emphasize vendor education (even though the majority of towns in DuPage had laws prior to the inception of these meetings). The Sheriff was also in the process of developing a tobacco licensing and enforcing ordinance which would effect the approximately 40 retail vendors that exist in unincorporated areas.
Many researchers feel that the best strategy to reduce illegal sales of
cigarettes is to use enforcement procedures, which involve activities similar to what was
developed in Woodridge. This perspective is supported by a state-wide group of
anti-smoking activists, called the Illinois Coalition Against Tobacco, whose purpose is to
influence state policy towards enactment of legislation which would license tobacco
vendors. The Illinois Association of Retail Merchants has opposed moves towards
licensing vendors while insisting that the responsibility of illegal sales to minors be
equally carried by the youth who illegally purchase them. The concerns of this
merchant association were taken into account by the ILCC in the development of its
"Kids Can't Buy 'Em Here campaign." DuPage County is the community in
which these competing views operate. On the one hand, the state originally eschewed
licensing vendors and, only with the enactment of the Synar amendment in 1993, begun a
program to limit cigarette sales to minors. On the other hand, the "anti"
tobacco forces have been strongly advocating for ordinances with penalties that are
rigorously enforced, as they have been in Woodridge since 1989. In order to assess
the influence of these conflicting messages, town mayors, managers, and police were
surveyed to assess their understanding of problems related to tobacco use, youth smoking,
and youth access to tobacco products.
DuPage County is located in northeastern Illinois on the western border of Cook County, which is the county in which Chicago is located. DuPage has a population of 781,666, of which 83,114 are between the ages of 10 and 17. The racial composition is 91% White, 2% Black, 5% Asian, and 2% Hispanic and other. The median family income is $54,920 (1990 U.S. Census).
There are 33 independent municipalities located within DuPage County. This study also included the village of Lemont, which is partially in DuPage county and partially in Cook County. Four municipalities did not respond (i.e., Itasca, Willow Brook, Villa Park, and Lisle). The total number of municipalities surveyed was 29.
Prior to interviewing personnel, copies of tobacco regulation ordinances for each of the municipalities were obtained and analyzed by feature. Many of the towns modeled their legislation after the Woodridge legislation of 1989 which predated the Synar amendment. The Woodridge ordinance states that it is illegal to dispense tobacco to persons under the age of 18, or for them to possess tobacco. Those who sell or dispense tobacco must apply for and be granted a license and may be subject to a fine, suspension, or revocation of that license if they sell to persons under the age of 18. Persons under the age of 18 who are in possession of tobacco are subject to a fine of $25.00, and a fine of $50.00 for attempting to purchase tobacco. The police policy and procedure guidelines detail the procedures for carrying out quarterly inspections of vendors (personal communication, Deputy Chief Kelter, 1997). At the time of the study, only one town did not have tobacco minor access ordinances, the rest of the towns had vendor enforcement ordinances and 16 towns had minor possession ordinances. Some towns without laws concerning minor possession of tobacco can fine minors due to the 1994 Pro-Children Act, which bans smoking on school property. The Illinois General Assembly amended the School Code to accommodate the Pro-Children Act by requiring school boards to prohibit tobacco use on school property when used for any authorized activities, inside or outside of the building, and before, during, and after school, whether or not schools are in session. This law has allowed towns that do not have possession laws to issue citations to youth (as well as adults) who are in violation of this law. What occurs in some towns is that a group of youngsters that are being disruptive next to a school, can be approached by police who will give children observed smoking a ticket in an effort to attempt to disrupt their problematic behavior.
After reviewing the laws, a telephone survey was administered to key town
personnel to assess how they felt about six issues related to minors access to
tobacco. Survey questions were first presented to town managers, and in several
instances to mayors. Typically, town managers referred the interviewer to the chief
of police, and about half of the time the police chief further referred the interviewer to
other officers. The interviews occurred from Sept. to Dec. of 1997.
Respondents were asked to identify the time when their municipality enacted legislation limiting minor access to tobacco. Twenty seven persons responded. Seventeen correctly identified the date that their municipality enacted legislation. Respondents tended to state that their municipality's legislation was enacted more recently than it actually was. Of the municipalities, 9 enacted their laws in 1990, the year after Woodridge passed their law.
Respondents were asked about their understanding of why their municipality enacted legislation. However, only 11 respondents were present when their municipality enacted legislation. Of those 11, five thought that their municipality enacted legislation because other communities were demonstrating interest in stopping the sale of cigarettes to minors, two thought the enactment was to make possession by a minor punishable, and two thought the enactment was out of a general concern about minor's smoking.
Respondents were asked to describe their understanding of the intent of their municipality's law. Twenty-four persons responded, with 15 indicating that the purpose of their law was to regulate sales to minors and to apprehend youth who were in possession of tobacco, while 9 thought that the ordinance enabled them to pursue youth who were in possession of tobacco. One of these respondents viewed their ordinance as a way to control gang presence. Twenty-five respondents answered inquiries about enforcement penalties. Twenty-two respondents indicated that their municipality leveled fines against minors and youth, 3 respondents indicated that their municipality only fined youth.
The fourth area of inquiry was whether or not the respondents knew if their municipality licensed tobacco vendors. Twenty-nine respondents answered, 25 correctly identifying this part of their ordinance.
Respondents were asked if they knew how many people die each year from smoking, what are the direct medical costs per year, the number of minors who begin smoking each day, and at what average age minors begin to smoke. The actual figures are that 434,000 are estimated to die yearly, direct medical costs are estimated to be 50 billion dollars per year, and about 3,000 minors begin smoking each day at an average age of 14. Of the 29 respondents, 24 did not know the answers to any of these questions. Three respondents were able to estimate the annual number of deaths, and one respondent correctly identified the number of minors who begin smoking daily.
Lastly, respondents were asked to share their personal feelings about minors using tobacco products. Twenty-eight persons responded. One police official said that it did not matter, another said it wasn't his responsibility, and one police official said that while he was against youth smoking, he had "nothing against the tobacco companies". The remaining 25 were clearly against smoking, and 19 made additional comments. Three spoke of how they had made smoking a personal concern and were proactively pursuing the cause. Four reported personal losses of death and illness in their families due to smoking. Four felt frustrated and not able to understand why children and adults smoke. Four felt that persons were incapable of choosing until they were 18 years of age. Two said that they understood that the marketing strategy of the tobacco industry targets youth. One felt that children with low self-esteem were more vulnerable to smoking, and one person said that youth needed more education.
The Woodridge plan came about because once town officials became aware of the details of the problem they were driven to action. According to Officer Bruce Talbot (Personal Communication, Feb. 11, 1998), the average police officer merely uses the minor possession law as another tool to do the job as defined by the authorities in that particular police department. However, there, there are a few persons who are strongly committed to the ideals of the anti tobacco crusaders, but they are not the majority. As an example, in the town of Lemont, one police officer was found to be taking a very active role in an attempt to limit the use of tobacco. This officer conducts an educational program for youngsters as well as enforcing the town's tobacco ordinance limiting youth access to tobacco. Additionally, she has worked to limit smoking with the police department. When we interviewed Officer Duerkoop, we learned that since 1988, when she became active in the area of tobacco use, she had written anti-tobacco curriculum for students from preschool up to high school, organized a wide range of activities, such as sleep-overs and pizza parties, and coordinated the American Cancer Society's Great American Smoke-Out. Within the police department she has crusaded to ban smoking in all but one room and is actively attempting to ban smoking in patrol cars. Here efforts parallel the efforts of Sergeant Talbot in Woodridge
The standard DARE Program is designed for presentation to fifth or sixth graders, and consists of several sessions, each 30 to 60 minutes in length. In Lemont, DARE has been modified by Officer Duerkoop so that it is also presented to preschool children, first and third graders, and high school students over the entire year. In preschool, the program focuses on how medicine differs from *street* drugs and why and how to refuse medicines or drugs from friends or siblings. Parent follow-up is included in the preschool program. In the first grade, children are given a three week program about safety practices, including some information about street drugs. This program is expanded to a six week presentation in third grade.
The high school modification of the DARE program is taught for several hours in a freshman health class. In this program, teens are taught about domestic violence and date rape. They are taught how date rape occurs and what signs to look for in a person who might engage in this offense. They are taught what the qualities of a "healthy" relationship are, as well. This class allows students to anonymously submit a question on, literally, any topic and have that question answered by the instructing police officer.
In November, during the American Cancer Society's 'Great American SmokeOut Week', the DARE lesson of the week is replaced by a Smoke Screen contest. In this contest, kids are encouraged to present a dramatic piece of their own creation, such as a poem. The winner of the contest, who is allowed to bring along two friends, is given a ride in a police car, with the siren and emergency lights turned on. Officer Duerkoop also invites a representative of the American Lung Association to visit the school one day each year to present a hands on experience in which experiments are presented , such as having the smoke from a cigarette put through a cotton ball to demonstrate the tar and residues in cigarette smoke. These programs address drug issues as well as some personal safety behaviors and interpersonal skills, and are part of the curriculum in the public and Catholic schools. The end of the program is celebrated with a graduation session to which parents are invited.
Other activities that enhance civic responsibility have also been introduced by Officer Duerkoop . For example, during the Christmas season, the 'Dare to Share' project involves youth donating "gently used" toys, which are then distributed to a women's domestic abuse shelter. Each child is also assigned a job, such as advertising the event, listing the toys received, or dressing up as an elf as part of project. After all of the toys have been collected, a raffle is held to determine who will accompany the bus drivers to deliver the toys. Another event is the 'Boys Activity Day' during which the boys engage in sporting activities and contests. Plenty of food is provided to encourage a supportive and enjoyable atmosphere.
As a result of delivering drug prevention programs for the last 10 years to the Lemont community, Investigator Duerkoop believes she has established herself as an individual whom children seek out for assistance. She reports, for example, that a high school student recently asked her about the effects of smoking marijuana because he was planning on using marijuana and was concerned about his ability to drive. As a result of their discussion, he chose to have a friend accompany him as a designated driver.
The national survey, Monitoring the Future Study (Johnston, Bachman, O'Malley, Schulenberg, and Wallace, 1997) reports that for 8th. graders, 49.2% report having ever tried cigarettes, 20.4% report ever having tried chewing tobacco, 23.1% report ever having tried marijuana, 21.2% report ever having tried inhalants, and 4.5% report ever having tried cocaine. An anonymous survey was administered to the students in the Lemont junior high school (R. Katz and Leonard Jason, Personal Communication, Dec., 1997). In comparison to the National sample, the 8th. grade sample from Lemont reported that 42.3% having ever tried cigarettes, 11.7% having ever tried chewing tobacco, 17.9% having ever tried marijuana, 18.5% having ever tried inhalants, and 1.6% having ever tried cocaine. This comparison suggests that Lemont has surpising low levels of tobacco and other drug usage. It is possible that educational and enforcements efforts being exerted by the concerned police official influenced these figures. The success of Lemont, like Woodridge, may result from the dedication of one individual pursuing a course to reduce use of tobacco by youth. Quite possibly, in this regard, the motivations of one individual may be the kernel of success. The majority of the Lemont students (89.9%) were aware of the law prohibiting cigarette sales to minors; however, only 28.3% thought the law prevented access, while an additional 40.6% thought it impaired access. The largest percentage of smokers (48.2%) report obtaining cigarettes from friends and relatives over 18, and the second largest percentage (45.8%) report obtaining cigarettes from persons under 18. Smokers felt that they successfully bought cigarettes 1.9 times out of theirlast 10 attempts. Only 3.6% of smokers reported being caught smoking at school and only 3.0% reported being caught smoking in the community by the police.
Summarizing the findings from this survey in DuPage county, 59% of the respondents knew when their municipality enacted it's legislation and the majority knew that the purpose of legislation was to limit illegal sales and minor's possession of tobacco. Eighty six percent of the respondents knew that their municipality licensed vendors. The majority reported feeling that smoking is not a desirable practice; however, few indicated that they have made the issue a personal concern.
The survey of DuPage municipalities revealed that there are mixed motivations for developing youth access laws. Many of the towns enacted laws due to events external to their municipality, and only 3 respondents suggested that they have made the reduction of youth smoking a personal goal. Perhaps this lack of motivation to bring a halt to the problem stems from officials not knowing the extent of the problem. The majority of city and police officials were not aware of the numbers of lives lost each year, the yearly medical cost of smoking, or the numbers of children who begin smoking each day.
Jacobson and Wasserman (1997) note that to achieve success the smoking issue must be high on the agenda of public policy concerns, the state and local laws must be integrated, and that compliance must be enforced. In contrast, when public policy concerns are countered by powerful interests, policy becomes diluted and goals are not fully achieved. This might be the case in Illinois, where the ILCC originally focused their campaign towards merchant education, rather than focusing on enforcement.
Tornatzky and Fergus (1982) note that the successful diffusion of a program requires
the active selling of that program to all bureaucratic levels in a target community, as
well as consulting to the adopting community on implementation procedures. To some degree,
this is what occurred in DuPage when Sergeant Talbot presented the Woodridge plan of
enforcement to surrounding communities. This may account for the fact that a majority of the communities possess laws limiting youth access to tobacco, and that these laws were passed after the town of Woodridge passed its law. However, as Tornatzky and Fergus noted, successful implementation of ideas requires an active consulting relationship with the plan originators.
The case study data from Lemont provide intriguing findings, and suggest that strong enforcement laws and fining minors might have important affects on youth smoking and drug experimentation. However, it is also important to recognize that there are many sources for obtaining cigarettes, including friends and family members. Even if stores stop selling cigarettes to minors, some minors will still be able to obtain them. However, it is possible that when stores are less likely to be a source of cigarettes, this serves as a partial barrier to becoming a regular smoker for some adolescents in regularly enforcing communities. In addition to creating this partial barrier for obtaining cigarettes, it might be critical to also combine this approach with other interventions (e.g., fining minors for tobacco possession), which brings an additional message to youth that smoking is not an acceptable activity. Unfortunately, there are few studies to guide us on which combination of enforcement programs are most effective in deterring youth from smoking (Jason, Berk, Schnopp-Wyatt, & Talbot, 1999).
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