title: Are the federal and state governments complying with the Synar Amendment?
abstract: BACKGROUND
  In 1992, Congress enacted the Synar Amendment, requiring states and territories to enact a law prohibiting the sale of tobacco to minors and to enforce that law in a manner that could reasonably be expected to decrease the availability of tobacco to minors. The Department of Health and Human Services (DHHS) was mandated to withhold block grant funding from noncompliant states.
  
  
  OBJECTIVE
  To determine if DHHS and applicant states and territories are complying with the Synar Amendment.
  
  
  METHODS
  Fiscal year 1997 substance abuse block grant applications from 59 states and territories.
  
  
  METHODS
  Whether applicants had enacted a tobacco sales law, conducted enforcement inspections, penalized violators, and conducted a statewide survey, and whether DHHS regulations and actions were consistent with the statutory requirements of the Synar Amendment.
  
  
  RESULTS
  Two applicants failed to enact appropriate laws, 15 failed to conduct enforcement inspections, 18 failed to provide a single example of a violator being penalized, and 1 failed to conduct a survey. Nineteen applicants failed to meet the statutory requirements, but none were sanctioned by DHHS as required by the Synar Amendment. The DHHS regulations, as implemented, do not require states to enforce their laws or to achieve illegal tobacco sales rates low enough to reduce the availability of tobacco to minors.
  
  
  CONCLUSIONS
  The states and DHHS are violating the statutory requirements of the Synar Amendment, rendering it ineffective. Few states have implemented effective enforcement programs, and national surveys confirm that there has been no measurable reduction in the availability of tobacco to youths.
authors.affiliation: Department of Family Medicine and Community Health, University of Massachusetts Medical Center, Worcester 01655, USA. Joe.Difranza@banyan.ummed.edu
authors.forename: J R
authors.initials: JR
authors.lastname: DiFranza
mesh_terms: D000293:Adolescent; D002648:Child; D003132:Commerce / Q000331:legislation & jurisprudence*; D003625:Data Collection; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006801:Humans; D012907:Smoking / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D012926:Social Control, Formal; D014029:Tobacco Use Disorder / Q000517:prevention & control*; D014481:United States