title: Interventions for preventing tobacco sales to minors.
abstract: BACKGROUND
  Laws restricting sales of tobacco products to minors exist in many countries, but young people may still purchase cigarettes easily.
  
  
  OBJECTIVE
  The review assesses the effects of interventions to reduce underage access to tobacco by deterring shopkeepers from making illegal sales.
  
  
  METHODS
  We searched the Cochrane Tobacco Addiction group trials register and Medline. Date of the most recent searches: July 1999.
  
  
  METHODS
  We included controlled trials and uncontrolled studies with pre- and post intervention assessment of interventions to change retailers' behaviour. The outcomes were changes in retailer compliance with legislation (assessed by test purchasing), changes in young people's smoking behaviour, and perceived ease of access to tobacco products.
  
  
  METHODS
  Studies were prescreened for relevance by one person and assessed for inclusion by two people independently. Data from included studies were extracted by one person and checked by a second. Study designs and types of intervention were heterogeneous so results were synthesised narratively, with greater weight given to controlled studies.
  
  
  RESULTS
  We identified 27 studies of which 13 were controlled. Giving retailers information was less effective in reducing illegal sales than active enforcement and/or multicomponent educational strategies. No strategy achieved complete, sustained compliance. In three controlled trials, there was little effect of intervention on youth perceptions of access or prevalence of smoking.
  
  
  CONCLUSIONS
  Interventions with retailers can lead to large decreases in the number of outlets selling tobacco to youths. However, few of the communities studied in this review achieved sustained levels of high compliance. This may explain why there is limited evidence for an effect of intervention on youth perception of ease of access to tobacco, and on smoking behaviour.
authors.affiliation: ICRF General Practice Research Group, Division of Public Health and Primary Health Care, Institute of Health Sciences, Old Road, Headington, Oxford, UK, OX3 7LF. lindsay.stead@dphpc.ox.ac.uk
authors.forename: L F
authors.initials: LF
authors.lastname: Stead
authors.forename: T
authors.initials: T
authors.lastname: Lancaster
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D002648:Child; D003132:Commerce / Q000331:legislation & jurisprudence; D006801:Humans; D012907:Smoking / Q000331:legislation & jurisprudence* / Q000523:psychology; D000074606:Smoking Prevention; D012926:Social Control, Formal; D019460:Tobacco Industry / Q000331:legislation & jurisprudence*