title: Sources of tobacco for youths in communities with strong enforcement of youth access laws.
abstract: OBJECTIVE
  To determine how youths obtain tobacco in communities with strong enforcement of tobacco sales laws.
  
  
  METHODS
  Ten communities in Massachusetts with merchant compliance rates at or above 90%.
  
  
  METHODS
  Paper surveys and focus group discussions with 68 adolescent smokers.
  
  
  RESULTS
  Parents and friends are the primary sources of tobacco for new smokers. When stealing from parents can no longer satisfy the need for cigarettes, young adolescents ask strangers to buy them tobacco. For high school age smokers, teenage store clerks are a major source. Teenage clerks sell to other teenagers, steal tobacco, and help their friends steal from their employers. Friends who are 18 years of age or over are a second major source for older adolescents. Parents often purchase tobacco for older adolescents.
  
  
  CONCLUSIONS
  Recommended actions include raising the minimum age for the purchase of tobacco to 21 years, and prohibiting individuals less than 21 years of age from selling tobacco.
authors.affiliation: Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue, Worcester, MA 01655, USA. Difranzj@ummhc.org
authors.forename: J R
authors.initials: JR
authors.lastname: DiFranza
authors.forename: M
authors.initials: M
authors.lastname: Coleman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D012111:Residence Characteristics; D016540:Smoking Cessation / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires