Interventions for preventing tobacco sales to minors.
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, MEDLINE and EMBASE. Date of the most recent searches: October 2001.


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 30 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.
Stead
L F
LF
Dept of Health Care and Epidemiology, University of British Columbia, Mather Building, 5804 Fairview Avenue, Vancouver, Canada, V6T 1Z3. lindsay.stead@dphpc.ox.ac.uk
Lancaster
T
T
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*