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, MEDLINE and EMBASE. Date of the most recent searches: September 2004.
  
  
  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
  One reviewer prescreened studies for relevance, and both reviewers independently assessed the studies for inclusion. One reviewer extracted data from included studies and the second checked them. Study designs and types of intervention were heterogeneous so results were synthesized narratively, with greater weight given to controlled studies.
  
  
  RESULTS
  We identified 34 studies of which 14 had data from a control group for at least one outcome. Giving retailers information was less effective in reducing illegal sales than active enforcement or multicomponent educational strategies, or both. 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: Department of Primary Health Care, Oxford University, Old Road Campus, 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*