Utilizing a five-phase policy campaign model to reduce youth access to tobacco

Illegal sale of tobacco to minors is one of the major risk factors associated with tobacco use among youth. According to the Centers for Disease Control and Prevention, 1 in 5 youth identified as current smokers directly purchased their own cigarettes from stores or gas stations. Glendale, California—the third largest city in Los Angeles County—has high rates of illegal tobacco sales to minors and a large immigrant population vulnerable to pro-tobacco influence. In 2006, Glendale Adventist Medical Center (GAMC) implemented a five-phase policy campaign model to enforce stricter tobacco retail licensing policies. The five-phase model includes a community needs assessment, capturing youth access data and an assessment of community resources; policy campaign strategies such as a strong media campaign and educating key opinion leaders; coalition building and advocacy; policy implementation; as well as process and outcome evaluation. GAMC surveyed over 600 Glendale residents of which 96% believed that cigarette use is a very serious or somewhat serious health problem for minors. Furthermore, 53.4%of current tobacco users and 83.8% of non-tobacco users agreed that merchants should be licensed to sell cigarettes. Approximately 24% of merchants in multiple sting operations were willing to sell tobacco to minors, almost three times the state's rate. GAMC established the Glendale Healthy Youth Advocacy Coalition to rally support for stricter enforcement of tobacco retail licenses. As a result, a Glendale ordinance requiring merchants to obtain a permit to sell tobacco was put into effect on January 1, 2008. Outcomes will be presented.