Are strong laws enough? : Youth access laws and state-reported retailer violation rates (RVRs)

Background: State laws are important components of public health efforts to reduce youth access to tobacco products, but it is undetermined whether they are sufficient in and of themselves to reduce the rate of illegal tobacco sales to youth. This study examined and compared the extensiveness of state laws restricting youth access to tobacco and evaluated its association with state-reported rates of illegal tobacco sales to youth (RVRs) among all 50 states and the District of Columbia from 1996-2006.

Methods: Data from the National Cancer Institute, State Cancer Legislative Database (SCLD) were stratified by states' Preemption or Non Preemption policy status. Average summary RVRs according to youth tobacco access law extensiveness performance (LEP) were compared using ANOVA or Kruskal Wallis test. Additionally, bivariate analysis was used to evaluate the association between the LEP per year and RVRs.

Results: The average summary RVRs ranged from 40.6 in 1996 to 9.8 in 2006. Significantly lower average summary RVRs were observed in states where law extensiveness performance (LEP) was the highest in 1999 (p<0.05). However, average summary RVRs did not differ significantly (p>0.05) by LEP for the rest of the years evaluated. Higher law extensiveness scores were significantly associated with lower rates of illegal tobacco sales to youth (RVRs) in 1999 (p<0.05). Conclusion: Although it is important to have strong laws to control youth access to tobacco, these findings suggest that strong laws are not enough by themselves to reduce youth access to tobacco products through retail sources.