Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse...

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Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA) National Conference on Tobacco or Health December 10-12, 2003 Boston, MA U.S DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Prevention www.samhsa.gov

Transcript of Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse...

Page 1: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Effective Youth Tobacco Access Laws: A Comprehensive

Approach

Alejandro Arias, Ed.D.Substance Abuse and Mental Health Services Administration

(SAMHSA)

National Conference on Tobacco or HealthDecember 10-12, 2003

Boston, MA

U.S DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services AdministrationCenter for Substance Abuse Prevention www.samhsa.gov

Page 2: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Preventing Early Tobacco Use

• Approximately 75% of smokers begin smoking daily before the age of 20

• Most adolescent smokers will continue to smoke when they become adults

• About 1 in 3 teens who presently smoke cigarettes daily will die due to smoking

Source: Surgeon Generals Report, 2000

Page 3: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Retail outlets are key source of cigarettes for youth

In 2001, of students less than 18 years of age who were current smokers:– 19.1% reported having purchased cigarettes

at a store or gas station during the past 30 days

– 67.2% reported having purchased cigarettes without being asked to show proof of age during the past 30 days.

Source: Youth Risk Behavioral Survey, 2001

Page 4: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

The Synar Legislation

• Enact and enforce laws prohibiting the sale or distribution of tobacco products to individuals under the age of 18;

• Conduct random, unannounced inspections of tobacco outlets; and

• Report findings to the Secretary of HHS annually.

Page 5: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

The Synar Regulation*

• Conduct random, unannounced inspections to measure compliance with the law;

• Report annually to the Secretary on the progress in meeting overall Synar requirements; and

• Negotiate interim performance targets and timeline to achieve a retailer violation rate of 20 percent or below.

*Proposed rule issued in August 1993. Final rule issued in January 1996. Failure to meet the requirements of the Synar Legislation/Regulation could result in penalties against a State’s Substance Abuse Prevention and Treatment (SAPT) Block Grant.

Page 6: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

States Achieving Retailer Violation Rates of 20 Percent or Lower for

FY97-FY03*†

*All years include data from the 50 States and the District of Columbia.

† In FY03, 49 States and D.C. were found in compliance with the Synar goal of 20%, with a 3% margin of error

4

12

21 23

31

38

45

0

5

10

15

2025

30

35

40

45

50

1997 1998 1999 2000 2001 2002 2003

Fiscal Year

Nu

mb

er o

f S

tate

s

Page 7: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

National Weighted* Average Retailer Violation Rate: FY97-FY03†

*Weighted by the State population†All years include data from the 50 States and the District of Columbia.

25.4

20.5 2017.5 16.3

14.1

40.1

0

5

10

15

20

25

30

35

40

45

1997 1998 1999 2000 2001 2002 2003

Fiscal Year

Re

taile

r V

iola

tio

n R

ate

(%

)

Page 8: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Synar Compliance Rate and Perceived Availability of Cigarettes by 8th/10th

Graders, USA, FY96-FY03

50

55

60

65

70

75

80

85

90

95

100

1996 1997 1998 1999 2000 2001 2002 2003

Fiscal Year

Pe

rce

nt

8th Graders

10th Graders

Synar Rate

60%

91%

76%

86%

83%

64%

Source: Monitoring the Future, 2002

Page 9: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Synar Compliance Rate and 30 day Cigarette Use by 8th, 10th, and 12th

Graders, USA, FY96-FY03

0

10

20

30

40

50

60

70

80

90

100

1996 1997 1998 1999 2000 2001 2002 2003

Fiscal Year

Pe

rce

nt

8th Graders

10th Graders

12th Graders

Synar Rate

34%

30%

19%

27%

18%

11%

60%

86%

Source: Monitoring the Future, 2002

Page 10: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Key Youth Access Laws

• Ban sales of tobacco to youth under 18 years of age

• Ban tobacco vending machines

• Ban self-service displays

• Create a graduated system of civil or criminal penalties for owners of establishments selling to youth

• Require sign postage of age of sales

Page 11: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Enforcement-Related Laws for Youth Tobacco Access

• Specify State enforcement authority

• Require random, unannounced inspections

• License tobacco retailers

• Allow minors (<18) to conduct compliance checks

• Provide immunity to youth who conduct compliance checks (possession laws)

Page 12: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Synar Requirements:Changes in States Laws

• All States now prohibit the sale or distribution of tobacco to minors.

• All States now allow for the levying of either civil or criminal penalties for violations of youth access laws.

• All States now enforce laws restricting youth access to tobacco.

Page 13: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Other Key Youth Access Provisions

• 45 States ban the use of vending machines or restrict their accessibility

• 26 States allow the revocation or suspension of licenses if retailer sells to minors

• 38 States require age sign posting at point of sale

Page 14: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Enforcement-Related Laws, 2002

• Some States have, by law, a designated enforcement agency

• Some States require random, unannounced inspections of tobacco outlets in State law

• Some States require licensing of retailers• All States allow minors to conduct

compliance checks • Some States ban youth tobacco

possession

Page 15: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Case Study: Indiana

Page 16: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Indiana Legal Structure for Youth Tobacco Access, 2002

Enforcement of Youth Tobacco Access Laws primarily a State function

• Illegal to sell to youth under <18 years of age• Designated enforcement authority • Allow progressive penalties to vendors selling

tobacco products to underage• No licensing required• Allow police to use youth under 18 years in

enforcement activities. • Possession by youth illegal but provide immunity

to youth for tobacco possession during inspections

Page 17: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Indiana Tobacco Retailer Inspection Program (TRIP)

• Originally funded by the FDA, now funded by the State of Indiana

• Established partnership with Alcohol and Tobacco Commission (ATC) to conduct compliance checks and enforce youth access laws

• 1999 State law established – progressive penalties to retailers who sell to underage

youth– Authority of ATC to prosecute violators of underage

laws and signage law

Page 18: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

In 2002, TRIP

• Approved budget for enforcement of State tobacco laws• Contracts with off-duty police, adult monitors and youth• Conducted 4,766 inspections and imposed $85,000 in

fines• Sent letters to all inspected vendors with outcomes of

inspections• Posted results of inspections on ATC website as way to

bring attention to retailers who are or are not complying with law

• ATC prosecutors issue notices of civil penalties and handle prosecution of violators

Page 19: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)
Page 20: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)
Page 21: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Indiana Retailer Violation Rates, FY97-FY03

05

1015202530354045

1997 1998 1999 2000 2001 2002 2003

Fiscal Year

Ret

aile

r V

iola

tio

n R

ate(

%)

Page 22: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Case Study: Iowa

Page 23: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Iowa Legal Structure for Youth Tobacco Access, 2002

Enforcement of youth access laws primarily a local function

• Illegal to sell to youth under <18 years of age• Allow progressive penalties to retailers selling tobacco

products to underage• Permit system for tobacco retailers • Allows suspension or revocation of permit• Allows police to use youth under 18 years in

enforcement activities. • Provide immunity to youth for tobacco possession during

inspections

Page 24: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Enforcement System• The Department of Public Health (IDPH) is

responsible for:– Synar inspections – Enforcement of tobacco access laws

• In 2002, IDPH established agreement with State Alcohol and Beverage Commission (ABC) to conduct compliance checks of tobacco retailers – ABC contracts with local law enforcement agencies – Local law enforcement agencies cite and fine violators

of youth tobacco laws– ABC issues citations if local enforcement fails to cite

violators

Page 25: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Iowa Tobacco Permit System

State law* requires:– Annual tobacco retail permit, set fees for permits and

authorizes local government to collect fees – Cities and counties to submit copies of permits to

State Division on Tobacco• Since ABD pays local entities to conduct enforcement

checks, it is to locals’ advantage to report permits

*State law was implemented in 2000.

Page 26: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

ABC Enforcement Efforts

• In 2002, the agency conducted 9,399 inspections and issued 1047 citations

• The agency partnered with:– 136 police departments– 74 sheriff’s offices,– the state patrol,– the Attorney General’s Office, and – local prosecutors

Page 27: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

05

1015202530354045

1997 1998 1999 2000 2001 2002 2003

Fiscal Year

Ret

aile

r V

iola

tio

n R

ate(

%)

Iowa Retailer Violation Rates, FY97-FY03

Page 28: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Enforcement Challenges

• Perception that youth access is not important making enforcement of the law a low priority

• Need for interagency collaboration• Need for accurate/complete lists of vendors • Limited resources for enforcement • Penalty structure• Prosecutors/judges may be reluctant to

prosecute/penalize• Retailer complaints• State budgets

Page 29: Effective Youth Tobacco Access Laws: A Comprehensive Approach Alejandro Arias, Ed.D. Substance Abuse and Mental Health Services Administration (SAMHSA)

Conclusions

The Synar Legislation has had important effects on youth access to tobacco products:– Higher retailer compliance with tobacco access laws

over the last decade;– Improved tobacco access laws; and– Greater enforcement efforts nationwide resulting in:

• Higher Synar compliance rates; and• Reductions in youths’ perceptions of availability and youth

tobacco use.