Laws Don't Stop Kids From Smoking

By Bruce Sylvester, Contributing WriterHealth Behavior News Service

Laws criminalizing the sale of tobacco to kids might be good PR for politicians, but they have little or no effect of the use of tobacco by minors, a Swiss researcher concludes in a new review article.

The author, Jean-François Etter, Ph.D, of the Institute of Social and Preventive Medicine at the University of Geneva, reviewed all published studies on the subject, most of which were done in the United States, where, since 1992, the Synar Amendment requires all states to enact and enforce laws prohibiting the sale for tobacco to persons under the age of 18.

"The review showed that laws prohibiting tobacco sales to minors are widespread, but that there is little evidence that they have any impact on smoking rates among youth," said Etter.

States do not enforce the laws, and the federal government does not require states to penalize lawbreakers, according to the review to be published in the July issue of the American Journal of Preventive Medicine. Even when laws are followed, the analysis found "no effect of sales prohibitions on tobacco use by minors, at any level of compliance by retailers."

Minors easily find "social" sources — family and friends — to get tobacco products and circumvent the laws, the review found, and the weight of criminalization is being shifted from retailers to underage users of tobacco.

"In an authoritarian move, many states in the U.S. enacted laws that prohibit youth to possess, use or purchase tobacco, called PUP laws," Etter said. "Criminalizing young smokers in this way 'for their own good' is not ethical, in particular because there is no evidence that PUP laws decrease smoking prevalence among minors." He said that supporters of these laws "neglected to evaluate scientifically their positive and negative consequences." "I agree with Dr. Etter that current approaches to prevent underage cigarette sales are a dismal failure, largely due to a lack of political will to enact meaningful and practical laws and sensible enforcement strategies," said Arnold H. Levinson, Ph.D., director of the Tobacco Program Evaluation Group at the University of Colorado/AMC Cancer Research Center in Lakewood. "I also agree that laws alone will not solve the problem of adolescent smoking."

But Levinson added, "As long as cigarettes are a legal, over-the-counter product, keeping kids from smoking will require a large, multi-strategy effort. There's still no good science to say we should abandon tobacco-sales laws and enforcement."

The review was commissioned by the Swiss Federal Office of Public Health.

Etter J-F. Laws prohibiting the sale of tobacco to minors: impacts and adverse consequences. Am J Prev Med 31(1), 2006.