The long-term effect of local policies to restrict retail sale of tobacco to youth

Many adolescent smokers rely significantly on retail tobacco sources to initiate or maintain their smoking behavior. Though promising, the results from various interventions aimed at curtailing retail tobacco access have been mixed. In the present study, 14 communities were randomly assigned to intervention and control groups in an attempt to determine the long-term effect of local youth access laws and policies on adolescent smoking. The intervention continued for 32 months. Assessments were conducted at baseline (1991) and at years 3, 5, and 7. The intervention was based on a community-organizing approach that mobilized community members to support adoption and enforcement of local ordinances to restrict minors' access to commercial sources of tobacco. The major outcome measure for the study was cross-sectional prevalence of daily tobacco use among all students in grades 8, 9, and 10 in each community, measured by a self-administered student survey. A short-term significant intervention effect was observed and reported previously. That difference between intervention and control communities was maintained through the year 5 assessment but had dissipated by the year 7 assessment, very likely related to adoption of ordinances by control communities. Restricting commercial access to tobacco through local ordinances is effective in reducing adolescent smoking both immediately after the intervention (year 3) and 2 years later (year 5). Longer-term results are still inconclusive, because control communities adopted ordinances similar to those in the intervention communities.