A Comprehensive Approach to Reducing Youth Access to

Tobacco Products

Cheryl SbarraSenior Staff Attorney and Tobacco Control Director

Massachusetts Association of Health Boards

Overview of Youth Access Strategies

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Why is limiting youth access so important?

“Today’s teenager is tomorrow’s potential regular customer, and the overwhelming majority of smokers first begin to smoke while in their teens…it is during the teenage years that the initial brand choice is made: At least a part of the success of Marlboro Red during its most rapid growth period was because it became the brand of choice among teenagers who then stuck with it as they grew older.” (From a memo by Tina Walls, Vice President, State

Government Affairs, Philip Morris.)

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Youth Smoking Prevention Strategies

Tobacco price increases

Tobacco advertising restrictions

Tobacco education

Tobacco supply reduction

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Two Different Means of Tobacco Supply

Commercial sources Purchase from establishment Purchase from internet Theft from self-service displays Free samples

Non-Commercial sources Friends Relations Strangers - third party sales

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Types of MA Youth Access Laws (1)

Board of Health Regulation M.G.L. Ch111, Sec.31 To enact reasonable health regulations

Municipal Ordinance or By-Law Home Rule Amendment of the Massachusetts

Constitution

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State Law M.G.L. Ch. 270, Sec. 6 Where there is no local law

Attorney General Regulations FDA (no longer in effect)

Types of MA Youth Access Laws (2)

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Components of MA Local Regulations

Local license or permit for sale of tobacco

Penalties for sales to minors

Loss of local licenses or permits for repeat sales

Ban on vending machines or restriction to “adult-only” establishments

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Components of MA Local Regulations

Ban on self-service displays or restriction to “adult-only” establishments

Ban on sale of individual cigarettes (state law)

Ban on free distribution of cigarettes (promotions)

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MA Attorney General Consumer Protection Regulations

Prohibit self service displays except in adult only facilities

Restrict vending machines with lockouts to establishments with liquor licenses

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MA Attorney General Consumer Protection Regulations

Prohibit free samples and promotional giveaways except in adult only facilities

Require warning signs if selling individual a hand rolled cigarette

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MA Attorney General Consumer Protection Regulations

Requires retailers to implement all measures reasonably necessary to prevent the sale of tobacco products to minors

Requires retailers to card anyone who appears to be 27 years of age or younger

Retailers must only accept a government-issued photographic identification

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Reporting Complaints toMA Attorney General

www.ago.state.ma.us

Click on ‘consumer protection’

then

Click on ‘tobacco enforcement’

then

Click on ‘contact us’ for a complaint form

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Preventing sales to minors

Compliance checks

Inspections

Merchant Education

Cesar Pungirum, Director Five City Tobacco Control Collaborative

Tobacco Compliance Check Procedures

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Tobacco Compliance Checks

What are they?

Why are they done?

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Enforcing Your Regulation

Regulation Strong & enforceable You have to know it! Enforcement tool:

– Permit suspension

– Ticket

– Both

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Important Decisions

Who enforces it?

How’s the authority given to enforcement officers?

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Written Protocol

Enforcement officers 1 or 2 adults? What are their roles? How are they trained?

Youth buyers 1 or 2 kids? How are they trained? Will they carry Ids? Parents’ permission

Transportation Whose car? Insurance

Materials Forms Labels Notices/Tickets Sales history Copy of regulation

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Written Protocol (2)

Handling sales What constitutes

evidence? Processing the product When notice is served? Tickets?

– Who writes them?

– To whom?

– Who keeps track of them?

Follow up Communications Compliance notices Sale confirmations

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Conducting Compliance Checks

Be consistent (follow procedures) Be thorough Be safe Vary days and times Use routes Careful documentation

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Sample Compliance Check

Scheduling kids and adult monitors

Preparing the material Camera (with film) Forms Labels Money Back up list of buyers Incentives (giveaways)

Assemble the route Pick up the kid Take pictures Empty pockets Review guidelines Brief the kid Drive to the route

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Sample Compliance Check (2)

Give the kid money Observe the kid enter

the establishment If there’s no sale:

Collect basic information

Move to the next store

If there’s a sale: Count change Process the evidence

– Name & address– Date and time– Price & signature

Gather seller’s description

Confirm description Move to the next store

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Sample Compliance Check (3)

Finish route Drive the kid home Check sales history Prepare notices of violation or tickets Serve notices or tickets Re-inspect forms Go home

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Processing Evidence

Log them

Lock them

Destroy them

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Processing Data

Database Careful & consistent data entry Make copies Filing Reporting

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Processing Sales

Send certified notifications Send tickets to appropriate office Schedule any appropriate hearings:

Board of Health Court Other

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Processing Non-sales

Notices of compliance

Warning letters

Robert Collett, DirectorCape Cod Regional Tobacco

Control Program

Training Adults and Youth

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Why Train Adults and Youth?

Accountability

Consistency

Credibility

Standardization

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Training Adults

If for enforcement purposes, must use adults who are agents of local Board of Health

Agents/officers should be trained according to state and local board of health protocols

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Who Makes Good Compliance Officers?

Staff- Designated Agents Local Police/D.A.R.E. Officers Youth Resource Officers Retired Law Enforcement Personnel Health Agents

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Sample Compliance Agent Responsibilities

Attend pertinent Department of Public Health trainings

Learn and understand state and local regulations

Drive youth to retailers

Ensure youth compliance with protocols/assure safety

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Sample Compliance Agent Responsibilities (2)

Complete paperwork in detail

Label evidence/report honestly

Appear at hearings if necessary

Handle unexpected situations

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Selection of Youth Buyers

Age is a significant factor

FDA (over 150,000 compliance checks)

– 15 years old 17.70%

– 16 years old 25.30%

– 17 years old 36.30%

Research by Battelle, funded by NCI

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Training Outline for Youth Buyers

Basic tobacco information/Tobacco 101 Youth Access laws and regulations Compliance Check 101

What, when, where, why, who and how Compliance Check walk through Observation Safety

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Training Youth Buyers

Role playing increases confidence

Rehearse ways to ask for tobacco using props

Rehearse “what-if’s”

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Training Youth Buyers

Use experienced or former buyers to help with training and screening Share “best” and “worst” experiences Share tips to succeed Have new buyer observe experienced buyer Have experienced buyer observe new buyer

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Resources for Training Youth

http://www.CDC.gov/tobacco

http://www.health.org (Center for Substance Abuse Prevention)

http://www.tobaccofreekids.org

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Finding Youth Buyers

Health-related peer leadership programs Local high schools and churches

Classes in government or journalism Clubs focusing on criminal justice or law Community service requirements

Co-workers and neighbors Collaborate with neighboring Tobacco Control

Programs

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MA Examples for Compensating Youth

Put on payroll as employee Put on payroll as consultant Give a cash token of appreciation

Participating as part of an organized community service program / not paid

James Wells, DirectorSouth Shore

Boards of Health Collaborative

Merchant Education

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Merchant Education Options Include

One-on-one with the clerk Pre-arranged training at a store Training open to any retailer Working with regional/corporate chains Information packets (mail or hand deliver)

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Sample Content for Retailer Training

State and Local Regulations Required Signage Product Placement Techniques for Checking ID Distractions Harassment

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Retailer Resource Kit

• Materials directed to managers

• Materials directed to sales clerks

• Materials directed to customers

• Produced jointly by MTCP and AG’s Office

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MTCP Project Social Sources Campaign

• Letter to retailers

• Decal/sticker

• Employee card

• Newspaper ad

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Merchant Education Video

Utilized local access cable television to produce educational training video

Conclusion

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MTCP funded Boards of Health Sales of tobacco to minors

0

5

10

15

20

25

30

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40

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1994 1996 1998 2000 2002

Sales to minors

Calendar years

Calendar years

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Youth Smoking Reduction

According to the 2001 Massachusetts Youth Risk Behavior Survey, 26% of MA high school students smoked within the prior month.

This represents a significant improvement from the 36% smoking rate reported in 1995.

Questions?

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Contact Information

Cheryl Sbarra sbarra@mahb.org Cesar Pungirum

cpungirum@ci.somerville.ma.us Robert Collettt bcollett@cape.com James Wells jim@smokefreenews.com