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PEDIATRICS Vol. 109 No. 6 June 2002, pp. 1088-1092

Youth Access Interventions Do Not Affect Youth Smoking
Caroline M. Fichtenberg, MS and Stanton A. Glantz, PhD

From the Center for Tobacco Control Research and Education,
Institute for Health Policy Studies, Cardiovascular
Research Institute, University of California, San
Francisco, San Francisco, California

Objective. To determine the effectiveness of laws
restricting youth access to cigarettes on prevalence of
smoking among teens.
Methods. We conducted a systematic review of studies that
reported changes in smoking associated with the presence
of restrictions on the ability of teens to purchase
cigarettes. We calculated the correlation between merchant
compliance levels with youth access laws and prevalence (30-
day and regular) prevalence of youth smoking, and between
changes in compliance and prevalence associated with youth
access interventions. We also conducted a random effects
meta-analysis to determine the change in youth prevalence
associated with youth access interventions from studies
that included control communities.

Results. Based on data from 9 studies, there was no
detectable relationship between the level of merchant
compliance and 30-day (r = .116; n = 38 communities) or
regular (r = .017) smoking prevalence. There was no
evidence of a threshold effect. There was no evidence that
an increase in compliance with youth access restrictions
was associated with a decrease in 30-day (r = .294; n = 18
communities) or regular (r = .274) smoking prevalence.
There was no significant difference in youth smoking in
communities with youth access interventions compared with
control communities; the pooled estimate of the effect of
intervention on 30-day prevalence was -1.5% (95% confidence
interval: -6.0% to +2.9%).

Conclusions. Given the limited resources available for
tobacco control, as well as the expense of conducting
youth access programs, tobacco control advocates should
abandon this strategy and devote the limited resources that
are available for tobacco control toward other
interventions with proven effectiveness.