Youth Access Interventions Do Not Affect Youth Smoking

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Abstract
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.