Accessibility to Minors of Cigarettes from Vending Machines -- Broward County, Florida, 1996

The sale of tobacco products to persons aged 18 years has been prohibited by law in Florida since October 1992, and since May 1994, a statewide law in Florida has required retailers or owners of businesses that sell cigarettes or other tobacco products to post a conspicuous sign stating that tobacco sales to minors are illegal and that proof of age is required to purchase tobacco products.* To assess the impact of these laws in Broward County (1990 population: 1,255,531) during February-March 1996, the Florida Atlantic University Department of Exercise Science/Wellness Education conducted studies of vendor compliance with laws enacted to prevent minors from gaining access to cigarettes through vending machines and to ensure that tobacco vendors comply with the sign statute. This report summarizes the findings of the assessment of access to cigarettes from vending machines, which indicated that approximately one third of such attempts by minors were successful.

The 1995-1996 Beverage License File maintained by the Florida Department of Business and Professional Regulation was used to identify four categories of businesses in Broward County: bars, hotels/motels, restaurants, and miscellaneous (e.g., bowling lanes, country clubs, pool halls, and amusement centers) (n=1861). A map of the county was divided into four equally sized areas; within each of these areas, approximately 20% of the businesses were randomly selected to produce a total sample of 373 businesses. Of these 373, a total of 270 were excluded because they had no cigarette vending machines on site, had closed, sold only over-the-counter cigarettes, or were bars that would not admit persons aged <21 years. The remaining 103 businesses represented 6% of the 1861 county total and constituted 64 (14%) of the 466 bars, five (5%) of the 95 hotels/motels, 27 (2%) of the 1218 restaurants, and seven (9%) of the 82 miscellaneous businesses. The assessment employed seven teams of volunteers, each comprising one minor and one adult; five of the minors were female (ages 12 years {one}, 15 years {two}, and 17 years {two}), and six were male (ages 13 years {two}, 15 years {two}, 16 years {one}, and 17 years {one}).

One purchase attempt was made at each of the 103 businesses. Purchase attempts used the following procedure (1): the adult member of the team entered the business first to note the presence of any clearly displayed signs stating that tobacco products would not be sold to minors. The adult then observed while the minor entered and attempted to obtain change from a vendor to use in a cigarette vending machine. If no vendor was present, the minor went directly to a vending machine to mimic purchase of cigarettes. The attempt was considered successful if the minor received change for purchasing cigarettes and was able to insert money into a cigarette vending machine and press the coin return without interference. The attempt was considered unsuccessful if the minor was refused change, prevented from inserting money in a cigarette vending machine, or asked for age verification and denied change for purchasing cigarettes. The adult member noted the vendor's reasons for refusal at the time of the request for change; when no refusal reason was provided to the minor, the adult team member waited until the minor had departed and asked the vendor about the reason for refusal. Significance testing was performed using Pearson chi-square tests.

Overall, attempts by minors to obtain cigarettes from vending machines were successful in 34 (33%) of the 103 business sites (Table_1); 30 (88%) of these successes occurred after the minor received change from the vendor. At four businesses, a vendor was absent, and minors went directly to the vending machines. Twenty-five (74%) of the businesses and purchase attempts were within a radius of one half mile of an elementary, middle, or high school. Overall, success rates were similar among those aged <17 years and aged 17 years (35% {95% confidence interval (CI)="+/-11%}" versus 28% {95% CI="+/-17%});" however, the rate was higher for females than males (24 {45% (95% CI="+/-14%)}" of 53 attempts versus 10 {20% (95% CI="+/-12%)}" of 50 attempts). Success rates were similar for each category of business, including 21 (33% {95% CI="+/-12%})" bars, two (40% {95% CI="+/-68%})" hotels/motels, eight (30% {95% CI="+/-18%})" restaurants, and three (43% {95% CI="+/-43%})" other businesses. Warning signs provided by the Florida Department of Business and Professional Regulation were posted and clearly visible in 84 (82%) of the 103 businesses; however, success rates were similar in businesses with and without signs (30 {36% (95% CI="+/-11%)}" of 84 versus four {21% (95% CI="+/-20%)}" of 19, respectively).

Reasons specified by the vendors for the 69 unsuccessful attempts were that the minor had no proper identification (41 {59%}), the minor appeared to be underaged (16 {23%}), and the sale of cigarettes to minors was illegal (nine {13%}); other reasons accounted for three unsuccessful attempts.

Reported by: FS Bridges, EdD, Dept of Health, Leisure and Sports, The Univ of West Florida, Pensacola; BS Graves, EdD, Dept of Health Sciences, Florida Atlantic Univ, Davie, Florida.

Editorial Note

Editorial Note: The assessment in Broward County indicates that, despite the enactment of state laws prohibiting the sale of tobacco products to persons aged <18 years, approximately 33% of minors aged 12-17 years were successful in attempts to purchase cigarettes from vending machines. These success rates were lower than those reported in surveys conducted in Massachusetts and Minnesota (86% and 42%, respectively) (2,3). Study design differences (i.e., in the Florida study and one other study {1}, minors requested change from vendors before mimicking purchases at vending machines) may have contributed to these discrepancies, and both studies may have underestimated the ease of cigarette access. If minors had gone directly to the vending machine, they might have been more successful.

The findings in this report are subject to at least one limitation. Data were obtained from the files of the Florida Department of Business and Professional Regulation for only four types of businesses because cigarette vending machines were most likely to be present on the premises of these businesses. Although businesses included in the analysis probably do not differ from businesses in other categories that were not included, it could not be determined whether purchasing cigarettes from vending machines at businesses that were not surveyed would have been more difficult.

The findings of this assessment will be used locally to educate the public and the business community about the need to support local, state, and federal laws restricting the sale of tobacco to minors. For example, the Synar Amendment requires all states receiving federal funds for prevention and treatment of substance abuse to have and enforce a law prohibiting the sale of tobacco to persons aged <18 years and to reduce the statewide illegal sales rate to less than or equal to 20% over several years ** (4). These findings provide further support for the Food and Drug Administration (FDA) regulations that, in addition to other provisions aimed at decreasing the appeal of and access to tobacco products by minors, ban vending machines except in facilities where only adults are permitted (5). The effective date for the provision restricting sales through vending machines is August 28, 1997. The FDA rule will further enhance state and local efforts to decrease minors' access to tobacco.

References

1. Hoppock KC, Houston TP. Availability of tobacco products to minors. J Fam Pract 1990;30:174-6.

2. DiFranza JR, Savageau JA, Aisquith BF. Youth access to tobacco: the effects of age, gender, vending machine locks, and "It's the Law" programs. Am J Public Health 1996;86:221-4.

3. Forster JL, Hourigan ME, Kelder S. Locking devices on cigarette vending machines: evaluation of a city ordinance. Am J Public Health 1992;82:1217-9.

4. Substance Abuse and Mental Health Services Administration. Final regulations to implement section 1926 of the Public Health Service Act regarding the sale and distribution of tobacco products to individuals under the age of 18. Federal Register 1996;61:13,1492-500.

5. Food and Drug Administration. Regulations restricting the sale and distribution of cigarettes and smokeless tobacco products to protect children and adolescents -- final rule. Federal Register 1996;61:41, 314-75.

Florida Revised Statutes 859.06-859.061. ** Public Law 102-321, SS1926 (42 USC SS300x-26).

+------------------------------------------------------------------- ------+ |             | | Erratum: Vol. 45, No. 47 | |             | | SOURCE: MMWR 45(50);1105 DATE: Dec 20, 1996 | |             | | In the article "Accessibility to Minors of Cigarettes from | | Vending Machines -- Broward County, Florida, 1996" (page 1036), the | | confidence intervals (CIs) for the findings presented in the text | | and Table 1 were incorrect. Below is Table_1E with the corrected | | CIs; CIs in the text should have matched those presented in this | | table.     | |             | +------------------------------------------------------------------- ------+

TABLE 1. Number of successful attempts by minors * to purchase cigarettes from
vending machines, by category -- Broward County, Florida, February-March 1996
================================================================================
                               Successful attempts
                    No.     --------------------------
Category         attempts   No.    (%)      (95% CI +)
------------------------------------------------------
Age (yrs)
  <17               71       25  (35.2)     (+/-11.4%)
   17               32        9  (28.1)     (+/-16.5%)

Sex of minor
  Male              50       10  (20.0)     (+/-11.5%)
  Female            53       24  (45.3)     (+/-13.9%)

Type of store
  Bar               64       21  (32.8)     (+/-11.8%)
  Hotel/Motel        5        2  (40.0)     (+/-68.0%)
  Restaurant        27        8  (29.6)     (+/-18.4%)
  Other &            7        3  (42.8)     (+/-42.9%)

Warning sign
  Yes               84       30  (35.7)     (+/-10.5%)
  No                19        4  (32.9)     (+/-20.2%)

Total              103       34  (33.0)     (+/- 9.2%)
------------------------------------------------------
* Persons aged <18 years.
+ Confidence interval.
& Includes bowling lanes, country clubs, pool halls, and amusement centers.
================================================================================

TABLE 1. Number of successful attempts by minors * to purchase cigarettes from
vending machines, by category -- Broward County, Florida, February-March 1996
================================================================================

                                    Successful attempts
                    No.        -----------------------------
Category          attempts     No.     (%)      (95% CI +)
------------------------------------------------------------
Age (yrs)
  <17                71        25     (35.2)   (24.2%-47.5%)
  17                 32         9     (28.1)   (13.8%-46.8%)

Sex of minor
  Male               50        10     (20.0)   (10.0%-33.7%)
  Female             53        24     (45.3)   (31.6%-59.6%)

Type of store
  Bar                64        21     (32.8)   (21.6%-45.7%)
  Hotel/Motel         5         2     (40.0)   ( 5.3%-85.3%)
  Restaurant         27         8     (29.6)   (13.8%-50.2%)
  Other &             7         3     (42.9)   ( 9.9%-81.6%)

Warning sign
  Yes                84        30     (35.7)   (25.6%-46.9%)
  No                 19         4     (21.1)   ( 6.1%-45.6%)

Total               103        34     (33.0)   (24.1%-43.0%)
------------------------------------------------------------
* Persons aged <18 years.
+ Confidence interval.
& Includes bowling lanes, country clubs, pool halls, and amusement centers.
================================================================================

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