It Is Premature to Abandon Youth Access to Tobacco Programs

In a recent meta-analysis study, Fichtenberg and Glantz1 argue that youth access tobacco programs do not affect teen smoking prevalence because as fewer merchants sell tobacco to minors, teens will use social sources to obtain tobacco. They conclude, as well as in a recent editorial,2 that it is time to abandon youth access tobacco programs. The likely result of reversing this policy would be that the majority of merchants would once again sell minors tobacco, thereby providing them easy access to this dangerous substance. Previous studies that have investigated the relation of retail tobacco availability (RTA) to youth tobacco use have measured this factor as the proportion of retailers assessed who illegally sold cigarettes.3–6 Fichtenberg and Glantz7 concur that this is the most commonly used metric for assessing youth access programs, and if this is not an accurate reflection of youth access, “then none of the studies of youth access that base their effectiveness on merchant compliance are valid.” Unfortunately, this approach does not account for the relative density of tobacco retailers in each community, which may affect the likelihood that a youth will encounter a retailer who is not compliant with the tobacco sales law. As an example, in one town we recently studied,8 …