Relation between access to tobacco and adolescent smoking

Objective: To examine the relation between rates of sales of tobacco to minors and youth smoking prevalence. Design: Repeated annual cross sectional surveys. Setting: Seventy five communities in Oregon. Participants: A random sample of students in grades 8 and 11 ( ages 13 and 17 years) and retail outlets in each participating community. Main outcome measures: Thirty day and daily smoking prevalence. Results: The rate of illegal merchant sales in the communities was related to the smoking rate for 11th graders in those communities, but not for 8th graders. For every 10% increase in illegal sales rates there was an estimated 0.8% increase in 11th grade 30 day smoking prevalence and a 0.4% increase in daily smoking. Communities with lower illegal merchant sales rates had expanded use of social sources and reduced use of commercial sources by 11th graders, with the opposite pattern seen in 8th graders. Conclusions: There appears to be a relatively small positive linear relation between the community rate of sales to minors and 11th grade youth smoking prevalence in those communities. Youth adjust their tobacco sources depending on the level of commercial availability.