1. A Comprehensive Approach to Reducing Youth Access to Tobacco Products

2. Cheryl Sbarra Senior Staff Attorney and Tobacco Control Director Massachusetts Association of Health Boards Overview of Youth Access Strategies

3. 3 Why is limiting youth access so important? “Today’s teenager is tomorrow’s potential regular customer, and the overwhelming majority of smokers first begin to smoke while in their teens…it is during the teenage years that the initial brand choice is made: At least a part of the success of Marlboro Red during its most rapid growth period was because it became the brand of choice among teenagers who then stuck with it as they grew older.” (From a memo by Tina Walls, Vice President, State Government Affairs, Philip Morris.)

4. 4 Youth Smoking Prevention Strategies n Tobacco price increases n Tobacco advertising restrictions n Tobacco education n Tobacco supply reduction

5. 5 Two Different Means of Tobacco Supply l Commercial sources n Purchase from establishment n Purchase from internet n Theft from self-service displays n Free samples l Non-Commercial sources n Friends n Relations n Strangers - third party sales

6. 6 Types of MA Youth Access Laws (1) l Board of Health Regulation n M.G.L. Ch111, Sec.31 n To enact reasonable health regulations l Municipal Ordinance or By-Law n Home Rule Amendment of the Massachusetts Constitution

7. 7 l State Law n M.G.L. Ch. 270, Sec. 6 n Where there is no local law l Attorney General Regulations l FDA (no longer in effect) Types of MA Youth Access Laws (2)

8. 8 Components of MA Local Regulations l Local license or permit for sale of tobacco l Penalties for sales to minors l Loss of local licenses or permits for repeat sales l Ban on vending machines or restriction to “adult-only” establishments

9. 9 Components of MA Local Regulations l Ban on self-service displays or restriction to “adult-only” establishments l Ban on sale of individual cigarettes (state law) l Ban on free distribution of cigarettes (promotions)

10. 10 MA Attorney General Consumer Protection Regulations l Prohibit self service displays except in adult only facilities l Restrict vending machines with lockouts to establishments with liquor licenses

11. 11 MA Attorney General Consumer Protection Regulations l Prohibit free samples and promotional giveaways except in adult only facilities l Require warning signs if selling individual a hand rolled cigarette

12. 12 MA Attorney General Consumer Protection Regulations l Requires retailers to implement all measures reasonably necessary to prevent the sale of tobacco products to minors l Requires retailers to card anyone who appears to be 27 years of age or younger l Retailers must only accept a government- issued photographic identification

13. 13 Reporting Complaints to MA Attorney General www.ago.state.ma.us Click on ‘consumer protection’ then Click on ‘tobacco enforcement’ then Click on ‘contact us’ for a complaint form

14. 14 Preventing sales to minors l Compliance checks l Inspections l Merchant Education

15. Cesar Pungirum, Director Five City Tobacco Control Collaborative Tobacco Compliance Check Procedures

16. 16 Tobacco Compliance Checks l What are they? l Why are they done?

17. 17 Enforcing Your Regulation l Regulation n Strong & enforceable n You have to know it! n Enforcement tool: –Permit suspension –Ticket –Both

18. 18 Important Decisions l Who enforces it? l How’s the authority given to enforcement officers?

19. 19 Written Protocol l Enforcement officers n 1 or 2 adults? n What are their roles? n How are they trained? l Youth buyers n 1 or 2 kids? n How are they trained? n Will they carry Ids? n Parents’ permission l Transportation n Whose car? n Insurance l Materials n Forms n Labels n Notices/Tickets n Sales history n Copy of regulation

20. 20 Written Protocol (2) l Handling sales n What constitutes evidence? n Processing the product n When notice is served? n Tickets? –Who writes them? –To whom? –Who keeps track of them? l Follow up Communications n Compliance notices n Sale confirmations

21. 21 Conducting Compliance Checks l Be consistent (follow procedures) l Be thorough l Be safe l Vary days and times l Use routes l Careful documentation

22. 22 Sample Compliance Check l Scheduling kids and adult monitors l Preparing the material n Camera (with film) n Forms n Labels n Money n Back up list of buyers n Incentives (giveaways) l Assemble the route l Pick up the kid l Take pictures l Empty pockets l Review guidelines l Brief the kid l Drive to the route

23. 23 Sample Compliance Check (2) l Give the kid money l Observe the kid enter the establishment l If there’s no sale: n Collect basic information n Move to the next store l If there’s a sale: n Count change n Process the evidence –Name & address –Date and time –Price & signature n Gather seller’s description n Confirm description n Move to the next store

24. 24 Sample Compliance Check (3) l Finish route l Drive the kid home l Check sales history l Prepare notices of violation or tickets l Serve notices or tickets l Re-inspect forms l Go home

25. 25 Processing Evidence l Log them l Lock them l Destroy them

26. 26 Processing Data l Database l Careful & consistent data entry l Make copies l Filing l Reporting

27. 27 Processing Sales l Send certified notifications l Send tickets to appropriate office l Schedule any appropriate hearings: n Board of Health n Court n Other

28. 28 Processing Non-sales l Notices of compliance l Warning letters

29. Robert Collett, Director Cape Cod Regional Tobacco Control Program Training Adults and Youth

30. 30 Why Train Adults and Youth? l Accountability l Consistency l Credibility l Standardization

31. 31 Training Adults l If for enforcement purposes, must use adults who are agents of local Board of Health l Agents/officers should be trained according to state and local board of health protocols

32. 32 Who Makes Good Compliance Officers? l Staff- Designated Agents l Local Police/D.A.R.E. Officers l Youth Resource Officers l Retired Law Enforcement Personnel l Health Agents

33. 33 Sample Compliance Agent Responsibilities l Attend pertinent Department of Public Health trainings l Learn and understand state and local regulations l Drive youth to retailers l Ensure youth compliance with protocols/assure safety

34. 34 Sample Compliance Agent Responsibilities (2) l Complete paperwork in detail l Label evidence/report honestly l Appear at hearings if necessary l Handle unexpected situations

35. 35 Selection of Youth Buyers l Age is a significant factor n FDA (over 150,000 compliance checks) – 15 years old 17.70% – 16 years old 25.30% – 17 years old 36.30% l Research by Battelle, funded by NCI

36. 36 Training Outline for Youth Buyers l Basic tobacco information/Tobacco 101 l Youth Access laws and regulations l Compliance Check 101 n What, when, where, why, who and how n Compliance Check walk through n Observation n Safety

37. 37 Training Youth Buyers l Role playing increases confidence n Rehearse ways to ask for tobacco using props n Rehearse “what-if’s”

38. 38 Training Youth Buyers l Use experienced or former buyers to help with training and screening n Share “best” and “worst” experiences n Share tips to succeed n Have new buyer observe experienced buyer n Have experienced buyer observe new buyer

39. 39 Resources for Training Youth l http://www.CDC.gov/tobacco l http://www.health.org (Center for Substance Abuse Prevention) l http://www.tobaccofreekids.org

40. 40 Finding Youth Buyers l Health-related peer leadership programs l Local high schools and churches n Classes in government or journalism n Clubs focusing on criminal justice or law n Community service requirements l Co-workers and neighbors l Collaborate with neighboring Tobacco Control Programs

41. 41 MA Examples for Compensating Youth l Put on payroll as employee l Put on payroll as consultant l Give a cash token of appreciation l Participating as part of an organized community service program / not paid

42. James Wells, Director South Shore Boards of Health Collaborative Merchant Education

43. 43 Merchant Education Options Include l One-on-one with the clerk l Pre-arranged training at a store l Training open to any retailer l Working with regional/corporate chains l Information packets (mail or hand deliver)

44. 44 Sample Content for Retailer Training l State and Local Regulations l Required Signage l Product Placement l Techniques for Checking ID l Distractions l Harassment

45. 45 Retailer Resource Kit Materials directed to managers Materials directed to sales clerks Materials directed to customers Produced jointly by MTCP and AG’s Office

46. 46 MTCP Project Social Sources Campaign Letter to retailers Decal/sticker Employee card Newspaper ad

47. 47 Merchant Education Video l Utilized local access cable television to produce educational training video

48. Conclusion

49. 49 MTCP funded Boards of Health Sales of tobacco to minors Calendar years

50. 50 Youth Smoking Reduction l According to the 2001 Massachusetts Youth Risk Behavior Survey, 26% of MA high school students smoked within the prior month. l This represents a significant improvement from the 36% smoking rate reported in 1995.

51. Questions?

52. 52 Contact Information l Cheryl Sbarra sbarra@mahb.org l Cesar Pungirum cpungirum@ci.somerville.ma.us l Robert Collettt bcollett@cape.com l James Wells jim@smokefreenews.com