Youth Possession Laws: Promising Approach Or Diversion?

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Youth Possession Laws: Promising Approach Or Diversion? Prepared for the 6 th National Synar Workshop March 13, 2002 ImpacTeen and YES! are part of Bridging the Gap: Research Informing Practice for Healthy Youth Behavior, supported by the Robert Wood Johnson Foundation.

Bridging the Gap: Research Informing Practice for Healthy Youth Behavior Frank Chaloupka, Gary Giovino, Cindy Tworek Sandy Slater, Melanie Wakefield, Pam Clark, Erin Ruel, Dianne Barker, Barbara Sasso, Elizabeth Molnar and Brad Gray Additional support provided by the National Cancer Institute and the Centers for Disease Control and Prevention www.impacteen.org

Purpose of the Initiative: To evaluate the impact of: Policies Programs Practices Addressing various types of substances: Alcohol Use Illicit Drug Use Tobacco Use At various levels: State Community School Individual

University of Michigan Institute for Social Research Monitoring the Future (MTF) Youth, Education and Society (YES!) University of Illinois at Chicago Health Research and Policy Centers ImpacTeen Coordinating Center, Community Data Collections Polysubstance Use Research UIC Alcohol Policy Research Team U of MN Illicit Drug Policy Research Team Andrews U and RAND Tobacco Policy Research Team Roswell Park

Data Collections Half-Sample of MTF Schools Cycling Out of the National Sample c. 215 Schools Per Year National Replicate Sample Administrators in Those Schools Surveyed Community Data Collected From Their Catchment Areas Observational Studies of Retail Outlet and Communities Key Informant Interviews in the Community Local Ordinances and Regulations Other Existing Archival Data State Level Data on Laws, Policies, and Environmental Data

Key Informant Surveys Modular Approach: Core Modules Universal Questions Demographic Module Health Department Police Agency Police Officer Coalitions 5 Targeted Modules Youth access enforcement Policy/media advocacy Public education Ordinance Feedback Modules Youth Tobacco Possession Keg Registration Curfews Inhalants Drug Paraphernalia Medical Marijuana

State Tobacco Policy/Legislative Data Tobacco Control Expenditures CDC/NCI/ RTI - Since 1991 Price Data Tax Burden on Tobacco, American Chamber of Commerce Researchers Association, Observational Data, Scanner Data, Self-Reported Data 1955+ Smoke-Free Air Laws CDC, ALA, RPCI; 1991+ Sales to Minors Laws CDC, SLATI, MIT; 1991+ Purchase, Possession, and Use Laws CDC, ALA, RPCI; 1988+

Real Average Cigarette Excise Tax 85 80 State and Federal Tax (FY00 cents per pack) 75 70 65 60 55 50 45 40 35 1970 1975 1980 1985 1990 1995 2000 Year

Cigarette Smoking Among Youth by the Average Price of a Pack of Cigarettes in 50 States and the District of Columbia, 1999 Percent Past Month Smokers (Adolescents) 30 25 KY ND 20 AK 15 NY 10 UT CA HI 5 0 175 200 225 250 275 300 325 350 375 400 Average Price of a Pack of Cigarettes (in cents) r 2 = 0.255 ß = -0.045 P < 0.001 N = 51 Sources: 1999 NHSDA (12-17 year olds); 1999 Tax Burden On Tobacco Note: Past Month Smoking = smoking on > 1 day during the previous 30 days

12th Grade 30 Day Smoking Prevalence and Price Real Price Per Pack $3.25 $3.00 $2.75 $2.50 $2.25 $2.00 $1.75 $1.50 $1.25 1981 1986 1991 1996 Year 39 37 35 33 31 29 27 Smoking Prevalence Cigarette Price 30 Day Smoking Prevalence

Restrictiveness Of State Laws Regulating Smoking In Public Places U.S., 1960-1999 55 50 45 40 35 30 25 20 15 10 5 0 1960 1964 1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 NUMBER OF STATES Extensive Moderate Basic Nominal YEAR Sources: 1989 Surgeon General s Report, ALA s SLATI, CDC s STATE system, Roswell Park Cancer Institute. Note: Includes the District of Columbia; Alabama = only state with no restrictions on public smoking.

Mean Smoke-Free Air Law Rating Per State* -- United States, 1988-2001 Smoke-Free Air index (mean) 10 9 8 7 6 5 4 3 2 1 0 1988 1989 1990 1991 1992 1993 1994 1995 *Includes the District of Columbia; Theoretical Range = -5-42 Year Sources: ALA s SLATI, CDC s STATE system, and Roswell Park Cancer Institute 1996 1997 1998 1999 2000 2001

Cigarette Smoking Among Youth by the Clean Indoor Air Legislation Rating in 50 States and the District of Columbia,1999 Percent Past Month Smokers (Adolescents) 30 25 KY ND 20 NC 15 10 NY CA UT 5 0-10 -5 0 5 10 15 20 25 30 35 Clean Indoor Air Legislation Rating r 2 = 0.208 ß = -0.219 P = 0.001 N = 51 Sources: 1999 NHSDA (12-17 year olds); ALA s SLATI, CDC s STATE system, and the Roswell Park Cancer Institute. Note: Past Month Smoking = smoked on > 1 day in the previous 30 days

Possession, Use, and Purchase Laws Penalize minors, not vendors States want to avoid criminal record for offender (Teen Court or Peer Court) Penalties include: - Fines -- most common - range as high as $750 (some graduated) - majority < $100 Other penalties in lieu of or in addition to fines: - Community Service - Smoking Education Classes - Smoking Cessation Classes - Driver s License Suspension

Arguments In Favor of PUP Laws Promote Accountability, Personal Responsibility - Vendors Shouldn t be Liable Add a Cost to Tobacco Use Can be Used by Law Enforcement Officers to Inspect Suspicious Youths - May Reduce Crime Rate Send a Message That Adults Mean What They Say Alcohol Experience - minimum age increase (to 21 years old) has reduced drinking and saved lives

Arguments Against PUP Laws Youths are Enticed to Smoke by Marketing, Only to Be Punished for Wanting the Promoted Product Enforcement Costs; May Reduce STM Enforcement Profiling Youth Focus Diverts Attention/Resources From Effective Tobacco Control Efforts Kids Rebel Age-aspiration Means Adult Status is Attractive Efficacy of Sales to Minors Laws in Doubt

Number of U.S. States including D.C.*, with Legislation Restricting Possession of Cigarettes to Persons aged >18 years, 1988-2001 # of States 50 45 40 35 30 25 20 15 10 5 0 6 7 8 13 14 14 17 19 20 25 28 31 31 32 1988 1989 *District of Columbia 1990 1991 1992 1993 1994 1995 Year Source: State Legislated Actions On Tobacco Issues, 1988-2001, CDC s STATE system, Roswell Park Cancer Institute. 1996 1997 1998 1999 2000 2001

Number of U.S. States including D.C.*, with Legislation Restricting the Use of Cigarettes to Persons aged >18 years, 1988-2001 50 40 # of States 30 20 10 6 7 8 11 11 11 13 15 15 17 17 18 18 19 0 1988 1989 *District of Columbia 1990 1991 1992 1993 1994 1995 Year Source: State Legislated Actions On Tobacco Issues, 1988-2001, CDC s STATE system, Roswell Park Cancer Institute. 1996 1997 1998 1999 2000 2001

Number of U.S. States including D.C.*, with Legislation Restricting the Purchase of Cigarettes to Persons aged >18 years, 1988-2001 50 # of States 40 30 20 10 10 14 14 18 21 24 26 27 29 32 33 36 36 37 0 1988 1989 *District of Columbia 1990 1991 1992 1993 1994 1995 Year Source: State Legislated Actions On Tobacco Issues, 1988-2001, CDC s STATE system, Roswell Park Cancer Institute. 1996 1997 1998 1999 2000 2001

Mean Number of Possession, Use, and Purchase Laws per State* -- United States, 1988-2001 Possession, Purchase, and Use Index (Mean) 2 1.8 1.6 1.4 1.2 1 0.8 0.6 0.4 0.2 0 1988 1989 1990 1991 1992 1993 1994 1995 Year *Includes the District of Columbia; Theoretical Range = 0-3 Sources: ALA s SLATI, CDC s STATE system, and Roswell Park Cancer Institute 1996 1997 1998 1999 2000 2001

91.6 100 90 Percent 80 70 60 50 40 Tobacco Possession Ordinance Enforced in Your Community Yes No 30 20 8.4 10 0 Year 2001 Resources Adequate to Effectively Enforce Tobacco Possession Ordinance 100 LOCAL ENFORCEMENT: 2001 Percent 90 80 70 60 50 40 51.7 48.3 Adequate Not Enough 30 20 10 0 Year 2001

LOCAL ENFORCEMENT 100 Pattern of Possession Ordinance Enforcement: 90 80 Percent 70 60 50 40 30 20 10 54.4 33.3 15.0 63.5 30.6 3.2 Enforced among any youth smoker Enforced only in response to complaint Enforced rarely 0 1999 2000 Year

100 Percent 90 80 70 60 50 40 30 20 10 10.3 21.8 35.6 19.5 12.6 Community Priority of Tobacco Possession Ordinance Enforcement Very Low Low Moderate High Very High 0 Year 2001 Effectiveness of Possession Ordinance in Giving Police a Tool to Intercept Youth for Other Issues or Concerns 100 LOCAL ENFORCEMENT: 2001 Percent 90 80 70 60 50 40 30 20 10 37.8 46.8 13.9 6.6 Very Effective Somewhat Effective Not Very Effective No Help at All 0 Year 2001

Local communities indicate that the following are typical actions taken when a minor is caught possessing tobacco: Citation issued Notification of parents Warning issued Appearance in peer or teen court Local communities indicate that the following are typical penalties imposed when a minor is caught possessing tobacco (2001): Fines (65%) Community service (19%) Participation in Tobacco Cessation Program (15%) Counseling (12%) LOCAL ENFORCEMENT

Policy Implementation Tobacco Possession If saw 14 year old smoking in public park, would: give teen warning notify parents do nothing 2000 45% 23% 65% 2001 55% 40% 47%

Percent 100 90 80 70 60 50 40 30 20 10 0 8.1 LOCAL PERCEPTIONS Effectiveness of Possession Ordinance in reducing tobacco use by minors: 50.0 35.1 6.8 9.1 28.6 1999 2000 Year 46.8 15.6 Very Effective Somewhat Effective Not Very Effective No Help at All

Cigarette Smoking Among Youth by the Historical PPU Legislation Rating in 50 States and the District of Columbia, 1999 Percent Past Month Smokers (Adolescents) 30 25 20 15 10 5 0 SC NY DC KY CA UT SD NH r 2 < 0.001 ß = 0.008 P = 0.898 N = 51 0 5 10 15 20 25 30 PPU Legislation Rating Sources: 1999 NHSDA (12-17 year olds); ALA s SLATI, CDC s STATE system, and the Roswell Park Cancer Institute Note: Past Month Smoking = smoked on > 1 day during the previous 30 days Historical PPU Legislation Rating = Sum of PPU laws for previous 8 years (0 = no law; 1 = law present)

Control Variables for Merged Analyses Tobacco Control Expenditures, Cigarette Prices, Sales to Minors Laws, Smoke-free Air Laws Age, Sex, Race/Ethnicity, Father s Education, Mother s Education, Respondent s Earned Income, Respondent s Income From Other Sources, Labor Force Status, Mother s Work Status, Religiosity, School Performance

Table 1. Logit Analyses of the Association Between Purchase, Possession, and/or Use Laws and Cigarette Smoking among Minors United States, 1991-1998 Past Month Smoking Adjusted* Purchase Possession Use PPU Index Coefficient (z-score) -0.075 (-1.75) -0.050 (-1.11) -0.017 (-0.46) -0.040 (-2.08) Past Month Smoking Intensity Adjusted* Coefficient (z-score) p-value 0.080 0.266 0.642 0.038 p-value Purchase Possession Use PPU Index -0.089 (-1.94) -0.066 (-1.39) -0.016 (-0.41) -0.048 (2.30) 0.052 0.166 0.682 0.022 *Adjusted for demographics, risk, and tobacco control variables N (Weighted) = 248,369

Table 2. Logit Analyses of the Association Between Purchase, Possession, and/or Use Laws and Past Month Smoking among Minors, by Age and Risk Group United States, 1991-1998 Past Month Smoking Age/Risk Group Purchase Possession Use PPU Index z-score p-value z-score p-value z-score p-value z-score p-value < 14 yrs/low -2.13 0.033-2.00 0.046-1.99 0.047-3.53 <0.001 < 14 yrs/medium -0.68 0.497-2.05 0.040-2.79 0.005-2.91 0.004 < 14 yrs/high 0.15 0.885-0.22 0.826-1.52 0.128-0.58 0.564 15-16 yrs/low -0.96 0.336-0.52 0.602-1.54 0.124-1.49 0.137 15-16yrs/Medium -0.61 0.541 0.89 0.373 0.90 0.366 0.56 0.578 15-16 yrs/high -1.83 0.068 1.02 0.309 2.10 0.035 0.28 0.777 17 yrs/low -2.08 0.038-1.36 0.174 0.91 0.361-1.60 0.110 17 yrs/medium -0.58 0.559-0.18 0.859-0.35 0.725-0.75 0.452 17 yrs/high -1.60 0.111-0.26 0.795 0.64 0.520-1.23 0.219 Note: Adjusted for demographics and tobacco control variables N (Weighted) for each age/risk strata ranges from 9,894 62,766

Table 3. Logit Analyses of the Association Between Purchase, Possession, and/or Use Laws and Past Month Smoking Intensity among Minors, by Age and Risk Group United States, 1991-1998 Age/Risk Group Past Month Smoking Intensity Purchase Possess Use z-score p-value z-score p-value z-score p-value z-score PPU Index p-value < 14 yrs/low -2.20 0.028-2.13 0.033-1.98 0.047-3.64 <0.001 < 14 yrs/medium -0.61 0.542-2.15 0.032-2.94 0.003-3.03 0.002 < 14 yrs/high -0.31 0.753-1.23 0.218-1.74 0.082-1.51 0.130 15-16 yrs/low -1.11 0.268-0.69 0.492-1.77 0.077-1.73 0.084 15-16yrs/Medium -0.84 0.402 0.58 0.564 0.78 0.435 0.17 0.861 15-16 yrs/high -2.28 0.023 0.36 0.719 2.00 0.045-0.30 0.763 17 yrs/low -2.18 0.029-1.50 0.135 0.78 0.434-1.73 0.084 17 yrs/medium -0.97 0.331-0.61 0.544-0.45 0.653-1.29 0.197 17 yrs/high -1.26 0.209-1.01 0.313 0.21 0.830-1.48 0.139 Note: Adjusted for demographics and tobacco control variables N (Weighted) for each age/risk strata ranges from 9,894 62,766

Compliance Check Analysis Draws on data from FDA compliance checks done from 1998 through early 2000 - over 100,000 initial checks - control for conditions of check, store characteristics Data on state policies matched based on store location - Includes sales to minors policies and policies limiting youth purchase, use, or possession Data on community population characteristics added based on store zip code

Compliance Check Analysis Result Compliance more likely in states with more comprehensive restrictions on sales to minors Compliance less likely in rural, low-income, and/or minority neighborhoods Compliance not significantly related to state policies limiting youth purchase, use, or possession of tobacco products - weak evidence that compliance is higher in states with these policies

Conclusions Policies limiting youth purchase, use and/or possession of tobacco products have spread rapidly during the 1990s Enforcement increasing in recent years Mixed support for these policies at the level of implementation and enforcement Not a high priority in most communities Inadequate resources provided in many communities Perceived to have little impact on youth smoking Policies more commonly used as tool to intercept youth for other concerns or issues

Conclusions State laws limiting youth purchase, use, and/or possession of tobacco products have little impact on youth smoking prevalence or intensity Some evidence that combination of policies has weak impact on overall youth smoking Effects appear limited to lower risk/younger teens who are least likely to smoke to begin with No evidence that purchase, use, or possession laws adversely impact on retailer compliance with sales to minors policies

Next Steps.... PUP Analyses to Incorporate: State Enforcement Data Local Laws and Enforcement Focus Group Data in Communities with Various Degrees of Enforcement Cost-Effectiveness Analysis Ongoing/Planned Analyses of Merged Data Sets: Tobacco Control Expenditures, Smoke-Free Indoor Air Laws Other Outcomes, Such as Purchase Experiences, Attitudes, Quitting

Bridging the Gap Research Informing Practice for Healthy Youth Behavior Supported by the Robert Wood Johnson Foundation and administered by the University of Illinois at Chicago www.impacteen.org