BACKGROUND AND OBJECTIVES:

A previous single-county study found that retail stores usually asked young-looking tobacco customers to show proof-of-age identification, but a large proportion of illegal tobacco sales to minors occurred after the customers had shown identification proving they were too young to purchase tobacco. We sought to investigate these findings on a larger scale.

METHODS:

We obtained state reports for federal fiscal years 2017 and 2018 from a federal agency that tracks tobacco sales to supervised minors conducting compliance checks in retail stores. We used descriptive and multivariable logistic regression methods to determine (1) how often stores in 17 states requested identifications, (2) what proportion of violations occurred after identification requests, and (3) if violation rates differed when minors were required versus forbidden to carry identification.

RESULTS:

Stores asked minors for identification in 79.6% (95% confidence interval: 79.3%–80.8%) of compliance checks (N = 17 276). Violations after identification requests constituted 22.8% (95% confidence interval: 20.0%–25.6%; interstate range, 1.7%–66.2%) of all violations and were nearly 3 times as likely when minors were required to carry identification in compliance checks. Violations were 42% more likely when minors asked for a vaping product versus cigarettes.

CONCLUSIONS:

Stores that sell tobacco to underage customers are more likely to be detected and penalized when youth inspectors carry identification during undercover tobacco sales compliance checks. The new age-21 tobacco sales requirement presents an opportunity to require identifications be carried and address other long-standing weaknesses in compliance-check protocols to help combat the current adolescent vaping epidemic.

Subjects:
Advocacy, Federal Policy, Smoking, Substance Abuse
Topics:
tobacco
What’s Known on This Subject:

In a single-county study, it was found that tobacco retailers often sold to underage customers despite viewing proof the customers were legally underage. It is unknown whether this pattern is widespread.

What This Study Adds:

We analyzed federal monitoring data from 17 states, representing ∼100 000 tobacco retailers, and found that sales violations after identification requests constituted approximately one-fourth of all violations. Violation rates were higher when states required undercover youth inspectors to carry identification.

When young-looking retail customers ask for a tobacco product, United States and state laws require the store to perform 2 steps: (1) examine proof-of-age identification and (2) refuse to sell if the customer is <18 years of age1  (19 or 21 years in some jurisdictions2,3 ; as of December 20, 2019, federal law raised the minimum age for tobacco sales to 21).4  The laws5  and their enforcement have reduced tobacco sales to minors and adolescent smoking,6  but violations remain frequent enough to fuel the current epidemic of adolescent vaping.7,8 

In a study of cigarette sales to undercover youth inspectors by a sample of 200 stores in Jefferson County, Colorado,9  the authors found that clerks usually fulfilled the first step, namely, they asked to see identification in 92.6% of >1000 compliance checks. The Jefferson County minors carried and were allowed to present their own identifications if asked, an inspection strategy that typically increases the detection of violation rates.10,11  More than two-thirds (69.2%) of violations in the study occurred after minors presented identifications showing they were too young to be sold cigarettes legally. The authors of the study concluded that retailers often sell tobacco to minors despite being shown the customer’s age.

In this study, we examined the results of federally required tobacco purchase attempts by undercover minors in 17 states to answer 3 questions. (1) What is the prevalence of identification requests? (2) What proportion of sales violations occur after identification requests? (3) Do violation rates differ when minors are required versus forbidden to carry age-accurate identification?

We obtained and analyzed secondary data that US states submit annually to the Substance Abuse and Mental Health Services Administration in a required report of retailer compliance with underage tobacco sales laws. The report includes an estimated retailer violation rate (RVR) based on compliance checks in random samples of retail stores. Starting with federal fiscal year (FFY) 2017 (October 1, 2016–September 30, 2017), the report included an optional data field, “Clerk asked Youth Inspector for identification (yes/no),” to track identification requests. The annual reports also indicate whether youth inspectors are required or forbidden to carry identification when conducting compliance checks.

We obtained data for FFYs 2017 and 2018 through a Freedom of Information Act request; data for FFY 2019 were unavailable at the time of the request. Seventeen states completed the optional identification-request field, either in 2018 only (n = 5 states) or both 2017 and 2018 (n = 12 states). We also obtained information about which states require (22 states) or forbid (27 states) youth inspectors to carry identification during compliance checks (one state allows it under some circumstances). Observations used in analyses (N = 17 276) included 157 (0.9%) with missing identification-request data that were coded 0 (identification not asked). Five observations were excluded because the minor was aged 18; observations were limited to those in which minors were aged 15 to 17, which is legally too young to be sold tobacco at the time.

In analyses, we used state-level poststratification weights that we calculated as the multiplicative inverse of sampling fractions included in state reports. Within-state sampling designs were incorporated for states that use stratified and/or clustered sampling designs. Weighted estimates represent ∼80 000 retail tobacco sellers in FFY 2017 and 100 000 in FFY 2018. Analyses used Stata svy programs (version 15.1; Stata Corp, College Station, TX).

Descriptive analyses estimated proportions of compliance checks without identification requests and RVRs for all visits and for visits with and without identification requests. We used multivariable logistic regression to model factors contributing to identification-request failures and sales violations. Potential factors included year, minor age and sex, store type, type of tobacco requested, and whether the state required or forbade minors to carry identification; identification request was included for modeling on sales violations. We began model building by comparing competing assumptions: that state by year was a random effect, which best matches the data structure, or that state was a fixed effect with 17 levels. Variable coefficients were substantially the same in both models, and for parsimony and fidelity to data structure, we report results of a mixed-effect model including state by year as a random effect. Regression results are reported as adjusted odds ratios (aORs).

Identification was requested in 79.6% of compliance checks (95% confidence interval [CI]: 78.9%–80.4%); excluding one state with a low outlier rate (21.2%; 95% CI: 18.7%–23.6%), identification was requested 88.1% of the time (95% CI: 87.3%–88.8%; data not shown in tables). The identification-request rate did not differ significantly by study year among combined states that provided both years’ data (78.0% vs 77.8%; P = .81); rates differed significantly between years for only one state (95.3% to 88.0%; P = .0003). The FFY 2018 rate of identification requests was significantly higher among states that reported only FFY 2018 data versus states that reported both years’ data (86.8% vs 73.0%; P < .0001).

The overall RVR was 9.3% (95% CI: 8.7%–9.9%; interstate range, 3.4%–18.0%). Sales after identification requests accounted for nearly one-fourth of all violations (22.8%; 95% CI: 20.0%–25.6%; interstate range, 1.7%–66.2% of violations), and it accounted for one-third or more of violations in half of the states (Table 1). Excluding the state with a low identification-request rate, sales after identification requests accounted for more than one-fourth of violations (28.5%; 95% CI: 25.2%–31.9%).

TABLE 1

Retailer Requests for Proof-of-Age Identification and RVRs in Underage Tobacco-Sales Compliance Checks (N = 17 276) From 17 States That Submitted Optional Data in Annual Federal Reports, FFYs 2017 and 2018

Coded StateFFY 2017FFY 2018Combined Years
Estimated Store Population (Weighted n)Asked for Identification, %RVR, %Estimated Store Population (Weighted n)Asked for Identification, %RVR, %Asked for Identification, %RVR, %Violations After Identification Request, %
All 80 416 78.0 10.0 108 312 80.8 8.8 79.6 9.3 22.8 
A 739 98.4 5.4 745 96.2 4.8 97.3 5.1 66.2 
B 5966 92.9 14.1 6013 93.4 9.1 93.1 11.5 56.0 
C 3436 91.7 8.7 3341 91.8 10.5 91.7 9.6 53.1 
D 2194 94.4 10.0 2200 95.6 7.8 95.0 9.0 52.7 
E — — — 8516 90.9 10.7 90.9 10.7 48.4 
F 12 738 82.2 14.3 10 389 78.9 18.5 80.5 16.4 46.6 
G 3167 87.4 4.2 3425 90.0 3.2 88.7 3.7 41.2 
H — — — 1085 96.6 3.4 96.6 3.4 33.3 
I 5463 91.5 5.4 5495 90.8 3.7 91.2 4.6 23.2 
J 2551 95.3 4.5 2835 88.1 9.9 91.1 7.6 21.1 
K 5087 89.8 7.7 4933 86.8 13.0 88.3 10.3 20.3 
L 502 89.0 11.7 535 92.3 4.5 90.6 8.1 18.4 
M — — — 4695 91.2 5.9 91.1 5.9 14.3 
N 29 342 82.1 10.3 28 095 83.6 5.7 82.9 8.0 12.9 
O — — — 5981 85.9 7.1 85.9 7.1 11.4 
P — — — 4811 82.0 18.0 82.0 18.0 10.4 
Q 8887 22.0 17.8 8871 20.4 13.6 21.2 15.7 1.7 
Coded StateFFY 2017FFY 2018Combined Years
Estimated Store Population (Weighted n)Asked for Identification, %RVR, %Estimated Store Population (Weighted n)Asked for Identification, %RVR, %Asked for Identification, %RVR, %Violations After Identification Request, %
All 80 416 78.0 10.0 108 312 80.8 8.8 79.6 9.3 22.8 
A 739 98.4 5.4 745 96.2 4.8 97.3 5.1 66.2 
B 5966 92.9 14.1 6013 93.4 9.1 93.1 11.5 56.0 
C 3436 91.7 8.7 3341 91.8 10.5 91.7 9.6 53.1 
D 2194 94.4 10.0 2200 95.6 7.8 95.0 9.0 52.7 
E — — — 8516 90.9 10.7 90.9 10.7 48.4 
F 12 738 82.2 14.3 10 389 78.9 18.5 80.5 16.4 46.6 
G 3167 87.4 4.2 3425 90.0 3.2 88.7 3.7 41.2 
H — — — 1085 96.6 3.4 96.6 3.4 33.3 
I 5463 91.5 5.4 5495 90.8 3.7 91.2 4.6 23.2 
J 2551 95.3 4.5 2835 88.1 9.9 91.1 7.6 21.1 
K 5087 89.8 7.7 4933 86.8 13.0 88.3 10.3 20.3 
L 502 89.0 11.7 535 92.3 4.5 90.6 8.1 18.4 
M — — — 4695 91.2 5.9 91.1 5.9 14.3 
N 29 342 82.1 10.3 28 095 83.6 5.7 82.9 8.0 12.9 
O — — — 5981 85.9 7.1 85.9 7.1 11.4 
P — — — 4811 82.0 18.0 82.0 18.0 10.4 
Q 8887 22.0 17.8 8871 20.4 13.6 21.2 15.7 1.7 

—, no data available.

View Large

The group of states that required minors to carry identification (n = 4) had a significantly higher identification-request rate than the group that forbade carrying identification (n = 13), although overall RVRs were similar (Table 2). Violations in the carry-identification group were >3 times as likely after identification requests (5.7% vs 1.8%; P < .0001) and constituted more than half (52.6%) of all violations. Adjusted for other factors, carrying identification was associated with >3 times the likelihood of being asked to show identification (aOR 3.69; 95% CI 1.60–8.50) and more than twice the likelihood of being sold tobacco (aOR 2.73; 95% CI 1.71–4.36; Table 3). Purchase attempts of vaping products were 35% less likely than cigarette purchase attempts to trigger an identification request (aOR 0.65; 95% CI 0.51–0.83) and 42% more likely to result in a sales violation (aOR 1.42; 95% CI 1.05–1.91). All store types were nominally less likely, with most being significantly less likely, to commit a sales violation than convenience stores. Sex, age, and year of inspections did not predict identification requests or sales violations.

TABLE 2

Identification-Request Rates and RVRs by Minor Allowed Versus Forbidden To Carry Identification in Tobacco Sales Compliance Checks (N = 17 276) From 17 States Submitting Optional Data in FFYs 2017 and 2018

Identification-Carry ConditionIdentification-Request RateRVR After Identification RequestRVR With No Identification RequestOverall RVRProportion of Violations After Identification Request
Required (4 states), % 92.9 5.7 67.2 10.0 52.6 
Forbidden (13 states), % 76.5 1.8 32.9 9.1 15.0 
P <.0001 <.0001 <.0001 .23 <.0001 
Identification-Carry ConditionIdentification-Request RateRVR After Identification RequestRVR With No Identification RequestOverall RVRProportion of Violations After Identification Request
Required (4 states), % 92.9 5.7 67.2 10.0 52.6 
Forbidden (13 states), % 76.5 1.8 32.9 9.1 15.0 
P <.0001 <.0001 <.0001 .23 <.0001 
View Large
TABLE 3

aORs of Asking for Proof-of-Age Identification and of Selling Tobacco to a Minor in Compliance Checks (N = 17 276) From 17 US States in FFYs 2017 and 2018

Asked for IdentificationSold Tobacco to a Minor
aOR (95% CI)PaOR (95% CI)P
Fixed effects     
 Identification-carry required (ref = forbidden) 3.69 (1.60–8.50) .003 2.73 (1.71–4.36) <.001 
 Product type (ref = cigarettes)     
  Small cigars and/or cigarillos 0.67 (0.37–1.21) .182 1.81 (0.79–4.17) .156 
  Smokeless tobacco 0.56 (0.30–1.05) .071 1.67 (1.00–2.79) .051 
  Ends 0.65 (0.51–0.83) .001 1.42 (1.05–1.91) .024 
  Other, missing 0.55 (0.29–1.04) .067 1.30 (0.40–4.26) .653 
 Business type (ref = gas station)     
  Tobacco store 0.70 (0.51–0.96) .027 0.80 (0.56–1.15) .225 
  Restaurant 0.98 (0.77–1.26) .872 0.73 (0.55–0.95) .022 
  Hotel 1.29 (0.35–4.69) .693 0.45 (0.31–0.64) <.001 
  Grocery store 1.12 (0.89–1.41) .336 0.79 (0.64–0.98) .032 
  Drug store 1.53 (0.86–2.71) .143 0.57 (0.67–0.89) .015 
  Other, missing 0.88 (0.66–1.17) .367 0.67 (0.51–0.89) .006 
 2018 (ref = 2017) 1.10 (0.36–3.34) .856 0.75 (0.39–1.42) .362 
 Male (ref = female) 1.01 (0.76–1.33) .957 0.85 (0.70–1.03) .092 
 +1 y of age (ref = age 15) 0.73 (0.47–1.14) .156 1.34 (0.97–1.84) .070 
 Asked for identification — — 0.03 (0.02–0.06) <.001 
Random effect for state-yearc     
 Variance of intercept 1.15 (0.44–2.98)a — 0.39 (0.13–1.10)b — 
Asked for IdentificationSold Tobacco to a Minor
aOR (95% CI)PaOR (95% CI)P
Fixed effects     
 Identification-carry required (ref = forbidden) 3.69 (1.60–8.50) .003 2.73 (1.71–4.36) <.001 
 Product type (ref = cigarettes)     
  Small cigars and/or cigarillos 0.67 (0.37–1.21) .182 1.81 (0.79–4.17) .156 
  Smokeless tobacco 0.56 (0.30–1.05) .071 1.67 (1.00–2.79) .051 
  Ends 0.65 (0.51–0.83) .001 1.42 (1.05–1.91) .024 
  Other, missing 0.55 (0.29–1.04) .067 1.30 (0.40–4.26) .653 
 Business type (ref = gas station)     
  Tobacco store 0.70 (0.51–0.96) .027 0.80 (0.56–1.15) .225 
  Restaurant 0.98 (0.77–1.26) .872 0.73 (0.55–0.95) .022 
  Hotel 1.29 (0.35–4.69) .693 0.45 (0.31–0.64) <.001 
  Grocery store 1.12 (0.89–1.41) .336 0.79 (0.64–0.98) .032 
  Drug store 1.53 (0.86–2.71) .143 0.57 (0.67–0.89) .015 
  Other, missing 0.88 (0.66–1.17) .367 0.67 (0.51–0.89) .006 
 2018 (ref = 2017) 1.10 (0.36–3.34) .856 0.75 (0.39–1.42) .362 
 Male (ref = female) 1.01 (0.76–1.33) .957 0.85 (0.70–1.03) .092 
 +1 y of age (ref = age 15) 0.73 (0.47–1.14) .156 1.34 (0.97–1.84) .070 
 Asked for identification — — 0.03 (0.02–0.06) <.001 
Random effect for state-yearc     
 Variance of intercept 1.15 (0.44–2.98)a — 0.39 (0.13–1.10)b — 

Adjusted for other covariates shown. ref, reference category; —, not applicable.

a

Residual intraclass correlation coefficient = 0.26 (95% CI: 0.12–0.46).

b

Residual intraclass correlation coefficient = 0.10 (95% CI: 0.04–0.24).

c

Data shown as variance (95% CI).

View Large

More than three-fourths of US tobacco retailers are asking underage tobacco “customers” conducting federally approved compliance checks to show proof of age as required by law, but approximately one-fourth of violations occur after identification is requested. Among states that require compliance-check minors to carry identification, more than half of all sales violations occur after identification requests. In the context of extensive previous findings that federally approved compliance checks underestimate tobacco sales to minors and prevalence of stores that sell tobacco underage, the current results suggest that minors in these compliance checks should carry identification to increase both the rate of identification requests and the rate of detecting violations.

In this study, we also found that retailers were less likely to ask for identification, and more likely to sell, when minors attempted to buy vaping products. This problem, that of easier access to vaping products than to combustible cigarettes, adds urgency to the need for more realistic compliance-check protocols to reduce the adolescent vaping epidemic.

Standards adopted by US motor vehicle administrators require that driver licenses and identifications be vertical for individuals younger than age 21 and horizontal for ages ≥21,12  enabling stores to visually determine if a customer is old enough to purchase alcohol. Results in our study as well as previous studies10,11,13  reveal that vertical identifications have not prevented underage tobacco sales, possibly because the vertical orientation signified the bearer was younger than 21 although the sales age for tobacco was 18.

With tobacco sales now restricted to customers aged 21 or older, stores no longer need to calculate age; vertical identifications provide a clear message that the customer is not old enough to buy tobacco. If youth inspectors universally carry identifications in federally approved compliance checks, this protocol and the age-21 sales threshold could increase enforcement efficacy and simplify the store’s obligation to refuse tobacco sales to individuals younger than age 21.

Our results are based on 17 states from which study-relevant data were accessible. Although the states were not randomly selected, they appear arbitrarily distributed across 7 of 9 US Census divisions (not covered: New England and South Central divisions) and 9 of 10 standard federal regions (not covered: region I). They contain 36.0% of the US population and reported a combined, weighted RVR (10.2%) similar to the overall US rates in 2017–2018 (9.7%–9.6%). Further research can determine if the results apply nationally.

Stores that sell tobacco to underage customers are more likely to be detected and penalized when youth inspectors carry identification during undercover tobacco sales compliance checks. The new age-21 tobacco sales requirement presents an opportunity to require identifications be carried and address other long-standing weaknesses in compliance-check protocols to help combat the current adolescent vaping epidemic.

Prof Levinson conceived and designed the study, analyzed the data, and drafted the initial manuscript; Profs Lee and Jason and Dr DiFranza made important intellectual contributions to the content; and all authors reviewed and revised the manuscript, approved the final manuscript as submitted, and agree to be accountable for all aspects of the work.

FUNDING: No external funding.

aOR

adjusted odds ratio

CI

confidence interval

FFY

federal fiscal year

RVR

retailer violation rate

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Competing Interests

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

Copyright © 2020 by the American Academy of Pediatrics
2020