Substance Use
Randomized experiment for the effect of warm delivery of tobacco 21 toolkits to retailers in New Orleans James Buckley* James Buckley Daisy Dai
Background: Tobacco use is the leading cause of preventable death worldwide, causing more than 480,000 deaths each year in the United States. The federal Tobacco 21 (T21) law signed in December 2019 raised the minimum legal age of tobacco sales from 18 to 21 years nationwide. The “Tobacco Nation” region, a collection of 13 U.S. states in the South and Midwest, has higher adult and youth smoking prevalence and poorer health outcomes while also lacking effective tobacco control policies laws and tobacco prevention spending relative to the rest of the U.S.
Methods: 100 tobacco retail establishments in the New Orleans metropolitan area were identified and visited twice by covert buyers aged 18-20. The buyer attempted to purchase a tobacco product and recorded if the store pulled down the product and if ID was asked for. A T21 toolkit, composed of T21 materials from the FDA, was delivered to 50 stores in the sample. Following delivery, a second visit occurred where the same attempt to purchase was made by a covert buyer. McNemar’s test was used to compare violation between rounds of inspections overall and by group.
Results: Overall, 37% of stores in the first wave were in violation of T21 laws. 45.83% of the stores in the toolkit group and 28.84% of the stores in the no-toolkit group were in violation of T21 laws during the first inspection. Overall, 24.24% of stores in the second wave were in violation. 21.27% of the stores in the toolkit group and 26.92% of the stores in the no-toolkit group were in violation. The decrease in violations was significant for the toolkit group(p=0.02) and not significant for the no-toolkit group(p=0.85).
Conclusions: The stores which received a T21 toolkit saw approximately a 44% decrease in T21 violations while stores which did not receive a toolkit saw negligible change. This study highlights the importance of retailer education in effectively enforcing youth tobacco use prevention laws.
