Contextual and community factors associated with youth access to cigarettes through commercial sources.

OBJECTIVES: This study examines contextual and community-level characteristics associated with youth access to tobacco through commercial sources in 50 non-contiguous mid-sized California communities.
METHODS: The study is based on data from access surveys conducted by four confederate buyers (two men and two women) in 997 tobacco outlets. City demographics, adult smoking prevalence, and measures of tobacco outlet density, local tobacco retailer licencing and cigarette tax were included.
RESULTS: Multilevel regression analyses indicated that buyer's actual age, a male clerk and asking young buyers about their age were related to successful cigarette purchases. Buyer's actual age and minimum age signs increased the likelihood that clerks will request an identification (ID). At the community level, a higher percentage of minors, higher education, and a greater percentage of African-Americans were associated with an increased likelihood of a successful purchase. Lower percentage of minors, lower education, lower percentage of African-Americans, and having a local tobacco retailer licencing were associated with the retailer asking for an ID. Additionally, supermarkets charged significantly more for a pack of cigarettes than small markets, whereas, smoke/tobacco shops and drug stores/pharmacies charged less. Higher prices were associated with higher median household income and greater percentage of Hispanics. Findings about community characteristics, however, differed by cigarette brand.
CONCLUSIONS: This study enhances our understanding of the associations between contextual and community characteristics and youth access to tobacco through commercial sources which can help policymakers to identify and target at-risk communities and outlets to decrease youth access to tobacco.