Enforcement of tobacco possession, use, and purchase laws in relation to smoking behavior and attitudes toward smoking among youth
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Despite recent increases in legislation restricting minors' possession, use, and purchase (PUP) of tobacco products, evaluation of PUP laws and their enforcement in relation to youth smoking behavior has been minimal. The three study objectives were: to describe the existence and enforcement of state and local PUP laws; to assess the relationship between PUP laws, including enforcement, and youth smoking behavior and attitudes; and to assess youth awareness, perceptions, opinions, experiences, smoking behavior, and attitudes in communities with PUP ordinances. PUP laws have been controversial; this study assesses the laws and their enforcement from a national perspective. State and local PUP enforcement data were collected via key informant interviews, and state and local PUP enforcement indices were developed. Logit regression was used to analyze the association of PUP laws, with enforcement, and youth smoking behavior and attitudes from nationally representative 8 th , 10th , and 12th grade Monitoring the Future student data (total N = 29,362). Analyses controlled for demographic and state tobacco control policy variables. In addition, four focus groups, involving 25 minors, were conducted in two New Jersey communities with local possession ordinances. Results indicated that purchase laws were the most common state-level PUP law, while possession ordinances were most common locally. Most PUP enforcement occurred in localities, and fines were the most common PUP penalty. State PUP laws were not consistently associated with youth smoking behavior or attitudes, while local possession ordinances were associated with lower odds of current smoking and increased odds of anti-smoking attitudes, especially in the absence of state possession laws. However, PUP enforcement did not have a consistent dose-response relationship with youth smoking behavior or attitudes. Focus group participants did not find local PUP ordinances, or their enforcement, to be effective in influencing youth smoking behavior or attitudes. Study findings do not consistently support PUP laws and their enforcement as effective tobacco control policies to discourage youth smoking. In a tobacco control environment with increasingly limited money and resources, comprehensive tobacco control policies and programs focusing on both youth and adults are important to denormalize smoking in society and can achieve the maximum benefit for the entire population.