Majority of tobacco retailers comply with tobacco age law

State officials this week touted a new survey that showed Kentucky retailers have reached record-level compliance with a state law tobacco shopsthat prevents tobacco sales to minors. However, Kentucky’s youth still rank second highest in the nation for smoking, and smoking among Warren County teens is even higher than the state average.

The problem is not retail access, according to health experts, it is social access and cultural norms in the tobacco belt of southcentral Kentucky.

The 2009 Annual Synar Buying Survey of retail tobacco outlets - mandated under the 1992 Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act, which includes the Synar Amendment aimed at decreasing youth access to tobacco - shows that 96.5 percent of retailers in 2008 complied with the law barring tobacco sales to anyone under 18.

Yet Kentucky ranks behind only West Virginia for youth cigarette use. Twenty-five percent of school students in Kentucky smoke on a regular basis compared with 23 percent nationally, according to the Centers for Disease Control and Prevention. In Warren County, the Foundation for a Healthy Kentucky estimates the rate of teenage smokers is as high as 26 percent.

“Retailers got the message,” said Johnnie Woods, spokeswoman for the Kentucky Cabinet of Health and Family Services’ Mental Health and Substance Abuse Division. “The problem is social access.”

Research has identified the availability of tobacco as a risk factor for youth, and there are two types of availability: illegal retail and social. A Warren County community assessment by the Save Our Kids Coalition showed zero reported sales to minors from 2004 to 2007 in the most recent data.

“That’s excellent news, but in southcentral Kentucky, our biggest issue with availability is ‘social,’ where youth are obtaining tobacco from family and friends,” said Eric Gregory, executive director of the coalition.

Save Our Kids research shows that 32 percent of seventh-graders in Warren County report that tobacco is “fairly easy” or “very easy” to get, a trend that continues to increase through the 12th grade, where the percentage rises to 75.8. Further, one in 5.5 fifth-graders and one in four sixth-graders report that tobacco is “easy to get.”

Finally, the elementary version of the survey asks students where they get their tobacco.The largest percentage of fifth-graders report getting tobacco from “home.” For sixth-graders, “home” is only barely second to the “other” category, which includes multiple locations such as grandparents, on the street or in a store.

“This just further supports the impact of social availability on tobacco use with our youth,” Gregory said.

There are, however, other risk factors, such as peer influence, that tend to have a slightly greater effect than availability. But availability still rates high when looking at predicting local youth use of tobacco, he added.

“The bigger issue at hand is the community norms surrounding youth use of tobacco in our area,” Gregory said. “The message that we as parents, peers, teachers as a community send to our youth about tobacco use is the most important factor. If someone wants to protect the youth in their lives from tobacco use, or any drug use for that matter, they need to invest in building relationships with youth and sending a clear message that the expectation is that they not use. And, they had better begin sending this message starting in early elementary school.”

But cultural norms are slow to change, and Warren County’s history is deeply rooted in the culture of tobacco. In September 2007, when a proposed ordinance was voted down with a split vote of 3-2, Bowling Green City Commissioners made the city the largest in Kentucky without a clean indoor air ordinance.

Youth smoking rates are a concern, but there has been a decline in the state overall from 2000 to 2008, noted Kentucky Department for Public Health Commissioner Dr. William Hacker.

The Kentucky Youth Tobacco Surveys 2000 to 2008 show an overall decline in youth smoking, with Kentucky’s middle school youth smoking in 2000 at 22 percent compared with 9.7 percent in 2008.

“Data shows that Kentucky is going in the right direction,” Hacker said. “Kentucky has come a long way in reducing smoking prevalence through programs like compliance monitoring, awareness and prevention campaigns, local tobacco ordinances and increases in cigarette taxes, but there is more work to do. Kentucky is behind the curve when it comes to tobacco prevention and cessation because of the long history of growing tobacco. Though there are many risk factors for smoking, the most prevalent are family history, socioeconomic status and level of education - along with what has historically been our state’s tobacco-friendly culture.

“We are, however, decades behind states like California, Massachusetts and New York,” Hacker added. “Additionally, Kentucky does not spend as much as other states on prevention and cessation and spends far less than CDC’s recommendation. As for what communities can do, we strongly support tobacco prevention and cessation aimed at youth. We would also point out that communities that have passed local secondhand smoking ordinances (smoking bans) have seen an accelerated decrease in youth smoking.”

Carol Douglas, health educator for the Barren River District Health Department, said that while the retail survey is welcome news, local health officials are still very concerned with the use of tobacco among youth here, and educational measures are still a focus for children from kindergarten through college age.

“Compliance is something to be proud of, but there is still work to be done. Youth smoking is still a serious concern here,” she said.

That concern is not limited to just smoking tobacco. The use of spit tobacco is also a problem but is harder to detect, Douglas said.

But as smaller working farms become a thing of the past and the tobacco industry continues to evolve, tobacco production in Warren County continues to decline and social attitudes continue to evolve. Some youth leaders are meeting the challenge head on, and many schools are doing a lot to address the issue, Douglas said. For example, Western Kentucky University recently hosted a Tobacco Youth Conference.

The state is also taking a proactive role. In addition to vendor compliance checks, Gov. Steve Beshear recently announced a partnership with the Legacy Foundation to promote the “Become an Ex” campaign - a mass marketing campaign to encourage people to stop smoking - across the state.

Similarly, Kentucky legislators voted during the 2009 legislative session to increase the state excise tax on cigarettes by 30 cents, bringing the state tax to 60 cents per pack effective April 1, 2009.

At the national level, federal law authorizes the Substance Abuse Prevention and Treatment (SAPT) Block Grant, which requires states to enact and enforce laws designed to reduce the availability of tobacco products to people younger than 18. States must conduct an annual buying survey using a scientific random sample study protocol approved by the federal Center for Substance Abuse Prevention, and must demonstrate that its noncompliance rate does not exceed the target of 20 percent for illegal tobacco sales to minors. The SAPT Block Grant, administered by the Cabinet of Health and Family Services, is the single largest funding stream in Kentucky supporting substance abuse prevention and treatment.

The Synar Amendment, named for the late Rep. Mike Synar of Oklahoma, requires states, the District of Columbia and the eight U.S. jurisdictions to keep sales below 20 percent. The amendment requires states to enact and enforce laws prohibiting the sale or distribution of tobacco products to individuals under 18 years of age or lose 40 percent of their SAPT funding.

Tobacco use remains the leading cause of death and disease in the United States, with more than 400,000 deaths annually attributed to smoking, according to federal data.

By LIZ SWITZER, Daily News
December 6, 2009

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