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Nicotine Tob Res. 2018 Nov 8. doi: 10.1093/ntr/nty238. [Epub ahead of print]

Youth Access to Tobacco Products in the United States: Findings from Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) Study.

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Geisel School of Medicine at Dartmouth/Norris Cotton Cancer Center, Lebanon, NH.
Geisel School of Medicine at Dartmouth, Lebanon, NH.
Westat, Rockville, MD and Georgetown University, Washington, DC.
New York University, New York, NY.
National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD.
Food and Drug Administration, Center for Drug Evaluation and Research.
Food and Drug Administration, Center for Tobacco Products.
Roswell Park Cancer Center, Buffalo, NY.



Tobacco products in the US market are growing in diversity. Little is known about how youth access tobacco products given this current landscape.


Data were drawn from 15-17 year olds from the Wave 1 youth sample of the US nationally-representative Population Assessment of Tobacco and Health (PATH) Study. Past 30-day tobacco users were asked about usual sources of access to 12 different tobacco products, and if they had been refused sale due to their age.


Among 15-17 year olds, social sources ("someone offered"/"asked someone") were the predominant usual source of access for each tobacco product. "Bought by self" was the usual source for users of smokeless (excluding snus; 23.2%), cigarillos (21.0%), cigarettes (13.8%), hookah (12.0%), and e-cigarettes (10.5%). Convenience stores/gas stations were the most often selected retail source for all products except hookah. Among youth who attempted purchase, 24.3% were refused sale of cigarettes; 23.9% cigarillos, and 13.8% smokeless tobacco.


Most 15-17 year old tobacco users obtain tobacco products through social sources, however among those who purchased tobacco, the vast majority report not being refused sale due to age. At the time of survey, cigarette and cigar sales to <18y were prohibited in all 50 states, and e-cigarettes sales in 47 states and two territories. 2014 Annual Synar Reports signaled increasing trends in retail violations of state/district laws prohibiting tobacco product sales to under 18y. Monitoring illicit youth sales, conducting compliance check inspections, and penalizing violations remain important to reduce youth tobacco access at retail venues.


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