Objective-To determine if the standard compliance check protocol is a valid
measure of the experience of underage smokers when purchasing tobacco in u
Setting-160 tobacco outlets in eight Massachusetts communities where undera
ge tobacco sales laws are vigorously enforced.
Procedure-Completed purchase rates were compared between underage smokers w
ho behaved normally and inexperienced non-smoking youths who were not allow
ed to fie or present proof of age (ID).
Results-The "smoker protocol" increased the likelihood of a sale nearly six
fold over that for the non-smokers (odds ratio (OR) 5.7, 95% confidence int
erval (Cl) 1.5 to 22). When the youths presented an ID with an underage bir
th date, the odds of a completed sale increased dramatically (OR 27, 95% CI
3.4 to 212). Clerks judged to be under 21 years of age were seven times mo
re likely to make an illegal sale (OR 7.6, 95% Cl 2.4 to 24.0).
Conclusions-Commonly used compliance check protocols are too artificial to
reflect accurately the experience of underage smokers. The validity of comp
liance checks might be improved by having youths present ID, and by employi
ng either tobacco users, or non-tobacco users who are sufficiently experien
ced to mimic the self confidence exhibited by tobacco users in this situati
on. Consideration should be given to prohibiting the sale of tobacco by ind
ividuals under 21 years of age.