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Young people’s access to tobacco: a mixed-method systematic review

What do we want to know?

This report describes the findings and methods of a systematic review of research exploring how young people aged 11-18 years access tobacco in the UK. The review was commissioned to support the development of policies to reduce rates of smoking among young people; it sought to understand the relative importance of both retail and social sources of tobacco for young people.

Who wants to know? 

Policy makers, practitioners, researchers, young people, parents.

What did we find?

Data from over 9,000 young smokers in seven surveys revealed friends and shops to be the sources most used by young people in the UK. Shop bought tobacco is far more likely to be purchased from independent newsagents and sweetshops than larger stores such as supermarkets. Access patterns are shaped by age, gender and whether young people are occasional or regular smokers.

Qualitative data from approximately 500 young people in six UK studies revealed that they find it easy to access cigarettes. Young people described friends, shops and proxy-purchasing (asking others to buy cigarettes on their behalf) as their most significant access routes. They also indicated that access is facilitated by the sociability and visibility of access and the apparent complicity of adults, but risk, cost and young age or age-appearance act as barriers to obtaining cigarettes.

We looked for interventions targeting non-retail access and found four broad types that have been evaluated: possession laws; retail interventions measuring non-retail access; school policies; and home access restrictions. The quality and relevance of this research is low: little methodologically strong research has been conducted in this area, and no UK studies were identified.

What are the implications?

Although there is currently a lack of robust evidence about what is effective in curbing access here in the UK, the survey and qualitative data illustrate that both social and retail access need addressing, and indicate potential avenues for action. First, since tobacco exchange amongst friends and peers in schools was described by young people as being ubiquitous, highly organised and very visible, the effectiveness of tighter regulation in schools for reducing social access should be explored.

Second, since the data indicated that where retail regulation is implemented consistently it will deter access attempts, there is a need to explore reasons for, and to identify ways to combat, lax implementation of regulations in smaller stores.

Third, the qualitative evidence also suggests the need to tackle proxy purchasing; survey data published since the review was conducted substantiates this.

How did we get these results?

The review addressed the following questions.

  1. What are the retail and non-retail sources of tobacco used most by young people aged 11 to 18 and do patterns vary according to contextual factors such as age and sex?;
  2. How do young people describe accessing tobacco and what do they indicate are the barriers to, and facilitators of, tobacco access?; and
  3. What kinds of interventions that aim to limit the non-retail supply of tobacco to young people have been evaluated and how do they address the barriers and facilitators identified as significant by young people in the UK?

To answer these questions this report draws together findings from three interconnected pieces of work:

  • A synthesis and statistical meta-analysis of survey data from young people in the UK
  • A synthesis of qualitative research from young people in the UK; and
  • A descriptive map of international research activity examining the impact of interventions on non-retail access.

This summary was prepared by the EPPI Centre.

This report should be cited as:

Sutcliffe K, Brunton G, Twamley K , Hinds K, O'Mara-Eves AJ, Thomas J (2011) Young people’s access to tobacco: a mixed-method systematic review. London: EPPI Centre, Social Science Research Unit, Institute of Education, University of London.

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