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.
To address this issue, we asked:
- 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?
- How do young people describe accessing tobacco and what do they indicate are the barriers to and facilitators of tobacco access?
- 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.
Which sources are most used by young people in the UK?
- Friends, closely followed by shops, are the most frequently reported sources across all young people surveyed.
- Boys, older young people and regular smokers are more likely to use retail sources.
- Girls, younger young people and occasional smokers are more likely to use social sources.
- Meta-analysis confirms that regular smokers are 2.6 times more likely to use retail sources than social sources compared to occasional smokers.
What do young people in the UK say about tobacco access?
- Young people feel ‘it’s easy’ to access cigarettes, given the right strategy.
- They state that friends, shops and proxy purchasing are the most significant sources for them.
- Young age or age-appearance, risk and cost are described as barriers to obtaining cigarettes.
- The sociability and visibility of access and the apparent complicity of adults are described as facilitating tobacco access.
What evidence is available about ways to curtail non-retail access?
- Four broad types of intervention targeting non-retail access have been evaluated: possession laws; retail interventions measuring non-retail access; school policies; and home access restrictions.
- These interventions address some, but not all, of the barriers and facilitators identified by young people, and none tackle proxy purchasing specifically.
- Quality and relevance is low: little methodologically strong research has been conducted in this area, and no UK studies were identified.
Implications for policy, practice and research
- Intervening to prevent tobacco access from social sources will be necessary to prevent young people from starting smoking, as both younger and occasional smokers predominantly depend upon social sources.
- Intervention evidence suggests that more effort has gone into developing retail interventions – possibly due to difficulty of knowing how to tackle social sources – making social sources a priority area for intervention development and evaluation.
- The sociability and visibility of accessing tobacco through friends and peers in schools clearly facilitates this source; targeting the organised exchange of tobacco between young people in schools may be key to reducing this type of access.
- Though raising the purchase age to 18 in the UK appears to have reduced access via shops, it remains one of the most popular routes for young people.
- Patterns of retail access shown in surveys and qualitative data suggest that retail regulation implementation is variable, but where implemented consistently will deter access attempts.
- It is important to explore reasons for, and to identify ways to combat, lax implementation of regulations in smaller stores.
- Sensitive approaches are needed, as young people’s attitudes towards regulation are complex, and increased regulation may serve to heighten the kudos of smoking.
- Qualitative research suggests that proxy purchasing is a significant access route for young people, though the very limited amount of survey evidence available at the time of the review does not support this view.
- Survey data published since the review was conducted validate the qualitative findings.
- Low levels of access using sources that do not require face-to-face contact with a retailer (vending machines, stealing, internet and black market) are reported in comparison to shops and friends.
- Ease of access using other routes may mean that it is unnecessary to use these, but they may become more popular if interventions to tackle access from shops and friends prove successful.
- There is a continuing need for both qualitative and survey research to keep abreast of shifting patterns of access and ‘new’ sources of tobacco.
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.