Restricting Minors’ Access to Tobacco Products

Research Gaps

What are Research Gaps?

Prior to and during the literature review and data analysis, the review team and the Community Preventive Services Task Force attempt to address the key questions of what interventions work, for whom, under what conditions, and at what cost. Lack of sufficient information often leaves one or more of these questions unanswered. The Community Guide refers to these as "research gaps." Research gaps can be pulled together in the form of a basic set of questions to inform a research agenda for those in the field.

Identified Research Gaps

Effectiveness

The studies identified in this review provide evidence of effectiveness of community mobilization when coordinated with other interventions in reducing both tobacco use among youth and youth access to tobacco from commercial sources. A better understanding of the relative impact of community mobilization on reducing youth demand for tobacco products would assist local programs significantly in setting priorities for future intervention efforts. Research issues identified by others overlap with the questions generated as the result of this review:

• What intervention combinations, intensity, and duration are the minimum required to reduce youth tobacco use?
• What effect, if any, do interventions to reduce youth access to tobacco products through commercial sources have on access through social sources? What effect, if any, do interventions to reduce youth access to tobacco products through social sources have on access through commercial sources?
• What is the required intensity and duration of active enforcement components?
• What effect does decreasing the number of outlets selling tobacco products have on youth access?
• How do age verification devices (such as scanners) affect retailer sales compliance?

Applicability

Community mobilization interventions included efforts to identify and incorporate community concerns. When tailored to resonate with the sociocultural composition of the population, community mobilization combined with additional interventions should be applicable to most U.S. settings. Some questions remain regarding applicability of these interventions in settings and populations other than those studied.

• Are there differences in the effectiveness of or barriers to these interventions in urban and rural settings or in communities that cross jurisdictions?

Other Positive or Negative Effects

This review did not identify any additional positive or negative effects of these interventions

Economic Evaluations

The information available for economic evaluation consisted of a single study evaluating one component (active enforcement directed at retailers) of an effective multicomponent intervention. Considerable research is, therefore, warranted regarding the following questions:

• What are the costs of these interventions?
• What is the cost-effectiveness of these intervention combinations?
• What is the cost-effectiveness, net cost, or net benefit of these intervention combinations when cost-effectiveness analysis includes cost savings of illness averted?
• What combination(s) of components are most cost effective?

Barriers

Significant barriers to implementing interventions to reduce youth access were noted in this review. Research issues important to communities and to local and state governments involving potential barriers include the following:

• What components of community mobilization are most effective in building and maintaining support for retailer compliance with sales laws?
• What components of community mobilization are most effective in building and maintaining support for active enforcement, including the consistent application of effective penalties?
• What aspects of efforts to prevent or to overturn state preemption laws are effective?