Adolescent access to cigarettes contributes to initiation of smoking.1–4
There is some evidence that children of smokers are more likely to begin smoking at an early age, that they are most likely to procure their cigarettes from home (with or without parental knowledge), and that this group helps to 'seed' smoking among their peers.5,6 Whoever supplies their early cigarettes, once smoking is initiated, young smokers adapt their means of access to fit the prevailing social and legislative environment.7
Data from the Australian Secondary School Students' Alcohol and Drug Survey in 2008 showed that the most common ways for adolescents to access cigarettes was through friends (45% of current smokers) and asking someone else to buy them (17% of current smokers).8 Although it is illegal to sell tobacco products to children under the age of 18 years in all states and territories of Australia, overall, 20% of current smokers aged 12–17 years in 2008 reported that they bought their last cigarette (compared with 23% in 2005). Some jurisdictions have reported lower rates of children purchasing tobacco compared to the national data. For example, in New South Wales in 2008, fewer than 1 in 10 students (8.7%) aged 12–17 years purchased their last cigarette (compared with 22% in 2002 and 20% Australia wide). In South Australia 15% of students aged 12–17 years purchased their last cigarette in 2008 (compared with 19% in 2002). In general, the likelihood of having made a personal purchase increases with age, and with frequency of smoking behaviour.
In 2008, 19% of all students thought it would be 'very easy' or 'easy' for them to purchase cigarettes. The proportion believing this increased with age and peaked among boys aged 17 years at 39%.8 Almost half (49%) of all students thought it would be easy or very easy to get someone else to buy cigarettes for them and this belief increased with age. Among current smokers aged 12–17 years, 49% of male and 38% of female students thought it would be easy or very easy for them to buy cigarettes themselves. The majority of current smokers (81%) thought it would be easy or very easy to get others to buy cigarettes for them.
Consistent with efforts by states and territories to strengthen and enforce legislation to reduce illegal sale of tobacco to children, trend data show that there has been a large decrease over time in the proportion of current smokers purchasing their cigarettes. In 1987 more than half of students aged 12–17 years purchased their last cigarette compared with 20% in 2008–see Section 5.21 for further details.
Data from the National Drug Strategy Household Survey (2010) also confirm that the majority of young people generally obtain cigarettes from friends and relatives. In 2010, 60% of young people aged 12–17 years surveyed obtained their cigarettes from a friend, acquaintance or relative and 31% purchased cigarettes from a retailer or through the Internet. About 9% obtained cigarettes through other sources (including stealing).9
Research from New Zealand shows that students with both parents smoking were much more likely to obtain cigarettes from family than students with neither parent smoking. Socio-economic status and living in highly populated areas were also factors significantly associated with purchase of tobacco.6
For a small number of young smokers, problems of availability and affordability of tobacco may be in part ameliorated by use of unbranded, untaxed loose tobacco, commonly known as 'chop-chop'. The 2007 National Drug Strategy Household Survey10 reports that of young people aged 14–19, 32.6% were aware of chop-chop, and 4.5% had used it. Note however that fewer than 0.1% (+/–.05%) report using it 'half the time or more'.10 Analysis of the 2007 data set by Cancer Council Victoria showed that no young people aged 14 years were current users. The report on the 2010 survey9 does not include data by age. Analysis of the 2010 data set by Cancer Council Victoria showed that 7% of smokers under 18 years of age were using chop-chop. Once again only about 1% of smokers were using it half the time or more. None of respondents aged 14 years interviewed had ever used chop-chop (personal communication on selected findings from the dataset of the 2010 National Drug Strategy Household Survey to M Scollo, Cancer Council Victoria, from M Zacher, 2011).
Some studies have suggested that adolescent smoking may also be influenced by the density of tobacco retail outlets. A California study found that the prevalence of current smoking was three percentage points higher at schools in neighbourhoods with a high density of retail outlets (more than five tobacco outlets) compared with neighbourhoods without tobacco outlets.11 For discussion about prevention initiatives focused on tobacco access and supply, see Section 5.21.
1. US Department of Health and Human Services. Preventing tobacco use among young people: a report of the Surgeon General, 1994. Atlanta, Georgia: Public Health Service, Centers for Disease Control and Prevention, Office on Smoking and Health, 1994. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/sgr_1994/index.htm
2. Tyas S and Pederson L. Psychosocial factors related to adolescent smoking: a critical review of the literature. Tobacco Control 1999;7(4):409–20. Available from: http://tobaccocontrol.bmj.com/cgi/content/full/7/4/409
3. US Department of Health and Human Services. Reducing tobacco use: a report of the Surgeon General. Atlanta, Georgia: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2000. Available from: http://www.cdc.gov/tobacco/sgr/sgr_2000/index.htm
4. Sargent J and DiFranza J. Tobacco control for clinicians who treat adolescents. CA A Cancer Journal for Clinicians 2003;53(2):102-23. Available from: http://caonline.amcancersoc.org/cgi/reprint/53/2/102
5. DiFranza J and Coleman M. Sources of tobacco for youths in communities with strong enforcement of youth access laws. Tobacco Control 2001;10:323-8. Available from: http://tobaccocontrol.bmj.com/cgi/reprint/10/4/323
6. Nelson R, Paynter J and Arroll B. Factors influencing cigarette access behaviour among 14-15-year-olds in New Zealand: a cross-sectional study. Journal of Primary Health Care 2011;3(2):114–22. Available from: http://www.rnzcgp.org.nz/assets/documents/Publications/JPHC/June-2011/JPHCOSPNelsonJune2011.pdf
7. Dent C and Biglan A. Relation between access to tobacco and adolescent smoking. Tobacco Control 2004;13(4):334–8. Available from: http://tc.bmjjournals.com/cgi/content/abstract/13/4/334
8. White V and Smith G. Tobacco use among Australian secondary students. Australian secondary school students' use of tobacco, alcohol, and over-the-counter and illicit substances in 2008. Canberra: Drug Strategy Branch Australian Government Department of Health and Ageing, 2009. Available from: http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/Publishing.nsf/content/school08
9. Australian Institute of Health and Welfare. 2010 National Drug Strategy Household Survey: survey report. Drug statistics series no. 25, AIHW cat. no. PHE 145. Canberra: AIHW, 2011. Available from: http://www.aihw.gov.au/publication-detail/?id=32212254712&libID=32212254712&tab=2
10. Australian Institute of Health and Welfare. 2007 National Drug Strategy Household Survey: detailed findings. Drug statistics series no. 22. AIHW cat. no. PHE 107. 2. AIHW, 2008. Available from: http://www.aihw.gov.au/publication-detail/?id=6442468195
11. Henriksen L, Feighery E, Schleicher N, Cowling D, Kline R and Fortmann S. Is adolescent smoking related to the density and proximity of tobacco outlets and retail cigarette advertising near schools? Preventive Medicine 2008;47(2):210–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18544462