Synar Amendment: Ineffective Because Unenforced
Sale of tobacco to minors still commonplace

September 14, 2000

WORCESTER, Mass. - The majority of states continue to do a poor job of enforcing federal laws that prohibit the sale of tobacco to children, according to an audit conducted by researchers at the University of Massachusetts Medical School (UMMS). "Many state legislatures are more interested in protecting tobacco retailers from being penalized for breaking the law than they are in protecting children from becoming addicted to tobacco," asserts the author of the study, Joseph DiFranza, MD, professor of Family Medicine and Community Health at UMMS.

In 1992, Congress passed the Synar Amendment, which requires states and territories to enact laws prohibiting the sale of tobacco to minors, and to enforce those laws effectively. States are required to report their progress each year to the federal department of Health and Human Services (HHS). States that fail to enforce their laws effectively may lose millions of dollars in federal block grant funds. The DiFranza study, published in the September 2000 issue of the Archives of Pediatric & Adolescent Medicine, entailed an audit of the progress reports from 59 states and territories, describing activities during fiscal year 1997. Applications were evaluated to determine if the state had an appropriate law, if enforcement inspections were conducted, if violators were prosecuted, and if the state had completed a scientific survey to determine the proportion of merchants making illegal sales to children.

The study found that although a few states were doing an excellent job enforcing the law, many were non-compliant. Reasons for non-compliance included failure to conduct enforcement inspections, failure to prosecute violators, failure to conduct a valid survey, and failure to demonstrate compliance with violation rate targets. Moreover, many states certified to the federal government that they had enforced the law, although they had not done so. The study also identifies 14 sources of bias in state survey methods that make violation rates appear lower than they actually are. "Many states failed to enforce the law, yet none of them has been penalized by HHS," stated DiFranza.

"Throughout fiscal 1997, the vast majority of states continued to take in more money from the illegal sale of tobacco to children than they spent to prevent those illegal sales," DiFranza. added. During 1997, it is estimated that youths under age 18 spent $1.86 billion on tobacco, generating nearly $300 million in tax revenue for the states.

The widespread and ongoing sale of tobacco to minors is particularly disturbing in light of the recent findings of another study by DiFranza which revealed that adolescents can become addicted to nicotine much more quickly than was previously thought. DiFranza's study, published in the September 2000 issue of the journal Tobacco Control, revealed that nicotine addiction in youths can occur within days of the onset of occasional smoking.

The University of Massachusetts Medical School is one of the fastest growing medical schools in the country, attracting more than $93 million in research funding annually. A perennial top ten finisher in the annual US News and World Report ranking of primary care medical schools, UMMS is composed of a medical school, a graduate school of nursing, a graduate school of biomedical sciences and an active research enterprise, and is a leader in health sciences education, research, and public service. It is the academic partner of UMass Memorial Health Care.