By Lisa Rapaport

U.S. regulations require retailers to check ID for everyone under age 27 who tries to buy tobacco products, but half of tobacco and vape shops don’t do this, a 2018 study of California retailers suggests.

Forty-five percent of tobacco and vape shops sold e-cigarettes and vaping supplies to researchers posing as underage shoppers, the analysis also found. Sales violations were more common with vaping products than with traditional cigarettes.

“We don’t know why underage sales were more common for vape products than cigarettes, however, young people are more likely to use vape products rather than cigarettes,” said lead study author April Roeseler of the California Tobacco Control Program at the California Department of Public Health in Sacramento.

Between the 2016 and 2018 school years, vaping among California high school students increased by 27%, rising from 8.6% to 10.9%, while use of all other tobacco products decreased, Roeseler said by email.

Only 2% of California high school students smoke cigarettes. Among California adults under age 30, 9.4% use vape products, compared to only 1.8% of adults over age 30.

“Flavored products seem to be fueling the rise in these products,” Roeseler added.

Across the U.S., vaping surged 78% among high school students from 2017 to 2018, according to the U.S. Centers for Disease Control and Prevention, a spike driven largely by flavored vaping products. In an effort to combat this trend, the U.S. Food and Drug Administration announced its intent to limit sales of flavored tobacco products, with the exception of menthol, to age-restricted adult-only locations like tobacco and vape shops.

The study results, however, suggest that limiting sales to tobacco and vape shops won’t help and might actually hurt efforts to curb underage smoking and vaping.

That’s a problem because habits that start at an earlier age may be more likely to stick.

“Nicotine is very addictive and is detrimental to the developing brain, whether administered via cigarettes or vaping products,” said Jessica Barrington-Trimis, an assistant professor of preventive medicine at the University of Southern California in Los Angeles.

“The earlier that kids begin using nicotine, the greater the likelihood of the development of addiction and the harder it is to quit using nicotine products,” Barrington-Trimis, who wasn’t involved in the study, said by email. “There is also a substantial literature showing that youth who vape are significantly more likely than those who have not vaped to subsequently begin smoking and to follow a similar trajectory into more frequent cigarette use patterns.”

California raised the legal age of tobacco sales from 18 to 21 in 2016. Researchers posing as shoppers in the study appeared to be 18 to 19 years old, below the legal age for purchasing these products in California.

They were randomly assigned to buy either traditional cigarettes or vape products at tobacco and vape shops, liquor stores, small markets, convenience stores, and pharmacies in California.

Among all the stores, pharmacies were the most likely to check for IDs and the least likely to sell tobacco and vaping products to underage shoppers.

“Violations could be even more frequent elsewhere, given notably strong local tobacco control policies and anti-vaping public messaging in California,” said Benjamin Chaffee of the Center for Tobacco Control Research and Education at the University of California San Francisco.

Still, the study findings “challenge the assumption that limiting the sales of vape products to adult-only tobacco and vape shops will successfully reduce youth access to these products,” Chaffee, who wasn’t involved in the study, said by email. “On the contrary, these establishments were the most likely to sell to youth.”

SOURCE: JAMA Pediatrics, online June 24, 2019.