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Federal Fiscal Year 1998

Joseph R. DiFranza, MD

Arch Pediatr Adolesc Med. 2001;155:572-578.

Background  The Synar Amendment requires states and territories to enact a law prohibiting the sale of tobacco to minors and to enforce that law in a manner that could reasonably be expected to decrease the availability of tobacco to minors.

Objective  To determine if the Department of Health and Human Services (DHHS) and applicant states and territories are complying with the Synar Amendment.

Data Sources  Block grant applications from 59 states and territories describing activities during the federal fiscal year 1998.

Measures  Whether applicants had enacted a tobacco sales law without loopholes, conducted enforcement inspections, penalized violators, and conducted a valid statewide survey with violation rates below the permissible threshold, and whether DHHS actions were consistent with the statutory requirements of the Synar Amendment.

Results  Three applicants had laws containing loopholes, 6 failed to conduct enforcement inspections, 7 failed to prosecute violators, 2 failed to conduct a valid survey, and 10 failed to demonstrate compliance with violation rate goals. Fifteen applicants failed 1 or more criteria and 8 were ultimately penalized by DHHS. No measurable progress in reducing violation rates was reported by 30 states, with 16 reporting an increase during the previous year. Twenty-four applicants were granted delays.

Conclusions  States that demonstrated remarkable progress were balanced by states with worsening performance; as a whole there was no significant national progress toward reducing the availability of tobacco to youths. This failure can be attributed to inadequate resources devoted to enforcement and reliance on merchant education in lieu of bona fide law enforcement.

From the Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester.

Corresponding author and reprints: Joseph R. DiFranza, MD, Department of Family Medicine and Community Health, 55 Lake Ave, University of Massachusetts Medical School, Worcester, MA 01655.

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