The tobacco sales ban and tobacco purchases by adolescents: a general population study in The Netherlands.

Background: The study aimed to assess the effect of the introduction on 1 January 2003 of a legal tobacco sales ban in The Netherlands on tobacco purchases by smoking and non-smoking adolescents aged <16 years.

Methods: Two cross-sectional surveys were conducted among adolescents aged 13 through 15 years, one at end 1999 (n = 4751) and the other at end 2003 (n = 13 298).

Results: The percentage of adolescents buying tobacco decreased significantly from 26.3% in 1999 to 10.8% in 2003 (P < 0.001). Further analysis showed that, after the ban, the proportion of smokers among buyers almost tripled [Odds Ratio (OR) = 2.9], while the likelihood of non-smokers buying tobacco decreased strongly (OR = 0.17). A difference in the pattern of purchasing tobacco also emerged after the ban. In 2003, the proportion of smokers buying at least weekly in commercial outlets was larger than in 1999. For non-smokers there was no difference between 1999 and 2003 in the proportion buying weekly. The variety of commercial outlets in which purchases were made increased among both smoking and non-smoking purchasers of tobacco.

Conclusions: Implementation of the 2003 tobacco sales ban has had the (intended) effect of lowering tobacco purchases among adolescents. This was mainly due to the decrease in the likelihood of buying tobacco among those who regard themselves as a non-smoker. The decrease in buying tobacco is associated with a decrease in prevalence of smoking. The sales ban has probably contributed to a stronger decrease in prevalence of smoking.