International Journal of Epidemiology, Volume 33, Number 2, pp. 432
IJE vol.33 no.2 © International Epidemiological Association 2004; all rights reserved.
Letter to the Editor |
Use of cigarette vending machines by minors in Italy
1 Osservatorio Fumo, Alcool e Droga, Istituto Superiore di Sanità, Rome, Italy
2 Istituto di Ricerche Farmacologiche ‘Mario Negri’, 20157 Milan, Italy
3 Istituto DOXA, Gallup International Association, Milan, Italy
4 Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, 20133 Milan, Italy
Correspondence: Prof C La Vecchia, Istituto di Ricerche Farmacologiche ‘Mario Negri’, 20157 Milan, Italy. E-mail: lavecchia{at}marionegri.it
Sirs—Cigarette automatic vending machines were rare in Italy until the early 1990s, and were gradually introduced, mainly in urban areas, over the last decade.
We considered the frequency of use of vending machines by minors (aged 13–17), using data from a survey investigating smoking habits, carried out through seven subsequent waves based on nationally representative samples, conducted between March and May 2003. The samples were selected from telephone lists, within strata of age, sex, geographical area, and size of the municipality of residence, in order to be representative of the general Italian population, and included a total of 7210 individuals. Using a ‘quota’ method (by sex and age, i.e. 13–14 and 15–17), a sample was identified of 498 subjects aged 13–17. Data collection was based on telephone interviews, carried out in about 500 municipalities from all of the 20 Italian regions, using automated data collection instruments.1
Out of 498 subjects aged 13–17 interviewed, 60 (12%) were current cigarette smokers, with an average daily consumption of 7.1 cigarettes. Of these, 87% bought their cigarettes themselves, 94% from stores and 35% from vending machines (27% at least twice per week; the proportion is over 100% since some subjects reported both). In Italy, tobacco stores are allowed to sell cigarettes to minors aged 16 and over.
Overall, automatic vending machines accounted for 15% of tobacco sales to Italian minors (22% in the North, 10% in the Centre, 7% in the South of the country). Although these figures are relatively unstable, given the small number of smokers interviewed who were minors, they confirm the interest of the tobacco industry and distribution aimed at tobacco sales to minors,2,3 and indicate that a considerable proportion of cigarette consumption by minors in Italy is linked to automatic vending machines. Consequently, to restrict sales to the youngest, from 2004 vending machines will be closed in Italy between 7 a.m. and 11 p.m., following an agreement between the Minister of Health and the National Tobacco Agency (ETI).
The large majority of cigarettes are however sold in stores, and intervention at this level is also required, with an extension to 18 years of the age limit for buying cigarettes.
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Acknowledgments
This work was supported by the Italian Minister of Health, by the contributions of the Italian League against Tumors. The authors thank Mrs Ivana Garimoldi for editorial assistance.
References
1 Gallus S, Colombo P, Scarpino V, Zuccaro P, Apolone G, La Vecchia C. Smoking in Italy, 2002. Tumori 2002;88:453–56.[Web of Science][Medline]
2 Clark PI, Natanblut SL, Schmitt CL, Wolters C, Iachan R. Factors associated with tobacco sales to minors. JAMA 2000;284:729–34.
3 Ling PM, Glantz SA. Why and how the tobacco industry sells cigarettes to young adults: evidence from industry documents. Am J Public Health 2002;92:908–16.
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