This study analyzes changes over a three-year period among Ontario retailers selling cigarettes to minors. Under supervision, 13 and 14-year-old minors were sent into stores to attempt to buy cigarettes. These minor-purchase-events (MPEs) were carried out in a local health unit that had implemented a community-based intervention and in an adjoining comparison health unit. After the local program we observed a large reduction (from 46% to 6%) in merchants willing to sell tobacco to minors. In the neighbouring health unit, a high rate of selling continued until a federal program using a similar intervention was implemented, after which a large reduction (from 47% to 2%) was observed. This magnitude of change has been unprecedented, except when active enforcement was implemented by police officers. Thus, from a public health perspective, it is important to understand what is influencing the store operators.
OBJECTIVE: to describe 10 years of experiences of the Swedish National Bicycle Safety Programme which started during 1990 as part of an initiative taken by the World Health Organization (WHO). In relation to WHO's efforts with regard to accident and injury prevention, a global programme to increase helmet-wearing by two-wheel riders was launched. The idea was to introduce a simple 'vaccine' for everyone that was achievable at a low cost. The Swedish initiative was taken up by the Karolinska Institute and the National Institute of Public Health. METHOD: at an operational level, all available methods and data sources were utilized in the programme: surveillance of injuries, provision of information and advice, training and supervision, environment and product improvements, and legislation. RESULTS: considerable progress has been made in reducing bicycle-related injuries in Sweden over the last two decades. Cycling injuries among the elderly must be a matter of particular concern. CONCLUSIONS: our 10 years of experiences from a bicycle helmet promotion programme lead to the conclusion that there is a case for mandatory helmet wearing, as one of the most important strategies on the national level. But regional and community-based efforts will still need to be more comprehensive. Besides this, efforts must be made to intensify the activities of parties already involved in prevention programmes. New target groups must be approached, such as immigrants, vulnerable social groups, and teenagers. Sustainability of the Swedish Bicycle Helmet Initiative Group, including continued participation of group members and organizations, is the key--in the long term--to protecting Swedish bicyclists against head injuries.
To evaluate the effects of the 1977 and 1995 tobacco sales bans on tobacco acquisition of minors.
Biennial nationwide postal surveys (adolescent health and lifestyle survey, AHLS) in 1977-2003; annual classroom surveys (school health promotion survey, SHPS) in 1996-2003.
Entire Finland-12, 14, 16, and 18 year olds (AHLS, n = 80 282); eighth and ninth graders (14-16 year olds) (SHPS, n = 226 681).
Purchase of tobacco from commercial sources during the past month, purchase from different commercial (shop, kiosk, other outlet) and social sources, ease of buying tobacco, overall acquisition of tobacco products, daily smoking, tobacco experimenting.
Decrease in tobacco purchase from commercial sources was small and short term after 1977 but large and permanent after 1995: purchase rate among 14 year old smokers diminished from 90% to 67% in 2003, 16 year olds from 94% to 62%. Purchases in shops decreased most (14 year olds: from 39% to 14%; 16 year olds: from 76% to 27%); purchases in kiosks less. An increase was observed in obtaining tobacco from other outlets and friends (social sources). Only 2-3% of 14-16 year old smokers used commercial sources exclusively when obtaining tobacco. Daily smoking began to decrease after 2001, following an earlier decrease in those experimenting. No changes were observed among age groups not targeted by the ban.
Legislation appears to have permanently changed tobacco sales practices and decreased purchases from commercial sources. Social sources need to be taken into account when controlling access to tobacco. Sales bans should be accompanied by other health promotion measures.