Abstract
Background
In 2019, the United States (U.S.) raised the legal age of tobacco sales from 18 to 21 (i.e., Tobacco 21 [T21]); however, underage tobacco sales remain widespread, indicating the need to identify factors affecting T21 implementation. We examined whether tobacco product and store type contributed to compliance in three U.S. states: New Jersey (NJ), Nevada ([NV], the first state to require electronic ID verification), and North Carolina (NC).
Methods
In summer 2025, buyers aged 18–20 attempted tobacco purchases (cigarettes, cigarillos, e-cigarettes, nicotine pouches, smokeless tobacco) at 60 randomly selected stores in NJ, 51 in NC, and 66 in NV. Using an electronic survey, buyers recorded whether clerks checked or scanned IDs and completed sales (yes/no). We used Bayesian logistic regression and included fixed effects for store type, product type, and state and random effects for store and buyer.
Results
We completed a total of 2811 purchase attempts. On average, IDs were checked in 80.9% of attempts, and underage sales occurred in 26.8% of attempts. Non-chain convenience stores (vs. chain) had a lower likelihood of ID check (aOR: 0.22, 95% CI: 0.10-0.46), and purchase attempts for smokeless tobacco (vs. cigarettes) had 0.51 (95% CI: 0.31, 0.85) times the odds of ID check. Non-chain (vs. chain) stores were less likely to scan IDs (aOR: 0.11, 95% CI: 0.05-0.26). NV had a lower likelihood of underage sales than other states (aOR: 0.74, 95% CI: 0.22, 2.58).
Conclusions
Underage sales rates were high despite T21 implementation, underscoring the need for continued evaluation and surveillance in the U.S. and other countries considering T21 policies. Store type and tobacco product type are associated with T21 implementation efficacy, which may inform targeted regulatory efforts to improve compliance (e.g., increased compliance checks at non-chain convenience stores). ID scanning may be particularly useful for reducing underage sales.
Key messages
• Across 2,811 underage tobacco product purchase attempts in three U.S. states, underage sales occurred in 1 of 4 attempts.
• Non-chain stores and smokeless tobacco purchases had lower ID-check compliance, suggesting targeted enforcement could strengthen T21 implementation