2017 Synar Inspection Study
“Activities to increase restrictions on tobacco product sales and availability” are key to reducing the “availability of tobacco products” and “susceptibility to experimentation with tobacco products.” Over time, these activities reduce initiation of tobacco use, the prevalence of tobacco use among young people, and the morbidity and mortality that result from tobacco use (Centers for Disease Control and Prevention [CDC], 2014, p. 21). The Synar amendment and related monitoring of compliance with state laws against selling tobacco products to minors are key parts of tobacco prevention efforts nationally and in Wyoming.
The 2017 (FFY 2018) weighted Synar tobacco retailer violation rate (RVR) was 4.6%, below the federally stipulated maximum of 20.0%. This is also a return to a low RVR after the high RVR in 2016 (FFY 2017; Figure ES-1). WYSAC met the Substance Abuse and Mental Health Administration’s (SAMHSA’s) sample size requirements and their precision requirement of a 3% or smaller margin of error (SAMHSA, 2016). WYSAC satisfied SAMHSA requirements of having a balance of inspections completed by youth of each gender and youth of each age (16 or 17).
As it has been since 2007 (WYSAC 2017a), clerks not asking for identification was the strongest predictor of violations. Overall, the odds of a clerk violating when not asking for identification were 153.0 times higher than when asking for identification. Only two clerks (one cigarette inspection and one smokeless tobacco inspection) asked for identification and then committed a violation by being willing to sell the tobacco product (Figure ES-2).
2017 ENDS Pilot Study
The Wyoming legislature and governor added electronic nicotine delivery systems (ENDS) to Wyoming’s legal definition of tobacco products in the state’s youth access law in 2013 (State of Wyoming, 2013; 2017). In 2015, Wyoming high school students reported greater prevalence of using ENDS than U.S. high school students (Youth Risk Behavior Surveillance System [YRBSS], 2015), and ENDS use has been linked to greater risk for using combustible tobacco products (Leventhal et al., 2015). Because of this law and these dual concerns, the Wyoming Department of Health, Public Health Division (PHD), requested a pilot study to prepare for ENDS to be included in future Synar work and/or other work related to preventing youth access to ENDS.
In 2017, the second year of the ENDS Pilot Study, WYSAC drew a random sample of one-third of the Synar sample to be inspected for ENDS products in addition to the Synar inspections. The ENDS Pilot Study protocol had youth inspectors ask for the two products that are the national market leaders for mass-produced ENDS. Vape shops—retailers that focus on selling ENDS, sometimes to the exclusion of selling traditional tobacco products—were not included in the ENDS Pilot Study. In 2017, inspection teams attempted 114 inspections across the state and completed 63 of them (55.3%, compared to completing 85.5% of all attempted Synar inspections) Although this rate is better than the 2016 raw completion rate for the ENDS Pilot Study (46.1%), it still indicates that incorporating ENDS into official Synar inspections would make it more difficult to meet SAMHSA’s minimum completion rate requirements for Synar.
During the Synar inspections for cigarettes and smokeless tobacco, youth were trained to look for whether cigarettes, smokeless tobacco, and/or ENDS were accessible to customers without asking the clerk. This protocol also serves as a visual inspection for the presence of ENDS in Synar-eligible retailers. Youth noted the location of ENDS in 32.5% of the completed Synar inspections. The results of those often quick visual inspections could underestimate the availability of ENDS in Synar eligible retailers. Still, the fact that it is a low percentage provides additional evidence that these products are often unavailable in Wyoming’s Synar-eligible retailers. Continuing improvements to the Synar retailer list, specifically identifying which stores sell which products, could improve the chances of completing an inspection.
The unweighted violation rate for the ENDS inspections was 4.8% (three violations out of 63 completed inspections). This compares to a violation rate of 11.8% in 2016. In both years, the unweighted violation rates for the Synar Inspection Study (12.0% in 2016 and 5.2% in 2017) and the ENDS Pilot Study were roughly similar.
In 2017, the vast majority (93.4%) of clerks asked the youth inspectors for their identification during the completed ENDS inspections. This indicates that clerks are aware that these products should not be sold to minors. The small number of completed inspections combined with the imbalance in results (90.2% of clerks asked inspectors for identification and then terminated the sale when the inspector did not provide identification) prevented WYSAC from determining whether there is a statistical relationship between asking for identification and violations for ENDS.