In the JournalsPerspective

Online age-verification fails to prevent minors from purchasing e-cigarettes

Teenagers in North Carolina were able to buy electronic cigarettes online due to widespread failure of age-verification measures required of Internet tobacco vendors in compliance with North Carolina law.

“From 2011 to 2013, the number of U.S. youth who used e-cigarettes but had never used cigarettes more than tripled from 79,000 to more than 263,000; these youth were almost twice as likely to intend to smoke cigarettes than youth who had never used e-cigarettes,” Rebecca S. Williams, MHS, PhD, from the University of North Carolina at Chapel Hill, and colleagues wrote. “One million adolescents reported purchasing cigarettes, cigars, and smokeless tobacco online in 2012. To our knowledge, no studies have yet examined youth access to e-cigarettes online.”

To determine whether minors were able to successfully purchase e-cigarettes through Internet tobacco vendors, researchers enrolled 11 nonsmoking minors aged 14 to 17 years to visit 98 different tobacco vendor websites and purchase e-cigarettes. The buyers were instructed to visit the websites and attempt to purchase the cheapest available disposable nicotine e-cigarette or — if unavailable — the cheapest nicotine e-cigarette starter kit. The researchers tracked the details of the purchase, including items purchased, cost and age-verification attempts

“We tracked whether e-cigarette sellers provided age verification at delivery, a service offered by UPS, DHL, and FedEx, but not by the U.S. Postal Service,” Williams and colleagues wrote. “When available, buyers chose USPS to assess the proportion of vendors shipping e-cigarettes without the possibility of age verification at delivery.”

The researchers said minors obtained deliveries of e-cigarettes from 76.5% of purchase attempts, with no efforts made by delivery services to verify recipient ages at delivery — 95% of delivered orders were left at the door.

Eighteen orders failed for reasons unrelated to age verification, while only five of the remaining 80 youth purchase attempts were rejected due to age verification, resulting in a youth buy rate of 93.7%. None of the Internet tobacco vendors was found compliant with North Carolina’s e-cigarette age-verification law.

“Federal law should require rigorous age verification for all e-cigarette sales similar to a federal policy under the PACT Act that bans Internet cigarette sales to minors,” Williams and colleagues wrote. “This could be implemented by either the FDA or by expanding the PACT Act to include e-cigarettes. Regardless … without careful enforcement, these laws will be ineffective at restricting e-cigarette sales to minors.”

Disclosure: One researcher reports serving as an expert consultant in litigation against tobacco companies.

Teenagers in North Carolina were able to buy electronic cigarettes online due to widespread failure of age-verification measures required of Internet tobacco vendors in compliance with North Carolina law.

“From 2011 to 2013, the number of U.S. youth who used e-cigarettes but had never used cigarettes more than tripled from 79,000 to more than 263,000; these youth were almost twice as likely to intend to smoke cigarettes than youth who had never used e-cigarettes,” Rebecca S. Williams, MHS, PhD, from the University of North Carolina at Chapel Hill, and colleagues wrote. “One million adolescents reported purchasing cigarettes, cigars, and smokeless tobacco online in 2012. To our knowledge, no studies have yet examined youth access to e-cigarettes online.”

To determine whether minors were able to successfully purchase e-cigarettes through Internet tobacco vendors, researchers enrolled 11 nonsmoking minors aged 14 to 17 years to visit 98 different tobacco vendor websites and purchase e-cigarettes. The buyers were instructed to visit the websites and attempt to purchase the cheapest available disposable nicotine e-cigarette or — if unavailable — the cheapest nicotine e-cigarette starter kit. The researchers tracked the details of the purchase, including items purchased, cost and age-verification attempts

“We tracked whether e-cigarette sellers provided age verification at delivery, a service offered by UPS, DHL, and FedEx, but not by the U.S. Postal Service,” Williams and colleagues wrote. “When available, buyers chose USPS to assess the proportion of vendors shipping e-cigarettes without the possibility of age verification at delivery.”

The researchers said minors obtained deliveries of e-cigarettes from 76.5% of purchase attempts, with no efforts made by delivery services to verify recipient ages at delivery — 95% of delivered orders were left at the door.

Eighteen orders failed for reasons unrelated to age verification, while only five of the remaining 80 youth purchase attempts were rejected due to age verification, resulting in a youth buy rate of 93.7%. None of the Internet tobacco vendors was found compliant with North Carolina’s e-cigarette age-verification law.

“Federal law should require rigorous age verification for all e-cigarette sales similar to a federal policy under the PACT Act that bans Internet cigarette sales to minors,” Williams and colleagues wrote. “This could be implemented by either the FDA or by expanding the PACT Act to include e-cigarettes. Regardless … without careful enforcement, these laws will be ineffective at restricting e-cigarette sales to minors.”

Disclosure: One researcher reports serving as an expert consultant in litigation against tobacco companies.

    Perspective
    John P. Pierce

    John P. Pierce

    This study clearly demonstrates that, although 41 states have laws banning sale of e-cigarettes to minors, over 76% of teens who attempted to purchase over the Internet actually received an e-cigarette product in the mail. It wasn’t that these Internet vendors were unaware of the law, as the vast majority included an age-verification strategy on their website. They just chose a strategy that could not possibly work.

    Furthermore, the reason minors did not receive their ordered product rarely involved a successful age verification. Once again, it has been proven that age-restriction laws without strategies for enforcement are completely ineffective.

    The United States is experiencing a rapid growth of e-cigarette use that appears very clearly related to the unfettered ability of manufacturers to advertise on the broadcast media. Use by minors appears to be increasing exponentially with poly-use (with cigarettes) being a consistent pattern. Thus, the public health success in reducing tobacco use in young people over the past 20 years would appear to be in considerable jeopardy.

    In January the state health officer in California released a report labeling e-cigarettes as a community health threat.

    This report offers detailed information on the harm potential of these products that pediatricians and pediatric specialists can use when confronted with possible consumers of e-cigarettes.

    Reference:

    Chapman R. State Health Officer’s Report on E-Cigarettes. A Community Health Threat. www.cdph.ca.gov/programs/tobacco/Documents/Media/State%20Health-e-cig%20report.pdf.

    • John P. Pierce, PhD
    • Distinguished professor, department of family medicine and public health, Director for population sciences, University of California, San Diego, Moores Cancer Center

    Disclosures: Pierce reports no relevant financial disclosures.