Logging On, Lighting Up

Internet sites lure smokers and kids with cheap cigarettes

TUESDAY, Dec. 11, 2001 (HealthDayNews) -- Internet tobacco vendors, many of whom offer illegal tax-free or duty-free cigarettes and some of whom sell to minors, may be the biggest threat yet to tobacco regulation in the United States, two new studies warn.

American tobacco control researchers are calling for tough state, federal and international regulation of Internet cigarette sales across the United States. Those sales, according to analysts' estimates, could rise to between 14 percent and 20 percent of all tobacco sales within the next decade. Right now, overall annual sales of tobacco products are over $40 billion.

The findings appear in the December issue of the journal Tobacco Control.

In the first study, researchers at the University of North Carolina at Chapel Hill used the top five Internet search engines during January 2000 to find English-language, U.S.-based Internet cigarette vendors (ICVs).

Lead author Kurt Ribisl, an assistant professor of health behavior and health education, found 88 such Web sites, operating in 23 states in the United States. Of those, 43 were clustered in New York State, followed by nine in Virginia and four in North Carolina.

Forty-nine of the ICVs were based on Indian reservations, 80 percent of which are in New York State. Attempts to regulate sales on these Web sites could be particularly difficult, says Ribisl, because treaty rights define reservations as sovereign territory, and several reservations have said that state laws don't apply to them.

The sites sold a wide variety of tobacco products: 97 percent offered widely available brands, 18 percent sold clove cigarettes, and 8 percent sold bidis, which are small tobacco cigarettes from India wrapped in a leaf.

Nineteen sites sold duty-free Marlboros and gray-market cigarettes that were banned by the 1998 multibillion-dollar, multistate Master Settlement Agreement, which settled states' lawsuits against the tobacco industry for tobacco-related health costs.

Several sites sold cigars and loose tobacco, and two sites sold tobacco seeds and a kit with instructions for growing and making your own cigarettes.

The sites offer a multitude of purchasing methods and payment options. Forty-six sites offered delivery by United Parcel Service, while 33 sites used the U.S. Postal Service.

Although 81.8 percent of the sites featured a warning about the minimum legal age for buying tobacco products, only 28.4 percent carried a U.S. Surgeon General's warning about smoking's potential health risks, which include lung cancer, emphysema, coronary heart disease and stroke.

Ribisl says that some ICVs would calculate how much the user smoked based on the ordering patterns and would offer a standing monthly order option. Others offered referral bonuses for e-mailing friends about the site.

"There's a whole new growth in Internet marketing strategies that are being employed that are potentially alarming and need to be examined," he says.

In the second study, scientists in California focused on whether adolescents were buying cigarettes online. Led by Jennifer Unger, associate director of the University of Southern California's Transdisciplinary Tobacco Use Research Center, the team surveyed 17,181 10th- and 12th-grade students from 86 California schools during the 1999-2000 school year.

The students filled out a questionnaire on whether they had tried to buy cigarettes online in the previous year. The form also asked for information about each student's smoking habits and experiences with trying to buy cigarettes. (For example, whether they had been asked for photo identification, as required by state law.)

The 1,689 students in the survey group who were current smokers were split evenly by gender and were ethnically diverse. Unger and her colleagues found that among that group, only 2.2 percent had tried to buy cigarettes online. Of those, 32 percent reported that the Internet had been the source of their most recent cigarette purchase.

Aside from the Internet, the students said they bought cigarettes from liquor stores, gas station stores and small markets. Fewer than 25 percent of the students said that they had been asked for ID or had been refused by a cigarette merchant in the last month, and 94 percent said that getting cigarettes was "easy" or "very easy."

As more homes gain access to the Internet, and as the number of ICVs increase, Unger says more teens will try to buy cigarettes online.

But she adds, parents can take several steps to try to prevent this from happening.

"They can talk to their kids about smoking and encourage them not to smoke," Unger says. "Second, they can monitor their kids' use of the Internet, to make sure their kids aren't using the Internet to buy cigarettes. Third…if the kids have access to credit cards, check the credit card bill and inquire about any unfamiliar charges. If the kids are buying money orders at stores with cash, and suspicious packages are arriving at the house, find out what's in the packages."

What's needed, Unger says, are tough laws requiring that Web sites verify their customers' ages and not deliver to minors.

"Although the number of teens who tried to buy cigarettes in 1999-2000 was fairly low, anyone who sells cigarettes to minors is breaking the law and endangering the health of our country's youth," she says. "We need to be proactive and stop this now before online cigarette sales to minors increase even more."

In an accompanying editorial in the journal, a group of Canadian tobacco control researchers suggests that youths will turn to the Internet as it becomes more difficult for them to buy cigarettes in retail stores.

Joanna Cohen, a scientist at the Ontario Tobacco Research Unit in Toronto, says she expects to see more ICVs in the future. "We're at the early stages of a problem," says Cohen. "It has the potential for getting a lot worse."

Rep. Martin Meehan, D-Mass., introduced a bill yesterday to ban the Internet sale of tobacco products to minors. But Ribisl says that international regulations also need to address Internet tobacco marketing and sales.

Next month, the North Carolina group is planning to expand its study to include English-language ICVs from around the world.

What To Do

Smoking-related diseases claim the lives of more than 400,000 Americans every year. If you smoke, talk to your physician about a plan to help you quit permanently.

For more information about how smoking affects health, visit the American Lung Association Web site, or the Centers for Disease Control and Prevention's Tobacco Information and Prevention Source. For more on Meehan's bill, read this.

The Campaign for Tobacco-Free Kids publishes this article on tobacco advertising on the Internet. (You need Adobe Acrobat Reader to open this file.)

SOURCES: Interviews with Jennifer B. Unger, Ph.D., research assistant professor, Institute for Health Promotion and Disease Prevention Research, and associate director, University of Southern California Transdisciplinary Tobacco Use Research Center, University of Southern California, Alhambra, Calif.; Kurt M. Ribisl, Ph.D., assistant professor, Department of Health Behavior and Health Education, University of North Carolina School of Public Health, Chapel Hill, N.C.; Joanna E. Cohen, Ph.D., scientist, Ontario Tobacco Research Unit, and assistant professor, department of Public Health Sciences, University of Toronto, Ontario; December 2001 Tobacco Control
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