Retailers’ Compliance with Federal Age of Cigarette Sales Policies – Pitt County, North Carolina, January–March 2022

Background Tobacco use remains a leading cause of preventable morbidity and premature mortality. In December 2019, the federal age of sale for tobacco products increased from age 18 to age 21. This study aimed to evaluate the implementation of federal Tobacco 21 policies in Pitt County, North Carolina, by conducting multiple purchase attempts for cigarettes. Methods Stores in Pitt County that sold cigarettes were randomly sampled and visited by up to six different underage buyers (aged 18–20 years) who attempted to buy cigarettes from January to March 2022. Buyers made a total of 217 cigarette purchase attempts from 49 Pitt County retailers. Analyses were conducted using SPSS Complex Samples (v.28/Macintosh) to estimate retailer prevalence of requesting identification (ID) and selling to underage buyers across multiple purchase attempts. Results On average, retailers failed to request ID in 15.4% of purchase attempts (95% CI; 9.4%–21.3%) and sold to an underage buyer 34.2% of the time (95% CI; 27.0%–41.4%). Additionally, 75.5% (95% CI; 63.4%–84.6%) of retailers sold to an underage buyer at least once. Limitations This study is limited to a single county in North Carolina and to underage buyers aged 18 to 20 years. Conclusions There is widespread noncompliance with federal age-of-sale policies for tobacco products in Pitt County, North Carolina. State enforcement is warranted, and North Carolina’s youth access law should be amended to match the federal age of sale. Changes to the law should allow research involving underage purchases.