'You do it through the grapevine'. A qualitative study of how young people in Europe access cigarettes
Rebecca Hewer 1  
,   Sarah Hill 2,   Amanda Amos 1
 
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1
University of Edinburgh, Centre for Population Health Sciences, United Kingdom
2
University of Edinburgh, Global Public Health Unit, United Kingdom
Publication date: 2018-03-01
 
Tob. Induc. Dis. 2018;16(Suppl 1):A551
 
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WCTOH
 
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ABSTRACT
Background:
Reducing youth smoking uptake is a key goal of tobacco control. Article 16 of the FCTC requires governments to prohibit tobacco sales to minors, yet young people continue to access cigarettes despite widely adopted legislation on minimum age of sale. This qualitative study explores the experiences of young people in Europe in accessing cigarettes.

Methods:
Over 50 focus groups were carried out with 15-17 year olds in seven countries across Europe (Belgium, Finland, Germany, Ireland, Italy, the Netherlands, Portugal). Most participants were 15, and all were below the legal age of sale in their country. Focus groups were conducted in the dominant national language and recorded, transcribed and translated into English. Data were analysed to identify key themes in young people's accounts of how they and their peers source cigarettes.

Results:
Ability to access cigarettes was reported in all focus groups. Sources included direct purchase (from shops, vending machines, bars/cafes); proxy purchase (where an older person buys on their behalf); and reciprocal peer sharing arrangements. Participants' accounts indicate that social capital is an important resource in accessing cigarettes across all countries, with young people frequently asking older acquaintances or siblings to purchase for them. Social and cultural capital are also important in the (less common) use of strangers, which required a sophisticated understanding of how to recognise potential proxy buyers. Commercial sources of cigarettes varied by country, with shops (particularly small retailers) more important in some countries (eg Ireland), while vending machines were more commonly used in others (eg Portugal).

Conclusions:
The effectiveness of tobacco sale age restrictions is influenced by broader aspects of the tobacco environment, including social norms and material access to less regulated outlets. Under-age smokers draw on different forms of capital to circumnavigate these legal restrictions, highlighting the importance of a multi-dimensional approach to youth smoking prevention.

eISSN:1617-9625