DiFranza J R
Department of Family Medicine and Community Health, 55 Lake Ave, University of Massachusetts Medical School, Worcester, MA 01655.
Arch Pediatr Adolesc Med. 2000 Sep;154(9):936-42. doi: 10.1001/archpedi.154.9.936.
The Synar Amendment requires states and territories to enact a law prohibiting the sale of tobacco to minors and to enforce that law in a manner that could reasonably be expected to decrease the availability of tobacco to minors.
To determine whether the Department of Health and Human Services (DHHS) and applicant states and territories are complying with the Synar Amendment.
Block grant applications from 59 states and territories describing activities during federal fiscal year 1997.
Whether applicants had enacted a tobacco sales law without loopholes, conducted enforcement inspections, penalized violators, and conducted a valid statewide survey with violation rates below the permissible threshold, and whether DHHS actions were consistent with the statutory requirements of the Synar Amendment.
Three applicants had laws containing loopholes, 8 failed to conduct enforcement inspections, 8 failed to prosecute violators, 6 failed to conduct a valid survey, and 8 failed to demonstrate compliance with violation rate targets. Fifteen applicants failed 1 or more criteria, but none was ultimately penalized by DHHS. Fourteen sources of bias were identified in state survey protocols that could substantially lower reported violation rates.
A few states did a remarkable job with enforcement, while many others made little effort. Because the DHHS regulations are so weak and DHHS is willing to accept biased surveys, states can be in full compliance with the regulations without ever enforcing their laws or having any impact on the availability of tobacco to minors.
《西纳尔修正案》要求各州和领地制定法律,禁止向未成年人销售烟草,并以合理预期能减少未成年人获得烟草机会的方式执行该法律。
确定卫生与公众服务部(DHHS)以及申请的各州和领地是否遵守《西纳尔修正案》。
59个州和领地的整笔拨款申请,描述了1997财年的活动。
申请者是否制定了无漏洞的烟草销售法律、进行了执法检查、处罚了违规者、开展了有效的全州范围调查且违规率低于允许阈值,以及DHHS的行动是否符合《西纳尔修正案》的法定要求。
3名申请者的法律存在漏洞,8名未进行执法检查,8名未起诉违规者,6名未开展有效调查,8名未证明符合违规率目标。15名申请者未达到1项或多项标准,但最终均未受到DHHS的处罚。在州调查方案中发现了14个偏差来源,这些偏差可能会大幅降低报告的违规率。
一些州在执法方面表现出色,而其他许多州则几乎没有付出努力。由于DHHS的规定非常宽松,且DHHS愿意接受有偏差的调查,各州可能在完全遵守规定的情况下却从未执行其法律,也未对未成年人获得烟草的机会产生任何影响。