Interagency collaboration for retailer compliance checks – 3/6/12

Q: A state tobacco control program is the process of collecting data on illegal tobacco sales to youth through retailer compliance checks. They are considering a data collection tool other than Synar. They would like to know if other state programs used a data collection tool/method other than Synar and if any state experienced interagency jurisdiction challenges. The program would like to learn:

• Which state agency is responsible for implementing Synar in your state?
   
• Does your state tobacco program work in collaboration with the agency that implements Synar to collect data on illegal tobacco sales to youth? If not, please describe how your state collected the data and if there were any jurisdiction concerns with implementing compliance checks in retail stores.
   
• Does your state use a method other than Synar to collect data on illegal tobacco sale to youth? If so, what tool was used? Can you share sample materials?

A:

1. Arizona: The Arizona Department of Health Services is responsible for addressing Synar program requirements.
    
   In Arizona, the Department of Health Services (“DHS”) has a program designed to collect Synar data and a separate program designed to enhance enforcement of state laws prohibiting the sale of tobacco products to minors. This program is run through an Intergovernmental agreement with the Attorney General’s Office (“AGO”). Inspections are conducted by the AGO and data is compiled on several aspects of each inspection. This data is shared openly between AGO and DHS. AGO works closely with local law enforcement on all enforcement issues. Most jurisdictions are happy to help. Some courts are more enthusiastic than others about prosecuting the citations that result from failed inspections. AGO maintains and develops relationships with law enforcement officers and local prosecutors to provide as much support for prosecution as possible in an effort to increase citations that ultimately result in penalties to offenders.
    
   AGO uses a custom-designed database for the inspection data. We would be happy to provide samples of our data.
    
   Our inspection program has identified several factors that seem to affect youth access:
    
   • Rural communities/areas that have fewer compliance inspections
      
   • Retail locations near high schools
      
   • Retail locations that are busy and/or understaffed at the time of purchase
      
   • Corporate practices can have a significant impact on youth access rates- active training programs and significant consequences seem to greatly reduce sales to minors
      
   • Licensing tobacco retailers with licensing consequences for sales to minors seems to reduce youth access
      
   We also have data on factors such as age of clerk, type of tobacco product requested, age of volunteer, time of day, availability of electronic age verification equipment, whether the clerk asked the volunteer’s age, and price of the tobacco product.
    
2. New Hampshire: The NH Department of Health and Human Services, Bureau of Drug Abuse agency is responsible for addressing Synar program requirements. The Service works with and contracts with the Division of Liquor Enforcement, as this agency has field agents across the state. The NH DHHS, Tobacco Program wrote the content of the FDA/CTP Retailer Inspection Contract that now sits with the Division of Liquor Enforcement. The three agencies meet quarterly to determine how best to decrease redundancies and advance changes.
    
   Data collection: Synar uses paper and pen, while FDA data are collected using iPhones. Synar and FDA are year round, while Synar used to be a seasonal only check.
    
3. North Carolina: The agency responsible for the Synar requirements in North Carolina is the Division of Mental Health, Developmental Disabilities and Substance Abuse Services, DHHS. In addition to the Synar Inspections, the Division contracts with and collects tobacco compliance checks data from Alcohol Law Enforcement (ALE), which is the state agency designated for enforcement of tobacco and alcohol laws. ALE also has statewide jurisdiction. Because NC does not have a retailer licensing system, ALE's database is likely the most comprehensive list of retail tobacco outlets in the state. GIS mapping of ALE's compliance checks data is used to identify counties with high rates of tobacco sales to minors; patterns of violations across the state; areas for stepped up enforcement; and where to conduct the Red Flag Campaign and other community mobilization activities. The Division also checks annually limited data from the Office of the Administrative Courts (AOC). The AOC collects data on offense codes for selling/purchasing tobacco products in regards to charges and convictions. Unfortunately, it does not collect data on penalties.
    
   Materials that we can share include: sample maps of violation patterns across the state and by ALE district; slides/handouts describing Geocoding/GIS process for mapping the compliance checks data; Red Flag retailer education packets and description of the campaign; and a map of pre/post outcomes for the Red Flag Campaign. The Division is also working with the UNC Gillings School of Global Public Health to create a website for tobacco control coalitions, advocates and youth that would include interactive maps of ALE's tobacco compliance checks data. This website will allow communities to map compliance checks data by county, city or town and to determine where the violations occurred. They may use this information for planning local tobacco prevention and control activities. They will also be able to upload data such as identifying new stores that have opened in their area. The website should be available for public use in the next two months.
    
4. Washington: Washington State uses Synar methodology to determine rates of illegal sales of tobacco to youth. The Department of Social and Health Services is identified as the single state authority and receives the block grant tied to Synar compliance.
    
   • Department of Health receives funding from cigarette licenses as per state statute, and per that same statute distributes funds to local health departments and the Liquor Control Board
      
   • Department of Health also creates the stratified random sample for Synar
      
   • Liquor Control Board conducts the Synar compliance checks except in King County (Seattle) where the health department conducts those checks.
      
   • Liquor Control Board also assesses fines and other administrative actions on any retailer found to be in violation of the law. (Liquor Control Board also receives the FDA contract to enforce federal laws on tobacco.)
      
   Once the Synar forms are completed, they are returned to Department of Health who compiles the data using SAMHSA’s software. We submit the results to DSHS who submits the Synar report to SAMHSA.
    
   We do not have formalized memorandums of understanding with DBHR. We have contracts with Liquor Control Board and the local health departments including King County. Prior to this year, we had health departments in every county conduct Synar compliance checks. This year we are asking LHJ’s to focus their efforts on retailer education and community mobilization with their limited funds except King County who continues to do the Synar checks.
    
   Liquor Control Board has jurisdiction across the state to do compliance checks, and we have not had any jurisdictional concerns. Local health jurisdictions (health departments) have jurisdiction in their county, but with cuts to public health, there were concerns about capacity in some counties.
    
   We have maintained a non-compliance rate of less than 20% since the inception of Synar. You can see our Synar compliance check history here on the DOH website.
    
   Although Synar and non-Synar checks are conducted with the same Synar methodology throughout the state, unfortunately we still do not have a statewide data collection system that collects all Synar and non-Synar inspections in the state. In addition, our youth access FDA inspection data is not currently shared. This lack of a single data collection system makes assessing youth access to tobacco in Washington difficult.
    
5. West Virginia: The Bureau for Behavioral Health (BBH) is responsible for Synar compliance in West Virginia. Our Division of Tobacco Prevention works very collaboratively with BBH. BBH will also be responsible for our FDA-CTP compliance efforts in West Virginia. The other agency in WV who also does compliance checks on illegal tobacco sales to youth is the State Alcohol Beverage Control Administration, but they only inspect those with beer or liquor licenses. ABCA does not share its compliance findings.
    
6. Wisconsin: In Wisconsin, the Department of Health Services Bureau of Substance Abuse contracts with the Tobacco Prevention and Control Program (TPCP) to address the Synar program requirements. The TPCP implements a comprehensive youth access program called Wisconsin Wins (WI Wins) in addition to conducting the Synar checks. The WI Wins program includes year round compliance checks throughout the state and public and media outreach, and involves local public health departments, community agencies and law enforcement. Click here to view the form that is filled out for each compliance check. The information is then entered into the WI Wins database and this is the data that is used to determine each county’s youth access to tobacco rate which you can find on the WI Wins website.
    
   The main difference between the Synar checks and the WI Wins checks is that the Synar checks are conducted using a scientific sample while the WI Wins checks do not use a scientific method.

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