September 14, 2009

Dr. Kurt Ribisl tracks one of the many websites that offer online purchase of tobacco products.

Dr. Kurt Ribisl tracks one of the many websites that offer online purchase of tobacco products.

The drop in the number of Americans who smoke, from 42.4 percent in 1965 to just under 20 percent in 2007, is touted as one of the great public health success stories in the 20th century.

Given the well-known link between smoking and lung cancer, Kurt Ribisl, PhD, is working to ensure that success doesn’t falter because of the growing number of people selling tobacco online.

“We’ve made outstanding progress in reducing tobacco use,” says Ribisl, an associate professor of health behavior and health education in the UNC Gillings School of Global Public Health. “We don’t want (these gains) unraveled by a new system of marketing and distribution through the Internet.”

For the past decade, Ribisl has led a team of researchers who have tracked the number of online cigarette vendors. That research has potential for widespread benefits, as it could lead to Internet regulations for hand guns and alcohol as well as cigarette sales to minors.

In January 2000, Ribisl’s researchers identified 88 unique domestic Internet cigarette vendors by entering key words such as “discount cigarettes” and “tax-free cigarettes” into several search engines. By January 2005, 664 Internet cigarette vendors in the United States and abroad were identified through automated searching strategies developed by a private online risk-monitoring and management firm.

The problem with many of these vendors is twofold, says Ribisl, who published his findings in a chapter of the book, Ending the Tobacco Problem: A Blueprint for the Nation. First, many online tobacco vendors do not charge excise taxes. Further, many do not take steps to prevent minors from purchasing cigarettes.

Excise taxes can serve as a great deterrent to smoking. Now, however, smokers can find cheaper cigarettes online, Ribisl noted in the book. In fact, smokers in areas with high cigarette taxes, such as New York or Illinois, are more likely to buy cigarettes online than those who live where taxes are lower, such as North Carolina, Ribisl found.

“The Internet is now providing a back channel, a way for people to avoid those higher prices at stores,” says Ribisl, who also serves as director of the UNC Coordinating Center of the Cancer Prevention and Control Research Network, whose members conduct community- based participatory cancer research.

Another downside to sidestepping tobacco excise taxes is that federal and state governments depend on the money generated from them, and some proceeds often go to cancer screening or tobacco-control programs. No published estimates of the tax revenue lost have been peer-reviewed, Ribisl said. He notes, however, that North Carolina has a fair number of online cigarette vendors and gains tax revenue because those vendors are selling and shipping to customers in states with higher taxes.

Besides not charging taxes, these sites can make it easier for minors to buy cigarettes because vendors rarely verify their customers’ ages as required by federal law, Ribisl says.

Ribisl, who gave a briefing to Congress on online cigarette sales a few years ago, is using that research as a springboard for formulating some recommendations for policymakers on how to regulate the online sale and marketing of other age-restrictive and hazardous goods. His work also could help prevent the sexual exploitation of children over the Internet.

“If you can successfully figure out how to verify the age of the people who buy cigarettes on the Internet, you can do it for other things,” Ribisl says.

On June 22, 2009, P resident Barack Obama signed into law the Family Smoking Prevention and Tobacco Control Act, which gives the Food and D rug Administration authority to regulate tobacco products. The legislation has been in development for more than a decade. Key provisions include tighter restrictions on advertising and packaging, and a ban on candy- and fruit-flavored cigarettes.

— Natalie Gott

Carolina Public Health is a publication of the University of North Carolina at Chapel Hill Gillings School of Global Public Health. To view previous issues, please visit