March 19, 2015

A study led by researchers at UNC Lineberger Comprehensive Cancer Center and the UNC Gillings School of Global Public Health has found that teens can buy electronic cigarettes easily online, despite a North Carolina law banning their purchase by minors and requiring online vendors to verify customer age.

This first-of-its-kind, National Cancer Institute-funded study was published online March 2 in The Journal of the American Medical Association Pediatrics. It found that only five of 98 attempts by teens to buy e-cigarettes online were blocked by online vendors’ attempts to verify customer age.

Dr. Kurt Ribisl

Dr. Kurt Ribisl

Rebecca S. Williams, PhD, a member of the UNC Lineberger center, is the study’s principal investigator. Kurt M. Ribisl, PhD, professor of health behavior at the Gillings School, UNC Lineberger’s Cancer Prevention and Control program leader and a national expert in tobacco control policy issues on the Internet, and Jason Derrick, MSW, of UNC Lineberger, are study co-authors.

“Very few online vendors even gave the appearance of trying to comply with North Carolina’s e-cigarette age verification law,” Williams said.

The findings underscore the need for federal regulations requiring and enforcing age verification in the sale of e-cigarettes, Williams states, as their use among teens has been growing, and there isn’t yet conclusive research showing their public health and safety impacts.

The Centers for Disease Control and Prevention has described a doubling in the rate of teens who reported ever using e-cigarettes from 2011 to 2012.1 A national survey released in 2014 also showed that more than 17.1 percent of 12th graders reported they used an e-cigarette in the past 30 days.2

In the study led by Williams, researchers recruited a group of teens to buy nicotine e-cigarettes from 98 Web-based vendors. Only five purchase attempts were rejected based on age verification strategies. Another 18 attempts failed, but for reasons unrelated to age verification such as flawed website functionality. After removing those 18 order attempts from the study sample, there were five out of 80 orders rejected based on age verification, i.e., a youth e-cigarette purchase success rate of 93.7 percent.

During the observed attempts to buy e-cigarettes, teens were allowed to type in false birth dates and check boxes to misrepresent their ages. While the study found that a number of vendors requested the buyers’ date of birth, in most cases, that information was not used in compliance with state law. North Carolina law requires online vendors of tobacco products, including e-cigarettes, to use a third-party service to check the buyer’s age against a public records database.

“Thirty-five percent of the vendors asked for date of birth, and that potentially could be used with a name and address to verify customers’ age in a public records database, but in most cases, it wasn’t,” Williams said. Five vendors claimed to use a service offered by shipping companies to verify age at delivery, but none actually did. Furthermore, none of the vendors used personal challenge questions to verify buyers’ identities.

No federal laws currently exist to regulate e-cigarette sales to minors, but 41 U.S. states currently do ban e-cigarette sales to minors.3 The U.S. Food and Drug Administration has proposed extending federal regulations currently in place for cigarettes to the sale of e-cigarettes and other tobacco products. As part of the proposed rule, there would be minimum age restrictions for e-cigarettes.

All participating teens received permission from their parents to be involved in the study. Researchers also obtained letters of support from the local police chief and district attorney stating they agreed not to prosecute participants since the purchase of e-cigarettes by minors is illegal in North Carolina.

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1 Corey C, Wang B, Johnson SE, et al; Centers for Disease Control and Prevention. Notes from the field: Electronic cigarette use among middle and high school students – United States, 2011-2012. MMWR Morb Mortal Wkly Rep. 2013; 62(35):729-730.
2 E-cigarettes surpass tobacco cigarettes among teens [news release]. Ann Arbor, MI: University of Michigan: December 16, 2014. Accessed Feb. 23, 2015.
3 National Conference of State Legislatures. Alternative Nicotine Products | Electronic Cigarettes. 2014; Accessed Feb. 23, 2015.


Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or dpesci@unc.edu.
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