Key Points: Reducing youth access to tobacco is one of the key elements of the CDC recommendations in Best Practices for Comprehensive Tobacco Control Programs. In general, enforcement strategies and retail education strategies have either failed to work or aroused substantial backlash. Published literature has shown that states fail to reach the federally mandated goal of 20% illegal sales of tobacco to minors let alone the 10% illegal sales rate or so thought to be associated with reduced youth prevalence of tobacco use. Better methods of reducing youth access to tobacco are required. Reward and Reminder (R&R) is an alternative approach to reduce illegal sales of tobacco to young people, which systematically rewards clerks in tobacco outlets for not selling tobacco to minors. R&R has three components: (a) quick building of a consensus among stakeholders against illegal tobacco sales; (b) periodic visits to all tobacco outlets; and (c) media to promote norms against sales. This has been done successfully in two states, Wyoming and Wisconsin.

Learning Objectives: We will provide background and research confirming R&R as an effective program, an overview of results from three statewide programs and a real life local implementation example.

Benefits: Quick reduction of youth access rates. At baseline, Wyoming and Wisconsin had federally-reported average illegal sales of tobacco to minors of 43% and 35% respectively. After Reward and Reminder, those federally-reported rates, independently collected, declined to an average of 8.5% for Wyoming and 11.4% for Wisconsin.