Area disparity in children's perceptions of access to tobacco and cigarette purchasing experiences in Taiwan

[[abstract]]BACKGROUND: Adolescents who perceive easy access to tobacco are more likely to acquire cigarettes and experience smoking. This study assesses area disparities in perceptions of access to tobacco and cigarette purchasing experiences among schoolchildren. METHODS: Data on children's tobacco-related variables were obtained from the Control of School-Aged Children Smoking Study Survey in Taiwan. A stratified random sample of 65 primary schools was included. Polytomous logistic regression analyzed factors associated with tobacco accessibility and purchasing experiences. RESULTS: More than half of the children reported that tobacco retailers often or always sold cigarettes to them. Rural and mountainous children were more likely to have access to cigarettes (adjusted odds ratio [AOR]=2.01 and 3.01, respectively) and have cigarette purchasing experiences (AOR=3.06 and 13.76, respectively). Cigarette purchasing from retailers (AOR=1.84) was significantly associated with children's perceptions of access to tobacco. The factors associated with cigarette purchasing experiences were families smoking (AOR=8.90), peers smoking (AOR=2.22), frequent exposure to entertainer smoking on TV and in films (AOR=2.15), and perceived access to tobacco (AOR=1.51). CONCLUSIONS: The health department should strictly enforce laws regarding retailers selling tobacco to underage, particularly in remote areas. Schools can reinforce tobacco-use prevention messages