Retailers ceasing the sale of tobacco were predominantly non-traditional stores and included those within 1000 feet of a school or 500 feet of another retailer. The retailers otherwise continued

to operate their non-tobacco product lines as they did prior to implementation. Additionally, all retailers who underwent tobacco sales to minors compliance checks were in compliance following the implementation of a tobacco retailer permit. While this finding does not compare sales to youth before and after the intervention, results from similar studies show a decline in illegal sales to youth following the implementation of a tobacco retail permit intervention (American Lung Association of California and Center for Tobacco Policy and Organizing, 2007, Ma et al., 2001 and Novak et al., 2006). However, the number TGF-beta inhibitor of retailers that discontinued the sale of tobacco following the intervention was surprising because the Cyclopamine clinical trial assumption was that the ordinance would prohibit more retailers from being permitted and not that existing retailers would stop selling tobacco.

Considering these findings, further investigation in this area may be indicated. One study of California retailers that voluntarily stopped selling tobacco products found that a desire to promote better health in the retail settings was a motivating factor in the decision (McDaniel and Malone, 2011). However, it is unknown whether retailers participating in that study operated in communities with tobacco retail permit ordinances. Several factors may limit the generalizability of these findings. The small number of retail establishments assessed prior to the implementation of

the tobacco retail permit, no baseline enforcement data, the small scope of the permitting intervention, and the assessment only being conducted at two points in time may impact this study’s ability to attribute the 100% compliance observed in post-tobacco retail permit enforcement actions to implementation of the tobacco retail permits. In addition, a lack of a non-equivalent comparison area and Santa Clara County’s unique geographic characteristics may limit the power to generalize the results to other municipalities. Carnitine dehydrogenase Another limitation of this study is that retailer behavior may have also been influenced by several tobacco control policies at the state and local level that were introduced at the same time the tobacco retail permit ordinance was implemented. In October 2010, California adopted a new vertical identification (ID) law designed to curb underage sales of tobacco and alcohol by making it easier for retailers to identify individuals under the age of 21 by changing the orientation of driver’s licenses and state identification cards from the traditional horizontal shape to vertical.