摘要：The “We Card” program is the most ubiquitous tobacco industry “youth smoking prevention” program in the United States, and its retailer materials have been copied in other countries. The program's effectiveness has been questioned, but no previous studies have examined its development, goals, and uses from the tobacco industry's perspective. On the basis of our analysis of tobacco industry documents released under the 1998 Master Settlement Agreement, we concluded that the We Card program was undertaken for 2 primary purposes: to improve the tobacco industry's image and to reduce regulation and the enforcement of existing laws. Policymakers should be cautious about accepting industry self-regulation at face value, both because it redounds to the industry's benefit and because it is ineffective. THE “WE CARD” PROGRAM IS the most widely used tobacco industry “youth smoking prevention” program in the United States. Its logo ( Figure 1 ) is visible on doors and windows of gas stations and convenience, grocery, and drug stores throughout the country. 1 Comparable programs have been developed in other nations. 2 – 4 Although the tobacco industry explicitly marketed tobacco to youth as late as the 1970s, 5 , 6 today the industry says it agrees that tobacco should not be marketed to the legally underage 7 – 11 and claims that We Card successfully reduces sales to youths. 1 , 7 , 12 Evidence on the effects of retailer ID checks, however, is mixed, 13 – 19 and a systematic review concluded that retailer programs were the least effective intervention proposed to reduce tobacco use among youths. 20 Tobacco control advocates have debated whether youth access programs are worth pursuing, given that such programs’ “forbidden fruit” messages are attractive to adolescents, 21 – 27 but no previous studies have examined We Card's development, uses, and goals. Open in a separate window Open in a separate window FIGURE 1 Age-of-sale warning signs for (a) the We Card program and (b) STAKE. Note . STAKE = Stop Tobacco Access to Kids Enforcement. We Card is a “youth smoking prevention” program created by the Tobacco Institute, the US tobacco industry's former lobbying organization. STAKE is a California law that requires retailers to post a notice including a telephone number to report to the state failures to check identification for tobacco purchases. Economic theory predicts that industry self-regulation will achieve social benefits far smaller than those gained from government regulation, 28 although governments increasingly view self-regulation as a means to achieve public goals without public spending. 29 However, industries and governments may have competing agendas, suggesting that public health advocates should be wary of self-regulation strategies. We evaluated industry self-regulation in the context of public health by analyzing the development and uses of We Card. This program's success in reaching tobacco retailers and attracting independent allies has made We Card one of the tobacco industry's major public relations achievements. However, despite industry claims that the program is effective, internal industry evidence suggests that We Card has not reduced tobacco sales to minors and that it was not designed to do so. Instead, We Card was explicitly structured to improve the industry's public image and to thwart regulation and law enforcement activity.
