Preventing Underage Tobacco Access: A Cross-Sectional Study of Retailer Training in Southern Illinois.

This article focuses on a 2023 cross-sectional study assessing tobacco retailers' knowledge, opinions, resource utilization, and training needs related to preventing underage tobacco sales in 16 southern counties of Illinois. Despite nearly universal awareness (98.3%) of the Tobacco-21 law raising the minimum legal sale age to 21, over half of the 118 surveyed store owners and managers doubted its effectiveness, with notable gaps in knowledge about enforcement policies for Electronic Nicotine Delivery Systems (ENDS). The study found disparities in preventive practices and training engagement, particularly in rural areas and smaller stores, where utilization of educational resources like the FDA's "This is Our Watch" program was low despite widespread use of the industry-supported "We Card" program. The findings highlight a critical need for targeted, accessible retailer education and training—especially for newly hired clerks—to improve compliance and reduce youth access to tobacco products, with implications for policy, practice, and future research on enforcement and training effectiveness.