Illegal sales of cigarettes to young people in Philadelphia have more than doubled in the last year, reversing a two-year decline in the practice, the Philadelphia Public Health Department announced Tuesday.

The information came from the 2018 Pennsylvania Synar report, which annually tracks sales of cigarettes to youth. The survey was done in summer 2018 by trained and supervised youth ages 15 to 17 who tried to buy cigarettes from retailers across the state.

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As many as 11% of Pennsylvania retailers sold cigarettes to the teens. In Philadelphia, as many as 29.3% of retailers made illegal sales, according to the study.

“We don’t actually understand this,” said Cheryl Bettigole, director of chronic disease and injury prevention at the health department. For two years the city increased its own checks on tobacco sales to minors, increased penalties, and focused on education, an effort that seemed to be working, she said.

“All of a sudden we see this skyrocketing,” Bettigole said.

The study did not look at the sales of e-cigarettes, which have become epidemic in youth across the country and which are cause for special concern now as serious and even fatal lung diseases have been reported in otherwise healthy young people who vape.

The increase in illegal sales is additionally worrisome because about 90% of current smokers started the habit when they were 18 years or younger.

“In Philadelphia, you see tobacco marketing everywhere,” Bettigole said. A lot of what kids are buying are single cigarettes, known as “loosies,” cigars and cigarillos, she said.

Statewide the study found that a 16-year-old was about 5.3 times more likely to be sold cigarettes than a 15-year-old. Females were 3.7 times more likely than their male counterparts to have been sold cigarettes. And African American youths were as much as 6.6 times more likely to be sold cigarettes than white youths.

More than 50% of the illegal sales occurred at gas/convenience or convenience/food stores, according to the study.

The pattern appears to vary around the commonwealth, the report suggests. The study broke the state into geographic regions and also supplied specific data for Erie, Allegheny, Delaware, and Philadelphia Counties. Just three of 78 outlets in Delaware County illegally sold cigarettes to youths. In the northwest region and Allegheny County there were no violations.

Philadelphia health officials contacted their counterparts in Allegheny County and the state Department of Health to see what they were doing differently.

They found Philadelphia was using supervised teens in the checks who tended to be 17, minority, and female, which was representative of the cities’ underage buyers. However, in Allegheny and throughout the state the teens that were used in the study tended to be younger, male, and white, Bettigole said.

City officials are now looking at different ways to reach out to vendors. They are focusing on the range of tobacco products that are illegal to sell to minors, providing multilingual signs for clerks and customers, increasing the checks, and tightening up the ticketing process, she said.

Fines for illegal sales are $250 per violation. If a clerk failed to check identification, it is another $250 fine, she said.

“We are redoubling efforts to catch and prevent people from selling to kids, because we really need to protect our kids,” Bettigole said.

To report illegal sales of tobacco to youth, visit Smoke Free Philly.