Tobacco Youth Access Act - Allows the use of vending machines to sell tobacco products only in an area or establishment to which individuals under 18 years old (or such higher age as a State has set) (minimum age) are denied access. Allows the sale or distribution of cigarettes only in a package of 20 cigarettes. Prohibits offering or distributing tobacco products for sampling except in an area or establishment to which individuals under the minimum age are denied access.

Mandates signs in retail establishments indicating the tobacco product purchase minimum age and the proof of age requirements, which must include photo identification. Requires retailers and their employees to sign an annual certification of knowledge of the minimum age and to conduct all tobacco product sales face-to-face.

Prohibits the distribution of tobacco products through the redemption of coupons or coins except in face-to-face transactions.

Requires the termination of any block grant under provisions of the Public Health Service Act relating to substance abuse, tuberculosis, and acquired immune deficiency syndrome (AIDS) if a State does not restrict youth access to tobacco as prescribed in this Act.