Policy coherence, integration, and proportionality in tobacco control: Should tobacco sales be limited to government outlets?

Abstract

Multiple factors, including marijuana decriminalization/legalization, tobacco endgame discourse, and alcohol industry pressures suggest that the retail regulatory environment for psychoactive or addictive substances is a dynamic one in which new options may be considered. In most countries the regulation of tobacco, marijuana, and alcohol is neither coherent, integrated, nor proportional to the potential harms related to these substances. We review the possible consequences of restricting tobacco sales to outlets run by government-operated alcohol retail monopolies, as well as the likely obstacles to such a policy. Such a move would allow governments increased options for regulating tobacco sales, and increase policy coherence, integration, and proportionality for substance regulation. It also could serve as an incremental step toward an endgame goal of eventually eliminating sales of commercial combustible tobacco.

Retailers’ perspectives on selling tobacco in a low-income San Francisco neighbourhood after California’s $2 tobacco tax increase

“…The retail sector is becoming an important focus of tobacco control policy discussion, with advocates and researchers proposing various strategies to reduce the number of tobacco retailers (eg, prohibiting tobacco sales within a certain distance of schools, regulating the distance between tobacco outlets, confining sales to particular types of stores) 45–47. If these efforts are to succeed, it will be important to enlist retailers as allies.…”

Strategies and barriers to achieving the goal of Finland’s tobacco endgame

“…The framework method was chosen for the content analysis of transcripts because of its systematical approach, multi–disciplinary appeal and frequent application to the semi-structured interview 22. The coding process involved a broad deductive approach in which codes were first pre–selected based on a review of academical papers and government documents 2–4 12 14 19 23–25. Additional codes were then developed through the open coding of four transcripts, which were independently examined by three co-authors.…”

“… 18 Policy experts were first asked about the rationale for Finland’s current strategy versus innovative strategies that focus on the product, user and supply of tobacco. 7 While all innovative strategies were open to discussion, three were given particular attention: (1) the “sinking lid” because of its high probability of success, 16 (2) the prospect of government-controlled tobacco outlets being modelled after Alko, 19 Finland’s hard alcohol retailer and (3) reasons why Finnish policymakers are no longer pursuing the “tobacco-free generation”. Participants were then queried about the impact of the EU’s 2014 TPD on the endgame, including new regulations on electronic cigarettes, notification requirements for new products, prohibition on characterising flavours versus all additives 20 and invocation of Article 24 of the TPD to ban a certain category of tobacco.…”

The tobacco endgame: The neglected role of place and environment

“…These are undoubtedly a subset of a larger number addressing broader smoke-free or tobacco-free agendas but they serve to highlight continued focussed engagement with the idea of the endgame. Three papers focussed on retail policy endgame strategies (Petrović-van der Deen and Wilson, 2018;Robertson et al, 2017;Smith et al, 2017), two on moral and ethical questions (Hoek et al, 2017;Verweij, 2017), while single papers considered links to e-cigarettes (Ruokolainen et al, 2017), reaching established smokers (Edwards et al, 2017) and creating smoke-free generations (David et al, 2017).…”