Retail reform. How conditions of license can be applied to strengthen tobacco control in a range of local circumstances

摘要

Background and challenges to implementation: In most developed countries, most smokers visit a retail store a few times a week to buy cigarettes, providing a hundred or more moments of contact over a year. Tobacco companies invest heavily in their relationship with retailers to control these moments of contact and to maximize influence on price, word of mouth and other promotions. Yet controls on retail are almost absent from globally-recommended tobacco control strategies, like the Framework Convention on Tobacco Control, the Bloomberg-funded MPOWER measures, or the European Union Directive. None of these offer a model for tobacco retail management. This is in contrast with international guidance on comparable health concerns like alcohol, where the World Health Organization recommends a range of supply-controls, like minimum pricing, government retail monopolies and retail licensing. Intervention or response: To address this global policy gap, researchers and advocates are independently contributing to a menu of new options for localized retail reform. These proposals draw on the experience with tobacco and other products in diverse countries. Results and lessons learnt: Requirements can be imposed by law or conditions of license to better align tobacco retail practice with public health goals. Financial and non-financial requirements already exist in tobacco retailing, including mandatory training of retailers in health consequences of tobacco use, requirements to provide health authorities with data on local sales, requirements to distribute materials to support cessation, restrictions on locations, types of venues or types of license-holders. Other licensing requirements can be adapted from existing distribution controls currently applied to alcohol, pharmaceutical products, cannabis and other products with risks associated with public health risk. Conclusions and key recommendations: Retail reform has been identified as a next frontier for tobacco control. A wide range of options are available for adaptation to local or national circumstances.