Expert Review by Dr Eleonora Feletto.
Tobacco is the number one cause of preventable illness and premature death globally. It stands to reason that we should look more closely at the way tobacco products are available in the market.
The discussion at the 2014 World Cancer Congress brought together a number of researchers from marketing and social and behavioural science to discuss different models of tobacco retail regulation and suggest the next steps for tobacco control.
Dr Timothy Dewhirst from the University of Guelph, Canada, set the scene for tobacco retail emphasising the problematic “high density” nature of the industry. Tobacco, usually in the form of cigarettes, has what marketers describe as intensive distribution which means it is available virtually on every street corner and, often, 24 hours a day. Research has shown that impulse purchases that are made possible by these distribution channels play an important role on consumption for existing and former smokers.
Changing these distribution channels by introducing new policies and regulations are effective in reducing the availability of tobacco and influencing its consumption. Dr Dewhirst outlined international models of licencing with the central recommendation being the need for consistency in tobacco regulation. This is especially important in countries where state regulations drive reform. Other, newer tobacco products, such as e-cigarettes, that are changing how people consume tobacco are also important considerations for future reform.
Dr Louise Marsh and Ms Lindsay Robertson from the Cancer Society Social and Behavioural Research Unit at the University of Otago, outlined their work in New Zealand, where the government has committed to a goal to make the nation smoke free by 2025. Dr Marsh and colleagues have undertaken an audit of 5008 tobacco retail outlets in New Zealand. There is currently no licencing required and they found a density of one outlet for every 617 adults and one outlet for every 129 smokers with a higher number of outlets in low socio-economic areas showing widespread availability of tobacco.
Following the audit, Ms Robertson studied the attitudes of retailers to changes in tobacco related policies and regulations. This work suggests that any new initiative in tobacco reform clearly communicate its purpose, highlight long-term benefits and focus on advantages for retailers to gain support. Suggested changes to the New Zealand tobacco retailing market included mandatory retailer registration, prohibition of tobacco sales from particular outlets types and in specified zones (such as close to schools) with limits to the number outlets overall.
Professor Sue Burton of the School of Marketing at the University of Western Sydney then told of a similar audit of New South Wales (NSW) tobacco retailers. In NSW, there is currently a one-time listing system in place for retailers with no fee and the audit found that the regulations on tobacco display and sales were not readily enforced. Coverage was 17.7 outlets per postcode and for every 11 listed outlets there was one unlisted tobacco outlet identified. These audit results informed Cancer Council NSW campaign’s on “Selling tobacco anywhere, anytime: harmful not helpful”. This campaign was used in government lobbying and has resulted in the establishment of a taskforce charged with reviewing tobacco retailing in NSW. Later findings from looking at ex-tobacco retailers found that the outlets leaving the market were generally licenced premises and, while they do not represent the channels with the largest market share, they represent where spontaneous buying occurs so their effect on smoking habits could be important.
Overwhelmingly we are led to understand that more stringent and consistent regulation of the tobacco retail market is required globally. However, what we mustn’t forget are the new products on the market that are flying under the radar and the potential unintended consequences of stringent regulations that could drive smaller outlets out of the market, leaving only the big supermarket type outlet, which would overhaul tobacco retailing all together. The insightful and thought provoking presentations shared at the World Cancer Congress illustrated the state of tobacco retailing, the wealth of information gained through retail audits that is not available by any other means and the actions that have been taken to enact real changes as a result.
Dr Eleonora Feletto is a Research Fellow at Cancer Council NSW who is currently seconded to the International Agency for Research on Cancer, in Lyon, France, undertaking a two year fellowship developing the Environmental and Lifestyle Exposure Assessment (ELEA) study, a standardised tool for collecting cancer risk factor data in any location around the world.