Tobacco retail policy innovation to reduce health disparities

摘要 在结束烟草流行方面取得的重大进展主要是由于政策变化， 包括增加烟草税和无烟政策。然而，研究表明，即使在 现有的预防和戒烟方案加快了，烟草流行的结束不太可能 在没有额外政策创新的情况下实现。烟草零售环境已成为当前关注的焦点 烟草控制政策对话，研究探讨零售商密度降低的影响。到目前为止 未经研究的方法是利用控制酒精(或潜在的大麻)的州的现有基础设施 限制烟草销售的零售系统。将烟草销售(TTS)过渡到国有零售网点将使 各州加强对价格、销售点广告、品牌数量和类型、工作时间和门店的控制 密度。处于不利地位的社区可以体验到最大的好处，因为目前 低收入和种族多元化社区的烟草销售点。然而，还没有研究评估 这一行动的可行性、障碍和潜在的健康和税收影响。 该项目旨在评估实施烟草控制系统作为减少烟草的一种方式的前景和潜在影响 可获得性、烟草使用和与烟草相关的健康差距。该项目的具体目标是：具体目标 #1：对易燃物销售的潜力和障碍进行全面评估 烟草产品向12个州的州零售点提供酒精控制和销售系统，以及在2个州 潜在的大麻控制状态；具体目标2：检查经济和其他方面的程度 可以通过限制销售国家控制的白酒来缩小烟草零售可及性方面的差距 商店；具体目标#3：使用经过验证的烟草控制模拟模型，分析对吸烟的影响 流行率、吸烟导致的死亡、与健康相关的结果和移动烟草的国家收入 向国家控制的酒类销售点销售产品。这项研究回应了烟草控制协会最近的一项呼吁 NCI科学顾问委员会创新烟草研究优先研究工作组 控制可能具有变革性的政策举措。确定健康和经济影响 将烟草销售转移到国营商店可能为政策制定者考虑这一点或 更多增量零售商降价措施。

ABSTRACT The significant progress made toward ending the tobacco epidemic has primarily resulted from policy changes, including tobacco tax increases and smokefree policies. However, research suggests that even if progress on existing prevention and cessation programs is accelerated, an end to the tobacco epidemic is unlikely to be achieved without additional policy innovations. The tobacco retail environment has become a focus of current tobacco control policy conversations, with studies exploring the impact of reduced retailer density. An as yet unstudied approach is using the existing infrastructure of states with alcohol (or potentially marijuana) control retail systems to restrict tobacco sales. Transitioning tobacco sales (TTS) to state retail outlets would enable states to increase control over price, point-of-sale advertising, numbers and types of brands, hours, and outlet density. Disadvantaged communities could experience the greatest benefit, given the current concentration of tobacco outlets in lower income and racially diverse neighborhoods. However, no research has assessed the feasibility, obstacles to and potential health and revenue effects of such a move.The overall objective of this project is to evaluate the prospects for and potential impact of implementing TTS as a way to reduce tobacco accessibility, tobacco use, and tobacco-related health disparities. The project's specific aims are: Specific Aim #1: Conduct a comprehensive appraisal of the potential for and obstacles to moving sales of combustible tobacco products to state retail outlets in 12 states with such systems for alcohol control and sales, and in 2 potential marijuana control states; Specific Aim #2: Examine the extent to which economic and other disparities in the retail accessibility of tobacco could be reduced by limiting sales to state-controlled liquor stores; Specific Aim #3: Using a validated tobacco control simulation model, analyze the impact on smoking prevalence, smoking attributable deaths, health-related outcomes, and state revenues of moving tobacco product sales to state-controlled liquor outlets. This research answers a recent call by the Tobacco Control Research Priorities Working Group of the NCI Board of Scientific Advisors for research on innovative tobacco control policy initiatives that are potentially transformative. Pinpointing the health and economic impacts of moving tobacco sales to state-run stores could lay the groundwork for policymaker consideration of this or more incremental retailer reduction measures.