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Identifying best practices in adoption, implementation and enforcement of flavoured tobacco product restrictions and bans: lessons from experts
  1. Katherine Peck1,
  2. Rebekah Rodericks1,
  3. Lola Irvin2,
  4. Lila Johnson2,
  5. Jill Tamashiro2,
  6. Lance Ching2,
  7. Tetine Sentell1,
  8. Catherine Pirkle1
  1. 1Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
  2. 2Chronic Disease Prevention and Health Promotion Division, Hawai'i State Department of Health, Honolulu, Hawai'i, USA
  1. Correspondence to Rebekah Rodericks, Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA; rebekah7{at}


Objective To identify recommended components for adopting, implementing and enforcing bans or restrictions targeting flavoured tobacco products.

Methods Between April and June 2019, semistructured interviews were conducted with 17 high-level experts across the USA and Canada with expertise in flavoured tobacco product policies. Participants included health department staff, researchers, legal professionals and local government officials. Interviews were recorded, transcribed and analysed for key themes.

Results Major findings were organised into four categories: programme planning and legislative preparations; education and community outreach; implementation and enforcement; and policy impact. Critical pre-implementation elements included using comprehensive policy language, identifying enforcement agents, examining potential economic costs, deploying media campaigns and engaging community partners and retailers. Recommended implementation processes included a 6-month preparation timeline, focus on retailer education and clearly outlined enforcement procedures, particularly for concept flavours.

Conclusions Flavoured tobacco policies have successfully limited sales, withstood legal challenges and become more comprehensive over time, providing useful lessons to inform ongoing and future legislative and programmatic efforts. Identifying and sharing best practices can improve passage, implementation, efficacy and evaluation of flavoured tobacco policies.

  • public policy
  • non-cigarette tobacco products
  • prevention

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  • Contributors KP and RR were responsible for designing the study, conducting interviews, overseeing the qualitative analysis and drafting the article. TS and CP advised on conceptualising and designing the study, developing a plan for qualitative analysis, and assisted with editing the article. LJ, JT, LC and LI assisted with conceptualising the study, interpreting the data and editing the article. All authors contributed substantially to article preparation, reviewing and approving the final product.

  • Funding This project was funded by the Hawai'i State Department of Health’s Chronic Disease Prevention and Health Promotion Division, through a contract with the University of Hawai'i’s Office of Public Health Studies, Healthy Hawai'i Initiative Evaluation Team.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The UH Office of Research Compliance’s Human Studies Program determined this study protocol to be exempt (UH IRB No 2019-00063).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Deidentified data may be provided for public health-related requests that include reasonable justification.

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