RT Journal Article
SR Electronic
T1 Can tobacco control endgame analysis learn anything from the US experience with illegal drugs?
JF Tobacco Control
JO Tob Control
FD BMJ Publishing Group Ltd
SP i49
OP i51
DO 10.1136/tobaccocontrol-2012-050809
VO 22
IS suppl 1
A1 Peter Reuter
YR 2013
UL http://tobaccocontrol.bmj.com/content/22/suppl_1/i49.abstract
AB The goals of tobacco control endgame strategies are specified in terms of the desired levels of tobacco use and/or tobacco related health consequences. Yet the strategies being considered may have other consequences beyond tobacco use prevalence, forms and related harms. Most of the proposed strategies threaten to create large black markets with potential attendant harms: corruption, high illegal earnings, violence and/or organised crime. Western societies of course have considerable experience with these problems in the context of prohibition of drugs such as cannabis, cocaine, heroin and methamphetamine. These experiences suggest that low prevalence has been achieved only by tough enforcement with damaging unintended consequences. Tobacco prohibition (total or partial) may not present the same trade-off but there is little basis for making a projection of the scale, form and harms of the attendant black markets. Nonetheless, these harms should not be ignored in analyses of the endgame proposals.