Table 3

Concepts and themes to consider related to implementation and enforcement of a state-wide flavoured tobacco ban

Themes	Codes	Sample responses
Implementation timeline	Ideal implementation timeframe identified as 3–12 months. Need to understand how local, state and federal rules and regulations could impact timeline. Widely acknowledged that a grace period was critical for education, selling off flavoured tobacco product and allowing for warning visits.	‘I would say three to six months. I think anything shorter than three months is too fast, because there will just be chaos. Which is bad for everybody, the retailers, the enforcement agencies, everybody else. I think longer than six months, it starts dragging out and the momentum, if you manage to get this thing through the legislature, it will be a big loud fight. And the big loud fight will generate a lot of publicity, which is itself very helpful in terms of establishing public awareness for proper implementation. And if you wait too long…people forget about that.’
Components of the implementation phase	Initial notification considered the first step in the process. Retailer education: widely seen as the key step, and a lengthy, resource-intensive process. Necessary to advertise complementary cessation programmes while implementing flavour ban.	‘Distribute a notification letter to all retailers in the state, let them know about the new law, timeline, and new signage and posters if needed. Also make the materials available at city hall or another place for retailers to go.’
Retailer education	Knowing your retailers is key to creating effective and appropriate educational materials. One-on-one outreach is the most effective approach in providing education and answering questions; may require volunteer support. Additional communication approaches could include a hotline, textline and web postings. Be clear with messaging for retailers: create low-literacy materials and translate for store owners as needed, and include visual images of flavoured products as a training tool. Town halls were not identified as a useful approach for retailer education. Vendors, wholesalers and distributors can be useful allies in reaching retailers.	‘Many of our retailers don’t fully understand the difference between tobacco product and a nicotine product and an e-juice. They’re selling these products, but they don’t understand necessarily what has nicotine and what doesn’t have nicotine. And so having to explain that and be really precise about the really nuanced products that are out there can be challenging, especially when a vendor is not happy to see you to begin with.’
Responsible agencies for enforcement	No one set approach to enforcement: other jurisdictions often involved health department and law enforcement. Assessing current capacity and responsibilities will help identify who is in the best position. Most jurisdictions did not hire additional staff to enforce a restriction or ban.	‘There’s a wide range of agencies, ranging from the health departments, to local police departments, to code enforcement…some jurisdictions have dedicated licensing entities that handle…all business licensing. I think it really comes down which agency has the infrastructure in place to do it most effectively.’
Enforcement procedures	Licensing key to identifying population of retailers. Engaging local youth can improve in-person and online enforcement operations. Many aspects of protocol to consider, including jurisdiction of inspection teams, use of courtesy checks and enforcement of concept flavours. Will also need to establish protocol for identifying flavours, including use of sniff test and process for contesting.	‘We also recognize from an enforcement point of view, we didn’t want our locals to go in and enforce on the most difficult product right away. Because we do have some zealots who would rush in and want to try to nail them on a product that was designed to be right on the line as to flavored or not flavored…Don’t fall on that sword early on in the process. Just go with the obvious stuff.’
Addressing non-compliance	Stand-alone fines were not seen as an effective deterrent for retailers. A combination of fines, suspensions and revocations is typically employed in other jurisdictions. Establishing an appeals process is also critical. Be aware of potential impact of political pressure from probusiness interests in appeals and impact on consistency of enforcement.	‘I think the potential loss of a retail license is a bit more motivating for compliance (vs fines).’
Concept flavours and product lists	Concept flavours identified as among the single biggest challenges and evolving issues. Need a set protocol for identifying concept flavours. Flavoured tobacco product lists have been attempted in many jurisdictions but were widely seen as ineffective and impossible to maintain. Non-flavoured tobacco product lists identified as a potential approach to addressing this issue.	‘I know that in State ___, they were curating a list of flavored tobacco products that they were certifying as flavored tobacco. That list is dozens and dozens and dozens of pages. It’s very dense. I think what worked for them is they had folks who were sort of living and breathing tobacco compliance and were able to know the ins and outs of all of those products. Our enforcement team, there’s just no way for them to be living and breathing hundreds and thousands of products and if the color red is somehow flavored today but wasn't flavored yesterday.’