Smokers' Perceptions of the Relative Effectiveness of Five Tobacco Retail Reduction Policies

Introduction: Reducing the widespread retail availability of tobacco could help realize tobacco endgame strategies. We assessed New Zealand smokers' perceptions of five potential policies designed to reduce the retail supply of tobacco, relative to a "benchmark" policy of annual tobacco tax increases.

Methods: A sample of 623 smokers was recruited from an internet panel. Participants evaluated one of six randomly assigned policy scenarios that would reduce tobacco outlet density: (1) no tobacco sold at alcohol on-licensed premises, (2) no tobacco sold within 500 m of a high school, (3) no tobacco sold within 1 km of any school, (4) tobacco sold only at pharmacies, and (5) tobacco sold only at half the existing liquor stores. Continued 10% annual tobacco tax increases served as a benchmark condition. Participants rated the likely effectiveness of one policy on preventing uptake by a 15-year-old susceptible never-smoker and supporting quitting by an adult smoker. Analyses involved pooled t tests and logistic regression.

Results: The policy scenarios in which tobacco was only sold at half the existing liquor stores or only at pharmacies were rated more likely to prevent youth smoking initiation, and at least as likely to help smokers to quit, relative to the benchmark policy.

Conclusions: This is the first study to compare potential retail interventions against a measure known to reduce smoking prevalence. Policies that substantially reduce tobacco availability and remove it from smokers' usual places of purchase are perceived as being at least as effective in reducing smoking initiation and supporting cessation, as tax increases.

Implications: Tobacco control advocates have proposed a range of policies to reduce tobacco retail outlet density, as part of endgame strategies. There are no published data on the relative effectiveness of different approaches, therefore it is unclear which would be most likely to reduce smoking prevalence. This study provides an insight into smokers' perspectives on the effectiveness of retail reduction strategies and indicates that some of these could be at least as effective in reducing initiation and promoting quitting as tax increases. Smokers' perceptions of the relative effectiveness of these policy options may help inform the advocacy efforts of the sector.