Theoretical impacts of a range of major tobacco retail outlet reduction interventions: modelling results in a country with a smoke-free nation goal

Abstract

Objective To inform endgame strategies in tobacco control, this study aimed to estimate the impact of interventions that markedly reduced availability of tobacco retail outlets. The setting was New Zealand, a developed nation where the government has a smokefree nation goal in 2025. Methods Various legally mandated reductions in outlets that were phased in over 10 years were modelled. Geographic analyses using the road network were used to estimate the distance and time travelled from centres of small areas to the reduced number of tobacco outlets, and from there to calculate increased travel costs for each intervention. Age-specific price elasticities of demand were used to estimate future smoking prevalence. Results With a law that required a 95% reduction in outlets, the cost of a pack of 20 cigarettes (including travel costs) increased by 20% in rural areas and 10% elsewhere and yielded a smoking prevalence of 9.6% by 2025 (compared with 9.9% with no intervention). The intervention that permitted tobacco sales at only 50% of liquor stores resulted in the largest cost increase (∼$60/ pack in rural areas) and the lowest prevalence (9.1%) by 2025. Elimination of outlets within 2 km of schools produced a smoking prevalence of 9.3%. Conclusions This modelling merges geographic, economic and epidemiological methodologies in a novel way, but the results should be interpreted cautiously and further research is desirable. Nevertheless, the results still suggest that tobacco outlet reduction interventions could modestly contribute to an endgame goal.

Tobacco retail availability and risk of relapse among smokers who make a quit attempt: a population-based cohort study

“…Second, it suggests that large changes in availability could have dramatic impacts in use. Pearson et al 33 examined the effect of reducing tobacco availability in New Zealand using a model that predicted behaviour change based on a continuous function of travel times translated into increased costs and found limited effects of a 95% reduction in the number of outlets. However, a threshold model would suggest that the impact of a major reduction would vary depending on the details of how that reduction was achieved.…”

Tobacco retail outlet density and risk of youth smoking in New Zealand

“…Internationally, jurisdictions have implemented zoning restrictions limiting the distance that tobacco retailers can be located to a school 17. In NZ, there is strong support for a reduction of tobacco outlets around schools,18 and recent modelling has demonstrated that eliminating tobacco outlets within 2 km of a school would lead to a reduced smoking prevalence 19. Policymakers should consider restricting the density of tobacco retail outlets around schools to reduce smoking initiation and opportunities to purchase tobacco.…”

Who stops selling? A systematic analysis of ex-tobacco retailers

“…This has led to calls by multiple commentators to review tobacco retailing and its regulation, with a focus on decreasing the number of retailers 3 7–11. A reduction in retailer numbers could be achieved through a number of mechanisms: a sharp increase in the price of an annual tobacco retailer license,12 a progressive reduction (or ‘sinking lid’) in the number of retailer licenses,13 restrictions on the number and location of retailers,7 incentives for retailers to stop selling tobacco8 and banning tobacco sales at pharmacies where such sales are permitted 3…”