A consortium of over 30 public health organizations recently released a joint statement on equitable tobacco control enforcement. Titled “Tobacco Control Enforcement for Racial Equity: Decriminalizing Commercial Tobacco – Addressing Systemic Racism in the Enforcement of Commercial Tobacco Control,” the document sets forth “aspirational principles to help local and state health departments, decisionmakers, advocates and other stakeholders advance equitable enforcement practices related to purchase, possession, sale and distribution of all tobacco products.”
Despite significant public health and legislative successes in tobacco control over the past few decades, the tobacco industry continues to spend over $1 million per hour to advertise and promote their deadly products – most of it in the retail environment. Moreover, these tobacco advertisements and promotions are strategically marketed to and targeted at certain populations based on demographics like race, ethnicity, geography, socioeconomic status, sexual orientation, and gender expression. As a result, historically marginalized group, including Black and Brown communities, are often exposed to a greater quantity of targeted point-of-sale tobacco advertisements, cheaper prices for tobacco products, and a higher density of tobacco retailers. In turn, these communities and populations, which already are at the intersection of multiple social inequities and injustices, exhibit a higher prevalence of tobacco use and associated tobacco-related harms.
Just as disparities exist in the manner in which the tobacco industry markets and promotes its products, inequities exist in protection and coverage by tobacco control legislation, as well as enforcement of these tobacco control policies. Public health laws can support social justice, but they can also contribute to systemic racism. It is imperative for public health professionals as well as all those involved in tobacco control – from advocates to educators to decisionmakers – to consider and address the role of structural racism and discrimination in policy work and enforcement and to continually take meaningful steps towards equitable tobacco control and prevention.
The joint statement outlines four overarching values, along with various principles and practices for all those in tobacco control to consider and aspire to during planning, implementation, and enforcement of tobacco control measures. Below are the values:
Value 1: Commercial tobacco control laws and policies, including regulations on the sale and distribution of commercial tobacco products, are first and foremost public health measures.
Value 2: State and local governments should reform or eliminate laws, policies, and enforcement practices that target individuals, especially youth, rather than businesses and industry actors.
Value 3: Enforcement practices and penalties for violations of commercial tobacco control laws should be proportional to the alleged violation and address health, equity, and social justice considerations.
Value 4: State and local governments should adopt legal and policy frameworks that facilitate the effective, equitable enforcement of commercial tobacco control laws by holding businesses and other industry actors accountable for violations.
In addition to the statement, these resources focus on equity and equitable solutions in tobacco control:
- Health Equity and Point of Sale Tobacco Control Policy, CounterTobacco.org
- Best Practices User Guides: Health Equity in Tobacco Prevention and Control, Centers for Disease Control and Prevention
- Equitable Enforcement to Achieve Health Equity: An Introductory Guide for Policymakers and Practitioners, ChangeLab Solutions
- Health Equity Policy Framework, Massachusetts Public Health Association
- Communities in Action: Pathways to Health Equity, National Academies of Sciences, Engineering and Medicine
- Tobacco Retail Licensing Policy: A Health Equity Impact Assessment, Upstream Public Health
- PUP in Smoke: Why Youth Tobacco Possession and Use Penalties are Ineffective and Inequitable, ChangeLab Solutions
- Youth Purchase, Use, or Possession Laws are Not Effective Tobacco Prevention, Campaign for Tobacco-Free Kids
- Tobacco 21, CounterTobacco.org
- Licensing, Zoning, and Retailer Density, CounterTobacco.org
- Tobacco Retailer Density: Place-Based Strategies to Advance Health and Equity, ChangeLab Solutions
- Tobacco Retail Licensing: An Essential Tool to Reduce Youth Usage and Foster Health Equity, Tobacco 21