Restricting Product Availability

Large retailer power wall display with countless brands offering various sales and discounts Retail availability of tobacco products is an integral component of the tobacco industry’s marketing scheme. Retail availability of tobacco:

Perpetuates social norms about tobacco use. The ubiquitous presence of tobacco retailers gives the impression that tobacco is available and accessible.
Increases exposure to industry point of sale advertising, marketing, and promotions. The tobacco industry channels most of its marketing dollars into the retail environment (Read More).
Reduces search costs for tobacco products. Proximity to tobacco retailers is associated with higher smoking rates^[1] and can reduce the success of quit attempts for smokers looking to curb their tobacco use.^[^2, 3^]
Contributes to social and environmental inequities. Tobacco retail outlet density is higher in low income and minority neighborhoods, fueling disparities in tobacco use and its associated health effects.^[⁴^,⁵^,⁶^]Read Tobacco Retail Licensing Policy: A Health Equity Impact Assessment for more on how licensing can help improve health equity in communities.
Contributes to higher smoking rates. Tobacco retail outlet density is associated with high rates of youth ^[⁴^,⁵^, 6^, 7^] and adult tobacco use, ^[¹^] as well as higher rates of tobacco use initiation among young adults.^[⁸^]Recent evidence also shows that higher tobacco retailer density is associated with higher rates of smoking among pregnant women.^[9]
Increases perceived availability and accessibility of tobacco products, especially among youth.^[2] Research has found that stores where youth are more likely to shop contain up to twice as much shelf space dedicated to the three brands most popular among youth.^[3]
Increases brand recognition, especially among youth,^[2]which increases odds of smoking.^[4]
Encourages impulse purchases of tobacco products, cues cravings, and undermines quit attempts. ^[⁵^,¹⁰^,¹¹^]

Several options to restrict tobacco product availability are intended to close loopholes in the 2009 Family Smoking Prevention and Tobacco Control Act. While the Act banned the sale of flavored and single cigarettes and vending machines for cigarettes and smokeless products, it excluded many categories of other tobacco products (OTPs) from these restrictions. The tobacco industry has capitalized on these loopholes with the proliferation of new flavored OTPs in recent years and increased spending on advertising for OTPs as compared to cigarettes. OTPs are cheaper and more accessible in the absence of minimum pack laws, and flavored OTPs are particularly attractive to youth.^[6] Read more about the threat of cigars and cigarillos in the Campaign for Tobacco-Free Kids’ 2023 updated report, “Not Your Grandfather’s Cigar.”

Availability Restrictions

Tobacco product availability restrictions help to control the accessibility of tobacco products at the point of sale. Many of these restrictions can be implemented as part of licensing and zoning schemes or as stand-alone laws. Options include:

Restrict retailer location, and/or density through licensing and zoning laws.
Limiting where any tobacco product can be sold, such as prohibiting the sale of tobacco at pharmacies.
Restricting the sale of flavored tobacco products. States and localities across the country have implemented regulations that restrict the sale of flavored tobacco products in a number of ways. These include:
- Comprehensive Restrictions that are jurisdiction-wide, with no exemptions any products, places, or flavor types.
  - Yolo County, CA adopted an ordinance in November 2016 that prohibits the sale of any flavored tobacco products, including menthol cigarettes, in any tobacco retailer in the unincorporated areas of the county.
  - San Francisco, CA has passed an ordinance effective April 2018 that prohibits the sale of flavored tobacco products, including menthol, without exception. While the tobacco industry funded a campaign against the measure that resulted in a referendum, voters in the city later upheld the policy 68% to 32%.
  - Richmond, CA passed an ordinance in July 2018 that prohibits the sale of all flavored tobacco products, including menthol, anywhere in the city.
  - Oakland, CA passed a measure in May 2020 that updated their previous ordinance, making it comprehensive instead of restricting the sale of all flavored tobacco products, including menthol, to adult-only tobacco specialty stores.
- Restrictions by place sold:
  - New York City has restricted the sale of flavored tobacco products (with the exception of mint or menthol flavors) to tobacco bars only.
  - Boston and many other municipalities in Massachusetts (prior to the state-wide ban on the sale of all flavors) restricted the sale of flavored tobacco to adult-only stores. Several cities in Minnesota have taken this approach as well, including Minneapolis and St. Paul which both originally exempted menthol, but later updated their ordinances to include menthol in the sales restriction.
  - Santa Clara County, CA restricts the sale of all flavored tobacco products, including menthol, to retailers that are only accessible to those 21 years of age or older, which is the minimum legal sales age for tobacco in the state of California.
  - Boulder, CO and Philadelphia, PA have also taken this approach.
- Restrictions on the sale of certain flavor types:
  - Providence, Rhode Island has banned the sale of tobacco products in any flavor except for menthol, mint, and wintergreen flavors. Learn more about how the city developed and successfully implemented this ordinance in a case study from the Center for Public Health Systems Science. St. Louis Park, MN has also taken this approach.
  - Many localities in Massachusetts have prohibited the sale of flavored tobacco products except for mint, menthol, and tobacco-flavors and have included “concept” flavors (e.g. “red,” “jazz,” “pirate’s cave,” etc.) based on their taste or aroma of flavors other than those exempted. See their full list of prohibited flavors. However, some Massachusetts localities are now amending their ordinances to also include menthol flavored tobacco products as well, including menthol cigarettes.
- Restrictions on the sale of specific flavored product type:
  - Maine has specifically banned the sale of flavored cigars.
  - New Jersey and Rhode Island have banned the sale of flavored e-cigarettes.
- Restrict the sale of flavored tobacco within a certain distance of schools:
  - Chicago has prohibited the sale of flavored tobacco products, including menthol, within 500 feet of schools. For more information, review:
    - Chicago’s Regulation of Menthol Flavored Tobacco Products: A Case Study from the Public Health Law Center
    - Chicago’s Ordinance and list of flavors
    - For an updated list of restricted flavors, search Chicago’s Restricted Flavored Tobacco Products
  - Berkeley, CA has also prohibited the sale of flavored tobacco products including menthol within 600 ft from schools
  - Contra Costa County, CA has prohibited the sale of flavored tobacco products, including menthol, within 1000 ft of schools, playgrounds, parks, and libraries in all unincorporated areas of the county.
Note that enforcement of flavor bans can be a challenge and require retailer education. Learn about Providence, RI’s efforts to both evaluate the success of and improve enforcement of their policy here.

Story from the Field: Minneapolis Flavor Restrictions

Minneapolis, MN enacted restrictions on the sale of flavored tobacco products, other than menthol flavored, limiting them to adult-only tobacco stores. These restrictions apply to products such as cotton candy-flavored shisha, apple-flavored chewing tobacco, grape-flavored little cigars, and e-liquids that are sold in thousands of kid-friendly fruit and candy flavors. At the same time, the city of Minneapolis also set a minimum sales price for cigars of $2.60 each or $10.40 for packs of four or more. Read more.

Story from the Field: San Francisco

In June 2017, San Francisco became the first city to completely restrict the sale of any flavored tobacco product, including menthol, within the city limits, without exception. Learn about the groundwork involved in making it happen.

Story from the Field: Local Menthol Policy Case Studies - Minneapolis, St. Paul, and Oakland

This webinar offers case studies for successfully passed local policies restricting the sale of menthol tobacco products. Come find out Minneapolis, St. Paul, and Oakland were able to pass their policies, who helped, lessons learned, and more.

Endgame strategies

“Endgame Strategies” have been defined as “initiatives designed to change/eliminate permanently the structural, political, and social dynamics that sustain the tobacco epidemic, in order to end it within a specific time.” ^[12] As described in a tobacco endgame qualitative review and synthesis, beyond tobacco control strategies that are based on the continued presence and widespread availability of tobacco products in the consumer market, “endgame” strategies move towards a tobacco-free future wherein the availability of commercial tobacco products is heavily restricted and their use is phased out. ^[13] While these strategies are exploratory rather than evidence-based best practices, and they may encounter legal challenges from the tobacco industry, considering “endgame” concepts may drive discussion of what a tobacco-free future looks like and spur innovation. Some of these strategies focusing on product availability include:

- Restricting the sale of tobacco products to only one type of outlet, such as adult-only, tobacco specialty shops or state-run outlets, as some states have done with liquor. ^[7]
- Restricting or prohibiting the sale of all combustible tobacco products – This could be done with well advanced notice and targeted, increased access to cessation counseling and medication to give people the time and resources to quit, possibly while lifting restrictions on strongly regulated less dangerous nicotine products (e.g. e-cigarettes). ^[13]Read more about this policy option:
- Retailer Reduction:
  - Limit the number, location, and hours of tobacco retailers
  - Prohibiting new outlets:
    - Retailer Caps: limit the number of tobacco retailers allowed in a city or other geographic area. This has been done Philadelphia, San Francisco, and in many localities in Massachusetts.
    - Moratoriums: prohibit any new tobacco retailers from opening
  - Raise cost of licenses and cost of violations to discourage tobacco sales
  - Incentivize retailers to give up tobacco licenses ^[11]
  - See resources on Licensing, Zoning, and Retailer Density for strategies to implement each of these policies.

The evidence for restricting tobacco product availability

Policies that restrict tobacco product availability can help to counteract the tobacco industry’s efforts to attract new, current and recently quit smokers.

Evidence has shown that restricting the sale of flavored tobacco products can reduce youth tobacco use. We have also seen the impact on a local level in New York City. After New York City restricted sales of flavored tobacco products (excluding e-cigarettes and menthol cigarettes) in November 2010, the sale of all flavored products declined by 87%. ^[12] In addition, the percent of New York City teens who reported ever use of flavored tobacco products or use of any tobacco products declined significantly (37% lower odds of ever trying flavored tobacco products and 28% lower odds of using any type of tobacco product) after the policy was implemented.^[12]

The 2009 FSTPCA ban on flavored cigarettes was associated with a 17% reduction in the probability of middle and high school youth becoming smokers and a 58% reduction in cigarettes smoked by current youth smokers. ^[13] However, the ban was also associated with an increase 45% increase in use of menthol cigarettes, a 34% increase in use of cigars, and a 55% increase in use of pipes, indicating that youth may be substituting menthol cigarettes and other flavored tobacco products in place of flavored cigarettes.^[13] Overall, the probability of youth using any form of tobacco dropped by 6% following the ban on flavored cigarettes, showing the impact that restrictions on flavored tobacco products can have. However, the increases in use of other products that are commonly flavored is concerning and points towards the potential impact that more comprehensive restrictions on menthol cigarettes and all flavored other tobacco product could have on youth tobacco use. ^[13]

According to a 2011 report by the FDA’s Tobacco Products Scientific Advisory Committee (TPSAC), removing menthol cigarettes from the marketplace would benefit public health. They estimate that the effects of such a ban would include:

39% of menthol smokers would quit
47% of African American menthol smokers would quit
preventing over 17,000 fewer premature deaths by 2020
preventing nearly 2.3 million people from initiating smoking by 2020

Ontario, Canada implemented a ban on menthol cigarettes on January 1, 2017. One month after the ban took effect, 29.1% of menthol smokers had attempted to quit, a larger proportion than the 14.5% who previously said they would quit. ^[14] Of menthol smokers who made a quit attempt, 80% reported that the menthol ban affected their decision at least a little.^[14] A larger proportion of menthol smokers (29.1%) also reported using other flavored tobacco or e-cigarette products compared with the 5.8% who had said they would do so before the ban.^[14] While menthol cigarettes only make up 5% of cigarette sales in Canada, this study indicates that a menthol ban may encourage both cessation and also product switching if other flavored products are not also restricted.

We know that smoking rates are lower in areas with lower tobacco retailer density and that living within close proximity of a tobacco retailer makes staying quit more difficult. Reducing the number of tobacco retailers reduces accessibility, availability, and environmental cues for tobacco use.

Countless packages of various flavored Swisher Sweets cigarillos with "2 cigars for 99 cents" emblazoned on packaging and product boxes