How tobacco control advocates and organizational leaders in California view endgame policies
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University of California, Social & Behavioral Sciences, United States of America
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A34
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Tobacco control policy innovations often start at the local level. The U.S. state of California, and localities within it, have been tobacco control policy leaders. Currently, policies designed to end, rather than just reduce or mitigate the tobacco epidemic are being discussed around the world. This study explored California tobacco control leaders' and advocates' opinions about new policy concepts characterized as endgame ideas.

We conducted 7 focus groups with tobacco control advocates (professional and volunteer) in 5 California cities. In each group, participants were invited to comment on 4 briefly described proposed endgame policies (smoker licensing, banning sales, aging out smoking/tobacco-free generation (TFG), and gradual retailer reduction). We also interviewed leaders of 11 major tobacco control and health voluntary organizations and networks. Interview questions explored participants' knowledge of tobacco endgame discussions and ideas, and their reactions to the 4 policy proposals.

Of the four proposals, the TFG and retailer reduction were the most popular, though some participants saw advantages and disadvantages to all of them. TFG's focus on youth and noninterference with current smokers were regarded positively; however, participants were concerned that continuing to allow sales to current smokers would limit its effectiveness and might exacerbate existing inequities. Retailer reduction was approved for being politically viable, addressing the problem more directly, and focusing on sales rather than users. Objections included doubt about its effectiveness, and concerns about equity if reductions were not distributed fairly. All proposed policies were thought to lead to black markets.

Advocates and leaders were concerned that endgame proposals be effective and equitable. Black markets were seen as a downside to all proposals. Novel proposals will need careful development and messaging to gain advocates' support.

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