Thursday, July 26, 2012

Lynn Health Officials Propose to Reduce Youth Access to Cigarettes by Capping Number of Stores that Sell Tobacco at 180 and Prohibiting Pharmacies from Selling Cigarettes

According to an article in the Daily Item (Lynn, MA), health officials in Lynn have proposed two regulations designed to limit youth access to tobacco. First, the number of tobacco retailers would be capped. Second, tobacco sales would not be allowed in pharmacies. These proposed regulations were inspired by the finding that Lynn has the highest ratio of tobacco outlets to population in the state.

According to the article: "Local teenagers have more opportunities to buy cigarettes and other tobacco products in local stores than their peers in many other Massachusetts cities, said city Health Director MaryAnn O’Connor and an anti-smoking advocate working with the city. Citing state Public Health statistics, O’Connor and Joyce Redford said Lynn has almost three local stores selling tobacco products for every 1,000 people age 18 and older living in the city. ... O’Connor said the Board of Health is reviewing several measures aimed at keeping cigarettes and other tobacco products out of teenagers’ hands, such as capping the number of tobacco retailers in the city and banning tobacco sales at pharmacies." ...

"O’Connor said a ban on pharmacy sales of tobacco would immediately drop the ratio by banning sales in chain-operated drug stores as well as independently owned pharmacies like Crown Drug on Lewis Street. ... Girl’s Inc. substance abuse prevention coordinator Cassie Haughton said the number of licensed tobacco retailers in Lynn exceeds the state average by 60 percent. She said that statistic translates into opportunities for teens or people they can convince to buy for them to obtain cigarettes. “We’re hoping the city can put a cap on the number of tobacco licenses they allow in the city,” Haughton said." ...

"O’Connor said placing a cap on the number of local retailers at, say 180 licenses, would allow new stores or ones that have not had licenses to acquire them when other license holders close."

The Rest of the Story

This is just the latest example of how tobacco control has gone awry. Here, health officials are proposing to limit youth access to cigarettes by making sure that there are no more than 180 places in Lynn for kids to buy cigarettes and by making sure that they cannot buy cigarettes at pharmacies.

I am quite confident that youth in Lynn would have just as easy a time obtaining cigarettes if there were 180 places to buy cigarettes in Lynn than if there were 250 places to buy cigarettes. Capping the number of tobacco retail outlets at 180, or even half that number, is not going to have any effect whatsoever on youth access to cigarettes.

First of all, less than half of youths obtain their cigarettes by purchasing them in the first place. Second, limiting the number of stores that sell cigarettes will simply send kids to the stores that do sell cigarettes.

In other words, the effect of the proposed regulations will be nothing other than re-distributing the market share for the sale of cigarettes to youth to a lower number of stores, as well as shifting tobacco sales to youth from pharmacies to gas stations and convenience stores.

As I have argued previously, prohibiting sales of tobacco in pharmacies will have no effect on youth access to cigarettes. If the Lynn health officials really wanted to limit youth access to cigarettes, then they should ban the sale of tobacco in all places other than pharmacies. Pharmacies are the least likely place for youth to purchase cigarettes. They are much more likely to buy cigarettes in gas stations and convenience stores, retailers that are left untouched by the proposal.

The proposed regulations are also terribly inconsistent and hypocritical. If cigarettes are so bad that they should not be sold in pharmacies, then why aren't cigarettes so bad that they shouldn't be sold at gas stations or convenience stores? Obviously, this measure isn't about public health protection, it's about being political cowards and trying to achieve political gain without having to actually take a principled stand.

The proposal to limit the number of cigarette retailers is also hypocritical. Officials are telling us that cigarettes are so bad and their sale exposes children and promotes tobacco use. So what are we going to do about it? Get rid of the sale of cigarettes in Lynn stores? No, of course not. Instead, we're going to set an arbitrary limit of 180 stores that can sell tobacco.

What the crafters of this proposal are basically saying is: "It's only a problem if more than 180 stores in Lynn sell cigarettes. As long as we limit the number of stores that sell cigarettes to 180 or less, then everything is fine. There's no need to protect the kids that live around those 180 stores from the sale of cigarettes, just the kids who would live around the 181st store."

This is absurdity. It makes no sense. If there is a public health justification for banning the sale of tobacco products in Lynn, then ban it. If not, then don't. But to pretend that arbitrarily setting the number of tobacco outlets at 180 is some sort of public health measure is insane. It does nothing to prevent the sale of cigarettes, which will certainly remain readily available with 180 outlets in the city.

Do you mean to tell me that if there 181 stores that sell cigarettes in Lynn, there is a major public health problem, but if we get that number down to 180, we have addressed that problem?

I just don't understand this type of reasoning. What are these folks thinking?

The rest of the story is that limiting the number of stores in Lynn that sell cigarettes is not going to have any impact on smoking and the policy therefore does not protect the public's health. As such, it represents an unjustified intrusion on private business and is therefore an arbitrary and inappropriate public policy. If advocates want to work in their communities and try to limit the sale of tobacco, that is fine. It serves an educational purpose and allows the community to mobilize around the issue. But a legislated mandate on the number of stores of a given type is not justified unless there is evidence that it would serve a substantial government interest, like protecting the public's health. Cutting the number of tobacco-selling stores down to 180 and preventing tobacco sales in pharmacies is not going to have any impact on smoking in Lynn. Cigarettes will remain readily accessible.

This is a waste of time. Advocates in Lynn should instead be focusing on how to prevent youth from wanting to buy cigarettes in the first place. Interventions that reduce the demand for cigarettes are the tried and true, evidence-based approaches to youth smoking prevention.

No comments: