Imagining the future: Law and tobacco control towards a sub-10% smoking prevalence environment

Background:

California has one of the lowest adult smoking rates in the world, with 14% in 2005. Overall, in 2003, 21.6% of Americans were current smokers. In Australia, smoking prevalence had fallen to 17.4% in 2004, whereas 24% of British adults smoked in 2005, and 23.5% of New Zealanders in 2006.

Statistics like these suggest that a sub-10% smoking prevalence environment is a challenging, even formidable goal, for most governments and public health stakeholders in the medium term. While law has played an important role in tobacco control efforts in recent decades, little thought has been given to defining law's place within successive, future stages of a long-term tobacco control strategy.

Objective

This paper presents a broad view of the strategies that tobacco control laws have employed up to the present time. It proposes a model for the staged introduction of new laws and institutions to support efforts to move progressively from 20-25% prevalence to a sub-10% environment.

Results

Law has an important and evolving role in the future of tobacco control: “locking in” emerging community norms around health, and stimulating the formation of new norms. As tobacco use continues to decline, and becomes even more clearly the domain of disadvantaged groups, difficult issues will arise about the proper limits of public health law and the merits of for-profit versus not-for-profit models for the tobacco industry. Important strategic issues also arise, beginning with the question of whether and how to regulate the manufacturing process and constituents of cigarettes.