Tobacco control policy: The need to prepare for unintended consequences

Organizations that have opposed tobacco control policies were among the first to bring attention to “unintended” consequences. Bars and restaurants claimed that smokefree policies decreased business revenues, and organizations, researchers, and advocates claimed that cigarette taxes were regressive for the poor. These and other arguments have been used to impede policies rather than to discuss the helpful and harmful effects at the micro and macro levels. Because of the unilateral focus of various parties to impede policies, the tobacco control field has maintained its unilateral lens on reducing second-hand smoke exposure and prevalence rates. The field has paid little attention to unintended consequences out of fear of jeopardizing policies.

Recent legislation and treaties, however, prompt the need to critically investigate policy effects through a broader lens. The Framework Convention on Tobacco Control, the Children's Health Insurance Program Reauthorization Act (2009), and the Family Smoking Prevention and Tobacco Control Act (2009) aim to reduce tobacco use/exposure, but the evidence-base demonstrating the intended and unintended consequences among vulnerable populations is lacking. This session discusses what we know about policies effects on low socioeconomic status populations, who bear the burden of tobacco; describes the importance of examining policy effects on vulnerable populations at the micro and macro levels; and provides an overview of the Tobacco Research Network on Disparities project, Unintended Consequences of Tobacco Policies on Low Socioeconomic Status Women and Girls. Investigating unintended consequences will help the tobacco control community frame future policies and programs that optimize the impact on vulnerable populations.