How San Francisco successfully implemented its comprehensive flavor ban on tobacco products

Working in collaboration with colleagues at the San Francisco Department of Public Health and the San Francisco Tobacco Free Coalition, we just published “Compliance with San Francisco’s flavoured tobacco sales prohibition” in Tobacco Control.  The paper details the educational campaign and engagement with local retailers followed by formal enforcement that has led to 80% compliance on direct inspection.

There was a huge battle to defend this law when RJ Reynolds (maker of Newport, the leading menthol cigarette) rolled into town and spent $12 million in an unsuccessful effort to block the law by forcing a referendum (which they lost with 68% supporting the law).  While it is important to study what it takes to get tobacco control laws passed and defend them against industry rear-guard actions, the literature on implementation is much more limited.  Active implementation is at least as important as the political fight to get the law passed. 

Our paper also includes an extensive supplemental file that contains more details on the specific aspects of the implementation program and educational materials that were (and continue to be) made available to retailers.  These materials are freely available for other health departments to use in developing their implementation programs.

Here is the abstract:

Background In June 2018, San Francisco voters upheld the first comprehensive prohibition on sales of flavoured tobacco products (all products including menthol, everywhere in the city with no exceptions).

Methods This paper used data collected by the San Francisco Department of Public Health as part of its implementation and enforcement of San Francisco’s city-wide ban on the sale of flavoured tobacco products. Every licensed tobacco retailer was visited and inspected. The San Francisco Department of Public Health and volunteers conducted an educational campaign from September 2018 to December 2018, including emailing all licensed tobacco retailers about the law, mailing a fact sheet poster, conducting four listening sessions and visiting permitted tobacco retailers to educate them about the law and solicit questions.

Results Compliance inspections started in December 2018, which found that compliance was 17%. Compliance increased in January 2019 and averaged 80% between January 2019 and December 2019. After the phase-in period, all retailers were visited as part of routine inspections. This effort resulted in 80% compliance.

Conclusion Including retailer education prior to enforcement can result in compliance with a comprehensive ban on the sale of menthol and other flavoured tobacco products.

The full citation is:   Vyas P, Ling P, Gordon B, Callewaert J, Dang A, Smith D, Chan B, Glantz S. Compliance with San Francisco’s flavoured tobacco sales prohibition.  Tobacco Control Published Online First: 16 April 2020. doi: 10.1136/tobaccocontrol-2019-055549.  It is available here.