Policies that limit youth access and exposure to tobacco: a scientific neglect of the first stages of the policy process

Thomas G Kuijpers,Marc C Willemsen,Anton E Kunst

doi:10.1186/s12889-019-7073-x

Abstract

BackgroundPolicymakers can adopt and implement various supply-side policies to limit youth access and exposure to tobacco, such as increasing the minimum age of sale, limiting the number or type of tobacco outlets, or banning the display of tobacco products. Many studies have assessed the impact of these policies, while less is known about the preceding policy process. The aim of our review was to assess the available evidence on the preceding process of agenda setting, policy formulation, and policy legitimation.MethodsA systematic literature search was conducted using the PubMed and the Social Sciences Citation Index databases. After selection, 200 international peer-reviewed articles were identified and analyzed. Through a process of close reading, evidence based on scientific enquiry and anecdotal evidence on agenda setting, policy formulation and policy legitimation was abstracted from each article.ResultsScientific evidence on the policy process is scarce for these policies, as most of the evidence found was anecdotal. Only one study provided evidence based on a scientific analysis of data on the agenda setting and legitimation phases of policy processes that led to the adoption of display bans in two Australian jurisdictions.ConclusionThe processes influencing the adoption of youth access and exposure policies have been grossly understudied. A better understanding of the policy process is essential to understand country variations in tobacco control policy.

Highlights

Policymakers can adopt and implement various supply-side policies to limit youth access and exposure to tobacco, such as increasing the minimum age of sale, limiting the number or type of tobacco outlets, or banning the display of tobacco products
This study provided evidence on the agenda setting and legitimation phases of policy processes that resulted in the adoption of display bans in two Australian jurisdictions [42]
It seems that most literature that we found could be grouped into the first category, which is often reflected by normative comments in the discussion sections in which authors conclude that policymakers should consider scientific evidence about effectiveness to base policymaking decisions on

Summary

Introduction

Policymakers can adopt and implement various supply-side policies to limit youth access and exposure to tobacco, such as increasing the minimum age of sale, limiting the number or type of tobacco outlets, or banning the display of tobacco products. The aim of our review was to assess the available evidence on the preceding process of agenda setting, policy formulation, and policy legitimation. The policy most often used to achieve this reduction of access is raising the minimum age-of-sale for the purchase of tobacco. A reduction in illegal sales to minors does not necessarily mean that youth tobacco consumption is decreased, because minors can often still access tobacco through social sources [8]. This is one of the reasons some authors have concluded that age-of-sale policies are ineffective [9]. Others conclude that such policies may be effective, as long as they are well enforced [10]

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