Background
Methods
Study | Aim | Proposed MOEM | MOEM function within the supply chain |
---|---|---|---|
Liberman [17] | • Tackle the “perverse incentive” of tobacco companies to break the nexus between profit making and harm causing via a regulatory system • To minimise harm caused by tobacco | An agency would oversee the whole regulatory system and fill in ‘regulatory gaps’ within the supply chain | The agency has an overarching regulatory presence on all the processes of the supply chain |
Borland [8] | • Regulate the tobacco industry, by incentivising them to produce less harmful product via regulating the market • To minimize the harm of tobacco product | Tobacco product agency (TPA) would act as a health-oriented intermediary that would remove the marketing power of the tobacco industry from the supply chain | Act as an intermediary between the manufacturers and the distributors: take over the marketing component |
Callard [9] | • Transfer the responsibility of tobacco product manufacturing from a profit making to a non-profit making institution via taking over the work of the tobacco industry and achieve health goals • To reduce tobacco, use in a timely manner | A non-profit agency (NPE) with public health mandate to take over the work of the tobacco industry | Transfer the supply chain work to a non-profit agency removing the tobacco industry from the whole market |
Thomson et al. [18] | • Provide New Zealand government with a proposal on how to regulate the tobacco market • To maximize harm reduction and eliminate marketing of branded tobacco | Establish a government tobacco authority monopoly (to use an approach like the one suggested by Borland) | Similar to Borland but also proposes regulating the retailers by binding them to a license agreement |
Thomson el al [11] | • Eliminate the availability of commercial smoked tobacco within a 10-year period to reach ‘(near) zero’ sales • To be able to ensure the best health and social outcomes for people | A government agency that would run a ‘sinking lid’ quota on tobacco product to be auctioned to manufacturers and importers. The manufacturer can only sell the traded amount to distributors | The agency will be introduced before the manufacture in the supply chain and will provide suppliers with a tradable quota |
• Regulate the toxicity of tobacco products and entirely transition to less harmful products within a 5 year period • To shift consumers towards less harmful product | Suggests a government run tobacco marketing monopoly (to use an approach like the one suggested by Borland) | Same as Borland | |
Smith et al. [21] | • Introduce the concept of moving tobacco sales to government owned outlets as a progressive step towards the tobacco endgame | A government tobacco monopoly to regulate the pre-existing “government-operated alcohol retail monopolies”- to start selling tobacco product | A government tobacco monopoly be introduced to act as sole buyer from the manufacturers and remove the retailer from the supply chain and replace them by government operated retailers |
Results
Governance structure
Sub-themes | Liberman [17] | Borland [8] | Callard [9] | Thomson et al. [18] | Thomson et al. [11] | Smith et al. [21] | |
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Ownership of the MOEM | |||||||
(1) Government (2) Ministry of Health | The ownership was not specified but it need to be distant from executive governmental body | (1-Or equivalent that is different from the department that collects taxes that could be the department of finance or equivalent) | Ownership was not discussed. But it was stated it could be public or private. It could be similar to pre-existing models: water utilities, public broadcasting, hospital systems | (2) | (1) | (1) | (1) |
Control—External | |||||||
(1) Established by legislation to act under charter and certain criteria (2) To have PH mandates/goals (3) To ensure control of illicit trade (4) To report on its work to an independent body (5) To require the TTC to disclose information on its research and products (6) To have the power to set differential tax in co-ordination with treasury | (1)(2)(3) (4- To report to a federal/state body in the same field of work such as drugs, health.) (5- The MOEM will incentivise tobacco manufacturers towards developing less harmful/addictive products) | (1)(2)(3) (4) (5- The MOEM will incentivise them to disclose information to the TPA) (6) | (1) (2) | (1)(2)(4) (5- Disclosure will be to the Tobacco Authority or Ministry of Health) | (1)(2)(4- Reporting will aim at evaluating the phasing out) (5-The MOEM will aim to implement Article 5.3) | (1)(2) | (1)(2)(3) |
Control—Internal | |||||||
(1) Establish a board of experts from different fields (2) To have board members distant from executive government and political interference to ensure independence | (1)(2) | (1)(2) | Unspecified | (2- Just mentions independent) | Unspecified | Unspecified | Unspecified |
Reporting mechanism | |||||||
The MOEM transparently communicates information by making it publicly available This information includes: (1) Meetings (2) Decisions (3) Operations (4) Price changes (5) About products (6) Licensing (e.g., retailers or farmers) (7) Deals/agreements with TTC | (1)(2)(3)(5)(6)(7) Reporting mechanism should be made possible (a) By routine publication on the internet (b) Given the freedom of information legislation | (2)(3)(4)(5)(7) | Unspecified | Unspecified | (4) | Unspecified | (4)(5) |
Financing- Source to cover cost of operation | |||||||
(1) Government budget (2) Self-financed through business (3) From tax revenue | Unspecified | (1)(2) | (2)(3) | (3) | (2- Revenue from quota bidding on residual tobacco) (3) | (3) | (2) |
Financing- means to address financial interest / vested interest /corruption | |||||||
(1) Earmark the profit for tobacco control and CSR activities to avoid reliance on tobacco sales (2) Gradually drop tax revenue in line with decrease in tobacco consumption to avoid the government incentive to maintain sale (3) Incentivising staff to maintain the agency integrity/involve them in cessation programmes (4) Hold staff accountable for their work (5) Benchmark the work of the agency toward another agency in jurisdiction (6) Isolate the MOEM decision making regarding revenue (7) Decrease dependence on revenue by setting a date to eliminate tobacco | (6) | (3)(6) | (2) | Unspecified | (1) | (1- Fund anti-smoking activities) (4) | (1- Provide retailors with one-time transition fund to shift to other business; for education; enforcement of the ban.) (7) |
Ownership and control
Reporting mechanism
Financing
The supply chain operational remit
Sub-themes | Liberman [17] | Borland [8] | Callard [9] | Thomson et al. [18] | Thomson et al. [11] | Smith et al. [21] | |
MOEM function within the supply chain | |||||||
The agency has an overarching regulatory presence on all the processes of the supply chain | Between the manufacturers and the distributors: take over the marketing component | • Transfer the supply chain work to a non-profit agency removing the tobacco industry from the whole market •Tobacco growers, stakeholders, distributors, and retailers could remain in the market but should change to other goals as the tobacco market will vanish | •Similar to Borland but also regulate the retailers via licensing •Take over the marketing component | •The agency will be introduced before the manufacture in the supply chain and will supply suppliers with tradable quota •SOTM can participate in the auction (to control potential auction rigging by suppliers) | Same as Borland Take over the marketing component | A government tobacco monopoly be introduced, and act as sole buyer. The retailer will be removed from the supply chain and be replaced by government operated retailers | |
Product design | |||||||
(1) Reveal ingredient/content (2) Labelling (3) Packaging (4) Determine the tobacco manufacturing process | (1)(2)(3)(4) | (1) | (2)(3- Design and manufacture their cigarettes in ways that reduce their attractiveness or addictiveness) | (1)(3) | (2)(3) | (1)(2-Generic) (3) | (1)(2)(3) |
Purchase | |||||||
(1) Become the sole purchaser of tobacco products from the manufacturer (2) Adopt a regulatory role over the work of the manufacturer (licensing) (3) Set the amount of tobacco product/or brands/or tendered amount to be allowed into the market (4) Set the whole price | (1)(2)(3) | (1)(3)(4) | (3) | (1)(3)(4) | (3- Quota on manufactured and imported products)(4) | (1) | (1)(3)(4) |
Promotion | |||||||
(1) Control tobacco product communication (what goes on the pack) (2) Move into unbranded products (3) Control what retailers can communicate with consumers | (1)(3) | (1)(2)(3) | (1) | (1)(2) | (2) | (1)(2) | (1) |
Distribution | |||||||
(1) Bind the distributor to a license agreement – full control (2) Take over distribution (3) Keep the relationship between the manufacturer and distributor (4) Complimentary intervention to address potential fake shortages of supply | (1) | (1) | (2) | (1) | (3)(4) | (2- Into government owned retail shops by removing the retailing sector and retailers) | |
Retailing | |||||||
(1) Bind the retailer to a license agreement – full control (2) Takeover the retail (3) Indirect control with licensing (4) Set retail price (5) Anti-monopoly laws (6) Support retailers to switch to alternative markets through financial reward/incentivise to be involved in cessation programmes (7) Restrict store density and location (8) Set condition under which products could be available in the market (9) Set age of purchase (10) Limit selling hours (11) Set limit on purchases to control secondary illegal sale to minors | (1)(4)(8) | (3)(4)(5)(7) | (2)(6) | (1)(7)(8) | (4- Price would increase as supply decreases)(8)(9) | (3)(4)(6)(7) | (2- Restricting sale to government owned retail stores)(4)(6)(7)(8)(9)(10)(11) |
Final consumption | |||||||
(1) Ensure that demand is met (2) Act to reduce demand (3) Shift demand to less harmful products (4) Communicate with consumers: awareness; cessation; price change (5) Allow growing tobacco for personal use | (1)(2)(3)(4-cessation information) | (1)(2)(3) | (1)(2) | (5) | (3) | (1) |