Further description: These fee-based policies are examples of 'polluter pays' approaches that seek to apply a fee to tobacco products to offset costs incurred by government related to tobacco-related issues.

Types of identified fee-based policies: mitigation fees (e.g., levy per-pack fees); licensing fees (e.g., charge to retailers to fund retailer licensing programmes).

What we know: There is limited but inconclusive evidence of the effects of fee-based policies. Mitigation fees could be used to offset government costs to clean-up cigarette litter, which one cited study reported can account for almost a fourth of all waste-related costs from cigarettes (Golden et al., 2016). Use and increase of licensing fees could lead to increased product prices but evidence of impact is inconclusive (Golden et al., 2016).

Examples of implementation: San Francisco (USA) has a cigarette litter abatement policy to offset government costs of clean-up (Golden et al., 2016). Estimating the cost of (22 cents per pack of cigarettes in the case of San Francisco) was noted as an approach that could used to inform development of fee-based policies in other contexts (Golden et al., 2016).

What we know: Matthes et al., (2023) identified five types of countermarketing activities against tobacco industry interference: exposing harmful industry practices and false claims, accessing political decision-makers, generating and using scientific evidence, use of legal tools (e.g., filing complaints) and mobilising coalitions of potential supporters. Reported tactics for exposing harmful practices and false claims included use of press conferences, press releases, op-eds, media interviews, rallies and advertisements (Matthes et al., 2023). Effective examples of counterstrategies were characterised by increased public awareness of tobacco industry wrongdoing, generated community support for tobacco control measures and greater pressure on political and legal decision-makers (Matthes et al., 2023).

Examples of implementation: Matthes et al., (2023) reports on several case examples of national and local level displays of counterstrategy activities to tackle tobacco industry interference. One cited example from Mexico City (Mexico) involved advocates launching media campaigns during the early implementation stages of its new local 100% smoke-free law (i.e., all enclosed public places and workplaces became smoke-free) to counter British American Tobacco's attempts to cause confusion over local smoke-free and the weaker federal laws (see Crosbie, Sebrié and Glantz, 2010 in Matthes et al., 2023). Another cited example from Minnesota (USA) involves advocates successfully countering false tobacco industry claims around second-hand smoke by sponsoring a local advertising campaign that framed second-hand smoke as a health issue (see Tsoukalas and Glantz 2003 in Matthes et al., 2023).

Types of taxes: excise duties, duty escalators, minimum excise taxes.

What we know: There is strong evidence indicating the efficacy of sales and excise taxes on tobacco products with a range of associated health improving outcomes and likelihood for reducing health inequalities (Naik et al., 2019; Wilson et al., 2012). Higher excise taxes on tobacco products have been associated with reduced cigarettes sales and consumption (Hatchard et al., 2023) and increased prices have been shown to negatively impact smoking prevalence in both youth and adults and smoking initiation in young people (Wilson et al., 2012). Duty escalators have been shown to impact tobacco-related hospital admissions and mortality rates (Hatchard et al., 2023). Cited studies by Hatchard et al., (2023) have estimated that changes to the duty rates on hand-rolled tobacco in the UK would increase product prices, and in turn, lessen the tax gaps between factory manufactured and hand-rolled tobacco and ultimately work to reduce smoking uptake (Hatchard et al., 2023). Comprehensive, multi-component policy approaches to tobacco control (e.g., increase tax, clean indoor air law, advertising bans, warning labels) appear to be more highly cost-effective than increases to tobacco taxes alone (Singh et al., 2018). O'Connell and Kephart, (2020) suggest the need to consider vaping products in relation to tobacco cigarettes when devising taxation and pricing strategies, pointing to literature that increased cigarette prices can lead to increased past 30-day e-cigarette use, suggesting a substitution effect.

Types of identified policies: restrictions of the sale of flavoured non-cigarettes with exclusions for menthol tobacco and certain retailers, such as: adult-only tobacco shops with more than 90% tobacco sales revenue; adult-only tobacco shops with more than 90% sales from tobacco products; adult-only establishments such as bars, vape shops; tobacconists; retail tobacco store or smoking bars; and smoking bars.

What we know: A high quality review from Rogers et al., (2021) on local US bans and restrictions on the sale of flavoured and/or menthol tobacco products reported that these policy approaches have been associated with decreased availability of flavoured and menthol tobacco products, decreased marketing and advertising of flavoured/menthol tobacco products, decreases in flavoured tobacco product use and decreases in flavoured e-cigarette use. Evidence within the low quality review of O'Connell and Kephart, (2020) echoed these findings and highlighted the need for further research into the effectiveness of local policies on young people’s use of flavoured and non-flavoured e-cigarettes or vaping devices and subsequent swapping and/or quitting intentions and behaviours.

Examples of implementation: As reported by Rogers et al., (2021), the US cities with these policy restrictions included: Providence (RI), Minneapolis (MN), St Paul (MN), Lowell (MA), Boston (MA) and 38 other municipalities in Massachusetts.

What we know: A high quality review from Rogers et al., (2021) on local US bans and restrictions on the sale of flavoured and/or menthol tobacco products reported that these policy approaches have been associated with decreased availability of flavoured and menthol tobacco products, decreased marketing and advertising of flavoured/menthol tobacco products, decreases in flavoured tobacco product use and decreases in flavoured e-cigarette use. Evidence within the low quality review of O'Connell and Kephart, (2020) echoed these findings and highlighted the need for further research into the effectiveness of local policies on young people’s use of flavoured and non-flavoured e-cigarettes or vaping devices and subsequent swapping and/or quitting intentions and behaviours.

Examples of implementation: In Massachusetts (USA), the local implementation of a flavoured tobacco product restriction that was inclusive of e-cigarettes/vapes was associated with significant decreases in the availability of flavoured cigars and flavoured e-cigarettes/vapes and their e-liquids over time compared to communities without the restrictions (see Farley & Johns, 2017 and Kingsley et al., 2020 in O'Connell and Kephart, 2020). Short-term findings of decreased current use of flavoured and non-flavoured tobacco products among high school youth within a local Massachusetts community were also described within a cited study evaluating the efficacy of these flavour restrictions (see Kingsley et al., 2020 in O'Connell and Kephart, 2020).