Tobacco Retail Report 2013 - Selling Tobacco Anywhere, Anytime Harmful Not Helpful

CanActBeat cancer together
HARMFUL not helpful
The greater the availability of tobacco, the more people smoke
Anywhere, anytime
Selling tobacco

Suggested citation
Fry R, Williams K, Tang A, Burton S, Walsberger S, Soulos
G, Egger S, Chapman K. Selling tobacco anywhere, anytime:
harmful not helpful. Sydney: Cancer Council NSW, 2013.
Acknowledgments
The study was funded by Cancer Council NSW which receives
fundraising support from many large and small retailers.
Cancer Council NSW would like to thank Dr Becky Freeman for
reviewing the literature on the tobacco retail environment and
Michael Narag and Maria Uribe for research assistance with
the literature review. A sincere thank you also to Alicia Harper,
Susanna Lawrence and Charlotte Allen for coordinating the
production and distribution of survey materials.
We are indebted to Cancer Council NSW volunteer data
collectors and staff for their considerable time and effort in
supporting and conducting the survey.
Glossary
Entrenched smokers: Smokers who are not considering
quitting and who typically plan cigarette purchases in advance
to buy at a lower price and avoid running out.
Non-tobacco smoking product: Any product (other than a
tobacco product) intended to be smoked, including any product
known or described as herbal cigarettes.1
Smoking accessories: Cigarette papers, pipes, cigarette
holders, hookahs, water pipes and any other smoking
implements.1
The Public Health (Tobacco) Act 2008 (NSW)1
does not include matches or lighters in the definition of smoking
accessories, which means they can be lawfully displayed.
Specialist tobacconist: A person who operates a business
which, in the 12 months preceding 25 September 2008 (the
date the Public Health (Tobacco) Act 2008 was introduced to
Parliament), obtained at least 80% of its gross turnover from
the sale of tobacco, non-tobacco smoking products or smoking
accessories.1
The person has also been approved as a specialist
tobacconist by the NSW Ministry of Health.
Tipping point smokers: A person who does not intend
to smoke at all (e.g. attempting quitters who relapse) or
does not intend to smoke very much. Both are more likely
than entrenched smokers (see definition above) to buy
cigarettes on impulse and are more likely to be susceptible to
point‑of‑purchase cues to smoke.
Tobacco products: Tobacco, cigarettes, cigars or any
other product containing tobacco, designed for human
consumption or use.1
Tobacco retailers: Stores and other outlets selling tobacco,
including supermarkets, tobacconists, petrol stations,
convenience stores, bottle shops, and cigarette vending
machines in pubs and clubs.
Contents
Executive summary 1
Recommendations3
Introduction4
How does the retail environment
influence smoking? 6
Tobacco retailing in NSW 9
Cancer Council NSW audit of
tobacco retailers 11
The case for tobacco retail reform 16
Conclusion20
References22

Executive summary
Tobacco, a product that kills half its long-term users and is
Australia’s leading cause of preventable death and disease,
is startlingly easy to buy. Cigarettes are available ‘anywhere,
anytime’ – a legacy of the time when society was ignorant of
their dire health effects. There are more than five times as many
places to purchase tobacco in NSW as there are places to buy
prescription medicines. Tobacco retailers are also less regulated
than sellers of second-hand goods.
To date, tobacco control policies have concentrated on reducing
the demand for tobacco products. Apart from a long-standing
ban on sales to under-18s, there are few limits on supply, such
as who may sell tobacco, where and when they may sell, or
limits on the number of outlets selling tobacco.
Tobacco use remains an urgent health and social problem
and there is enormous potential for retail reform to help solve it.
In the state plan, NSW 2021, the NSW Government has targets
to lower smoking rates by 3% for non-Aboriginal people and 4%
for Aboriginal people by 2015. Under the National Partnership
Agreement on Preventative Health, the Government has
committed to reduce daily smoking among adults to 10%
or lower by 2020.
The NSW Minister for Health has endorsed the National
Tobacco Strategy 2012–2018, thereby undertaking to consider
further options for tobacco retailer licensing and to commission
research on regulatory approaches to control the number and
type of tobacco outlets.
Cancer Council NSW has examined the evidence relating to the
retail environment and smoker behaviour and has conducted an
audit of 1,739 tobacco outlets in NSW. This report presents our
findings, which show targeted reforms to the retail sector could
make it easier for smokers to quit and remain quit, help stop
young people taking up smoking and protect communities we
have so far failed to protect.
Developing a policy and research strategy for retail reform
will require partnerships across government and non-
government organisations. As a first step, Cancer Council NSW
recommends the Minister for Health establish a Ministerial
taskforce. This taskforce would explore, evaluate and advise on
policies designed to reform the tobacco retail environment and
effectively accelerate declines in smoking prevalence.
How does the retail environment influence smoking?
• There is evidence that high retail density and widespread
distribution contribute to smoking, though there are some
limitations to this evidence.
• There is Australian and international evidence
suggesting tobacco outlet density is higher in
disadvantaged communities.
• There is international evidence indicating the presence
of tobacco retailers near schools contributes to tobacco
purchase and smoking prevalence in adolescents.
• There is some evidence that people trying to quit smoking
are more likely to relapse if they live close to retailers
selling tobacco.
• There is evidence that convenience, route and impulse
outlets (e.g. convenience stores, small grocers, petrol
stations, bars, pubs and clubs) may disproportionately
contribute to unplanned purchases of tobacco products
by people not intending to smoke (e.g. quitters who
relapse) or people smoking more than they intend.
• There is consistent evidence that consuming alcohol,
especially in social settings like bars and clubs, increases
the amount of smoking, increases the likelihood of
non‑daily smokers smoking and undermines quit attempts.
• There is strong evidence that removing point-of-sale
displays will reduce retail cues to smoking. However,
there is emerging evidence from NSW indicating it will
not completely eliminate retail cues. The mere sight of a
retail outlet, particularly tobacconists and liquor stores,
prompts some smokers and quitters to think about
smoking or buying cigarettes. This highlights the
potential public health benefits of policies to limit
the number and/or type of tobacco outlets.
1

Cancer Council NSW audit of tobacco retailers
Cancer Council NSW used the Retailer Notification Scheme to
better understand the structure, density and distribution of the
tobacco retail sector in NSW and to find out whether retailers
were complying with the new laws under the Public Health
(Tobacco) Act 2008 (NSW). We also used it to measure
differences in cigarette prices between retailers.
Using the list of notified retailers obtained under a Government
Information (Public Access) request (formerly Freedom of
Information), we randomly selected a sample of postcodes
in urban and regional NSW. Thanks to 166 volunteer and
staff data collectors, we visited and made observations in
1,739 retail outlets.
More than one in four audited tobacco retailers (26.6%) did
not comply with the requirements of the Act, either because
they had not notified under the Retailer Notification Scheme
or because they failed to comply with in-store requirements,
or both. The most commonly observed breach of the
legislation was failure to display a ‘Smoking kills’ warning
sign (11.9% of retailers).
We found that the Retailer Notification Scheme does not
accurately record the number, type and location of tobacco
retailers in NSW. Some retailers were not on the list and
the audit indicated there is one unlisted retailer for about
every 13 listed retailers. Unlisted retailers were more likely
to breach the legislation.
The list of notified retailers also included a large number of
multiple listings and out-of-date retailer records. Although
the list received from the Ministry of Health contained 13,439
retailer records, our results estimate the actual number of
active tobacco retailers in NSW, as of February 2013, is 9,597.
Convenience, route and impulse retailers (e.g. licensed
premises, convenience stores, petrol stations and newsagents)
represented 78.3% of tobacco outlets, despite the fact that
supermarkets and tobacconists dominate market share.
This is a striking finding, as previous research suggests
convenience, route and impulse retailers disproportionately
contribute to purchases by ‘tipping point’ smokers,
such as people not intending to smoke and attempting
quitters who relapse.
Cigarette prices varied between different types of outlets.
Prices were cheaper, on average, in postcodes with a
higher proportion of children in the population and in
disadvantaged areas.
Retail: the weak link
Retail availability of tobacco is the weak link in tobacco control.
Public health experts have proposed various strategies to limit
supply, including mandated quotas, nationalising the tobacco
industry, banning sales to anybody born after a certain year,
requiring smokers to have a licence to purchase tobacco,
phasing out retail sales completely and limiting the number,
type, location and/or opening hours of outlets.
Cancer Council NSW believes the most feasible approach is
incremental, and the evidence supports the introduction of limits
on the number, type and location of outlets.
Stronger regulation would further reposition tobacco as the
harmful product that it is and contribute to denormalisation
of smoking and tobacco products.
Public support for stronger regulation of tobacco retailing
is high. In a recent Cancer Council NSW community-based
survey of 2,473 people, 79% of respondents supported policies
requiring retailers to have a licence to sell tobacco products, in
the same way retailers need a licence to sell alcohol. Licensing
has higher levels of support than point-of-sale display bans and
plain packaging, which are already in place.
Kids are more likely
to take up smoking
when there are more
tobacco outlets closer
to their school.
2

Recommendations
Addressing the retail availability of tobacco in NSW could
accelerate declines in smoking prevalence, support people
more effectively to quit smoking, promote health in socially
disadvantaged areas and protect children from tobacco.
A taskforce for tobacco retail reform
Cancer Council NSW recommends the NSW Minister for Health:
1. Convene a taskforce under the auspices of the Minister’s
office to explore, evaluate and advise on policies for tobacco
retail reform that will most effectively accelerate declines in
smoking prevalence.
2. Require the taskforce to base their advice to the Minister
on the best available evidence.
3. Include the following responsibilities among the taskforce’s
terms of reference:
• commission research to more closely assess the impact
of retail distribution on smoking in the NSW context;
• consult with the public and affected retail sub-sectors;
• assess the potential for a positive licensing scheme,
with associated conditions of licence and an annual
fee, as a means to boost resources for monitoring
and enforcement;
• develop strategies to restrict the number, type and
distribution of retail outlets; and
• outline the essential elements of a regulatory scheme
that would effectively address the impact of tobacco
retail availability on smoking rates.
4. Appoint a maximum of nine members to the taskforce,
including the chair, with expertise in:
• tobacco control (one or two members);
• public health, particularly preventive health in Aboriginal
and disadvantaged communities (one or two members);
• public health law and regulation (one member);
• academic retail marketing research relevant to the terms
of reference (one member); and
• the retail sector (maximum of three members, chosen
to reflect the diversity of the retail market).
5. Exclude from taskforce membership (but include in
consultations) individuals and/or organisations that
receive funding from tobacco companies or are directly
affiliated with those companies.
6. Request the taskforce to report their findings within
one year of being convened.
Strengthening compliance with existing
tobacco retail laws
Cancer Council NSW recommends the NSW Ministry of Health:
7. Introduce systems to ensure notifications under the Retailer
Notification Scheme are accurately collected and recorded,
so as to provide up-to-date information about outlet
address, changes in business ownership and whether the
outlet continues to sell tobacco.
8. Provide a publicly accessible, searchable online database
of all notified tobacco retailers in NSW.
9. Provide publicly accessible annual reports with quantitative
measures of retailer monitoring, compliance, prosecutions
and convictions for each Local Health District.
3

Introduction
Australia is a world leader in reducing smoking. In NSW,
smoking prevalence is at a historic low with 14.7% of people
aged 16 and over now current smokers,2
compared to 41%
of men and 30% of women in 1977.3
Lower smoking rates have been achieved through a series of
actions over many years, including:
• bans on tobacco advertising, promotion and sponsorship;
• mass media campaigns about harms to health;
• taxes to increase tobacco prices;
• health warnings on cigarette packs;
• free advice and support to quit smoking;
• subsidised pharmacotherapies to help with quitting;
• laws that ensure tobacco must be out of sight in
retail outlets; and
• legislated smoke-free areas, both indoors and outdoors.
Despite enormous progress, however, more than 800,000
people in NSW continue to smoke.2,4
Tobacco is a powerfully
toxic product and remains Australia’s leading cause of
preventable death and disease.5
It kills more than 5,000
people per year in NSW – 20 times the number killed by motor
vehicle crashes.6,7
One in two long-term smokers will die from
smoking-related causes.8
Moreover, the impact of smoking is increasingly concentrated
among the most disadvantaged members of our community.
Aboriginal people in NSW have more than twice the smoking
prevalence of non-Aboriginal people9
and residents of low
socio-economic status (SES) neighbourhoods have more
than twice that of high SES neighbourhoods.10
Among very
disadvantaged people, (e.g. people with mental health issues
and injecting drug users), smoking rates of 66%11
to 94%12
have been reported.
The NSW state plan, NSW 2021, has a target to reduce
smoking rates by 3% by 2015 for non-Aboriginal people
and by 4% for Aboriginal people.13
NSW is also committed
to the target set out in the National Partnership Agreement
on Preventative Health to reduce daily smoking among adults
to 10% or lower by 2020.14
There is still much work to be done. We must find new ways
to make it easier for smokers to quit and remain quit, to stop
young people taking up smoking, and to protect communities
we have so far failed to protect.
Retail: the next step
To date, tobacco control efforts have concentrated on reducing
demand (i.e. discouraging people from wanting to buy and
smoke cigarettes). Apart from a long-standing ban on sales to
under-18s, limits on the sale of tobacco have been neglected.
Cigarettes are widely available in corner shops, supermarkets,
petrol stations, newsagents, tobacconists, pubs, clubs
and bottle shops.
The ban on retail displays (known as point-of-sale displays)
is an important step forward. NSW and other Australian states
have introduced this legislation over the past few years and are
among the first jurisdictions in the world to do so. Along with
plain packaging, this effectively removes one of the remaining
forms of cigarette promotion.
However, these provisions do not restrict the supply of tobacco.
Existing legislation places very few restrictions on the type and
number of outlets where tobacco may be sold. It is still available
‘anywhere, anytime’.15
It is an anomaly that such a dangerous product is so easy to
get. The ubiquity of tobacco is out of step with other products
that are legal, yet potentially lethal. Alcohol, for example, is
regulated by strict licensing conditions. There are restrictions
on the type of outlet that can sell alcohol, where outlets can
be located, what hours a retailer may operate and what training
staff must undertake. Medicines are also subject to laws about
where and by whom they can be sold. Even businesses selling
second-hand musical instruments require a licence, but not
those selling cigarettes.16
Tobacco: available anywhere
Tobacco, a product which is harmful by nature and kills
half its long-term users, is much more widely available
than other goods which are not by their nature harmful
to health. At 30 June 2012, there were 13,439 notified
tobacco retailers in NSW.#
This is compared to just
1,831 registered pharmacy businesses17
and 1,129
Australia Post outlets.18
#
As noted later in this report, the number of tobacco retailer notifications
as provided to Cancer Council NSW by the Ministry of Health (13,439)
overestimates the number of currently active retailers. However, our best
estimates suggest the actual number is still close to 10,000.
4

Reform of the tobacco retail environment would help achieve
the NSW Government’s policy goals. The NSW Cancer Plan
2011–15 includes policies to further restrict the availability
and supply of tobacco products as a key activity in its goal
to reduce smoking prevalence.19
In November 2012, the NSW Minister for Health and her
counterparts from other states endorsed the National Tobacco
Strategy 2012–2018.20
This Strategy includes the following
actions relating to tobacco retailing:
• Consider and explore further regulatory options to implement
tobacco licensing schemes for retailers and wholesalers
(Responsibility: State and territory governments).
• Commission research to examine the potential benefits,
feasibility and best practice regulatory approaches of placing
controls on the number and type of tobacco outlets in the
community (Responsibility: Australian Government; state and
territory governments; non-government organisations).
The National Tobacco Strategy notes that a positive licensing
scheme, which links compliance with tobacco control legislation
to the right to sell tobacco products, is generally recognised
as best practice.20
A positive licensing scheme is one that
requires a retailer to gain prior approval to sell tobacco.21
In 2002, the Commonwealth Department of Health and
Ageing commissioned the Allen Consulting Group to review
the feasibility, cost-effectiveness and public health benefits of
registration and/or licensing schemes for tobacco retail outlets
in Australia. The review found a strong case for positive licensing
of tobacco retailers, not only as a means to improve monitoring
and compliance but also to reinforce the understanding that
selling tobacco is a privilege, not a right.21
Positive licensing schemes now exist in the Australian Capital
Territory, Northern Territory, South Australia, Tasmania and
Western Australia.22-26
Licence fees range from $200 per year in
the ACT to $302 in Tasmania. Some states also make registers
of retailers available to the public. Western Australia, notably,
has a searchable online register of retailers.
NSW has a ‘negative licensing’ scheme where retailers do not
need a licence to sell tobacco. However, they are required
to notify the government that they intend to sell the product
and can be prohibited from selling if they repeatedly breach
the conditions of sale. Queensland and Victoria do not have
licensing or notification schemes,27,28
and as yet there is no
jurisdiction in Australia that limits the type or location of tobacco
outlets. Similarly, no jurisdiction places caps on the number of
available licences.
Regulating the tobacco retail environment can send “an
unambiguous public signal that governments regard tobacco
as an exceptionally harmful product.”29
The widespread availability
of tobacco sends a mixed message to the community, diminishes
the likelihood of successful quit attempts and undermines
efforts to denormalise smoking. Cancer Council NSW believes
there are opportunities to reduce tobacco use and accelerate
progress towards government targets through reform of the
retail environment.
This report:
• summarises existing evidence on the relationship between
the retail environment and smoking;
• describes current arrangements for tobacco retailing in NSW;
• reports the results of an audit of retail outlets
selling tobacco; and
• provides recommendations for reducing smoking in the
community through tobacco retail reform.
Smokers are less
likely to quit when
they live closer to
tobacco outlets.
5

How does the retail environment
influence smoking?
Density and distribution
The presence of cigarettes in every corner shop is a legacy of
the time when society was ignorant of their dire health effects.
Historically, tobacco has been treated like bread, milk, chewing
gum, or any other fast-moving consumer good, with widespread
distribution through a variety of retail outlets.
Even without product displays, the widespread availability of
tobacco is itself a form of promotion. Retail access is likely to
prompt cigarette purchase by providing environmental cues,
to facilitate smoking by making it easy to buy tobacco and to
normalise smoking by sending a signal that tobacco is like any
other product.15,29-33
In a population-based NSW survey, 87.5% of smokers reported
they were within walking distance of a retail tobacco outlet during
their daily activities.15
When asked what they would do if this was
not the case, 7.8% said they would try to quit and 20.0% would
cut down.15
* In a prospective diary-style study, also in NSW,
participants recorded their smoking and cigarette purchases at
four-hourly intervals over four days.32
* They saw cigarettes for sale
in more than 40% of four-hour periods spent outside the home.
In international studies, high retail outlet density (the number of
tobacco retailers per area or per population) has been found to
be associated with smoking in both adolescents and adults.34-39
A study in Massachusetts, for example, found people living in
communities with a higher density of tobacco retailers were
more likely to be smokers, after adjusting for other individual
and community-level risk factors.36
A Californian study found
the density of convenience stores and distance to the nearest
convenience store were associated with the number of
cigarettes smoked per day.34
Most studies on retail density have been cross-sectional
and have been conducted in the United States and other
jurisdictions where point-of-sale promotions remain. Causation
cannot be assumed and their findings cannot be directly
translated to the NSW retail environment. However, ‘place’
is one of the ‘4Ps’ that make up any marketing strategy
(along with product, price and promotion40,41
) and the literature
relating to tobacco density and distribution points to the need to
consider place – or retail geography – in tobacco control.
Young people
Among young people, the density of retailers and their proximity
to schools has been shown to influence smoking and tobacco
purchase.35,37,38,42-45
Studies in Canada and New Zealand found
access to tobacco retailers made it more likely that high-school
aged children bought their own cigarettes.42,45
In California, smoking
prevalence was higher in schools with more than five tobacco
outlets within walking distance than in schools without tobacco
retailers nearby.35
New York research showed an association
between high tobacco retail density and young people believing
that smoking made them look cool and helped them fit in.43
Research has established that adolescents aged 11 to 14
who perceive cigarettes are easily available are more likely to
experiment with smoking and to progress to heavier smoking.46,47
Disadvantaged neighbourhoods
Disadvantaged communities are more likely to have a higher
concentration of tobacco retail outlets.35,38,48-54
Evidence
of this relationship has been found in numerous studies
internationally,35,38,49-51,53,54
and recently in NSW52
and WA.48
The NSW study found higher tobacco retail density in
disadvantaged local government areas (as measured by
socio‑economic indexes for areas, or SEIFA55
) and in remote
areas. Both associations were significant after controlling for
smoking prevalence, indicating higher outlet density is not
simply due to higher demand.52
Similarly, the density of tobacco outlets in WA was found to be
more than four times as high in suburbs and towns in the bottom
quartile of SEIFA scores than in those in the top quartile.48
A nation-wide US study found areas of disadvantage had higher
densities of tobacco retail outlets regardless of whether the
community was urban or rural.51
A study in New Jersey showed
income was the strongest and most consistent predictor of
tobacco outlet density, with higher tobacco outlet densities
in geographic areas with lower median household income.54
Tobacco outlet density was also likely to be higher in areas with
higher percentages of ethnic minorities.54
Another New Jersey
study found for every US$10,000 increase in median household
income, there was a 0.9 unit decrease in tobacco outlet density.56
Many of the studies on retail density and disadvantage have
controlled for smoking prevalence. This accounts for the fact
that higher outlet density in disadvantaged neighbourhoods is
partly due to higher prevalence of smoking and therefore higher
retail demand. Whether or not the relationship between density
and disadvantage is causal, the correlation is cause for concern
as it suggests the retail environment adds to the many social
and environmental factors known to make it more difficult for
disadvantaged people to give up smoking.57
Attempting quitters
There are few studies on the effect of the tobacco retail
environment on cessation attempts, but some research
suggests easy access makes it harder to quit. In Texas,
attempting quitters living less than 500 metres from the
nearest tobacco retailer were less likely to remain abstinent
during the six month-period after a quit attempt. The effect
was even stronger for those less than 250 metres away.58
Retailer density, unlike proximity, did not affect quitting success.
This study is notable because of its prospective, longitudinal
design, its finding of a dose-response relationship and because
it used physical tests to verify participants’ self-report of their
smoking status.58
*This study received funding from Cancer Council NSW.
6

More people are
likely to smoke...
When there are more tobacco
outlets closer to where they live.
PEOPLE
How many
Smoke
Smokers are less
likely to quit...
When they live closer
to tobacco outlets.
PEOPLE
Whether
Quit
Kids are more likely
to take up smoking...
When there are more tobacco
outlets closer their school.
PEOPLE
Whether
Smoke
OF
THE AVAILABILITY
TOBACCO INFLUENCES...
THE
and this increases
RISK of cancer
7

A study in Finland, with a long follow-up period, found living
close to a store selling tobacco and having one or more stores
within 0.5 km were associated with lower quitting success
among men who were moderate or heavy smokers, but not
among women or lighter smoking men.59
Type of outlet
Lower-priced outlets
There is evidence that smokers use different types of retail
outlets in different ways. Supermarkets and tobacconists
generally charge lower prices,60
and a prospective diary‑style
study in NSW found smokers made larger purchases at these
outlets than at other outlets, although the difference was not
significant among attempting quitters.31‡
By charging lower
prices, supermarkets and tobacconists may encourage
price‑sensitive smokers to buy larger quantities and to smoke
at higher levels. These outlets may be disproportionately used
by entrenched smokers who are likely to purchase on price,
plan ahead to avoid stock-outs and buy in bulk.61
Convenience outlets
A NSW diary-style study including 1,112 smokers drawn from
a population sample, and 2,287 attempting quitters drawn
from Quitline callers, was undertaken in NSW.31
Participants
recorded when and where they obtained tobacco products, and
how much they smoked, at four-hourly intervals over four days.
Lighter smokers were more likely than heavier smokers to buy
tobacco products at convenience stores, bars, pubs and clubs,
suggesting these outlets may disproportionately contribute
towards impulse purchases and confirming the link between
alcohol and smoking.31
Convenience-type outlets appear likely to encourage purchase
by quitters who relapse. Participants in a NSW telephone
survey who had tried to quit within the previous 12 months
were asked where they usually bought cigarettes and where
they bought their first relapse-related cigarettes.15
Supermarkets
comprised about half of usual purchases for this group,
but only 25.7% of relapse purchases. Service stations and
convenience stores accounted for 23.8% and 23.2% of relapse
purchases respectively.15
Licensed premises
Consuming alcohol, especially in social settings like bars and
clubs, increases the amount of smoking and the likelihood of
non-daily smokers smoking. It is also known to undermine
quit attempts.62-64
The disinhibiting effect of alcohol and the
presence of other smokers are contributing factors, but smokers
report that access to purchase also increases consumption.
Twenty‑two per cent of surveyed smokers in NSW said having
cigarettes sold on the premises meant they smoked ‘a lot more’
and 17% ‘a little more’, with those aged 18 to 39, women and
light smokers more likely to report increased consumption in
bars, pubs and clubs.15
Point-of-sale displays
A compelling body of evidence contributed to the adoption
of retail display bans by NSW and other Australian states and
territories. A 2009 systematic review concluded that point‑of‑sale
display bans are justified on the grounds tobacco promotion has
been clearly proven to influence children to begin smoking.65
Visible tobacco displays are known to contribute to unplanned
purchase,66-68
make quitting more difficult,69,70
and increase the
amount of smoking and the likelihood of purchasing.32
Studies in Ontario, Canada and Melbourne have found full
display bans achieved high compliance.71,72
In contrast, a
partial display ban in New Zealand was found to be difficult
to implement and achieved limited compliance.73
Compliance
varied between retailer types, with small local general stores
and convenience stores least compliant.73
Effects of retailer access versus point-of-sale displays
As noted previously, one of the difficulties in determining the
relevance of international research to NSW is that many studies
have been done in jurisdictions where point-of-sale displays
may confound the effect of retailer density and proximity on
smoker behaviour. It is unclear whether, in the absence of
all point‑of‑sale marketing, the abundance of tobacco retail
outlets will still trigger tobacco purchases and sabotage quit
attempts. How do we know whether smokers are prompted to
buy cigarettes by seeing packets of cigarettes, by the presence
of the outlet itself, or both?
Recent qualitative research in NSW goes some way towards
answering this question.74‡
Following the introduction of display
bans in all stores except tobacconists, the study investigated
whether the sight of tobacco retailers, tobacco shelving and
signage created environmental cues to buy and/or smoke
cigarettes among smokers and attempting quitters.74
As well
as being interviewed, subjects used a voice recorder and
disposable camera to make recordings over a four-day period
whenever they were tempted to smoke or buy cigarettes.
Alcohol was the strongest environmental factor associated
with smoking.74
All participants but one provided unprompted
comments that they were more likely to smoke at licensed
premises, often more than they intended.74
This was
particularly the case for light smokers.74
The sight of tobacco cupboards and signage was an
environmental cue for some participants.74
Seeing the outside
of a tobacco retailer, particularly tobacconists and liquor stores,
also triggered the urge to smoke among some subjects.74
The results are preliminary and more research is needed, but
this study provides the first evidence that the sight of tobacco
retailers, even in the absence of point-of-sale displays, can prompt
people to buy cigarettes and/or smoke.74
It suggests the removal
of point-of-sale display will reduce, but not completely eliminate,
environmental cues and highlights the potential benefits of policies
limiting the number and/or type of tobacco outlets. The researchers
emphasised that any review of tobacco retailing should consider
how licensed premises promote impulse purchases.74
‡
This study received funding from Cancer Council NSW.
8

Tobacco retailing in NSW
The Ministry of Health states the purpose of tobacco
legislation in NSW is to reduce the incidence of smoking and
the consumption of tobacco and other smoking products
(e.g. water pipes and herbal cigarettes), particularly
by young people.75
A display ban on tobacco products was enacted by the
Public Health (Tobacco) Act 2008 (NSW)1
hereafter referred to
as ‘the Act’, which came into effect on 1 July 2009. Along with
the Public Health (Tobacco) Regulation 2009,76
it sets a number
of conditions for the legal sale of tobacco and related products
in NSW (see below).
Key provisions of the Public Health (Tobacco) Act 2008 (NSW)1,76
• Sale of tobacco products to persons under the age of
18 years is prohibited, as is purchase on behalf of a
person under 18.
• Tobacco retailers must notify the Ministry of Health before
they engage in tobacco retailing.
• Tobacco products, non-tobacco smoking products and
smoking accessories must not be visible to the public
from inside or outside the premises. The display ban has
been phased in over four years and small retailers and
specialist tobacconists have had extra time to comply.
At the time of the Cancer Council NSW audit of tobacco
retailers, all retailers except specialist tobacconists were
required to comply. As of July 2013, all retailers including
specialist tobacconists should be fully compliant.
• Tobacco and related products may be sold only from
one point of sale (i.e. cash register) on each premises.
• Vending machines can only be placed in an area of a
hotel, club or casino restricted to over 18s, and only one
vending machine per licensed premises is allowed.
• Vending machines must be controlled by staff members
(e.g. by supplying tokens or remote control).
• Retailers must display a standard ‘Smoking kills’ warning
sign and a notice that it is illegal to sell tobacco products
to persons under 18.
• Prices may be displayed either on price tickets or on a
single price board, but not both. There are restrictions
on the size and colour of price displays.
• Tobacco and related products cannot be included in
shopper loyalty programs.
• Smokeless tobacco products, fruit-flavoured cigarettes
and confectionary-flavoured cigarettes cannot be sold.
• Sales are not permitted from mobile or temporary
retail outlets.
Note:
There is no law against people aged under 18 years
selling cigarettes.
See the glossary on the contents page for definitions of
tobacco products, non‑tobacco smoking products and
smoking accessories. Matches and lighters are not covered
by the legislation and may be legally displayed.
More information about tobacco retailing laws can be found
at: www.health.nsw.gov.au/publichealth/healthpromotion/
tobacco/information_for_tobacco_retailers_
and_consumers.asp
9

Retailer Notification Scheme
The Act requires tobacco retailers to notify the Ministry of Health
before they engage in tobacco retailing. The set of arrangements
for complying with this requirement is called the Retailer
Notification Scheme. Businesses selling tobacco at the time the
legislation was passed were also required to notify the Ministry
of their retailing status. Notification is free, however specialist
tobacconists paid a one-off fee of $250 to be listed as such
and be granted extra time to comply with the new legislation.77
Tobacco retailers must provide details of each retail premises via
the NSW Government Licensing Service.77
Details include the
business name, business type (e.g. petrol station, newsagent,
licensed premises), business address, trading address,
Australian Business Number, and owners’ and directors’ names.
Retailers are required to update their details if there is a change
in the business address, trading address or business ownership.
In the case of tobacco vending machines, both the owner of
the machine and the lessee (e.g. the occupier of a pub or club
where the machine is located) must notify the Ministry of their
business details.78
The Retailer Notification Scheme is described as a ‘negative
licensing’ scheme.21
This means retailers do not need to obtain
a licence or meet any defined requirements prior to selling
tobacco, but can be prohibited from selling if they repeatedly
breach the conditions of sale. If a retailer is convicted of two
offences against the same provision of the legislation (such as
failure to notify) on the same premises within a three-year period,
they will be prohibited from selling tobacco for three months.
Three offences on the same premises within three years incurs
a 12‑month prohibition.75
The stated purpose of the Notification Scheme is to inform the
Ministry of Health about the number and location of tobacco
retailers in NSW, in order to support enforcement of the display
ban and other retail laws.77
Environmental Health Officers are
able to check whether tobacco retailers have made a notification
when they are undertaking routine checks on compliance with
display and signage laws.78
Selling tobacco without notification
can incur an on-the-spot fine of $250 and a maximum
penalty of $11,000.79
Monitoring, enforcement and compliance
Effective enforcement of tobacco retailing laws is crucial if
these laws are to successfully reduce smoking in the population.
A recent systematic review of the effectiveness of sales to
minors legislation, for example, found every intervention that
had successfully disrupted the sale of tobacco to minors was
associated with an observed reduction in tobacco use by
youth.80
Strategies that were not strong enough to effectively
disrupt sales, or relied entirely on retailer education, did not
reduce smoking on their own.80
Cancer Council NSW has not identified any publicly available
data about the number of compliance checks, violations,
prosecutions or convictions of tobacco retailers under the
Public Health (Tobacco) Act 2008. Published research from
the NSW Central Coast in the 1990s found that where there
was active enforcement of sales to minors legislation, along
with retailer education and media publicity about prosecutions,
there was increased retailer compliance and reduced youth
smoking.81-83
The most recent readily available state-wide data
indicate compliance with sales to minors legislation of 84% in
1998‑1999.84
A newspaper report on the NSW North Coast
indicated 81% compliance in 2012.85
Another news report said
NSW Health had made around 1,000 inspections on 12,500
tobacco retailers in 2010–2011,86
which if correct, means fewer
than 10% of retailers were inspected during the year.
of smokers are within
walking distance of a
retail outlet, during their
daily activities.
87%
10

Cancer Council NSW audit
of tobacco retailers
Following the introduction of the Public Health (Tobacco)
Act 2008, Cancer Council NSW has explored opportunities
to support quit attempts, to reduce smoking rates in
disadvantaged communities and to further reduce smoking
uptake by young people.
The available evidence shows that the number and location
of retail outlets can influence smokers’ behaviour and different
types of outlets affect different types of smokers. Reforms
designed to differentially reduce purchases by young people
and attempting quitters, as well as impulse purchases, would
be attractive options to explore as they may increase the
impact of tobacco control policy.
The Retailer Notification Scheme presented an opportunity
to better understand the structure, density and distribution of
the tobacco retail sector as it provided a source of information
about all retailers in NSW.
Cancer Council NSW obtained the list of retailers that
had notified with the Retailer Notification Scheme under a
Government Information (Public Access) request (formerly
Freedom of Information), since the list is not publicly available.
Release was granted on the basis of overriding public interest in
disclosure of the information, and because the information was
already publicly available although not in a consolidated source.
Cancer Council NSW received the list of notified retailers as a
spreadsheet, with data fields including the registered business
name, ACN, type of business, trading address and in some
cases, the trading name of the business. The first data set of
12,451 records was received in April 2011. Cancer Council
NSW made a second request for updated data in 2012 and
received two additional data sets. Together, the three files
comprised 13,439 records and covered retailer notifications
up to 30 June 2012.
What we wanted to find out
Our objective was to conduct an audit of a sample of tobacco
retailers. We wanted to assess the potential of the Retailer
Notification Scheme data as a research resource, and to
determine whether the data adequately captured the number
and location of retailers in NSW for use in monitoring compliance
with retail legislation.
The audit aimed to discover if there were retailers that have not
notified under the Retailer Notification Scheme, and to assess
retailer compliance with the point-of-sale display ban and other
in-store provisions of the Public Health (Tobacco) Act 2008.
We also wanted to measure variations between retailers in
the price of one popular brand of cigarettes, to obtain data
on the entry and/or exit of tobacco retailers from the market,
Sydney
Newcastle
Dubbo
Coffs
Harbour
Gold
Coast
Tamworth
Bendigo
Figure 1: Location of postcodes selected for survey
Sydney
Liverpool
Penrith
Gosford
11

and to investigate whether there were differences in compliance
by retail outlets in urban compared to regional areas, more
disadvantaged compared to less disadvantaged areas, and
areas with higher compared to lower proportions of children
in the population.
What we did
Preliminary examination of the 13,439 retailer records provided
by the Ministry of Health revealed that some records were
incomplete, incorrect, or could not be matched to a street
address. We reviewed those that were obviously incorrect
(e.g. where the postcode did not match the suburb), recorded
errors and corrected them where possible. There were many
cases of multiple records for the same premises and after
excluding records that exactly matched the business name
and address in another record, 12,731 tobacco retailers
remained in 605 postcodes.
Audit area
Cancer Council NSW has a network of regional offices, eight
of which took part in the study. These regions covered 468
postcodes containing 10,794 retailer records, or 77.4% of the
postcodes and 80.3% of the notified retailer records represented
on the Ministry of Health list.
To select a sample of tobacco retailers, we randomly selected
postcodes within each region until we reached pre-defined
sampling targets.87
Through this process, 100 postcodes were
randomly selected. Five of those postcodes were very small
rural localities in which no data collectors could be recruited,
resulting in a sample of 2,279 retailer records in 95 postcodes.
Of these, 51 were in regional NSW and 44 were in the Sydney
metropolitan area (Figure 1).
The sample records included 61 recorded address errors, which
included incorrect postcode (24), missing street name and/or
number (21) and incorrect suburb (8).
Survey and data collection
We developed a survey to record observations of key features
of the in-store environment (including products on display,
presence or absence of a ‘Smoking kills’ warning sign and
features of price boards or price tickets) and to record the price
of a standard brand of tobacco (Winfield 25 pack and 50 pack).
Data were collected in each Cancer Council NSW region by
166 staff and volunteers who had received either face-to-face
or telephone training. The audit took place between November
2012 and early February 2013, with most data collected in
November and December 2012.
Data collectors received survey forms for all notified retailers in
their allocated postcode or neighbourhood, a summary list of
notified retailers in their area, and maps. Each data collector
was asked to audit approximately 20 notified (‘listed’) retailers
within one of the randomly selected postcodes, and to look for
any tobacco retailers in their area that did not appear on their
summary list (‘unlisted’ retailers). If any unlisted retailers were
found, they performed the same audit as for listed retailers.
It was expected that data collectors would have more success
finding unlisted retailers in an area familiar to them. Therefore, if
they were assigned to audit a randomly selected postcode that
was not their home (residential) postcode, data collectors were
also asked to look for unlisted retailers in their home postcode.
What we found§
All unlisted tobacco retailers identified by data collectors were
reviewed against the original list of notified retailers provided by
the Ministry of Health and against an updated list that included
notifications during the period of the study. After this process,
174 retailers in 79 postcodes were categorised as unlisted and
added to the audit data.
There was an average of 17.7** active tobacco outlets (i.e.
outlets currently selling tobacco) per postcode. Postcode 2010
(Darlinghurst/Surry Hills) had the highest number, with 107 active
outlets. Within the 17 remote and outer regional postcodes
in our selected sample, there was an average of 7.3††
active
tobacco outlets per postcode.
Almost 80% of outlets are convenience, route and
impulse retailers
Together, convenience, route and impulse retailers (i.e.
licensed premises, convenience stores, petrol stations
and newsagents) represented 78.3% of tobacco outlets.
By contrast supermarkets and tobacconists dominate market
share.88
Outlets in licensed venues were the most numerous,
representing 34.2% of our sample (Figure 2).
Figure 2: Proportion of each type of outlet in survey sample
% of all surveyed outlets^^
^ Includes vending machines and over-the-counter sales in pubs, clubs, hotels,
bars, bottle shops and licensed restaurants.
^^Surveys were completed for 1,739 retailers, comprising 1,565 listed retailers
and 174 unlisted retailers. Of the 2,279 listed records sampled, 664 were multiple
listings or retailers no longer selling tobacco and 50 were not surveyed.
O
ther/N
otspecified
G
eneralgrocery
store
Tobacconist
Superm
arket
N
ew
sagent
Petrol/service
station
C
onvenience
store
Licensed
prem
ises^
0
10
20
30
40
5
15
25
35
Convenience, route
and impulse retailers
= 78.3%
Convenience, route
and impulse retailers
= 78.3%
§
This is a summary of our findings. Further results are available in a separate report.87
**Standard deviation 17.5. ††
Standard deviation 9.5.
12

The Retailer Notification Scheme does not provide
accurate information about tobacco retailers in NSW
The audit showed the Retailer Notification Scheme does not
accurately record the number, type and location of tobacco
retailers in NSW. It found there are retailers not included in the list
of notified retailers provided by the Ministry of Health. In addition,
the list of notified retailers includes a large number of multiple
listings and out-of-date retailer records. Multiple listings for the
same business may mean businesses are not notifying changes
to business location or ownership, or notifications of changes
are not reflected in Ministry of Health records.
We estimate that there is one unlisted tobacco outlet for
about every 13 listed outlets
To estimate the ratio of unlisted to listed outlets, we compared
the number of unlisted to listed retailers in randomly selected
postcodes where at least one of the data collectors lived in the
postcode.87
In this subset of postcodes, 109 unlisted outlets
were identified in addition to 1,369 listed outlets, resulting in
a ratio of one unlisted outlet for every 12.56 listed outlets. It is
unlikely data collectors located every unlisted retailer, so this
figure is probably an underestimate.
The likelihood of being unlisted varied between different types
of outlets. General grocery stores had the highest proportion
of unlisted outlets (34.8%), while convenience stores and
tobacconists had the lowest (6.1 and 6.2% respectively;
Figure 3). Outlets in major cities were more likely to be
unlisted than those outside major cities.
Figure 3: Proportions of unlisted outlets and outlets with one
or more breaches, by type of outlet
% unlisted^^ % with one or more in-store breaches^^
^^Total of 1,739 listed and unlisted outlets.
We estimate that NSW has approximately 9,597
tobacco outlets
The Retailer Notification Scheme does not accurately quantify
the number of tobacco retailers in NSW because it includes a
large number of multiple listings and excludes unlisted outlets.
However, we can estimate the total number by using the audit
results. Of the 2,229 listings checked during our survey (2,279
records less 50 not visited‡‡
), 664 were multiple listings or
retailers no longer selling tobacco.§§
Applying the proportion
of listings found to be active outlets (1,565/2,229=70.2%) to
the number of records listed under the Scheme after exact
duplicates were removed (12,731 as at 30 June 2012), and
adding an estimate of unlisted retailers based on the ratio
described above, the result is an estimate of 9,597 tobacco
retail outlets in NSW.87
One in four tobacco retailers did not comply with
the legislation
More than one in four audited tobacco retailers (26.6%, Table 1)
did not comply with the requirements of the Act, either because
they had not notified under the Retailer Notification Scheme
(according to Ministry of Health records) or because they failed
to comply with in-store requirements, or both.
The most commonly observed breach was failure to display
a ‘Smoking kills’ warning sign (11.9% of retailers, Table 1).
Tobacco products were on display in 5.5% of retailers and
smoking accessories or non-tobacco smoking products were
displayed in 3.6% of retailers. (These figures do not include
specialist tobacconists, which could still legally display tobacco
and related products at the time of the survey.)
Results regarding the two types of breaches involving exact
measurements should be interpreted with caution. The Public
Health (Tobacco) Regulation 200976
states price lettering
must be no more than 2 cm high and/or 1.5 cm wide. Also,
any tobacco display in a specialist tobacconist must be more
than 2 m away from any public facing opening. Data collectors
estimated rather than measured these distances so these data
may not be entirely accurate.
O
ther/N
otspecified
G
eneralgrocery
store
Tobacconist
Superm
arket
N
ew
sagent
Petrol/service
station
C
onvenience
store
Licensed
prem
ises
0
10
20
30
40
5
15
25
35
45
‡‡
Data collectors did not audit 50 retailers in selected postcodes (3.1% of active outlets) because they were closed at the time of visit or due to lack of time.
§§
Of these 664 records, some were legitimate dual listings for vending machines: NSW legislation requires notification by both the vending machine operator and the
licensee. While correctly reflecting the legislation, such dual listings, if unaccounted for, inflate the actual number of tobacco outlets in NSW.
13

Table 1: Observed breaches of tobacco retail legislation
Type of breach Number (%)
of outlets
No ‘Smoking kills’ sign 201 (11.9)
Outlet selling tobacco but not listed with
Ministry of Health
120 (6.9)
Displaying tobacco but not a specialist tobacconist 93 (5.5)
Displaying smoking accessories or non-tobacco
smoking products but not a specialist tobacconist
60 (3.6)
More than one type of price display 22 (1.3)
Prices more than 2 cm high and/or 1.5 cm wide 18 (1.1)
Outlet advertising or promoting cigarettes 14 (0.8)
Specialist tobacconist displaying tobacco less than
2 m away from a public facing opening
14 (0.8)
Non-compliant warning sign colour (identified from
volunteer comments)
1 (0.1)
Outlets with one or more observed breaches 448 (26.6)
Total breaches observed n=543^
^Some outlets had more than one breach.
% = percentage of 1,685 listed and unlisted outlets surveyed in randomly
selected postcodes.
Unlisted retailers and those in disadvantaged areas were
more likely to break retailing laws
Retailers not listed under the Retailer Notification Scheme were
significantly more likely than listed retailers to breach in-store
provisions of the legislation, even after adjusting for other
factors. Among unlisted outlets, 36.8% recorded a breach,
compared to 21.0% of listed retailers.
Retailers in disadvantaged postcodes were significantly more
likely to breach in-store provisions of the legislation than those
in less disadvantaged postcodes. Again, this relationship held
after adjusting for other factors.
Breaches were more likely in certain types of outlets. In the
survey, tobacconists were observed to have the highest
proportion of breaches of in-store provisions, but the most
common breaches were price lettering more than 2 cm high
and or 1.5 cm wide, and display less than 2 m away from
any public facing opening. This finding should be interpreted
cautiously for the reasons noted previously.
General grocery stores, convenience stores and other/unspecified
types of outlets also had relatively high proportions of outlets with
one or more breaches (Figure 3). Petrol stations scored lowest,
with 15.5% of petrol stations having one or more breaches of
in-store provisions.
Cigarettes were cheaper in areas with more young people
and in disadvantaged areas
The average price for a pack of Winfield 25s in audited outlets
was $18.01. Prices varied significantly between different types
of outlets with tobacconists and supermarkets the cheapest,
at $16.09 and $16.51 respectively. Convenience stores, petrol
stations and licensed premises were all significantly more
expensive than supermarkets. Licensed premises (including
pubs, clubs, bars and bottle shops) had the highest average
pack price at $18.83 (Figure 4).
After taking into account the type of outlet and other factors
affecting prices, we found a significant trend for lower prices
in postcodes with a higher proportion of young people
(aged under 18) in the population.
Prices also varied according to the level of disadvantage in the
postcode, with the lowest average price ($17.40 per 25 pack)
in the most disadvantaged postcodes. The relationship remained
significant, but was not linear, after adjusting for other factors.
Unexpectedly, prices were not significantly different in regional
and remote areas compared to major cities. Prices were slightly
(but not significantly) lower in regional and remote areas, even
after taking into account the type of outlet and other factors.
Figure 4: Cigarette prices
Average price per 25-pack ($)^^
^Includes vending machines and over-the-counter sales in pubs, clubs, hotels,
bars, bottle shops and licensed restaurants.
^^Sample of 1,579 listed and unlisted outlets with information on price.
Some tobacco retailers are leaving the market
The audit results indicated 418 of the 2,279 notified retailer
records were either no longer selling tobacco or no longer
at the stated address. However, it was not possible to
quantify the number of retailers that had entered or exited
the market over the three years the Retailer Notification Scheme
has been in place. The list of retailer records provided to Cancer
Council NSW by the Ministry of Health was a cumulative list
and did not record entry or exit dates. Therefore, we could
not determine whether the total number of tobacco retailers is
increasing or decreasing over time.
15.0
15.5
16.0
16.5
17.0
17.5
18.0
18.5
19.0
O
ther/N
otspecified
Tobacconist
Superm
aket
N
ew
sagent
G
eneralgrocery
store
C
onvenience
store
Petrolstation
Licensed
prem
ises^
Alloutlets
14

What we learned
The Cancer Council NSW audit of tobacco retailers provides
new and unique information about tobacco retailing in NSW.
Thanks to the Government Information (Public Access) Act
200989
and the efforts of 166 staff and volunteer data collectors,
we are able to provide the first publicly available data regarding
retailer compliance with key features of the Public Health
(Tobacco) Act 2008.1
We also gathered new data regarding
cigarette prices.
The study had some limitations which should be noted. It did
not include most of western NSW and the large number of data
collectors may have led to some inconsistencies in observation.
Cancer Council NSW would welcome the release of any Ministry
of Health tobacco retailer compliance data and monitoring
procedures for comparison.
The high average number of tobacco outlets per postcode
(17.7 across all postcodes in the sample and 7.3 in outer
regional and remote postcodes) suggests there is scope to
reduce the number of outlets without making it unreasonably
difficult to buy cigarettes. Almost four out of five outlets are
convenience, route and impulse retailers, so the current level
of retail density is of little utility to entrenched smokers, who
tend to make planned purchases in lower-cost outlets.
Compliance must improve
Many retailers are not meeting the full range of requirements of
the Act. Though compliance with the point-of-sale display ban
was reasonably high, the audit found 26.6% of retailers failed
to comply with one or more provisions of the legislation.
This is almost certainly an underestimate as:
• there was no attempt to monitor compliance with all
provisions of the legislation;
• it was not possible to check whether the listed business
name was up-to-date; and
• incomplete or invalid addresses were not counted in the
measure of non-compliance, though the Retailer Notification
Scheme requires retailers to give the address of the premises
where retailing occurs.1,77
Our estimate of one unlisted retailer for every 13 listed retailers is
also likely to be an underestimate as data collectors are likely to
have missed some unlisted retailers.
Retailers that had failed to notify (i.e. those hardest for
enforcement officers to find) were significantly more likely than
notified retailers to breach in-store retail laws. Also, retailers in
disadvantaged postcodes were less likely to comply with these
laws than those in less disadvantaged postcodes. As people
in disadvantaged communities are more likely to be smokers10
and find it harder to quit,90
the results suggest those at most
risk of tobacco-related harm are afforded the least protection
by the current laws.
Prices vary between areas
It is well established that lower prices are associated with
increased tobacco consumption.91
The finding that cigarette
prices were lower in disadvantaged areas and in areas with a
higher proportion of young people makes sense from a business
point of view, as these are neighbourhoods where customers
have less capacity to pay. However, from a tobacco control
point of view, it means communities at higher risk of harm from
tobacco are exposed to the least protective retail environment.
Prices were highest in the types of outlets more often used by
lighter smokers and impulse purchasers, such as bars, pubs,
clubs, bottle shops, petrol stations and convenience stores.
In these types of outlets, where smokers trade off price for
convenience, high prices may be less of a barrier to purchase
than in other types of outlets. Reducing access to cigarettes
by restricting retail supply may create an additional barrier in
impulse-prone environments, thereby helping ‘tipping point’
smokers to resist purchase.
A stronger notification system is needed
The Retailer Notification Scheme does not appear to meet its
stated objective, which is to inform the Ministry of Health about
the number and location of tobacco retailers in NSW in order
to support enforcement of the tobacco retailing requirements in
the Public Health (Tobacco) Act 2008.1,77
The notification data
contained invalid addresses, out-of-date records and many
cases of multiple listings for a single outlet. In one case there
were four listings under different business names at the same
address, presumably due to repeated turnover of the business
and notification by each new owner without removing or
inactivating notifications by the previous owner. In addition,
we found a substantial number of retailers selling tobacco
that did not appear in the list of notified outlets.
In the absence of publicly available information about
monitoring and enforcement activities, it is not possible to
assess whether Environmental Health Officers have access
to other, better quality retailer data. Even if they do, observed
levels of non‑compliance indicate a stronger system is needed
to enforce retailing laws and reduce tobacco use in NSW.
A positive licensing scheme with a requirement for annual
renewal and an associated licence fee, for example, would help
boost compliance by providing resources for enforcement and
communication. An annual licence renewal fee would also help
keep the retailer list up to date as retailers would then have a
financial incentive to notify if they stop selling tobacco products.
If the integrity of NSW tobacco retailer data is not improved,
it will become more and more inaccurate over time. The NSW
Government has a responsibility under the National Tobacco
Strategy 2012–201820
to consider further options for licensing
schemes and to commission research to examine approaches
for placing controls on the number and type of tobacco outlets.
Any action to ensure the reliability of notification data will make it
easier to carry out that work, as well as to conduct enforcement
and retailer education.
15

The case for
tobacco retail reform
The NSW and Australian Governments have banned tobacco
advertising, promoted anti-smoking messages through health
warnings and plain packaging, increased tobacco prices to
reduce demand, regulated to stop children buying tobacco and
introduced smoke-free public places and workplaces. However,
NSW still has close to 10,000 places to buy cigarettes.
Public health experts have proposed a number of supply-related
strategies to further decrease smoking and its associated health
costs, including:
• limiting the number of tobacco outlets;92
• restricting tobacco sales to certain types of outlets;92
• introducing a smoker licensing scheme, whereby smokers
would need a smart swipe-card licence to purchase tobacco
products from a licensed retailer;93
• banning tobacco sales to anybody born after a certain year
(i.e. young people);92
• mandated limits to supply;92
• nationalisation of the tobacco industry;92
and
• making tobacco products illegal.94
Cancer Council NSW believes the most feasible approach is
incremental, starting with stronger tobacco retail regulation.
The immediate benefit of stronger regulation is that it would
further reposition tobacco as the harmful product that it is,
and contribute to denormalisation of smoking and tobacco
products. The challenge is to identify policies that will maximise
public health benefits by supporting smokers to quit and remain
quit, preventing youth uptake, and reducing the disparity in
smoking rates between disadvantaged communities and the
general population.
What does the evidence suggest?
There is emerging evidence that retail cues to smoking persist,
even in the absence of point-of-sale displays. It is not just
children who are affected by the retail availability of tobacco.
The majority of smokers want to quit, but quitting is difficult,95
and while overall smoking prevalence has declined steadily
in NSW and in Australia, state96
and national97
data show the
percentage of people identifying as ex-smokers has stabilised.
This suggests the rate of quitting has slowed and the decline
in prevalence is now largely attributable to reduced uptake.
Tobacco retail policies that are aligned to support quit attempts
would therefore be appropriate and well-targeted.
Research suggests the ubiquity of tobacco retail outlets presents
a barrier to quitting.15,58,59
Convenience stores, service stations
and licensed outlets, for example, are more likely to be the site
of impulse and relapse purchasing.15,31
Living close to a tobacco
retailer also reduces the chance of quitting successfully.58
Generally reducing retail density will reduce tobacco use.
However, strategically reducing convenience, route and impulse
retailers may accelerate tobacco control by discouraging
purchase by attempting quitters and lighter smokers as they are
less likely to have a stock of cigarettes on hand. They may also
be at the ‘tipping point’ of susceptibility to point-of-purchase
cues to smoke.61
Any measure to eliminate tobacco sales at licensed outlets
is likely to lessen the role of alcohol in tobacco consumption.
Drinking alcohol, especially in social settings like bars and clubs,
increases the amount of smoking, increases the likelihood of
non-daily smokers smoking and undermines quit attempts.15,62-64
Tobacco outlets where alcohol is sold account for a small
percentage of cigarette purchases,98
and the tobacco industry’s
persistent expenditure of effort on these outlets suggests
a deliberate attempt to recruit new smokers and exploit
‘tipping point’ smokers for impulse and relapse purchases.
Higher prices in these outlets appear to be insufficient to
discourage purchase.
Retail reform may help address disparities in smoking rates and
reduce health inequities. There is a higher density of tobacco
retail outlets in disadvantaged local government areas of
NSW after adjusting for smoking prevalence,52
and our audit
has found compliance with retail legislation is lower in more
disadvantaged postcodes. This suggests the retail environment
is more ‘smokogenic’ for disadvantaged people, who already
have higher smoking rates and poorer health than the general
population. They also find it harder to quit smoking.90
To prevent young people taking up smoking, retailer compliance
with laws banning sales to under-18s is crucial.80
Research
on sales to minors also shows effective compliance requires
ongoing monitoring and enforcement, not just retailer
education.80
Our audit did not assess compliance with sales
to minors legislation, but found room for improvement
in compliance with other provisions, such as notification
and signage requirements. We also found cigarettes were
significantly cheaper in areas with higher proportions of children
in the population, which is a cause for concern. Retail reforms
limiting young people’s exposure to outlets selling cigarettes,
such as excluding tobacco retailers in proximity to schools and
other youth facilities, could be a valuable adjunct to enforcement
of bans on sales to minors.
No single measure will be effective in addressing the tobacco
epidemic and successful tobacco control comprises a portfolio
of measures that contribute to reducing uptake of smoking,
promoting quitting and reducing relapse after quitting. There
is enormous potential for tobacco retail reform to help the
government achieve its targets for further reducing smoking.
However, restructure of the retail sector requires an active
retail regulatory regime. A positive licensing system could be
innovatively designed to discourage purchase by young and
‘tipping point’ smokers and to improve compliance with existing
legislation. Strategic research and stakeholder engagement
is needed to inform decisions about the most effective model
of retail reform.
16

Regulation of other products
In NSW, there are many precedents for licensing systems for
businesses that supply goods or services entailing varying
degrees of risk.
Alcohol
Liquor licensing places limits on where, when and to whom
alcohol may be sold. Community and social factors are
considered during the application process. Applicants for
a liquor licence in NSW must include a National Police
Certificate, a community impact statement, a scaled plan
of the proposed licensed premises and a copy of the local
council’s development consent or approval for the proposed
premises.99
The licensee, service staff and security officers
must hold Responsible Service of Alcohol certificates.100
Licence fees vary depending on the type of outlet (e.g. for
a restaurant or small bar the application fee is $500).101
Once a licence is approved, licensees are subject to a ‘three
strikes scheme’ whereby non-adherence to sale and supply
laws may result in the licence being subject to conditions,
suspended for up to 12 months, or cancelled. A licensee can
also be disqualified for any period of time. Additionally, all
licensees are required to report back to the licensing authority
biennially in order to confirm the accuracy and currency of
the database.102
Prescription medicines
To sell scheduled medicines in Australia, pharmacists
must hold a pharmacy degree. They must maintain their
registration or face severe penalties which include the loss
of registration and criminal prosecution if found to be selling
some medicines without being presented with a valid doctor’s
prescription.103
Equally, when a person is prescribed a medicine, the
prescription specifies the pharmacist can only release a
limited supply. Patients requiring more must return to a
doctor for a repeat prescription. This stands in stark contrast
to tobacco – a product with no safe level of use – which any
person can sell to any other person aged 18 or over.
Registration of a new pharmacy business in NSW incurs a
fee of $500, plus an additional $300 inspection fee.104
Annual
renewal of registration is $300. Registration of a change of
address is $300 and a change of ownership is $500.104
Second-hand goods
All pawnbrokers in NSW must have a licence and second‑hand
dealers must have a licence if they buy or sell certain goods,
including musical instruments, sporting goods, photographic
equipment, tool kits, mp3 players, computer equipment,
microwave ovens and certain jewellery.16
To be eligible, licensees must be considered fit and proper
for the purposes of the licence and provide address details of
the premises where goods will be sold. Licence details must
be conspicuously displayed on the business premises.105
The application fee is $473 while the renewal is $341.16
Others
Other businesses that must be licensed in NSW include:106
• businesses that handle or process certain foods,
including meat, seafood, dairy products, eggs
and sprouts;107
• tattoo parlours;108
• real estate agents;109
• motor dealers;110
and
• travel agents.111
17

Public opinion
There is strong public support for tighter regulation of tobacco
retailers. In a recent Cancer Council NSW community-based
survey, 2,473 adults were asked for their reaction to policies
requiring retailers to have a licence to sell tobacco products
in the same way retailers need a licence to sell alcohol.112
Almost eight in 10 respondents (79%) ‘strongly supported’
or ‘supported’ the policy – higher levels of support than for
point-of-sale display bans and plain packaging, which are
already in place.
The results of the 2009 NSW Smoking and Health Survey
also indicate that the community is ready for tobacco retailer
licensing. Ninety-one per cent of adults supported such
regulation, including 88% of smokers.113
Given most smokers
have made at least one quit attempt,113,114
perhaps they
are reflecting on the problem that retail availability poses
to quit success.
In another NSW population-based survey in 2004, 81%
of respondents agreed tobacco products are too easy to
buy. The same percentage supported phasing out vending
machines in licensed premises to reduce access by minors,
73% supported reducing the number and type of tobacco
outlets and 57% supported completely prohibiting tobacco
within 10 years.115
Innovative model of retail reform: California
Tobacco licensing in California is regulated at the local
government level. The Center for Tobacco Policy and
Organizing, which is funded by the state government’s
California Tobacco Control Program, has examined the
tobacco retail licensing ordinances of 94 communities
across California.116
It defines a strong licensing
ordinance as one that:
• requires all retailers to hold a licence to sell tobacco
products, which must be renewed annually;
• sets a licence fee high enough to sufficiently fund
administration of the program and enforcement efforts;
• clearly states an enforcement plan that includes
compliance checks;
• coordinates tobacco regulations so that a violation of any
existing local, state or federal tobacco regulation violates
the licence; and
• provides a financial deterrent through fines and penalties,
including the suspension and revocation of the licence.116
Beyond this, different communities have introduced a variety
of provisions, such as restrictions on the type of retailer,
limits on the location and density of retailers, prohibitions on
smoking within and near the premises, and sales conditions.
Examples of such provisions are (note that different
provisions apply in different places):116
• a licence may not be granted to any business offering
food or alcoholic beverages for sale for consumption
on the premises;
• a licence may not be granted to new businesses
that are ‘significant tobacco retailers’ (i.e. retailers for
which the principal or core business is selling tobacco
products, tobacco paraphernalia, or both [exempting
existing retailers]);
• the total number of licences is restricted to one per
1,000 residents (exempting existing retailers);
• a licence may not be granted in any location exclusively
zoned for residential use;
• a licence may not be granted to any retailer located within
500 feet of a youth-populated area, such as a school,
park, playground, childcare facility, recreation facility or
youth centre (exempting existing retailers);
• a licence may not be granted to any retailer within a
certain distance of another tobacco retailer (200 feet or
500 feet, depending on the jurisdiction and exempting
existing retailers);
• people selling tobacco must be of the minimum legal age
to purchase tobacco products (18 years);
• smoking is prohibited inside retail premises and within
20 feet of any entrance, exit or window to the store;
• all licence applicants must verify that they have attended
an approved training program on the laws relating to the
sale of tobacco products; and
• the frequency of compliance checks is stated, with some
communities making up to four compliance checks on
each retailer per year.
Licence fees in California range from a nominal US$30 to a
high of US$655 annually.
18

Retailer opinion
Research analysing tobacco industry documents has highlighted
the importance of the retailer’s role in communicating industry
messages to consumers.117
The industry knows that small, local
retailers are an acceptable face for pro-tobacco lobbying, and
has leveraged this relationship in its campaign against plain
packaging reforms.118
There is emerging evidence, however, that retailers are
not always comfortable selling tobacco.119
Some retailers
interviewed for a small qualitative study in New Zealand
revealed that selling tobacco was something they disliked, but
felt they had to do because everyone else did.119
The majority
of these same retailers supported the concept of tobacco
retailer licensing. They compared it to alcohol and felt it should
be treated in a similar manner, though were understandably
wary that a licensing system would be costly and complicated.
The interviewees also supported tobacco retailers playing a role
in providing cessation materials to customers, including being
required to sell nicotine replacement therapies.119
Interviews with Californian grocery store managers who had
stopped selling tobacco revealed there were opportunities for
businesses if they were no longer tobacco retailers.120
Store
managers saw the decision to end tobacco sales as image
enhancing and consistent with being positioned as selling
healthy foods. Focus groups with store customers showed that
while they were largely unaware these retailers had stopped
selling tobacco, they all supported the decision and said it
made them more likely to shop there.120
Research with retail businesses in NSW would be useful to
explore the diversity of retailer opinions and business needs.
A model for reducing the number of
tobacco retailers over time: New York
As in California, tobacco retailer licensing in the state of New York is a local government responsibility. Researchers at
the Center for Public Health and Tobacco Policy have developed a model ordinance for tobacco retailing that includes a
detailed strategy for slowly rolling back the total number of tobacco retailers by restricting licence availability.121
The work was
funded by a grant from the New York State Department of Health. The model ordinance is yet to be fully implemented, but
proposes that:121
• For the first year of the licensing scheme, only those retailers who had registered as tobacco sellers at least six months
prior to the launch of the scheme will be granted a licence;
• Following the first year, the number of licences issued will not exceed that of the previous year; and
• Following the first year, only one new licence will be issued for every two revoked or lapsed in the previous year.
If the number of applications exceeds the maximum number of licences that may be issued according to the conditions
above, then applications will be prioritised as follows:121
• First, licences will be granted to those who previously held a licence and are located a minimum distance from a school,
where the distance is agreed upon by the local authority. If this still results in an excess of applications, then a lottery
system is suggested;
• Second, licences will be granted only to those who sell from an adult-only facility. Again, if there are still more applicants
than licences, a lottery system is suggested; and
• Third, if there are any remaining licences, these shall be distributed by a lottery system.
19

Conclusion
Retail availability is the weak link in tobacco control. Selling
tobacco ‘anywhere, anytime’ thwarts people’s attempts to give
up this powerfully addictive substance and makes it harder for
the government to reduce smoking prevalence – which is still
unacceptably high. It is simply not helpful for a substance
that kills half its long-term users to be easier to buy than
a postage stamp.
Supply-side measures have tremendous potential to further
denormalise tobacco and reduce use. Developing a policy and
research strategy will require partnerships across government
and non-government organisations.
Cancer Council NSW recommends, as the first step, that
the NSW Minister for Health establish a Ministerial taskforce
to explore, evaluate and advise on policies for tobacco
smoking prevalence.
A successful precedent for this approach is the NSW Passive
Smoking Taskforce, which was established by the (then)
NSW Department of Health in March 1996. It was convened
to “advise the Department on options for eliminating exposure
to environmental tobacco smoke in places where food and
beverages are consumed, and prepare a report for the
Minister for Health.”
Membership included government representatives, health
groups, stakeholders from the hotels, clubs and restaurant
industries, and WorkCover NSW. Independent experts were
also commissioned to examine scientific issues and possible
approaches. The Taskforce conducted public consultations
to canvass community views. It released its report in 1997,
recommending the introduction of legislation to ban smoking
in indoor places where food and drink are consumed.
The legislation came into effect in the year 2000.
Cancer Council NSW believes a taskforce would be valuable
in developing innovative, evidence-informed policies for
tobacco retail reform. Its purpose would be to create a
retail environment that supports, rather than counters, other
tobacco control initiatives.
In the meantime, there is also a clear need to improve
compliance with existing laws and to ensure the integrity of
retailer data collected under the Retailer Notification Scheme.
A publicly accessible, searchable list of notified tobacco
retailers in NSW should be available through the Government
Licensing Scheme website. Similar online lists already exist
for many licensed and registered businesses, professions
and tradespeople.106
This would make it easier for community
members to report a possible breach of the legislation
and facilitate research by non-government and academic
organisations.
Finally, publicly available data are needed on monitoring and
enforcement of tobacco retailers, including the proportion
of tobacco retailers receiving compliance checks each year,
compliance rates, prosecutions and convictions. Tobacco
control is vitally important to the community, both ethically
and economically, and greater transparency would promote
collaboration and public engagement.
20

Recommendations
Addressing the retail availability of tobacco in NSW could
accelerate declines in smoking prevalence, support people
more effectively to quit smoking, promote health in socially
disadvantaged areas and protect children from tobacco.
A taskforce for tobacco retail reform
Cancer Council NSW recommends the NSW Minister for Health:
1. Convene a taskforce under the auspices of the Minister’s
office to explore, evaluate and advise on policies for tobacco
smoking prevalence.
2. Require the taskforce to base their advice to the Minister
on the best available evidence.
3. Include the following responsibilities among the taskforce’s
terms of reference:
• commission research to more closely assess the impact
of retail distribution on smoking in the NSW context;
• consult with the public and affected retail sub-sectors;
• assess the potential for a positive licensing scheme,
with associated conditions of licence and an annual
fee, as a means to boost resources for monitoring
and enforcement;
• develop strategies to restrict the number, type and
distribution of retail outlets; and
• outline the essential elements of a regulatory scheme
that would effectively address the impact of tobacco
retail availability on smoking rates.
4. Appoint a maximum of nine members to the taskforce,
including the chair, with expertise in:
• tobacco control (one or two members);
• public health, particularly preventive health in Aboriginal
and disadvantaged communities (one or two members);
• public health law and regulation (one member);
• academic retail marketing research relevant to the terms
of reference (one member); and
• the retail sector (maximum of three members, chosen to
reflect the diversity of the retail market).
5. Exclude from taskforce membership (but include in
consultations) individuals and/or organisations that receive
funding from tobacco companies or are directly affiliated
with those companies.
6. Request the taskforce to report their findings within one year
of being convened.
Strengthening compliance with existing tobacco retail laws
Cancer Council NSW recommends the NSW Ministry of Health:
7. Introduce systems to ensure notifications under the Retailer
Notification Scheme are accurately collected and recorded,
so as to provide up-to-date information about outlet
address, changes in business ownership and whether the
outlet continues to sell tobacco.
8. Provide a publicly accessible, searchable online database
of all notified tobacco retailers in NSW.
9. Provide publicly accessible annual reports with quantitative
measures of retailer monitoring, compliance, prosecutions
and convictions for each Local Health District.
2121

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