Reducing the Density and Number of Tobacco Retailers: Policy Solutions and Legal Issues

Because higher density of tobacco retailers is associated with greater tobacco use, U.S. communities seek ways to reduce the density and number of tobacco retailers. This approach can reduce the concentration of tobacco retailers in poorer communities, limit youth exposure to tobacco advertising, and prevent misleading associations between tobacco and health messaging

A Health Justice Response to School Discipline and Policing

Inequities in school discipline and policing have been long documented by researchers and advocates. Longitudinal data is clear that Black, Indigenous, people of color (BIPOC) students are punished and policed at higher rates than their white classmates. For students who have disabilities, especially those with intersectional identities, the impact of school discipline and policing is amplified, with disparities existing at some of the highest rates across multiple categories. And this disproportionality has not diminished during short- and long-term school closures resulting from the COVID-19 pandemic. In fact, schools have employed new models of exclusion in the pandemic setting that operate simultaneously with “traditional” punitive responses, e.g., suspensions and expulsions. This raises significant concerns that in a time of heightened vulnerability resulting from COVID-19, discipline disparities and educational inequities are not only being replicated but exacerbated, and in some cases, escalated. Despite evidence of the significant co-influential nature of health and education, school policies and practices have not been deemed public health priorities. Too often, the operation of such policies and practices are narrated and re-narrated as falling outside health law and policy. This Article aims to alter this current pathway by examining two overused, yet underexamined drivers of health inequities—school discipline and policing—through the health justice framework. The application of health justice to discipline and policing is an essential first step to developing a more comprehensive approach to eliminating entrenched health inequities that have affected BIPOC students and students who have disabilities before, during, as well as beyond the COVID-19 pandemic. In a time of increasing race-conscious approaches to public health and recognition that “all policy is health policy”¹ the urgency to address the two- tiered system of racialized and gendered discipline and policing in the U.S. education system as a health justice priority is clear. From evidence of direct individual negative health outcomes to potential indirect adverse health consequences for peers, families, and communities, the predictable patterns of exposure and risk for diminished health status of marginalized students during key stages of development underscores the importance of dismantling legal, political, and social structures that drive health injustice

Reducing the Density and Number of Tobacco Retailers: Policy Solutions and Legal Issues

INTRODUCTION: Because higher density of tobacco retailers is associated with greater tobacco use, U.S. communities seek ways to reduce the density and number of tobacco retailers. This approach can reduce the concentration of tobacco retailers in poorer communities, limit youth exposure to tobacco advertising, and prevent misleading associations between tobacco and health messaging. METHODS: Communities can reduce the density and number of tobacco retailers by imposing minimum distance requirements between existing retailers, capping the number of retailers in a given geographic area, establishing a maximum number of retailers proportional to population size, and prohibiting sales at certain types of establishments, such as pharmacies, or within a certain distance of locations serving youth. Local governments use direct regulation, licensing, or zoning laws to enact these changes. We analyze each approach under U.S. constitutional law to assist communities in selecting and implementing one or more of these methods. There are few published legal opinions that address these strategies in the context of tobacco control. But potential constitutional challenges include violations of the Takings Clause of the Fifth Amendment, which protects property owners from onerous government regulations, and under the Fourteenth Amendment’s Equal Protection and Due Process Clauses, which protect business owners from arbitrary or unreasonable regulations that do not further a legitimate government interest. CONCLUSION: Because there is an evidentiary basis linking the density of tobacco retailers to smoking rates in a community, courts are likely to reject constitutional challenges to carefully crafted laws that reduce the number of tobacco retailers. IMPLICATIONS: Our review of the relevant constitutional issues confirms that local governments have the authority to utilize laws and policies to reduce the density and number of tobacco retailers in their communities, given existing public health data. The analysis guides policy makers in crafting laws that comply with constitutional requirements by outlining the most important procedures and evidentiary justifications to use in development, implementation, and enforcement. This perspective also highlights the importance of reviewing state constitutions, statutes, and municipal codes and getting local input from attorneys and community stakeholders to assess the likely success of some methods over others