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Butt out? Should the government intervene and enforce licences for smokers?
Butt out? Should the government intervene and enforce licences for smokers?

A smoker's licence designed to limit access to tobacco products and encourage quitting has been proposed by Professor Simon Chapman, from the University of Sydney.

Professor Chapman, from the School of Public Health, outlines his idea for a smart card licence in PLOS One Medicine.

It would allow smokers to set daily limits, would give financial incentives for permanent licence surrender and test knowledge of smoking health risks.

"A smoker's licence may seem like a radical step toward ending the epidemic of disease caused by tobacco, but it is far less radical than prohibiting the sale of tobacco, which is not a strategy that has yet been supported by any international expert report or political forum," Professor Chapman said.

"A smoker's licence allows smokers the choice to continue smoking within a regulatory framework that promises new disincentives to smoke and a major financial incentive to quit."

The licence, Chapman argues, would be most viable in high-income nations that are actively pursuing tobacco control goals. He compares his proposal to how the sale of pharmaceuticals is regulated through the use of prescriptions or 'temporary licences' for medications that could be used incorrectly, for too long, or that require users to be monitored.

The main elements of the licence model are as follows.

All smokers would be required to obtain a smart swipecard licence for purchases from a licenced tobacco retailer. Most licence registrations would take place online, providing a useful database on tobacco use and a means to communicate health messages to smokers.

The smart card licence would be encoded with a maximum purchase limit, chosen from a range, at the time of application. Smokers would pre-commit to a certain number of cigarettes a week and when they made their purchase the sale would be approved or declined based on that agreement.

The more cigarettes a licencee opted for, the higher the fee. There would be an upper limit of 50 cigarettes per day, averaged across 14 days, and the licence would be renewed annually.

As an incentive to quit all licence fees paid during a smoker's licenced smoking history would be fully refundable, with compound interest if they surrendered their licence.

"The requirement for a licence would send a powerful, symbolic message to all smokers and potential smokers that tobacco is not an ordinary commodity like grocery items, confectionery, or any product on unrestricted sale," Professor Chapman said.

"It would mark tobacco as a product uniquely deserving of such regulation and invite smokers to reflect on why this exceptional policy had been introduced. This step may diminish self-exempting views that smoking is just another, unexceptional risk in 'life's jungle'."

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