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Los Angeles Region is the Epicenter of a Global Revolution in Public Health

On February 18, 2020, the Manhattan Beach city council voted 4-1 to phase out the sale of all tobacco products in the city, becoming the second U.S. city to do so (after Beverly Hills). The Pasadena city council has asked its staff to draft a similar ordinance, and Hermosa Beach among others have made public statements indicating their intention to follow.

Three cheers! These communities are showing courage and vision. This is the beginning of the last chapter in the tobacco epidemic. For decades, we in the public health community did “tobacco control,” as if there was some acceptable number of customers the tobacco industry could kill in pursuit of profit. In the 70 years since we’ve known tobacco use is deadly, we have consistently blamed the victim, focusing our attention on limiting demand but allowing the sale basically anywhere. Society is starting to understand that the central “wrong” causing the tobacco epidemic is the marketing and sale of products that are deadly when used as intended and deliberately engineered to be as addictive as possible. It is not the smokers; it’s the tobacco industry.

Southern California may seem like an outlier, but they are not moving alone. Cities and states across the U.S., and countries around the world, are moving to limit or eliminate the supply of tobacco. Next week, the Dutch parliament will vote on a bill limiting tobacco sales to adult-only dispensaries, a huge decrease in accessibility. A few cities in Massachusetts are looking at that same policy option to reduce the density of tobacco sales. Tasmania, Australia is considering a bill to ban sales to anyone born after a specific date (such as 1/1/2000); effectively a sales ban with a grandfather clause. Balanga City in the Philippines passed a similar ordinance, but it was struck down after the tobacco industry sued. And cities and states across the U.S. are banning all flavorings in tobacco products, including menthol cigarettes through which the tobacco industry has targeted minority groups, particularly African Americans.

We have successfully dealt with public health threats through sales bans in the past – think lead paint, asbestos and DDT. Government and civil society didn’t spend decades trying to convince people not to buy lead paint while ignoring the sale; it was taken off the market because it was unacceptably dangerous. Our work on demand has reduced tobacco use prevalence to historic lows, but we can’t cure the disease until we eliminate the source.