The Lebanese Regie state-owned tobacco monopoly: lessons to inform monopoly-focused endgame strategies

A political economy of the tobacco supply chain in an Eastern Mediterranean country: The case of Lebanon

The literature on tobacco has traditionally focused on health effects, public policies for tobacco control, and smoker profiles. However, there is a notable gap in understanding the supply chains and industry practices within the tobacco market. This paper addresses this gap by examining the structure of the tobacco market in Lebanon. Using an exploratory qualitative research approach, this paper maps the tobacco supply chain in Lebanon and investigates the interactions among various stakeholders, including key policymakers, regulators, researchers, and industry experts, as well as their underlying interests. Lebanon is a compelling case study due to its high smoking prevalence, the presence of a state-owned tobacco monopoly (the Regie Libanaise de Tabacs et Tombacs (Regie)), and the ongoing financial crisis that has affected various sectors, including the tobacco industry. The findings reveal three key issues: a complex political economy centered around monopolization and conflicting interests, the absence of a clear national strategy on tobacco leading to ineffective policy formulation, and inefficient tobacco cultivation practices requiring reforms for sustainable agricultural development. To address these issues, it is proposed to foster a more competitive and revenue-efficient tobacco market through the dissolution of the Regie monopoly via horizontal and vertical integration. This includes adopting an excise-specific tax on domestically manufactured tobacco goods and optimizing sales taxes on locally traded items. Secondly, expanding antitrust laws to encompass the tobacco industry and introducing legislative measures for fees and taxes are recommended to create an enabling environment for competition and revenue generation. Thirdly, reforming tobacco cultivation practices requires abolishing the current cultivation licensing framework, offering financial compensation to existing license holders, and supporting farmers in transitioning to alternative crops.

Should tobacco sales be restricted to state-run alcohol outlets? Perspectives from 10 US alcohol control states

BACKGROUND AND AIMS

The ubiquity of tobacco retailers helps to sustain the tobacco epidemic. A tobacco retail reduction approach that has not been tried is transitioning tobacco sales to state-controlled alcohol stores (TTS), which are limited in number and operate under some restrictions, e.g. regarding opening hours or marketing materials. This study summarizes policy experts' and advocates' views of TTS, including (1) advantages and disadvantages; (2) feasibility; and (3) potential implementation obstacles.

DESIGN

This study was a qualitative content analysis of semi-structured interviews.

SETTING

Ten US states with alcoholic beverage control systems were included.

PARTICIPANTS

The participants comprised a total of 103 tobacco control advocates and professionals, public health officials, alcohol policy experts and alcohol control system representatives, including two tribal community representatives.

MEASUREMENTS

Interviewees' perspectives on their state's alcoholic beverage control agency (ABC, the agency that oversees or operates a state alcohol monopoly) and on TTS were assessed.

FINDINGS

Interviewees thought TTS offered potential advantages, including reduced access to tobacco products, less exposure to tobacco advertising and a greater likelihood of successful smoking cessation. Some saw potential long-term health benefits for communities of color, due to the smaller number of state alcohol stores in those communities. Interviewees also raised concerns regarding TTS, including ABCs' limited focus on public health and emphasis on revenue generation, which could conflict with tobacco use reduction efforts. Some interviewees thought TTS could enhance the power of the tobacco and alcohol industries, increase calls for alcohol system privatization or create difficulties for those in recovery.

CONCLUSIONS

In the United States, transitioning tobacco sales to state-controlled alcohol stores (TTS) could have a positive public health impact by reducing tobacco availability, marketing exposure and, ultimately, tobacco use. However, tensions exist between alcohol control system goals of providing revenue to the state and protecting public health. Should a state decide to pursue TTS, several guardrails should be established, including building into the legislation an explicit goal of reducing tobacco consumption.