Breaking the alliance: Defeating the tobacco industry's allies and enacting youth access restrictions in Massachusetts

Objectives. We describe the tobacco industry's effort in Massachusetts to block the adoption of local regulations designed to reduce youth access to tobacco products. We also explain how state-funded tobacco control advocates overcame industry opposition. Methods. We examined internal tobacco industry documents and records of local boards of health and conducted interviews with participants in local regulatory debates. Results. The industry fought proposed regulations by working through a trade group, the New England Convenience Store Association. With industry direction and financing, the association's members argued against proposed regulations in local public hearings. However, these efforts failed because community-based advocates worked assiduously to cultivate support for the regulations among board of health members and local community organizations. Conclusions. Passage of youth access regulations by local boards of health in Massachusetts is attributed to ongoing state funding for local tobacco control initiatives, agreement on common policy goals among tobacco control advocates, and a strategy of persuading boards of health to adopt and enforce their own local regulations.