{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T03:48:54Z","timestamp":1792986534567,"version":"4.5.0"},"reference-count":45,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"unspecified","delay-in-days":559,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011019","name":"National Research, Development and Innovation Office of Hungary","doi-asserted-by":"crossref","award":["Data-driven Health Division of Health Security Nat"],"award-info":[{"award-number":["Data-driven Health Division of Health Security Nat"]}],"id":[{"id":"10.13039\/501100011019","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2024,1,10]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Policies that reduce tobacco retail density to decrease tobacco use among the youth are critical for the tobacco endgame. This paper reviews a Hungarian tobacco regulatory measure, which, since 2013, has confined the sale of tobacco products exclusively to so-called National Tobacco Shops, summarises the changes in the national tobacco retail marketplace and reports on analyses of the impact of this intervention on illegal sales to minors and adolescent smoking behaviour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed the available national statistical data on the structure and dynamics of the tobacco retail market. Changes in lifetime and current (past 30 days) use of cigarettes among Hungarian adolescents aged 13\u201317\u2009years were assessed using data from international youth surveys on health behaviours collected in 2010\u20132020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Since the start of policy implementation, the density of tobacco shops in Hungary decreased by 85%, from 4.1 to 0.6 per 1000 persons. The prevalence of lifetime and current cigarette smoking among adolescents declined by 13\u201324\u2009percentage points (pp) and by 4.8\u201315 pp, respectively. The rate of illegal sales of tobacco products to minors decreased by 27.6 pp, although the prevalence of compensatory access strategies, especially asking others to buy cigarettes for minors, increased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>After a significant decrease in the nationwide availability of licensed tobacco retailers, Hungary experienced short-term reductions in youth smoking prevalence. However, the sporadic implementation of complementary, evidence-based tobacco control strategies might limit further declines in youth smoking initiation and tobacco product use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tc-2023-058232","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T13:20:28Z","timestamp":1705670428000},"page":"430-435","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Impact of regulatory tightening of the Hungarian tobacco retail market on availability, access and cigarette smoking prevalence of adolescents"],"prefix":"10.1136","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3551-6125","authenticated-orcid":false,"given":"Tam\u00e1s","family":"Jo\u00f3","sequence":"first","affiliation":[{"name":"Data-Driven Health Division of the National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis University, Budapest, Hungary"},{"name":"Hungarian Healthcare Management Association, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3759-4581","authenticated-orcid":false,"given":"Kristie","family":"Foley","sequence":"additional","affiliation":[{"name":"Implementation Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3324-2255","authenticated-orcid":false,"given":"Zolt\u00e1n","family":"Brys","sequence":"additional","affiliation":[{"name":"Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary"},{"name":"Centre for Social Sciences, Institute for Sociology, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1592-2150","authenticated-orcid":false,"given":"Todd","family":"Rogers","sequence":"additional","affiliation":[{"name":"Public Health Division, RTI International, Research Triangle Park, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0648-9778","authenticated-orcid":false,"given":"Mikl\u00f3s","family":"Sz\u00f3cska","sequence":"additional","affiliation":[{"name":"Health Services Management Training Centre, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f3zsef","family":"Bodrogi","sequence":"additional","affiliation":[{"name":"University Pharmacy Department of Pharmacy Administration, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4645-8001","authenticated-orcid":false,"given":"P\u00e9ter","family":"Ga\u00e1l","sequence":"additional","affiliation":[{"name":"Hungarian Healthcare Management Association, Budapest, Hungary"},{"name":"Health Services Management Training Centre, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7396-4028","authenticated-orcid":false,"given":"Melinda","family":"P\u00e9nzes","sequence":"additional","affiliation":[{"name":"Data-Driven Health Division of the National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"key":"2025073109350540000_34.4.430.1","unstructured":"Malone RE , McDaniel PA , Smith EA . Tobacco control endgames: global initiatives and implications for the UK. 2014. Available: https:\/\/www.cancerresearchuk.org\/sites\/default\/files\/policy_july2014_fullendgame_report.pdf"},{"key":"2025073109350540000_34.4.430.2","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2021-056579"},{"key":"2025073109350540000_34.4.430.3","unstructured":"Drope J , Schluger N , Cahn Z , et al . The tobacco atlas. 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