Surveillance of compliance with tobacco regulations in ？rebro County, Sweden: a mixed methods study after the ban of test purchases

This study is an evaluation of the results from thematic surveillance and has a mixed methods approach. The quantitative analyses concerns protocols from 217 surveillance visits, where questions were asked about three themes (self-monitoring programs; marketing; labeling of products and pricing). In addition, questionnaires filled out by six tobacco administrators who worked within the project were analyzed qualitatively by content analysis in order to study their perceptions and opinions of the project.This study shows that half of the visited retailers had self-monitoring programs. Lack of self-monitoring programs was significantly more common in smaller stores/kiosks and at restaurants. Further, the tobacco administrators who worked within the project perceived thematic surveillance as a good method for accomplishing better structure in surveillance work, but not as effective as purchase attempts (mystery shopping).Thematic surveillance was perceived as positive and the method was also regarded to be a good way to work with surveillance. However, the method could be developed further for optimal use and better effect at the retailers. It is clear that people who work with tobacco prevention at the local level in ？rebro County want to use purchase attempts as a surveillance method, and that they believe that purchase attempts is the best way to make sure if store comply with the tobacco law.Tobacco use, in particular cigarette smoking, is one of the main causes for illness and premature deaths in the world [1-3]. The prevalence of smoking in Sweden is according to the National Board of Health and Welfare (NBHW) 15% among women and 12% among men, in the population age 16 and older. Daily smoking is most common in the age group 45-64 years where 21% of the women and 17% of the men smokes on daily basis [4]. Research has shown that onset of smoking is most common in youth even though smoking among youths in Sweden is less common today as compared to the 1970s; there