Original Article Policy coherence, integration, and proportionality in tobacco control: Should tobacco sales be limited to government outlets? Elizabeth A. Smith ,*, Patricia A. McDaniel , Heikki Hiilamo , and Ruth E. Malone Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, Box 0612, San Francisco, CA 94143, USA Department of Social Research, Social and Public Policy, University of Helsinki, KEY: Helsinki, Finland ROBLEM EPIDEMIOLOGICAL EVIDENCE *Corresponding author. E-mail: Libby.smith@ucsf.edtext POLICY ARGUEMENT & DESIGN Abstract Multiple factors, including marijuana decriminalizetion/legalization, tobacco endgame discourse, and alcohol industry pressures, suggest that the retail regulatory environment for psychoactive or addictive substances is a dynamic one in which new options may be considered. In most countries, the regulation of tobacco, marijuana, and alcohol is neither coherent, nor integrated, nor propor- tional to the potential harms caused by these substances. We review the possible consequences of restricting tobacco sales to outlets run by government-operated alcohol retail monopolies, as well as the likely obstacles to such a policy. Such a move would allow governments more options for regulating tobacco sales, and increase coherence, integration, and proportionality of substance regulation. It might also serve as an incremental step toward an endgame goal of eliminating sales of commercial combustible tobacco. Journal of Public Health Policy (2017) 38, 345-358. doi:10. 1057/$41271-017-0074-Z; published online, 21 April 2017