Point-of-sale Tobacco Research Articles

Mental health and support for rigorous tobacco control strategies in South Australia

IntroductionTobacco endgame strategy includes policies to end the tobacco epidemic. As tobacco smoking prevalence is higher among people with mental health conditions (MHC), understanding the impact of rigorous tobacco control...

A cross-sectional survey on violation of cigarettes and other tobacco products act around education institutions in Puducherry

Background: India is the second-largest tobacco consumer in the world and is responsible for around 1.3 million deaths every year. To achieve tobacco control amongst youth, it is essential that there should be strict enforcement of cigarettes and other tobacco products act (COTPA) in the vicinity of educational institutions. Objectives were to measure the violation of COTPA section 4 and 6 in Puducherry. Methods: An observational survey on COTPA violation was conducted over a period of three months in Puducherry among 300 educational institutions and tobacco point of sale (PoS). Two-stage sampling technique was used. Epicollectv5 incorporating the observational checklist was employed for data capturing and analysis was done with SPSSv24. The institute’s ethics committee approval was obtained. Results: 145 (48.3%) violated section 6b. Violation of section 6a was observed in the form of tobacco products sale by minors in 1 (0.7%) and tobacco products sale to minors in 58 (40%) amongst those 145 tobacco PoSs. Only 32 (10.7%) educational institutions complied to statutory display of “No smoking signage” board at the entrance of the educational institutions as per COTPA section 4. Active smoking was noticed within 100 meters radius in in nearly half of the institutions i.e., 133 (44.3%). Conclusions: This study showed that implementation of COTPA sections 4 and 6 in Puducherry to be deficient. It will need a concerted effort from all parties involved, including the police, educational institutions, and the local community to enforce strict implementation of the legislation for tobacco control.

Image Processing for Public Health Surveillance of Tobacco Point-of-Sale Advertising: Machine Learning-Based Methodology.

BackgroundWith a rapidly evolving tobacco retail environment, it is increasingly necessary to understand the point-of-sale (POS) advertising environment as part of tobacco surveillance and control. Advances in machine learning and image processing suggest the ability for more efficient and nuanced data capture than previously available.ObjectiveThe study aims to use machine learning algorithms to discover the presence of tobacco advertising in photographs of tobacco POS advertising and their location in the photograph.MethodsWe first collected images of the interiors of tobacco retailers in West Virginia and the District of Columbia during 2016 and 2018. The clearest photographs were selected and used to create a training and test data set. We then used a pretrained image classification network model, Inception V3, to discover the presence of tobacco logos and a unified object detection system, You Only Look Once V3, to identify logo locations.ResultsOur model was successful in identifying the presence of advertising within images, with a classification accuracy of over 75% for 8 of the 42 brands. Discovering the location of logos within a given photograph was more challenging because of the relatively small training data set, resulting in a mean average precision score of 0.72 and an intersection over union score of 0.62.ConclusionsOur research provides preliminary evidence for a novel methodological approach that tobacco researchers and other public health practitioners can apply in the collection and processing of data for tobacco or other POS surveillance efforts. The resulting surveillance information can inform policy adoption, implementation, and enforcement. Limitations notwithstanding, our analysis shows the promise of using machine learning as part of a suite of tools to understand the tobacco retail environment, make policy recommendations, and design public health interventions at the municipal or other jurisdictional scale.

Adolescents’ perceptions of tobacco accessibility and smoking norms and attitudes in response to the tobacco point-of-sale display ban in Scotland: results from the DISPLAY Study

BackgroundScotland implemented a ban on open display of tobacco products in supermarkets in April 2013, and small shops in April 2015. This study aimed to quantify changes in perceived tobacco...

How has the introduction of point-of-sale legislation affected the presence and visibility of tobacco retailing in Scotland? A longitudinal study

BackgroundReducing the local availability of tobacco is identified as the ‘next frontier’ in tobacco control. This paper examines the roles of tobacco retail outlet density and tobacco visibility in changing...

Advancing Tobacco Control Through Point of Sale Policies, Providence, Rhode Island.

Local point of sale (POS) policies are key strategies for preventing and decreasing tobacco use among youth. In January 2013, Providence, Rhode Island implemented a comprehensive POS tobacco policy restricting the sale of flavored tobacco products and discounts of tobacco product prices. Lack of sustained funding for enforcement has been challenging. Our research focuses on the policy evaluation after enforcement began. We observed a decrease in availability of flavored tobacco products as citations for violations increased. However, we observed little change in the availability of flavored tobacco products with ambiguous descriptors that connote a flavor. Current use (within 30 days before survey) of tobacco products among high school students declined after the policy was enforced. Collectively, these findings demonstrate that POS tobacco policies are effective. The tobacco industry’s marketing of products that do not explicitly reference flavors might undermine enforcement of POS tobacco restrictions in Providence and elsewhere in the United States.

Do graphic health warning labels on cigarette packages deter purchases at point-of-sale? An experiment with adult smokers.

This experiment tested whether the presence of graphic health warning labels on cigarette packages deterred adult smokers from purchasing cigarettes at retail point-of-sale (POS), and whether individual difference variables moderated this relationship. The study was conducted in the RAND StoreLab (RSL), a life-sized replica of a convenience store that was developed to evaluate how changing POS tobacco advertising influences tobacco use outcomes during simulated shopping experiences. Adult smokers (n = 294; 65% female; 59% African-American; 35% White) were assigned randomly to shop in the RSL under one of two experimental conditions: graphic health warning labels present on cigarette packages versus absent on cigarette packages. Cigarette packages in both conditions were displayed on a tobacco power wall, which was located behind the RSL cashier counter. Results revealed that the presence of graphic health warning labels did not influence participants' purchase of cigarettes as a main effect. However, nicotine dependence acted as a significant moderator of experimental condition. Graphic health warning labels reduced the chances of cigarette purchases for smokers lower in nicotine dependence but had no effect on smokers higher in dependence.

Adolescents notice fewer tobacco displays after implementation of the point-of-sale tobacco display ban in Finland.

INTRODUCTIONFinland implemented a point-of-sale (POS) display ban for tobacco products and their trademarks in 2012, and for electronic cigarettes in 2016. In this study we examine whether noticing tobacco products changed among adolescents after the implementation of the display ban and describe the noticing of e-cigarette displays post-implementation.METHODSRepeated cross-sectional national survey data of 12-to 16-year-olds from years 2011, 2013, 2015 and 2017 were used. Measures included adolescent self-report on noticing displays of tobacco and e-cigarettes in shops, kiosks and service stations. Adjusting for age, gender, smoking and academic achievement, logistic regression analyses were conducted by retailer type to test the association between survey year and noticing POS tobacco displays.RESULTSThe proportions of adolescents noticing tobacco displayed in shops, kiosks and service stations decreased from 2011 to 2013 (from over 80% to about 30%). Between 2013 and 2017, exposure to tobacco displays decreased for kiosks but slightly increased for shops and service stations. However, in all retailer types, rates in 2017 were still well below the pre-ban levels of 2011. In 2017, noticing e-cigarette displays by 12- to16-year-old adolescents was reported by 5.6% in shops, 20.5% in kiosks and 5.1% in service stations.CONCLUSIONSThe pronounced decline in adolescents’ exposure to tobacco products at POS observed in the current study implies adherence to the ban, as intended by the law. We encourage more countries to enact POS tobacco advertising and display bans, and to enforce the POS regulations to all tobacco products and novel nicotine delivery systems.

Compliance with point-of-sale tobacco control policies and student tobacco use in Mumbai, India

BackgroundWe measured how student tobacco use and psychological risk factors (intention to use and perceived ease of access to tobacco products) were associated with tobacco vendor compliance with India’s Cigarettes...

Share of Advertising Voice at the Point-of-Sale and Its Influence on At-Risk Students' Use of Alternative Tobacco Products.

As adolescent tobacco use shifts from traditional cigarettes to alternative products, it is important to understand the influence of point-of-sale (POS) advertising on product use. This research investigated whether the percentage of POS advertising for a particular product, known as the share of advertising voice (SAV), moderated the relationship between exposure to POS tobacco advertisements and tobacco use among at-risk youth. Longitudinal self-report data from 746 students attending 20 alternative high schools in southern California was merged with observational data cataloging 2101 advertisements for cigarettes, e-cigarettes, cigars, and smokeless tobacco from 87 tobacco retail outlets within a half mile of the schools. Four multilevel Poisson regression models examined whether SAV interacted with POS tobacco advertising exposure to influence the use of tobacco products 1 year later. Adolescent exposure to POS tobacco advertisements was significantly associated with increased use of all four tobacco products (p < .02). When SAV was added to the model as a moderator, the results showed a significant interaction, such that increasing the SAV for e-cigarettes was associated with greater use of that product (β = 0.27, SE = 0.07, p < .001). The same moderating effect was found for smokeless tobacco (β = 0.56, SE = 0.19, p = .004) but no moderating effect was observed for cigarettes or cigars. POS SAV has the potential to influence at-risk students' use of alternative tobacco products and may be a contributing factor to recent nationwide shifts in youth tobacco use. Future studies should monitor changes in SAV to gain insight into POS marketing trends that may be impacting youth tobacco use. In addition, state and local governments should consider implementing policies that limit the volume and proportion of POS tobacco advertising for all nicotine and tobacco products available in retail environments near schools. Restrictions placed on a single product may cause unintended shifts in product selection rather than a reduction in youth tobacco use.

Assessing Change in Tobacco Visibility at Point-of-Sale Following a Display Ban

Objectives: In this paper, we describe a point-of-sale (POS) tobacco visibility tool and examine its utility for assessing changes in visibility following legislation banning tobacco displays. Methods: An observational tool was developed as part of DISPLAY, a multimodal, longitudinal study evaluating the impact of the tobacco POS display ban in Scotland. Measures were taken of product and storage unit visibility, over 5 years, pre- and post-implementation in all retail outlets selling tobacco in 4 contrasting study areas (N = 103). Results: Data generated by the visibility tool illustrated that whereas the display ban had reduced product visibility, it had little impact on reducing visibility of tobacco storage units. However, it did narrow the inequality gap in storage visibility. It also found some shop types reduced product visibility before legally required to do so. Conclusions: The DISPLAY visibility tool provides a reliable method for measuring visibility of tobacco displays before and after implementation of POS legislation. Tobacco product visibility reduced as expected following implementation of the legislation, but storage unit visibility persisted, providing residual cues of tobacco availability which may confound the effects of the legislation. The DISPLAY tool has the potential to be utilized in countries planning POS display bans.

State-Level Point-of-Sale Tobacco News Coverage and Policy Progression Over a 2-Year Period.

Mass media content may play an important role in policy change. However, the empirical relationship between media advocacy efforts and tobacco control policy success has rarely been studied. We examined the extent to which newspaper content characteristics (volume, slant, frame, source, use of evidence, and degree of localization) that have been identified as important in past descriptive studies were associated with policy progression over a 2-year period in the context of point-of-sale (POS) tobacco control. We used regression analyses to test the relationships between newspaper content and policy progression from 2012 to 2014. The dependent variable was the level of implementation of state-level POS tobacco control policies at Time 2. Independent variables were newspaper article characteristics (volume, slant, frame, source, use of evidence, and degree of localization) and were collected via content analysis of the articles. State-level policy environment contextual variables were examined as confounders. Positive, significant bivariate relationships exist between characteristics of news content (e.g., high overall volume, public health source present, local quote and local angle present, and pro-tobacco control slant present) and Time 2 POS score. However, in a multivariate model controlling for other factors, significant relationships did not hold. Newspaper coverage can be a marker of POS policy progression. Whether media can influence policy implementation remains an important question. Future work should continue to tease out and confirm the unique characteristics of media content that are most associated with subsequent policy progression, in order to inform media advocacy efforts.

Point-of-Sale Tobacco Advertising and Display Bans: Policy Evaluation Study in Five Russian Cities.

BackgroundThe tobacco industry uses point-of-sale (POS) advertising, promotion, and product display to increase consumption of its products among current users, to attract new consumers, and to encourage former customers to resume tobacco use. As part of a comprehensive tobacco control effort, Russia—having one of the highest tobacco use prevalence rates in the world—enacted legislation that banned tobacco POS advertising, effective November 15, 2013, and banned the display of tobacco and the sale of cigarettes in kiosks, effective June 1, 2014.ObjectiveThe objective of the study was to evaluate the implementation of the national law by assessing the state of POS advertising, promotion, and product display, and sales in kiosks across Russia.MethodsTwo waves of observations were conducted to measure compliance with the POS restrictions: wave 1 took place in April-May 2014 after the advertising ban was in effect and again in August-September 2014 after the display ban and elimination of tobacco sales in kiosks came into effect. Observations were conducted by local trained staff that traveled to 5 populous cities in different regions of Russia (Moscow, St. Petersburg, Kazan, Ekaterinburg, and Novosibirsk). Staff followed a published POS evaluation protocol and used mobile phones to collect data. Observations were conducted in a roughly equal number of supermarket chains, convenience stores, and kiosks. Observed items included advertising at POS, product displays, and cigarette sales in kiosks.ResultsObservations were made in 780 venues in wave 1 and in 779 revisited venues in wave 2. In wave 1, approximately a third of supermarkets and convenience stores (34.2%, 184/538) were advertising cigarettes using light boxes, and over half of observed venues (54.3%, 292/538) had signage such as banners or shelf liners that used colors or images related to cigarette brands. Product displays were common in wave 1. In wave 2, compliance with advertising restrictions was very good: there were virtually no light boxes (1.0%, 5/489); banners or shelf liners were observed in 30.5% (149/489) of supermarkets/convenience stores; approximately 7.4% (36/489) of venues were still displaying products in a powerwall. In wave 2, 41.3% (100/242) of kiosks continued to sell tobacco.ConclusionsRussia’s compliance with POS bans was excellent. Remaining compliance issues are largely with the use of cigarette brand colors or images used in banners or shelf liners; this type of infraction is more difficult to enforce as inspectors need to be deeply familiar with tobacco industry products and marketing practices. A sizable proportion of kiosks continue to sell tobacco post restrictions.

Antismoking Ads at the Point of Sale: The Influence of Ad Type and Context on Ad Reactions

Efforts are underway to educate consumers about the dangers of smoking at the point of sale (POS). Research is limited about the efficacy of POS antismoking ads to guide campaign development. This study experimentally tests whether the type of antismoking ad and the context in which ads are viewed influence people’s reactions to the ads. A national convenience sample of 7,812 adult current smokers and recent quitters was randomized to 1 of 39 conditions. Participants viewed one of the four types of antismoking ads (negative health consequences—graphic, negative social consequences—intended emotive, benefits of quitting—informational, benefits of quitting—graphic) in one of the three contexts (alone, next to a cigarette ad, POS tobacco display). We assessed participants’ reactions to the ads, including perceived effectiveness, negative emotion, affective dissonance, and motivational reaction. Graphic ads elicited more negative emotion and affective dissonance than benefits of quitting ads. Graphic ads elicited higher perceived effectiveness and more affective dissonance than intended emotive ads. Antismoking ads fared best when viewed alone, and graphic ads were least influenced by the context in which they were viewed. These results suggest that in developing POS campaigns, it is important to consider the competitive pro-tobacco context in which antismoking ads will be viewed.

Cohort study investigating the effects of first stage of the English tobacco point-of-sale display ban on awareness, susceptibility and smoking uptake among adolescents

ObjectiveA prospective evaluation of the effect of 2012 point-of-sale (PoS) display ban in supermarkets in England on perceived exposure to PoS displays, and on changes in susceptibility and smoking uptake...

Setting the agenda for a healthy retail environment: content analysis of US newspaper coverage of tobacco control policies affecting the point of sale, 2007–2014

BackgroundTobacco control policies affecting the point of sale (POS) are an emerging intervention, yet POS-related news media content has not been studied.PurposeWe describe news coverage of POS tobacco control efforts...

Impact of removing point-of-sale tobacco displays: data from a New Zealand youth survey

IntroductionThe tobacco industry increasingly invests in point-of-sale (POS) marketing. In July 2012, New Zealand required the removal of POS tobacco displays concurrently with increased enforcement and penalties for selling tobacco...

Global Evidence on the Association between POS Advertising Bans and Youth Smoking Participation.

Background: Point-of-sale (POS) tobacco advertising has been linked to youth smoking susceptibility and experimental smoking. However, there is limited evidence of the association between POS advertising bans and youth smoking participation. This study aims to examine how such bans are associated with current smoking, daily smoking, and regular smoking (≥1 cigarettes per day) participation among youth. Methods: one to two waves (primarily one wave) of the Global Youth Tobacco Survey were conducted in 130 countries between 2007 and 2011. These surveys were linked to the WHO “MPOWER” data using country and year identifiers to analyze the association between POS advertising bans (a dichotomous measure of the existence of such bans) and smoking participation in the past month. Weighted logistic regressions were employed to analyze this association while controlling for age, gender, parents’ smoking status, 6 MPOWER policy scores, and GDP per capita. Results and Conclusions: We find that in countries with POS advertising bans, current smoking (OR = 0.73, p ≤ 0.1), daily smoking (OR = 0.70, p ≤ 0.1), and regular smoking (OR = 0.75, p ≤ 0.05) participation in the past month is significantly lower, suggesting that POS promotion bans can potentially reduce youth smoking. This study provides evidence to support the implementation of POS promotion regulations by the US FDA and implementation of the WHO FCTC guidelines regarding restrictions on tobacco POS promotion.

Impact on smoking of England's 2012 partial tobacco point of sale display ban: a repeated cross-sectional national study

BackgroundA partial tobacco point of sale (PoS) display ban was introduced in large shops (>280 m2 floor area) in England on 6 April 2012. The aim of this study was...

The importance of continued engagement during the implementation phase of tobacco control policies in a middle-income country: the case of Costa Rica

ObjectiveTo analyse the process of implementing and enforcing smoke-free environments, tobacco advertising, tobacco taxes and health warning labels from Costa Rica's 2012 tobacco control law.MethodReview of tobacco control legislation, newspaper...