The Center for Public Health System Science at Washington University recently published a report on tobacco point-of-sale promotion. The executive summary is below. Full report is here.

Tobacco companies promote their brands through advertising, product placement, and price promotions. Advertising and promotions at the POS increase impulse purchases and normalize the presence of tobacco products in everyday life.(1) Tobacco product exposure and price promotions at the POS encourage initiation and discourage cessation.(2-4)

 

It is important for professionals looking to advance POS work to understand the current retail and legal landscape, as well as potential policy options. This report provides data on the tobacco retail environment, tangible next steps and resources to get started in the POS area, and important evidence to help guide the tobacco control policy debate.

 

FINDINGS

 

What does the tobacco retail environment look like?

 

In the U.S. only 36 states mandate tobacco retailer licensing. Without a nationwide mandatory licensing system for tobacco retailers, it is impossible to know how many tobacco retailers operate in the U.S. We estimate that there are 374,584 retailers in the contiguous U.S. Relative to consumer demand for tobacco products, the number of tobacco retailers is excessive.

 

We found that tobacco retailer density is highly correlated with population density and tobacco retailers are frequently clustered together. The majority of tobacco is sold at convenience stores. In the U.S. supermarkets are another top seller of tobacco products. Other common tobacco retailers include: liquor stores, pharmacies, and tobacco shops. The high number of retailers correlates to a vast amount of POS advertising and marketing in the retail environment.

 

The tobacco industry spends most of its marketing budget at the POS.5 The tobacco industry uses the strategic placement of products, price promotions and price discounts, signage and functional items containing product logos, and the products themselves to advertise and market tobacco products. Marketing and advertising in the POS is ever-present, yet policies to restrict advertising and promotions at the POS are largely underused in the U.S.

 

What policy activity is occurring across the nation?

 

The majority of states perceive POS policies as important to their state tobacco control programs. However, most states and communities are underusing POS policies. Policy activity was reported in all six policy areas surveyed, including policies that: address licensing and density, utilize non-tax approaches to raise tobacco prices, restrict product placement, restrict advertising at the POS, require health warnings, and ‘Other POS’ policies. The majority of states surveyed reported state-level activity in at least one area. California reported the greatest amount of POS policy activity, yet its policy activity was low when compared to the total number of policy options examine in this study.

Overall, the two most common of the six policy areas were the Licensing and Density area and the Non-tax Approaches area. The most common activity reported within the Licensing and Density area was to establish or increase tobacco licensing fees. Still, most states either have no licensing fee provision or require just a small fee (less than $75 annually) for licenses. The most common activity reported in the Non- tax Approaches area was implementing cigarette minimum price laws.

 

What are the barriers to policy implementation?

 

Given that POS is still an emerging area and that policy activity is low, we asked states what barriers they have experienced when trying to plan or implement POS policies. The most common barriers reported include:

 

• Lack of background knowledge;
• Lack of funding; and
• Competing priorities.

 

What resources would help advance POS policy work?

 

States were also asked to describe resources that have been helpful in advancing POS efforts and to identify what resources are needed to advance POS work in the future.

 

The most helpful resources reported include:

 

• Relationships with national organizations;
• Legal and policy support; and
• Learning from successful campaigns in other communities.

 

The most needed resources reported include:

 

• Funding and
• Model case studies.

 

RECOMMENDATIONS

 

Given the national tobacco retail and policy environment, states and communities should consider POS policies as a core strategy of tobacco control. States that have already achieved levels of success with strong smoke-free air policies and higher than average excise taxes could consider expanding their efforts into the POS policy area. States at other stages of tobacco control policy success may also benefit from incorporating POS policies into their current tobacco control programs. Tobacco control advocates in the planning stages of POS policy adoption should take the following steps:

 

#1: Assess the retail environment
Map and visit retailers. Find out what products are being sold, survey where advertising and products are situated inside and outside stores, and monitor prices and price promotions.

 

#2: Examine public opinion and assess the policy and legal landscape
Survey the public and conduct interviews with key leaders and decision makers. Work with legal counsel to understand what agency has administrative authority in the state or community and to understand if and how preemption and other legal concerns will affect policy development.

 
#3: Strategize and design the campaign
Build support by understanding the target audience and use appropriate messages that reflect their interests and concerns. Include strategies that will garner support from decision makers. Seek guidance from states and communities that have implemented similar policies.

 

#4: Implement the policy and evaluate the process
Raise both retailer and public awareness about provisions of the policy to aid in compliance and enforcement. Highlight successes by demonstrating the positive effects the implemented policy is having in the community or state.

 

 

References

1. Campaign for Tobacco-Free Kids. Deadly Alliance: How Big Tobacco and Convenience Stores Partner to Market Tobacco Products and Fight Life-Saving Policies. 2012.

2. Paynter J, Edwards R. The impact of tobacco promotion at the point of sale: A systematic review. Nicotine Tob Res. Jan 2009;11(1):25-35.

3. Slater SJ, Chaloupka FJ, Wakefield M, Johnston LD, O’Malley PM. The impact of retail cigarette marketing practices on youth smoking uptake. Arch Pediatr Adolesc Med. May 2007;161(5):440-445.

4. Wakefield M, Germain D, Henriksen L. The effect of retail cigarette pack displays on impulse purchase. Addiction. Feb 2008;103(2):322-328.

5. Federal Trade Commission. Cigarette Report for 2011. 2013. http://1.usa.gov/1n69LX6 . Accessed June 16, 2014.

Advancing Science and Policy in the Retail Environment (ASPiRE) is funded by the National Cancer Institute’s (NCI) State and Community Tobacco Control (SCTC) Research Initiative. ASPiRE is a consortium of researchers from the Center for Public Health Systems Science (CPHSS) at Washington University in St. Louis, the Stanford Prevention Research Center, and the University of North Carolina Gillings School of Global Public Health. In 2011, ASPiRE received a five-year grant from SCTC to conduct research on how to maximize state and local policies to restrict tobacco marketing in the point of sale (POS) and in the broader retail environment.