Youth tobacco sales in a metropolitan county: factors associated with compliance

OBJECTIVE: To describe and identify factors associated with tobacco sales in a metropolitan county. SETTING: King County, Washington is the largest county in Washington State with an estimated population of 1.8 million or about 30% of the state's population. DATA SOURCE: The data analysis is based on compliance checks in King County between January 2001 and March 2005. The 8879 checks were conducted by 91 youth operatives aged 14-17. Analysis of data was completed in 2006. STATISTICAL ANALYSIS: The outcome variable for this analysis was whether "a sale was made" to a youth operative during a compliance check. Associations between independent variables and the outcome variable were examined using 2 x 2 tables, univariate (unadjusted) logistic regression, and multivariate (adjusted) logistic regression analysis. RESULTS: Overall tobacco sales during the 4-year and 3-month period was 7.7%. Convenience stores selling gas were significantly more likely to sell tobacco products to minors, whereas restaurants, bars, and tobacco discount stores were less likely to sell to minors. Other factors that were significantly associated with sales are described. CONCLUSIONS: In a county that has adopted many of the required youth access laws, opportunities still exist to reduce sales of tobacco products to minors. Asking for age and photo identification still appears to be an effective strategy in reducing sales of tobacco products to minors.     

Point-of-sale tobacco marketing in rural and urban Ohio: Could the new landscape of Tobacco products widen inequalities?

Considerable research has examined how cigarette point-of-sale advertising is closely related to smoking-related disparities across communities. Yet few studies have examined marketing of alternative tobacco products (e.g., e-cigarettes). The goal of the present study was to examine external point-of-sale marketing of various tobacco products and determine its association with community-level demographics (population density, economic-disadvantage, race/ethnicity) in urban and rural regions of Ohio. During the summer of 2014, fieldworkers collected comprehensive tobacco marketing data from 199 stores in Ohio (99 in Appalachia, 100 in Columbus), including information on external features. The address of each store was geocoded to its census tract, providing information about the community in which the store was located. Results indicated that promotions for e-cigarettes and advertising for menthol cigarettes, cigarillos, and cigars were more prevalent in communities with a higher percentage of African Americans. Cigarillos advertising was more likely in high-disadvantage and urban communities. A greater variety of products were also advertised outside retailers in urban, high-disadvantage, African American communities. Findings provide evidence of differential tobacco marketing at the external point-of-sale, which disproportionately targets urban, economically-disadvantaged, and African American communities. There is a need for tobacco control policies that will help improve equity and reduce health disparities.     

After the master settlement agreement: targeting and exposure of youth to magazine tobacco advertising

Targeting and exposure of youth to magazine advertising of tobacco products is associated with increased smoking initiation. National magazine advertising and youth exposure declined in the period following the Master Settlement Agreement (MSA). However, tobacco companies continued targeting youth with brands that were popular among them through magazine advertising and placement of ads in magazines with high youth readership. Existing restrictions, followed by enforcement through litigation, have achieved a marked reduction in overall magazine advertising but may be less adequate compared with pending federal legislation to fully protect youth from the marketing of tobacco products designed to appeal to them.     

Point-of-purchase tobacco environments and variation by store type--United States, 1999

To promote its products, the tobacco industry spent $8.2 billion on marketing in 1999, an increase of $1.5 billion over the previous year. Tobacco advertising in various media increases tobacco consumption and adolescents are more susceptible than adults to being influenced by some forms of tobacco advertising. To describe the retail tobacco advertising and marketing environment, researchers from the Robert Wood Johnson Foundation-sponsored ImpacTeen Project collected and analyzed store observation data in 163 communities throughout the United States. This report summarizes the extent of point-of-purchase (POP) tobacco advertising and marketing found in various types of stores. The findings in this report indicate that certain retail environments frequented by teenagers heavily promote tobacco use. To reduce demand for tobacco products among adolescents, public health efforts should address POP environment exposure to tobacco advertising and marketing.     

The relationship of neighborhood demographic characteristics to point-of-sale tobacco advertising and marketing

Objectives. Exposure to tobacco marketing has been associated with an increased likelihood that youth start smoking and may interfere with tobacco cessation. We aimed to describe the prevalence, placement, and features of tobacco advertising at the point of sale by race, ethnicity, and other neighborhood demographics, as well as by store type.

Design. A cross-sectional assessment of the advertising environment in establishments that held tobacco licenses in our study region (a metropolitan area in the Midwest USA) was conducted in 2007. Stores were geocoded and linked with block group demographic data taken from the Year 2000 US census. We calculated associations between our hypothesized predictors, race, ethnicity, and other neighborhood demographics, and two types of outcomes (1) amount and (2) characteristics of the advertising.

Results. Tobacco advertising at the point of sale was most common in gas stations/convenience stores, liquor stores, and tobacco stores. A 10% difference in a block group's African-American/Black population was associated with 9% (95% confidence interval [CI]=3%, 16%) more ads as well as a greater likelihood that ads would be close to the ground (prevalence ratio [PR]=1.15 [95% CI=1.04, 1.28]). Block groups with greater African-American/Black, Asian, people on public assistance or below 150% of the poverty threshold, or people under the age of 18 years had more ads for menthol brands. Block groups with greater proportions of Whites were more likely to have ads that used health words, such as ‘light’ or ‘natural’ (PR for 10% difference in White population=1.41 [95% CI=1.17–1.70]). Chain stores were more likely to have greater amounts of advertising, ads close to the ground, ads for price deals, or ads that use words that imply health.

Conclusion. Tobacco advertising targets communities with various racial and ethnic profiles in different ways. Now that US Food and Drug Administration has the authority to regulate the marketing and sale of tobacco products, there is new opportunity to reduce the harmful impact of tobacco advertising.     

An experimental study of effects on schoolchildren of exposure to point-of-sale cigarette advertising and pack displays

By creating a sense of familiarity with tobacco, cigarette advertising and bold packaging displays in stores where children often visit may help to pre-dispose them to smoking. A total of 605 ninth-grade students were randomly allocated to view a photograph of a typical convenience store point-of-sale which had been digitally manipulated to show either cigarette advertising and pack displays, pack displays only or no cigarettes. Students then completed a self-administered questionnaire. Compared with those who viewed the no cigarettes, students either in the display only condition or cigarette advertising condition perceived it would be easier to purchase tobacco from these stores. Those who saw the cigarette advertising perceived it would be less likely they would be asked for proof of age, and tended to think a greater number of stores would sell cigarettes to them, compared with respondents who saw no tobacco products. Respondents in the display only condition tended to recall displayed cigarette brands more often than respondents who saw no cigarettes. Cigarette advertising similarly influenced students, and tended to weaken students' resolve not to smoke in future. Retail tobacco advertising as well as cigarette pack displays may have adverse influences on youth, suggesting that tighter tobacco marketing restrictions are needed.     

Operation storefront Hawaii: tobacco advertising and promotion in Hawaii stores

Our objective was to explore the nature and location of tobacco product advertising and promotion in retail stores in Hawaii. We performed a cross-sectional study of tobacco product store-based advertisements, including the number, location (indoor/outdoor; proximity to candy, toys, school), size, and brand of the ads. Trained youth (ages 12-19 years) collected data on 3,151 advertisements and promotions among 184 stores. We found that most ads appeared indoors, and the most heavily advertised brand was Kool. Kool is also the most heavily smoked brand among youth in Hawaii. This study underscores the high visibility of retail store advertising and promotions (both indoor and outdoor) in places that attract the attention of youth.     

Analysis of the publicity campaign of the tobacco brand Fortuna in 1999-2000

The majority of tobacco advertisement in Spain is directed at youth. This advertisement, carried out on several fronts, is particularly effective with young people. In the present work we analyze different advertising efforts involved in the ad campaign carried out by Fortuna-brand (a product of the company Tabacalera S.A., and sector leader of sales in Spain) in 1999 and 2000. In terms of their marketing strategy, we can conclude that Fortuna's principal commercial objective is presenting tobacco as intrinsically associated with being young. Both the indirect promotion of its products through activities and its commercials, are aimed towards developing the image that tobacco symbolizes the series of core values more appreciated by youth. Relevant legislation will have to be adapted to this reality in order to control specifically the manner in which publicity such as that promoted by Fortuna is directed to the population.     

Outdoor tobacco advertising in six Boston neighborhoods: Evaluating youth exposure

Background: The Food and Drug Administration (FDA), in its 1996 regulations to restrict certain forms of cigarette advertising likely to appeal to adolescents, prohibited outdoor tobacco advertising within 1,000 feet of schools and playgrounds. No published studies have determined the density of outdoor tobacco advertising within the FDA’s prescribed 1,000-foot buffer zone around schools.Objective: To determine the prevalence, type, and proximity to public schools of all stationary, outdoor tobacco advertising in six Boston neighborhoods.Design: A cross-sectional field survey conducted in six Boston neighborhoods with varying ethnic, cultural, and socioeconomic characteristics. The main outcome measure was advertising density within buffer zones around public schools.Results: Youth in the six neighborhoods are heavily exposed to stationary, outdoor cigarette advertising. This exposure is intense in areas close to public schools, and more intense in neighborhoods with more children, with significant Black and Hispanic/Latino populations, and with low socioeconomic status. Advertising strategies employed by the tobacco industry are in line with accepted professional marketing practice that targets adolescents for other products.Conclusions: Given the pervasive nature of the outdoor tobacco advertising we observed in the present study, it appears that the only way to protect youth from exposure is by eliminating it from the community.     

Alcohol Outlet Characteristics and Alcohol Sales to Youth: Results of Alcohol Purchase Surveys in 45 Oregon Communities

Reducing youth access to commercial sources of alcohol is recognized as a necessary component of a comprehensive strategy to reduce underage drinking and alcohol-related problems. However, research on policy-relevant factors that may influence the commercial availability of alcohol to youth is limited. The present study examines characteristics of off-premise alcohol outlets that may affect alcohol sales to youth. Random alcohol purchase surveys (N = 385) were conducted in 45 Oregon communities in 2005. Underage-looking decoys who were 21 years old but did not carry IDs were able to purchase alcohol at 34% of the outlets approached. Purchase rates were highest at convenience (38%) and grocery (36%) stores but were relatively low (14%) at other types of outlets (e.g., liquor and drug stores). Alcohol purchases were less likely at stores that were participating in the Oregon Liquor Control Commission’s Responsible Vendor Program (RVP), when salesclerks asked the decoys for their IDs, and at stores with a posted underage alcohol sale warning sign. Alcohol purchases were also inversely related to the number of salesclerks present in a store, but were not related to salesclerks’ age and gender. Findings of this study suggest that more frequent compliance checks by law enforcement agents should target convenience and grocery stores, and owners of off-premise outlets should require training of all salesclerks to ensure reliable checks of young-looking patron IDs, and should post underage alcohol sales warning signs in clear view of patrons.     

Inequalities in Tobacco Retailer Compliance Violations Across the State of Oklahoma, 2015–2019

Objective

To evaluate the relationship between compliance check violations, and characteristics of the tobacco retailer and neighborhood social vulnerability in Oklahoma.

Design

This cross-sectional study utilized the US Food and Drug Administration (FDA) Compliance Check Inspections of Tobacco Product Retailers database for 2015–2019. These data were combined with Neighborhood social vulnerability variables using the Centers for Disease Control and Prevention (CDC) Social Vulnerability Index.

Setting

The setting of this study is the state of Oklahoma, USA.

Outcome measures

The outcome variable for this analysis was whether a sale was made to the youth during the compliance check (e.g., violation; yes/no) regardless of the outcome of the violation, and number of violations per a retailer.

Results

We observed a strong association between having a violation and retailer store type, after controlling for socioeconomic vulnerability and percentage of mobile homes. The proportion of a tobacco retailer’s violations also varied by store type.

Conclusions

More targeted enforcements and retailer education by store type may be necessary to increase compliance.

     

Minor access control of Hong Kong under the framework convention on tobacco control

BackgroundAsia's tobacco control movement was strengthened owing to the need to fulfill the Framework Convention on Tobacco Control (FCTC).ObjectiveThe present study aims to assess the compliance rates of tobacco retailers to the law forbidding the sales of tobacco to minors in Hong Kong before and after the growth of the tobacco control movement brought by the enactment of the newly amended tobacco control law with effect from 2007. The legislation was enacted to fulfill the FCTC.Design and methodTwo waves of territory-wide compliance checks conducted in 2006 and 2008 were compared. The compliance check was conducted using Standard Protocol.ResultThe overall compliance rate was still low though it increased from 18.9% in 2006 to 27.0% in 2008. The compliance rate of convenience stores and newspaper stands improved whereas the rate for restaurants, grocery stores and petrol stations worsened. Less tobacco retailing outlets displayed a specified warning sign required in 2008 (33.7%) comparing to 2006 (41.4%).ConclusionThe indoor smoking ban of the FCTC unintentionally changed the cigarette retailing landscape and finally improved the compliance rate. The case study also demonstrated that the Asia region still has much room for improvement in fulfilling the FCTC in term of effective implementation and enforcement.     

Fatal deception: the tobacco industry's "new" world standards for tobacco marketing]

Being increasingly threatened by the worldwide antismoking struggle, the major tobacco companies are eager to improve their public image. This leads the companies to adopt inconsequential "measures" such as the tobacco industry's "new" standards for tobacco marketing that were "voluntarily" issued in September 2001 by the British American Tobacco company. These measures are clearly attempts to reduce the disapproval generated by the companies' promotion and advertising campaigns, which indirectly target young people. With these standards the tobacco companies supposedly commit themselves, among other things, to not using advertising directed at youth and to not selling or distributing tobacco products in places frequented by young people. This document explains why these measures are completely ineffective, are not anything new, and are a subtle effort to feign a conscientious, responsible attitude, which is far from genuine. As long as there are marketing activities directed at adults, young people will be exposed to the influence of those activities. Many countries have completely prohibited the marketing of tobacco products, given that the "new" marketing standards do not represent progress in any way whatsoever.     

Implications for Tobacco Control of the Multistate Tobacco Settlement

The 1998 master settlement agreement between major tobacco manufacturers and the US states will have a profound effect on many tobacco industry practices and will significantly influence future settlements with the tobacco industry. This article analyzes the settlement's key provisions pertaining to youth sales, advertising, marketing, and lobbying. It also examines the ways in which the settlement restricts industry practices as well as the many industry practices that remain unregulated.     

Measuring statewide merchant compliance with tobacco minimum age laws: the Massachusetts experience.

OBJECTIVES: This study evaluated merchant compliance with laws prohibiting the sale of tobacco to minors in Massachusetts. METHODS: Stratified cluster sampling was used to select outlets from which youths aged 13 to 17 years attempted to purchase tobacco. RESULTS: Illegal sales were more common when the youth purchasing the tobacco was older, when the clerk was male, and when tobacco was obtained from a self-service display or unlocked vending machine. Failure to request proof of age was the strongest predictor of illegal sales. CONCLUSIONS: Measured compliance rates are strongly influenced by the age of the youths used to purchase tobacco.     

Young adults: vulnerable new targets of tobacco marketing

OBJECTIVES: We examined young adult smoking patterns and receptivity to cigarette advertising to assess vulnerability to tobacco marketing strategies. METHODS: We obtained data from a telephone survey of 12,072 Massachusetts adults. RESULTS: Smokers aged 18 to 30 years were more likely than older adults to smoke only occasionally and to consume fewer than 10 cigarettes per day. They also were more receptive to cigarette marketing and were more likely to be frequent patrons of bars and clubs. CONCLUSIONS: Many young adult smokers are in the initiation phase of smoking and are likely to undergo a transition to either nonsmoking or heavier smoking. If unimpeded by regulation, tobacco promotion in bars and clubs is likely to lead to increased adult smoking prevalence.     

A comparison of the advertising and accessibility of cigars, cigarettes, chewing tobacco, and loose tobacco

BACKGROUND: Tobacco products were compared in regard to their price, point-of-purchase advertising, accessibility to shoplifters, and rate of sale to minors. METHODS: An experimental design compared the rates of illegal sales to minors of cigarettes, chewing tobacco, and cigars. Observational surveys of 102 stores measured the number of advertisements for four tobacco products, the manner in which products were displayed, and their accessibility to shoplifters. RESULTS: Illegal sales rates were similar for cigarettes, chewing tobacco, and cigars. Cigars were the least expensive. Cigarettes were the most heavily advertised product, followed by chewing tobacco, cigars, and loose tobacco. Cigarettes were the most accessible to shoplifters. All types of tobacco products were displayed to permit the package to serve as advertising. CONCLUSIONS: Point-of-purchase advertising for cigars may be increasing, and their lower price makes them more affordable to youths. Food and Drug Administration regulations that limit point-of-purchase advertising for tobacco products should be expanded to include cigars. Manufacturers pay retailers for the placement of product displays that allow the package to be used as an advertisement without the appearance of the Surgeon General's warning. Generic packaging may be necessary to protect children from point-of-purchase advertising.     

Associations between tobacco marketing and use among urban youth in India

OBJECTIVES: To study if receptivity and exposure to tobacco marketing are correlated with tobacco use and psychosocial risk factors for tobacco use among a sample of urban Indian youth. METHODS: Analysis of cross-sectional survey data from Project MYTRI, a group randomized intervention trial, in Delhi and Chennai, India, collected from sixth and eighth graders (n=11,642), in 32 schools in 2004. RESULTS: Exposure to tobacco advertisements and receptivity to tobacco marketing were significantly related to increased tobacco use among students. CONCLUSION: This association suggests the need to strengthen policy and program-based interventions in India to reduce the influence of such exposures.     

Expert opinions on optimal enforcement of minimum purchase age laws for tobacco.

A questionnaire on how youth access laws should be enforced was sent to 20 experts who had administered and/or evaluated a youth access enforcement program. Respondents agreed on the need for a high level of retail compliance, checkers representative of the community, checks at least twice per year, a graduated penalty structure with license revocation, and bans on self-service and vending machines. Respondents indicated the need for research on the effects of ID use, frequency of checks, penalty structures, and the effects on smoking rates of youth access policies alone and in conjunction with other tobacco control policies.