BackgroundCigarette smoking continues to be a leading cause of preventable deaths in the U.S., in part because the U.S. has not adopted the World Health Organization Framework Convention on Tobacco Control and the tobacco industry continues to counteract tobacco control policies the U.S. has in place. One way the tobacco industry in the U.S. counteracts effective tobacco control policies is by heavily advertising cigarettes at the point-of-sale in retailers (e.g., marketing outside of stores, at the cash register, etc.), and by offering discounts on cigarettes.MethodsThe current study used a within-subject experimental design to investigate if point-of-sale cigarette promotions increase smokers’ cigarette craving in a way that is comparable to other visual smoking cues, and if exposure to point-of-sale cigarette promotions with a discount (vs. without) increases cigarette craving. The study also examined how individual smokers’ subjective social status (i.e., their belief about how they compare to others in the U.S.) relates to cigarette craving after exposure to point-of-sale cigarette promotions with and without a discount. ResultsThe results indicated that exposure to smoking cues, including point-of-sale cigarette promotions, elicited increased levels of craving relative to non-smoking cues. Further, point-of-sale cigarette promotions with a discount elicited higher levels of craving compared to point-of-sale cigarette promotions without a discount. Finally, we observed an interaction between subjective social status and response to promotions. Participants with a lower (vs. higher) subjective social status craved cigarettes more overall and there was no difference in their craving between promotions with and without a discount, while craving was higher for promotions with a discount than without for higher subjective social status participants. ConclusionTogether these results highlight the causal effects of point-of-sale tobacco marketing on smokers’ cravings and suggest that the effects may differ according to price discounts and smokers’ subjective social status. More restrictions on point-of-sale tobacco marketing could help reduce cigarette smoking and address status-related health inequities in the U.S.
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