Standardized Tobacco Assessment for Retail Settings (STARS): dissemination and implementation research

Abstract

ObjectiveThe Standardized Tobacco Assessment for Retail Settings (STARS) was designed to characterise the availability, placement, promotion and price of tobacco products, with items chosen for relevance to regulating the retail tobacco environment. This study describes the process to develop the STARS instrument and protocol employed by a collaboration of US government agencies, US state tobacco control programmes (TCPs), advocacy organisations, public health attorneys and researchers from the National Cancer Institute's State and Community Tobacco Control (SCTC) Research Initiative.MethodsTo evaluate dissemination and early implementation experiences, we conducted telephone surveys with state TCP leaders (n=50, response rate=100%), and with individuals recruited via a STARS download registry on the SCTC website. Website registrants were surveyed within 6 months of the STARS release (n=105, response rate=66%) and again after ∼5 months (retention rate=62%).ResultsAmong the state TCPs, 42 reported conducting any retail marketing surveillance, with actual or planned STARS use in 34 of these states and in 12 of the 17 states where marketing surveillance was not previously reported. Within 6 months of the STARS release, 21% of surveyed registrants reported using STARS and 35% were likely/very likely to use it in the next 6 months. To investigate implementation fidelity, we compared data collected by self-trained volunteers and by trained professionals, the latter method being more typically in retail marketing surveillance studies. Results suggest high or moderate reliability for most STARS measures.ConclusionThe study concludes with examples of states that used STARS to inform policy change.

Availability, price and promotions for cigarettes and non-cigarette tobacco products: an observational comparison of US Air Force bases with nearby tobacco retailers, 2016

“…Furthermore, our analysis is limited to technical training bases and may not represent pricing and marketing differences on all military bases. It is, however, conceivable that our results generalise to other military populations, as two of our study areas are also Army bases on which Airmen train, and at which many other military personnel (including non-trainees) from across services are also stationed, but further research is needed to confirm this supposition Finally, while telephone surveys potentially allow greater geographical reach, we demonstrate the feasibility of using STARS33 as an in-person measure that does not require clerk time and permits the opportunity to capture tobacco marketing characteristics.…”

Using the Vape Shop Standardized Tobacco Assessment for Retail Settings (V-STARS) to Assess Product Availability, Price Promotions, and Messaging in New Hampshire Vape Shop Retailers

“…Development of V-STARS was based on the approach used to develop the Standardized Tobacco Assessment for Retail Settings (STARS), 18 and more information about the development of V-STARS is documented elsewhere. 19 Data collectors included 3 staff members from the New Hampshire Department of Health and Human Services and 1 public health associate from the Centers for Disease Control & Prevention, all of whom had previous experience conducting store assessments and had reviewed a comprehensive training manual on utilizing V-STARS.…”

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

“…Measures identified in the literature review which were relevant to the current study included: the presence of a display unit or 'power wall' of visible tobacco products, 26 the position of tobacco products in relation to the till, 15 and signage indicating that tobacco products are for sale. 14,26 Although existing and previously used audits often include measures of the volume and size of tobacco advertising in stores, 13,27,28 we did not find any suitable audit tools which measured the size and positioning of product display units. This is important, particularly in a context where in-store advertising has been restricted, as the display unit itself can be seen to function as a form of tobacco advertising.…”

“…Various studies have also examined POS tobacco marketing, 12 culminating in efforts to develop standardized tools, most notably the Standardized Tobacco Assessment for Retail Settings (STARS). 13 STARS was developed to assess a wide range of marketing variables, based on the 4Ps of marketing (product availability, placement, promotion, and price), but was not intended to provide detailed measurements of product display and storage unit visibility. Other protocols developed to measure tobacco marketing in the retail environment also fail to capture all the display characteristics relevant to measuring visibility, 14,15 such as the proximity of customer traffic flows to tobacco displays within the store.…”