Tobacco display and brand communication at the point of sale: implications for adolescent smoking behaviour

Abstract

BackgroundIn England, point-of-sale (PoS) displays in larger shops were prohibited in April 2012, with an exemption for smaller retailers until 2015. The aim of this study was to examine the association between tobacco displays and brand communication at the PoS and adolescent smoking behaviour, and to assess the potential benefits likely to accrue from this legislation.MethodsSelf-completion questionnaire survey in students aged 11–15 years in March 2011.ResultsThe odds of ever-smoking doubled for those visiting shops almost daily relative to less than once a week (OR 2.23, 95% CI 1.40 to 3.55), and susceptibility increased by around 60% (OR 1.62, 95% CI 1.25 to 2.10). Noticing tobacco on display every time during store visits increased the odds of susceptibility more than threefold compared with never noticing tobacco (OR 3.15, 95% CI 1.52 to 6.54). For each additional tobacco brand recognised at the PoS, the adjusted odds of being an ever-smoker increased by 5% (OR 1.05, 95% CI 1.03 to 1.06) and of susceptibility by 4% (OR 1.04, 95% CI 1.02 to 1.05). The association between frequency of visiting stores and susceptibility was predominantly due to exposure in small shops.ConclusionsExposure to and awareness of PoS displays and brands in displays were associated with smoking susceptibility. The association between PoS display exposure and smoking susceptibility was predominantly due to exposure in small shops. These findings suggest that a one-off, comprehensive tobacco display ban is the recommended approach for countries considering a display ban.

Exposure to point‐of‐sale displays and changes in susceptibility to smoking: findings from a cohort study of school students

“…We have previously reported evidence from a cross‐sectional analysis of the 2011 data from this cohort that noticing tobacco PoS displays more frequently when visiting shops was associated with an increased likelihood of being susceptible to smoking 11. These new prospective data demonstrate that after adjustment for the effects of other determinants of smoking behaviours, visiting shops and noticing PoS displays more frequently is associated with an increased likelihood of non‐susceptible never smokers becoming susceptible to smoking, but is not related to the likelihood of becoming an ever smoker.…”

“…We received questionnaires from 4302 students (approximately 69% of those eligible, based on the total number of students reported by schools to be on their rolls) from the eight schools surveyed in 2012, of whom 3672 were in school years 8–11 and hence potentially also participants in the 2011 survey 11. We were able to link questionnaires from 2011 and 2012 for 2354 (64%) of these, but had to exclude 47 respondents who did not provide data on susceptibility to smoking in both years, and 37 respondents with incompatible primary outcome responses (24 who reported in 2012 that they were non‐susceptible never smokers, having been ever smokers in 2011; and 13 who indicated that they were susceptible never smokers in 2012, having been ever smokers in 2011).…”

“…In March 2011, we carried out a cross‐sectional study of smoking and PoS display exposure in students attending 11 secondary schools in Nottingham 11. We then invited the same 11 schools to repeat the survey in March 2012, immediately before the English law prohibiting PoS displays in large retailers came into force, and eight schools agreed to do so.…”

“…These include point‐of‐sale (PoS) displays and the tobacco pack itself, both of which promote tobacco brands to existing and new customers 6, 7. Exposure of existing smokers to tobacco products in PoS displays increases the likelihood of purchasing 8, makes quitting more difficult by urging recent quitters to smoke 9, and although there is less evidence of effects on potential new smokers, cross‐sectional data suggest that adolescents who recall PoS exposure are more likely to be smokers or to be susceptible to smoking uptake 10, 11. Most smokers take up smoking during adolescence.…”

“…In England, open PoS displays are being prohibited in two stages, starting with large shops such as supermarkets from April 2012, and in smaller retailers, which occur typically in the locality of schools and are the main source of children's exposure to PoS displays 11, from April 2015. We have investigated prospectively the association between PoS exposure and the development of susceptibility to smoking, and uptake of smoking, among secondary school students in the period leading up to the first stage of PoS prohibition in April 2012.…”