Factors influencing support for point-of-sale provisions of the tobacco control act: retailer and public opinion

Background: The Family Smoking Prevention and Tobacco Control Act (FSPTCA) of 2009 provided new opportunities to regulate tobacco products at the point-of-sale (POS). Little is known about retailer, public and smoker support for 10 FSPTCA POS policies in five domains (1) minors' access to tobacco, (2) regulating promotion, (3) product bans (menthol, flavored cigarettes), (4) advertising restrictions, and (5) labeling changes (graphic warnings). Study 1: This study conducted a survey of 257 tobacco retailers in three counties in North Carolina and linked their opinions about tobacco control policies with audit data of their stores' compliance with POS policies. Through structural equation modeling and generalized estimating equations, I found that store noncompliance with tobacco control policies was associated both with more retailer barriers to compliance and less support for POS policies. Awareness and Source of information about tobacco control regulations was not associated with compliance. Study 2: This study surveyed a US nationally representative sample of 17,507 respondents using linear regression to calculate weighted point estimates and identify factors associated with support for POS policies among adult respondents and smokers. For smokers we also examine the interaction of individual characteristics and policy self-interest on support for specific POS policies. Overall, non-smokers had more support than smokers. African-Americans, Hispanics, and those of other races, had more support than Whites. Education level and income were generally unrelated to level of support. Among smokers, those patterns also held. Policy support varied by provision with the highest support for minor's access restrictions (over 80%) and the lowest for advertising restrictions like black and white text advertising (23%). Among smokers, policy self-interest moderated the relationship between intention to quit and support for graphic warnings. Other self-interest variables had a direct effect on policy support. Conclusions: This dissertation study provides new information on retailer support and compliance and public support for policies that are or could be implemented under the Tobacco Control Act at POS. Tobacco control advocates and the FDA can build on existing levels of public support to promote, enforce, and maintain controversial policy changes in the retail environment.Doctor of Philosoph

E-Cigarette Availability, Price Promotions and Marketing at the Point-of Sale in the Contiguous United States (2014-2015): National Estimates and Multilevel Correlates

Electronic cigarette (e-cigarette) sales and use have increased rapidly, yet point-of-sale e-cigarette availability and marketing is understudied. We estimated changes in e-cigarette availability and marketing among tobacco retailers in the U.S., and associations with neighborhood characteristics. A national sample of tobacco retailers in the Contiguous U.S. was audited in 2014 and 2015 (n = 1,905 and n = 2,126, respectively) to observe e-cigarette availability and marketing (signs, ads, displays and promotions) and generate national prevalence estimates. Store, neighborhood and state level correlates of 2015 e-cigarette availability, price promotions and exterior advertising were analyzed using multilevel mixed-effects generalized linear models. E-cigarettes were sold at 72.0% of retailers in 2014 and at 79.2% in 2015. Price promotions increased from 11.9% to 20.2% of retailers. Among retailers that did not previously sell e-cigarettes in 2012, availability in 2015 was greater for retailers in neighborhoods with the highest proportion of Black residents (vs. lowest). E-cigarette price promotions were more prevalent in neighborhoods with more Hispanic residents, while exterior e-cigarette marketing was more prevalent in neighborhoods with more Black residents. State smoking prevalence was positively associated with e-cigarette availability, promotions and advertising. E-cigarette point-of-sale availability and marketing increased between 2014 and 2015 and expanded to neighborhoods with a higher proportion of Black residents between 2012 and 2015. Retailers located within states with high smoking prevalence appear to be targeted by e-cigarette marketing. As e-cigarettes become the target of more regulations, understanding changes in the e-cigarette retail environment is critical to inform potential policies regulating their sale and marketing

Field validation of secondary data sources for enumerating retail tobacco outlets in a state without tobacco outlet licensing

Identifying tobacco retail outlets for U.S. FDA compliance checks or calculating tobacco outlet is difficult in the 13 states without tobacco retail licensing or where licensing lists are unavailable for research. This study uses primary data collection to identify tobacco outlets in three counties in a non-licensing state and validate two commercial secondary data sources. We calculated sensitivity and positive predictive values (PPV) to validate the secondary data sources, and conducted a geospatial analysis to determine correct allocation to census tract. ReferenceUSA had almost perfect sensitivity (0.82) while Dun & Bradstreet (D&B) had substantial sensitivity (0.69) for identifying tobacco outlets; combined, sensitivity improved to 0.89. D&B identified fewer “false positives” with a PPV of 0.82 compared to 0.71 for ReferenceUSA. ReferenceUSA geocoded over 90% of outlets to the correct census tract. Combining two commercial data sources resulted in enumeration of nearly 90% of tobacco outlets in a three county area. Commercial databases appear to provide a reasonably accurate way to identify tobacco outlets for enforcement operations and density estimation

Education and Outreach in the Life Sciences: Qualitative Analysis Report

The DOE's National Nuclear Security Agency (NNSA) asked Pacific Northwest National Laboratory (PNNL) to consider the role of individual scientists in upholding safety and security. The views of scientists were identified as being a critical component of this policy process. Therefore, scientists, managers, and representatives of Institutional Biosafety Committees (IBCs) at the national labs were invited to participate in a brief survey and a set of focus groups. In addition, three focus groups were conducted with scientists, managers, and IBC representatives to discuss some of the questions related to education, outreach, and codes of conduct in further detail and gather additional input on biosecurity and dual-use awareness at the laboratories. The overall purpose of this process was to identify concerns related to these topics and to gather suggestions for creating an environment where both the scientific enterprise and national security are enhanced

Integrating Tobacco Control and Obesity Prevention Initiatives at Retail Outlets

Tobacco products are sold in approximately 375,000 US retail outlets, including convenience stores and pharmacies, which often sell energy-dense, low-nutrient foods and beverages. The Food and Drug Administration's (FDA's) increased authority over tobacco product sales and marketing, combined with declining smoking rates, provides an opportunity to transition tobacco retailers toward healthier retail environments. Unfortunately, research into improving consumer retail environments is often conducted in isolation by researchers working in tobacco control, nutrition, and physical activity. Interdisciplinary efforts are needed to transform tobacco retailers from stores that are dependent on a declining product category, to the sale and promotion of healthful foods and creating environments conducive to active living. The objective of this article is to describe the potential for interdisciplinary efforts to transition retailers away from selling and promoting tobacco products and toward creating retail environments that promote healthful eating and active living

Retailer Adherence to Family Smoking Prevention and Tobacco Control Act, North Carolina, 2011

IntroductionThe Family Smoking Prevention and Tobacco Control Act regulates the sales and marketing of tobacco products in the United States; poor adherence by tobacco retailers may reduce the effectiveness of the Act’s provisions. The objectives of this study were 1) to assess whether and to which provisions retailers were adherent and 2) to examine differences in adherence by county, retailer neighborhood, and retailer characteristics.MethodsWe conducted multivariate analysis of tobacco retailers’ adherence to 12 point-of-sale provisions of the Tobacco Control Act in 3 North Carolina counties. We conducted observational audits of 324 retailers during 3 months in 2011 to assess adherence. We used logistic regression to assess associations between adherence to provisions and characteristics of each county, retailer neighborhood, and retailer.ResultsWe found 15.7% of retailers did not adhere to at least 1 provision; 84.3% adhered to all provisions. The provisions most frequently violated were the ban on sales of cigarettes with modified-risk labels (eg, “light” cigarettes) (43 [13.3%] retailers nonadherent) and the ban on self-service for cigarettes and smokeless tobacco (6 [1.9%] retailers nonadherent). We found significant differences in rates of nonadherence by county and type of retailer. Pharmacies and drug stores were more than 3 times as likely as grocery stores to be nonadherent.ConclusionMost tobacco retailers have implemented regulatory changes without enforcement by the US Food and Drug Administration. Monitoring rates of adherence by store type and locale (eg, county) may help retailers comply with point-of-sale provisions

Pro-tobacco marketing and anti-tobacco campaigns aimed at vulnerable populations: A review of the literature.

INTRODUCTION:We reviewed research literature on pro-tobacco marketing and anti-tobacco campaigns targeting eight vulnerable populations to determine key findings and research gaps. Results can inform tobacco policy and control efforts and the design of public education campaigns for these groups. METHODS:Five journal databases in medicine, communication, and science, were used to identify 8875 peer-reviewed, original articles in English, published in the period 2004-2018. There were 144 articles that met inclusion criteria on pro-tobacco marketing or anti-tobacco campaigns aimed at eight US groups: women of reproductive age, racial/ethnic minority groups (African American, Hispanic/Latino, Asian/Pacific Islander and American Indian/Alaska Native), Lesbian/Gay/Bisexual/Transgender (LGBT) populations, groups with low socioeconomic status, rural/inner city residents, military/veterans, and people with mental health or medical co-morbidities. We summarized the number of articles for each population, type of tobacco, and pro-tobacco or anti-tobacco focus. Narrative summaries were organized by population and by pro-tobacco or anti-tobacco focus, with key strategies and gaps by group. RESULTS:There were more studies on pro-tobacco marketing rather than anti-tobacco campaigns, and on cigarettes rather than other tobacco products. Major gaps included studies on Asian Americans, American Indian/Alaska Natives, pregnant women, LGBT populations, and those with mental health or medical co-morbidities. Gaps related to tobacco products were found for hookah, snus, and pipe/roll-your-own tobacco in the pro-tobacco studies, and for all products except cigarettes in anti-tobacco studies. Common tobacco industry methods used were tailoring of product and package design and messages that were used to reach and appeal to different sociodemographic groups. Studies varied by research design making it difficult to compare results. CONCLUSIONS:We found major research gaps for specific groups and tobacco products. Public education campaigns need a stronger foundation in empirical studies focused on these populations. Research and practice would benefit from studies that permit comparisons across studies

Electronic nicotine delivery devices, and their impact on health and patterns of tobacco use: a systematic review protocol

Introduction E-cigarettes or electronic nicotine delivery systems (ENDS) have recently attracted considerable attention. Among some individuals there is strong debate and a polarisation of views about the public health benefits versus harms of ENDS. With little regulation, the ENDS market is evolving, and new products are introduced and marketed constantly. Rapid developments in manufacturing, marketing and consumer domains related to ENDS will warrant frequent re-evaluation, based on the state of the evolving science. The purpose of this article is to describe a protocol for an ongoing comprehensive review of the published scientific literature on ENDS. Methods and analysis We will undertake a systematic review of published empirical research literature on ENDS using the National Library of Medicine\u27s PubMed electronic database to search for relevant articles. Data from included studies will be extracted into a standardised form, tables with study details and key outcomes for each article will be created, and studies will be synthesised qualitatively. Ethics and dissemination This review synthesises published literature and presents no primary data. Therefore, no ethical approval is required for this study. Subsequent papers will provide greater detail on results, within select categories, that represent gaps in the literature base

A Systematic Review of Neighborhood Disparities in Point-of-Sale Tobacco Marketing

We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant articles from 893 results of a systematic search in 10 databases updated May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbanicity)

Education and Outreach in the Life Sciences: Quantitative Analysis Report

The DOE's National Nuclear Security Agency (NNSA) asked Pacific Northwest National Laboratory (PNNL) to consider the role of individual scientists in upholding safety and security. The views of scientists were identified as being a critical component of this policy process. Therefore, scientists, managers, and representatives of Institutional Biosafety Committees (IBCs) at the national labs were invited to participate in a brief survey. This report presents the results from the web survey