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© 2008 American Public Health Association
DOI: 10.2105/AJPH.2007.124321
LETTER |
Joanna E. Cohen, Lynn C. Planinac, and Shawn C. O’Connor are with the Ontario Tobacco Research Unit, University of Toronto, Ontario. Joanna E. Cohen is also with the Department of Public Health Sciences at the University of Toronto, Toronto. Anne M. Lavack is with the Faculty of Business Administration at the University of Regina, Regina, Saskatchewan. Daniel J. Robinson is with the Faculty of Information and Media Studies at the University of Western Ontario, London, Ontario. At the time of writing, Francis E. Thompson was with the Non-Smokers’ Rights Association, Ottawa, Ontario.
Correspondence: Requests for reprints should be sent to Joanna E. Cohen, PhD, Ontario Tobacco Research Unit, University of Toronto, 33 Russell Street, T5, Toronto, Ontario M5S 2S1 Canada (e-mail: joanna.cohen{at}utoronto.ca).
Husten’s editorial on smoking cessation in young adults highlights the need for the public health community to support young adults’ quit attempts through environmental changes, including increasing tobacco prices, encouraging smoke-free public places, workplaces, and homes, and improving coverage of cessation interventions.1 One important initiative missing from this list is restricting tobacco promotions at the retail point-of-sale (POS). The tobacco industry spends more money on POS promotions than on all other forms of cigarette marketing combined.2 Tobacco promotions at retail outlets provide product cues to would-be starters and would-be quitters, and may present relapse challenges for the latter group.3–5 While restricting POS promotions may seem daunting given its pervasiveness, some jurisdictions have been successful in doing so.
Ontario, Canada’s largest province, has adopted a phased-in approach to restricting tobacco promotions at POS. "Enhancements" of cigarette powerwalls behind the cash counter, cigarette countertop displays, outdoor signs, and most indoor signs were prohibited in May 2006, and the visible display of tobacco products at POS will be completely banned as of May 2008.
In 2005, prior to POS tobacco promotion restrictions, we visited a random selection of 481 Ontario retail outlets to measure the extent of tobacco promotions. We found extensive tobacco promotions across the province, including countertop displays, large signs with cigarette packs attached, and sophisticated powerwalls with "enhanced" features, such as display panels, colored shelf liners, and colored shelf gliders.6
We returned to a subset of these stores in 2006, 1 month prior to the implementation of the restrictions described above. Although these restrictions were not yet in force, 54% of stores were already complying with the regulations. Among noncompliant stores, only 22% had increased their promotions from the previous year. An increase in promotions was not significantly associated with store type, city size, city smoking prevalence, strength of clean air by-laws, store sales, neighborhood household income or education level, or proximity to a school.
Restrictions on POS tobacco promotions can elicit relatively high cooperation from both retailers and the tobacco industry, even prior to the actual implementation date. A survey conducted in the fall of 2006 found 89% of Ontario vendors compliant with all restrictions on POS promotions.7 Eliminating this ubiquitous form of advertising will reduce the impact of tobacco promotions on current, former, and potential smokers, including young adults, and will contribute to the comprehensive approach needed to support youth smoking cessation.
Acknowledgments
This research was funded through the strategic initiative, Advancing the Science to Reduce Tobacco Abuse and Nicotine Addiction. This initiative is a partnership of government and nonprofit organizations under the coordination of the Canadian Tobacco Control Research Initiative. The authors acknowledge Kirsten Sears and Tyler Ward, who assisted with data collection, and Joanne Cordingley, who assisted with data entry.
Human Participant Protection
This study was approved by the institutional review board of the University of Toronto.
Footnotes
Contributors
J. E. Cohen originated, obtained funding for, and supervised the study. L. C. Planinac collected data, completed the analysis, and assisted with the writing. All authors made substantial contributions to the study design and the interpretation of data, revised the letter critically for important intellectual content, and provided final approval of the letter.
Accepted for publication September 8, 2007.
References
1. Husten CG. Smoking cessation in young adults. Am J Public Health. 2007;97:1354–1356.
2. Cigarette Report for 2004 and 2005. Washington, DC: Federal Trade Commission; 2007.
3. Wakefield MA, Terry-McElrath YM, Chaloupka FJ, et al. Tobacco industry marketing at point of purchase after the 1998 MSA Billboard Advertising Ban. Am J Public Health. 2002;92:937–940.
4. Donovan RJ, Jancey J, Jones S. Tobacco point of sale advertising increases positive brand user imagery. Tob Control. 2002;11:191–194.
5. Feighery EC, Ribisl KM, Schleicher N, Lee RE, Halvorson S. Cigarette advertising and promotional strategies in retail outlets: results of a statewide survey in California. Tob Control. 2001;10:184–188.
6. Cohen J, Griffin K, Robinson D, et al. Point-of-sale tobacco marketing prior to the elimination of tobacco retail displays. Poster presented at: the 12th Annual Meeting of the Society for Research on Nicotine and Tobacco; February, 2006; Orlando, Fla.
7. Dubray J, Schwartz R, Garcia J, Bondy S, Victor JC. Formative Evaluation of the Smoke-Free Ontario Act: Comparison of Baseline and Post-SFOA Measurements. Ontario Tobacco Research Unit, Special Report Series. Toronto: Ontario Tobacco Research Unit; 2007.
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