Tobacco Free Alliance of Pierce County 2013 Summit Taking Action to Reduce Tobacco Marketing to Youth December 9 2013 Allison E Myers MPH Retail tobacco marketing What is happening in the store ID: 599817
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The Impact of Retail Tobacco Marketing on Health
Tobacco Free Alliance of Pierce County2013 Summit: Taking Action to Reduce Tobacco Marketing to Youth December 9, 2013
Allison E. Myers, MPHSlide2
Retail tobacco marketing
What is happening in the store?Slide3
The ProblemSlide4
The Problem in Washington StateSlide5
Youth Initiation in Washington StateSlide6
Federal Trade Commission Cigarette and Smokeless Reports, 2010
Retail Tobacco Marketing
$1 Million/HourSlide7
Federal Trade Commission Cigarette and Smokeless Reports for 2011
Retail Tobacco MarketingSlide8Slide9Slide10Slide11Slide12Slide13Slide14Slide15
Health impact of tobacco retailing
How does tobacco retailing impact health?Slide16
Buying Health Behavior Impact
NEVER-SMOKER
SMOKERTRYING TO QUIT
Consider three customer segments:Slide17
Industry is buying health behavior impact
Exposure to retail tobacco promotion prompts smoking initiation Paynter J and Edwards R, 2009,
Nicotine & Tobacco ResearchAmong children, exposure to retail tobacco promotion is associated with:Susceptibility to smokingExperimentation with smokingOccasional smokingRegular smokingSlide18
Shopping, Brand Impressions Prompt Initiation
GREATER VISIT FREQUENCY, GREATER BRAND IMPRESSIONS = HIGHER ODDS OF INITIATION
NEVER-SMOKERSlide19
From Never-Smoker to Established-Smoker
NEVER-SMOKER
Slater, et al. (2007) Arch Pediatr Adolesc MedPUFFERGreater ADVERTISING in stores
= 8% higher odds of becoming a puffer.Slide20
From Never-Smoker to Established-Smoker
NEVER-SMOKER
Slater, et al. (2007) Arch Pediatr Adolesc MedPUFFERGreater ADVERTISING in stores
= 8% higher odds of becoming a puffer.
EXPERIMENTER
ESTABLISHED
Greater PROMOTIONS in stores increase odds of youth moving towards higher levels of uptake.Slide21
Retailer Density Linked to Prevalence
AREAS WITH HIGHER RETAILER DENSITY (>5) WITHIN WALKING DISTANCE HAD HIGHER OVERALL SMOKING PREVALENCE (15.1%)Henriksen, et al., 2008:
Preventive Medicine
SCHOOL
SCHOOL
SCHOOL
NO RETAILERS
(n=45)
LOW DENSITY
(1-5) (n=43)
HIGH DENSITY
(>5) (n=47)
11.9%
prevalence
13.6%
prevalence
15.1%
prevalenceSlide22
Industry is buying health behavior impact
Tobacco displays and advertising make tobacco seem easy to buyPaynter J and Edwards R, 2009,
Nicotine & Tobacco ResearchExperimental studies with school students indicate that seeing tobacco displays and advertising is associated with belief that:Tobacco is accessibleTobacco is easy to buyTobacco use prevalence is higher than it isSlide23
Adult Smokers & Trying To Quit
SMOKER
TRYING TO QUITConsider three customer segments:Slide24
Cigarette displays cue craving and impulse purchase in adults
SMOKER
Carter, et al., 2006, Nicotine & Tobacco Research; Wakefield, et al., 2008, AddictionSlide25
Smokers who live within walking distance of a retailer are less likely to quit successfully
TRYING TO QUIT
250 mOR = 0.5495%[CI] = 0.33, 0.87<250 m vs. ≥250m
Reitzel
, et al., 2010,
American Journal of Public HealthSlide26
Demographic Disparities
INCOME/SES
RACE/ETHNICITYRURAL/URBANConsider demographic variables:Slide27
Low-income and minority communities suffer a disproportionate burden of retail outlets
Retailer Density = the concentration of retailersMeasured as number of retailers per 1000 populationHigher in communities with lower median household income
1-3Higher in communities with higher percentage of African American1,2 or Latino families1Schneider JE et al. Prev Sci, 2005
Hyland, A, et al.,
AJPH, 2003
Loomis, BR, et al, Public Health, 2013Slide28
Lower Income Neighborhoods
1. Barbeau, Wolin, Naumova, & Balbach, 2005; 2. Seidenberg, Caughey, Rees, & Connolly, 2010;3. Siahpush
, Jones, Singh, Timsina & Martin, 2010; 4. Frick, Klein, Ferketich, & Wewers, 2011. HIGH-INCOME NEIGHBORHOOD
LOW-INCOME NEIGHBORHOOD
Fewer brand advertisements
1
Lower % of tobacco retailers with advertisements
2
Fewer marketing items per square mile
3
Fewer stores with self-service cigars
4
More brand advertisements
1
Higher % of tobacco retailers with advertisements
2
Larger sized
advertisements
2
More price ads, menthol ads, lower mean advertised price
2
More marketing items per square mile
3
More stores with self-service cigars
4Slide29
African American Neighborhoods
1. Henriksen, Schleicher, Dauphinee, & Fortman, 2012; 2. Feighery, Schleicher, Cruz, & Unger, 2008.
Higher proportion of African American people in the neighborhood near store: HIGHER number of advertisements2HIGHER number of advertisements with sales promotions2Higher proportion of African American students in a school: HIGHER proportion of menthol advertising1
HIGHER odds of Newport promotions
1
LOWER price
of Newport
1Slide30
Summary of Industry Targeting
LOWER INCOME
MINORITYRURAL
Lower prices and higher amounts of ads and promotions in lower income, minority and rural areas.
Higher retailer density in lower income and minority communities.Slide31
Summary: $1Million/Hour Well Spent
Retail marketing:
Prompts initiation
Promotes daily consumption
Discourages quitting
New York Data – What’s In Store CampaignSlide32
The Solution
Minimum
package sizeBan sales of tobacco near schools
Limit price promotions & coupons
Ban sales of tobacco in pharmaciesSlide33
New Power to Change Local & State Tobacco Retail Policy
Family Smoking Prevention and Tobacco Control ActJune, 2009Slide34
Tobacco Retailer Licensing
Certain types of businesses are required to purchase government-issues licenses that grant license-holding businesses permission to sell certain tobacco products under certain conditions.Use to:
Limit number, type, location of retailersMaintain a list of retailersFund compliance monitoring, enforcement effortsAllow license suspensionInclude “Plug-Ins” for stronger controlSlide35
Restrict Flavored Little Cigars and CigarillosSlide36
Prohibit Sales Near Schools or Parks
New Orleans, Louisiana
Santa Clara County, CaliforniaSlide37
Restrict Tobacco Sales in Pharmacies
Boston, Massachusetts
San Francisco, CaliforniaSlide38
Prohibit Coupon Redemption and Multi-pack Discounts
Angel Taveras,
Mayor,Providence, RISlide39
Fewer smokers: saving lives and dollars
Healthier stores and communities
Reduce exposure to tobacco marketingSuccess measured in lives and dollars
A place-based approach: When your ZIP code doesn’t determine your health statusSlide40
Questions?
Thank you!
aem@countertools.orgSlide41
Policy context
Local advertising and promotion lawsOver-the-counter retail licensure