Point-of-Sale Poster Strategies for Reducing Teen Tobacco Use

Overseen By William G Shadel, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: RAND

Disqualifiers: Medical, psychiatric conditions, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to find better ways to reduce tobacco use among teens by studying how different poster displays at stores affect their risk of using tobacco products like cigarettes and e-cigarettes. Researchers will test three strategies: fewer posters with prices, many posters without prices, and many posters with prices. College students aged 18-20 who haven't participated in a similar study before are good candidates for this study.

As an unphased trial, this study offers participants the opportunity to contribute to innovative research that could shape future tobacco prevention strategies.

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What prior data suggests that these poster strategies are safe for reducing teen tobacco use?

Research shows that changing how tobacco products are advertised in stores can affect smoking habits. For instance, studies have found that fewer tobacco posters can reduce the likelihood of young people starting to smoke. This finding reassures those concerned about the dangers of tobacco advertising exposure.

However, many posters without showing prices can sometimes have mixed effects. Some research suggests that certain types of posters might increase the risk of smoking among teens. Examining the content of these posters is important to better understand their impact.

Overall, the trial treatments involve changing how tobacco is advertised, which is generally safe. Previous studies focus on the effects of these ads rather than any direct health risks from participating in the trial. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how different point-of-sale poster strategies might impact teen tobacco use. Unlike traditional approaches that often focus on price restrictions or health warnings, this trial examines the influence of poster quantity and pricing information. The "Reduced Poster" strategy limits the number of posters but includes pricing details, while the "No Price" approach allows for many posters without pricing information. By understanding how these variables affect teen behavior, researchers hope to discover new ways to reduce tobacco use among teens, potentially offering more effective prevention strategies.

What evidence suggests that these poster strategies are effective for reducing teen tobacco use?

This trial will compare different point-of-sale poster strategies to reduce teen tobacco use. Research has shown that reducing the number of tobacco posters in stores, as participants in the "Reduced Poster" arm will experience, can greatly lower the chances of teenagers starting to smoke. Specifically, one study found that fewer posters led to a significant drop in the likelihood of young adults smoking in the future.

Another strategy tested in this trial involves removing price information from tobacco ads, as seen in the "No price" arm. Studies indicate that eliminating price discounts and coupons can significantly decrease students' interest in trying tobacco products. Both strategies aim to make tobacco less appealing to young people, potentially leading to reduced tobacco use. ^{1 2 3 5 6}

Are You a Good Fit for This Trial?

This trial is for college students aged 18-20 who haven't been in a previous StoreLab study. It's not suitable for those with medical or psychiatric conditions that could interfere with following the study rules.

Exclusion Criteria

Previous participation in a previous StoreLab study

Any medical or psychiatric condition which would make compliance with the study protocol difficult (based on parent report)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Experimental Manipulation

Participants are exposed to different point-of-sale advertising conditions in the StoreLab to assess tobacco use risk

1 visit

1 visit (in-person)

Follow-up

Participants are monitored for self-reported tobacco use risk after exposure to experimental conditions

1 week

What Are the Treatments Tested in This Trial?

Interventions

• Fewer posters, no price restrictions
• Many posters, no prices
• Many posters with prices

Trial Overview

The study tests how different numbers and types of tobacco product posters at points-of-sale influence young adults' tobacco use. It looks at cigarettes, e-cigarettes, smokeless tobacco, and cigarillos across two concurrent studies.

How Is the Trial Designed?

Group I: Reduced Poster Experimental Treatment 1 Intervention

This condition will allow for a reduced number of posters with pricing information to be displayed.

Group II: No price Experimental Treatment 1 Intervention

This condition will allow for many posters with no pricing information to be displayed.

Group III: Status Quo Active Control 1 Intervention

This condition will allow for many posters with pricing information to be displayed.

Who Is Running the Clinical Trial?

RAND

Lead Sponsor

Trials

145

Recruited

617,000+

Published Research Related to This Trial

In a study of 81 schools, it was found that retail stores near schools with high smoking prevalence had lower cigarette prices, more in-store promotions, and fewer health warnings compared to those near schools with low smoking prevalence.

The results suggest that Point of Purchase (PoP) tobacco marketing strategies are more aggressive in areas with higher youth smoking rates, indicating a need for legislation to regulate these marketing activities and enhance health warnings in school neighborhoods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tobacco Point-of-Purchase marketing in school neighbourhoods and school smoking prevalence: a descriptive study. Lovato, CY., Hsu, HC., Sabiston, CM., et al.[2020]

About 13% of U.S. middle and high school students reported exposure to tobacco coupons in the past 30 days, with higher rates among current tobacco users (34%) and those receptive to tobacco marketing (23%).

Factors such as being a current tobacco user, living with a tobacco user, and being receptive to tobacco marketing were significantly associated with increased exposure to coupons, highlighting the need for targeted efforts to reduce youth exposure to tobacco promotions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exposure to tobacco coupons among U.S. middle and high school students. Tessman, GK., Caraballo, RS., Corey, CG., et al.[2023]

A study involving 1216 youth aged 13 to 17 showed that banning tobacco displays at the point of sale significantly reduced awareness of tobacco products and attempts to purchase them, with only 32% aware of products compared to 85% in the status quo.

The results suggest that policies banning tobacco displays could effectively deter youth from buying tobacco, while banning ads had little effect on purchase attempts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of tobacco displays and ads on youth: a virtual store experiment. Kim, AE., Nonnemaker, JM., Loomis, BR., et al.[2022]

A study involving 1313 adult smokers and recent quitters found that banning tobacco displays significantly reduced the urge to smoke and the likelihood of attempting to purchase cigarettes.

Implementing plain packaging and advertisements also decreased purchase attempts, suggesting that these policies could effectively reduce smoking rates among adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of point-of-sale tobacco displays and plain black and white cigarette packaging and advertisements on adults: Evidence from a virtual store experimental study. Nonnemaker, J., Kim, A., Shafer, P., et al.[2022]

A study of Australian students aged 12-17 from 1993 to 2008 found that higher exposure to tobacco control advertising (measured in targeted rating points, or TRPs) is linked to lower smoking prevalence among adolescents, particularly when cumulative exposure exceeds 5800 TRPs.

Specifically, exposure to at least 400 TRPs/month consistently reduced smoking likelihood, while even less frequent exposure at 800 TRPs/month was effective, highlighting the importance of both the intensity and duration of anti-smoking campaigns in reducing adolescent smoking rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What is the role of tobacco control advertising intensity and duration in reducing adolescent smoking prevalence? Findings from 16 years of tobacco control mass media advertising in Australia. White, VM., Durkin, SJ., Coomber, K., et al.[2023]

Tobacco advertising is most prevalent in gas stations, convenience stores, liquor stores, and tobacco shops, with a notable increase in ads in neighborhoods with higher African-American/Black populations, indicating targeted marketing strategies.

Communities with more diverse racial and ethnic backgrounds are exposed to different types of tobacco ads, such as menthol brands in areas with more African-American/Black and Asian residents, while predominantly White neighborhoods see ads that promote health-related claims, highlighting the need for regulatory action to mitigate these disparities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The relationship of neighborhood demographic characteristics to point-of-sale tobacco advertising and marketing. Widome, R., Brock, B., Noble, P., et al.[2023]

The 2012 point-of-sale display ban in supermarkets led to a significant decrease in the number of young people noticing tobacco displays, dropping from 58.8% in 2012 to 45.7% in 2013, indicating reduced exposure to tobacco marketing.

Despite the reduction in exposure to point-of-sale displays, the ban did not significantly affect smoking susceptibility or uptake among young people, suggesting that further measures may be needed to impact smoking behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cohort study investigating the effects of first stage of the English tobacco point-of-sale display ban on awareness, susceptibility and smoking uptake among adolescents. Bogdanovica, I., McNeill, A., Britton, J.[2022]

From 2015 to 2018, exterior cigarette advertisements near New Jersey high schools decreased, indicating a potential reduction in youth exposure to cigarette marketing, while interior advertisements remained stable.

Conversely, cigar advertisements increased significantly during the same period, suggesting a shift in marketing strategies that could influence youth tobacco use, highlighting the need for ongoing monitoring and regulation of point-of-sale advertising.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changes in Tobacco Product Advertising at Point of Sale: 2015-2018. Jeong, M., Kurti, MK., Hrywna, M., et al.[2021]

Following the implementation of a point-of-sale (POS) tobacco display ban in New Zealand, smoking experimentation among year 10 students decreased from 23% in 2011 to 17% in 2014, indicating a significant reduction in youth smoking behaviors.

The study also found that the prevalence of current smoking dropped from 9% to 7%, and the association between visiting tobacco-retailing stores and smoking behaviors weakened, suggesting that POS display bans effectively contribute to reducing smoking initiation among young people.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of removing point-of-sale tobacco displays: data from a New Zealand youth survey. Edwards, R., Ajmal, A., Healey, B., et al.[2019]

The Real Cost campaign, launched by the FDA in 2014, successfully raised awareness about the dangers of tobacco among U.S. youth, with 89% of them recalling at least one advertisement within 6 to 8 months of its launch.

The campaign was particularly effective among its target groups, achieving awareness levels of 90.5% among susceptible nonsmokers and 94.6% among youth who had experimented with smoking, indicating a strong initial impact on tobacco-related attitudes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Youth's Awareness of and Reactions to The Real Cost National Tobacco Public Education Campaign. Duke, JC., Alexander, TN., Zhao, X., et al.[2022]

Exposure to supportive antismoking ads significantly reduced the urge to smoke among current smokers, indicating their potential effectiveness in tobacco control efforts.

Graphic antismoking ads and price promotions did not show a significant impact on smoking urges or tobacco purchases for either current smokers or recent quitters, suggesting that different types of ads may have varying levels of effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Antismoking Advertisements and Price Promotions and Their Association With the Urge to Smoke and Purchases in a Virtual Convenience Store: Randomized Experiment. Dutra, LM., Nonnemaker, J., Bradfield, B., et al.[2020]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC12289229/

Restricting Tobacco Poster Advertising Space at Retail ...

Restricting poster coverage at POS was associated with a significant reduction in future susceptibility to cigarette smoking (adjusted odds ratio [aOR] = 0.21, ...

2.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/40643369/

Restricting Tobacco Poster Advertising Space at Retail ...

Results: Restricting poster coverage at POS was associated with a significant reduction in future susceptibility to cigarette smoking (adjusted ...

3.

hecaod.osu.edu

hecaod.osu.edu/restricting-tobacco-poster-advertising-space-at-retail-point-of-sale-reduces-some-young-adults-susceptibility-to-future-cigarette-smoking/

Restricting Tobacco Poster Advertising Space at Retail ...

Takeaway: Restricting tobacco poster space at retail stores can reduce smoking susceptibility among young adults who have been heavily exposed ...

4.

researchgate.net

researchgate.net/publication/393615106_Restricting_Tobacco_Poster_Advertising_Space_at_Retail_Point_of_Sale_Reduces_Some_Young_Adults'_Susceptibility_to_Future_Cigarette_Smoking

Restricting Tobacco Poster Advertising Space at Retail ...

Results: Restricting poster coverage at POS was associated with a significant reduction in future susceptibility to cigarette smoking (adjusted ...

5.

tobaccofreekids.org

tobaccofreekids.org/us-resources/fact-sheet/tobacco-company-marketing-that-reaches-kids-point-of-sale-advertising-and-promotions

Point of Sale Advertising and Promotions

These strategies work to keep tobacco prices low through price discounts, promotional allowances, and “retail value added” offers like buy- downs (payments to ...

6.

rand.org

rand.org/news/press/2015/11/23.html

Hiding Tobacco Products at Convenience Stores Reduces ...

Researchers found an 11 percent reduction in cigarette smoking susceptibility when the tobacco “power wall” was hidden compared to when the ...