July 2023 News and Research Roundup

Welcome to CounterTobacco.org’s “News and Research Roundup!” Each month we post a summary of the latest research, reports, and news stories on counteracting tobacco product sales and marketing at the point of sale (POS). Keeping up with what’s happening in the POS movement all across the country can help you choose policies and strategies that work best for your community. New research can help provide support for your work and evidence for the importance of the “War in the Store.” Have a story you don’t want us to miss? E-mail it to us!

New Research

E-Cigarettes

Perceived threat and fear responses to e-cigarette warning label messages: Results from 16 focus groups with U.S. youth and adults, PLOS One
- This study explores the impact of health warnings on e-cigarettes for perceived danger, fear/emotional responses, attitudes, and intentions regarding use of them. Beyond the current federally mandated e-cigarette warning, “WARNING: This product contains nicotine. Nicotine is an addictive chemical,” additional and alternative warnings could help further inform the public of e-cigarette risks and discourage product use. From July-August 2020, the researchers conducted 16 online focus groups with 47 adults and 32 youth. Participants were shown hypothetical e-cigarette warnings to measure their response to these statements on the health effects of e-cigarettes. The results showed that participants who smoke had less belief and perception of risk than those who don’t. Youth responded with more skepticism, defensiveness, and resistance about the toxic ingredients in and negative health effects of e-cigarettes than adults, and this was highest with young males. Future studies should further explore the effectiveness of warnings on different audiences.
- Read more about health warnings

Tobacco Policy & ENDS Policy Influences on Adolescent Vaping across U.S. States, American Journal of Preventive Medicine

- This study examined the effects of state-level policies on indoor smoking/vaping, excise taxes, and purchase age based on past month adolescent e-cigarette use from 2013-2019. Cohort and policy data came from the Population Assessment of Tobacco and Health (PATH) Study and the Americans for Nonsmokers’ Rights Foundation repository. The odds of using e-cigarettes were 21% lower for adolescents when a state had a purchase age restriction, and 55% lower when the state had a comprehensive tobacco smoking ban. These findings reinforce how policies have an impact on youth vaping.

Trends in public interest in shopping and point-of-sales of JUUL and Puff Bar 2019–2021, BMJ

- This study investigated public interest in JUUL and Puff Bar e-cigarettes from 2019-2021 using shopping trends from online search queries (“relative search volume”) and retail sales data from Nielsen for these products. When JUUL Labs suspended sales of its sweet/fruity flavors in 2019 after the Trump administration’s plan to ban flavored e-cigarettes, relative search volume and sales declined for JUUL while Puff Bar saw an increase. When cited by the FDA for selling unauthorized products, Puff Bar’s sales steeply declined in 2020, but this slowed after Puff Bar relaunched with “synthetic nicotine” in 2021. These results show that sales trends are significantly determined by regulatory factors. Federal action to regulate synthetic nicotine products like Puff Bar should be of increased priority.

Flavored Tobacco Products

An experimental evaluation of the effects of banning the sale of flavored tobacco products on adolescents’ and young adults’ future nicotine vaping intentions, Addictive Behaviors

- This study tested whether removing flavored tobacco products from a retail setting diminished intention by adolescents to vape. Using a model convenience store called RAND StoreLab, tobacco products were displayed with tobacco, sweet, and menthol/mint flavors, only tobacco and menthol/mint, and only tobacco flavors. Youth in the Pittsburgh, PA area were recruited and participated in this experiment from September 2020-May 2022. The results showed that removing menthol/mint- and sweet-flavored products significantly increased future intentions to use tobacco-flavored products particularly among adolescents who vape. Previous studies provide contrasting views on the effect of flavored tobacco product bans on youth vaping. This data highlights the need to consider the impact of flavored tobacco product bans more critically.

Heated Tobacco Products

Brief report on IQOS point-of-sale marketing, promotion and pricing in IQOS retail partner stores in Atlanta, Georgia, USA, BMJ

- This study examined marketing and pricing at the point of sale for the IQOS heated tobacco product after its introduction to the U.S. in 2019. During February-November 2020, staff visited 75 stores in Georgia selling IQOS to assess store characteristics, product availability and accessibility, marketing, promotions, and pricing using a Standardized Tobacco Assessment for Retail Settings (STARS) based survey form. All the stores assessed sold HeatSticks in at least tobacco, smooth menthol, and fresh menthol flavors, but did not sell the actual IQOS device that the HeatSticks are used in. Marketing for IQOS was present inside 98.5% and outside 17.3% of stores assessed, which was comparable to other tobacco products. Although future sales of IQOS are unknown due to pending legal challenges, these study findings show IQOS marketing is very apparent at the point of sale. Novel products like IQOS should be continually monitored as they enter the market.
- Learn more about heated tobacco products at the point of sale

Other

Moving hearts and minds: how the Big Tobacco, Tiny Targets campaign builds support for tobacco control policy, BMJ

- This paper provides background on the “Big Tobacco, Tiny Targets” campaign which includes community engagement, technical assistance, research dissemination, data collection, and policy advocacy. Since 2015, the Campaign for Tobacco-Free Kids, Johns Hopkins Bloomberg School of Public Health, and international organizations have monitored cigarette advertising and promotions in stores near schools and playgrounds in 42 low- and middle-income countries. Volunteers used an observational checklist programmed into KoboToolbox, a mobile data collection application. The primary tactics observed at the point of sale were display of cigarettes near snacks, sweets or sugary drinks, cigarette ad placement at youth eye-level, flavored cigarette product displays and ads, and sales of single cigarettes. Of the 42 countries, 32 of them engaged in advocacy campaigns. Positive policy outcomes around tobacco advertising, promotion and sponsorship (TAPS) were observed in at least 16 countries, particularly Burkina Faso, Georgia and Pakistan. Elements of this campaign could be replicated in other areas to further tobacco control policy change.