News and Research Round Up – Counter Tobacco

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

Density

Reducing the density and number of tobacco retailers: Policy solutions and legal issues, Nicotine & Tobacco Research
- This paper provides an overview of policy options for reducing the number and density of tobacco retailers through licensing, zoning, and direct regulation. It also analyzes potential legal challenges to those policy options. Policies discussed include the following: imposing minimum distance requirements between existing retailers or between retailers and locations that serve youth (e.g. schools, playgrounds); capping the number of retailers in a given geographic area; establishing a maximum number of retailers proportional to population size; and prohibiting sales at certain types of establishments, such as pharmacies. The authors conclude that because of evidence linking tobacco retailer density to smoking rates at a community level, courts are likely to reject constitutional challenges to well-designed polices that aim to reduce tobacco retailer density.
- Learn more about licensing and zoning as strategies to reduce retailer density.

Packaging and POS Health Warnings

American Spirit Pack Descriptors and Perceptions of Harm: A Crowdsourced Comparison of Modified Packs, Nicotine & Tobacco Research
- In this study, participants rated American Spirit packs with the descriptors “Made with Organic Tobacco,” “100% Additive-Free,” and “100% US Grown as less harmful than American Spirit packs without the descriptors. Participants also rated American Spirit packs with and without the descriptors as less harmful than Marlboros. This indicates that the descriptors and other aspects of the American Spirit packaging communicate reduced harm. The study’s findings also provide support for the FDA’s warning to Sante Fe Natural Tobacco Company on their unauthorized modified risk claim.
- News Story: New Research Underscores FDA’s Need to Take Action on American Spirit Cigarettes’ Misleading Packaging, PR Newswire
Pictorial cigarette pack warnings: a meta-analysis of experimental studies, Tobacco Control
- This study found that pictorial (graphic) health warnings on cigarette packs were more effective than text-only health warnings at increasing quit intentions and decreasing intentions to start smoking. They also better attracted attention, better held attention, and elicited stronger reactions and more negative attitudes from participants.
Effects of plain package branding and graphic health warnings on adolescent smokers in the USA, Spain and France, Tobacco Control
- This study found that across all three countries, health warnings with a higher level of graphicness were associated with thoughts of quitting among adolescent smokers. Both plain packaging and graphic health warnings reduced craving, increased fear, and decreased feelings of embarassment or shame. When combined, plain packaging can strengthen the direct effects (cravings, fear, pack feelings) of graphic health warnings. Plain packaging had a stronger effect for the US adolescents.
Implications of tobacco industry research on packaging colors for designing health warning labels, Nicotine & Tobacco Research
- This study found that the tobacco industry’s internal research suggests that health warning labels printed on a yellow background with black lettering and borders would be most effective at drawing the attention of consumers and conveying a message of danger.
Learn more about point of sale health warnings.

E-Cigarettes

Exposure to Advertisements and Electronic Cigarette Use Among US Middle and High School Students, Pediatrics
- This study found that exposure to e-cigarette advertising in the retail setting is associated with e-cigarette use among middle and high school students. The association also increases in magnitude as exposure increases – the greater the exposure to advertising, the greater the likelihood of e-cigarette use. 14.4 million middle and high school students reported exposure to ads in stores, and high school students who reported the most exposure were 91% more likely to be current e-cigarette users. Middle school students with the highest exposure were more than twice as likely to be current users.
- News Story: E-Cigarette Ads Get Through to Teens, Study Finds, NBC News
Relationship between e-cigarette point of sale recall and e-cigarette use in secondary school children: a cross-sectional study, BMC Public Health
- News story: Seeing e-cigarettes in shops may influence their use by teenagers, Medical Xpress
Point-of-sale cigarette marketing and smoking-induced deprivation in smokers: results from a population-based survey,BMC Public Health
- This study conducted with smokers in Omaha, Nebraska found that smokers who were exposed to a higher level of point of sale cigarette marketing were more likely to also have experienced smoking-induced deprivation (a time in the last six months when spending money on cigarettes resulted in not having enough money for household essentials such as food). The relationship between POS cigarette marketing and smoking-induced deprivation was partly mediated by cravings to smoke, urges to buy cigarettes, and unplanned purchases of cigarettes at neighborhood stores, which we know are linked to POS advertising.
Evaluating an Excise Tax on Electronic Cigarette Consumption: Early Results, Tobacco Regulatory Science
- In 2013, Minnesota raised taxes on both cigarettes and e-cigarettes at the same time. An initial analysis of changes in e-cigarette sales following implementation of the tax show an initial spike in e-cigarette sales to 36% higher than expected, followed by a decline to 40% below expected.
Commentary: Regulatory oversight and ENDS product defects, Tobacco Control
A framework for evaluating the public health impact of e-cigarettes and other vaporized nicotine products, Addiction
Electronic Cigarette Refill Liquids: Child-Resistant Packaging, Nicotine Content, and Sale to Minors, Journal of Pediatric Nursing
- This study was conducted in 16 unlicensed vape stores in North Dakota, prior to a state law that prohibits the sale of e-cigarettes to minors and requires child-resistant packaging for e-liquid nicotine containers. Results showed that mislabeling the amount of nicotine in e-liquids was very common. This finding highlights the need for the inclusion of vape shops in licensing programs, and the need for implementation and enforcement of child-resistant packaging and nicotine labeling laws.
Advertising, Habit Formation, and U.S. Tobacco Product Demand, American Journal of Agricultural Economics
- News Story: Cigarette sales get a boost from TV commercials for e-cigs, says study, Campaign
Learn more about e-cigarettes at the point of sale.

New Reports

Tobacco Use Among Middle and High School Students – United States, 2011-2015, CDC MMWR
- This report shows that while cigarette smoking had been on a decline since 2011 when the youth smoking rate was at 15.8%; however, no progress was made between 2014 (9.2%) and 2015 (9.3%). However, e-cigarettes have become the most commonly used tobacco product among youth, and use is continuing to grow, with 16% of high school students and 5.3% of middle school students reporting use – a total of 3 million youth. Cigars also remain popular, with cigar use among high school boys actually surpassing cigarette use. About one in four high school students use some form of tobacco use, and half of those use at least two products.
- News Stories:
  - No decline in overall youth tobacco use since 2011, CDC
  - Statement of the National Alliance for Hispanic Health: New CDC Data Show Hispanic Tobacco Tipping Point, National Alliance for Hispanic Health
  - Progress ending youth tobacco use stalled – national youth tobacco survey 2015, Truth Initiative