September 2022 News and Research Roundup

Disparities, E-Cigarettes, Endgame, Flavors (including Menthol), Healthy Retailers, International, Licensing, Product Availability, Retailer Density

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

Evaluation of Flavored Tobacco Policies 

  • Impact of Massachusetts law prohibiting flavored tobacco product sales on cross-border cigarette sales, PLOS ONE 
    • This study estimated changes in cigarette sales in Massachusetts and its bordering states after Massachusetts’ flavored tobacco product sales ban was implemented in June 2020. Cigarette sales data was gathered through IRI retail scanner data from January 2020-December 2021 in four week increments and analyzed to compare sales before (January 2020-May 2020) and after (June 2020-December 2021) the ban was implemented. The outcomes assessed included state-level pack sales per 1000 population overall and by flavor status (menthol and non-flavored cigarettes). The border states included New Hampshire, Connecticut, Vermont, and Rhode Island and were compared to 28 non-border states. Before the ban, cigarette sales in border states were similar to non-border states, and after the ban, the average 4-week pack sales per 1000 people did not significantly change in border states. No substantial differences were found in typical sales patterns in non-border states versus border states. Additionally, when accounting for confounding factors, such as existing e-cigarette flavor policies, the COVID-19 pandemic, and differences across states in sociodemographic factors, there was also no substantial impact of the Massachusetts ban on cigarette sales in border states. This study reinforces the effectiveness of flavored tobacco product bans and refutes arguments around high cross-border sales after a policy is implemented. 
    • Learn more about flavored tobacco product bans
  • The impact of two state-level approaches to restricting the sale of flavored tobacco products, BMC Public Health
    • Ad for camel crush menthol cigarettes outside a retailerFlavors in tobacco products are a major contributor to youth tobacco product use. Flavors have also been heavily marketed to marginalized groups like African Americans, leading to disparities. This study analyzes the impact of the comprehensive Massachusetts and partial New Jersey bans on flavored tobacco products. As of June 2020, the Massachusetts ban encompasses all flavored tobacco products and limits them to licensed smoking bars, while as of April 2020, the New Jersey ban only restricts the sale of flavored e-cigarette products. In Massachusetts, Nielsen retail scanner data showed a significant decrease in sales across all flavored e-cigarettes with the highest decrease in fruit-flavored e-cigarettes since their ban was enacted. Sales of non-menthol flavored cigars and menthol-flavored cigarettes also notably decreased in Massachusetts. In New Jersey, there was a significant decrease in sales of menthol-flavored e-cigarettes, but non-menthol flavored cigars experienced a significant increase in per capita sales. Other than these, there were no other statistically significant increases or decreases in sales of other tobacco products in New Jersey. These results show the higher effectiveness of comprehensive flavor bans like in the case of Massachusetts compared to partial flavor bans like in New Jersey. Partial flavor bans may be less impactful and also lead to increased use of other tobacco products. This data supports the impacts on sales of comprehensive bans on the sale of all flavored tobacco products.
  • Expanding local sales restrictions on flavoured tobacco products to include menthol: retail sales changes in two Minnesota cities, Tobacco Control 
    • This study examined changes in tobacco products sales before and after implementation of Minneapolis and St. Paul, MN’s policies expanding their restrictions on the sale of flavored tobacco products to include menthol/mint/wintergreen flavored tobacco products. NeilsenIQ sales data from the two cities, the rest of the state of Minnesota, and the rest of the USA showed that after the expanded policy was implemented, sales of menthol cigarettes and menthol smokeless tobacco decreased to a greater degree than in comparison areas. Sales of flavored cigars had decreased further than they had after implementation of the cities’ bans on the sale of non-menthol/mint/wintergreen flavored tobacco products. Sales of menthol e-cigarettes increased in both cities and sales of other-flavored e-cigarettes increased in St. Paul, which researchers suggest may be due to retailer exemptions in the policies and/or policy noncompliance. Total sales of tobacco products also decreased across the two cities. 

Disparities in the Tobacco Retailer Landscape 

  • Variations in Tobacco Retailer Type Across Community Characteristics: Place Matters, Preventing Chronic Disease 
    • Dollar General with This study examined the different types of tobacco retailers present in communities within the state of Ohio. Results showed that for all census tracts, convenience stores were the most common retailer type, with some variation by community, with a higher prevalence in high-poverty urban census tracts with both high- and low- prevalences of racial and ethnic minorities. Similarly, discount stores were significantly more common in areas with a high prevalence of racial and ethnic minorities, high-poverty urban census tracts, high-poverty suburbs, and in both low- and high-poverty rural census tracts. In contrast, grocery stores and pharmacies showed the opposite effect, with a lower prevalence in high-poverty urban census tracts and tracts with both high- and low- racial and ethnic minorities. Vape shops, hookah shops, and alcohol stores had the lowest prevalence in rural census tracts. In conclusion, there were clear disparities in urban areas based on racial and ethnic composition and poverty, with convenience stores and discount stores driving these patterns. Due to the presence of certain retailer types in urban areas, areas with a high proportion of racial and ethnic minorities, and with high levels of poverty, those living in these communities have access to more and cheaper products which has implications for their tobacco use and quit success. The researchers suggest that policies to reduce retailer density should focus on retailer types like convenience stores and discount stores to reduce disparities in retailer density and the associated tobacco-related health disparities. 
    • Learn more about how tobacco retailer licensing can regulate tobacco retailer store types and location.

Heated Tobacco Products 

  • Brief report on IQOS point-of-sale marketing, promotion and pricing in IQOS retail partner stores in Atlanta, Georgia, USA, Tobacco Control 
    • IQOS is a heated tobacco product that was authorized for sale in the U.S. in April 2019. This study examined trends in the marketing and sales of IQOS in Atlanta, GA during the 1st year of its sale in the U.S. market. From February-November 2020, field staff assessed 75 retail stores in the Atlanta area that sold the IQOS device and its associated tobacco HeatSticks. To conduct these visits, staff used an assessment tool based on the Standardized Tobacco Assessment for Retail Settings (STARS) and adapted for IQOS. The assessment findings showed that all assessed stores sold and had high visibility of HeatSticks. The assessment results also showed that marketing for iQOS inside of these stores was as prevalent as marketing for cigarettes, smokeless tobacco, and/or little cigars and cigarillos, with 98.5% of stores including marketing for each product. Exterior marketing for IQOS was present at 17.3% of the assessed stores. This marketing included branded signs and displays along with health-promoting language and multipack discounts. The average price of a pack of HeatSticks was $6.80, slightly higher than the price of a pack of Marlboro Red cigarettes. While iQOS sales have been on hold in the U.S. since November 2021 due to a legal dispute, researchers note the importance of monitoring any future sales and marketing for iQOS and any other novel tobacco products in order to understand their marketing strategy and to equip agencies to better regulate them. 
    • Learn more about heated tobacco products at the point of sale. 

E-Cigarettes 

  • A Proposed Policy Agenda for Electronic Cigarettes in the US: Product, Price, Place, Promotion, Health Affairs 
    • wall display of flavored disposable e-cigarettes This article presents solutions in reducing e-cigarette uptake by youth and increasing adult smoking cessation. The researchers assert that conventional tobacco prevention and control efforts focus primarily on addressing e-cigarette risks and harms to youth, but give less extensive coverage on the implications of e-cigarettes for adults. There is a continuum of risk for products containing nicotine, with nicotine replacement therapy (NRTs) not having any significant health risks to cigarettes having some of the deadliest risks. The researchers assert that e-cigarettes fall closer to the NRT end of this continuum. They purport that existing messages and policies about e-cigarettes may be misleading and unintentionally harming public health by undermining the comparatively lower health risks of e-cigarettes. The researchers conclude that policies should be structured in a way to deter youth use of e-cigarettes and also offer options to adults who want to quit. Some key recommendations from the researchers include decreasing the addictiveness of combustible tobacco products, ensuring availability of reduced-risk nicotine products, imposing large excise taxes on combustible products and smaller excise taxes on e-cigarettes, establishing tobacco retailer licensing policies, limiting the sale of all tobacco and nicotine products to adult-only retailers, and developing better communications about the relative nature of e-cigarette risks. Researchers ranked lowering nicotine in combustible tobacco products to reduce their addictive nature was ranked as the highest priority of all potential interventions.
    • Learn more about e-cigarettes at the point of sale.

International

  • Toward tobacco-free retailers: feasibility of an intervention encouraging retailers to stop selling tobacco in Tasmania, Tobacco Control 
    • This study assessed the feasibility and impact of a non-regulatory intervention to encourage retailers in Tasmania that sell a low amount of tobacco to consider ending tobacco sales in their store entirely. The intervention focused on a socioeconomically disadvantaged area of Tasmania that has a high smoking rate and a high density of retailers. Between December 2018-2019, researchers contacted 164 retailers in this region via mailings, telephone calls, and onsite visits. In post-intervention interviews, retailers recalled the business-related reasons to stop selling tobacco. In addition, 72% agreed to take some steps towards ending tobacco sales, and 11% ended tobacco sales entirely. 
    • Read more about endgame strategies here and healthy retail strategies here.

Reports

Industry News

POS Policy in the Media

Menthol and Other Flavored Tobacco Products 

Licensing

Minimum Legal Sales Age

Multiple Regulations

Find more stories in last month’s News and Research Roundup.

Know of a story that we missed? Email us, and we’ll be sure to include it in next month’s roundup!

 

 

Posted September 27, 2022

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