A systematic review on the impact of point-of-sale tobacco promotion on smoking

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Ending the display and promotion of cigarettes and tobacco in retail shops helps prevent young people taking up smoking and keeps quitters on track, according to a new University of Otago study, led by ASPIRE2025 researcher Lindsay Robertson.

This included a review of all studies published since 2008 that investigated the relationship between tobacco promotion in retail stores and smoking.

Of the 20 studies Miss Robertson and colleagues reviewed, nine specifically examined children and adolescents, and each found that the more often young people saw tobacco displays or promotions in retail stores, the more likely they were to smoke.

For adult smokers, exposure to tobacco displays in stores appears to increase the risk of impulse tobacco purchases as well as smoking.

ABSTRACT

Introduction

The tobacco retail environment is a crucial marketing medium for the industry. A 2009 review found evidence of a positive association between exposure to point-of-sale (POS) tobacco promotion and increased smoking and smoking susceptibility, though limitations in the evidence base were identified.

Aim and methods

We reviewed and critically appraised recent evidence documenting the influence of POS tobacco promotion, and POS tobacco display bans, on smoking-related behaviour and cognitions. We reviewed original quantitative and qualitative research that examined the relationship between POS tobacco promotion and smoking prevalence, individual-level smoking, quitting, and tobacco purchasing behaviour, smoking susceptibility, and smoking-related cognitions.

Results

Twenty peer-reviewed studies (18 quantitative and 2 qualitative) met the inclusion criteria; each study reported findings consistent with a positive association between exposure to POS tobacco promotion and smoking or smoking susceptibility. Several studies met key criteria for causality: four indicated a dose-response association, two prospective studies were identified, and evidence from intervention studies supported the reversibility of the association. Findings were consistent across different study designs, settings and measures.

Conclusions

The existing evidence supports a positive association between exposure to POS tobacco promotion and smoking. This review provides evidence to support the continuation of POS tobacco display bans in those jurisdictions where such legislation has been introduced, and strengthens the evidence encouraging similar policies in jurisdictions without a POS display ban.

For further information please contact:

Miss Lindsay Robertson
University of Otago
Email: l.robertson@otago.ac.nz