Objective Over four-fifths of reported expenditures for marketing tobacco products occur at the retail point of sale (POS). To date, no systematic review has synthesized the methods used for surveillance of POS marketing. This review sought to describe the audit objectives, methods, and measures used to study retail tobacco environments. Methods We systematically searched 11 academic databases for papers indexed on or before March 14, 2012, identifying 2,906 papers. Two coders independently reviewed each abstract or fulltext to identify papers with the following criteria: (1) data collectors visited and assessed (2) retail environments using (3) a data collection instrument for (4) tobacco products or marketing. We excluded papers where limited measures of products and/or marketing were incidental. Two abstractors independently coded included papers for research aims, locale, methods, measures used, and measurement properties. We calculated descriptive statistics regarding the use of 4 P’s of marketing (product, price, placement, promotion) and for measures of study design, sampling strategy, and sample size. Results We identified 88 store audit studies. Most studies focus on enumerating the number of signs or other promotions. Several strengths, particularly in sampling, are noted, but substantial improvements are indicated in the reporting of reliability, validity, and audit procedures. Conclusions Audits of POS tobacco marketing have made important contributions to understanding industry behaviour, the uses of marketing, and resulting health behaviours. Increased emphasis on standardization and the use of theory are needed in the field. We propose key components of audit methodology that should be routinely reported.
Objective: To examine whether adolescents' exposure to youth smoking prevention ads sponsored by tobacco companies promotes intentions to smoke, curiosity about smoking, and positive attitudes toward the tobacco industry. Design: A randomised controlled experiment compared adolescents' responses to five smoking prevention ads sponsored by a tobacco company (Philip Morris or Lorillard), or to five smoking prevention ads sponsored by a non-profit organisation (the American Legacy Foundation), or to five ads about preventing drunk driving. Setting: A large public high school in California's central valley. Subjects: A convenience sample of 9th and 10th graders (n = 832) ages 14-17 years. Main outcome measures: Perceptions of ad effectiveness, intention to smoke, and attitudes toward tobacco companies measured immediately after exposure. Results: As predicted, adolescents rated Philip Morris and Lorillard ads less favourably than the other youth smoking prevention ads. Adolescents' intention to smoke did not differ as a function of ad exposure. However, exposure to Philip Morris and Lorillard ads engendered more favourable attitudes toward tobacco companies. Conclusions: This study demonstrates that industry sponsored anti-smoking ads do more to promote corporate image than to prevent youth smoking. By cultivating public opinion that is more sympathetic toward tobacco companies, the effect of such advertising is likely to be more harmful than helpful to youth.
BackgroundAfrican Americans are disproportionately exposed to cigarette advertisements, particularly for menthol brands. Tobacco industry documents outline strategic efforts to promote menthol cigarettes to African Americans at the point of sale, and studies have observed more outdoor and retail menthol advertisements in neighborhoods with more African-American residents. Little research has been conducted to examine the effect of this target marketing on adolescents’ recognition of cigarette brand advertising and on smoking uptake. To our knowledge, this is the first study to examine racial differences in brand recognition and to assess the prospective relationship between brand recognition and smoking uptake.MethodsSchool-based surveys assessing tobacco use and environmental and social influences to smoke were administered to 6th through 9th graders (ages 11 to 15) in an urban and racially diverse California school district. The primary outcome for the cross-sectional analysis (n = 2,589) was brand recognition, measured by students’ identification of masked tobacco advertisements from the point of sale. The primary outcome for the longitudinal analysis (n = 1,179) was progression from never to ever smoking within 12 months.ResultsAt baseline, 52% of students recognized the Camel brand, 36% Marlboro, and 32% Newport. African-American students were three times more likely than others to recognize Newport (OR = 3.03, CI = 2.45, 3.74, p < 0.01) and less likely than others to recognize Marlboro (OR = 0.60, CI = 0.48, 0.73, p < 0.01). At follow-up, 17% of never smokers reported trying smoking. In this racially diverse sample, brand recognition of Camel and Marlboro did not predict smoking initiation. Regardless of race, students who recognized the Newport brand at baseline were more likely to initiate smoking at follow-up (OR = 1.49, CI = 1.04, 2.15, p < 0.05) after adjusting for shopping frequency and other risk factors.ConclusionsThe study findings illustrate that African-American youth are better able to recognize Newport cigarette advertisements, even after adjustment for exposure to smoking by parents and peers. In addition, recognition of Newport cigarette advertising predicted smoking initiation, regardless of race. This longitudinal study contributes to a growing body of evidence that supports a ban on menthol flavored cigarettes in the US as well as stronger regulation of tobacco advertising at the point of sale.
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