“It Looks Like an Adult Sweetie Shop”: Point-of-Sale Tobacco Display Exposure and Brand Awareness in Scottish Secondary School Students

Abstract

Introduction:As further restrictions have been placed on tobacco advertising and promotions, point-of-sale (PoS) displays of cigarettes in shops have become an increasingly important source of young people’s exposure to tobacco products. This study explored the relationship between PoS displays of cigarettes and brand awareness among secondary school students in Scotland.Methods:Cross-sectional school surveys (n = 1406) and focus groups (n = 86) were conducted with S2 (13–14 years) and S4 (15–16 years) students in four schools of differing socioeconomic status in 2013, prior to the PoS display ban in large shops. Adjusted negative binomial regression analysis examined associations between brand awareness and exposure variables (visiting tobacco retailers, noticing displays of tobacco products).Results:Students visiting small shops more frequently (relative rate ratio [RRR] 1.19, 95% confidence interval [CI] 1.01–1.41) and those who noticed cigarette displays in small shops (RRR 1.24, 95% CI 1.03–1.51) and large supermarkets (RRR 1.15, 95% CI 1.01–1.30) had higher brand awareness. The focus groups supported these findings. Participants described PoS tobacco displays as being eye-catching, colorful and potentially attractive to young people.Conclusions:This mixed-methods study showed that higher cigarette brand awareness was significantly associated with regularly visiting small shops and noticing PoS displays in small and large shops, even when students’ smoking status, smoking in their social networks, leisure activities, and demographics were included as confounding variables. This highlights the importance of PoS displays of tobacco products in increasing brand awareness, which is known to increase youth smoking susceptibility, and thus the importance of implementing PoS display bans in all shops.Implications:As increasing restrictions have been placed on tobacco promotion in many countries, PoS displays of cigarettes in shops have become an important source of young people’s exposure to tobacco products and marketing. This mixed-methods study showed that prior to the PoS display ban in Scotland, and controlling for other factors, 13- and 15-year olds who regularly visited small shops and those who noticed PoS displays in small and large shops, had a higher awareness of cigarette brands. This highlights the importance of PoS displays in increasing youth brand awareness, which increases smoking susceptibility, and thus the need for comprehensive bans on PoS displays which cover all shops.

Visibility of tobacco products and advertisement at the point of sale: a systematic audit of retailers in Amsterdam

“… 6–9 An increase in the susceptibility of smoking uptake may be caused by PoS tobacco promotion which increases perceived attractiveness of smoking and brand awareness. 8 High visibility of tobacco is likely to normalise smoking, as it supports a norm in which purchasing and using tobacco is accepted. 10 In the UK, around 80% of youth noticed tobacco displays at the PoS.…”

‘It's like sludge green’: young people's perceptions of standardized tobacco packaging in the UK

“…addiction) trumped any negative feelings about the pack and health warnings, which could also be easily hidden. In addition, some participants echoed the views of young people when the point-of-sale ban was introduced, that adolescents would no longer be exposed to the health warnings on packs as they were no longer openly displayed in shops [6]. However, the findings from this study and those in Australia [18] indicate that young people continue to be exposed to the warnings, even if people in their social worlds do not smoke, mainly through discarded packs in litter and that (as predicted) they are now more noticeable.…”

“…The aim was to include adolescents most at risk of becoming adult smokers. These recruitment methods have been successfully used in previous qualitative studies on young people and smoking [6,26,27]. Twenty-eight participants were current smokers, 16 had tried smoking and 38 were never-smokers (Table 2).…”

“…A wealth of research has revealed how tobacco companies have used branding, including brand names, insignia, colours and symbols, to promote positive images of smoking to young people and to increase the allure of their products [2][3][4]. As more countries ban or restrict tobacco marketing, tobacco companies have focused their attention and promotional budgets on retail point-of-sale displays and cigarette branding and packaging [5][6][7]. These marketing strategies have created cigarette brand images that young smokers use as a form of symbolic consumption whereby the cigarette brand, and its perceived positive attributes (the brand heuristic), is used to construct and project a desirable identity to peers and others in their social worlds [8][9][10][11][12].…”

Analysis of the legislative process related to the implementation of graphic health warning labels on tobacco products in South Korea

“…Additionally, tobacco companies argued that cigarette advertising and display at the point-of-sale target only adult smokers 39 . In fact, frequent exposure to tobacco advertising is associated with higher levels of cigarette brand awareness, and increased rates of smoking initiation 40,41 and susceptibility among youth 42,43 . Therefore, public health advocates should consistently provide scientific evidence that may be brought to bear upon the regulatory process, and should pressure policymakers to swiftly adopt regulations 44,45 .…”