Studies show that exposure to point-of-sale (POS) cigarette advertising and promotions is associated with youth smoking experimentation and progression to regular smoking and unplanned tobacco purchases and urges to smoke among adult smokers. The 2009 Family Smoking Prevention and Tobacco Control Act gives states and local governments the authority to regulate the time, place, and manner of cigarette advertising. The proposed research builds on our previously developed virtual convenience store (Tobacco iShoppe) for comparing policy options to curb and counter the influence of POS cigarette advertising and pack displays. In Years 1 and 2 of the grant, we will conduct a series of qualitative and quantitative studies to develop, pilot test, and optimize the virtual store conditions. In Year 3, we will conduct a randomized controlled experiment to test the virtual store conditions in which POS tobacco ads, displays, and health warnings are modified and compared to a status quo condition. A national sample of youth (current smokers and susceptible never smokers) and adults (current smokers and recent quitters) will be recruited from a national online panel and randomized to one of five virtual store conditions. The test conditions are as follows: T1 (Ad and Display Ban), T2 (Graphic Health Warnings), T3 (Text-Only Tombstone Advertising), and T4 (Ban on Tobacco Price Promotions). Each participant will be given up to 10 minutes to complete a shopping task of selecting four items to purchase in the Tobacco iShoppe. We will capture data on participants'activity in the store, including the selection of tobacco products. Participants then will complete an online survey to assess urge to smoke (adults only) and other variables. The key study outcomes are cigarette purchase attempts in the virtual store for youth and adults and the urge to smoke for adults. In Year 4, we will conduct a randomized controlled experiment to test the virtual store conditions in which nicotine replacement therapy (NRT) and e cigarettes are prominently displayed at the POS, crossed with the display ban condition, and compared to a status quo condition.
The proposed research will provide policy-relevant data on the potential impact of restricting and countering tobacco ads at the POS on youth and adult smoking outcomes. The findings can help guide the development of state and local policies aimed at regulating the time, place, and manner of cigarette advertising so as to reduce youth and adult smoking.