1. Background and Significance
Tobacco product sales and advertisements at pharmacies in selected New York City neighborhoods: An observational study
Michael Schmeltz MS, DrPH(c)1, Douglas Nam Le MUP2
1CUNY School of Public Health at Hunter College, 2Asian Americans for Equality
Study Objective
Methods
Results
Results cont.
Objective: To explore the prevalence of tobacco marketing at point-of-sale in independent and chain pharmacies throughout New York City’s predominately Asian neighborhoods.
Neighborhoods selected were Chinatown (Manhattan), Sunset Park (Brooklyn) and Flushing (Queens). Geocoded locations of tobacco retailers were obtained from the New York City Coalition for a Smoke Free City and geocoded pharmacy retailers were obtained from the New York State Department of Education, Division of Professional Licensing.
57 pharmacies licensed to sell tobacco were identified for all neighborhoods combined. Of the stores identified, only 88% (45) of identified retailers were sampled. These stores were clustered in major commercial corridors while those that were outside these commercial areas were excluded.
Sales
Discontinued Sales
Closed
Total
Chain Pharmacies
16 (94%)
1 (6%) - 17
Independent Pharmacies
8 (29%)
18 (64%)
2 (7%) 28
All Pharmacies
24 (54%)
19 (42%)
2 (5%) 45
A majority of both chain and independent pharmacies did have postings of anti-tobacco warning and age of sale signs
Background and Significance
Over the past decade, New York City has made significant strides in reducing smoking rates through increased taxes, public policy such as the Clean Indoor Air Act, aggressive health counter media, public information, and facilitating access to smoking cessation products. However, progress is impeded by tobacco companies spending $1 million every day in New York State marketing their deadly products.
Focusing on tobacco marketing and sales, a number of advocates and researchers have identified tobacco’s changing marketplace. The number of cigarettes sold nationwide has continued to decline; between 2005 and 2009 the total number of cigarette sales in the United States decreased by 17.43%. Within this same time frame, however, national pharmacy cigarette sales have increased by 22.72%. A contributing factor to this trend may be the increased number of national chain pharmacies and the decreased number of individually owned and operated independent pharmacies. However current market research suggests that revenue generated from tobacco products still account for less than 1% of pharmacy retailers’ total sales.
Conclusion
It was observed that most independent pharmacies that were licensed as tobacco retailers no longer sell tobacco products. The reasoning for this was not explicitly known. Based on these observations we can assume that independent pharmacies discontinued sales of tobacco products in order to avoid the ethical conflict of selling products that are harmful to health while serving as a health care resource for the community. The widespread practice of discontinued sales among the independent pharmacies sampled in this study may indicate that discontinuing sales of tobacco products was not detrimental to the financial viability of these businesses.
Additional research, including interviews with business owners is needed to better understand why some independent pharmacies are no longer selling tobacco products and why chain pharmacies continue to sell products that account for the primary known risk factor for death in the United States. (Also, other harmful products are already regulated. Decades of aggressive tobacco marketing and the normalization of smoking makes the average adult non-smoker less surprised to see cigarettes behind the cash register at a pharmacy as opposed to liquor. But smoking, not alcohol, is the number one cause of death and disease in the United States).
Despite advances in reducing the point of sale of tobacco products and limiting areas people are allowed to smoke, smoking remains our nations number one health problem. By denormalizing tobacco placement and use we can continue to reduce the prevalence and incidence of smoking,
Exterior store advertising was limited for all locations. Only 3 stores (1 chain and 2 independent pharmacies) had exterior tobacco advertising, in the form of a small poster/sticker facing the outside of the store. There were no other displays such as illuminated signs or large window posters.
The interior of the pharmacies were where most of the tobacco advertisements were placed though most of this was concentrated at or behind the cashier. Only 3 locations (1 chain and 2 independent pharmacies) had advertising in other parts of the store.
Eighty-eight percent of chain pharmacies had a power wall displayed. This set-up of a power wall and concentrated advertisements behind the cashier was apparent in the majority of chain pharmacies. The displays are set up similarly in each chain pharmacy so that no matter what the purchase is, tobacco products will be viewed by each patron.
Source: NYC Department of Health and Mental Hygiene, Community Health Survey
New York has always been at the forefront of tobacco control efforts and supporting a ban on the sale of tobacco products in pharmacies is critical to changing public perception away from the use of tobacco and toward improving the health of all New Yorkers.
Acknowledgements
Most chain pharmacies have confectionary items displayed within sight of tobacco products as well as cessation products right next to tobacco products. Along with advertisement, the use of tobacco promotions, such as coupons, prizes, mail-in-rebates and multi-carton discounts was seen in 69% of chain pharmacies compared to 37% in independent pharmacies
We would like to thank the following individuals for their time and support on research conducted for this report: Devlin Chen, Abigail Deatley, Jian Hui Huang, Tiffany Kan, Sammi Lin, Min Chao Liu, Theo Oshiro, Cindy Wen, Ling Juan Wu, Julia Yu, Jian Qiang Zeng, Liu Zhen, and Susan Zhao. We also thank Shannon Farley, Sheelah Feinberg, Dan Ferris and the members of New York City Coalition for a Smoke Free City for their leadership and contributions to this important issue.
This publication was made possible in part by funding from the U.S. Department of Health and Human Services and the New York State Department of Health.
A data collection instrument was developed to capture detailed information on the type and placement of tobacco advertisements and products as well as placement of cessation products and warning signs. The data collection instrument included items pertaining to exterior and interior tobacco advertisements, power walls, countertop displays, and information on promotions as well as presence of ‘age of sale’ and ‘we card’ signage. Retailers were either identified as a chain pharmacy (e.g. Duane Reade) or an independent pharmacy.
Since 2006 Asian Americans for Equality (AAFE) has been a member of the New York City Coalition for a Smoke Free City, a health advocacy group that works to increase awareness of tobacco control issues among community members and policy makers. The Coalition partners with community groups, elected officials, and health advocates to support neighborhood-based efforts for effective and long term change throughout NYC.
Source: NYC Department of Health and Mental Hygiene, Community Health Survey