1. THE IMPORTANCE OF POINT OF SALE Counter Tobacco Allison E. Myers, MPH Kurt M. Ribisl, PhD Adapted from a presentation given January 16, 2013 Office of Smoking and Health Centers for Disease Control and Prevention Atlanta, GA

5. Industry spends $1M/hour at retail Federal Trade Commission Cigarette and Smokeless Reports $7,196,000,000 2010 spend on cigarette and smokeless marketing, advertising and promotion at the point of sale SmokelessCigarettes

6. Industry is buying health behavior impact NEVER-SMOKER SMOKER TRYING TO QUIT Consider three customer segments:

7. NEVER-SMOKER Consider three customer segments:

8. Shopping, brand impressions prompt initiation Henriksen, et al., 2010, Pediatrics GREATER VISIT FREQUENCY, GREATER BRAND IMPRESSIONS = HIGHER ODDS OF INITIATION GREATER VISIT FREQUENCY, GREATER BRAND IMPRESSIONS = HIGHER ODDS OF INITIATION NEVER-SMOKER

9. From never-smoker to established-smoker NEVER-SMOKER Slater, et al. (2007) Arch Pediatr Adolesc Med PUFFER Greater ADVERTISING in stores = 8% higher odds of becoming a puffer.

10. From never-smoker to established-smoker NEVER-SMOKER Slater, et al. (2007) Arch Pediatr Adolesc Med PUFFER Greater ADVERTISING in stores = 8% higher odds of becoming a puffer. EXPERIMENTER ESTABLISHED Greater PROMOTIONS in stores increase odds of youth moving towards higher levels of uptake.

11. Retailer density linked to prevalence AREAS WITH HIGHER RETAILER DENSITY (>5) WITHIN WALKING DISTANCE HAD HIGHER OVERALL SMOKING PREVALENCE (15.1%) Henriksen, et al., 2008: Preventive Medicine SCHOOL NO RETAILERS (n=45) LOW DENSITY (1-5) (n=43) HIGH DENSITY (>5) (n=47) 11.9% prevalence 13.6% prevalence 15.1% prevalence

12. SMOKER TRYING TO QUIT Consider three customer segments:

13. Cigarette display cues craving PICTURE OF EIGHT CIGARETTE PACKS INCREASED CRAVING AMONG NICOTINE-DEPRIVED AND NON-NICOTINE DEPRIVED SMOKERS SMOKER Carter, et al., 2006, Nicotine & Tobacco Research

14. Cigarette displays prompt impulse purchase SMOKERS NOTICE THE DISPLAY. SOME GET THE URGE TO BUY. SOME BUY, EVEN THOUGH TRYING TO QUIT SMOKERS NOTICE THE DISPLAY. SOME GET THE URGE TO BUY. SOME BUY, EVEN THOUGH TRYING TO QUIT Wakefield, et al., 2008, Addiction SMOKER TRYING TO QUIT

15. Residential proximity linked to quit success LOWER ODDS OF SMOKING ABSTINENCE WITH CLOSER RESIDENTIAL PROXIMITY TO TOBACCO RETAILER LOWER ODDS OF SMOKING ABSTINENCE WITH CLOSER RESIDENTIAL PROXIMITY TO TOBACCO RETAILER 250 m OR = 0.54 95%[CI] = 0.33, 0.87 <250 m vs. ≥250m Reitzel, et al., 2010, American Journal of Public Health

16. Summary: $1M/hour well spent Retail marketing: Prompts initiation Promotes daily consumption Discourages quitting New York Data – What’s In Store Campaign