Influence of retail tobacco advertising and promotions on smoking among adults and youth in New York state

Background: Studies suggest that youth exposure to retail tobacco advertising is associated with smoking experimentation and progression to established smoking. Previous studies have relied on self-reported exposure which is prone to recall bias. Little is known about how retail tobacco advertising influences adults. We used observational measures of retail tobacco advertising and promotions to assess their influence on youth and adult smoking.

Methods: Retail tobacco advertising and promotions were measured annually by trained coders conducting in-store observations of a random sample of licensed tobacco retailers in New York state (NYS) from 2004-2008. We examined the number and placement of interior/ exterior advertisements; and the number and type of price promotions. Annual, county level estimates of retail tobacco marketing were linked to smoking outcomes (e.g. ad awareness, attitudes, purchasing/smoking behaviors) from the NYS Adult and Youth Tobacco Surveys. Regression analyses were conducted to estimate the influence of retail tobacco marketing on smoking outcomes, controlling for individual and county-level confounders.

Results: Youth who lived in areas with higher prevalence of tobacco price promotions were more likely to be a current smoker and to report retail stores as their usual source of cigarettes. The average number of retail tobacco ads did not significantly affect any outcomes. Adults who lived in areas with higher prevalence of retail tobacco marketing were more aware of ads and had more permissive attitudes about tobacco marketing.

Conclusions: In New York, retail tobacco marketing appears to influence smoking behaviors among youth, but only awareness and attitudes among adults.