Who uses tobacco promotional offers? Evidence from the Communities Putting Prevention to Work initiative

Background: The retail environment is the primary venue for tobacco promotions and advertising. Of the nearly $10 billion in annual tobacco industry marketing expenditures, the vast majority is spent on in-store promotions, advertising, and retailer discounts to reduce the price of tobacco products. Literature on who uses tobacco promotions is scarce and prior research has been limited in geographic scope. This study examines whether tobacco promotion use varies by socio-demographic characteristics, tobacco-use behaviors, and cessation intentions and behaviors in a large sample of adults from diverse communities across the U.S. Methods: 2011 BRFSS data was collected from 37 communities participating in CDC's Communities Putting Prevention to Work initiative. Survey items assessed the frequency of using promotional offers such as “dollar off” or “two-packs-for-the-price-of-one” type deals, in addition to socio-demographic characteristics, smoking behaviors, and cessation intentions and behaviors. We estimated multivariable logistic regression models to examine the strength of association between promotion use and each of the other covariates. Results: More than half of smokers (58%) take advantage of promotions and 41% did so every time they purchased tobacco products. Multivariable analyses identified non-Hispanic whites, younger adults, those with less than a college education, and everyday smokers as more likely to always or often use promotions. Contrary to prior research, gender was not significantly associated with promotion use. Conclusions: Findings highlight disparities in tobacco promotion use and could inform community strategies to eliminate or reduce the prevalence of retail promotions.