Experimental Study Using a Virtual Retail Store to Examine the Impact of Point-of-Sale Tobacco Displays and Anti-Smoking Signs on Adult Smokers and Recent Quitters

Background: Studies suggest that point-of-sale (POS) tobacco ads and displays may act as cues to smoke, stimulate purchases among those not intending to buy cigarettes, and potentially influence relapse among recent quitters. Studies are needed to inform state/local governments' efforts to regulate the time, place, and manner of tobacco advertising under the Family Smoking Prevention and Tobacco Control Act of 2009. We developed an interactive virtual convenience store to experimentally test the impact of banning POS tobacco displays and posting anti-smoking signs on adult outcomes.

Methods: Adult smokers and recent quitters (N=1,216) were randomized to 1 of 6 virtual store conditions in which the POS tobacco display was either open (status quo), enclosed, (display ban), or enclosed with ads on cabinet (potential unintended consequence of display ban), and anti-smoking ad was either absent or present. Participants completed a shopping task in the virtual store which included the opportunity to purchase tobacco and a survey post exposure.

Results: Compared with adults in the status quo condition, adults in the enclosed display condition with no anti-tobacco sign had a significantly lower urge to smoke (beta= -6.11, p=0.015) and were significantly less likely to try purchasing cigarettes in the virtual store (OR=0.02, 95% CI=0.01-0.06, P<.001).

Conclusions: Banning tobacco product displays may reduce urges to smoke and unplanned purchases. Adding anti-smoking ads did not have an effect on adult outcomes over and above the effect of the display ban.