Online Program

Standardized Tobacco Assessment for Retail Settings (STARS): Comparative data for US stores

Wednesday, November 4, 2015 : 8:50 a.m. - 9:10 a.m.

Kurt Ribisl, PhD, Gillings School of Global Public Health, UNC, Chapel Hill, NC
Shelley Golden, UNC Gillings School of Global Public Health, Chapel Hill, NC
Katie Byerly, BSPH, MPH, Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, NC
Heather D'Angelo, MPH, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NC
Douglas Luke, PhD, Center for Public Health Systems Science, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO
Lisa Henriksen, PhD, Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA
Background: Omnipresent tobacco product marketing and availability at the point of sale (POS) increases youth and adult tobacco consumption. The Standardized Tobacco Assessment for Retail Settings (STARS) is a 10-minute assessment with supporting materials, developed by NCI’s State & Community Tobacco Control Initiative in collaboration with CDC, the Tobacco Control Legal Consortium, and five state Tobacco Control Programs. The purpose of this presentation is to summarize current levels of tobacco marketing, promotions and product availability ascertained using STARS questions. These data provide a national comparison for tobacco control professionals who are increasingly adopting the STARS instrument for local, state or regional retail assessments.

Methods: We used a two-stage sampling design to select a random sample of 97 counties in 40 states in the contiguous United States proportionate to county population size, and a random selection of retail stores within each county. In 2014, professional data collectors completed assessments in 2,278 stores.

Results: Tobacco marketing materials are ubiquitous: all stores displayed at least one interior branded sign, display or functional item and 56.8% of stores displayed exterior advertisements. In addition, 72.9% of stores displayed at least one interior tobacco product price promotion, including 61.0% featuring menthol cigarettes. Although only 22.3% of stores featured interior cigarette marketing below three feet, 86.0% of stores sold flavored cigarillos, which often appeal to youth.  Electronic cigarettes were sold at 69.8% of stores, and 47.3% sold flavored e-cigarettes. The average price without sales tax was $6.23 for one major brand, $6.87 for a major menthol brand, and $10.01 for a disposable e-cigarette.

Conclusions: Cigarette companies use retail stores extensively to promote products to current and future customers. STARS allows comparisons across jurisdictions and informs local practitioners advocating for evidence-based policies for the retail environment. These results provide the first benchmark from a representative sample of US stores.

Learning Areas:

Assessment of individual and community needs for health education
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the Standardized Tobacco Assessment for Retail Settings (STARS) Analyze findings from a national sample of tobacco retailers that used the STARS form Discuss the utility of a standardized tool for tobacco assessment for retail settings and how it can be used to advocate for new point-of-sale policies

Keyword(s): Tobacco Control, Built Environment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked with this study since its start in 2012 in data collection, monitoring, and analysis. I also served as the managing editor and project director of, an online resource devoted to developing and disseminating information on point of sale tobacco control to local, state, and federal tobacco control practitioners.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.