Online Program

Identifying rural tobacco point of sale interventions: Analyzing a census of Vermont's tobacco retailers

Tuesday, November 3, 2015

Sarah Wylie, MPH, Division of Health Promotion and Disease Prevention, Vermont Department of Health, Burlington, VT
Matthew Thomas, PhD, Division of Health Surveillance, Vermont Department of Health, Burlington, VT
Rhonda Williams, MES, Division of Health Promotion and Disease Prevention, Vermont Department of Health, Burlington, VT
background:Residents of U.S. rural areas are more likely to smoke, use smokeless tobacco, smoke while pregnant, and be heavy smokers than urban dwellers. While tobacco prevention groups are prioritizing point of sale interventions, progress has focused in urban population centers. There is little evidence regarding effective rural point of sale interventions.

methods: The Vermont Department of Health conducted a census of Vermont’s tobacco retail outlets between October and December 2014. Community prevention groups used a modified Standardized Tobacco Assessment for Retail Settings and the Counter Tools online interface. We used the 2010 Decennial Census and American Community Survey 5-year 2012 data set at the census tract level to define urban clusters and urbanized areas. Using a “percent urban” value, store characteristics were compared between areas that were at most 68% urban to areas that were greater than 68% urban.

results: Auditors completed 981 audits, and 945 (96%) could be assigned a percent urban value. 68% of stores were in rural and 32% in urban jurisdictions. Rural stores were more likely to have price promotions. 46% of rural stores (n=549) had cigarette price promotions as compared to 41% of stores located in urban jurisdictions (n = 246). Menthol price promotions were also disparate: 34% of rural stores (n = 541) had menthol price promotions compared to 26% of stores (n = 246) in urban jurisdictions.

conclusions: The rural tobacco retail landscape differs significantly from urban jurisdictions. Pricing strategies may be more effective than other point of sale interventions in reducing rural tobacco disparities.

Learning Areas:

Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Explain significant differences between rural and urban tobacco retail landscapes. Describe key challenges facing rural prevention groups focusing on tobacco point of sale. Identify point of sale strategies that could have a significant impact on rural tobacco disparities based on store audit results.

Keyword(s): Policy/Policy Development, Rural Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Community and Policy Specialist for the Tobacco Control Program at the Vermont Department of Health since 2012. I am the primary project coordinator for the Counter Tools mapping and audit project in Vermont. My interests include using data for community mobilization and supporting community and statewide policy development.
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.