Retail point-of-sale (POS) environments serve as major venues for tobacco advertising, with colorful posters and promotional displays that increase smoking susceptibility among young people. While public health authorities have focused on regulating POS tobacco marketing, enforcement challenges and content-neutrality requirements have limited policy effectiveness. Moreover, there is insufficient evidence regarding whether restricting the physical space allocated to tobacco advertisements would reduce smoking intentions among youth. This study addresses this gap by examining how poster space restrictions at retail POS affect smoking susceptibility among young adults aged 18-20, using an experimental retail environment and shopping task to provide evidence for space-limitation policy strategies.
This study was conducted with a sample of 297 college students. Participants first completed a pre-survey assessing demographic characteristics, perceptions and experiences related to tobacco use, and convenience store shopping habits. They were then randomly assigned to one of two conditions (high exposure vs. low exposure) in the RAND StoreLab (RSL), a simulated convenience store featuring tobacco advertising, where they completed a shopping task before responding to a post-survey. Analyses included univariate and bivariate tests to examine sample characteristics and group differences, followed by multiple logistic regression to evaluate the effect of poster exposure condition on smoking susceptibility. Baseline smoking susceptibility, breadth of advertising exposure, age, race, gender identity, and socioeconomic status were included as control variables, and the moderating effect of prior tobacco advertising exposure was also tested.
A total of 297 participants were randomly assigned to either low exposure poster condition (n = 144) or high exposure poster condition (n = 144), with no significant differences between groups in demographic characteristics, tobacco use history, or baseline smoking susceptibility. While the overall analysis revealed no significant main effect of low exposure poster condition on smoking susceptibility (p = 0.41), a significant interaction was found between breadth of past month advertising exposure and study condition (β= -1.90, SE = 0.82, p = .020). Subgroup analysis demonstrated that among participants with high breadth of advertising exposure in the past month, the low exposure poster condition significantly reduced cigarette smoking susceptibility (aOR = 0.16, 95% CI 0.03 – 0.75, p = .021), while this effect was not observed in participants with low advertising exposure (p = 0.334).
Takeaway: Restricting tobacco poster space at retail stores can reduce smoking susceptibility among young adults who have been heavily exposed to tobacco advertising.