Ban on Tobacco Displays at the Point-of-sale

Point-of-sale marketing of tobacco, including tobacco display racks and sales incentives for retailers, has grown in importance to tobacco companies as other forms of tobacco advertising have been prohibited. 1, 2

Tobacco companies have not disclosed their spend on marketing in the UK, but in the US Point-of-sale marketing accounted for 85% of the total $15 billion spent on promoting tobacco in 2003. 1 An example of a point-of-sale tobacco display is shown in the image below.

An example of a Point-of-sale tobacco display3

The UK Government’s 2011 tobacco control plan for England committed the current administration to banning point-of-sale display of tobacco products. 4 This has been enforced in large shops from April 2012 and will be enforced for all other shops from April 2015.

Evidence of the possible benefits

A systematic review of observational and experimental studies found that exposure to point-of-sale tobacco displays was associated with increased smoking uptake in children and adolescents.5 This finding is supported by a more recent Cochrane systematic review, which found that exposure to tobacco advertising and promotion, including point-of-sale displays, increases the likelihood that adolescents will start to smoke. 6

In adult smokers, there is some evidence that exposure to tobacco displays is linked to impulse buying and undermining of intention to quit. 7, 8, 9 Furthermore, in a proportion of ex-smokers, exposure to tobacco displays has been shown to induce urges to re-start smoking. 10

Public opinion appears to be supportive of tobacco display bans.  A Cancer Research UK survey found 73% of adults in England support putting tobacco out of sight in shops. 10 An Australian study found 49% of cigarette buyers supported a ban, while only 12% opposed it, with the rest indifferent.8

Evidence from before and after studies in Ireland, Iceland and Canada, where point-of-sale tobacco displays have already been banned, suggests that such bans have not had an immediate impact on smoking prevalence. 11, 12 However, falls in smoking prevalence resulting from bans of point-of-sale tobacco displays are likely to be gradual rather than immediate, taking place over a number of years as a cohort of young people grows up without exposure to this mode of tobacco marketing. 13

Evidence of the possible risks

The cost and difficulty of implementing display changes in stores has been cited as a barrier to implementation. 14   Experience from Ireland suggests the cost of transition is usually met by tobacco companies 15 and the average cost was £300, rather than the £5000-£10,000 cited by retailers’ associations. 16

A number of further arguments against the ban on point-of-sale displays have been proposed in the tobacco retail press. These arguments include product display as a basic right of the retailer and customer, burdens for sales staff and increased crime in stores. 12 None of these arguments are supported by international evidence. 12 Risks to public health have not been proposed as a reason for opposing the ban. 12

Implications for Health and Wellbeing

Smoking is the leading cause of preventable morbidity and premature death in the UK, accounting for around 81,700 deaths in England in 2010. Over two thirds of current and ex-smokers in England started smoking before the age of 18. Two thirds of current smokers want to quit, with three quarters of them reporting an unsuccessful attempt in the past. 17

There is evidence that tobacco displays influence smoking uptake rates in young people and undermine smokers who attempt to quit. There is no evidence that a ban on tobacco displays poses a risk to public health. Helping people to never start or to stop smoking will have a positive impact on population health and wellbeing.

Authors: 

Bhavini Patel, MBBS, specialty registrar in general practice, London Deanery

Conall Watson MSc, specialty registrar in public health, London Deanery

Will Maimaris MSc, specialty registrar in public health, London Deanery

References

1. Pollay RW. More than meets the eye: on the importance of retail cigarette merchandising. Tobacco Control  2007;16(4):270-74.
2. Lavack AM, Toth G. Tobacco point-of-purchase promotion: examining tobacco industry documents. Tobacco Control 2006;15(5):377-84.
3. Picture taken with permission from: ASH Briefing. Tobacco Displays at the  Point of Sale. ASH 2012.
4. Department of Health. Healthy Lives, Healthy People: A Tobacco Control Plan for England. London, UK: Department of Health, 2011. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_124917
5. Paynter J, Edwards R. The impact of tobacco promotion at the point of sale: a systematic review. Nicotine Tob Res. 2009 Jan;11(1):25-35. Epub 2009 Jan 27.
6. Lovato C, Watts A, Stead LF. Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours. Cochrane 2011 Oct 5;(10):CD003439.
7. Wakefield M, Germain D and Henriksen L (2008). The effect of retail cigarette pack displays on impulse purchase. Addiction. 2008 Feb;103(2):322-8. Epub 2007 Nov 27.
8. Carter OB, Mills BW, Donovan RJ. The effect of retail cigarette pack displays on unplanned purchases: results from immediate postpurchase interviews. Tob Control. 2009 Jun;18(3):218-21. Epub 2009 Mar 4.
9. Germain D, McCarthy M, Wakefield M. Smoker sensitivity to retail tobacco displays and quitting: a cohort study. Addiction. 2010 Jan;105(1):159-63. Epub 2009 Oct 5.
10. Cancer Research UK. Press Release: Huge public support to remove cigarette vending machines and tobacco displays in shops London, UK: CRUK, 25 Jul 2010. http://info.cancerresearchuk.org/news/archive/pressrelease/2010-25-07-public-support-to-remove-cigarette-vending-machines
11. McNeil A. Evaluation of the removal of point-of-sale tobacco displays in Ireland. Tob Control. 2011 Mar;20(2):137-43. Epub 2010 Nov 18
12. The Centre for Tobacco Control Research, University of Stirling. Point of Sale Display of Tobacco Products. 2008. http://info.cancerresearchuk.org/prod_consump/groups/cr_common/@nre/@pol/documents/generalcontent/crukmig_1000ast-3338.pdf
13. Evidence for youth smoking prevention measures.  ASH Scotland. 2011. http://www.ashscotland.org.uk/media/3929/Evidence_base_for_smoking_prevention_measures_May2011.pdf
14. Association of Convenience Stores. Tobacco Display Ban Should Be Abandoned Not Delayed, 9 Mar 2011. http://www.acs.org.uk/en/Press_Office/details/index.cfm/obj_id/63D9DE93-41AF-46E8-AD36B7BA52B7DDD9
15. Rooke C, Cheeseman H, Dockrell M, Millward D, Sandford A. Tobacco point-of-sale displays in England: a snapshot survey of current practices. Tobacco Control 2010;19(4):279-84.
16. Action on Smoking and Health. The smoke filled room: How Big Tobacco influences health policy in the UK. London, UK: ASH, 2010. http://www.ash.org.uk/SmokeFilledRoom
17. NHS Health and Social Care Information Centre. Statistics on Smoking: England, 2011