Tobacco Use
Conditions
Brief summary
The overall aim of this research is to experimentally evaluate different, legally-viable approaches to reducing the impact of the point-of-sale (POS) retail environment on adolescent tobacco use risk. This study will be investigating regulations for four classes of tobacco products (cigarettes, e-cigarettes, smokeless tobacco, little cigars/cigarillos). Study 2 and study 3 (out of 3 studies), occurring concurrently, will examine whether changing the number and content of posters on the outside doors at POS reduced adolescents' tobacco use risk.
Detailed description
Tobacco advertising at retail point-of-sale (POS) includes promotional allowances that permit tobacco products to be advertised and sold at reduced cost to consumers (e.g., two-for-one specials); high visibility sale and therefore placement of hundreds of tobacco products on power walls; and the display of a large, diverse collection of poster advertisements on the exterior of the stores. Adolescents are at significant risk for having repeated exposures to this tobacco rich POS environment and such exposures contribute to increases in adolescent tobacco use. Although curbing the effect of the tobacco rich POS environment on adolescent tobacco use is a critical public health goal, some POS advertising regulations are unlikely to be viable in the United States because they impinge upon the tobacco industry's commercial free speech rights. For example, eliminating the tobacco power wall is probably not a viable option in the US as it has been successfully challenged in court by the tobacco industry. POS regulations that do not violate the industry's commercial free speech rights stand a better chance of being upheld by the courts. For example, eliminating tobacco product price promotions, reducing the availability of tobacco products by restricting the sale of flavored products, and restricting how much door/window space tobacco product posters can occupy at POS, all have been implemented as feasible and legally defensible regulatory options at POS. The evidence base supporting the efficacy of these initiatives is, however, almost non-existent - leaving them open to legal scrutiny. The overall aim of this research is to experimentally evaluate different, legally-viable approaches to reducing the impact of the POS retail environment on adolescent tobacco use risk. This research will be investigating the regulations for four classes of tobacco products (cigarettes, e-cigarettes, smokeless tobacco, little cigars/cigarillos): the extent to which eliminating tobacco product price promotions (Study 2), restricting how much door/window space tobacco posters can occupy at POS (Study 3), and eliminating the sale of flavored and/or mentholated tobacco products (Study 1) reduce adolescent tobacco-use risk. Each study will evaluate for possible gender and race (African-American vs Caucasian) differences. The studies will take place in the RAND StoreLab, a life-sized replica of a convenience store that was developed to experimentally evaluate how altering aspects of tobacco promotion at POS influences tobacco use. The present record is for Study 2 and Study 3.
Interventions
OTHERMany posters with prices
No poster number or price restrictions
OTHERMany posters, no prices
No poster number restrictions, but price restrictions
OTHERFewer posters, no price restrictions
Poster number restrictions, but no price restrictions
Sponsors
RAND
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 20 Years
Healthy volunteers
Yes
Inclusion criteria
ages 18-20, in college \-
Exclusion criteria
any medical or psychiatric condition which would make compliance with the study protocol difficult (based on parent report). Previous participation in a previous StoreLab study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Self-reported Cigarette Smoking Risk After Shopping in the StoreLab | There is one visit in this research: This variable is assessed at that visit, within 5 minutes of the experimental manipulation | Respondents answer the following items: Do you think you will try a cigarette anytime soon?, Do you think you will try a cigarette anytime in the next year?; and If one of your best friends offered you a cigarette, would you smoke it?. Responses are made on a 1 (Definitely not) to 10 (Definitely yes) scale and summed to produce a total smoking risk scale score (range from 3 - 30). Total scale scores are dichotomized: scores of 3 are coded as '0' (no risk) and any score greater than 3 is coded as '1' (at risk). Outcome is proportion at risk of cigarette smoking (number of participants at risk over number of participants within condition). |
| Self-reported Vaping/ENDS Risk of Use | There is one visit in this research: This variable is assessed at that visit, within 5 minutes after experimental manipulation | Respondents answer the following items: Do you think you will try a vaping product anytime soon?, Do you think you will try a vaping product anytime in the next year?; and If one of your best friends offered you a vaping product, would you use it?. Responses are made on a 1 (Definitely not) to 10 (Definitely yes) scale and summed to produce a total vaping risk scale score (range from 3 - 30). Total scale scores are dichotomized: scores of 3 are coded as '0' (no risk) and any score greater than 3 is coded as '1' (at risk). Outcome is proportion at risk of vaping (number of participants at risk over number of participants within condition). |
| Self-reported Smokeless Tobacco Use Risk | There is one visit in this research: This variable is assessed at that visit, within 5 minutes of the experimental manipulation | Respondents answer the following items: Do you think you will use smokeless tobacco anytime soon?, Do you think you will try smokeless tobacco anytime in the next year?; and If one of your best friends offered you smokeless tobacco, would you use it?. Responses are made on a 1 (Definitely not) to 4 (Definitely yes) scale and summed to produce a total smokeless tobacco risk scale score (range from 3 - 30). Total scale scores are dichotomized: scores of 3 are coded as '0' (no risk) and any score greater than 3 is coded as '1' (at risk). Outcome is proportion at risk of smokeless tobacco use (number of participants at risk over number of participants within condition). |
| Self-reported Cigarillo/Little Cigar *LCC) Use Risk | There is one visit in this research: This variable is assessed at that visit, within 5 minutes of the experimental manipulation | Respondents answer the following items: Do you think you will try a cigarillo/little cigar anytime soon?, Do you think you will try a cigarillo anytime in the next year?; and If one of your best friends offered you a cigarillo, would you smoke it?. Responses are made on a 1 (Definitely not) to 4 (Definitely yes) scale and summed to produce a total cigarillo risk scale score (range from 3 - 30). Total scale scores are dichotomized: scores of 3 are coded as '0' (no risk) and any score greater than 3 is coded as '1' (at risk). Outcome is proportion at risk of LCC use (number of participants at risk over number of participants within condition). |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Status Quo This condition will allow for many posters with pricing information to be displayed.
Many posters with prices: No poster number or price restrictions | 150 |
| Reduced Poster This condition will allow for a reduced number of posters with pricing information to be displayed.
Fewer posters, no price restrictions: Poster number restrictions, but no price restrictions | 147 |
| No Price This condition will allow for many posters with no pricing information to be displayed.
Many posters, no prices: No poster number restrictions, but price restrictions | 148 |
| Total | 445 |
Baseline characteristics
| Characteristic | Status Quo | Total | No Price | Reduced Poster |
|---|---|---|---|---|
| Age, Continuous | 19.10 years STANDARD_DEVIATION 0.77 | 19.14 years STANDARD_DEVIATION 0.79 | 19.16 years STANDARD_DEVIATION 0.78 | 19.16 years STANDARD_DEVIATION 0.81 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 12 Participants | 41 Participants | 11 Participants | 18 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 137 Participants | 400 Participants | 136 Participants | 127 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 51 Participants | 157 Participants | 51 Participants | 55 Participants |
| Race (NIH/OMB) Black or African American | 15 Participants | 40 Participants | 8 Participants | 17 Participants |
| Race (NIH/OMB) More than one race | 8 Participants | 25 Participants | 10 Participants | 7 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 2 Participants | 5 Participants | 3 Participants | 0 Participants |
| Race (NIH/OMB) White | 72 Participants | 213 Participants | 75 Participants | 66 Participants |
| Region of Enrollment United States | 150 Participants | 445 Participants | 148 Participants | 147 Participants |
| Sex/Gender, Customized Gender identity Female | 102 Participants | 306 Participants | 106 Participants | 98 Participants |
| Sex/Gender, Customized Gender identity Male | 31 Participants | 102 Participants | 33 Participants | 38 Participants |
| Sex/Gender, Customized Gender identity Other than male or female | 16 Participants | 35 Participants | 9 Participants | 10 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 150 | 0 / 147 | 0 / 148 |
| other Total, other adverse events | 0 / 150 | 0 / 147 | 0 / 148 |
| serious Total, serious adverse events | 0 / 150 | 0 / 147 | 0 / 148 |
Outcome results
Primary
Self-reported Cigarette Smoking Risk After Shopping in the StoreLab
Respondents answer the following items: Do you think you will try a cigarette anytime soon?, Do you think you will try a cigarette anytime in the next year?; and If one of your best friends offered you a cigarette, would you smoke it?. Responses are made on a 1 (Definitely not) to 10 (Definitely yes) scale and summed to produce a total smoking risk scale score (range from 3 - 30). Total scale scores are dichotomized: scores of 3 are coded as '0' (no risk) and any score greater than 3 is coded as '1' (at risk). Outcome is proportion at risk of cigarette smoking (number of participants at risk over number of participants within condition).
Time frame: There is one visit in this research: This variable is assessed at that visit, within 5 minutes of the experimental manipulation
Population: Some participants were missing data, which accounts for differences in the n.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Status Quo | Self-reported Cigarette Smoking Risk After Shopping in the StoreLab | .59 proportion of participants |
| Reduced Poster | Self-reported Cigarette Smoking Risk After Shopping in the StoreLab | .52 proportion of participants |
| No Price | Self-reported Cigarette Smoking Risk After Shopping in the StoreLab | .39 proportion of participants |
95% CI: [0.347, 1.553]
95% CI: [0.234, 0.947]
Primary
Self-reported Cigarillo/Little Cigar *LCC) Use Risk
Respondents answer the following items: Do you think you will try a cigarillo/little cigar anytime soon?, Do you think you will try a cigarillo anytime in the next year?; and If one of your best friends offered you a cigarillo, would you smoke it?. Responses are made on a 1 (Definitely not) to 4 (Definitely yes) scale and summed to produce a total cigarillo risk scale score (range from 3 - 30). Total scale scores are dichotomized: scores of 3 are coded as '0' (no risk) and any score greater than 3 is coded as '1' (at risk). Outcome is proportion at risk of LCC use (number of participants at risk over number of participants within condition).
Time frame: There is one visit in this research: This variable is assessed at that visit, within 5 minutes of the experimental manipulation
Population: Some participants opted to not complete some items, hence the different n.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Status Quo | Self-reported Cigarillo/Little Cigar *LCC) Use Risk | 0.36 proportion of participants |
| Reduced Poster | Self-reported Cigarillo/Little Cigar *LCC) Use Risk | 0.41 proportion of participants |
| No Price | Self-reported Cigarillo/Little Cigar *LCC) Use Risk | 0.44 proportion of participants |
95% CI: [0.72, 2.832]
95% CI: [0.681, 2.96]
Primary
Self-reported Smokeless Tobacco Use Risk
Respondents answer the following items: Do you think you will use smokeless tobacco anytime soon?, Do you think you will try smokeless tobacco anytime in the next year?; and If one of your best friends offered you smokeless tobacco, would you use it?. Responses are made on a 1 (Definitely not) to 4 (Definitely yes) scale and summed to produce a total smokeless tobacco risk scale score (range from 3 - 30). Total scale scores are dichotomized: scores of 3 are coded as '0' (no risk) and any score greater than 3 is coded as '1' (at risk). Outcome is proportion at risk of smokeless tobacco use (number of participants at risk over number of participants within condition).
Time frame: There is one visit in this research: This variable is assessed at that visit, within 5 minutes of the experimental manipulation
Population: Some participants opted to not respond to some items, hence the different n.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Status Quo | Self-reported Smokeless Tobacco Use Risk | 0.41 proportion of participants |
| Reduced Poster | Self-reported Smokeless Tobacco Use Risk | 0.30 proportion of participants |
| No Price | Self-reported Smokeless Tobacco Use Risk | 0.23 proportion of participants |
95% CI: [0.295, 1.301]
95% CI: [0.237, 1.006]
Primary
Self-reported Vaping/ENDS Risk of Use
Respondents answer the following items: Do you think you will try a vaping product anytime soon?, Do you think you will try a vaping product anytime in the next year?; and If one of your best friends offered you a vaping product, would you use it?. Responses are made on a 1 (Definitely not) to 10 (Definitely yes) scale and summed to produce a total vaping risk scale score (range from 3 - 30). Total scale scores are dichotomized: scores of 3 are coded as '0' (no risk) and any score greater than 3 is coded as '1' (at risk). Outcome is proportion at risk of vaping (number of participants at risk over number of participants within condition).
Time frame: There is one visit in this research: This variable is assessed at that visit, within 5 minutes after experimental manipulation
Population: Some participants opted to not answer some items, hence the differing n.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Status Quo | Self-reported Vaping/ENDS Risk of Use | 0.55 proportion of participants |
| Reduced Poster | Self-reported Vaping/ENDS Risk of Use | 0.68 proportion of participants |
| No Price | Self-reported Vaping/ENDS Risk of Use | 0.52 proportion of participants |
95% CI: [0.727, 3.107]
95% CI: [0.398, 1.938]