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Point-of-purchase tobacco access and advertisement in food stores
  1. Akiko Sugimoto Hosler,
  2. Jamie Rochelle Kammer
  1. Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, New York, USA
  1. Correspondence to Dr Akiko S Hosler, Department of Epidemiology and Biostatistics, University at Albany School of Public Health, One University Place, Rensselaer, NY 12144-3456, USA; ahosler{at}

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A great majority of tobacco retailers are food stores, such as convenience stores,1 which provide underage youth easy access to tobacco products.2 Largely unregulated tobacco point-of-purchase advertisement in food stores can entice experimental smoking in adolescents,3 ,4 and expose young children to crafted tobacco brand images.5 Food stores could offer unique opportunities for policy-based tobacco control, as multiple government agencies regulate them through sanitary inspection, taxation, licensing (eg, lottery tickets sales) and nutrition assistance programmes.6 This study identifies food-store characteristics associated with point-of-purchase youth tobacco access and advertisement in order to formulate food-store-specific tobacco control strategies.

All food stores in downtown Albany, New York, were identified through government lists of retailers and community canvassing. We defined a food store as a retail outlet that sold at least one of the following items: milk, bread, fruits or vegetables.6 ,7 We surveyed each store using a reliability-tested measurement tool during June and July 2009.7 We observed whether any tobacco products were sold and whether they were advertised, as indicated by the presence of tobacco products for sale, and by the presence of a poster, plaque, banner or sign bearing the name and/or image of a tobacco brand, respectively. The presence of tobacco advertisements placed at the eye level of a child (91 cm or lower)8 was also recorded. We obtained a list of retailers who were penalised for selling tobacco to underage youth during 2008–2009 from the New York State Department of Health.9 A minority neighbourhood was defined as a Census Block Group having ≥50% Hispanics and/or non-Whites. We presented the results of multivariate logistic regression analyses (table 1) for the associations between selected store characteristics and youth tobacco access violations and in-store advertisement measures.

Table 1

Multivariate logistic regression models for youth tobacco access violations and in-store tobacco advertisement: OR and 95% CI

Among 117 eligible food stores, 98 (83.8%) sold tobacco, and 14 (12.0%) had violated youth access laws. The majority of food stores (65.8%) advertised tobacco, including two stores that did not sell it. Forty-four stores (37.6%) had tobacco advertisement at child eye level. As shown in table 1, youth tobacco access violations were positively associated with business hours longer than 105 h per week, and negatively associated with minority neighbourhood, selling lottery tickets and being a supplemental nutrition assistance program (SNAP) retailer. Presence of any tobacco advertisements was positively associated with selling lottery tickets, longer store hours and minority neighbourhood, and was negatively associated with being a SNAP retailer. Finally, tobacco advertisements at child eye level were positively associated with selling lottery tickets, but negatively associated with being a SNAP retailer.

Unlike SNAP, participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) was not significantly associated with youth tobacco access violations or tobacco advertising. However, all WIC retailers sold tobacco and 42.9% had low-height tobacco advertisement (data not shown). The WIC program is a federally funded food voucher and health services programme for low-income pregnant women, infants and children up to the age of 5 years.10 Tobacco policies need to be enacted in the WIC program to monitor tobacco access and eliminate low-height tobacco advertisement in authorised retailers' premises. Finally, lottery retailers were more likely to have in-store tobacco advertisement, but less likely to be youth tobacco access violators. The latter appears to be an effect of the current New York State policy that suspends or revokes lottery licenses of repeated youth access violators. The state lottery agency needs to expand its policy to control tobacco advertisement among its licensed retailers.

What this paper adds

  • This study is the first to examine the relationship between food assistance programme participation and tobacco advertising and youth access law violations in food stores.

  • The authors found that participation in the Supplemental Nutrition Assistance Program(formerly known as Food Stamp Program) was associated with a lower likelihood of having tobacco advertisements and youth access violations.

  • Women, Infant and Children (WIC) program participation was not significantly associated with any of the outcomes; however, all WIC stores sold tobacco and 43% had low-height advertisement.

  • Given that WIC is a federally funded food assistance and health services programme for low-income pregnant women, infants and children up to 5 years, we urge establishment of tobacco policy in this programme.


This study was conducted as part of the University at Albany's epidemiology student internship research project. The authors thank Aliza Dharssi and Kevin L Leadholm for their assistance in data collection.



  • Competing interests None.

  • Ethics approval This study was approved by the insititutional review board of University at Albany.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement De-identified and cleaned Excel or SPSS files containing all relevant variables from this study will be made available to other qualified researchers within 1 year after the final manuscript from the project is published. A data sharing agreement will be required to ensure that the data will not be used for commercial or other purposes inconsistent with the terms of our informed consent or New York State law.