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Standardized Tobacco Assessment for Retail Settings (STARS): dissemination and implementation research
  1. Lisa Henriksen1,
  2. Kurt M Ribisl2,
  3. Todd Rogers3,
  4. Sarah Moreland-Russell4,
  5. Dianne M Barker5,
  6. Nikie Sarris Esquivel3,
  7. Brett Loomis3,
  8. Erin Crew1,
  9. Todd Combs4
  1. 1Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
  2. 2Gillings School of Global Public Health, University of North Carolina—Chapel Hill, Chapel Hill, North Carolina, USA
  3. 3RTI International, Research Triangle Park, North Carolina, USA
  4. 4Center for Public Health Systems Science, Brown School of Social Work, Washington University in St. Louis, St., Louis, Missouri, USA
  5. 5Barker Bi-Coastal Health Consultants, Calabasas, California, USA
  1. Correspondence to Dr Lisa Henriksen, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA 94305-5705, USA; lhenriksen{at}


Objective The Standardized Tobacco Assessment for Retail Settings (STARS) was designed to characterise the availability, placement, promotion and price of tobacco products, with items chosen for relevance to regulating the retail tobacco environment. This study describes the process to develop the STARS instrument and protocol employed by a collaboration of US government agencies, US state tobacco control programmes (TCPs), advocacy organisations, public health attorneys and researchers from the National Cancer Institute's State and Community Tobacco Control (SCTC) Research Initiative.

Methods To evaluate dissemination and early implementation experiences, we conducted telephone surveys with state TCP leaders (n=50, response rate=100%), and with individuals recruited via a STARS download registry on the SCTC website. Website registrants were surveyed within 6 months of the STARS release (n=105, response rate=66%) and again after ∼5 months (retention rate=62%).

Results Among the state TCPs, 42 reported conducting any retail marketing surveillance, with actual or planned STARS use in 34 of these states and in 12 of the 17 states where marketing surveillance was not previously reported. Within 6 months of the STARS release, 21% of surveyed registrants reported using STARS and 35% were likely/very likely to use it in the next 6 months. To investigate implementation fidelity, we compared data collected by self-trained volunteers and by trained professionals, the latter method being more typically in retail marketing surveillance studies. Results suggest high or moderate reliability for most STARS measures.

Conclusion The study concludes with examples of states that used STARS to inform policy change.

  • Advertising and Promotion
  • Price
  • Public policy
  • Surveillance and monitoring
  • Environment

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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