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Neighbourhood exposure to point-of-sale price promotions for cigarettes is associated with financial stress among smokers: results from a population-based study
  1. Mohammad Siahpush1,
  2. Melissa Tibbits1,
  3. Ghada A Soliman1,
  4. Brandon Grimm1,
  5. Raees A Shaikh2,
  6. Molly McCarthy1,
  7. Neng Wan3,
  8. Athena K Ramos4,
  9. Antonia Correa4
  1. 1 Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
  2. 2 Oklahoma Tobacco Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
  3. 3 Department of Geography, University of Utah, Salt Lake City, Utah, USA
  4. 4 Center for Reducing Health Disparities, University of Nebraska Medical Center, Omaha, Nebraska, USA
  1. Correspondence to Mohammad Siahpush, Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha, NE 68198-4365, USA; msiahpush{at}


Aim To examine the association between neighbourhood exposure to point-of-sale (POS) cigarette price promotions and financial stress among smokers in a Midwestern metropolitan area in the USA.

Methods Survey data from 888 smokers provided information on sociodemographic and smoking related variables. Financial stress was measured with the question: ‘In the last six months, because of lack of money, was there a time when you were unable to buy food or pay any important bills on time, such as electricity, telephone, credit card, rent or your mortgage? (Yes/No).’ Using audit data from 504 tobacco retailers, we estimated a score of POS price promotions for each respondent by summing the different types of promotion in each store in their neighbourhood, as defined by a 1-km roadway buffer.

Results Adjusted results provided strong support for an association between higher scores of neighbourhood POS cigarette price promotions and a higher probability of financial stress (p=0.007).

Conclusion Exposure to POS cigarette price promotions is associated with financial stress. This finding, coupled with previous reports that smokers with financial stress are less likely to attempt to quit or succeed in quitting smoking, suggests that POS cigarette price promotions may act as an impediment to smoking cessation.

  • Point-of-sale cigarette price promotions
  • tobacco marketing
  • financial stress

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  • Contributors All authors included in this manuscript fulfil the criteria of authorship. All have made substantial contributions to: conception or design; or the acquisition, analysis or interpretation of the data. They all have contributed drafting of the work or revising it critically for intellectual content. They all approve the final version to be published. In addition, there is no one else who fulfils the criteria but has not been included as an author.

  • Funding Research reported in this publication was supported by NIH grant R01CA166156 and FDA Center for Tobacco Products (CTP). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.

  • Competing interests None declared.

  • Ethics approval University of Nebraska Medical Centers’ Institutional Review Board.

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