The researchers found that the vast majority of retailers that sell tobacco, albeit out of view, had prominent displays of e-cigarettes (used as a smoking cessation aid) and smoking paraphernalia, such as cigarette lighters.
Displays of tobacco products at the point of sale in retail stores are banned in many countries, because of their potential link to the harmful habit of increased smoking and higher susceptibility to smoking in children.
Twenty countries, including England, implemented tobacco point of sale display bans between 2001 and 2016, and increasingly they have been replaced with covered tobacco storage units often placed alongside tobacco signage and displays of e-cigarettes and smoking paraphernalia.
However, the extent of this potential problem is unknown because the visibility and placement of e-cigarette and smoking paraphernalia point of sale displays has not been described in detail.
The team of researchers aimed to address this gap to inform future research examining the impact of e-cigarette and smoking paraphernalia point of sale displays on tobacco smoking, particularly in children, as well as differences in visibility according to area of deprivation.
Researchers visited 166 stores in Bristol and Cambridge, of which 133 sold the relevant products and agreed to take part. These included small and large format stores of four supermarket chains and a randomly selected sample of convenience stores.
A standardised checklist was used to create a total visibility score for point of sale displays of e-cigarettes and smoking paraphernalia that were encountered, while other measures of visibility and placement were also captured.
Results showed that both e-cigarette and smoking paraphernalia point of sale displays were present in 96 per cent of stores. These point of sale displays were highly visible across all stores with an average visibility score of 14.7 out of 17 for e-cigarettes and 12.7 out of 17 for smoking paraphernalia on the standardised checklist.
Analysis of the results also revealed that the use of multiple display units was more common for e-cigarettes (53 per cent) than for smoking paraphernalia (12 per cent). Signage was present in most stores (62 per cent) for e-cigarettes, but not for smoking paraphernalia (five per cent).
Visible pricing was present in most stores (70 per cent) for e-cigarettes, but less so (45 per cent) for smoking paraphernalia.
Most stores had smaller e-cigarette (74 per cent) and smoking paraphernalia (93 per cent) displays than their tobacco storage unit, and these were positioned next to it (49 per cent and 50 per cent, respectively).
Just over half (53 per cent) of stores had some form of promotional material for e-cigarettes, with the most common types involving price (23 per cent), ease of use (15 per cent), and flavours (14 per cent).
The researchers did not find any clear evidence of a relationship between visibility and deprivation status of the store’s location.
The authors acknowledged that having data from stores in only two cities could limit how generalisable its findings are. However, this is the first study (to their knowledge) to describe the visibility and placement of e-cigarettes and smoking paraphernalia in large tobacco retailers and a standardised measure of visibility was used.
They concluded: “E-cigarette and smoking paraphernalia point of sale displays are near ubiquitous and highly visible in supermarkets and convenience stores in two cities in England.”
“The high frequency and visibility of these displays could be undermining the effectiveness of the tobacco point of sale display ban. Their impact on smoking in children merits urgent attention.”
The researchers’ next study is experimental and aims to estimate the impact of online exposure to e-cigarette retail displays on susceptibility to tobacco smoking and e-cigarette use in children (aged 13-17 years) in the UK.
Paper
'Electronic cigarette and smoking paraphernalia point of sale displays: an observational study in England' by Laura A Brocklebank, Marcus R Munafò et al in Tobacco Control [open access]