4th November 2011, Volume 124 Number 1345

Janet Hoek, Anne Jones, Richard Edwards, Ninya Maubach, Julian Crane, Ben Youdan; for the ASPIRE2025 collaboration

Background—The research initiative for the 2025 countdown to end of tobacco in New Zealand has well and truly begun with the ASPIRE1 inaugural symposium, which brought together nearly 90 delegates on 29 September 2011 to consider removal of tobacco retail displays.

The Smokefree Environments (Controls and Enforcement) Amendment Act 2011 (SECEA Act), which Parliament passed by 117 votes to 3 in July 2011, requires the removal of tobacco retail displays. In so doing, the legislation responds to an increasing volume of evidence documenting the adverse effect these displays have. First outlined comprehensively in a systematic review,2 subsequent work has further documented how displays increase the risk of experimentation among children,3–5 promote impulse purchase6,7 and induce lapsing among former smokers and quitters.8,9 There is also evidence from Ireland that removal of point of sale displays has a range of positive effects,10 and do not result in the disastrous economic impacts predicted by the tobacco industry and other opponents.11

Yet, while the new ACT reflects a substantial evidence base, its effectiveness will depend largely on the regulations developed to implement its provisions. To explore implementation questions, examine new opportunities, and learn from others’ experiences, the ASPIRE2025 collaboration (Research for a tobacco-free Aotearoa; http://aspire2025.org.nz/) recently held a seminar examining how various Australian states and territories had implemented measures requiring the removal of tobacco retail displays. Anne Jones, CEO of ASH Australia, provided insights into regulations implemented in Australia and their outcomes, following which policy makers, NGO representatives, and researchers outlined issues arising from their perspectives. To stimulate discussion around these questions, we summarise key elements of the seminar below.

Implementation: timing, inclusiveness and specificity—Australian jurisdictions varied in the timing requirements they set for retailers; some set earlier dates for general retailers but allowed ‘specialist tobacconists’ a longer phase-in period. The net effect was a proliferation of such specialists, which diluted the initial impact of the measure. New Zealand should follow the all-inclusive approach taken by the Northern Territory, whose legislation applied to all tobacco retailers equally.

Duty-free tobacco sales have attracted increasing research attention12,13 and the new Act should apply equally to in-bound and out-bound stores, thus avoiding the situation that occurred in New South Wales, where the regulation was implemented initially for out-bound displays while a legal challenge delayed application of the policy to in-bound flights for 12 months. This anomaly resulted in in-coming passengers being exposed to very large POS displays regulators.

Retail storage varies in Australia; some retailers have products under the counter while others use cupboards behind the counter. Cupboards behind the counter present strong visual cues and also require retailers to turn their backs on customers, something retailers believe represents a security risk.14,15 For these reasons, we strongly suggest the regulations require all tobacco products to be stored in under the counter drawers, which provide no overt visual cues and offer retailers a safer and more secure storage option

What is left at point of sale?—Smaller retailers have argued that removing tobacco displays may confuse smokers and predispose them towards shopping in larger stores, which they may consider more likely to stock tobacco products.14,16The Act responds to this concern by allowing retailers to display a sign indicating that tobacco products are available; the Regulations will define the content, size and position of these signs.

We suggest these signs should be limited to the size of a business card, akin to the stickers used by debit card companies to indicate a retailer accepts a specific card. Further research is required to test whether retailers who choose to display an availability sign should also be required to feature a large graphic health warning or a Quit sign in a prominent position.

Depending on the jurisdiction, Australian retailers may feature up to three different types of signage: a price ticket, price board and price list. Retailers use price tickets to identify the products stored in alphabetical order and obscure tobacco products that may not be displayed (such as products at additional points of sale). States allowing price tickets prescribe the size, colour, content and font size of information on these.17 Price boards may detail tobacco brands available; variants; pack sizes and prices (including discounts, which Victoria allows).18 Price lists are not visible within the store but refer to pages detailing the brands and variants available, and the cost of these; where regulators have permitted price lists, retailers may only provide these on request. Table 1 below outlines the current situation in Australian States and Territories.

Some Australian states also allow retailers to display price boards, lists, or both; given the use of these to promote brands and bonus packs, we suggest New Zealand regulators allow only price tickets with no visible price board or, failing this, a price list, to be shown only on request. If the regulations allow price boards or lists, we recommend these should also feature a graphic health warning that covers at least 50 percent of the page surface. In the case of multi-page price lists, we recommend each page feature a different warning to ensure smokers are exposed to as many different warning messages as possible, should they ask to peruse a price list.

Given the variety of policies implemented, it is imperative that New Zealand’s regulations reflect best practice and research findings, and that a full evaluation plan is also implemented. The tobacco industry and its front groups have consistently opposed legislation to remove POS displays by arguing these have failed in other jurisdictions.14 Evidence from marketing theory suggests decreasing the visibility and accessibility of a product will reduce its salience, perceived normality, and use,19 making it highly unlikely these policies would have no effect. However, without evidence from evaluations to test the industry’s claims, policy makers considering removing POS marketing may be swayed by industry arguments and defer passing legislation.

Table 1: Price tickets/Price boards/Labelling after POS display ban – Australian State/Territory legislation (at July 2011)
Jurisdiction
Price tickets – display
Price Boards
Price list
Other labels
ACT
✓(can be located ‘below or next to blocked out smoking products’ – could be inside or outside cupboard)
X
X
(Staff barcode sheet permitted)

NSW

(must be attached to a sales unit)
✓ (Board or price tickets not both, most retailers use price board)
X

NT
X
✓ (Can be produced on customer request)
✓ (Small label visible to retailer only, no price info)
QLD – TBC – Bill currently before QLD Parliament; new regulations not yet drafted.
✓ (Bill says must be ‘fixed at the place’ where tobacco products are kept – could be in or outside unit)
X
X

SA
✓ (can be located inside or outside cupboard or both)
X

TAS
X
X
✓ (Can use price ticket inside cupboard; must only be visible to retailer)
VIC
X
X
✓ (Dept advises ok as long as does not amount to a tobacco advertisement)
WA
✓ (can be located inside or outside cupboard)
✓ (Can be produced on customer request)
X
Source: Table courtesy of Anne Jones, ASH Australia; information supplied originally by Quit Victoria

New opportunities in the retail sector: looking to the future—The SECEA Act represents an important advance in tobacco control, but achieving the tobacco free Aotearoa 2025 goal will require additional policy measures and interventions. The SECEA Act does not introduce retailer licensing and thus misses opportunities to create more protective environments. Implementing a retailer licensing or registration scheme would enable greater monitoring of outlets selling tobacco, facilitate communication with tobacco retailers, and enable the implementation of further measures. Licensing arrangements would assist reputable retailers by making those who currently breach sales regulations more accountable.

Licensing could lead to a number of potentially useful developments: For example, all retailers might receive training to ensure they understood the legal requirements of the new law and regulations as well as the toxicity and addictiveness of tobacco products. Licensing could stipulate that only people aged 18 or over should sell tobacco (thus aligning the sales and purchase age requirements). It should also require retailers to provide cessation advice and information to smokers each time they purchase tobacco, thus ensuring cessation messages are delivered and repeated at the point of every sale, an intervention likely to promote quit attempts.

Two-thirds of smokers purchase tobacco from dairies but only 20% of smokers used NRT to assist their last quit attempt; of these, 75% obtained NRT from a pharmacy using a Quitcard.20 The Maori Affairs Select Committee Inquiry into the Tobacco Industry Report recommended: “That nicotine replacement therapies be required to be sold everywhere tobacco is sold, thereby ensuring smokers can choose a safe option whenever they crave nicotine”.21 Policy makers now have a golden opportunity to implement this recommendation, require retailer licensing, and create a retail environment that facilitates quitting rather than maintains smokers’ addiction. Tobacco retailers potentially represent one of the best sources of regular quit advice; given smokers frequent interactions with retailers, linking traditional tobacco supply outlets to NRT provision and Quitline follow-up could represent a major cessation force.

Other measures could include additional protections, such as restricting entry to outlets selling tobacco to people aged 18 or over, a measure that would further decrease children’s exposure to tobacco, help prevent young people taking up smoking, and drive increases in quit attempts. Measures to control the location, proximity to schools, opening hours, and density to tobacco retailers in lower decile areas may also be warranted. Licensing would enable communities to have a stronger input into tobacco retailing locations within their area, while local authorities could set a cap on the licences issued and ensure tobacco retailing was not concentrated in areas of high deprivation.

Perhaps most importantly, licensing would clearly signal that, although tobacco retains its status as an anomalous ‘legal’ product, it is nevertheless a toxic and abnormal product; and that selling tobacco is not a right but a restricted service contingent on meeting certain proscribed standards.

Despite the excellent progress the SECEA Act represents, the ASPIRE2025 symposium reminds us that the task is not yet complete. Not only do the regulations accompanying the Act need to avoid problems experienced in Australia, but retail environments themselves require further analysis so we can avail ourselves of the opportunities they present to promote cessation.

Janet Hoek, Anne Jones, Richard Edwards, Ninya Maubach, Julian Crane, Ben Youdan; for the ASPIRE2025 collaboration

Author Information

Janet Hoek, Anne Jones, Richard Edwards, Ninya Maubach, Julian Crane, Ben Youdan; for the ASPIRE2025 collaboration

References

  1. ASPIRE2025. Point of Sale and Beyond: A Research and Policy Seminar. Wellington, 2011.
  2. Paynter J, Edwards R. The impact of tobacco promotion at the point of sale: A systematic review. Nicotine & Tobacco Research 2009;11(1):25-35.
  3. Paynter J, Edwards R, Schluter PJ, McDuff I. Point of sale tobacco displays and smoking among 14-15 year olds in New Zealand: a cross-sectional study. Tob. Control 2009;18(4):268-74.
  4. Thomson G, Hoek J, Edwards R, Gifford H. Evidence and arguments on tobacco retail displays: marketing an addictive drug to children? N Z Med. J. 2008;121(1276):87-98.
  5. Henriksen L, Schleicher NC, Feighery EC, Fortmann SP. A longitudinal study of exposure to retail cigarette advertising and smoking initiation. Pediatrics 2010;126(2):232-8.
  6. Carter OBJ, Mills BW, Donovan RJ. The effect of retail cigarette pack displays on unplanned purchases: results from immediate postpurchase interviews. Tob. Control 2009;18(3):218.
  7. Burton S, Clark L, Jackson K. The association between seeing retail displays of tobacco and tobacco smoking and purchase: findings from a diary style survey. Addiction 2011.
  8. Hoek J, Gifford H, Pirikahu G, et al. How do tobacco retail displays affect cessation attempts? Findings from a qualitative study. Tob. Control 2010;19(4):334.
  9. Germain D, McCarthy M, Wakefield M. Smoker sensitivity to retail tobacco displays and quitting: a cohort study. Addiction 2010;105(1):159-63.
  10. McNeill A, Lewis S, Quinn C, et al. Evaluation of the removal of point-of-sale tobacco displays in Ireland. Tob. Control 2011;20(2):137.
  11. Quinn C, Lewis S, Edwards R, McNeill A. Economic evaluation of the removal of tobacco promotional displays in Ireland. Tob. Control 2011;20(2):151.
  12. Vardavas C, Seidenberg A, Connolly G. Regulating duty free sales and tobacco advertising in airports: a call for action. Tobacco induced diseases 2011;9(1):1-3.
  13. Wilson N, Thomson G, Edwards R, Peace J. Estimating missed government tax revenue from foreign tobacco: survey of discarded cigarette packs. Tobacco Control 2009;18(5):416-18.
  14. Association of Community Retailers. Submission to the Health Select Committee on the Smoke-free Environments (Controls and Enforcement) Amendment Bill, 2011.
  15. Hoek J, Vaudrey R, Gendall P, et al. Tobacco retail displays: a comparison of industry arguments and retailers' experiences. Tobacco Control 2011.
  16. Association of Community Retailers. Submission to Ministry of Health’s Proposal to Ban Tobacco Retail Displays in New Zealand: Association of Community Retailers, 2010.
  17. City Health Information.http://www.melbourne.vic.gov.au/enterprisemelbourne/industries/healthcare/Documents/Tobacco_Retailing.pdf Melbourne, UD.
  18. State Government of Victoria Department of Health. Tobacco retailers: Price board requirements: State Government of Victoria, 2010.
  19. Hoek J, Jones SC. Regulation, public health and social marketing: a behaviour change trinity. Journal of Social Marketing 2011;1(1):32-32-44.
  20. Ministry of Health. Tobacco Use in New Zealand: Key findings from the 2009 New Zealand Tobacco Use Survey. In: Health Mo, editor. Wellington: Ministry of Health 2010.
  21. Māori Affairs Committee. Inquiry into the tobacco industry in Aotearoa and the consequences of tobacco use for Māori. Wellington: New Zealand Parliament, 2010.