Experimentos de exposición en laboratorio….…..…………………………15-18

The following findings on the characteristics of tobacco POS displays at baseline have been published in full in Stead et al.10_{© 2016 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for} Public Health. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/). Adapted with permission from The Royal Society for Public Health.

Methods

In examining POS tobacco display characteristics we focused on seven key features: internal and external visibility of storage units and products (i.e., whether they could be seen both inside the shop and from the street outside); any internal and external tobacco advertising (e.g., on the window or door);

DOI: 10.3310/phr08010 Public Health Research 2020 Vol. 8 No. 1

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the style of storage unit; any brand advertising on the storage unit itself; the visibility of on-pack health warnings when packs were stocked in the unit; storage unit size; and proximity of tobacco products to products with potential appeal to children. For most items, observers simply noted their presence or absence, while overall visibility inside the outlet was rated on a scale of 1–5 and visibility from outside the shop was rated as‘not very visible’, ‘fairly visible’ or ‘very visible’. Retail outlets were linked to the SIMD63_{by their postcode and grouped by SIMD quintile for the purpose of analysis by area deprivation.} Data analysis was conducted in IBM SPSS Statistics version 21.

The methods for the school survey are described in Chapter 2, Cross-sectional school survey of school children with embedded cohorts. The findings in this paper focus on young people’s recall of tobacco POS displays and their frequency of visiting small shops and supermarkets. The data presented are from February 2013, wave 1 (see Table 2), before the legislation was implemented in large supermarkets.

Results

Characteristics of tobacco displays in retail outlets

In total, 96 outlets were mapped and observed across the study areas: grocery/convenience stores (n= 58), CTN (n = 16), large supermarkets (> 280 m2_{of retail space) (n}= 9), petrol station forecourt shops (n= 10) and fast-food/takeaway outlets (n = 3).

The internal main tobacco display was visible from the main entrance of most (69%) outlets. Displays were nearly always positioned behind the main service counter, at customer eye-level and within arm’s reach of the server. Tobacco displays were rated to be most prominent in supermarkets (mean 4.3) and petrol station forecourt stores (mean 3.5), and less prominent in grocery/convenience stores (mean 3.0) and CTN (mean 2.6). External visibility of tobacco products or descriptors was noted in only a small minority of outlets.

Nearly all of the displays were purpose-designed storage units with the cigarette packs displayed upright, facing forwards and with branding clearly visible. However, over one-third of storage units were designed in such a way that pack health warnings were wholly or partially obscured by the front shelf strip. Half of the storage units featured brand advertising, typically on shelf-edge strips. The majority of units also featured generic tobacco messages such as the words‘cigarettes’ or ‘rolling tobacco’ on the top panel. Storage units ranged in size from 0.0 m2_{(where tobacco products were} stored out of customer sight) to 6.9 m2_{, with an average of 2.0 m}2_{. Price information was provided on} shelf strips on 90% of the units, and on price-marked packs on 64% of the units. In the majority of outlets, tobacco products were displayed in proximity to products with potential appeal to children and young people. There was higher proximity of tobacco products to confectionery in CTN (81%) and grocery/convenience stores (72%) than in other outlets.

Young people’s frequency of visiting different retail outlets and recall of tobacco displays

In the school survey, young people were asked‘How often, if ever, do you visit?’ the following shop types: newsagents/corner shops; garage shops/petrol stations; grocery shop or mini-marts; large supermarkets; fish and chip shops; takeaway shops; and mobile ice cream/burger vans. Response options were on a seven-point scale (every day; most days; about two or three times per week; about once per week; less than once per week; never; and don’t know). They were also asked whether they could remember seeing cigarette and tobacco packs in large supermarkets or small shops in the past 30 days. The response options were‘yes’, ‘no’ and ‘don’t know’. In 2013, young people visited large supermarkets and small shops (including CTN and grocery/convenience stores) more often than they visited other types of outlet. Overall, boys visited all retail outlets more often than girls, particularly CTN and fast-food/takeaway outlets. Eighty per cent of young people recalled noticing tobacco products for sale in both supermarkets and small shops, and there was higher recall among young people living in areas of greater socioeconomic deprivation (p< 0.007). Those aged ≥ 15 years were

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more likely to recall displays in small shops than were those aged< 15 years (p < 0.004). In the stores young people visited more often (large supermarkets, CTN, grocery/convenience stores), tobacco displays were less likely to be visible from outside the store (p< 0.001), and pack health warnings were more likely to be visible (p< 0.001). There were few significant differences in tobacco display characteristics by level of deprivation, but, as area deprivation increased, the likelihood that cigarette pack warnings were obscured by the design of the display unit decreased (p< 0.001). When the analysis by area-level socioeconomic deprivation included only CTN and groceries (two of the three categories of outlet more frequently visited by young people), tobacco display units were on average significantly larger in areas of more deprivation than in areas of less deprivation (p= 0.03).