Does removing menthol cigarettes in convenience stores reduce susceptibility to cigarette smoking? An experimental investigation in young people

Does Reducing the Size of the Tobacco Power Wall Affect Young People's Risk of Future Use of Tobacco Products? An Experimental Investigation

OBJECTIVE

A ban on tobacco power walls (in-store package displays) is unlikely in the United States because of concerns that such bans violate commercial free speech rights. This experiment evaluated the effectiveness of a more measured strategy for mitigating the influence of the power wall on young people's susceptibility to tobacco use: limiting its size.

METHOD

The experiment took place in the RAND StoreLab, a life-sized replica of a convenience store. Participants (N = 275) ages 11-20 years were randomly assigned to shop in a variant of the StoreLab that had either a large (status quo), medium, or small power wall situated behind the checkout counter. Before and after shopping, participants completed measures of risk of future use of unflavored and flavored cigarettes and vaping products.

RESULTS

Study condition was unrelated to future risk of smoking unflavored cigarettes, using menthol vaping products, and using sweet-flavored vaping products. Study condition was related to future risk of smoking menthol cigarettes and using unflavored vaping products; compared with exposure to a large power wall, exposure to a small power wall increased the odds of a participant's being at risk for future smoking of menthol cigarettes (odds ratio [OR] = 3.29, 95% CI [1.10, 9.83]) and the odds of a participant's being at risk for using unflavored vaping products (OR = 4.09, 95% CI [1.41, 11.85]).

CONCLUSIONS

These findings call into question the viability of reducing the size of the power wall as a singular strategy for dampening its effect on young people's susceptibility to tobacco use.

Doing more with less: A proposal to advance cigarette packaging regulations in the United States

Cigarette packages are potent marketing tools. Following guidance from the WHO Framework Convention on Tobacco Control, many countries have sought to diminish this marketing power by mandating that (1) large graphic health warnings be affixed to the packages (i.e., text warnings combined with graphic images of the health consequences of smoking) and (2) all packages be fully "plain" in their design (i.e., all packages use the same drab/bland color and font type; no brand logos, other colors, or designs are permitted). Yet, the United States lags other countries in implementing regulations designed to blunt the marketing power of cigarette packages. This is not because of a lack of effort on the part of the Food and Drug Administration, the main governmental body charged with regulating tobacco products in the United States. Rather, it is because the regulatory options that that have been advanced in the country (e.g., graphic health warnings) have not been found - yet - to be legally feasible by its courts. This commentary works through some of the conceptual, practical, and legal issues regarding packaging regulations in the United States. It considers the political and bureaucratic risks involved with issuing new regulations. The overall intent is to prompt our field to think creatively about what is realistic in this regulatory space and to offer a novel perspective that may help move the United States tobacco control community forward in its efforts to reduce the promotional power of cigarette packages.