11.9 Retail promotion and access

Last updated: April 2016 
Suggested citation: Greenhalgh, EM. 11.9 Retail promotion and access. In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2016. Available from http://www.tobaccoinaustralia.org.au/chapter-11-advertising/11-9-retail-promotion-and-access

11.9.0 Marketing of tobacco in retail outlets 

The retail environment is crucial to the marketing of tobacco products.1  In decades gone by, promotion in retail outlets merely supported advertising in the mass media and outdoors. Over the late 1980s and early 1990s, advertising in the media and outdoors (including on the outside of shops) was progressively more restricted, leading tobacco companies to systematically shift their marketing focus and budget to promotion inside retail outlets.1 Retail outlets became one of the few places in which the image of brands could be communicated, and relationships with consumers fostered.2  Throughout the 1990s it was common to see prominent advertisements not only on cigarette dispensing units, but also above and below the serving counter, hanging from the ceiling and elsewhere inside the shop. Carefully considered placement of tobacco products and advertisements maximised visibility (see Fig. 11.9.0).1

A service station in Swan St, Melbourne, 2001

Figure 11.9.0 
A service station in Swan St, Melbourne, 2001

Source: Quit Victoria

The tobacco industry also employed techniques such as strengthening on-pack brand imagery, redesigning point-of-sale hardware to emphasise particular brands, forming alliances with retailers, rewarding retailers through loyalty programs, and promoting brands through retail trade magazines. When retail advertising was restricted by some states, the tobacco industry often found ways to continue maximising retail exposure.2  For example, restrictions allowed only one packet of each product line to be displayed, and Australian tobacco companies responded by introducing more products lines.3  Peter Jackson product lines almost doubled from 1999 to 2005, and Winfield went from 11 product lines in 1998 to 18 in 2004. The ways in which restrictions were undermined highlights the importance of this form of promotion to the tobacco industry.2  

11.9.1 Display of products at the point of sale

In the face of increasing restrictions on tobacco advertising at the point of sale (POS), displays of tobacco products were for many years in Australia a crucial form of promotion of tobacco products. They alerted customers to the available brands, and the features and appeal of the different brand extensions and variants. These displays enabled tobacco companies to communicate availability and capitalise on strengthened package design.4  Displaying tobacco alongside other universally purchased consumer goods was likely to have created the impression that tobacco was much more socially acceptable and commonly used than was truly the case.5  ‘Powerwalls’ of cigarettes would be displayed in supermarkets (see Fig 11.9.1) and typically dominated small retail outlets such as convenience stores, which are frequented by young people. POS product displays would show in carefully constructed ways a variety of packs deliberately designed to communicate brand values, thus blurring the line between display and promotion.4   

Figure 11.9.1

Figure 11.9.1
A cigarette display 'powerwall' in a supermarket

Source: Simon Chapman private collection

 
11.9.2 Legislation banning promotion and display in retail outlets

Although the Tobacco Advertising Prohibition (TAP) Act 1992 banned most forms of tobacco advertising in Australia, in-store advertising was permitted; however, this exception could be overridden by stronger state legislation. Throughout the late 1990s and early 2000s, all states and territories introduced bans on advertising in retail outlets, with the exception of product displays. The display of tobacco products at point of sale was then progressively banned in Australian states and territories over the 2000s—see Section 11.4

Figure 11.9.2

Figure 11.9.2
An ACT tobacco display following the implementation of the ban

Source: ASH Australia

11.9.2.1 International advertising and display bans

In the absence of legislation in some countries, POS promotion is ubiquitous. For example, US research published in 2014 found that almost all tobacco retailers (96%) had at least one tobacco marketing material, with an average of nearly 30 marketing materials per store. About one in ten retailers displayed tobacco products at heights of less than three feet (about 90cm) and displayed them within about 30cm of lollies.6  

While about one third of countries have restricted or banned POS advertising, fewer have banned POS product displays.7  Along with Australia, countries such as Canada, India, New Zealand, Norway, Russia, Thailand, and the UK have banned all tobacco advertising and displays at the POS (although some legislation exempts specialist tobacconists).7   

In the UK, bans of the promotion and display of tobacco products at POS were introduced in April 2012 in larger shops, with an exemption for smaller retailers. Research showed that adolescents who continued to be exposed to POS displays in small shops were more susceptible to smoking, suggesting the need for a comprehensive ban.8  In April 2015, the regulations were extended to tobacco specialty shops.9  Smaller retailers, such as newsagents, convenience stores, petrol stations, hotels, pubs and nightclubs, must now also adhere to bans of the promotion and display of tobacco products at the point of sale.10  In the lead up to the ban, many retailers were unprepared for its implementation. Philip Morris and British American Tobacco offered free solutions to retailers; Philip Morris offered shutters branded with its Nicocig e-cigarette range under the condition that retailers displayed Nicocig point of sale material in prominent positions, while BAT’s shutters advertise its MOR£ Together trade partnership scheme.11

11.9.2.2 Compliance with laws

Research that has assessed adherence by retailers to POS regulations has generally found high compliance in developed countries such as Norway,12 Ireland,13 the UK,14 and Australia,15 and lower compliance rates in developing countries such as India16 and Mexico.17 Despite a recent POS advertising ban in Lebanon, a subsequent study in Beirut showed very poor compliance, with widespread advertising still present.18 A lack of enforcement is a key impediment to the success of promotion restrictions,9 which is particularly apparent in lower-income countries. 

11.9.2.3 Auditing issues

Audits of retail tobacco marketing are increasingly used to monitor tobacco industry strategies and their influence on tobacco use. A systematic review of store audit methods found that their reliability is generally good, although the authors highlighted a range of un-standardised measures being cited and recommended  improvements in conduct and reporting.19

11.9.3 Rationale for restrictions on advertising and display in retail outlets

11.9.3.1 Fulfilling international obligations

Advertising and display bans are in line with evidence on the effects of promotion at POS on uptake and smoking (see below) and are helping Australia to fulfil its international obligations as a signatory to the WHO Framework Convention on Tobacco Control (FCTC). Australia became a Party to the FCTC on February 27, 2005. Article 13 obliges Parties to introduce and enforce a comprehensive ban on tobacco advertising, promotion and sponsorship, or to restrict these practices are far as is practically possible. It goes on to state that:

Display of tobacco products at points of sale in itself constitutes advertising and promotion. Display of products is a key means of promoting tobacco products and tobacco use, including by stimulating impulse purchases of tobacco products, giving the impression that tobacco use is socially acceptable and making it harder for tobacco users to quit. Young people are particularly vulnerable to the promotional effects of product display. To ensure that points of sale of tobacco products do not have any promotional elements, Parties should introduce a total ban on any display and on the visibility of tobacco products at points of sale, including fixed retail outlets and street vendors.20

11.9.3.2 Evidence on the effects of retail advertising and display on uptake

Young people who begin smoking early and persistently are at high risk for chronic nicotine dependence.21  Studies exploring the effects of tobacco promotion at the POS have consistently found significant associations between exposure to these promotions and smoking uptake among susceptible children and adolescents.22 Research in the US has shown that living in areas with greater volumes of retail cigarette advertisements is associated with young people having positive attitudes about smoking.23   

Experimental research with Australian adolescents found that the presence of tobacco product displays—even in the absence of advertisements—influenced their beliefs about the ease of purchasing cigarettes, increased their ability to recall cigarette brands, and weakened their resolve not to smoke in the future.24 A Canadian study found that schoolchildren from neighbourhoods with high levels of in-store tobacco promotions had higher rates of smoking than schoolchildren from neighbourhoods with shops that had few such promotions.25 Year 10 students (age 14–15) in New Zealand who visited shops more than once per week were more susceptible to smoking than those students who visited shops less than weekly.26   

In 2012, the US Surgeon General concluded that advertising and promotional efforts of the tobacco companies cause the initiation and progression of tobacco use among young people.27 A meta-analysis of exposure to POS tobacco promotion and increased smoking and smoking susceptibility among children and adolescents published in 2016 showed that young people more frequently exposed to POS promotion had about 1.6 times higher odds of having tried smoking and approximately 1.3 times higher odds of being susceptible to future smoking, compared with those less frequently exposed. There was no difference between places where the only form of POS promotion is the tobacco product display and those that allow more extensive POS tobacco promotions, suggesting that any type of in-store tobacco promotion—whether signage, posters, or the pack display—is associated with increased odds of smoking and smoking susceptibility.28 Taken together, the evidence suggests that restricting POS advertising and display would be an effective strategy for discouraging young people from trying smoking,2729 and to be effective, bans should cover both in-store advertising (such as brand or price promotions) and the display of tobacco products.28

11.9.3.3 Evidence on the effects of retail advertising and display on smoking, relapse, and unplanned purchases

Along with encouraging the uptake of smoking, retail promotion can also prompt unplanned purchases and smoking among current smokers, and relapse among recent quitters. 

POS pack displays can lead to unplanned cigarette purchases, and influence brand selection.30 In a telephone survey of 2996 adults in Victoria, 25.2% of smokers reported having purchased cigarettes at least sometimes on impulse as a result of seeing a cigarette display.31 In a Western Australian intercept survey of 206 adult daily smokers who had been observed making a tobacco purchase, 22% of participants had made an unplanned cigarette purchase.30 POS displays influenced nearly four times as many unplanned as planned purchases (47% vs. 12%).

A study of Australian adult smokers found that exposure to POS product displays was associated with a higher likelihood of smoking within the same four-hour period, and with higher levels of smoking, even when the person did not purchase cigarettes.32 A systematic review published in 2014 supported a positive relationship between exposure to POS tobacco promotion and smoking. It reported findings from a number of studies demonstrating a dose–response relationship (i.e., the greater the exposure the greater the smoking), as well as a temporal relationship between exposure and smoking outcomes. The authors conclude that these findings support the continuation and/or introduction of retail display bans.33

For people who are attempting to quit, retail promotion can serve as a potential barrier to success in cessation attempts. POS displays can create temptation and lead to impulse purchases, increasing chances of relapse.30, 34-36  Victorian survey research found that 38% of smokers who had tried to quit in the past 12 months and 33.9% of recent quitters experienced an urge to buy cigarettes as a result of seeing retail cigarette displays. One-third of smokers thought the removal of cigarette displays from stores would make it easier for them to quit.31  Another Australian study examined sensitivity to displays measured as more frequently noticing displays, impulsively purchasing tobacco, and deciding on brand of purchase based on what products were on display. This found that increased sensitivity to retail tobacco displays reduced the likelihood of a smoker successfully quitting: pack displays were found to make quitting more difficult for smokers most sensitive to the presence of displays.34 

11.9.3.4 Evidence on the effects of advertising and display bans on consumers

Research has also supported the efficacy of comprehensive bans on retail promotion.

An Australian study evaluating the effects of tobacco product display bans in New South Wales and Queensland among young people 12 to 24 years of age showed an immediate impact on young peoples’ exposure to the displays, which likely has a flow-on effect for smoking-related outcomes such as estimates of the prevalence of peer smoking. The authors suggest that these regulations can help to denormalise smoking among youth.37 Similarly, research in Ireland showed that following implementation of POS display bans, young people’s beliefs regarding the proportion of smokers their age significantly decreased.13 The removal of POS tobacco displays in Norway was perceived as an obstacle to young people's access to tobacco products, as affecting attachment to cigarette brands, and as helping to denormalise tobacco.12 An experimental study using a virtual store environment found that enclosing tobacco product displays deterred youth from attempting to purchase tobacco in retail stores.38 An analysis of global evidence on the association between POS advertising bans and youth smoking has concluded that in countries with such bans, current smoking, daily smoking, and regular smoking participation in the past month is significantly lower, suggesting that banning tobacco promotion at the POS can reduce youth smoking.39

In relation to adults, a study comparing the effects of POS marketing restrictions in countries that have implemented them (Australia and Canada) with those in countries that have not (the US and formerly the UK) found that the bans lead to lower exposure to tobacco marketing and fewer impulse purchases.40 An experiment comparing POS tobacco displays showed that having no visible display reduced current smokers’ and recent quitters’ urge to smoke and current smokers’ purchase attempts, demonstrating that POS tobacco displays influence purchase behaviour, and suggesting that banning them may reduce cues to smoke and unplanned tobacco purchases.41 A survey of young adults in London found that one in four former smokers felt that POS display bans had helped them quit, while 17 per cent of current smokers said that the bans helped them cut down.42

Best practices for regulation of retail environments have been summarised as (1) comprehensive bans on tobacco advertising, promotion and sponsorship at the POS, and (2) a complete ban on the display of tobacco products at the POS.9

11.9.4 Opposition to restrictions on advertising and display in retail outlets

11.9.4.1 Tobacco industry opposition

The tobacco industry has fiercely opposed the growing global adoption of POS display bans. On its website, Philip Morris International (PMI) argues that such bans are “ineffective and unnecessary” and “impede competition, impose significant costs and other burdens on retailers, encourage price competition (and cheaper cigarettes), and foster illicit trade in tobacco products”. They instead argue for minimum age laws and educational programs to prevent youth smoking.43 The site provides links to several PMI-commissioned reports that support its assertions.44, 45

Tobacco companies and retailers have attempted to overturn laws restricting display of tobacco products on a number of occasions. In 2012, a POS advertising ban in a New York village was quickly rescinded after seven tobacco companies and the New York Association of Convenience Stores filed a lawsuit arguing that the regulations violated their First Amendment free speech rights. The lawsuit also alleged that no credible evidence supports claims that tobacco marketing increases youth initiation of tobacco use.46 In 2013, New York City passed comprehensive tobacco control legislation, which originally included display restrictions. However, these restrictions were subsequently dropped, with speculation that this was due to fierce opposition and a likely powerful constitutional challenge.47   

Similar challenges have been less successful in countries outside of the US. In Scotland, Imperial Tobacco lost a two year battle that aimed to prevent a ban on POS displays.48 Philip Morris Norway initiated legal action against the Norwegian Government alleging that its POS display ban was incompatible with the 1994 European Economic Area Agreement. The Oslo District Court ruled that the POS display ban does not contravene this agreement, and concluded that it is a necessary measure to protect public health.49 A Nova Scotia tobacco store owner lost a constitutional challenge against restrictions on advertising and displaying tobacco products, with the judge ruling that any infringement on freedom of expression rights is necessary for the public good.50 In response to a claim by Nobleza Piccardo (one of the main tobacco companies in Argentina) against the government of the Province of Santa Fe, Argentina, in regards to the complete prohibition of advertising and promotion of tobacco products, the Argentinian Supreme Court ruled that restricting tobacco advertising does not infringe upon free speech because tobacco advertising is not related to the working of republican and democratic institutions. The court also stated that tobacco control measures are a matter of human rights.51

A retail display ban was adopted in the Canadian province of Saskatchewan in 2002, and all Canadian provinces and territories have since banned retail displays. The Saskatchewan legislation was subjected to and survived a lengthy legal challenge by the tobacco industry to the Supreme Court of Canada.52 Health Canada, the Canadian national government agency responsible for tobacco control, describes the marketing potential of tobacco displays as follows: ‘The ubiquitous presence of these displays means that they reach young people, former smokers and smokers trying to quit. Their presence makes tobacco products socially prominent, and this prominence conflicts with the health message that tobacco products are harmful. Such displays may undermine government efforts to protect young people and others from inducements to use tobacco products and from becoming dependent on them’ (p1).53   

11.9.4.2 Retailer opposition

Tobacco industry and retail groups have frequently predicted or claimed far-reaching consequences of POS display bans for retailers. These have included:

Costly implementation. The Association of Convenience Stores (ACS) in the UK estimated that it would cost retailers £10,000+ per store to implement a display ban.54 Post-ban, the average cost in Ireland was calculated at just £300, with most retailers having their conversion costs covered by the manufacturers.55   

Increased serving times. There were also estimates in the UK that queuing and serving times would double, leading to lost customers. These concerns were not realised following implementation, with no significant increase in service times.56  

Substantial revenue losses. Following the removal of POS tobacco advertising and displays, Irish retailers claimed that cigarette sales fell 40% as a result of the legislation. However, research has found no statistically significant change in cigarette pack sales following implementation of the legislation.57 Following the implementation of retail display bans in the UK, survey research found that about two-thirds of retailers reported that implementation was easy and that there was no noticeable decline in tobacco sales.58  

Shops closures. There were predictions and claims in Canada and Ireland of widespread shop closures following the implementation of display bans; however, these were not borne out by subsequent analyses.56, 57  

11.9.5 Price promotion at point of sale

11.9.5.1 Regulation of price boards

Although the display and advertising of tobacco products at the POS is banned in most Australian jurisdictions, some legislation does permit signage that lists the available brand names and prices of tobacco products. For example, in Victoria, one unlit price board of no bigger than 150cm by 150cm is allowed, which must include a graphic health warning either on or beside it.59 Table 1 shows restrictions on price displays for each state/territory. 

Table 1 
Price tickets/Price boards/Labelling after POS display ban--State/Territory legislation (as at September 2015) 

 

Price tickets

Price board

Price list

Other signage

ACT 

i  

  

Staff barcode sheet permitted to assist scanning pricesii 

M: Licence detailsiii

P: Sales to minorsiv  

NSW

Board or price tickets (not both)v

Board or price tickets (not both)vi  

M: Health warningvii

M: Sales to minorsviii

P: Tobacco sold at this cash register onlyix  

NT

x  

xi  

Can be produced on customer requestxii  

M: Licence detailsxiii

M: Health warningxiv  

M: Sales to minorsxv  

Qld 

xvi  

   

M: Sales to minorsxvii

P: “Smoking Products Sold here”xviii  

SA 

xix  

xx 

 

M: Sales to minorsxxi

P: One prescribed notice or sign: “[tobacco products/cigarettes cartons/cigarettes sold here]”xxii 

Tas 

xxiii  

xxiv  

 

M: Licence (when display is required by licence)xxv

M: Sales to minors 

M: Graphic Health Warning

M: Health promotion noticexxvi

M: General retailers only: “tobacco products sold here”xxvii

Vic 

General retailersxxviii 

Specialist tobacconists or on-airport duty free shopsxxix  

xxx  

 

M: Sales to minorsxxxi

M: Health warning or cessation assistance signxxxii

P: General retailers only: “We sell tobacco here”xxxiii 

WA 

xxxiv 

xxxv  

Can be produced on customer requestxxxvi  

M: Health warningxxxvii

M: Sales to minorsxxxviii  

*Note: does not include requirements specific to vending machines or cigars 

= allowed = banned; M= Mandatory; P= Permitted

 
11.9.5.2 Price promotion by price board

Price boards can serve as a form of advertising, with brands and prices strategically arranged to target particular groups or consumers. Following the 2011 POS display ban, an audit was undertaken in Victoria that examined the prevalence and contents of tobacco product price boards. It found that most stores arranged their lists of brands in a manner other than alphabetical or price order. Rather, brands listed at the top of the price board were over-represented by premium brands, were more frequently owned by the same tobacco company, and more likely to reflect the brand segment smoked by the socio-economic status of the store neighbourhood. The authors suggest that POS bans should also encompass bans on price board displays, in order to prevent tobacco companies using the boards as a means of advertising particular brands or discounts.60 Several leading Australian health organisations have also called for a ban on tobacco price boards.61   


11.9.6 Tobacco retailer density

While display bans place tobacco products out of sight, they do not limit the availability of tobacco products for purchase. Even in Australian states that require licencing of tobacco retailers, there are no limits regarding the number of stores or licences in a given area.62, 63 Studies exploring the effects of alcohol retailer density on drinking behaviours in the US have linked greater density around college campuses to higher rates of drinking64 and drink driving.65 However, as noted by researchers in New South Wales, ‘Relatively little attention has been given to the retail availability of tobacco products despite the likelihood that ubiquitous supply may represent a primary form of tobacco promotion in Australia’. Their study on retail outlet density and smoker perceptions and behaviour found that 88% of smokers reported daily retail availability of tobacco in walking distance, with a conservative estimate of one tobacco outlet for every 77 smokers. The study concluded that some groups of smokers appear vulnerable to the availability of tobacco, and that a reduction in the availability of tobacco would likely benefit smokers who wish to quit.66  

11.9.6.1 Density as a form of targeting

11.9.6.1.1 Density greater in disadvantaged areas

People who are disadvantaged in terms of their employment type, income, and education level have the highest rates of smoking (see Section 1.7),67 and also experience poorer outcomes in terms of their health and life expectancy.68 Recent studies have examined the relationship between socioeconomic status (SES) and tobacco retailer density, and found a clear inverse association between the two. That is, the density of tobacco outlets tends to be higher in areas with lower average incomes.69-73 For example, a study in regional Western Australia found that the most disadvantaged suburbs and towns had more than five times the number of tobacco outlets than the least disadvantaged.71 Researchers in New South Wales found this association after controlling for smoking prevalence, and have speculated on this basis that this may reflect a deliberate marketing strategy by the tobacco industry, rather than an issue of demand.72 Further research in NSW found that disadvantaged areas were significantly more likely to have higher tobacco outlet densities, and that after controlling for a range of demographic factors, density was significantly and positively associated with individuals' smoking status.74 A study in New York found that tobacco retailing around schools was greater in socially disadvantaged areas,75 while other research in the US found that higher rates of same-sex couples, who tend to live in lower income areas, was associated with a higher density of tobacco retailers.76 Researchers in Scotland similarly found that areas with the lowest average household incomes have the highest density of alcohol and tobacco outlets, while the most well-off neighbourhoods have the fewest.77

The disproportionate number of tobacco outlets in low-SES areas has a number of implications for public health. Greater density creates greater competition between retailers, leading to greater price competition that may have a more significant influence on people with lower incomes. It may contribute to the normalisation of tobacco use, which may exacerbate already high rates of prevalence and acceptability among low-SES groups. Finally it may contribute to financial hardship by prompting greater daily consumption and making cessation more difficult.71   

11.9.6.1.2 Density greater near young people

Similar to the greater density of tobacco retailers found in low SES area, there are also high densities of outlets close to schools and young people.78, 79 In NSW, the median of tobacco outlet density around schools was shown to be significantly higher than the state median.74 Research in Chicago found a greater concentration of tobacco outlets in neighbourhoods with a larger proportion of residents under 18,80 while a study in Ontario, Canada found that most retailers are within a short walk of a school.70 This proximity to tobacco retailers serves to increase exposure to and opportunity to purchase tobacco products by young people,81 which may promote the transition from experimentation to regular smoking.82

11.9.6.2 Rationale for reducing tobacco retailer density

Given the relationship between retailer density and smoking behaviours (outlined next), tobacco control advocates have called for limitations to be placed on the number of tobacco retail outlets, particularly around schools. For example, zoning restrictions may be used to restrict the availability and visibility of cigarettes around young people.27, 83 This approach draws on evidence of the positive effect of reductions in the density of alcohol outlets on alcohol-related problems.84

11.9.6.2.1 Greater density leads to greater exposure 

The widespread availability of tobacco can lead to greater exposure to cigarettes and advertising, particularly in areas that have not implemented POS display or advertising bans. The close proximity of schools to tobacco promotion and advertising has been linked to adolescents’ greater awareness of advertising in India.85 In the US, over two-thirds of students reported retail store exposure to pro-tobacco advertisements in 2012.86 Exposure to tobacco marketing via visits to small grocery, convenience, or liquor stores have been linked with a 50% increase in the odds of ever smoking.87 Young people’s recall of POS tobacco displays, pro-smoking beliefs, and smoking behaviours all fell following POS display bans in Australia.37

11.9.6.2.2 Increased price competition

Research in South-East Queensland found that the price of cigarette packs is lower in low-SES suburbs compared with high-SES suburbs, possibly due to a greater density of outlets and therefore greater competition.69   

11.9.6.2.3 Greater exposure leads to greater uptake

Greater density of tobacco retailers has been suggested as an important factor in the uptake of smoking. Areas that are more densely populated with tobacco retailers may promote adolescent smok¬ing not only by increasing access but also by increasing environmental cues to smoke.27 A recent study in Scotland found that the density of retail outlets selling tobacco in residential neighbourhoods was associated with a greater likelihood of adolescents having ever smoked and currently smoking. The authors suggested that an appropriate policy response would be to reduce the overall density of outlets selling tobacco, rather than the more traditional approach of concentrating on ‘child spaces’.88   

A number of studies in the US have found higher rates of smoking among young people living80 or going to school78 in areas with a greater density of tobacco retailers. Research published in 2015 exploring uptake of a range of tobacco products among young adults found that density was significantly associated with recent initiation of use of cigarettes and other combustibles (e.g., cigars), but this impact varied by age; greater density was associated with a higher likelihood of initiating cigarette use among adults aged 25–34, and of initiating use of non-cigarette combustible products among 18–24 year olds.89 Another study found that tobacco outlet density was positively associated with smoking among young people, with higher density more closely associated with smoking when respondents were younger.90 Among African American young adults, one study found that gender appears to moderate the relationship between retailer density and tobacco use, such that the relationship is significant only among young women.91 Similar results have been found in a number of African countries, where researchers have shown a positive association between the proximity of tobacco outlets to school and the use of combustible and smokeless tobacco products.86 Research in Japan found a significant dose-response relationship between smoking among marginalised and disadvantaged young people and patronage of convenience stores.92   

Smoking experimentation/initiation has also been linked with greater retailer density and exposure to retail advertising.83, 93-96 A study in the US found that retail density was associated with intention to smoke among African American youth.97 Research in New Zealand found that students attending schools surrounded by a higher density of tobacco outlets had greater odds of smoking susceptibility, and were more likely to try and purchase tobacco, compared with students at schools with zero density of outlets. No associations were found between density of tobacco outlets and successful purchasing, nor experimental smoking. The authors suggest that reducing the density of tobacco outlets around schools would be one way of achieving the country’s goal of a smokefree nation by 2025.98 Extending research linking exposure to point-of-sale marketing with cigarette smoking among young people, research in Scotland also found that living in an area of high tobacco retail density predicted intention to try electronic cigarettes among adolescents.99

11.9.6.2.4 Greater exposure leads to greater relapse, unplanned purchases

Recent research has explored the effects of tobacco availability and exposure on smoking cessation. A study in Finland found that living within walking distance of a tobacco store reduced the likelihood of smoking cessation among men who were moderate/heavy smokers.100 Research in Scotland found that adults living in environments with a greater availability of tobacco outlets were more likely to start and/or keep smoking, and less likely to quit.101 The high availability of tobacco can serve to undermine cessation by triggering or enabling impulse purchasing.66 Vulnerable groups may be particularly affected; a study in California found tobacco retailer densities were two-fold greater among smokers with serious mental illness than for the general population, and were associated with poorer mental health, greater nicotine dependence, and lower self-efficacy for quitting.102   

Together, these studies highlight that the interests of the many smokers who wish to quit are not well-served by the current ubiquity of tobacco in the retail environment.

11.9.6.3 International regulatory precedents

11.9.6.3.1 End to sales in drug stores

Pharmacies in Australia have never sold tobacco products. The Pharmacy Board of Australia’s guidelines state that the sale or supply of tobacco products is considered unprofessional conduct within the meaning of the National Law.103 However, this is a topic of concern in North America and other places internationally.

The sale of tobacco products has been banned in pharmacies in a number of locations throughout the world. Proponents of bans argue that selling tobacco products creates a conflict of interest for pharmacists and is inconsistent with the practice of pharmacy, that otherwise provides health care advice and health-related services. Opponents tend to argue that bans will lead to significant losses in revenue and economic hardship for pharmacies.104    

In Canada, the sale of tobacco is prohibited in pharmacies in all provinces and territories except for British Columbia. A report from the Physicians for a Smoke-Free Canada concluded that despite initial predictions, banning cigarette sales in pharmacies did not result in pharmacy closures in the province of Ontario.105 Pharmacy sales of tobacco products are also banned in the United Kingdom, France, Italy,104 and a number of cities in California and Massachusetts. On February 5, 2014, the large US pharmacy chain CVS announced that it would stop selling tobacco products on October 1st.106 Although there were predictions of enormous revenue losses, in 2014 CVS reported record profits, increasing net revenues by 9.9%.107   

Despite these restrictions, the sale of tobacco in US pharmacies has been widespread; between 2005 and 2009, pharmacy cigarette sales increased 22.72%, while total cigarette sales decreased 17.43%.108 However, pharmacists are overwhelmingly opposed to these sales; a recent study in Los Angeles suggested that when given a choice, pharmacists choose not to sell tobacco products,109 while research in New York found that most pharmacists surveyed would prefer to work in a pharmacy that does not sell tobacco products.110 A majority of consumers surveyed recently also supported either banning sales of tobacco in grocery stores and pharmacies, or implementing display restrictions.111 Pharmacies affiliated with chains, grocery stores, and mass merchants are often unwilling to discontinue the sale of tobacco products, therefore stronger legislation may be needed as a public health measure.109

11.9.6.3.2 Voluntary abandonment of tobacco sales

Retailers can play a key role in reducing the availability of tobacco. Research to date on voluntary abandonment of tobacco sales has focused primarily on pharmacies; however, several grocery store chains across the US have also voluntarily stopped selling tobacco products.112 In 1996, Target stopped selling tobacco products,113 and Walmart has also considered eliminating them from its stores.114 Costco has reportedly been slowly phasing out the sale of tobacco from some of its stores, stating that tobacco is a very low margin business, tends to have higher theft, and can be labour intensive.115 In Australia, Aldi does not sell cigarettes.116 Voluntary initiatives can also serve to increase support for the introduction of mandatory policies. For example, the abandonment of tobacco sales by some pharmacies preceded recent bans on pharmacy tobacco sales in many US cities.112  

Research in New Zealand found that the vast majority of convenience store owners were unwilling to voluntarily stop or restrict tobacco sales, as they perceived it as a key product for their businesses. The authors suggest that reducing the availability of tobacco likely requires legislative approaches.117 A systematic analysis of ex-tobacco retailers in NSW explored which retailers stop selling tobacco, and why. Results showed that retailers who stopped selling tobacco were disproportionately likely to be businesses with low sale volume (i.e., those businesses where tobacco made up only a very small proportion of total sales). Low profits from tobacco sales contributed to the decision for almost all retailers, but other major changes were also a significant prompt to stop selling. For example, some changed their businesses focus or location, while others cited legislative changes (such as display bans and changes to vending machine requirements) as influencing the decision to stop selling.118

11.9.6.3.3 Direct government action to reduce density

There have been a number of attempts by governments internationally to reduce the density and availability of tobacco products. For example, a number of jurisdictions in Canada prohibit tobacco sales in specific places, such as schools, universities, bars, and hospitals.119 Similarly, several places in the US mandate minimum distances that tobacco retailers must be from schools.120, 121 In the United Arab Emirates, tobacco products cannot be sold in locations that are within 100 metres of places of worship, and within 15 metres of kindergartens, schools, universities and colleges. Shisha cafes also have to be at least 150 metres away from residential areas, and these cafes can only be open from 10am to 12pm.122  
 
Retailer licensing schemes that limit the type of outlets permitted to sell tobacco, the hours in which it can be sold, and/or the location have also been suggested as a way to reduce tobacco retailer density—see Section 11.9.7, below. 


11.9.7 Licensing of retailers

11.9.7.1 Types of licences

The licencing of tobacco sellers is widely supported by public health officials and tobacco control advocates. There are a number of forms that licencing can take, for example:

Notification/registration: Notification/registration requires businesses to provide information about themselves to a specified agency. However, registration does not allow for restrictions or conditions to be placed on the business. 

Accreditation/certification: Accreditation schemes are essentially non-mandatory licences. Businesses must comply with minimum standards in order to be accredited, but lack of accreditation does not prevent partaking in the business activity. Accredited sellers would be unlikely to be sought out by consumers. This model would not appear to provide a helpful regulatory response to tobacco sales. 

Negative licensing: Negative licencing systems allow businesses to operate without a licence or permit, but they face bans if they seriously breach required standards. These systems are reactive rather than proactive, and do not allow for comprehensive records of tobacco retailers. As no fees are paid to obtain a licence, they also do not raise money for education and monitoring programs. 

Positive licensing: Positive licencing requires prior approval for conducting business activities, and adherence to minimum standards. This has been identified as the most appropriate form of licencing for tobacco sales.123

In Australia, tobacco retailers require a positive licence in all states except NSW, Queensland, and Victoria (see table 2). However, even where these licences are in place, there are few laws that restrict the type or number or conditions relating to the sale of tobacco, and this widespread availability can help to normalise tobacco and promote perceptions that it is not overly harmful. A number of health organisations have supported measures that reduce the access and availability of cigarettes, including a positive licensing scheme whereby retailers must apply and pay a fee for a license to allow them to sell tobacco products.62, 63, 124   

Table 2 
Tobacco retail licencing schemes in Australia (as at September 2015) 

 

Licence needed?

Terms and fee

ACT   

12 months for $306 or payments by quarterxxxix

Common expiry/renewal time of 31 Augustxl  

Qld

 (negative scheme)  

N/A 
NSW 

 (notification scheme) 

General retailer: no fee for notificationxli

Specialist Tobacconist: $250 to be categorised as a specialist tobacconists (one off fee)xlii  

NT   

12 months for $230xliii

Renewed annually (same cost)xliv  

SA   

12 months for $266xlv
Renewed annually (same cost)xlvi 

Tas   

12 months for $360.89xlvii
Renewed annually (same cost)xlviii  

Vic* 

 (negative scheme)  

N/A 
WA   

12 months for $180 (+$60 application fee)xlix
Renewed annually for $204l  

*The Victorian Tobacco Act grants power to the Department of Health to require from tobacco manufacturers or wholesalers the names and/or addresses of tobacco retailersli   

11.9.7.2 Benefits of licensing

There are a number of potential benefits of licencing. First and foremost, it can facilitate the enforcement of tobacco control measures, such as prohibiting sales to minors and banning POS displays. Licencing can provide health authorities with the addresses of sellers, which allows for communicating with retailers about regulatory requirements and with undertaking compliance checking.123 Fees paid by retailers to obtain licences can provide revenue to fund this monitoring.62 Further, recent research in South Australia found that a significant tobacco licence price increase led to an overall decrease in the number of licences; thus, high licence fees are a potentially effective method of reducing tobacco points of sale.125

Licencing also facilitates the provision of accurate and appropriate information to retailers regarding any changes in laws, and their subsequent obligations.123 It can also allow for additional conditions to be placed on tobacco sales, and for sanctions, including the revocation of authority to sell, if conditions or regulations are not adhered to.123  

11.9.7.3 Licensing to reduce retailer density

Some public health experts have suggested that licensing schemes that reduce tobacco retailer density or limit their proximity to schools or licensed premises are an important next step in tobacco control. Placing restrictions on the circumstances in which a licence can be obtained could serve to reduce the availability of tobacco. For example, by limiting the type of outlets permitted to sell tobacco, the hours in which it can be sold, and the location (for example, limiting the number near schools).62, 63 A comparison of policy approaches in the US for reducing density found that a minimum allowable distance of 500 feet between tobacco outlets had the single greatest impact, while a combined pharmacy and near-schools ban would also significantly reduce density.126

A qualitative study in New Zealand explored retailers' views on existing and potential future tobacco retail policies. About half of the retailers were positive or indifferent about a possible future licensing scheme, and several believed licensing would not have a large impact on them. Restricting the sale of tobacco near schools was generally supported. The authors conclude that a proposed licensing policy is unlikely to be met with blanket opposition from tobacco retailers. Framing policies in terms of how they can protect young people may be helpful in increasing support for such policies.127   

The cost of licences may also prompt retailers to voluntarily stop selling tobacco products, with research in South Australia showing that a significant tobacco licence price increase led to an overall decrease in the number of retailers purchasing licences.125 A study in California following the introduction of tobacco retail permits also found an immediate reduction in the number of stores selling tobacco.128

A summary of evidence in relation to tobacco retailer regulation concluded that a combination of licensing, enforcement, education, promotion restrictions at the point of sale, and a well-funded compliance program to prevent sales to minors is a best-practice approach. However, the paper notes that evidence for restricting the number, type, or location of retail outlets is limited, and further research is needed to determine whether these measures would be effective in Australia.129   

11.9.7.4 International licensing precedents

Many sub-national jurisdictions require some form of tobacco retailer licencing: in the US, more than 40 states require that a business obtain a licence before it is allowed to sell tobacco products.130 Small numbers of jurisdictions have introduced measures to reduce density. In January 2015, Newburgh, New York adopted a new law mandating that stores selling tobacco products will need a permit and will not be allowed to sell those items if they are within 1000 feet of a school.121 The Californian city of El Cerrito also enacted a licensing program in 2015 that bans sales of flavoured tobaccos, and limits new tobacco retailers at locations within 1,000 feet of existing retailers and 500 feet from schools, recreation centres, libraries and parks.120, 128 San Francisco is debating a proposal that would cap the number of tobacco permits, which would include the sale of e-cigarettes.131   

Several European countries have also implemented tobacco retailer licensing schemes, with a range of objectives in mind. In Finland, changes in tobacco regulations in 2010 aimed primarily to enforce the prohibition of sales to minors. In Norway and Scotland, licencing schemes have been considered, but no steps have been taken yet toward implementation.132 In 2013, Hungary implemented a controversial law that made tobacco retailing a government monopoly and dramatically reduced the number and type of tobacco outlets.133

In Islamabad, the capital of Pakistan, tobacco retailers must obtain tobacco selling licences. Licensed retailers are prohibited from selling tobacco products to people under 18, from selling loose cigarettes, from advertising tobacco products, and from setting up a tobacco selling point within 50 yards of an educational institution.134   

11.9.7.5 Reductions in smoking following reductions in retailer density

Following the substantial reduction in the type and number of tobacco outlets in Hungary in 2013, a survey found that about one quarter of respondents reported changing their smoking habits. Thirteen percent of respondents thought they would not buy cigarettes as often and would smoke less. Only a small minority indicated they would visit the tobacconist less frequently but buy larger amounts of cigarettes each time and continue smoking at the same level. These results provide some of the first evidence internationally of the real-world effects of reduced retailer density.135

11.9.8 Reducing smoker capacity to access tobacco in retail outlets

11.9.8.1 Full smoker licensing

NSW public health academic Professor Simon Chapman has proposed a multi-faceted licencing system for smokers to be able to purchase cigarettes, which includes the following elements:

  • Smart card technology
  • A database of smokers
  • A maximum purchase limit chosen by the smoker
  • A maximum daily limit of 50 cigarettes per day, averaged across two weeks
  • A reasonable licence fee
  • Periodic renewal
  • A financial incentive to surrender the licence
  • A 6-month cooling off period that allows smokers to cancel their licence revocation
  • A knowledge of risk test for new smokers, similar to the test undertaken when obtaining a driver’s licence
  • The possibility of a gradual increase in the minimum age for purchase.136

However, opponents of this proposal argue that regulations should remain focused on the promotion and sale of tobacco products rather than the purchaser. By focusing on individual smokers, it is argued, a system that licensed smokers would condemn victims, further stigmatise smokers, and marginalise the poor.137

11.9.8.2 Smart cards

Other Australian researchers have suggested the introduction of a “smart card” licencing system that smokers would need to obtain in order to buy cigarettes. Producing the licence would be a precondition to buying tobacco products, while retailers would be required to reconcile their stock purchases against a digital record of retail sales to card-holding smokers. Together, these requirements would aim to reduce unlawful sales to minors, and to use the gathered information in an effective and tailored way to help adult smokers quit.138   

11.9.8.3 Tobacco-free generation

In March 2015 the Tasmanian Parliament debated draft legislation (the Public Health Amendment (Tobacco-free Generation) Bill 2014) making it illegal, from 2018, to supply tobacco to everyone born after 2000. The Bill was introduced by an independent member of the Legislative Council, Ivan Dean, and aims to create a generation of people not exposed to tobacco products. It is one of the most significant global attempts to slowly phase out cigarette smoking. 

The draft legislation is widely supported by Tasmanian health organisations, while being vigorously opposed by tobacco companies, which claim that the regulations would be difficult to manage and enforce.139, 140 In late 2015 a Parliamentary committee was considering its workability.141

11.9.8.4 Raising the minimum age of purchase

As an alternative to the tobacco-free generation, the Tasmanian Government has proposed raising the legal age of smoking to 21 or 25.142 This proposal is in light of a robust body of evidence showing that almost all smokers start smoking when they are teenagers.27 In the US, the states of Hawaii and California have recently passed legislation restricting tobacco sales to people 21 or over.143   

11.9.9 Retailer–industry alliance

In the face of increasing restrictions on tobacco marketing, the tobacco industry has a history of collaborating with the retail sector in opposing new policies. Tobacco companies aggressively seek support from retailers, and provide retailers with the encouragement, tools, information, and financial support to involve themselves in the legislative process. This allows politicians to oppose anti-tobacco control legislation, without publicly aligning with the tobacco industry. Instead, they can be perceived as supporting local stores and retail groups, who do not have the tobacco industry’s extremely negative reputation.144 

These alliances can successfully shape legislation; in 2011, the sales tax on cigarettes in New Hampshire was reduced based on a report from the New Hampshire Grocers Association, whose evidence was drawn from materials by tobacco industry allies. Convenience stores in the US have also distributed flyers opposing tobacco tax increases.144 The damage that new policies may cause to shops is frequently overstated by the tobacco industry and retailers. Tobacco control legislation, including tax increases, does not affect retailers to the extent that is claimed; people whose tobacco use declines spend their money on other products instead. The number of convenience stores and retail employment also remain unchanged following new legislation.144        

POS promotion has also been used by the tobacco industry to develop relationships with retailers. Retailers have been led to believe that their businesses will be harmed if they choose not to prominently display tobacco products.4 Retailers in England described a relationship where manufacturers were competing to exert control over their retail environment through a combination of contractual obligations, incentives, and pressure from company representatives concerning pricing, display and other promotion of tobacco products.145

In the lead up to the introduction of plain packaging in Australia, tobacco industry-funded retailer groups claimed that the standardised packs would be difficult to differentiate, leading to significantly longer retrieval times for workers and the loss of frustrated and inconvenienced customers.146 For example, a report prepared by Deloitte for The Alliance of Australian Retailers (which was supported by British American Tobacco Australasia Limited, Philip Morris Limited, and Imperial Tobacco Australia Limited) estimated that the economic cost of plain packaging to convenience stores would be an additional 455 – 1,692 hours, or $9,000 – $34,000.147 Research following its introduction showed no lasting effects on retrieval times.146, 148

11.9.10 Public support for reducing retail promotion and access

Public support for new policies often sways politicians’ willingness to introduce new tobacco control strategies.149

There is extensive support among consumers for the implementation of display bans and other retail restrictions. In Norway, the POS tobacco display ban was supported by a majority of the population, and by one out of three daily smokers.12 Likewise, the removal of POS displays in Ireland was well supported by the population.13 Interviews with smokers and ex-smokers in New Zealand indicated that tobacco displays tempt smokers attempting cessation, and there was widespread support for display bans.150, 151  Surveys of adolescents have also shown support for New Zealand's smoke-free goal and the interventions that could help attain it.152 Researchers in New York found that, although opinions varied between smokers and non-smokers, price and retail-based tobacco control strategies were consistently supported by the public.153

There were also substantial levels of public support in New Zealand for ending sales of tobacco products altogether within 10 years, although smokers were concerned with the availability of effective nicotine substitutes.149 Similarly, research in Victoria in 2009–10 found that many adults and smokers were supportive of restrictions being placed on the sale of cigarettes in the future, including the complete phase out of sales.154

Recent news and research

For recent news items and research on this topic, click here (Last updated October 2016)    

References

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66. Paul C, Mee K, Judd T, Walsh R, Tang A, et al. Anywhere, anytime: Retail access to tobacco in New South Wales and its potential impact on consumption and quitting. Social Science & Medicine, 2010; 71(4):799–806. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20554363 

67. Siahpush M. Smoking and social inequality. Australian and New Zealand Journal of Public Health, 2004; 28(3):297. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15707179

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69. Dalglish E, McLaughlin D, Dobson A, and Gartner C. Cigarette availability and price in low and high socioeconomic areas. Australian and New Zealand Journal of Public Health, 2013; 37(4):371–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23895481

70. Chaiton MO, Mecredy GC, Cohen JE, and Tilson ML. Tobacco retail outlets and vulnerable populations in Ontario, Canada. International Journal of Environmental Research and Public Health, 2013; 10(12):7299–309. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24351748

71. Wood L, Pereira G, Middleton N, and Foster S. Socioeconomic area disparities in tobacco retail outlet density: A Western Australian analysis. The Medical Journal of Australia, 2013; 198(9):489–91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23682892

72. Kite J, Rissel C, Greenaway M, and Willliams K. Tobacco outlet density and social disadvantage in New South Wales, Australia. Tobacco Control, 2014; 23(2):181–2. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23242978

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77. Shortt NK, Tisch C, Pearce J, Mitchell R, Richardson EA, et al. A cross-sectional analysis of the relationship between tobacco and alcohol outlet density and neighbourhood deprivation. BMC Public Health, 2015; 15(1):1014. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26437967

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82. Chan WC and Leatherdale ST. Tobacco retailer density surrounding schools and youth smoking behaviour: A multi-level analysis. Tobacco Induced Diseases, 2011; 9(1):9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21791116

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86. Agaku IT, King BA, and Dube SR. Trends in exposure to pro-tobacco advertisements over the internet, in newspapers/magazines, and at retail stores among US middle and high school students, 2000–2012. Preventive Medicine, 2014; 58:45–52. Available from: www.ncbi.nlm.nih.gov/pubmed/24183778

87. Henriksen L, Feighery E, Wang Y, and Fortmann S. Association of retail tobacco marketing with adolescent smoking. American Journal of Public Health, 2004; 94(12):2081–3. Available from: http://www.ajph.org/cgi/content/full/94/12/2081

88. Shortt NK, Tisch C, Pearce J, Richardson EA, and Mitchell R. The density of tobacco retailers in home and school environments and relationship with adolescent smoking behaviours in Scotland. Tobacco Control, 2014. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25370699

89. Cantrell J, Pearson JL, Anesetti-Rothermel A, Xiao H, Kirchner TR, et al. Tobacco retail outlet density and young adult tobacco initiation. Nicotine & Tobacco Research, 2016; 18(2):130–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25666816

90. Lipperman-Kreda S, Morrison C, Grube JW, and Gaidus A. Youth activity spaces and daily exposure to tobacco outlets. Health Place, 2015; 34:30–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25879915

91. Brown Q, Milam AJ, Bowie JV, Ialongo NS, Gaskin DJ, et al. The moderating role of gender in the relationship between tobacco outlet exposure and tobacco use among African American young adults. Prevention Science, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26680642

92. Watanabe I, Shigeta M, Inoue K, Matsui D, Ozaki E, et al. Personal factors associated with smoking among marginalized and disadvantaged youth in Japan: A strong relationship between smoking and convenience store use. International Journal of Behavioral Medicine, 2013; 20(4):504–13. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23015471

93. Adams M, Jason L, Pokorny S, and Hunt Y. Exploration of the link between tobacco retailers in school neighborhoods and student smoking. The Journal of School Health, 2013; 83(2):112–8 Available from: http://www.ncbi.nlm.nih.gov/pubmed/23331271

94. Pokorny SB, Jason LA, and Schoeny ME. The relation of retail tobacco availability to initiation and continued smoking. Journal of Clinical Child & Adolescent Psychology, 2003; 32(2):193–204. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12679277

95. Johns M, Sacks R, Rane M, and Kansagra S. Exposure to tobacco retail outlets and smoking initiation among New York city adolescents. Journal of Urban Health, 2013; 90(6):1091–101. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23700202

96. Henriksen L, Schleicher N, Feighery E, and Fortmann S. A longitudinal study of exposure to retail cigarette advertising and smoking initiation. Pediatrics, 2010; 126(2):232–8. Available from: http://pediatrics.aappublications.org/cgi/reprint/peds.2009-3021v1

97. Mennis J, Mason M, Way T, and Zaharakis N. The role of tobacco outlet density in a smoking cessation intervention for urban youth. Health Place, 2016; 38:39–47. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26798960

98. Marsh L, Ajmal A, McGee R, Robertson L, Cameron C, et al. Tobacco retail outlet density and risk of youth smoking in New Zealand. Tobacco Control, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26628495

99. Best C, van der Sluijs W, Haseen F, Eadie D, Stead M, et al. Does exposure to cigarette brands increase the likelihood of adolescent e-cigarette use? A cross-sectional study. BMJ Open, 2016; 6(2):e008734. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26908512

100. Halonen J, Kivimaki M, Kouvonen A, Pentti J, Kawachi I, et al. Proximity to a tobacco store and smoking cessation: A cohort study. Tobacco Control, 2014; 23(2):146–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23436138

101. Pearce J, Rind E, Shortt N, Tisch C, and Mitchell R. Tobacco retail environments and social inequalities in individual-level smoking and cessation among Scottish adults. Nicotine & Tobacco Research, 2016; 18(2):138–46. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25895953

102. Young-Wolff KC, Henriksen L, Delucchi K, and Prochaska JJ. Tobacco retailer proximity and density and nicotine dependence among smokers with serious mental illness. American Journal of Public Health, 2014; 104(8):1454–63. Available from: www.ncbi.nlm.nih.gov/pubmed/24922145

103. Pharmacy Board of Australia. Guidelines on practice-specific issues, 2014. Available from: http://www.pharmacyboard.gov.au/documents/default.aspx?record=WD10%2F2953&dbid=AP&chksum=sI9rHYKMu8ujWnUtzz2%2FHQ%3D%3D

104. Woodward A, Henley P, and Wilson D. Banning tobacco sales in Massachusetts' pharmacies. Journal of the American College of Nutrition, 2012; 31(3):145–8 Available from: http://www.ncbi.nlm.nih.gov/pubmed/23204149

105. Taylor M. Banning cigarette sales in pharmacies does not result in pharmacy closures. Physicians for a Smoke-Free Canada, 1997. Available from: http://www.smoke-free.ca/pdf_1/pharmacy.PDF

106. Americans for Nonsmokers' Rights. Tobacco-free pharmacies.  2014. Last update: Viewed Available from: http://www.no-smoke.org/learnmore.php?id=615.

107. Knowles V. CVS takes tobacco off shelves, reports record sales. Coincidence?, in 2 degrees 2015. Available from: https://www.2degreesnetwork.com/groups/2degrees-community/resources/cvs-takes-tobacco-off-shelves-reports-record-sales-coincidence/.

108. Seidenberg A, Behm I, Rees V, and Connolly G. Cigarette sales in pharmacies in the USA (2005-2009). Tobacco Control, 2012; 21(5):509–10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21953133

109. Corelli R, Aschebrook-Kilfoy B, Kim G, Ambrose P, and Hudmon K. Availability of tobacco and alcohol products in Los Angeles community pharmacies. Journal of Community Health, 2012; 37(1):113–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21644021

110. Smith D, Hyland A, Rivard C, Bednarczyk E, Brody P, et al. Tobacco sales in pharmacies: A survey of attitudes, knowledge and beliefs of pharmacists employed in student experiential and other worksites in Western New York. BMC Research Notes, 2012; 5(1):413. Available from: http://www.biomedcentral.com/content/pdf/1756-0500-5-413.pdf

111. Patwardhan P, McMillen R, and Winickoff J. Consumer perceptions of the sale of tobacco products in pharmacies and grocery stores among US adults. BMC Research Notes, 2013; 6:261. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708775/

112. McDaniel P and Malone R. Businesses' voluntary pro-health tobacco policies: A review and research agenda. Tobacco Control, 2012; 21(1):66–72. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21948806

113. Feder BJ. Target chain, citing costs, to stop selling cigarettes. New York Times, 29 August 1996. Available from: http://www.nytimes.com/1996/08/29/business/target-chain-citing-costs-to-stop-selling-cigarettes.html

114. No authors listed. Walmart debates continued tobacco sales. Adweek, 9 June 2009. Available from: http://www.adweek.com/news/advertising-branding/walmart-debates-continued-tobacco-sales-99531

115. Sozzi B. Costco is quietly removing tobacco from most of its stores. The Street, 2016. Available from: http://www.thestreet.com/story/13494053/1/costco-is-quietly-removing-tobacco-from-most-of-its-stores.html

116. No authors listed. Nearly a fifth of 11-15-year-olds in beijing admit they smoke - just days after the city vowed to ban public smoking again. Mail Online  2015. Available from: http://www.dailymail.co.uk/news/peoplesdaily/article-3111061/One-five-Beijing-schoolchildren-admit-smoking-public-smoking-ban.html

117. Paynter J, Glover M, Bullen C, and Sonia D. An intervention to reduce the number of convenience stores selling tobacco: Feasibility study. Tobacco Control, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25873646

118. Feletto E, Burton S, Williams K, Fry R, Sutton C, et al. Who stops selling? A systematic analysis of ex-tobacco retailers. Tobacco Control, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26962041

119. Ontario Tobacco Research Unit. Prohibition of tobacco sales in specific places: Monitoring update. 2012. Available from: http://otru.org/wp-content/uploads/2012/10/sales2012.pdf

120. Radin R. El Cerrito enacts license and new restrictions on tobacco retailers.  2015. Last update: Viewed Available from: http://www.santacruzsentinel.com/general-news/20150916/el-cerrito-enacts-license-and-new-restrictions-on-tobacco-retailers.

121. No authors listed. Newburgh: No tobacco sales within 1,000 feet of school. Daily Freeman, 2015. Available from: http://www.dailyfreeman.com/general-news/20150113/newburgh-no-tobacco-sales-within-1000-feet-of-school

122. No authors listed. Ministry of health announces new regulations in uae's anti-tobacco law. 7 days in Dubai, Aug 20 2013. Available from: http://www.7daysindubai.com/Ministry-Health-announces-new-regulations-UAE-s/story-19681633-detail/story.html

123. The Allen Consulting Group. Licensing of tobacco retailers and wholesalers. Canberra: Report to the Commonwealth Department of Health and Ageing, Endorsed by the Intergovernmental Committee on Drugs, 2002. Last update: Viewed Available from: http://www.health.gov.au/pubhlth/publicat/document/licensing_tobacco.pdf

124. Fry R, Williams K, Tang A, Burton S, Walsberger S, et al., Selling tobacco anywhere, anytime: Harmful not helpful. Sydney: Cancer Council NSW; 2013. Available from: http://canact.com.au/wp-content/uploads/2013/08/CCN15091_Policy-Report-1207_FINAL.pdf

125. Bowden JA, Dono J, John DL, and Miller CL. What happens when the price of a tobacco retailer licence increases? Tobacco Control, 2014; 23(2):178–80. Available from: http://tobaccocontrol.bmj.com/content/early/2013/06/18/tobaccocontrol-2012-050615.abstract

126. Myers AE, Hall MG, Isgett LF, and Ribisl KM. A comparison of three policy approaches for tobacco retailer reduction. Preventive Medicine, 2015; 74:67–73. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25689540

127. Robertson L, Marsh L, Hoek J, McGee R, and Egan R. Regulating the sale of tobacco in New Zealand: A qualitative analysis of retailers' views and implications for advocacy. The International Journal on Drug Policy, 2015; 26(12):1222–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26386891

128. Coxe N, Webber W, Burkhart J, Broderick B, Yeager K, et al. Use of tobacco retail permitting to reduce youth access and exposure to tobacco in Santa Clara county, California. Preventive Medicine, 2014. Available from: www.ncbi.nlm.nih.gov/pubmed/24513170

129. Smyth C, Freeman B, and Maag A. Tobacco retail regulation: The next frontier in tobacco control? Public Health Research and Practice, 2015; 25(3). Available from: http://www.ncbi.nlm.nih.gov/pubmed/26243488

130. No authors listed. Licencing and zoning. Counter Tobacco 2013. Last update: Viewed Available from: http://www.countertobacco.org/licensing-zoning-and-retailer-density

131. Sabatini J. SF leaders to debate 50 percent reduction in tobacoo-selling businesses. The Examiner, 2014. Available from: http://www.sfexaminer.com/sanfrancisco/sf-leaders-to-debate-50-percent-reduction-in-tobacco-selling-businesses/Content?oid=2913412

132. Monshouwer K, Verdurmen J, Ketelaars T, and van Laar MW. Points of sale of tobacco products: Synthesis of scientific and practice-based knowledge on the impact of reducing the number of points of sale and restrictions on tobacco product displays. Trimbos Instituut, 2014. Available from: http://www.trimbos.org/~/media/Files/Gratis%20downloads/AF1304%20Point%20of%20sale%20tobacco%20products_web.ashx.

133. No authors listed. Smokers to buy less cigarettes after tobacco law, survey shows. Politics.Hu, 31 July 2013. Available from: http://www.politics.hu/20130731/tobacco-law-to-change-smokers-habits-survey-shows/

134. Junaidi I. Tobacco retailers have to obtain licences within a week. Dawn 2015. Available from: http://www.dawn.com/news/1218864/tobacco-retailers-have-to-obtain-licences-within-a-week

135. MTI. Smokers to buy less cigarettes after tobacco law, survey shows. Politics. Hu, 2013. Available from: http://www.politics.hu/20130731/tobacco-law-to-change-smokers-habits-survey-shows/

136. Chapman S. The case for a smoker's license. PLoS Med, 2012; 9(11):e1001342. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23152726

137. Collin J. The case against a smoker's license. PLoS Med, 2012; 9(11):e1001343. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23152727

138. Magnusson RS and Currow D. Could a scheme for licensing smokers work in Australia? The Medical Journal of Australia, 2013; 199(3):181–4. Available from: https://www.mja.com.au/journal/2013/199/3/could-scheme-licensing-smokers-work-australia

139. Mather A. The world’s eyes are on us over push to ban smoking for those born after 2000. The Mercury, 2014. Available from: http://www.themercury.com.au/lifestyle/the-worlds-eyes-are-on-us-over-push-to-ban-smoking-for-those-born-after-2000/story-fnj64o6u-1227086900396

140. No authors listed. Tasmania considers phasing out cigarette sales. ABC News, 2014. Available from: http://www.abc.net.au/news/2012-08-21/upper-house-moves-motion-to-ban-the-sale-of-cigarettes/4214016

141. Walters E and Barnsley K. Tobacco-free generation legislation. Medical Journal of Australia, 2015; 202(10):509–10. Available from: https://www.mja.com.au/journal/2015/202/10/tobacco-free-generation-legislation

142. Waldhuter L. Tasmanian plans to lift legal smoking age to 21 or 25 could be world first. ABC News, 2015. Available from: http://www.abc.net.au/news/2015-12-21/state-plan-to-lift-tasmanias-legal-smoking-age-above-18/7044622

143. No authors listed. California lawmakers vote to raise smoking age to 21. Reuters, 2016. Available from: http://uk.reuters.com/article/us-california-smoking-idUKKCN0WC2I6

144. Campaign for Tobacco-Free Kids. Deadly alliance: How big tobacco and convenience stores partner to market tobacco products and fight life-saving policies.  2012. Available from: http://www.tobaccofreekids.org/content/what_we_do/industry_watch/store_report/deadlyalliance_full_report.pdf.

145. Rooke C, Cheeseman H, Dockrell M, Millward D, and Sandford A. Tobacco point-of-sale displays in England: A snapshot survey of current practices. Tobacco Control, 2010; 19:(4):279–84. Available from: http://tobaccocontrol.bmj.com/content/19/4/279.abstract

146. Wakefield M, Bayly M, and Scollo M. Product retrieval time in small tobacco retail outlets before and after the Australian plain packaging policy: Real-world study. Tobacco Control, 2014; 23(1):70–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23712769

147. Deloitte. Potential impact on retailers from the introduction of plain tobacco packaging. Sydney: Alliance of Australian Retailers, 2011. Available from: https://www.australianretailers.com.au/downloads/pdf/deloitte/2011_01_31_AAR_Plain_Packaging2.pdf

148. Bayly M, Scollo M, and Wakefield M. No lasting effects of plain packaging on cigarette pack retrieval time in small Australian retail outlets. Tobacco Control, 2014. Available from: http://tobaccocontrol.bmj.com/content/early/2014/05/30/tobaccocontrol-2014-051683.short

149. Edwards R, Peace J, Hoek J, Wilson N, Thomson G, et al. Majority support among the public, youth and smokers for retail-level controls to help end tobacco use in New Zealand. The New Zealand Medical Journal, 2012; 125(1357):169–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22854372

150. Thomson G, Hoek J, Edwards R, and Gifford H. Evidence and arguments on tobacco retail displays: Marketing an addictive drug to children? New Zealand Medical Journal, 2008; 121(1276):87–98. Available from: http://www.nzma.org.nz/journal/abstract.php?id=3120

151. Whyte G, Gendall P, and Hoek J. Advancing the retail endgame: Public perceptions of retail policy interventions. Tobacco Control, 2014; 23(2):160–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23842946

152. Jaine R, Healey B, Edwards R, and Hoek J. How adolescents view the tobacco endgame and tobacco control measures: Trends and associations in support among 14–15 year olds. Tobacco Control, 2014. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24794715

153. Farley SM, Coady MH, Mandel-Ricci J, Waddell EN, Chan C, et al. Public opinions on tax and retail-based tobacco control strategies. Tobacco Control, 2015; 24(e1):e10–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24365700

154. Hayes L, Wakefield MA, and Scollo MM. Public opinion about ending the sale of tobacco in Australia. Tobacco Control, 2013. Available from: http://tobaccocontrol.bmj.com/content/early/2013/01/08/tobaccocontrol-2012-050777.short

Sources for Table 1 and 2

i. ACT: Sections 9(2) and 23(4)(b) of the of the Tobacco Act 1927 (ACT).

ii. ACT: ACT Government, Department of Health, Guide to the Sale of Smoking Products in the ACT. Available from: http://health.act.gov.au/sites/default/files/Guide%20to%20the%20Sale%20of%20Smoking%20Products%20in%20the%20ACT.pdf 

iii. ACT: Section 64(2) of the Tobacco Act 1927 (ACT).

iv. ACT: Section 23(4)(d) of the of the Tobacco Act 1927 (ACT).

v. NSW: Section 16(3)(e) of the of the Public Health (Tobacco) Act 2008 (NSW); Regulation 15(1) of the Public Health (Tobacco) Regulation 2009 (NSW). 

vi. NSW: Section 16(3)(e) of the of the Public Health (Tobacco) Act 2008 (NSW); Regulation 15(1) of the Public Health (Tobacco) Regulation 2009 (NSW). 

vii. NSW: Regulation 16 of the Public Health (Tobacco) Regulation 2009 (NSW).

viii. NSW: Regulation 17 of the Public Health (Tobacco) Regulation 2009 (NSW).

ix. NSW: Regulation 19 of the Public Health (Tobacco) Regulation 2009 (NSW).

x. NT: Section 18 of the Tobacco Control Act (NT).

xi. NT: Section 18 of the Tobacco Control Act (NT). 

xii. NT: Northern Territory Government, Tobacco Control Act – Tobacco Retail Displays – Displays and Point of Sale, p.3. Available from: http://www.health.nt.gov.au/library/scripts/objectifyMedia.aspx?file=pdf/52/95.pdf

xiii. NT: Section 33 of the Tobacco Control Act (NT).

xiv. NT: Section 27 of the Tobacco Control Act (NT).

xv. NT: Section 27 of the Tobacco Control Act (NT).

xvi. QLD: Section 26E of the Tobacco and Other Smoking Products Act 1998 (Qld)

xvii. QLD: Section 26HC(1) of the Tobacco and Other Smoking Products Act 1998 (Qld); regulation 8 of the Tobacco and Other Smoking Products Regulation 2010 (Qld).

xviii. QLD: Section 26HC(2) of the Tobacco and Other Smoking Products Act 1998 (Qld); regulation 9 of the Tobacco and Other Smoking Products Regulation 2010 (Qld).

xix. SA: Section 40(3)(c) of the Tobacco Products Regulation Act 1997 (SA); regulation 10(3) of the Tobacco Products Regulations 2004 (SA). 

xxx. SA: Section 40(3)(c) of the Tobacco Products Regulation Act 1997 (SA); regulation 10(2) of the Tobacco Products Regulations 2004 (SA).  

xxi. SA: Section 38A(5) of the Tobacco Products Regulation Act 1997 (SA) and Schedule 1 to the Tobacco Products Regulations 2004 (SA).

xxii. SA: Regulation 9(1)(b) of the Tobacco Products Regulations 2004 (SA).

xxiii. TAS: Tasmania Government Department of Health and Human Services, Guidelines for the Sale of Tobacco, (2 March 2012), Part B, clauses 2(1)(a), 5(1) and 2(3)(a)-(b).

xxiv. TAS: Tasmania Government Department of Health and Human Services, Guidelines for the Sale of Tobacco, (2 March 2012), Part B, clauses 2(1)(c) and 2(3)(c). 

xxv. TAS: Section 74C(4)(b) of the Public Health Act 1997 (Tas). 

xxvi. TAS: Section 69A of the of the Public Health Act 1997 (Tas); Tasmania Government Department of Health and Human Services, Guidelines for the Sale of Tobacco, (2 March 2012), Part C; Tasmania Government Department of Health and Human Services, Approved Notices. http://www.dhhs.tas.gov.au/publichealth/tobacco_control/publications.  See the Approval and Location notice in particular.  

xxvii. TAS: Tasmania Government Department of Health and Human Services, Guidelines for the Sale of Tobacco, (2 March 2012), Part B, clause 2(b) and clause 3. 

xxviii. VIC: See sections 6(2AA) and 6(3) of the Tobacco Act 1987 (Vic).

xxix. VIC: Section 6(3)(cb) of the Tobacco Act 1987 (Vic). 

xxx. VIC: Sections 6(3)(ca) and 6(3)(cab) of the Tobacco Act 1987 (Vic). 

xxxi. VIC: Section 15C(3) of the Tobacco Act 1987 (Vic); Regulation 10 of the Tobacco Regulations 2007 (Vic). 

xxxii. VIC: Section 15C(1) of the Tobacco Act 1987 (Vic); Regulation 9 of the Tobacco Regulations 2007 (Vic).

xxxiii. VIC: Section 6(3)(d) of the Tobacco Act 1987 (Vic); Regulation 6A of the Tobacco Regulations 2007 (Vic).

xxxiv. WA:  Section 24(1) of the Tobacco Products Control Act 2006 (WA) and regulation 43 of the Tobacco Products Control Regulations 2006 (WA). 

xxxv. WA: Section 24(1) of the Tobacco Products Control Act 2006 (WA) and regulation 40 of the Tobacco Products Control Regulations 2006 (WA).

xxxvi. WA: Section 24(1) of the Tobacco Products Control Act 2006 (WA) and Regulation 46 of the Tobacco Products Control Regulations 2006 (WA).

xxxvii. WA: Section 25(3) of the Tobacco Products Control Act 2006 (WA) and regulations 40(4) and 51 of the Tobacco Products Control Regulations 2006 (WA).

xxxviii. WA: Section 25(1) of the Tobacco Products Control Act 2006 (WA) and regulations 48-49 of the Tobacco Products Control Regulations 2006 (WA).

xxxix. Tobacco (Fees) Determination 2015 (No 1). 

xl. Section 49 of the Tobacco Act 1927 (ACT). 

xli. See NSW Government, Service NSW, Frequently Asked Questions about Tobacco Retailer Notifications. Available from: http://www.onegov.nsw.gov.au/New/Agencies/trn/faqs#Q._Is_there_any_fee_to_submit_an_application_to_be_considered_a_Specialist_Tobacconist_ 

xlii. Schedule 4, clause 3(2) of the Public Health (Tobacco) Regulation 2009 (NSW). 

xliii. Section 32 of the Tobacco Control Act (NT); Regulation 25(2) of the Tobacco Control Regulations (NT); Northern Territory Government, Department of Treasury and Finance, Revenue Units, 1 July 2015 - 30 June 2016. Available from http://www.treasury.nt.gov.au/TaxesRoyaltiesAndGrants/AboutTerritoryRevenueOffice/Pages/Revenue-Units.aspx   

xliv. Section 32 of the Tobacco Control Act (NT); Regulation 25A (3) of the Tobacco Control Regulations (NT). Northern Territory Government, Department of Treasury and Finance, Revenue Units, 1 July 2015 - 30 June 2016. Available from http://www.treasury.nt.gov.au/TaxesRoyaltiesAndGrants/AboutTerritoryRevenueOffice/Pages/Revenue-Units.aspx   

xlv. Sections 8(1) and 10 of the Tobacco Products Regulation Act 1997 (SA); Regulation 4 of the Tobacco Products Regulations 2004 (SA). 

xlvi. Sections 8(1) and 10 of the Tobacco Products Regulation Act 1997 (SA): Regulation 4 of the Tobacco Products Regulations 2004 (SA).

xlvii. Section 74E of the Public Health Act 1997 (Tas); Regulation 4 of the Public Health (Tobacco Seller’s Licence) Regulations 2009 (Tas); Tasmanian Government, Department of Treasury and Finance, Fee Units. Available from: http://www.treasury.tas.gov.au/domino/dtf/dtf.nsf/v-ecopol/FB5D7C0503A0AC73CA257A2B0000D3D2   

xliii. Section 74F(9) of the Public Health Act 1997 (Tas); Regulation 4 of the Public Health (Tobacco Seller’s Licence) Regulations 2009 (Tas); Tasmanian Government, Department of Treasury and Finance, Fee Units. Available from: http://www.treasury.tas.gov.au/domino/dtf/dtf.nsf/v-ecopol/FB5D7C0503A0AC73CA257A2B0000D3D2   

xlix. Section 43 of the Tobacco Products Control Act 2006 (WA); Regulation 25 of the Tobacco Products Control Regulations 2006 (WA). 

l. Section 43 of the Tobacco Products Control Act 2006 (WA); Regulation 26(a) of the Tobacco Products Control Regulations 2006 (WA). 

li. Section 42A of the Tobacco Act 1987 (Vic). 

 

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