Assessing the Relationship between Retail Store Tobacco Advertising and Local Tobacco Control Policies: A Massachusetts Case Study

Objective. This study documents the extent of tobacco ads in retail stores and evaluates its association with the comprehensiveness of local tobacco control policies in the state of Massachusetts, US. Methods. Using a two-stage cluster sampling method, we sampled 419 retail stores across 42 municipalities to assess the presence and count of nine mutually exclusive tobacco ad categories. Tobacco ads by store type and municipality were analyzed using summary statistics and contingency tables. Regression models tested the association between the extent of tobacco ads and local tobacco control policy comprehensiveness. Results. Overall, 86.6% (n = 363) of all the retail stores had tobacco ads. On average, there were 6.7 ads per retail store (SD = 6.61) and 2804 ads across all the retail stores (range = 0: 32). Retail stores had an average of three different categories of tobacco ads (mean = 2.98, SD = 1.84). Across all retail stores, the most frequent ad categories were power walls (80.0%) and e-cigarette ads (55.8%). Retail stores in municipalities with more comprehensive local tobacco control policies were more likely to have fewer tobacco ads (IRR = 0.92, p<0.01) and a lower number of tobacco ad categories (OR = 0.88, p<0.05). Conclusion. Municipalities can adopt more comprehensive tobacco control policies to help limit the extent of tobacco retail advertising. This can ultimately reduce smoking in their jurisdiction.