The impact of tobacco promotion at the point of sale: A systematic review
Abstract
INTRODUCTION: Tobacco promotion increases the likelihood that adolescents will start smoking. Much of the tobacco industry's promotional budget is spent on point of sale (PoS) promotion in many jurisdictions. Consequently, tobacco is an eye-catching feature at the PoS in many places. METHODS: We reviewed the evidence that PoS tobacco promotion influences key smoking-related behaviors and beliefs, increases susceptibility to smoking in youth, undermines smokers' quit attempts, and promotes relapse among ex-smokers. RESULTS: We found 12 peer-reviewed studies, 10 of which were focused on children. Seven of 8 observational studies found statistically significant associations between exposure to tobacco promotion at the PoS and smoking initiation or susceptibility to smoking. Two experimental studies of children found statistically significant associations between exposure to PoS tobacco promotions and beliefs about ease of getting tobacco and smoking prevalence among their peers. An experimental study with adults found that a picture of collected tobacco pack elicited cravings for cigarettes among smokers. A cross-sectional study found that 25% of adult smokers reported impulse purchasing and a third of recent ex-smokers reported urges to start smoking after seeing tobacco displayed. DISCUSSION: More prospective studies are needed to clarify the temporal relationship between exposure to PoS tobacco and outcome. However, given the addictiveness of tobacco, the severity of the health hazards posed by smoking, the evidence that tobacco promotion encourages children to start smoking, and the consistency of the evidence that PoS promotion influences children's smoking, we believe that ample justification exists for banning PoS advertising and displays of smoked tobacco products.
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The powerful effects of tobacco advertising and promotion on consumer behavior are well documented, particularly among children and adolescents.
“The powerful effects of tobacco advertising and promotion on consumer behavior are well documented, particularly among children and adolescents.22,474–478”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [478]
The clear impact of advertising on tobacco-related attitudes and behaviors provides robust evidence that the absence or limitation of such influences reduces their pro-tobacco effects in youth.
“Overall, the clear impact of advertising on tobacco-related attitudes and behaviors22,474–478 provides robust evidence that the absence or limitation of such influences reduces their pro-tobacco effects in youth.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [478]
In longitudinal studies, exposure to tobacco marketing is consistently related to positive attitudes and beliefs about tobacco use, experimenting with cigarettes, and becoming a smoker, with a dose-response relation between extent of exposure to marketing and risk.
“In longitudinal studies, exposure to tobacco marketing is consistently related to positive attitudes and beliefs about tobacco use, experimenting with cigarettes, and becoming a smoker, with a dose-response relation between extent of exposure to marketing and risk.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [478]
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- Authors
- Paynter, J., & Edwards, R.
- Affiliations
- Action on Smoking and Health (GB)
- Venue
- Nicotine & Tobacco Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-01
- Volume
- 11
- Issue
- 1
- Pages
- 25-35
- ISSN
- 1462-2203 (ISSN-L)
- 1469-994X
- OpenAlex
- W2163432696
- Cited by
- 321
- References
- 39
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 7 · 2023: 14 · 2022: 19 · 2021: 18 · 2020: 25 · 2019: 28 · 2018: 23 · 2017: 25 · 2016: 36 · 2015: 28 · 2014: 21 · 2013: 18 · 2012: 11
- FWCI
- 1.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nicotine & Tobacco Research (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (acceptedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- tobacco advertising, smoking initiation, adolescent smoking, impulse buying, smoking urges, tobacco industry marketing
- MeSH terms
- Adolescent, Adolescent Behavior, Adult, Advertising, Commerce, Humans, Persuasive Communication, Photic Stimulation, Risk Factors, Smoking, Social Environment, Suggestion, United States, Tobacco Industry
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