Influence of point-of-sale tobacco displays and graphic health warning signs on adults: evidence from a virtual store experimental study

Am J Public Health. 2014 May;104(5):888-95. doi: 10.2105/AJPH.2013.301723. Epub 2014 Mar 13.


Objectives: We tested the impact of banning tobacco displays and posting graphic health warning signs at the point of sale (POS).

Methods: We designed 3 variations of the tobacco product display (open, enclosed [not visible], enclosed with pro-tobacco ads) and 2 variations of the warning sign (present vs absent) with virtual store software. In December 2011 and January 2012, we randomized a national convenience sample of 1216 adult smokers and recent quitters to 1 of 6 store conditions and gave them a shopping task. We tested for the main effects of the enclosed display, the sign, and their interaction on urge to smoke and tobacco purchase attempts.

Results: The enclosed display significantly lowered current smokers' (B = -7.05; 95% confidence interval [CI] = -13.20, -0.91; P < .05) and recent quitters' (Β = -6.00, 95% CI = -11.00, -1.00; P < .01) urge to smoke and current smokers' purchase attempts (adjusted odds ratio = 0.06; 95% CI = 0.03, 0.11; P < .01). The warning sign had no significant main effect on study outcomes or interaction with enclosed display.

Conclusions: These data show that POS tobacco displays influence purchase behavior. Banning them may reduce cues to smoke and unplanned tobacco purchases.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Advertising / methods*
  • Commerce*
  • Computer Simulation
  • Female
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Smoking / psychology*
  • Tobacco Products*
  • United States
  • User-Computer Interface
  • Young Adult