BEHIND THE POINT OF SALE: A CASE STUDY OF CHICAGO’S MENTHOL CIGARETTE SALES BAN FROM THE PERSPECTIVE OF THE RETAIL STORE

tobacco;public health agencies;retail;menthol;implementation;Public Health Studies

Czaplicki, Lauren MRutkow, Lainie ;

Johns Hopkins University

关键词: tobacco;    public health agencies;    retail;    menthol;    implementation;    Public Health Studies;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/60064/CZAPLICKI-DISSERTATION-2018.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

BACKGROUND Menthol cigarette use in the United States has remained stable or increased across demographic groups. Menthol cigarettes are associated with greater likelihood of initiation and decreased likelihood of cessation. In 2009, the Family Smoking Prevention and Tobacco Control Act banned the sale of cigarettes with a characterizing flavor but excluded menthol. Without national regulation, local retail policies have become a pathway to regulate access and reduce associated health disparities. Chicago, IL was the first major American city to ban the sale of menthol cigarettes as part of its partial ban on flavored tobacco sales in stores within 500 feet of high schools.This dissertation explored compliance with Chicago’s ban on menthol cigarette sales and explored the implementation experience from the point of view of retailers, including how this key group of implementation actors navigated the implementation process and framed the purpose and intended effect of Chicago’s partial ban. METHODSThis dissertation used a multi-method approach. First, a quantitative study was conducted to assess compliance with Chicago’s ban on menthol cigarette sales within a sample of 100 of 154 stores within 500 feet of a high school.Compliance was determined by whether a menthol cigarette pack was purchased and multivariable logistic regression modeled compliance by store type, school, and neighborhood-level factors. Next, semi-structured interviews were conducted with retailers in 31 stores not included in the compliance assessment. An inductive approach to disassembling and reassembling the data was used to develop the codebook and code data. Coded transcripts were compared to identify patterns and major themes. RESULTS: Overall, the rate of compliance with Chicago’s partial menthol cigarette sales ban was 57% (weighted, n=53). Gas stations had 81% lower odds (OR=0.19, 95%CI:0.06-0.58) of complying with the menthol cigarette ban compared to larger/chain stores (e.g. liquor stores, grocery stores). Interviews found that retailers in smaller convenience stores and gas stations were concerned over perceived profit losses and the loss of their ;;one stop shop” appeal. Stores managed these concerns by changing products offered, appealing whether the ban affected their store, or not complying with the ban on menthol cigarette sales. Generally, retailers saw the government as their main source of information about the ban and the threat of a fine was a motivating factor to comply. However, many felt that enforcement visits were invasive and a mechanism to make money for the city. Many also felt that the government’s communication about the ban and existing guidelines on what was considered a flavored tobacco product was one-sided and ambiguous, sometime leading to non-compliance. Finally, retailers largely framed Chicago’s partial ban as an effort to protect kids but felt it was redundant with the existing minimum age of sale rule. Many challenged whether the 500 feet buffer zone changed access to menthol cigarettes and suggested that there were more equitable approaches to prevent access, such as a comprehensive, city-wide ban.DISCUSSION: Results from the compliance assessment and interview studies suggest that a partial ban on menthol cigarette sales is a less preferred policy option for local jurisdiction. The compliance rate with a partial menthol cigarette sales ban was poor and interviews with retailers suggest that a partial ban may disproportionately impact the financial viability of affected retail stores while making limited gains in reducing access to menthol cigarettes, which were still widely available in affected stores and unaffected stores beyond 500 feet of high schools.Findings from this study suggest that local policymakers should actively engage retailers in the design and implementation of menthol cigarette bans and other tobacco control regulatory efforts. This active partnership can incorporate the unique perspective of retailers as implementation actors into the design of ordinances, capitalize on their potential support for comprehensive efforts, and enhance compliance by addressing retailers’ implementation needs.