Retail Tobacco Marketing in Rural Versus Nonrural Counties: Product Availability, Discounts, and Prices. Issue 1 (January 2020)

• Record Type: Journal Article
• Authors: Henriksen, Lisa; Schleicher, Nina C.; Johnson, Trent O.; Roeseler, April; Zhu, Shu-Hong
• Other Names: Spinner Jovonni R. guest-editor.; Araojo Richardae guest-editor.
• Is Part Of: Health promotion practice. Volume 21:Issue 1(2020)Supplement
• Page Start: 27S
• Page End: 36S
• Publication Date: 2020-01
• Subjects: tobacco prevention and control -- rural health -- health research -- social determinants of health -- health disparities -- marketing mix -- social marketing -- health communication; Health promotion -- Periodicals; Health promotion -- United States -- Periodicals; Health education -- Periodicals; Health education -- United States -- Periodicals; 613
• DOI: 10.1177/1524839919888652
• Languages: English
• ISSNs: 1524-8399

Abstract

Objectives . To assess tobacco product availability, advertised discounts, and prices in rural and nonrural stores, comparing results for two definitions of rural. Method. This geospatial study linked data from marketing surveillance in a representative sample of licensed tobacco retailers in California ( n = 1, 276) and categorized rural/nonrural stores at the county and tract levels. Data were collected from January to March, 2017, and mixed-models analyses tested for differences by location (rural vs. nonrural). Results. Compared to nonrural stores, rural-county stores were 2.1 (95% confidence interval [CI; 1.2, 3.6]) times more likely to sell chewing tobacco and 2.5 (95% CI [1.4, 4.2]) times more likely to sell roll-your-own. Rural-county stores sold larger packs of cigarillos for less than $1 (coefficient = 0.22, 95% CI [0.05, 0.39]) and charged less for the cheapest cigarette pack regardless of brand (estimated mean difference = $−0.21, 95% CI [−0.39, −0.03]). Contrary to expectation, a popular brand of chewing tobacco cost more in rural-county stores. A tract-level definition of rural reclassified only 1 in 10 stores, and did not substantially alter the results. Overall, 32.9% of stores advertised discounts on chewing tobacco, but this was more common in rural than nonrural census tracts (adjusted odds ratio = 1.81, 95% CI [1.14, 2.88]). Discussion. Evidence that $1 buys more cigarillos in rural-county stores than elsewhere adds to health equity concerns that the prevalence of cheap, flavored tobacco is not limited to neighborhoods characterized by socioeconomic disadvantage, higher proportions of African Americans, and higher proportions of school-age youth. Policies that focus on the retail environment for tobacco are needed to make tobacco less attractive and more costly everywhere, including rural areas.