"It looks like an adult sweetie shop": point-of-sale tobacco display exposure and brand awareness in Scottish secondary school students

Introduction: As further restrictions have been placed on tobacco advertising and promotions, point of sale (PoS) displays of cigarettes in shops have become an increasingly important source of young people’s exposure to tobacco products. This study explored the relationship between PoS displays of cigarettes and brand awareness among secondary school students in Scotland.
Methods: Cross-sectional school surveys (n=1406) and focus groups (n=86) were conducted with S2 (13-14yrs) and S4 (15-16yrs) students in four schools of differing socioeconomic status in 2013, prior to the PoS display ban in large shops. Adjusted negative binomial regression analysis examined associations between brand awareness and exposure variables (visiting tobacco retailers, noticing displays of tobacco products).
Results: Students visiting small shops more frequently (RRR 1.19, 95% CI 1.01-1.41) and those who noticed cigarette displays in small shops (RRR 1.24 95% CI 1.03-1.51) and large supermarkets (RRR 1.15 95% CI 1.01 -1.30) had higher brand awareness. The focus groups supported these findings. Participants described PoS tobacco displays as being eye-catching, colourful and potentially attractive to young people.
Conclusions: This mixed-methods study showed that higher cigarette brand awareness was significantly associated with regularly visiting small shops and noticing PoS displays in small and large shops, even when students’ smoking status, smoking in their social networks, leisure activities and demographics were included as confounding variables. This highlights the importance of PoS displays of tobacco products in increasing brand awareness, which is known to increase youth smoking susceptibility, and thus the importance of implementing PoS display bans in all shops.