Testing Legally Feasible Options Studies 2/3

Study Overview
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Brief Summary
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The overall aim of this research is to experimentally evaluate different, legally-viable approaches to reducing the impact of the point-of-sale (POS) retail environment on adolescent tobacco use risk. This study will be investigating regulations for four classes of tobacco products (cigarettes, e-cigarettes, smokeless tobacco, little cigars/cigarillos). Study 2 and study 3 (out of 3 studies), occurring concurrently, will examine whether changing the number and content of posters on the outside doors at POS reduced adolescents' tobacco use risk.

Detailed Description
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Tobacco advertising at retail point-of-sale (POS) includes promotional allowances that permit tobacco products to be advertised and sold at reduced cost to consumers (e.g., two-for-one specials); high visibility sale and therefore placement of hundreds of tobacco products on power walls; and the display of a large, diverse collection of poster advertisements on the exterior of the stores. Adolescents are at significant risk for having repeated exposures to this tobacco rich POS environment and such exposures contribute to increases in adolescent tobacco use. Although curbing the effect of the tobacco rich POS environment on adolescent tobacco use is a critical public health goal, some POS advertising regulations are unlikely to be viable in the United States because they impinge upon the tobacco industry's commercial free speech rights. For example, eliminating the tobacco power wall is probably not a viable option in the US as it has been successfully challenged in court by the tobacco industry. POS regulations that do not violate the industry's commercial free speech rights stand a better chance of being upheld by the courts. For example, eliminating tobacco product price promotions, reducing the availability of tobacco products by restricting the sale of flavored products, and restricting how much door/window space tobacco product posters can occupy at POS, all have been implemented as feasible and legally defensible regulatory options at POS. The evidence base supporting the efficacy of these initiatives is, however, almost non-existent - leaving them open to legal scrutiny. The overall aim of this research is to experimentally evaluate different, legally-viable approaches to reducing the impact of the POS retail environment on adolescent tobacco use risk. This research will be investigating the regulations for four classes of tobacco products (cigarettes, e-cigarettes, smokeless tobacco, little cigars/cigarillos): the extent to which eliminating tobacco product price promotions (Study 2), restricting how much door/window space tobacco posters can occupy at POS (Study 3), and eliminating the sale of flavored and/or mentholated tobacco products (Study 1) reduce adolescent tobacco-use risk. Each study will evaluate for possible gender and race (African-American vs Caucasian) differences. The studies will take place in the RAND StoreLab, a life-sized replica of a convenience store that was developed to experimentally evaluate how altering aspects of tobacco promotion at POS influences tobacco use. The present record is for Study 2 and Study 3.

Official Title
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Testing Legally Feasible Options at Retail Point of Sale - Prices and Posters

Conditions
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Tobacco Use

Intervention / Treatment
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* Other: Many posters with prices
* Other: Many posters, no prices
* Other: Fewer posters, no price restrictions


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ages 18-20, in college - Exclusion Criteria: any medical or psychiatric condition which would make compliance with the study protocol difficult (based on parent report). Previous participation in a previous StoreLab study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Status Quo<br>This condition will allow for many posters with pricing information to be displayed. | Other: Many posters with prices<br>* No poster number or price restrictions<br>|
| Experimental: Reduced Poster<br>This condition will allow for a reduced number of posters with pricing information to be displayed. | Other: Fewer posters, no price restrictions<br>* Poster number restrictions, but no price restrictions<br>|
| Experimental: No price<br>This condition will allow for many posters with no pricing information to be displayed. | Other: Many posters, no prices<br>* No poster number restrictions, but price restrictions<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-reported cigarette smoking risk after shopping in the StoreLab | Respondents answer the following items: Do you think you will try a cigarette anytime soon?, Do you think you will try a cigarette anytime in the next year?; and If one of your best friends offered you a cigarette, would you smoke it?. Responses are made on a 1 (Definitely not) to 4 (Definitely yes) scale and summed to produce a total smoking risk scale score (range from 3 - 12). Higher scores reflect greater risk. | There is one visit in this research: This variable is assessed at that visit, immediately after the experimental manipulation | 
| Self-reported vaping/ENDDS risk of use | Respondents answer the following items: Do you think you will try a vaping product anytime soon?, Do you think you will try a vaping product anytime in the next year?; and If one of your best friends offered you a vaping product, would you use it?. Responses are made on a 1 (Definitely not) to 4 (Definitely yes) scale and summed to produce a total vaping risk scale score (range from 3 - 12). Higher scores reflect greater risk. | There is one visit in this research: This variable is assessed at that visit, immediately after the experimental manipulation | 
| Self-reported smokeless tobacco use risk | Respondents answer the following items: Do you think you will use smokeless tobacco anytime soon?, Do you think you will try smokeless tobacco anytime in the next year?; and If one of your best friends offered you smokeless tobacco, would you use it?. Responses are made on a 1 (Definitely not) to 4 (Definitely yes) scale and summed to produce a total smokeless tobacco risk scale score (range from 3 - 12). Higher scores reflect greater risk. | There is one visit in this research: This variable is assessed at that visit, immediately after the experimental manipulation | 
| Self-reported cigarillo use risk | Respondents answer the following items: Do you think you will try a cigarillo anytime soon?, Do you think you will try a cigarillo anytime in the next year?; and If one of your best friends offered you a cigarillo, would you smoke it?. Responses are made on a 1 (Definitely not) to 4 (Definitely yes) scale and summed to produce a total cigarillo risk scale score (range from 3 - 12). Higher scores reflect greater risk. | There is one visit in this research: This variable is assessed at that visit, immediately after the experimental manipulation |