Adolescents’ perceptions of tobacco accessibility and smoking norms and attitudes in response to the tobacco point-of-sale display ban in Scotland : results from the DISPLAY study
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Background: Scotland implemented a ban on open display of tobacco products in supermarkets in April 2013, and small shops in April 2015. This study aimed to quantify changes in perceived tobacco accessibility, smoking norms and smoking attitudes among adolescents in Scotland, following the implementation of partial and comprehensive point-of-sale (POS) tobacco display bans. Methods: From the Determining the Impact of Smoking Point of Sale Legislation Among Youth (DISPLAY) Study’s 2013–2017 annual surveys we retrieved data comprising 6202 observations on 4836 12–17-year-old adolescents from four schools. Applying generalised estimating equations, associations between time (postban: 2016–2017 vs preban:2013) and three outcomes were estimated. Outcomes were perceived commercial access to tobacco, perceived positive smoking norm (friends think it’s OK to smoke) and positive smoking attitude (you think it’s OK to smoke). Analyses were adjusted for sociodemographics, smoking status, family smoking, friend smoking and e-cigarette use. Results: Crude trends showed an increase over time in perceived accessibility, norms and attitudes. However, after adjustment for confounders, mainly e-cigarette use, we found significant declines in perceived access (OR = 0.72, 95% CI 0.57 to 0.90) and in positive smoking attitude (OR = 0.67, 95% CI = 0.49 to 0.91), but no change in perceived positive smoking norm (OR = 1.00, 95% CI 0.78 to 1.29). Current/past occasional or regular e-cigarette use was associated with higher odds of perceived access (OR = 3.12, 95% CI 2.32 to 4.21), positive norm (OR = 2.94, 95% CI 2.16 to 4.02) and positive attitude (OR = 3.38, 95% CI 2.35 to 4.87). Conclusion: Only when taking into account that the use of e-cigarettes increased in 2013–2017 did we find that the POS tobacco display ban in supermarkets and small shops in Scotland was followed by reductions in adolescents’ perceived accessibility of tobacco and positive attitudes towards smoking.
Kuipers , M , Best , C , Wilson , M , Currie , D , Ozakinci , G , Mackintosh , A-M , Stead , M , Eadie , D , MacGregor , A , Pearce , J , Amos , A & Haw , S 2019 , ' Adolescents’ perceptions of tobacco accessibility and smoking norms and attitudes in response to the tobacco point-of-sale display ban in Scotland : results from the DISPLAY study ' , Tobacco Control , vol. Online First . https://doi.org/10.1136/tobaccocontrol-2018-054702
Copyright © Author(s). Published by BMJ. This work has been made available online in accordance with the publisher’s policies. This is the author created, accepted version manuscript following peer review and may differ slightly from the final published version. The final published version of this work is available at https://doi.org/10.1136/tobaccocontrol-2018-054702
DescriptionThis project was funded by the UK National Institute for Health Research (NIHR) Public Health Research Programme, project 10/3000/07.
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