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

Introduction:
This text is a summary of a research article examining the impact of a ban on point-of-sale (POS) tobacco displays in Scotland on adolescents' perceptions of tobacco accessibility, smoking norms, and attitudes. The study uses data from the Determining the Impact of Smoking Point of Sale Legislation Among Youth (DISPLAY) Study and aims to answer three research questions regarding the trends in these outcomes before and after the implementation of the ban.

Key Points:

* The study uses data from the DISPLAY Study, which includes annual surveys of Scottish adolescents in four secondary schools from 2013-2017.
* The researchers selected all second-year and fourth-year students who were represented in all survey years and had complete data on the variables used in the analysis.
* The study measures time as the survey year (2013-2017) and segments it into three time periods: pre-ban (2013), mid-ban (2014-2015), and post-ban (2016-2017).
* The outcome variables include self-reported perceived tobacco accessibility, smoking norm, and smoking attitude.
* The study also measures shop visit frequency and includes covariates such as age, gender, ethnicity, school year, Family Affluence Scale, smoking status, family smoking, friends' smoking, and e-cigarette use.
* The researchers used generalized estimating equations (GEE) analyses with a binomial distribution, logit link function, exchangeable correlation, and robust standard errors.
* The study found that after controlling for all covariates, the implementation of partial and comprehensive POS display bans was followed by a decrease in perceived tobacco accessibility and a more negative attitude towards smoking.
* The study also found that adolescents who more frequently visited small shops showed the largest reductions in perceived accessibility, but there was no variation in changes in smoking norms and attitudes by shop visit frequency.

Main Message:
The main message of this study is that the implementation of POS display bans in Scotland was followed by a decrease in perceived tobacco accessibility and a more negative attitude towards smoking among adolescents. However, smoking norms did not significantly change when fully adjusted. The study also highlights the importance of taking into account confounding factors such as e-cigarette use, which was found to be positively associated with perceived accessibility, smoking norm, and smoking attitude. Overall, the study suggests that POS display bans can be an effective tool for reducing tobacco accessibility and promoting negative attitudes towards smoking among adolescents.

Kuipers, Mirte Ag, Catherine Best, Michael Wilson, Dorothy Currie, Gozde Ozakinci, Anne-Marie MacKintosh, Martine Stead, et al. “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, May 3, 2019, tobaccocontrol-2018-054702. https://doi.org/10.1136/tobaccocontrol-2018-054702.