The Central Vermont New Directions Coalition has been providing substance misuse education in Washington County since 1998. For more than 20 years, we have educated youth, community members and policymakers about things that can help people make healthy choices about substances like tobacco, alcohol and other drugs. The retail environment has a big role to play in preventing substance misuse.
In the winter of 2017-18, Central Vermont New Directions Coalition and the Barre District Office of Local Health conducted audits of every store in Washington County that sells tobacco and/or alcohol. We were checking for conditions that make tobacco and alcohol more appealing to children who come into the store.
Most of the stores that sell alcohol and tobacco sell other things. Convenience stores, pharmacies, gas stations, general stores, grocery stores, chain stores, co-ops and mass merchandisers all may sell tobacco and/or alcohol. Kids frequent such stores, with and without their parents.
Why are we concerned?
Research shows that the marketing, placement, flavoring and promotion of alcohol and tobacco products influence youth use. The more youth see advertisements and products, the more likely they are to try them. On an audit, we look to see what is available in that store; we check if products are at kid-level or near kid-friendly products such as candy or toys; we look for price promotions; and we check for fancy flavors that only a kid could love, like bubble gum or doughnuts. (Fun fact: There are as many as 15,000 flavors in tobacco products.) With alcohol, we look for advertising, pricing, placement, alcopops and supersized beers.
Our audit: Washington County had 89 stores that sold tobacco and/or alcohol: 12% of them had a pharmacy counter; 16 were within 1,000 feet of a school; 25 percent of schools in Washington County are near (within 100 feet of) a retailer that sells tobacco and/or alcohol; 72% of retailers were within 500 feet of another retailer, which is one definition of “density.” Another way to look at density: Washington County has 1.5 retailers per 1,000 people, which is high.
Here are some retail risk factors we uncovered:
Proximity to schools: Schools with a higher number of tobacco retailers within walking distance have higher rates of youth smokers. Stores near schools increase youth access to tobacco products and youth experimentation with tobacco use.
Product placement: Exposure to in-store marketing is linked to tobacco use initiation, increasing the odds of someone ever smoking. These include products near candy, within 3 feet of the floor, ads near the floor, self-service displays and outdoor ads.
Price sensitivity: Cheaper prices, discounts, coupons and single-serve options appeal to youth, such as buying one cigarillo for less than a dollar instead of a pack of cigarettes costing $8-10 or more.
Flavors: Flavored products appeal to youth. The only flavor legally allowed in cigarettes is menthol, but a rainbow of flavors is available in cigars, cigarillos, chew and especially in Juuls, vapes or e-cigarettes. Sweet alcoholic beverages, like alcopops and lemonade, appeal to teens.
Advertising: Advertising on store windows, shelves, coolers, banners or signs in parking lots or on sidewalks call attention to the products. Advertising often increases nearer to schools. You cannot ban advertising based on content, but you can restrict the amount of window space allotted to advertising, or prohibit certain kinds of advertising like illuminated signs or sandwich boards.
Outlet density: Many small towns have just one store that sells alcohol and tobacco. But in other places, there may be several outlets on each block. Density increases exposure to alcohol and tobacco and normalizes their presence.
Why are we concerned in Washington County? Because our data shows that we have problems with youth substance use. Youth who begin using tobacco and alcohol in their teens are at higher risk for misusing these substance — and other, illegal substances — later on. In the six high schools in the county, trends show recent increases in alcohol use and binge drinking. The most-used substance is marijuana — something to think about when considering a retail system for cannabis.
What can we do? There are ways to limit the risks of point of sale practices. Limit inside and outside ads. Restrict where products are placed — not near the floor, candy or toys. Restrict displays. Stop selling in stores with pharmacy counters. Towns can use zoning or ordinance to limit outlet density, hours of operation or location (not near schools or child care facilities). The state can restrict flavored products or change the age of purchase — Tobacco 21 is certainly a step in the right direction.
Virginia Burley is Central Vermont New Directions Coalition prevention educator.