Exposures and responses to point-of-sale tobacco displays and support for banning displays in Hong Kong: a population-based cross-sectional survey

Abstract

Background: Point-of-sale (POS) tobacco displays can promote smoking and purchase of tobacco in current and former smokers, but no studies have examined such effect in never smoking adults. We investigated the correlates of frequent exposure to, and responses and attitudes towards POS tobacco displays in never smokers in Hong Kong, China.

Methods: We included 1,833 never smokers aged 15+ years from two random telephone surveys in 2015 (n=932) and 2016 (n=901). All respondents reported how often they noticed POS tobacco displays in the past 30 days (often, sometimes, not noticing), whether they perceived displays as attractive, felt encouraged to smoke by them, perceived them as advertisements, and supported the banning displays. Risk ratio (RR) adjusting for socio-demographic characteristics was used to examine factors associated with often noticing the display and other responses.

Results: Young adults aged 15-29 years (vs 60+) were more likely to report often noticing POS displays (RR = 2.39, 95% CI 1.47-3.91). Those with primary education or below (vs tertiary) reported less often noticing (RR = 0.41, 95% CI 0.23-0.73), but more perceiving displays as attractive (RR = 2.52, 95% CI 1.51-4.22). Often noticing displays (vs not noticing) was associated with perceiving them as attractive (RR = 1.90, 95% CI 1.32-2.75), and being encouraged to smoke (RR = 4.05, 95% CI 0.98-16.85). Sometimes (RR = 0.89, 95% CI 0.80-0.997) or often noticing (RR=0.86, 95% CI 0.77-0.97) displays were associated with lower support for banning displays.

Conclusions: In never smokers, younger adults were more exposed to POS tobacco displays and those with low education level were more attracted by them. Frequent exposure could induce never smokers to smoke, and reduce their support for banning displays. To eliminate the advertising and normalization of POS tobacco displays in the retail environment, the ban on tobacco advertisements should include those displays simultaneously.