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Objectives. We assessed the short-term ability to increase retail prices of the first US 1-cent-per-ounce excise tax on the distribution of sugar-sweetened beverages (SSBs), which was implemented in March 2015 by Berkeley, California. Methods. In 2014 and 2015, we examined pre- to posttax price changes of SSBs and non-SSBs in a variety of retailers in Berkeley and in the comparison cities Oakland and San Francisco, California. We examined price changes by beverage, brand, size, and retailer type. Results. For smaller beverages (≤ 33.8 oz), price increases (cents/oz) in Berkeley relative to those in comparison cities were 0.69 (95% confidence interval [CI] = 0.36, 1.03) for soda, 0.47 (95% CI = 0.08, 0.87) for fruit-flavored beverages, and 0.47 (95% CI = 0.25, 0.69) for SSBs overall. For 2-liter bottles and multipacks of soda, relative price increases were 0.46 (95% CI = 0.03, 0.89) and 0.49 (95% CI = 0.21, 0.77). We observed no relative price increases for nontaxed beverages overall. Conclusions. Approximately 3 months after the tax was implemented, SSB retail prices increased more in Berkeley than in nearby cities, marking a step in the causal pathway between the tax and reduced SSB consumption.

IntroductionDollar stores are rapidly altering the retail landscape for tobacco. Two of the three largest chains sell tobacco products in more than 24 000 stores across the USA. We sought to examine whether dollar stores are more likely to be located in disadvantaged neighbourhoods and whether dollar stores charge less for cigarettes than other tobacco retailers.MethodsData were collected from a statewide random sample of licensed tobacco retailers in California (n=7678) in 2019. Logistic regression modelled odds of a census tract containing at least one dollar store as a function of tract demographics. Linear mixed models compared price of the cheapest cigarette pack by store type, controlling for tract demographics.ResultsCensus tracts with lower median household income, rural status and higher proportions of school-age youth were more likely to contain at least one dollar store. The cheapest cigarette pack cost less in dollar stores compared with all store types examined except tobacco shops. Estimated price differences ranged from $0.32 (95% CI: 0.14 to 0.51) more in liquor stores and $0.39 (95% CI: 0.22 to 0.57) more in convenience stores, to $0.82 (95% CI: 0.64 to 1.01) more in small markets and $1.86 (95% CI: 1.61 to 2.11) more in stores classified as ‘other’.ConclusionsDollar stores may exacerbate smoking-related inequities by contributing to the availability of cheaper cigarettes in neighbourhoods that are lower income, rural and have greater proportions of youth. Pro-equity retail policies, such as minimum price laws and density reduction policies, could mitigate the health consequences of dollar stores’ rapid expansion.

BackgroundReducing the provision of tobacco is important for decreasing inequalities in smoking and smoking-related harm. Various policies have been proposed to achieve this, but their impacts—particularly on equity—are often unknown. Here, using national-level data, we simulate the impacts of potential policies designed to reduce tobacco outlet density (TOD).MethodsTobacco retailer locations (n=9030) were geocoded from Scotland’s national register, forming a baseline. Twelve policies were developed in three types: (1) regulating type of retailer selling tobacco, (2) regulating location of tobacco sales, and (3) area-based TOD caps. Density reduction was measured as mean percentage reduction in TOD across data zones and number of retailers nationally. Equity impact was measured using regression-based Relative Index of Inequality (RII) across income deprivation quintiles.ResultsPolicies restricting tobacco sales to a single outlet type (‘Supermarket’; ‘Liquor store’; ‘Pharmacy’) caused >80% TOD reduction and >90% reduction in the number of tobacco outlets nationally. However, RIIs indicated that two of these policies (‘Liquor store’, ‘Pharmacy’) increased socioeconomic inequalities in TOD. Equity-promoting policies included ‘Minimum spacing’ and exclusion zones around ‘Child spaces’. The only policy to remove statistically significant TOD inequalities was the one deliberately targeted to do so (‘Reduce clusters’).ConclusionsUsing spatial simulations, we show that all selected policies reduced provision of tobacco retailing to varying degrees. However, the most ‘successful’ at doing so also increased inequalities. Consequently, policy-makers should consider how the methods by which tobacco retail density is reduced, and success measured, align with policy aims.

BackgroundOn 1 January 2021, Beverly Hills and Manhattan Beach, California, became the first cities in the USA to ban tobacco product sales. We evaluated the effects of these policies on the sale of tobacco products and non-tobacco products by store in each city and its neighbouring area.MethodsWe used custom NielsenIQ retail scanner data by product and store to estimate actual and counterfactual sales trends for a set of convenience, grocery and drug stores in Beverly Hills and Manhattan Beach and their border areas using synthetic difference-in-differences models. Tobacco product unit sales were estimated overall and by tobacco product category. We also estimated changes in dollar sales of total non-tobacco products to evaluate broader economic impacts.ResultsTobacco sales in included stores ceased within 3 months of the policy going into effect in Beverly Hills and nearly ceased by December 2021 in Manhattan Beach. A shift in cross-border shopping was detected for cigars only. Non-tobacco product sales did not significantly change in either city or the border area.ConclusionThe tobacco sales bans in Beverly Hills and Manhattan Beach nearly eliminated local tobacco sales in the included stores, without prompting substantial cross-border shopping. Stability of non-tobacco product sales for included stores suggests these policies did not adversely affect local retail economies. These results suggest the viability of tobacco sales bans as an effective tobacco control strategy.

Objectives. To examine how much sugar-sweetened beverage (SSB) excise taxes increased SSB retail prices in Oakland and San Francisco, California. Methods. We collected pretax (April–May 2017) and posttax (April–May 2018) retail prices of SSBs and non-SSBs from 155 stores in Oakland, San Francisco, and comparison cities. We analyzed data using difference-in-differences high-dimensional fixed-effects regressions, weighted by regional beverage sales. Results. Across all beverage sizes, the weighted average price of SSBs increased by 0.92 cents per ounce (95% confidence interval [CI] = 0.28, 1.56) in Oakland and 1.00 cents per ounce (95% CI = 0.35, 1.65) in San Francisco, compared with prices in untaxed cities. The tax did not significantly alter prices of water, 100% juice, or milk of any size examined. Diet soda only, among non-SSBs, exhibited a higher price increase for some sizes in taxed cities. Conclusions. Within 4 to 10 months of implementation, Oakland’s and San Francisco’s SSB excise taxes significantly increased SSB retail prices by approximately the amount of the taxes, a key mechanism for reducing consumption.

Some of the staff frowned on this, said that she had been given an apartment with a private bathroom, a kitchenette, dishes, television, a bed and bedding, all more or less for free, and that she did not appreciate it, choosing instead to sleep in the common area or to wander the halls, or even stay in the streets sometimes. On the table by the window were a hairbrush, empty cigarette packs, dirty and clean cups, and little plastic containers that her methadone doses came in, her least favourite of all the available substances and saved for the absolute worst-case scenario when nothing else could be found. [...]I would think of our own junkyard, the sidewalks of Vancouver's Downtown Eastside that were waiting right behind our walls. Even if he did not get along with another client, he would come to a staff member and discuss the situation respectfully and without getting angry. Because of the nature of my position, I often didn't know a client's whole story, just the bits and pieces they told me, and I didn't know Jim's either, only that he had survived decades of homelessness while remaining stylish and cheerful.

The physical location of liquor stores near schools can strongly influence the chances of youth accessing and consuming alcohol(1). As children transit to and from school, it is feasible that the presence of liquor stores near schools could also increase their exposure to alcohol advertising. Cumulative exposure to advertising influences alcohol attitudes, intentions and alcohol use(2), so reducing children’s exposure to alcohol advertising is important to delay the initiation of drinking and reduce future harms. As this has not yet been investigated in Australia, the aim of this study was to investigate whether the presence of a liquor store near a school was associated with an increased prevalence of outdoor alcohol advertising in Perth, Western Australia. We identified all outdoor alcohol advertising within a 500m radius (audit zone) of 64 randomly selected primary and secondary schools from low and high socio-economic areas across metropolitan Perth. We recorded the size, type, setting, and location of each advertisement during field data collection. Each zone was categorised by the presence or absence of at least one liquor store within the school audit zone, and results compared across these stratifications. Over half (56%) of the 64 school audit zones had at least one alcohol advertisement. On average, there were 5.9 alcohol advertisements per zone. School audit zones that contained a liquor store (59%) had over thirty times the average number of alcohol advertisements compared with audit zones that did not contain a liquor store (9.7 vs 0.3). The majority of all the alcohol advertisements identified (63%) were located outside a liquor outlet as opposed to other food businesses (2%), along the roadside (31%), on a bus shelter (3%) or on/outside another business (0.5%). Our findings that Perth schools with a liquor store nearby had more outdoor alcohol advertising within a 500m radius, compared with schools without a nearby liquor store, were independent of school type (primary or secondary) or the socio-economic status of the area. This poses significant concerns about the exposure of underage populations to outdoor alcohol advertising, and the resultant influence on alcohol use. These results underscore the necessity for policy interventions to mitigate children’s exposure to alcohol marketing, especially during the daily school commute, by regulating the location of liquor stores and alcohol promotion near schools. It will be important to incorporate the voices of children when developing future policies to assert their right to be consulted, heard and appropriately influence their environments.

BackgroundTransitioning tobacco sales (TTSs) to state-controlled stores would reduce tobacco retailer density, making tobacco less accessible while also providing infrastructure to support retailer licensing, raise prices and restrict marketing. Using 10 US states with an alcohol retail monopoly as an example, this study estimated population average increases in driving time associated with implementing TTS, reporting changes overall and by race, ethnicity and poverty status.MethodsThis cross-sectional study combined 2020 licensing data, business records and American Community Survey 5-year estimates. Network (road-based) driving times to the nearest tobacco retailer were calculated at the census tract level for the status quo (existing tobacco retailers) and TTS counterfactual (state alcohol stores) in 2020. Travel times were weighted by subpopulations to assess equity reach of decreases in tobacco retailer accessibility.ResultsOn average, TTS would more than double travel times to the nearest tobacco retailer, resulting in a mean 119% increase in driving time (range: 30%–232%). The average per cent increase in travel time was slightly greater for black (127%) and Hispanic or Latino people (126%) than for white people (117%), and travel times increased more for black and/or Hispanic or Latino people in all states except Alabama, New Hampshire and Utah. There were larger increases in travel time for persons with incomes below the federal poverty line (vs above) in 7 of the 10 states.ConclusionsThe TTS policy would make tobacco less accessible and reduce racial, ethnic and socioeconomic disparities in tobacco retail accessibility in most of the states examined.

ObjectiveThis study aimed to evaluate the effectiveness of flavoured tobacco product restriction policies in reducing availability of flavoured products in Massachusetts communities.MethodsData were obtained from surveys of tobacco retailers conducted from July 2015 to March 2017. On a community level, flavoured product availability was defined as the per cent of retailers during a given 3-month quarter that sold flavoured cigars/cigarillos, electronic cigarettes and/or e-liquids. Communities that implemented the policy during the study period were grouped into wave 1 (n=18; 1481 retail surveys) and wave 2 (n=20; 483 retail surveys) by date of policy implementation; communities without a flavoured product restriction served as the control group (n=234; 4932 retail surveys). A difference-in-difference analysis was used to compare the change in flavoured product availability in wave 1 and wave 2 communities 3 months pre-policy and post-policy implementation to the change over the same time periods in the control group.ResultsFrom pre-policy to post-policy implementation period, communities in both waves experienced significant reductions in flavoured product availability (ranging from 27.2% to 50.9%), even after adjusting for community-level characteristics. In both waves 1 and 2, reductions in flavoured product availability were significantly greater compared with comparison communities during the same time frame, adjusting for community-level characteristics.ConclusionsCompliance with flavoured product restriction policies is high among tobacco retailers throughout Massachusetts, regardless of community demographic and retail characteristics. Reduced availability of flavoured tobacco in the retail environment has the potential to reduce youth exposure, access and use of these products.