Tobacco companies spend the overwhelming majority of their annual marketing budget at the point of sale (POS), an area in which they have enjoyed the greatest freedom from regulation. The POS refers to any location where tobacco products are advertised, displayed, and purchased. The POS encompasses not only the final point of purchase (i.e., the register) but also indoor and outdoor advertising at retail locations, product placement, and price. Tobacco companies use the retail environment to attract and retain customers by promoting their brands, increasing the likelihood of impulse product purchases and establishing the presence of tobacco products as commonplace in everyday life. Exposure to tobacco products and price discounts at the POS encourages initiation and discourages cessation. Finding solutions to POS issues is recognized as the fifth core strategy of tobacco control programming, along with: (1) raising cigarette excise taxes, (2) establishing smoke-free policies, (3) encouraging cessation, and (4) launching hard-hitting countermarketing campaigns. Since the 2009 passage of the Family Smoking Prevention and Tobacco Control Act (FSPTCA), many states and communities are more actively considering policies in the retail environment. This report is the second in the series of case studies to highlight states and communities that are implementing innovative POS policies. The case studies are intended to provide tobacco control advocates with practical, real-world examples that may be used to inform future policy efforts. To learn about the processes, facilitators, and challenges of implementing and enforcing POS policies, we conducted in-depth interviews with key stakeholders. We also reviewed relevant literature, legal documents, and news articles. This case study focuses on prohibiting the sale of tobacco in health care institutions, including pharmacies, and highlights the 80 municipalities in Massachusetts that have successfully adopted such policies. In addition to describing Massachusetts' efforts, the study provides a short background on tobacco-free pharmacy laws, legal considerations, and impacts on public health. States and communities considering similar policies can learn from Massachusetts' experience and take away practical next steps to put an end to the practice of selling tobacco in pharmacies and other health care institutions.
Center for Public Health Systems Science, "Regulating Pharmacy Tobacco Sales: Massachusetts" (2014). Center for Public Health Systems Science. 68.