A longitudinal study of externally visible cigarette advertising on retail storefronts in Massachusetts before and after the Master Settlement Agreement.

OBJECTIVES To assess the effect of the Master Settlement Agreement (MSA) on the amount of cigarette advertisements visible from outside of over-the-counter tobacco retailers, for five specific premium brands and an "all other" category, for five types of establishments, and in three areas (windows/doors, building/other detached areas, and sidewalks); to assess the relation of total exterior retail cigarette advertising to illegal sales to youth. METHODS Observations were conducted on the number of cigarette advertisements visible from outside tobacco retail establishments in a paired convenience sample (n = 556) in Massachusetts before and after the MSA. Archival databases containing information on merchant compliance with age related sales laws during the time period were used to assess the relation of total cigarette advertising with sales to underage youth. Paired sample t tests assessed planned comparisons pre- to post-MSA; Spearman's rho tested associations for dichotomous variables. RESULTS Significant post-ban increases were observed in the prevalence of exterior cigarette advertising on gas (petrol) stations and gas mini/marts (gasoline retailers) buildings, windows, and doors. Significant declines were observed on windows of liquor stores. Winston advertising declined overall, while advertisements of the "all other" brand category increased. Correlations between advertising and illegal sales, while modest, were significant. CONCLUSIONS These pre- to post-MSA increases suggest the tobacco industry may be shifting expenditures selectively from billboard advertising to retailer exteriors more favoured by youth. Greater amount of cigarette advertising visible from outside over-the-counter tobacco retailers is associated with greater cigarette sales to minors.