At baseline, http://www.selleckchem.com/products/Vorinostat-saha.html seven retail outlets (8%) were observed to have ST-branded decals on the counter and only one had an ST-branded floor decal (1%); at follow-up, neither counter nor floor ST-branded decals were observed. With regard to sales practices, self-service of tobacco decreased from 31% to 3% for ST products and from 12% to 7% for cigarettes after the TCA. The proportion of retail outlets selling cigars was significantly reduced after the TCA, although 85% of outlets were observed to sell these products at follow-up. Flavored cigarettes or cigars were also observed in a high proportion of retail outlets, with a significant increase to 83% at follow-up. No sales of loose cigarettes were observed at baseline or follow-up.

Discussion This investigation is the first study to examine certain changes in ST advertising and sales practices in tobacco-licensed retail outlets following the TCA. A reduction in the prevalence of ST advertisements was observed after the implementation of the TCA. Specifically, although there was no statistically significant reduction in the proportion of stores advertising ST, the frequency of exterior ads was significantly reduced in this sample of retail outlets. In the store interior, the mean number of observed ST brands doubled between baseline and follow-up. These initial findings represent a positive change in marketing exposure in tobacco-licensed retail outlets following the TCA. Yet, after the MSA, the tobacco industry demonstrated creativity and resilience in the development of new marketing strategies to reach potential consumers (Ruel et al.

, 2004), a pattern that may likely be repeated. Our results suggest that there is a high density of tobacco marketing messages that can be observed within retail outlets. The doubling of the number of ST brands being advertised after the regulation underscores the importance of ST as a growing aspect of tobacco marketing exposure and warrants continued monitoring to determine evolving trends. Future monitoring studies should evaluate the presence of flavored cigarettes, a practice banned under the TCA but not enforced until after these data were collected. Retail tobacco outlets have been associated with tobacco use behaviors and are often clustered in socially disadvantaged neighborhoods (Hyland et al., 2003; Li, Land, Zhang, Keithly, & Kelsey, 2009; Paul et al.

, 2010; Peterson, Lowe, & Reid, 2005; Yu, Peterson, Sheffer, Reid, & Schnieder, 2010); this yields additional challenges in youth prevention and adult cessation. For example, adolescent smoking prevalence has been Batimastat positively associated with retail outlet density near schools (Henriksen et al., 2008). Barriers to cessation include retail tobacco displays (Germain, McCarthy, & Wakefield, 2010; Hoek, Gifford, Pirikahu, Thomson, & Edwards, 2010) as well as living in proximity to tobacco outlets (Reitzel et al., 2011).