With the introduction of new preemption bills during the pandemic and existing preempted states, tobacco point-of-sale related preemption presents a challenge to policy action and local control. This webinar equipped attendees with information on the basis of preemption using a legal perspective, provided ways of how to respond to preemption, and gave examples of fighting back such as with local-level community engagement.

The speakers for this webinar also talked about how preemption operates using the newly-released Tobacco POS Preemption Playbook and gave insights from a state and local level of ways to navigate it. If you are interested in learning more about preemption from a tobacco point-of-sale perspective and want to hear from a preempted state, you can view the recording below.

Speakers:

• Sara Bartel, Senior Attorney, ChangeLab Solutions
• Nancy Cripe, Director/Coalition Coordinator, Tobacco Free Allen County (Indiana)
• Brandy Paul, Tobacco Epidemiologist, Indiana Department of Health – Tobacco Prevention and Cessation Commission (IDOH-TPC)

Download the slides here and view the recording below:

Our guest speaker was Dr. Pamela Trangenstein, PhD, Assistant Professor, Department of Health Behavior, UNC-Chapel Hill Gillings School of Global Public Health; and a leading alcohol researcher.

The advertising and selling of alcohol products at alcohol outlets (e.g., restaurants, bars/taverns, liquor stores etc.) has been associated with negative outcomes like violent crime. Research from areas such as Baltimore, MD, has shown that a reduction in alcohol outlets and advertisements can lead to a decrease in violent crime and improve communities.

During the webinar, Dr. Trangenstein discussed how to identify alcohol outlets, what the research shows, and key policy solutions.

Below are some materials from the webinar.

View the recording:

Slide deck – Alcohol at the POST – Places, Promotions, and Problems (PDF)

Research articles

Alcohol Advertising and Violence (PDF)

Alcohol Outlet Clusters and Population Disparities (PDF)

Outlet Type, Access to Alcohol, and Violent Crime (PDF)

The Violence Prevention Potential of Reducing Alcohol Outlet Access in Baltimore, Maryland (PDF)

Webinar Questions

Written Answers from Dr. Trangenstein

Our community health assessment cycle is coming up. What are some examples of language you would recommend avoiding to reduce stigma?

Re: language to avoid

• Terms like “high-poverty areas,” “high-crime areas,” “crime-ridden” can be stigmatizing, and so can rank ordering the neighborhoods with the fewest amenities. They still have some resources/amenities, but just fewer than other areas.
• I also try to catch myself when I am using the word “disparities” too much, because it means I am focusing on the problem and I’m not focusing on equity/liberation (the solution).
• I also avoid terms like “minority,” because it is imprecise and can refer to both numbers (e.g., who has the greater percentage) or power (e.g., are Black people a majority in Baltimore?). Instead, I elect to use more precise racial terms.
• For those of us who work with data, reference the Broward Co., FL data sheet they distribute to people who use their public data to provide historical context of where the data were generated. This is a great tool to situate data within history because data are not neutral.

Does the data of the increase of violence in clusters include underage drinking?

Re: clusters and underage drinking

I haven’t seen much associating clustering with underage drinking, but there is literature that examines associations with alcohol outlet density.

• This is one of the most rigorous analyses I know of: Rowland, B., Evans-Whipp, T., Hemphill, S., Leung, R., Livingston, M., & Toumbourou, J. W. (2016). The density of alcohol outlets and adolescent alcohol consumption: An Australian longitudinal analysis. Health & Place, 37, 43-49.
• Deb Furr-Holden has also done some interesting work around youth exposure to tobacco, alcohol, and other drugs if they have an outlet on their walk to school, e.g., Milam, A. J., Furr-Holden, C. D. M., Cooley-Strickland, M. C., Bradshaw, C. P., & Leaf, P. J. (2014). Risk for exposure to alcohol, tobacco, and other drugs on the route to and from school: the role of alcohol outlets. Prevention Science, 15(1), 12-21.

Are you anticipating many of the alcohol “special” exceptions during covid restrictions going back or becoming the norm? Oregon just approved cocktails to go.

Re: To-go sales vs. home delivery

I will note: I mentioned that we were less concerned with to-go sales than home delivery and online sales. That doesn’t mean that to-go sales are not alarming, because it turns bars and restaurants into off-premise outlets, which we saw today had more harms. The most concerning are states allowing bars and restaurants to sell cocktails to-go, especially those allowing bartenders to seal those cocktails on site. Undercover buys by coalitions have found this has included anything from a mason jar lid to a doily on top of a plastic cup. Once a customer carries their drink out of an outlet, this then violates open container rules for traffic safety, and NHTSA just ruled that Iowa’s to-go policy was in violation (I don’t know if it reviewed other states’ rules). I’d urge you to try to track these bills as they move through your legislature.

Public health advocates are increasingly focused on interventions that address social drivers of health. With produce prescriptions, healthcare providers address food security in the healthcare setting by connecting their patients with prescriptions for healthy fruits and vegetables. Reinvestment Partners manages several produce prescription programs across North Carolina and partners with Food Lion (a grocery chain) to provide access to fruits and vegetables. These programs are non-medical interventions that improve health, and they hold the potential to effect systems change in healthcare.

The webinar speakers were Neal Curran, Director of Food Programs at Reinvestment Partners and Sam Hoeffler, Food Programs Manager at Reinvestment Partners. Learn more about their work at ReinvestmentPartners.org.

During this webinar, the speakers discussed what produce prescriptions are, how they can improve population health, and the role they can play in altering the way we provide healthcare in the United States.

This webinar is over, but you can view the recording below. You can also download the slides from the webinar along with Massachusetts’ helpful “Food is Medicine” plan that was referenced during the webinar. 

Below is a video by Reinvestment Partners on their produce prescription process for enrollees.

The webinar was Tuesday, September 22nd from 2-3pm EST. Thank you to everyone who joined us!

Despite evidence of disparities in exposure to tobacco retailers and point-of-sale advertising, little is known about the extent to which tobacco advertisements within African American communities use three prominent messaging strategies: reassure use is safe despite health risks, redirect attention from health risks to other product features, or incite bravery to use despite health risks.

Using a multi-stage design, this study used Counter Tools’ Store Mapper to identify retailers, then assessed tobacco ad messages at retail stores in predominately African American communities in North Carolina. Findings suggest messaging strategies differ across product types. Cigarette and non-large cigar advertisement messages may prey upon African American communities by redirecting focus from harmful product effects toward favorable product attributes. Additionally, reassurance messaging may misconstrue risks associated with e-cigarettes.

Countering misleading messages and advocating policies regarding advertisement content and density within African American communities could help reduce health disparities.

Dr. Rosario is an associate professor at the University of North Carolina Greensboro, where she also serves as Associate Chair of the Department of Public Health Education. Her primary research interests are to advance place-based public health and impact social determinants of tobacco-related health disparities. Dr. Rosario’s research and practice are guided by principles of social justice and health equity in tobacco prevention and control.

The webinar is Wednesday, May 27th, 2020 | 1:00PM EST

Edit: View the webinar recording below and download the slides here.

Speakers Lindsay Kephart and Melody Kingsley will give an overview of Massachusetts’s statewide and local-level flavor policies, policy evaluation results based on published journal articles, and some key takeaways from their state’s experience.

The webinar is Wednesday, February 26th, 2020 | 1:00PM EST

Edit: View the recording of the webinar below!