An initiative focused on partnering with retailers to decrease the influence of tobacco, alcohol and lottery marketing is showing promise and could present a more effective way to protect public health throughout the country, according to researchers at The Ohio State University.
The program, called Retailers Creating a Responsible Environment (Retailers CARE) , launched in Montgomery County, Ohio, and may be the first effort in the nation to incentivize retailers to voluntarily reduce promotion of tobacco, alcohol and lottery products, said lead researcher Megan Roberts , associate professor at Ohio State’s College of Public Health.
Rather than focusing only on enforcement and penalties, Retailers CARE treats store owners as community partners. Participating retailers can earn financial incentives by meeting progressively stricter standards aimed at reducing youth access and limiting aggressive advertising.
A new paper outlining the program’s successful implementation appears in the American Journal of Public Health .
“It’s really a novel approach and it could inspire other communities to get creative about ways to incentivize compliance,” said Roberts, who is a member of Ohio State’s Center for Tobacco Research and The Ohio State University Comprehensive Cancer Center.
Public health experts have long viewed convenience stores and carryouts as a major source of exposure to unhealthy products, especially in historically marginalized neighborhoods where stores that sell tobacco products, alcohol and lottery tickets are often concentrated.
“The tobacco industry alone spends about $6 billion annually on point-of-sale advertising and promotions designed to drive sales,” Roberts said.
“Historically, most enforcement, especially around underage sales, has used the ‘stick’ method, punishing retailers for breaking the law. This community-driven project is based on a ‘carrot’ approach, encouraging the retailers to be partners in public health efforts.”
The program includes four levels — bronze, silver, gold and platinum — with rewards ranging from $2,700 to $7,200 for store improvements. To qualify, retailers adopt measures such as removing storefront advertisements, locking tobacco products behind counters, restricting alcohol sales hours, implementing drug-free workplace policies and keeping naloxone kits on site.
The pilot phase ran from fall 2023 through fall 2024 and identified 28 retailers in Montgomery County neighborhoods with poor health outcomes and high levels of tobacco, alcohol and lottery advertising. Seven stores agreed to participate.
After one year, five stores achieved bronze status, one reached silver and one earned gold certification. Among their commitments: Six participating retailers removed storefront window signage and six posted gambling helpline information. Incentive funds were used for practical upgrades including roof repairs, new lighting and redesigned sales counters.
The early results suggest retailers can be motivated to reduce harmful marketing when given financial support and practical resources, Roberts said.
The study also identified challenges, particularly recruiting businesses into the program. Independently owned stores appeared more willing to participate than chain retailers, likely because local owners have greater control over store policies and displays, Roberts said.
The researchers caution that the program still needs long-term evaluation to determine whether it improves community health outcomes. Sustaining funding may also be difficult, although new support from the Center for Disease Control and Prevention’s Drug Free Communities Support Program will allow the initiative to continue.
Taniayah O’Quinn-Sims with the Alcohol, Drug Addiction and Mental Health Services Board of Montgomery County, Ohio, is a co-author on the study.
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CONTACT: Megan Roberts, Roberts.1558@osu.edu
Written by Misti Crane, Crane.11@osu.edu ; 614-292-3739
American Journal of Public Health
Observational study
Not applicable