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PubMed1991

The effects of combining education and enforcement to reduce tobacco sales to minors. A study of four northern California communities.

OBJECTIVE: To examine the effects of a community education and law enforcement intervention on illegal tobacco sales to minors. DESIGN: A 2-year, before and after trial with retail stores as the unit of analysis. SETTING: Implementation occurred in four suburban California communities with populations of 25,000 to 100,000. PARTICIPANTS: All the retail stores in one intervention community and half the retail stores, randomly selected, in the other three intervention communities (n = 169) were visited by minors aged 14 to 16 years with the intent to purchase tobacco. INTERVENTION: Ongoing community and merchant education and four law enforcement operations were conducted. MAIN OUTCOME MEASURES: Over-the-counter and vending machine sales of tobacco to minors were the primary outcomes. RESULTS: Among a cohort of stores visited by minors at the pretest (n = 104) in June 1988, 71% sold tobacco over the counter and 92% sold tobacco through vending machines. At posttest 2 in May 1990, 24% sold tobacco over the counter and 93% sold tobacco through vending machines. Of the 31 stores issued citations, 16 were followed into the courts where the fines were dismissed or reduced. CONCLUSIONS: Education alone had a limited effect on reducing illegal tobacco sales to minors. It did promote community support for more aggressive enforcement strategies. Education plus enforcement decreased significantly over-the-counter sales; vending machine sales were unaffected by these interventions. The lack of support at the judicial level may temper the effectiveness of enforcement. Legislative remedies addressing judicial obstacles and vending machine sales are needed.

Adolescent↗
PubMed1994

The problem and sociocultural context of single-cigarette sales.

OBJECTIVE: To provide data on the sale of single cigarettes to adults and minors and to examine the sociocultural context in which these sales occur. DESIGN: A naturalistic observation study using repeated measures. Two hundred six stores in a convenience sample were visited by one minor and one adult who each attempted to purchase a single cigarette. MAIN OUTCOME MEASURES: Single-cigarette sales to an adult and/or minor. Data were obtained on type of store and, if a sale occurred, on the price, brand, and packaging of the cigarette. The ethnic composition of the neighborhood surrounding each store was determined. RESULTS: One hundred one (49.1%) of the stores sold single cigarettes. Singles were sold significantly more often to minors than to adults, and when both could make a purchase, minors paid more for these singles than did adults. Singles were least likely to be sold in white neighborhoods, more likely to be sold in integrated neighborhoods, and most likely to be sold in minority neighborhoods. Minors were able to purchase single cigarettes during 34.4% of the visits to white neighborhoods but could do so during 71.2% of the visits to minority neighborhoods; adults were able to make similar purchases during 24% of the visits to white neighborhoods and 37.3% of the visits to minority neighborhoods. CONCLUSIONS: The illegal sale of single cigarettes involves complex sociocultural factors heretofore unexamined. An understanding of such factors may be useful in planning merchant education programs and drafting policy to control illegal sales.

Adolescent↗
PubMed1994

The effect of price increases on contraceptive sales in Bangladesh.

In April 1990, the prices of five brands of contraceptives in the Bangladesh social marketing project were increased, by an average of 60%. The impact on condom sales was immediate and severe, with sales for the following 12 months dropping by 46% from the average during the preceding 12 months. The effect on oral contraceptive sales was less dramatic: average sales in the year following the increases dropped slightly despite a previously established pattern of rapidly rising sales. There appears no reasonable combination of events other than the price increase itself to explain most of the difference.

Bangladesh↗
PubMed2026

Simulating the effects of an alcohol minimum unit price policy on distilled spirits sales in 28 states of the USA.

BACKGROUND AND AIMS: Excessive alcohol use is a leading preventable chronic disease risk factor. Alcohol minimum unit pricing (MUP) policies are not used in the United States despite evidence of associations with reduced drinking and alcohol-related harms. To inform potential population-level chronic disease prevention strategies, we estimated effects of various hypothetical MUPs on alcohol sales. METHOD: Simulation based on observational time-series data. We used weekly off-premises product-specific alcohol retail sales and prices in 28 states of the United States for November 2022-November 2023 from NielsenIQ to estimate the own-price elasticity of spirits and cross-price elasticities of wine, beer and ready-to-drinks with respect to spirits. Using estimated elasticities, we simulated changes in total alcohol sales associated with hypothetical spirits MUPs ranging from $0.10 to $1.10 per standard drink (0.6 fluid ounces of alcohol). RESULTS: A hypothetical MUP of $0.80 per standard drink on spirits yielded the largest estimated decrease in alcohol sales (-1.7%) and would affect 5374 of 26 249 spirits products. To reach the $0.80 MUP, the sales-weighted average price increase among affected products was $0.24 per drink. CONCLUSIONS: Minimum unit pricing policies on distilled spirits in the United States could shift purchasing behavior and help reduce alcohol-related harms.

alcohol policy↗
PubMed2000

New York City pharmacists' attitudes toward sale of needles/syringes to injection drug users before implementation of law expanding syringe access.

In May 2000, New York State passed legislation permitting the sale, purchase, and possession of up to 10 needles and syringes (hereafter "syringes") without a prescription, intended to reduce blood-borne pathogen transmission among injection drug users (IDUs). To obtain baseline data on pharmacists' attitudes and practices related to human immunodeficiency virus (HIV) prevention and IDUs, a telephone survey was administered to 130 pharmacists systematically selected in New York City. Less than half of pharmacists were aware of the new law; 49.6% were willing to or supported providing nonprescription sales of syringes to IDUs. Pharmacists in support tended to be less likely to consider customer appearance "very important." Managing and supervising pharmacists were more likely than staff pharmacists to support syringe sales to IDUs. Managing and supervising pharmacists who stocked packs of 10 syringes and personal sharps disposal containers, pharmacists who supported syringe exchange in the pharmacy, and pharmacists who were willing to sell syringes to diabetics without a prescription were more likely to support syringe sales to IDUs. Syringe disposal was a prominent concern among all pharmacists. Those not in support of syringe sales to IDUs tended to be more likely to believe the practice would increase drug use. These data suggest the need for initiatives to address concerns about syringe disposal and tailored continuing education classes for pharmacists on HIV and viral hepatitis prevention among IDUs.

Attitude of Health Personnel↗
PubMed1990

Measuring medical cost and life expectancy impacts of changes in cigarette sales.

A change in cigarette sales triggers changes in medical-care costs and in years of life expectancy. Changes in sales result from changes in excise tax policy, agricultural policy, cigarette design, smoking behavior, or anti-smoking laws. The model uses data on medical costs, life expectancy, cigarette price elasticity, and smoking demographics to estimate medical-cost and life-year impacts for any change in cigarette sales. It takes into account the medical costs incurred by quitters over their extra years of life, the asymmetry of impacts for increases and decreases in sales, and the delayed medical effects for ages not yet subject to the health risks of smoking. For example, a 1% decrease in U.S. cigarette sales increases life expectancy in the United States by 1.45 million years and increases medical-care costs by $405 million for ages 25 to 79. This amounts only to $280 in added medical costs for each extra year of life. By generating aggregate health impacts at the margin, the model becomes a valuable tool for evaluating programs that affect smoking.

Adult↗
PubMed1995

Managing pharmaceutical sales activities in an academic anesthesiology department.

To contain costs, departments of anesthesiology must control the use of new, expensive drugs. Conflicts with pharmaceutical companies can arise when they promote drug sales. Pharmaceutical company sales represent anesthesiology department expenses. Anesthesiologists hold diverse opinions on this clash of interests, on the proper roles of pharmaceutical sales representatives in anesthesiology departments, and on the ethics of accepting industry gifts. Our department has managed pharmaceutical sales activities by encouraging discussion of the ethics and legal limits of industry gifts, by banning sales representatives from bringing food into the department, and by adopting The American Medical Association Guidelines on Gifts.

Academic Medical Centers↗
PubMed2006

Geographic variability in alcohol-related crashes in response to legalized Sunday packaged alcohol sales in New Mexico.

On July 1, 1995 the state of New Mexico lifted its ban on Sunday packaged alcohol sales. Legislation lifting the ban included a local option allowing individual communities within the state to hold an election to reinstitute the ban on Sunday packaged alcohol sales. Previous research has shown a clear statewide increase in alcohol-related crash and crash fatality rates after the ban was lifted. The goal of this study is to measure county-level variability in changes in alcohol-related crash rates while adjusting for county socio-demographic characteristics, spatial patterns in crash rates and temporal trends in alcohol-related crash rates. Bayesian hierarchical binomial regression models were fit to the observed quarterly crash counts for all counties between July 1, 1990 and June 30, 2000. Results show marked variability in the impact of legalized Sunday packaged alcohol sales on alcohol-related crash rates. Relative risks of an alcohol-related crash for the post-repeal versus pre-repeal period vary across counties from 1.04 to 1.90. Counties with older population suffered a greater negative impact of legalized Sunday packaged alcohol sales. Counties with communities that quickly passed the local option to re-ban packaged sales on Sundays were able to mitigate most of the deleterious impact of increased alcohol availability that was observed across the state.

Accidents, Traffic↗
PubMed2000

Commodification arguments for the legal prohibition of organ sale.

The commercial trading of human organs, along with various related activities (for example, advertising) was criminalised throughout Great Britain under the Human Organ Transplants Act 1989. This paper critically assesses one type of argument for this, and similar, legal prohibitions: commodification arguments. Firstly, the term 'commodification' is analysed. This can be used to refer to either social practices or to attitudes. Commodification arguments rely on the second sense and are based on the idea that having a commodifying attitude to certain classes of thing (e.g. bodies or persons) is wrong. The commodifying attitude consists of three main elements: denial of subjectivity, instrumentality, and fungibility. Secondly, in the light of this analysis, the claim that organ sale involves commodifying the human body is examined. This claim is found to be plausible but insufficient to ground an argument against organ sale, because the very same commodifying attitude is likely to be present in cases of (unpaid) organ donation. It is also argued that commodifying bodies per se may not be wrong. Thirdly, the view that organ sale involves commodifying persons is examined. Although this and the claim that it is wrong to commodify persons are probably true, there is--it is argued--little reason to regard organ sale as worse in this respect than other widely accepted practices, such as the buying and selling of labour. The conclusion is that although commodification is a useful ethical concept and although commodification arguments may sometimes be successful, the commodification argument against organ sale is not persuasive. This is not to say, though, that there are no arguments for prohibition--simply that this particular justificatory strategy is flawed.

Commerce↗
PubMed1998

Pharmacists' concerns and suggestions related to the sale of tobacco and alcohol in pharmacies.

A random sample of Pharmacists in Indiana was selected and surveyed regarding their thoughts and comments on the sale of tobacco and alcoholic products by pharmacies. A total of 212 pharmacists provided written responses to an open-ended question. The replies were then synthesized into major themes. The majority of comments categorized revealed strong opposition to pharmacies selling tobacco and alcohol products. The most frequently occurring message regarding the sale of these products by pharmacies was that it goes against the pharmacist's role as a professional health care provider and may harm their image. For some pharmacists, this issue posed a moral dilemma between caring for patient safety and the economic incentives provided by the sale of tobacco and alcohol. Based on these findings, a follow-up phone survey was conducted to solicit suggestions from pharmacists on how to advocate against the sale of tobacco and alcohol by pharmacies. The majority of pharmacists strongly recommended that they need to do more among themselves and within their store environment, rather than have regulations imposed on pharmacies when it comes to limiting the sale of these products.

Adult↗
PubMed2003

Sales of over-the-counter remedies as an early warning system for winter bed crises.

OBJECTIVES: To evaluate the pattern of emergency adult medical admissions during the winter period and the usefulness of sales of over-the-counter cough/cold remedies as a predictor of these. METHODS: The databases of a single NHS trust acute unit and pharmacy outlets in its catchment area were analyzed retrospectively, comparing numbers of emergency admissions, ICD-10 discharge codes, local electronic point-of-sale (EPOS) and national sales data. RESULTS: Over nine consecutive winter periods from 1992/3, peak admissions always occurred within a defined ten-day period from 29th December to 9th January. Emergency admissions increased significantly during this period (P = 0.0002). Pharmaceutical/retail data were available for three consecutive winters 1998/99, 1999/2000 and 2000/2001, none of which coincided with increased influenza activity nationally. Acute respiratory illness as defined by International Classification of Diseases, 10th edition (ICD-10) discharge coding did not appear to contribute to the increase in admissions at the peak. However, National and Local EPOS sales were positively correlated with admissions and the rate of EPOS sales exceeded an empiric threshold of 1000 units per week two weeks prior to the admissions peak in each year. CONCLUSIONS: Emergency admissions over the winter period are increasing and can be expected within a period of only ten days each year. No firm relationship between acute respiratory illness and admissions could be defined but local EPOS data may give up to two weeks warning of the peak in admissions and merits further prospective evaluation.

Antitussive Agents↗
PubMed1983

Supermarket sales of high-sugar products in predominantly Black, Hispanic, and white census tracts of Houston, Texas.

Sales of 488 sweet foods and beverages by supermarkets located in predominantly Black, Hispanic, and white census tracts of Houston, TX, were examined in relation to sales of a number of commodity foods. Mean sweet energy/commodity food sales ratios in Black and Hispanic census tract supermarkets were 122 and 108%, respectively, of those in white census tracts. Ethnic differences in sweet energy/commodity sales ratios were almost always statistically significant (p less than 0.05), but variation within ethnic groups of supermarkets remained large, indicating that nonethnic factors also influenced the food purchase patterns. Supermarket sales records offer a relatively inexpensive source of data for comparative or longitudinal studies of community purchase of food products postulated to play a role in the development of nutrition-associated health problems. The major problems in interpreting the data result from a need to use ratios, and lack of a valid measure of the population consuming the foods purchased.

Black or African American↗
PubMed2002

Hospitalization and mortality rates from peptic ulcer disease and GI bleeding in the 1990s: relationship to sales of nonsteroidal anti-inflammatory drugs and acid suppression medications.

OBJECTIVES: Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause peptic ulcer disease and upper GI bleeding. Acid suppression medications effectively treat NSAID-induced ulcers. However, it is unknown what effect the availability of proton pump inhibitors and over-the-counter preparations of NSAIDs and histamine type 2 receptor antagonists have had on population rates of hospitalization and mortality from GI toxicity. This study examines trends in hospitalization and mortality rates from GI toxicity during the 1990s. METHODS: We performed an analysis of secular trends of hospitalization and mortality rates from peptic ulcer disease, upper GI bleeding, and any GI bleeding using data from the National Hospital Discharge Survey, comparing them with sales of NSAIDs, aspirin, and acid suppression medications from 1992 to 1999. RESULTS: From 1992 to 1999, annual rates of hospitalization and mortality per 100,000 population for peptic ulcer disease declined from 205 to 165 and 7.7 to 6.0, respectively; calendar year was negatively correlated with both peptic ulcer disease hospitalization rates (p = -0.88, p = 0.007) and mortality rates (p = -0.71, p = 0.058). In contrast, these correlations did not reach statistical significance for upper or any GI bleeding (p > 0.1 for all comparisons). Sales of acid suppression medications were negatively correlated with peptic ulcer disease hospitalization rates (p = -0.76, p = 0.037) and mortality rates (p = -0.83, p = 0.015). Sales of NSAIDs were not positively correlated with hospitalization or mortality rates from peptic ulcer disease or GI bleeding (p > 0.2 for all comparisons). CONCLUSIONS: Despite changing patterns of use of NSAIDs and acid suppression medications during the 1990s, mortality rates from GI bleeding and peptic ulcer disease have been relatively stable, with an apparent decline in hospitalization rates and mortality from peptic ulcer disease. Changing rates of peptic ulcer disease morbidity and mortality were temporally related to increasing sales of antiulcerants but not to change in sales of NSAIDs.

Antacids↗
PubMed2005

The ALS/MND prevalence in Sweden estimated by riluzole sales statistics.

OBJECTIVES: To determine whether sales statistics for riluzole can be used as a marker for the prevalence of amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND) in Sweden. MATERIALS AND METHODS: A questionnaire was sent to all neurological units in Sweden asking about the numbers of patients with ALS/MND and whether these patients were treated with riluzole. Sales statistics for riluzole were obtained from the 906 public pharmacies and 89 hospital pharmacies in Sweden. RESULTS: Eighty percent of the neurological units answered the questionnaire. The estimated prevalence in September 2003 from the questionnaire was 5.4/100,000 inhabitants. The sales expressed in defined daily dose/100,000 inhabitants/day was 3.8. For the counties the correlation between these two parameters was 0.83. CONCLUSION: Estimated prevalence is highly correlated with sales statistics for riluzole. Riluzole sales statistics could be used as a crude marker for the prevalence of ALS/MND in Sweden.

Adolescent↗
PubMed1998

Snuff use and smoking among senior high school students: effects of a snuff sales ban.

OBJECTIVES: The popularity of snuff especially among adolescents is rising. The association between long-term snuff use and oral cancer discovered in epidemiological studies has prompted a variety of preventive measures to be taken to reduce snuff use and prevent adoption of the habit. In this study, the effect of a recent (1 March, 1995) snuff sales ban introduced in Finland was investigated. Further, the rates of smoking, snuff use, alcohol use and drug experimenting were investigated before the introduction of the ban to characterize the study population. DESIGN AND SUBJECTS: Two questionnaire studies were carried out. The first was carried out 3 months prior to the ban in 1994 and the second 9 months after the ban in 1995 in a senior high school population in southwestern Finland. The participants were 793 students (aged 15-22 years) in the first survey and 545 students (aged 16-23) in the second. Associations between variables were analyzed using cross-tabulation and step-wise logistic regression. The effects of the ban were determined on the basis of direct questions in the second questionnaire relating to the snuff sales ban. RESULTS: Snuff was used by 9% of the students participating in the first study. The results of the second questionnaire indicate that the implementation of the snuff sales ban reduced the rate of snuff use by 1% in the study population. The majority of the snuff users (76%) reported that they had maintained their snuff habit. Of those reporting that they were snuff users before implementation of the snuff sales ban, 12% had switched to smoking and 5% to drugs. CONCLUSIONS: The results of the present study suggest that the snuff sales ban in this population with a high rate of snuff use had little effect on snuff use rates and may have some short-term negative consequences as some snuff users switch to other substitutes, such as smoking, with known adverse health effects.

Adolescent↗
PubMed2005

Risk factors among handgun retailers for frequent and disproportionate sales of guns used in violent and firearm related crimes.

OBJECTIVE: To determine the retailer and community level factors associated with frequent and disproportionate sales of handguns that are later used in violent and firearm related crimes (VFC handguns). DESIGN: Cross sectional. The authors used California records to identify all handguns sold by study subjects during 1996-2000 and federal gun tracing records to determine which of these guns had been recovered by a police agency in the US or elsewhere and traced by 30 September 2003. SUBJECTS AND SETTING: The 421 licensed gun retailers in California selling at least 100 handguns annually during 1996-2000. MAIN OUTCOME MEASURE: The number of VFC handguns per 1000 gun years of exposure. Differences are expressed as incidence rate ratios (RR) with 95% confidence intervals (CI). RESULTS: Subjects accounted for 11.7% of California retailers with handgun sales, 81.5% of handgun sales, and 85.5% of VFC handguns. Among subjects, the 3426 VFC handguns accounted for 48.0% of all traced handguns and 65.0% of those linked to a specified crime. The median VFC handgun trace rate was 0.5/1000 gun years (range 0-8.8). In multivariate analysis, this rate increased substantially for each single-point increase in the percentage of proposed sales that were denied because the purchasers were prohibited from owning guns (RR 1.43; 95% CI 1.32 to 1.56), and was increased for pawnbrokers (RR 1.26; 95% CI 1.02 to 1.55). Community level crime rates and sociodemographics had little predictive value. CONCLUSIONS: Risk factors, largely determined at the retailer level, exist for frequent and disproportionate sales of handguns that are later used in violent and firearm related crimes. Screening to identify high risk retailers could be undertaken with data that are already available.

Adult↗
PubMed2006

Tobacco sales in pharmacies: time to quit.

OBJECTIVE: To assess the pharmacy profession's perceptions of tobacco sales in US pharmacies and explore whether a policy prohibiting sales of tobacco in pharmacies would alter adult consumer shopping behaviour. SUBJECTS AND DESIGN: In California, surveys were administered to 1168 licensed pharmacists and 1518 pharmacy students, and telephone interviews were conducted with 988 adult consumers. RESULTS: Most (58.1%) licensed pharmacists were strongly against sales of tobacco in pharmacies, 23.6% were against it, 16.7% were neutral, 1.2% were in favour of it, and 0.4% were strongly in favour of it. Pharmacists who were current tobacco users were more likely to be in favour of tobacco sales in pharmacies than were pharmacists who were current non-users (p < 0.005). Similar statistics were observed for pharmacy students. Most consumers (72.3%) disagreed with the statement, "I am in favour of tobacco products being sold in drugstores"; 82.6% stated that if the drugstore where they most commonly shopped were to stop selling tobacco products, they would shop there just as often, 14.2% would shop there more often, and 3.2% would shop there less often. CONCLUSION: Little professional or public support exists for tobacco sales in pharmacies.

Adolescent↗
PubMed1996

Tobacco industry efforts hindering enforcement of the ban on tobacco sales to minors: actions speak louder than words.

OBJECTIVE: The tobacco manufacturers state that they want to see laws that prohibit the sale of tobacco to minors enacted and enforced. Our purpose was to compare these public statements with the US tobacco industry's legislative agenda at the federal and state levels. DESIGN: A review of the industry's comments to the US Department of Health and Human Services (DHHS) regarding proposed federal regulations, and an analysis of pro-tobacco state legislation concerning tobacco sales to minors. RESULTS: The industry is strongly opposed to federal regulations requiring states to effectively enforce their laws prohibiting the sale of tobacco to minors. A food industry newsletter reports that the Tobacco Institute has circulated a model state bill concerning underage tobacco sales. Striking similarities between bills from several states would seem to confirm this report. These bills strip communities of enforcement authority while making effective enforcement by state officials virtually impossible. CONCLUSION: The evidence strongly suggests an industry strategy to undermine efforts to enforce laws prohibiting the sale of tobacco to minors. As has been the case in the past, the tobacco industry is publicly endorsing a socially responsible goal while apparently taking action behind the scenes to ensure that the goal is not achieved.

Adolescent↗