Standardized Tobacco Assessment for Retail Settings (STARS): Dissemination & Implementation Research

Regulating the retail environment for tobacco products is an important priority for US states and localities. Many state and local tobacco control programs (TCPs) conduct tobacco marketing surveillance in stores. However, an accessible, standard instrument is needed to make comparisons across jurisdictions and inform evidence-based policies.  Released in June 2014, the Standardized Tobacco Assessment for Retail Settings (STARS) is designed to characterize the availability, placement, promotion, and price of tobacco products. The 10-minute assessment form and supporting materials were developed by NCI’s State & Community Tobacco Control Initiative in collaboration with CDC, the Tobacco Control Legal Consortium, and five state TCPs.  To evaluate STARS dissemination and implementation, we conducted telephone surveys with state TCP leaders (n=48, response rate=90%), and individuals who agreed to be surveyed after downloading STARS within the first six months of release (n=98, response rate=55%). State TCP leaders reported that one-time or routine retail marketing surveillance was conducted in 34 states, and in 21 of these states, community or state programs were either using STARS or planned to do so. In addition, STARS was adopted by local or state programs in 7 of 11 states where marketing surveillance was not reported in the previous year.  Among the website registry, 52% were from local or state health departments, 22% from research institutions, and 28% from other organizations. Approximately 21% reported using STARS and 35% were likely/very likely to use it in the next six months. The most frequently reported objectives for use of STARS were to raise public awareness about retail tobacco marketing, describe marketing differences by neighborhood characteristics, and influence policy changes. Nearly all respondents (96%) were likely/very likely to recommend STARS to colleagues. User recommendations included creating a repository for additional items (e.g., more information on e-cigarettes) and for comparing or aggregating data from multiple jurisdictions.