Following a historic 2006 US Federal Court ruling, major cigarette manufacturers were mandated to display corrective statements about smoking harms at the point-of-sale (POS) in about 200 000 tobacco retailers nationwide from October 2023 to June 2025. This study assessed sign exposure and reactions among US adults who smoke (AWS) cigarettes and youth.
An online survey was conducted in late 2024 with nationally representative samples of (≥21 years) AWS (n=1575) and youth aged 15–20 (n=1039). Respondents viewed image examples and reported sign exposure over the past 12 months. Measures included exposure frequency, sign reactions and sociodemographic and behavioural correlates. Weighted prevalence estimates and multivariable logistic regression were used.
Self-reported exposure was 26.2% among AWS and 18.4% among youth. Exposure was higher among more frequent visitors to chain convenience stores and gas stations, younger adults, AWS interested in quitting and youth who had tried cigarettes. Most exposed participants saw the signs multiple times and reported signage trust (80.2% AWS; 88.7% youth), support (85.3% AWS; 88.7% youth) and thoughts about smoking risks (71.4% AWS; 81.9% youth). Sign exposure was considerably lower than for tobacco ads at POS (84.0% AWS; 74.3% youth).
About 18% of youth and 26% of smoking adults reported corrective statement exposure at POS. While exposure was positively associated with store visitation frequency, exposure was lower than for other tobacco POS messaging, suggesting that visual competition and limited retailer coverage may have constrained reach. Findings can inform future health messaging strategies in retail environments.