Inequities in the compliance of court-ordered point-of-sale tobacco industry corrective statements, USA

INTRODUCTION: In 2006, a federal US court found several major tobacco companies guilty of violating civil racketeering laws for deceiving the public about the harms of cigarettes. After 16 years of legal battles, the court ordered 17 corrective statements to be placed in over 200 000 tobacco retailers who have contracts with the tobacco companies to educate the public on the truth about tobacco-related harms. This study examined if corrective statement compliance was equitable across neighbourhoods. METHODS: We conducted a pooled cross-sectional analysis of compliance audit data collected by a court-approved auditor hired by the tobacco companies (33 977 in-person audits in 29 131 tobacco retailers in all US states). We downloaded census tract-level socio-demographic data from the 2019 to 2023 American Community Survey and fitted multivariable multinomial logistic regression models testing associations between neighbourhood socio-demographic variables and major non-compliance (vs compliance) and minor non-compliance (vs compliance). RESULTS: Overall compliance was 80.4%. Audits indicated retailers located in neighbourhoods with the highest (vs lowest) percentage of Black residents had 2.21 (95% CI 1.94 to 2.52) times the odds of being major non-compliant (vs compliant). Inequities in major and minor non-compliance were also present by percentage of Hispanic/Latine residents and median household income. DISCUSSION: Compliance with the mandated display of corrective statements, which was intended to increase knowledge and educate the public about the harm of cigarettes and the tobacco industry's deception, was not equitable in this sample. Future policies should include requirements that policy implementation is equitably enforced to ensure all populations realise public health benefits.