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The main innovation of the present study is to examine systematically the dissemination and implementation of STARS, the first surveillance tool for retail tobacco marketing that was designed for practitioners to inform state and local tobacco control policy efforts.Ī 2002 National Tobacco Monitoring, Research and Evaluation Workshop reviewed and identified improvements to the existing infrastructure for tobacco surveillance and evaluation. A steering committee of SCTC investigators-led by researchers from Stanford Prevention Research Center (SPRC), the University of North Carolina at Chapel Hill, RTI International and the University of Illinois at Chicago, and other partners, including five state TCPs, the Centers for Disease Control and Prevention (CDC) Office on Smoking and Health and the Tobacco Control Legal Consortium-developed the Standardized Tobacco Assessment for Retail Settings (STARS) survey and training materials in 2013–2014 (see online supplementary appendix). The National Cancer Institute (NCI) established the State and Community Tobacco Control (SCTC) Research Initiative to address high-priority research gaps, including tobacco industry marketing and promotion as well as tax and pricing policies. The current study addresses this significant gap in the literature. 11 An accessible, standard instrument is needed to make comparisons within and between jurisdictions, and to inform evidence-based policymaking in the USA and in other countries. 11 For example, the Nutrition Environment Measures Survey 12 has >150 citations, but the most frequently cited instruments that assess retail tobacco marketing have six or fewer citations. However, tobacco control research and practice lacks a standardised, widely used measure for retail marketing surveillance. Monitoring tobacco industry activity in the retail environment is essential to evidence-based policymaking and enforcement. 8 9 For these reasons, regulating the retail environment for tobacco is an increasing priority for many state and local tobacco control programmes (TCPs). 5 Such exposure encourages youth to start smoking 6 7 and makes it more difficult for smokers to quit. 4 More youth and young adults recall seeing tobacco marketing in stores than any other channel.
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1 2 In the USA, there were ∼375 000 tobacco retailers in 2013, 3 and the largest tobacco companies spent $8.6 billion (91% of annual marketing dollars) to increase the visibility of tobacco products at the point of sale and to reduce their price. Point of sale is the dominant channel for tobacco industry marketing, and the widespread availability of tobacco products and the visibility of tobacco marketing at the point of sale remain a significant public health concern, particularly in the poorest countries and communities.