Development and implementation of a rapid surveillance system for tobacco product retail availability in six U.S....

The tobacco/nicotine retail landscape is continuously evolving. Monitoring product availability is critical to identifying industry response to regulatory action and shifts in consumer behavior and patterns of use.

Beginning January 2024, a rapid retail surveillance system was implemented in brick-and-mortar retailers across six U.S. sentinel sites (California, Kentucky, New Jersey, North Carolina, Ohio, Vermont) with diverse policy environments and tobacco use patterns. At each site, biannual audits were conducted in approximately 60 retailers. Between January 2024 and May 2025, audits were staggered across months and used a standardized Qualtrics-based tool to document tobacco/nicotine product availability, including flavors, brands, and novel products.

Nicotine pouch availability increased from 71.6 % to 81.3 % across waves. Cigarillos and cigarettes remained consistently available in 90 % of retailers, while e-cigarettes were found in ∼75 %. Flavored products were available across categories. The number of unique nicotine pouch brands increased over time, with variation by retailer type and site.

Rapid surveillance enables timely detection of market trends and potential policy non-compliance. Continued data collection and integration with other surveillance tools will enhance tobacco control monitoring.