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As found in previous studies,54 55 the trend away from direct advertising and towards price discounting and promotional expenditures began accelerating after 1997 when the MSA restricted cartoons, transit advertising, most outdoor advertising, product placement in media, branded merchandise, free samples (except in adult-only facilities) and most sponsorships.53 Around the same time, federal taxes increased from $0.24 to $0.34 per pack on 1 January 2000, and then to $0.39 per pack on 1 January 2002, and state taxes were also increasing.56 In addition, other tobacco control policies (eg, smoke-free air laws and media campaigns) were ramping up in many states.57 58 Cigarette price discounting expenditures increased to 78% by 2009 and 85% by 2013, with a $0.62 federal tax increase and the Family Smoking Prevention and Tobacco Control Act in 2009.59 The per cent devoted to price discounting and promotional allowances, together, reached 93% of total marketing expenses in 2002 and then showed minimal increases over the next 17 years, peaking at 96.5% in 2019, perhaps suggesting that price discounting and promotional allowances had reached a saturation point as prices or taxes continued to increase

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Retail innovation and manufacturer-distributor strategic partnerships also have increased consumer interaction and availability