Requiring stores to hide tobacco product displays is one option some states are considering to curb teen smoking after the Family Smoking Prevention and Tobacco Control Act of 2009 was passed, according to the study's lead author.
"We know the retail environment is a very important place for tobacco companies to advertise and market their products," said Annice Kim, from the independent research institute RTI International in Research Triangle Park, North Carolina.
"They're prominently displayed at the point of sale, and it exposes all customers, including kids."
Kim's team wanted to test the effects of covering up such cigarette displays on teen shopping and opinion. But the researchers couldn't conduct a real world experiment because as of yet, no states have banned the displays.
So they designed a virtual reality game and sent more than 1,200 youth, between age 13 and 17, into a simulated online convenience store. Researchers asked the participants to select four items in the store: a snack from the aisles, a drink from the coolers and two products of their choice from the checkout counter.
In some scenarios, the cabinet behind the counter prominently displayed cigarettes, while other teens saw the cabinet closed and the display covered up.
Any teens that tried to ask the cashier for cigarettes were denied because of age - but what the researchers were interested in was how many asked.
Depending on other changes they made to the virtual convenience stores, the researchers found that 16 to 24 percent of teens tried to buy tobacco when the display was open, compared to 9 to 11 percent when it was closed.
In a post-virtual shopping survey, whether cigarettes were openly displayed wasn't clearly tied to teens' perceptions of how easy it would be to buy tobacco products if a similar store existed in their neighborhood.
However, 32 percent of youth said they were aware cigarettes were available for sale when the display case was closed in their virtual store, compared to 85 percent of those who had the open version, according to findings published today in Pediatrics.
"Policies that require retailers to store tobacco products out of view... could have a positive public health impact," Ms. Kim told Reuters Health.
Still, she said this single study, funded by the New York State Department of Health, would have to be considered along with other evaluations of the display restrictions before making policy recommendations.
One tobacco control researcher not involved in the new study said he thinks there is "strong justification" for hiding cigarette displays from youth, but that this study doesn't necessarily add much to that debate.
"It certainly shows that tobacco displays get people to think about cigarettes, which is what they're for," said Dr. Michael Siegel, from the Boston University School of Public Health.
But, "It can't be extrapolated into real life, because in real life kids would go to a store when they want to buy cigarettes," Mr. Siegel told Reuters Health.
"I don't know how many situations there are when a kid is hanging out in a convenience store with nothing to do and says, 'Oh, I'll just try a cigarette as long as they're here.'"
Rather, he said, banning the displays could help prevent youth from being exposed to marketing by cigarette companies and influenced in their attitudes toward smoking.