APW Retailer Environmental Scan Form: Nicotine & Cannabis

Purpose: This environmental scan helps prevention partners document the retail environment related to nicotine and cannabis products, including availability, marketing practices, pricing, placement, and youth appeal. Findings support prevention planning, education, and policy efforts.

Section 1: Scan Information

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* 1. Town/city of retail location:

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* 2. Your Name:

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* 3. Your Email:

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* 4. Date of Scan: / /____

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* 5. Store Name and Street Address

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* 6. Type of Retailer (check one)

Convenience store

Gas station

Grocery store

Liquor store

Smoke/Vape Shop

Cannabis Dispensary

Pharmacy

Other (please specify)

Section 2: Store Environment and Access

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* 7. Is the retailer located near youth-serving locations (within 1,000 feet)?

School

Park/Playground

Youth Center

Library

No youth-serving locations nearby

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* 8. Are age-restriction signs clearly posted at entrance and/or point of sale?

Yes - clearly visible

Somewhat visible

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* 9. Is ID required signage posted for nicotine and/or cannabis sales?

Yes

Section 3: Products Sold

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* 10. Which nicotine products are being sold (check all that apply)

Cigarettes

Cigars/Cigarillos

Smokeless tobacco products

E-cigarettes/Vapes

Disposable vapes

Synthetic nicotine products (e.g. Zyn-style pouches)

Hookah

Not sold at this location

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* 11. Which cannabis products are being sold (check all that apply)

Cannabis flower

Pre-rolled joints

Edibles

Vape cartridges/concentrates

Infused beverages

Topicals

Synthetic cannabis (delta-8, delta-9, THC-A, etc.)

Not sold at this location

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* 12. Which FDA approved vapes are being sold (check all that apply)

Logic

NJOY

Vuse

JUUL

None of the above

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* 13. Which additional products are being sold (check all that apply)

Whipped cream chargers

Tianeptine

CBD

Kratom

Mushrooms

Rolling trays, papers, grinders

Bongs and pipes

None of the above

Section 4: Product Placement and Visibility

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* 14. Are nicotine products visible from outside the store?

Yes

Not applicable

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* 15. Where are nicotine products placed? (check all that apply)

Behind the counter

On the counter

End caps/aisles

Near candy/other favored products

By front door/checkout

Not applicable

Other (please specify)

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* 16. Are cannabis products visible from outside the store?

Yes

Not applicable

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* 17. Where are cannabis products placed? (check all that apply)

Behind the counter

On the counter

End caps/aisles

Near candy/other favored products

By front door/checkout

Not applicable

Other (please specify)

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* 18. Are cannabis products stored in locked cases or restricted areas?

Yes

Not applicable

Section 5: Marketing, Advertising, & Youth Appeal

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* 19. Are there advertisements for nicotine products?

Inside only

Outside only

Both inside and outside

None observed

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* 20. Are there advertisements for cannabis products?

Inside only

Outside only

Both inside and outside

None observed

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* 21. Are price, promotions, or discounts advertised?

Buy one get one (BOGO)

Multi-pack discounts

Loyalty rewards

Coupons

Clearance/discounted products

None of the above

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* 22. Are flavored nicotine products available?

Yes

Not applicable

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* 23. Are flavored cannabis products available (e.g. edibles, vapes)?

Yes

Not applicable

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* 24. Do ads or packing appear youth-appealing? (check all that apply)

Bright colors

Cartoons/characters

'Fun' flavors (candy, dessert, fruit)

Slang or youth-oriented language

Social media reference

None of the above

Section 6: Compliance Observations (Observation Only)

APW Retailer Environmental Scan Form: Nicotine & Cannabis

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* 1. Town/city of retail location:

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* 2. Your Name:

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* 3. Your Email:

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* 4. Date of Scan: __ /__ /____

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* 5. Store Name and Street Address

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* 6. Type of Retailer (check one)

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* 7. Is the retailer located near youth-serving locations (within 1,000 feet)?

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* 8. Are age-restriction signs clearly posted at entrance and/or point of sale?

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* 9. Is ID required signage posted for nicotine and/or cannabis sales?

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* 10. Which nicotine products are being sold (check all that apply)

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* 11. Which cannabis products are being sold (check all that apply)

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* 12. Which FDA approved vapes are being sold (check all that apply)

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* 13. Which additional products are being sold (check all that apply)

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* 14. Are nicotine products visible from outside the store?

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* 15. Where are nicotine products placed? (check all that apply)

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* 16. Are cannabis products visible from outside the store?

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* 17. Where are cannabis products placed? (check all that apply)

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* 18. Are cannabis products stored in locked cases or restricted areas?

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* 19. Are there advertisements for nicotine products?

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* 20. Are there advertisements for cannabis products?

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* 21. Are price, promotions, or discounts advertised?

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* 22. Are flavored nicotine products available?

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* 23. Are flavored cannabis products available (e.g. edibles, vapes)?

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* 24. Do ads or packing appear youth-appealing? (check all that apply)

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* 25. Did staff appear to check ID for customers purchasing age-restricted products?

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* 26. Any potential compliance concerns observed? (describe)

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* 27. Comments/notes on photos

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* 28. Upload photo

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* 29. Upload photo

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* 30. Upload photo

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* 31. Is there anything else you'd like to share about this scan?

* 4. Date of Scan: / /____