Association between tobacco advertising policies, health warning mandates and adolescents’ exposure to tobacco advertising and warning labels in 80 countries
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Accepted version
Author(s)
Meng, Cathy Fan Ying
Bannon, Olivia
Laverty, Anthony A
Filippidis, Filippos T
Type
Journal Article
Abstract
Background Implementation of tobacco advertising, promotion and sponsorship (TAPS) bans and of health warning mandates varies by country, and their impact on adolescents’ exposure to tobacco-related messages is not well understood, particularly in low-income and middle-income countries.
Aim To explore the association of the implementation of TAPS bans and health warning mandates with the proportion of adolescents exposed to tobacco advertisements and health warnings in 80 countries from 2016 to 2021.
Methods The proportion of 11–17 years old exposed to tobacco advertising was assessed using Global Youth Tobacco Survey data (80 countries, n=428 347). We conducted country-level multivariable linear regressions to explore the association between these policies and the proportion of adolescents exposed by country.
Results Of the 80 countries assessed, 39 had implemented a ban on advertising at points of sale, 54 had a ban on free distribution, 44 prohibited the use of tobacco brand names on non-tobacco products and 72 had laws mandating health warnings on cigarette packages. Banning point-of-sale advertisements was associated with 7.8% (95% CI −3.7% to −12.0%) lower exposure to point-of-sale advertisements. There was no significant association between mandating health warnings and the prevalence of exposure to health warnings. We did not find significant associations between bans on the free distribution of tobacco products or labelling non-tobacco products with tobacco brand names with exposure to tobacco advertisements.
Conclusions We found that, in the context of varying implementation levels, bans on point-of-sale advertisements were associated with lower exposure to advertisements.
Aim To explore the association of the implementation of TAPS bans and health warning mandates with the proportion of adolescents exposed to tobacco advertisements and health warnings in 80 countries from 2016 to 2021.
Methods The proportion of 11–17 years old exposed to tobacco advertising was assessed using Global Youth Tobacco Survey data (80 countries, n=428 347). We conducted country-level multivariable linear regressions to explore the association between these policies and the proportion of adolescents exposed by country.
Results Of the 80 countries assessed, 39 had implemented a ban on advertising at points of sale, 54 had a ban on free distribution, 44 prohibited the use of tobacco brand names on non-tobacco products and 72 had laws mandating health warnings on cigarette packages. Banning point-of-sale advertisements was associated with 7.8% (95% CI −3.7% to −12.0%) lower exposure to point-of-sale advertisements. There was no significant association between mandating health warnings and the prevalence of exposure to health warnings. We did not find significant associations between bans on the free distribution of tobacco products or labelling non-tobacco products with tobacco brand names with exposure to tobacco advertisements.
Conclusions We found that, in the context of varying implementation levels, bans on point-of-sale advertisements were associated with lower exposure to advertisements.
Date Issued
2025-01-09
Date Acceptance
2024-12-24
Citation
Tobacco Control, 2025
ISSN
0964-4563
Publisher
BMJ Publishing Group
Journal / Book Title
Tobacco Control
Copyright Statement
Copyright © Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group. This is the author’s accepted manuscript made available under a CC-BY licence in accordance with Imperial’s Research Publications Open Access policy (www.imperial.ac.uk/oa-policy)
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39788728
PII: tc-2024-058786
Subjects
Advertising and Promotion
Low/Middle income country
Priority/special populations
Publication Status
Published online
Coverage Spatial
England
Article Number
tc-2024-058786
Date Publish Online
2025-01-09