The Effectiveness of Tobacco Marketing Regulations on Reducing Smokers’ Exposure to Advertising and Promotion: Findings from the International Tobacco Control (ITC) Four Country Survey

Abstract

Exposure to tobacco product marketing promotes the initiation, continuation, and reuptake of cigarette smoking and as a result the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) has called upon member Parties to enact comprehensive bans on tobacco advertising and promotion. This study examines the immediate and long term effectiveness of advertising restrictions enacted in different countries on exposure to different forms of product marketing, and examines differences in exposure across different socioeconomic status (SES) groups. Nationally representative data from the United Kingdom, Canada, Australia, and the United States, collected from adult smokers between 2002 and 2008 using the International Tobacco Control Four Country Survey (ITC-4), were used in this study (N = 21,615). In light of the specific marketing regulation changes that occurred during the course of this study period, changes in awareness of tobacco marketing via various channels were assessed for each country, and for different SES groups within countries. Tobacco marketing regulations, once implemented, were associated with significant reductions in smokers’ reported awareness of pro-smoking cues, and the observed reductions were greatest immediately following the enactment of regulations. Changes in reported awareness were generally the same across different SES groups, although some exceptions were noted. While tobacco marketing regulations have been effective in reducing exposure to certain types of product marketing there still remain gaps, especially with regard to in-store marketing and price promotions.

Staying a Step Ahead of Cancer

“…Moreover, smokers are exposed to multiple tumor promoting substances and inflammatory agents that exacerbate the process. Effective tobacco control led by clean air legislation, taxation, and anti-tobacco advertising is gradually contributing to decreased lung cancer incidence ((CDC) 2011, Bajoga et al 2011, Ballbe et al 2011, Kasza et al 2011, King et al 2011a, King et al 2011b, Mage et al 2011, Walsh et al 2011. Thorough understanding of the biochemical, genetic and behavioral mechanisms of smoking can help us identify people who have a particularly high susceptibility to tobacco promoted cancers.…”

Levels and Correlates of Awareness of Point-of-Purchase Tobacco Displays and Advertising

“…Although enactment of tobacco marketing regulation has led to reductions in exposure to pro-smoking cues in Europe and elsewhere (Kasza et al, 2011), salience of tobacco displays at point-of-purchase remains prominent among smokers in the Netherlands and UK. Around three quarters of smokers overall were aware of retail tobacco displays, after adjusting for demographic factors.…”

“…Hence, unless POP promotions are restricted, the tobacco industry will continue to exploit this unregulated channel. Evidence shows that there is a profusion of smoking cues in most retail outlets in several jurisdictions, with tobacco displays positioned at pointof-purchase for maximum salience (Kasza et al, 2011;Wakefield et al, 2008).…”

“…These two indicators were categorised into three levels (low, moderate, and high) respectively, and were only partly comparable across the two countries because of differences in educational systems and income levels. Consistent with Kasza et al (2011), a three-category indicator of SES was created in this order: if both education and income were low, then SES was defined as low, if either education or income was low, then SES was defined as moderate, and if neither education nor income were low, then SES was defined as high. Participants who responded to only one of the two items were included in the SES category called for by the answered item.…”

“…However, in-store tobacco promotions remained somewhat unregulated, and displays of tobacco at point-of-purchase as well as in-store advertising, which were restricted to A5 size, became a potent communication channel usually situated in prominent and observable locations. The Health Act (2009) however required the complete removal of tobacco advertising and displays at point-of-purchase in England by April 2012 in supermarkets but not until April 2015 in small shops (Kasza et al, 2011).…”