Declines in tobacco brand recognition and ever-smoking rates among young children following restrictions on tobacco advertisements in Hong Kong

Brand Awareness and Access to Cigarettes among Children 8-12 Years Old in the Czech Republic

OBJECTIVE

The aim of the study is to assess smoking behaviour, knowledge of cigarette brands and access to cigarettes among children 8-12 years old in the Czech Republic.

METHOD

Between 2009 and 2012, a cross sectional survey was conducted among 4,439 children aged 8-12 years attending 51 primary schools in Prague and Central Bohemia, Czech Republic. Data including age, gender, ever smoking, parental and sibling smoking, knowledge of cigarette brands, sources of cigarettes, and smoking frequency were collected.

RESULTS

Fifty nine percent of all children could name one or more cigarette brands, 62.8% of boys and 55.3% of girls (p<0.01). The most well-known brands were Marlboro and the local brand Petra. Marlboro was better known among boys, while Petra was more known among girls. Children whose parents smoke showed higher brand awareness than children with non-smoking parents, 72.5% and 45.6%, respectively (p<0.001), and 76.4% of children reported one or more possible sources where to obtain cigarettes. Nearly one quarter (23.3%) of children had ever tried cigarettes, water pipe, cigars, or marijuana. Nearly half of all children (43.1%) reported that they had obtained their first cigarette from a relative or at home, and the second most frequent source were their peers (22.8%). Only 3.9% of children reported that they had purchased their first cigarettes. Relatives were the main source of cigarettes among children that reported smoking more than once.

CONCLUSIONS

The high level of cigarette brand awareness and ever smoking provide evidence that tobacco control policies in the Czech Republic do not adequately protect children. Tougher legislation and effective strategies in accordance with the WHO Framework Convention on Tobacco Control are therefore required to better protect children from harmful effects of smoking and the influence of tobacco industry in the Czech Republic.

Systematic review of health branding: growth of a promising practice

Brands are marketing tools that create mental representations in the minds of consumers about products, services, and organizations. Brands create schema that help consumers decide whether to initiate or continue use of a product or service. Health branding determines behavioral choice by building consumer relationships and identification with health behaviors and their benefits. Health branding can be measured by the associations individuals form with health behaviors. In 2008, Evans and colleagues systematically reviewed the literature on health brands, reported on branded health messages and campaigns worldwide, and examined specific branding strategies in multiple subject areas. This paper extends that review. We replicated the comprehensive online literature search strategy from 2008. We screened a total of 311 articles and included 130 for full-text review. This included both articles from the 2008 review and new articles. After excluding those new articles that did not meet full-text inclusion criteria, we reviewed 69 in total. Of these, 32 were new articles since the 2008 review. Branded health campaigns cover most major domains of public health and appear worldwide. Since 2008, we observed improvement in evaluation, application of theory, and description of campaign strategies in published work. We recommend enhanced education of public health practitioners and researchers on the use and evaluation of branding.

Exploring the potential for a mass media campaign to influence support for a ban on tobacco promotion at the point of sale

This study explores whether exposure to advertisements that focus on the negative effects of tobacco industry advertising and promotion at the point of sale (anti-POS advertising) influence: (i) attitude toward POS advertising; (ii) perceived impact of POS advertising on youth smoking; and (iii) support for a ban on tobacco promotion at the POS among adult non-smokers in New York. Data are from a split-sample, experimental study, using an online media tracking survey with embedded TV, radio and print advertising. Exposure to anti-POS advertising was associated with higher odds of holding a negative attitude toward POS advertising (OR 2.43, P < 0.001) and support for a ban on tobacco promotion at the POS (OR 1.77, P < 0.05), but not with perceived impact of POS tobacco advertisements on youth smoking. Findings suggest the possibility that a mass media campaign could be used to influence public attitude toward POS advertising and support for a ban on tobacco promotion at the POS.

Prevalence of cigarette advertising and other promotional strategies at the point of sale in St Louis, Missouri: analysis by store type and distance from a school

Introduction

Point-of-sale advertising provides an opportunity for the tobacco industry to communicate with current and potential smokers. The US Family Smoking Prevention and Tobacco Control Act allows states to implement policies requiring that tobacco products be placed out of sight, and the Food and Drug Administration is considering banning point-of-sale advertising within 1,000 feet of schools. Our objective was to compare cigarette point-of-sale advertising near schools with grades prekindergarten through 12 and by store type.

Methods

All registered cigarette retailers (n = 1,229) and schools (n = 581) in the city of St Louis and St Louis County were geocoded and mapped by using ArcGIS. Retailers were divided into 2 groups, those within 1,000 feet and those within 1,001 to 2,000 feet of a school; 200 retailers from each group were randomly selected. We assessed tobacco interior and exterior advertising, brands advertised, discounts, gifts with purchase, “no sales to minors” signage, and cigarette functional items (eg, advertising on shopping baskets). Analyses were done by distance from a school and store type.

Results

We analyzed 340 retailers. Most retailers within 1,000 feet (91.2%) and from 1,001 to 2,000 feet (94.2%) of a school displayed cigarette advertising (P = .20). Convenience stores had the highest number of interior ads. In multivariable models, distance from school explained 0.2% of the variance in total advertising.

Conclusion

Cigarette point-of-sale advertising is highly prevalent in St Louis within 1,000 feet of schools. A ban based on distance from a school might decrease advertising exposure, but its effect on smoking prevalence is yet to be determined because advertising farther from schools would still prevail.

International reach of tobacco marketing among young children

BACKGROUND

Prosmoking messages, delivered through marketing and the media, can reach very young children and influence attitudes and behaviors around smoking. This study examined the reach of tobacco marketing to 5 and 6 year olds in 6 low- and middle-income countries.

METHODS

Researchers worked one-on-one with 5 and 6 year olds in Brazil, China, India, Nigeria, Pakistan, and Russia (N = 2423). The children were asked to match logos with pictures of products, including 8 logos for cigarette brands. Analyses examined, overall and by country, whether gender, age, location, household use of tobacco, and knowledge of media characters were associated with awareness of cigarette brand logos. Additional analyses considered the relationship between cigarette brand logo awareness and intentions to smoke.

RESULTS

Overall, 68% of 5 and 6 year olds could identify at least 1 cigarette brand logo, ranging from 50% in Russia to 86% in China. Across countries, being slightly older and having someone in the household who used tobacco, were significantly associated with greater odds of being able to identify at least 1 cigarette brand logo.

CONCLUSIONS

The majority of young children from low- and middle-income countries are familiar with cigarette brands. This study's findings suggest that more effective measures are needed to restrict the reach of tobacco marketing.

Impact of tobacco control interventions on smoking initiation, cessation, and prevalence: a systematic review

Background. Policymakers need estimates of the impact of tobacco control (TC) policies to set priorities and targets for reducing tobacco use. We systematically reviewed the independent effects of TC policies on smoking behavior. Methods. We searched MEDLINE (through January 2012) and EMBASE and other databases through February 2009, looking for studies published after 1989 in any language that assessed the effects of each TC intervention on smoking prevalence, initiation, cessation, or price participation elasticity. Paired reviewers extracted data from studies that isolated the impact of a single TC intervention. Findings. We included 84 studies. The strength of evidence quantifying the independent effect on smoking prevalence was high for increasing tobacco prices and moderate for smoking bans in public places and antitobacco mass media campaigns. Limited direct evidence was available to quantify the effects of health warning labels and bans on advertising and sponsorship. Studies were too heterogeneous to pool effect estimates. Interpretations. We found evidence of an independent effect for several TC policies on smoking prevalence. However, we could not derive precise estimates of the effects across different settings because of variability in the characteristics of the intervention, level of policy enforcement, and underlying tobacco control environment.

Comprehensive tobacco marketing restrictions: promotion, packaging, price and place

Evidence of the causal role of marketing in the tobacco epidemic and the advent of the WHO Framework Convention on Tobacco Control have inspired more than half the countries in the world to ban some forms of tobacco marketing. This paper briefly describes the ways in which cigarette marketing is restricted and the tobacco industry's efforts to subvert restrictions. It reviews what is known about the impact of marketing regulations on smoking by adults and adolescents. It also addresses what little is known about the impact of marketing bans in relation to concurrent population-level interventions, such as price controls, anti-tobacco media campaigns and smoke-free laws. Point of sale is the least regulated channel and research is needed to address the immediate and long-term consequences of policies to ban retail advertising and pack displays. Comprehensive marketing restrictions require a global ban on all forms of promotion, elimination of packaging and price as marketing tools, and limitations on the quantity, type and location of tobacco retailers.

Tobacco advertising through French TV in 2005: frequent illicit broadcasting; its impact on teenagers and young adults

BACKGROUND

Sports sponsorship is one of the tobacco industry's main strategies to recruit new smokers among teenagers and young adults.

METHODS

Monitoring Motor sports illicit broadcasting based on six channels in 2005; Dakar Rally (DR) and China Grand Prix impact evaluated with a one on one questionnaire administered on 12-24-year-old males and females (n = 805).

RESULTS

75,000 TV tobacco sponsoring appearances (90 h) were observed, total value: euro200.10(6); Mild Seven, Marlboro, West, Lucky Strike, Gauloises Blondes accounted for 92% appearances and 95% of euro values, with illegal broadcasting value worth euro19.10(6). A high interest in DR (71%) and Formula One (F1) (66%) was observed among males (versus females; P < 0.001), increasing with age (P < 0.05). Levels of spontaneous and assisted recall of cigarette brands were high among individuals interested in DR and F1, with better recall of brand names (versus non interested; P < 0.01); all individuals made correct associations between tobacco brands and car colors (P < 0.01). A non-significant higher percentage of daily smokers was observed among respondents interested in DR (34 versus 21%; P < 0.01) and F1 (30 versus 24%; P = 0.10).

CONCLUSION

This high level of indirect advertising for tobacco through motor sport sponsoring confirms the urgent need for a worldwide absolute ban on tobacco advertising in motor sports.

Population tobacco control interventions and their effects on social inequalities in smoking: systematic review

OBJECTIVE

To assess the effects of population tobacco control interventions on social inequalities in smoking.

DATA SOURCES

Medical, nursing, psychological, social science and grey literature databases, bibliographies, hand-searches and contact with authors.

STUDY SELECTION

Studies were included (n = 84) if they reported the effects of any population-level tobacco control intervention on smoking behaviour or attitudes in individuals or groups with different demographic or socioeconomic characteristics.

DATA EXTRACTION

Data extraction and quality assessment for each study were conducted by one reviewer and checked by a second.

DATA SYNTHESIS

Data were synthesised using graphical ("harvest plot") and narrative methods. No strong evidence of differential effects was found for smoking restrictions in workplaces and public places, although those in higher occupational groups may be more likely to change their attitudes or behaviour. Smoking restrictions in schools may be more effective in girls. Restrictions on sales to minors may be more effective in girls and younger children. Increasing the price of tobacco products may be more effective in reducing smoking among lower-income adults and those in manual occupations, although there was also some evidence to suggest that adults with higher levels of education may be more price-sensitive. Young people aged under 25 are also affected by price increases, with some evidence that boys and non-white young people may be more sensitive to price.

CONCLUSIONS

Population-level tobacco control interventions have the potential to benefit more disadvantaged groups and thereby contribute to reducing health inequalities.

Modifiable family and school environmental factors associated with smoking status among adolescents in Guangzhou, China

OBJECTIVE

To identify modifiable family and school environmental factors associated with Chinese adolescent smoking behaviors including never-smoking, experimental smoking, regular smoking, and attempting to quit.

METHODS

A cross-sectional survey using self-reported questionnaires was conducted in Huangpu, Guangzhou in December of 2004. A total of 3957 pupils agreed to complete the questionnaires. The prevalence odds ratio (risk) of experimental smoking was compared to never-smoking, adjusting for gender and age in unconditional logistic regression analysis. The risk of regular smoking was compared to experimental smoking, and the risk of attempting quitting was analyzed in regular smokers.

RESULTS

The cigarette smoking of peers, mothers, fathers, brothers, and supervising teachers, passive smoking, and seeing someone smoking on campus increased the risk of experimental smoking vs. nonsmoking, while no-smoking signs, perceived anti-tobacco atmosphere in school, and being taught smoking-related health knowledge decreased the risk. The factors associated with regular smoking compared to experimental smoking included the smoking of peers, brothers, fathers and supervising teachers, teacher's tolerance, and passive smoking. Being taught smoking-related knowledge, perceived anti-tobacco atmosphere and no-smoking signs in school were positively associated with regular smoker's attempt to quit, while supervising teacher's smoking, parents' and teachers' tolerance could delay it.

CONCLUSIONS

These modifiable family and school environmental factors as well as their interaction with gender and age should be highly considered in adolescent smoking prevention in China.