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Cross-country comparison of cigarette and vaping product marketing exposure and use: findings from 2016 ITC Four Country Smoking and Vaping Survey
  1. Yoo Jin Cho1,
  2. James Thrasher1,
  3. Michael Cummings2,
  4. Hua H Yong3,
  5. Sara C Hitchman4,
  6. Ann McNeill4,
  7. Geoffrey T Fong5,6,7,
  8. David Hammond7,
  9. James Hardin8,
  10. Lin Li3,
  11. Eric N Lindblom9
  1. 1Department of Health Promotion, Education and Behavior, School of Public Health, University of South Carolina, Columbia, South Carolina, USA
  2. 2Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
  3. 3VicHealth Centre for Tobacco Control, The Cancer Council Victoria, Melbourne, Victoria, Australia
  4. 4UK Centre for Tobacco Control Studies, National Addiction Centre, Institute of Psychiatry, King’s College London, London, UK
  5. 5Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
  6. 6Ontario Institute for Cancer Research, Toronto, Ontario, Canada
  7. 7School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
  8. 8Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, South Carolina, USA
  9. 9O'Neill Institute for National & Global Health Law, Georgetown University Law Center, Washington, District of Columbia, USA
  1. Correspondence to Ms Yoo Jin Cho, Department of Health Promotion, Educaiton and Behavior, University of South Carolina, Columbia, South Carolina 29208, USA; ycho{at}email.sc.edu

Abstract

Objective To compare exposure to and use of certain cigarette and vaping product marketing among adult smokers and vapers in four countries with contrasting regulations—Australia (AU), Canada, England and the USA.

Data sources Adult smokers and vapers (n=12 294) from the 2016 International Tobacco Control (ITC) Four Country Smoking and Vaping Survey (4CV1).

Analysis Self-reported exposure to cigarette and vaping product advertising through point-of-sale, websites/social media, emails/texts, as well as exposure to and use of price offers were assessed for country differences using logistic regression models adjusted for multiple covariates.

Results Reported exposure to cigarette advertising exposure at point-of-sale was higher in the USA (52.1%) than in AU, Canada and England (10.5%–18.5%). Exposure to cigarette advertising on websites/social media and emails/texts was low overall (1.5%–10.4%). Reported exposure to vaping ads at point-of-sale was higher in England (49.3%) and USA (45.9%) than in Canada (32.5%), but vaping ad exposure on websites/social media in Canada (15.1%) was similar with England (18.4%) and the USA (12.1%). Exposure to vaping ads via emails/texts was low overall (3.1%–9.9%). Exposure to, and use of, cigarette price offers was highest in the USA (34.0 % and 17.8 %, respectively), but the use rate among those exposed was highest in AU (64.9%). Exposure to, and use of, price offers for vaping products was higher in the USA (42.3 % and 21.7 %) than in AU, Canada and England (25.9%–31.5 % and 7.4%–10.3 %).

Conclusions Patterns of cigarette and vaping product marketing exposure generally reflected country-specific policies, except for online vaping ads. Implications for research and policy are discussed.

  • advertising and promotion
  • global health
  • non-cigarette tobacco products
  • public policy
  • surveillance and monitoring
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Footnotes

  • Contributors YJC and JFT wrote the first and final version of the manuscript. YJC performed the data analysis. All authors contributed to the revision of the drafts.

  • Competing interests KMC has been a consultant and received grant funding from the Pfizer, Inc. in the past five years. KMC has also been a paid expert witness in litigation against the cigarette industry. GTF was supported by a Senior Investigator Grant from the Ontario Institute for Cancer Research. The other authors declare that they have no conflicts of interest.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data relevant to the study are included in the article or uploaded as supplementary information.

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