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The Environmental Profile of a Community’S Health: A Cross-Sectional Study on Tobacco Marketing in 16 Countries; [Profil Environnemental De La Sante D’Une Communaute: Etude Transversale Sur Le Marketing Du Tabac Dans 16 Pays]; [El Perfil Ambiental De La Salud De Una Comunidad: Un Estudio Transversal Sobre La Publicidad Del Tabaco En 16 Paises] Publisher Pubmed



Savell E1 ; Gilmore AB1 ; Sims M1 ; Mony PK2 ; Koon T3 ; Yusoff K4 ; Lear SA5 ; Seron P6 ; Ismail N7 ; Calik KBT8 ; Rosengren A9 ; Bahonar A10 ; Kumar R11 ; Vijayakumar K12 Show All Authors
Authors
  1. Savell E1
  2. Gilmore AB1
  3. Sims M1
  4. Mony PK2
  5. Koon T3
  6. Yusoff K4
  7. Lear SA5
  8. Seron P6
  9. Ismail N7
  10. Calik KBT8
  11. Rosengren A9
  12. Bahonar A10
  13. Kumar R11
  14. Vijayakumar K12
  15. Kruger A13
  16. Swidan H14
  17. Gupta R15
  18. Igumbor E16
  19. Afridi A17
  20. Rahman O18
  21. Chifamba J19
  22. Zatonska K20
  23. Mohan V21
  24. Mohan D21
  25. Lopezjaramillo P22
  26. Avezum A23
  27. Poirier P24
  28. Orlandini A25
  29. Li W26
  30. Mckee M27
  31. Rangarajan S3
  32. Yusuf S3
  33. Chow CK28
Show Affiliations
Authors Affiliations
  1. 1. Department for Health, University of Bath, Bath, United Kingdom
  2. 2. Division of Epidemiology and Population Health, St John’s Medical College and Research Institute, Bangalore, India
  3. 3. Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada
  4. 4. Universiti Teknologi MARA, Shah Alam, Malaysia
  5. 5. Simon Fraser University, Burnaby, Canada
  6. 6. Department of Internal Medicine, Universidad de La Frontera, Temuco, Chile
  7. 7. Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  8. 8. Marmara University, Istanbul, Turkey
  9. 9. Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  10. 10. Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  11. 11. School of Public Health, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
  12. 12. Dr Somervell Memorial CSI Medical College, Karakonam, India
  13. 13. Africa Unit for Transdisciplinary Health Research, North-West University, Potchefstroom, South Africa
  14. 14. Primary Health Care Sector, Dubai Health Authority, Dubai, United Arab Emirates
  15. 15. Fortis Escorts Hospital, Jaipur, India
  16. 16. School of Public Health, University of the Western Cape, Cape Town, South Africa
  17. 17. Community Health Sciences, Aga Khan University, Karachi, Pakistan
  18. 18. Independent University Bangladesh, Dhaka, Bangladesh
  19. 19. Physiology Department, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
  20. 20. Department of Social Medicine, Wroclaw Medical University, Wroclaw, Poland
  21. 21. Madras Diabetes Research Foundation, Chennai, India
  22. 22. Medical School, Universidad de Santander, Bucaramanga, Colombia
  23. 23. Research Division, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
  24. 24. Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, Canada
  25. 25. ECLA Foundation, Rosario, Santa Fe, Argentina
  26. 26. National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
  27. 27. ECOHOST, London School of Hygiene and Tropical Medicine, London, United Kingdom
  28. 28. The George Institute for Global Health, Sydney Medical School (Westmead Campus), University of Sydney, PO Box M201, Missenden Road, Camperdown, 2050, NSW, Australia

Source: Bulletin of the World Health Organization Published:2015


Abstract

Objective To examine and compare tobacco marketing in 16 countries while the Framework Convention on Tobacco Control requires parties to implement a comprehensive ban on such marketing. Methods Between 2009 and 2012, a kilometre-long walk was completed by trained investigators in 462 communities across 16 countries to collect data on tobacco marketing. We interviewed community members about their exposure to traditional and non-traditional marketing in the previous six months. To examine differences in marketing between urban and rural communities and between high-, middle- and low-income countries, we used multilevel regression models controlling for potential confounders. Findings Compared with high-income countries, the number of tobacco advertisements observed was 81 times higher in low-income countries (incidence rate ratio, IRR: 80.98; 95% confidence interval, CI: 4.15–1578.42) and the number of tobacco outlets was 2.5 times higher in both low- and lower-middle-income countries (IRR: 2.58; 95% CI: 1.17–5.67 and IRR: 2.52; CI: 1.23–5.17, respectively). Of the 11 842 interviewees, 1184 (10%) reported seeing at least five types of tobacco marketing. Self-reported exposure to at least one type of traditional marketing was 10 times higher in low-income countries than in high-income countries (odds ratio, OR: 9.77; 95% CI: 1.24–76.77). For almost all measures, marketing exposure was significantly lower in the rural communities than in the urban communities. Conclusion Despite global legislation to limit tobacco marketing, it appears ubiquitous. The frequency and type of tobacco marketing varies on the national level by income group and by community type, appearing to be greatest in low-income countries and urban communities. © 2015, World Health Organization.
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