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The Effectiveness of Tobacco Marketing Regulations on Reducing Smokers’ Exposure to Advertising and Promotion


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

Karin A. Kasza 1,*, Andrew J. Hyland 2, Abraham Brown 3, Mohammad Siahpush 4, Hua-Hie Yong 5, Ann D. McNeill 6, Lin Li 5 and K. Michael Cummings 2

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Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA; E-Mails: andrew.hyland@roswellpark.org (A.J.H.); michael.cummings@roswellpark.org (K.M.C.)

Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, Stirling FK9 4LA, Scotland, UK; E-Mail: akb2@stir.ac.uk Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, 42nd and Emile Streets, Omaha, NE 68198, USA; E-Mail: msiahpush@unmc.edu VicHealth Centre for Tobacco Control, The Cancer Council Victoria, 100 Drummond Street, Carlton, Victoria 3053, Australia; E-Mails: hua.yong@cancervic.org.au (H.-H.Y.); lin.li@cancervic.org.au (L.L.)

Division of Epidemiology and Public Health, Nottingham City Hospital, University of Nottingham, Hucknall Road, Nottingham NG5 1PB, UK; E-Mail: ann.mcneill@nottingham.ac.uk

* Author to whom correspondence should be addressed; E-Mail: karin.kasza@roswellpark.org; Tel.: +1-716-845-8085.

Received: 30 November 2010; in revised form: 15 January 2011 / Accepted: 20 January 2011 / Published: 26 January 2011

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

Int. J. Environ. Res. Public Health 2011, 8 322

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

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