Impact of the Tobacco Products Directive on self-reported exposure to e-cigarette advertising, promotion and sponsorship in smokers—findings from the EUREST-PLUS ITC Europe Surveys
Year: 2020
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Advertising, promotion and sponsorship of electronic cigarettes (ECAPS) have increased in recent years. Since May 2016, the Tobacco Products Directive 2014/40/EU (TPD2) prohibits ECAPS in various advertising channels, including media that have cross-border effects. The objective of this study was to investigate changes in exposure to ECAPS in a cohort of smokers from six European Union member states after implementation of TPD2. METHODS: Self-reported exposure to ECAPS overall and in various media and localities was examined over two International Tobacco Control Policy Evaluation survey waves (2016 and 2018) in a cohort of 6011 adult smokers from Germany, Greece, Hungary, Poland, Romania and Spain (EUREST-PLUS Project) using longitudinal generalized estimating equations models. RESULTS: Self-reported ECAPS exposure at both timepoints varied between countries and across examined advertising channels. Overall, there was a significant increase in ECAPS exposure [adjusted odds ratio (aOR): 1.25, 95% CI: 1.09-1.44]. Between waves, no consistent patterns of change in ECAPS exposure across countries and different media were observed. Generally, ECAPS exposure tended to decline in some channels regulated by TPD2, particularly on television and radio, while exposure tended to increase in some unregulated channels, such as at points of sale. CONCLUSIONS: The findings suggest that the TPD2 was generally effective in reducing ECAPS in regulated channels. Nonetheless, further research is warranted to evaluate its role in reducing ECAPS exposure, possibly by triangulation with additional sources of data.
Authors: Sarah Kahnert, Pete Driezen, James Balmford, Christina N Kyriakos, Tibor Demjén, Esteve Fernández, Paraskevi A Katsaounou, Antigona C Trofor, Krzysztof Przewoźniak, Witold A Zatoński, Geoffrey T Fong, Constantine I Vardavas, Ute Mons, Constantine I Vardavas, Andrea Glahn, Christina N Kyriakos, Dominick Nguyen, Katerina Nikitara, Cornel Radu-Loghin, Polina Starchenko, Aristidis Tsatsakis, Charis Girvalaki, Chryssi Igoumenaki, Sophia Papadakis, Aikaterini Papathanasaki, Manolis Tzatzarakis, Alexander I Vardavas, Nicolas Bécuwe, Lavinia Deaconu, Sophie Goudet, Christopher Hanley, Oscar Rivière, Tibor Demjén, Judit Kiss, Anna Piroska Kovacs, Esteve Fernández, Yolanda Castellano, Marcela Fu, Sarah O Nogueira, Olena Tigova, Ann McNeill, Katherine East, Sara C Hitchman, Ute Mons, Sarah Kahnert, Yannis Tountas, Panagiotis Behrakis, Filippos T Filippidis, Christina Gratziou, Paraskevi Katsaounou, Theodosia Peleki, Ioanna Petroulia, Chara Tzavara, Antigona C Trofor, Marius Eremia, Lucia Lotrean, Florin Mihaltan, Gernot Rohde, Tamaki Asano, Claudia Cichon, Amy Far, Céline Genton, Melanie Jessner, Linnea Hedman, Christer Janson, Ann Lindberg, Beth Maguire, Sofia Ravara, Valérie Vaccaro, Brian Ward, Marc Willemsen, Hein de Vries, Karin Hummel, Gera E Nagelhout, Witold A Zatoński, Aleksandra Herbeć, Kinga Janik-Koncewicz, Krzysztof Przewoźniak, Mateusz Zatoński, Geoffrey T Fong, Thomas K Agar, Pete Driezen, Shannon Gravely, Anne C K Quah, Mary E Thompson
Institutions: German Cancer Research Center, Heidelberg University, University of Waterloo, University of Freiburg, University of Crete, European Network for Smoking and Tobacco Prevention, Institut d'Investigació Biomédica de Bellvitge, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Institut Català d'Oncologia, Centro de Investigación Biomédica en Red, Universitat de Barcelona, National and Kapodistrian University of Athens, European Respiratory Society, Evangelismos Hospital, Grigore T. Popa University of Medicine and Pharmacy, Civitas University, The Maria Sklodowska-Curie National Research Institute of Oncology, Uniwersytet Kaliski im. Prezydenta Stanisława Wojciechowskiego, Ontario Institute for Cancer Research
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: European Respiratory Society, Deutsches Krebsforschungszentrum, Ontario Institute for Cancer Research, Centres de Recerca de Catalunya, European Commission, Universiteit Maastricht, Generalitat de Catalunya, Federación Española de Enfermedades Raras, Bundesministerium für Gesundheit, University of Crete, University of Waterloo, National and Kapodistrian University of Athens, National Institutes of Health, Canadian Institutes of Health Research, Menzies Centre for Australian Studies, King's College London, University of London, European Regional Development Fund, National Cancer Institute, Ministerio de Universidades
Awards: G1266886338, European Regulatory Science on Tobacco:Policy implementation to reduce lung diseases, G1792873265, G2043478972, G2266799804, G279608871, G3700987392, G3747007695, G434337789, G45209591, G4949135953, Predicting and Understanding the Use of Nicotine Products In a Rapidly Evolving Nicotine Marketplace: The International Nicotine Product, Policy, and Market (INPAM) Study
OpenAlex ID: W3086750737