Exposure to smoking tobacco, roll-your-own tobacco,heated tobacco product, and e-cigarette advertising in 28European countries

INTRODUCTION Exposure to tobacco product advertising, promotion, and sponsorship remains a challenge to tobacco control in many areas across the globe.The objective of this study was to explore the prevalence, sources and factors associated with exposure to advertising of heated tobacco products (HTPs), e-cigarettes and smoking tobacco across 28 European countries.METHODS We performed a secondary analysis of wave 93.2 of the Eurobarometer survey, which was conducted in 28 European countries during August-September 2020.Respondents were requested to provide detailed information on their exposure to tobacco advertising through multiple sources, its frequency and their demographical characteristics.Weighting was performed within all descriptive analyses to account for the sampling design.RESULTS The reported exposure to advertising of smoking tobacco, e-cigarettes and HTPs was 34.6% (95% CI: 33.7-35.6),39.3% (95% CI: 38.4-40.4) and 28.2% (95% CI: 27.4-29.2),respectively.The overall prevalence of frequent exposure to smoking tobacco advertising was 4.3% (95% CI: 3.9-4.7);however, exposure to advertising of smoking tobacco products differed significantly across the 28 European countries surveyed.Frequent exposure to e-cigarette advertising was reported by 6.8% (95% CI: 6.3-7.4) of all respondents, with the United Kingdom (21.6%) and Ireland (14.1%) having the highest prevalence of frequent exposure.Higher exposure to advertising of tobacco and nicotine products was reported by those aged 15-24 years for smoking tobacco products (AOR=1.35;95% CI: 1.22-1.49),e-cigarettes (AOR=1.88;95% CI: 1.70-2.07),and HTPs (AOR=1.92;95% CI: 1.73-2.13)compared to older participants.CONCLUSIONS Our analyses indicate cross-country differences in exposure to advertising of smoking tobacco, e-cigarettes and HTPs and highlight sociodemographic characteristics associated with specific exposure routes of advertising in Europe.The current findings provide an evidence base that may fuel discussions related to potential revisions of the European Tobacco Advertising Directive.