Tobacco advertising, promotion, and sponsorship (TAPS) exposure, anti-TAPS policies, and students' smoking behavior in Botswana and South Africa.
OBJECTIVE
We examined the change over time in tobacco advertising, promotion and sponsorship exposure and the concurrent changes in cigarette smoking behavior among students age 13 to 15years in two African countries with different anti-tobacco advertising, promotion and sponsorship policies. In South Africa, anti-tobacco advertising, promotion and sponsorship policies became more comprehensive over time and were more strictly enforced, whereas the partial anti-tobacco advertising, promotion and sponsorship policies adopted in Botswana were weakly enforced.


METHOD
We analyzed two rounds of Global Youth Tobacco Survey data from South Africa (1999, n=2342; 2011, n=3713) and in Botswana (2001, n=1073; 2008, n=1605). We assessed several indicators of tobacco advertising, promotion and sponsorship exposure along with prevalence of current cigarette smoking and smoking susceptibility for each data round. Logistic regression was used to examine changes over time in tobacco advertising, promotion and sponsorship exposure and smoking behavior in both countries.


RESULTS
Between 1999 and 2011, South African students' exposure to tobacco advertising and sponsorship decreased significantly by 16% (p value, <0.0001) and 14% (p value, <0.0001), respectively. Exposure to tobacco promotion was lower and did not decrease significantly. Botswanan students' tobacco advertising, promotion and sponsorship exposure did not change significantly between 2001 and 2008. South African students' prevalence of cigarette smoking decreased over time (OR, 0.68) as did susceptibility to smoking (OR, 0.75), but declines did not remain significant after adjusting for parents' and friends' smoking. In Botswana, students' prevalence of cigarette smoking increased significantly over time (OR, 1.84), as did susceptibility to smoking (OR, 2.71).


CONCLUSION
Enforcement of strong anti-tobacco advertising, promotion and sponsorship policies is a vital component of effective tobacco control programs in Africa. Such regulations, if effectively implemented, can reduce tobacco advertising, promotion and sponsorship exposure among adolescents and may influence cigarette smoking behavior.
['English|Lorna McLeod|LM|', 'Hsia|Jason|J|', 'Malarcher|Ann|A|']
D000293:Adolescent D000294:Adolescent Behavior D000329:Advertising D001902:Botswana D005260:Female D006293:Health Promotion D006801:Humans D008297:Male D057766:Policy D015995:Prevalence D012907:Smoking D016540:Smoking Cessation D000074606:Smoking Prevention D013019:South Africa D013334:Students D011795:Surveys and Questionnaires
Tobacco advertising Africa Promotion and sponsorship Anti-tobacco policies Students smoking behavior Tobacco marketing