Exposure to tobacco advertisement and promotion programs among Chinese middle school students: a cross-sectional survey

Abstract

To exam the exposure status to tobacco advertisement and promotion programs in Chinese middle school students. Stratified multi-stage cluster sampling was used to select participated grade 7-9 middle school students in 31 provinces (n = 155 117). A self-administrated questionnaire was used in which questions related to behavior on tobacco use, exposure to second-hand smoking (SHS), access to tobacco products and prices, tobacco control advocacy, exposure to tobacco advertisement, and promotion as well as attitude and knowledge towards tobacco, etc. Data was weighted and analyzed, using the complex survey module of SAS 9.3 software. In the past 30 days, 48.5% of the students had a chance to see advertisement or promotion programs on tobacco. Tobacco advertisement or promotion were most frequently seen on TV (21.3%) among students, followed by outdoor billboard (20.1%), at the stands for sale (17.5%), and Internet (15.6%). In addition, 4.6% of the students reported having kept the items related to brand logos of tobacco products; 2.0% reported having been offered a free tobacco product by tobacco company representatives; 69.7% reported having seen scenes related to smoking on TV/videos/movie screens. Twenty five point two percent of the student smokers reported buying individual sticks at last purchase. Among those students who had never been exposed to tobacco, the ones who had been exposed to tobacco advertisement and promotion programs reported that they were more likely to feel smoking attractive than those who had not. They also reported that if a cigarette was offered by friends, they might try to smoke within the next 12 months, feeling that smoking would make him/her comfortable, and finally to feel that they might enjoy smoking (P < 0.000 1). Adolescents had been heavily exposed to tobacco advertisement and promotion programs in China. Students who had been exposed to tobacco advertisement or promotions were more likely to express positive attitude to tobacco use. It is urgent to make amendments to China's Advertising Law to completely prohibit tobacco advertisement, promotion and sponsorship programs, to keep the young people away from tobacco.