Advertising Restrictions Research Articles

Shifting the gaze on implementation: examining the association between the implementation of tobacco control laws and prevalence of tobacco using data from a nationally representative survey

BackgroundTobacco use and the associated health burden is a cause of concern in India and globally. Despite several tobacco control policies in place, their sub-optimal and variable implementation across Indian states has remained a concern. Studies evaluating the real-world implementation of policies such as Cigarettes and Other Tobacco Products (COTPA) or National Tobacco Control Program (NTCP) in India and its association with reductions in tobacco use are limited. In this paper, we analyse data from a nationally representative survey to examine how policy implementation is associated with the tobacco use prevalence in India.MethodsWe analysed data from the Global Adult Tobacco Survey (GATS 2016–17) India using multivariable logistic regression. The dependent variables were the use of smoked tobacco, smokeless tobacco, and tobacco in any form. The independent variables were proxies of implementation of the COTPA and the NTCP. We followed a step-wise backward elimination technique to reach the best fit models.ResultsPeople exposed to no-smoking signages had lower odds of using tobacco (OR = 0.70, p < 0.001). People exposed to second-hand smoke (OR = 1.51, p < 0.001) and tobacco product advertisements (OR = 1.23, p < 0.001) had greater odds of using tobacco. Exposure to tobacco advertisements was associated with higher odds of using smokeless tobacco (OR = 1.23, p < 0.001), and smoked (OR = 1.33, p < 0.001) forms of tobacco.ConclusionWe find significant association between the implementation of tobacco control laws/programs and tobacco use in India. Our findings highlight the potential that policy implementation holds in reducing population-level tobacco use thus drawing attention towards the implementation phase of policies. The findings have implications on prioritising enforcement of specific tobacco control measures such as smokefree laws, modifying COTPA signages to encompass all tobacco products including against smokeless tobacco use and strengthening indirect advertising restrictions. Future research could focus on developing and validating predictors specific to policy implementation to support policy evaluation efforts.

What works in advocating for food advertising policy change across an english region – a realist evaluation

BackgroundWith increasing recognition of the role of commercial determinants of health, local areas in England have sought to restrict the advertising of products high in fat, salt and sugar (HFSS) on council-owned spaces, as part of wider strategies to reduce obesity. While there is some evidence of the impact of such policy change on behaviour, little is known about what works in the process of implementing this policy change.MethodsGuided by a realist evaluation framework that explores the interaction between context, mechanism and outcomes, this study aims to investigate the factors that influence the restriction of outdoor advertising of HFSS products in one region in England. It refines a programme theory co-produced with stakeholders from 14 local authorities within a region and uses multiple data sources from each area with an in-depth examination of four case study sites. Data sources include longitudinal realist interviews, focus groups and surveys with policy advocates and policy stakeholders. Data were analysed retroductively to understand the causal link between context, mechanism and outcomes.ResultsOutcomes were driven by five dominant mechanisms: a strategic and staggered approach to stakeholder engagement, gathering intelligence, identifying policy champions, building relationships, reframing the issue; and two secondary mechanisms of amplifying the issue and increasing public will. These led to varied outcomes with no changes in formal policy position within the evaluation period but draft policy guidance in place and changes in political will demonstrated. Dominant context factors influencing change included having a named and resourced policy advocate in place supported by an external Community of Improvement and having existing aligned local objectives. Organisational complexity and change, financial concerns, lack of local examples, ideological positions and the pandemic were also influencing contextual factors.ConclusionEffecting policy change in this area requires the commitment of an extended period and the valuing of short-term policy outcomes, such as increasing political will. The importance of a resourced and well-supported policy advocate to lead this work is fundamental and the commercially sensitive nature of this policy change means that a complex interplay of mechanisms is required which may be dominated by a strategically staggered approach to stakeholder engagement.

Initiation Patterns of Disease-Modifying Therapies for Multiple Sclerosis Among US Adults and Children, 2001 Through 2020

Many disease-modifying therapies (DMTs) have been approved for multiple sclerosis (MS) in the past 2 decades. Research evaluating how these approvals have changed real-world prescribing patterns is scarce. To evaluate patterns in DMT initiations between 2001 and 2020 among commercially insured US adults and children with MS. This serial cross-sectional study was conducted from 2001 through 2020 (mean patient enrollment duration, 4.8 years) and used US commercial claims data (MarketScan). Analysis took place between January 2022 and March 2023. Of 287 084 patients with MS identified, 113 583 patients (113 095 adults and 488 children) with MS newly initiated at least 1 DMT. New initiation episode of a DMT, defined as no claim for the same DMT in the previous year. The proportion of total DMT initiations per year attributable to each DMT. Trends in initiations were evaluated annually. The study team identified 153 846 DMT initiation episodes among adults (median age, 46 [IQR, 38-53) years]; 86 133 female [76.2%]) and 583 among children (median age, 16 (IQR, 14-17) years; 346 female [70.9%]). Among adults, use of platform injectables showed an absolute decline of 73.8% over the study period, driven by a 61.2% reduction in interferon β initiations (P < .001 for trend). In contrast, the 2010 introduction of oral DMTs led to a rise in their use from 1.1% (2010) to 62.3% (2020) of all DMT initiations (P = .002 for trend). Infusion therapy initiations remained relatively low, accounting for 3.2% of all initiations since their introduction in 2004 but increased modestly annually after ocrelizumab was introduced (2017), reaching 8.2% of all initiations in 2020 (P < .001 for trend). Children showed similar initiation patterns, except for preferred oral therapy. Between 2019 and 2020, dimethyl fumarate was the most commonly initiated DMT in adults (23.3% to 27.2% of all initiations), while in children fingolimod was the most commonly initiated (34.8% to 68.8%). Current MS treatment guidelines emphasize shared decision-making between patients and clinicians to balance treatment efficacy, safety, cost, and convenience. This study found that oral DMTs were the predominant DMT type initiated by 2020. The cause of this shift cannot be determined from this study, but may reflect several factors, including convenience of administration, direct-to-consumer advertising, or insurance restrictions.

Pharmaceutical company responses to Canadian opioid advertising restrictions: A framing analysis.

The pharmaceutical industry's promotion of opioids in North America has been well-documented. Yet despite the clear consequences of improperly classifying pharmaceutical company messaging and frequently permissive approaches that allow the pharmaceutical industry to self-regulate its own advertising, there has been scarce investigation to date of how pharmaceutical industry stakeholders interpret definitions of "advertising." This study explores how variations of "marketing" and "advertising" are strategically framed by the different actors involved in the manufacturing and distribution of pharmaceutical opioids. We employed a framing analysis of industry responses to Health Canada's letter to Canadian manufacturers and distributors of opioids requesting their commitment to voluntarily cease all marketing and advertising of opioids to health care professionals. Our findings highlight companies' continuing efforts to frame their messaging as "information" and "education" rather than "advertising" in ways that serve their interests. This study also calls attention to the industry's continual efforts to promote self-regulation and internal codes of conduct within a highly permissive federal regulatory framework with little concern for violations or serious consequences. While this framing often occurring out of public sight, this study highlights the subtle means through which the industry attempts to frame their promotion strategies away from "marketing". These framing strategies have significant consequences for the pharmaceutical industry's capacity to influence healthcare professionals, patients, and the general public.

Sex differences in children’s exposure to food and beverage advertisements on broadcast television in four cities in Canada

Sex differences exist in children's obesity rates, dietary patterns and television viewing. Television continues to be a source of unhealthy food advertising exposure to children in Canada. Our objective was to examine sex differences in food advertising exposure in children aged 2 to 17 years across four Canadian English language markets. We licensed 24-hour television advertising data from the company Numerator for January through December 2019, in four cities (Vancouver, Calgary, Montréal and Toronto) across Canada. Child food advertising exposure overall, by food category, television station, Health Canada's proposed nutrient profiling model, and marketing techniques were examined on the 10 most popular television stations among children and compared by sex. Advertising exposure was estimated using gross rating points, and sex differences were described using relative and absolute differences. Both male and female children were exposed to an elevated level of unhealthy food advertising and a plethora of marketing techniques across all four cities. Differences between sexes were evident between and within cities. Compared to females, males in Vancouver and Montréal viewed respectively 24.7% and 24.0% more unhealthy food ads/person/year and were exposed to 90.2 and 133.4 more calls to action, 93.3 and 97.8 more health appeals, and 88.4 and 81.0 more products that appeal to children. Television is a significant source of children's exposure to food advertising, with clear sex differences. Policy makers need to consider sex when developing food advertising restrictions and monitoring efforts.

What does our region need in order to strengthen public policies on sugar-sweetened beverages? decision-makers' dialogue.

In order to prioritize public policies to reduce the consumption of sugar-sweetened beverages in Argentina, Brazil, El Salvador and Trinidad and Tobago and to identify information gaps related to the burden of disease attributable to their consumption, a policy dialogue was held with government members, civil society organizations, researchers and communicators from Latin American and Caribbean countries. Presentations and deliberative workshops were conducted using semi-structured data collection tools and group discussions. The prioritized interventions were tax increases, front labeling, restriction of advertising, promotion and sponsorship, and modifications regarding the school environment. The main perceived barrier was the interference from the food industry. This dialogue among decision-makers led to the identification of priority public policies to reduce the consumption of sugar-sweetened beverages in the region.

Policy Opportunities and Legal Considerations to Reform SNAP-Authorized Food Retail Environments.

There is an invigorated national interest in nutrition security, with emphasis on the Supplemental Nutrition Assistance Program (SNAP) playing a key role. To support healthy food purchasing, several strategies have emerged to modify the food retail environment. However, the legal feasibility of several such policy options has not been established. Research was conducted using Lexis+ to evaluate statutes, regulations, and case law to determine the legal feasibility of requiring retail-based SNAP signage and nutrition disclosures, healthy endcaps and checkout aisles, and tying advertising restrictions to the licensing of SNAP retailers. US in-store and online food retail retailers. Legal feasibility. Requiring retailers that designate certain foods or locations as SNAP-eligible to consistently do so in all SNAP-eligible pages/locations is likely feasible. If properly drafted to focus on the nutritional quality of food, healthy checkout and endcap restrictions are legally feasible. It is of unclear legal feasibility to require retailers (especially in-store) to disclose nutrition-related labeling, shelf tags, or nonfactual symbols indicating the relative healthfulness of products. Restricting or banning advertising is not legally feasible even if the government ties the restrictions to retail licensing requirements. Entities seeking to support healthy food retail should not seek to restrict advertising or compel retailers to convey messages against their interests. The government can license retailers and require them to abide by laws and other requirements that do not violate their constitutional rights. The government can also use its own speech through public service announcements, billboards, and transit advertising to encourage healthy food consumption for all shoppers including those who use SNAP. Additional research is warranted into online retail practices to evaluate variations in online checkout pages and to determine whether online retailers treat SNAP participants differently from non-SNAP participants.

Effectiveness of Regulatory Policies on Online/Digital/Internet-Mediated Alcohol Marketing: a Systematic Review

BackgroundThe rapid growth of social networking sites and video sharing platforms has created an opportunity for the alcohol industry to employ advanced advertising and marketing approaches to target their audiences, increasingly blurring the lines between commercial marketing and user-generated content, which poses a challenge for effective regulation.MethodsWe conducted a systematic search through three peer-reviewed journal databases (WoS, PubMed, Scopus). Studies were included if published in English, after 2004, and assessed statutory regulation or voluntary industry codes, enacted by an EU or nation’s governmental agency or private entity, and with the intent to restrict digital alcohol advertising. In addition, we conducted a manual search of gray literature.ResultsA total of 4690 records were identified. After duplicate removal and full-text assessment, 14 articles were examined. Our findings indicate that children and adolescents may often be exposed to alcohol advertisements on social media and websites due to industry’s self-regulatory age-affirmation systems being largely ineffective at preventing under-aged access. Cases of self-regulatory violations by the alcohol industry, and increasingly innovative ‘gray-area’ advertising approaches have also been noted. Additionally, research illustrates a lack of developed statutory restrictions of digital alcohol advertising and instead continued reliance on voluntary industry self-regulation.ConclusionsThere is a substantial need for further research to examine the effectiveness of digital alcohol advertising restrictions in social media, websites and image/video sharing platforms. Moreover, there is a necessity for countries to develop comprehensive statutory frameworks, which would effectively restrict and monitor rapidly advancing digital alcohol advertising practices on new digital media.

Stakeholder perspectives on Nigeria's national sodium reduction program: Lessons for implementation and scale-up.

To reduce excess dietary sodium consumption, Nigeria's 2019 National Multi-sectoral Action Plan (NMSAP) for the Prevention and Control of Non-communicable Diseases includes policies based on the World Health Organization SHAKE package. Priority actions and strategies include mandatory sodium limits in processed foods, advertising restrictions, mass-media campaigns, school-based interventions, and improved front-of-package labeling. We conducted a formative qualitative evaluation of stakeholders' knowledge, and potential barriers as well as effective strategies to implement these NMSAP priority actions. From January 2021 to February 2021, key informant interviews (n = 23) and focus group discussions (n = 5) were conducted with regulators, food producers, consumers, food retailers and restaurant managers, academia, and healthcare workers in Nigeria. Building on RE-AIM and the Consolidated Framework for Implementation Research, we conducted directed content qualitative analysis to identify anticipated implementation outcomes, barriers, and facilitators to implementation of the NMSAP sodium reduction priority actions. Most stakeholders reported high appropriateness of the NMSAP because excess dietary sodium consumption is common in Nigeria and associated with high hypertension prevalence. Participants identified multiple barriers to adoption and acceptability of implementing the priority actions (e.g., poor population knowledge on the impact of excess salt intake on health, potential profit loss, resistance to change in taste) as well as facilitators to implementation (e.g., learning from favorable existing smoking reduction and advertising strategies). Key strategies to strengthen NMSAP implementation included consumer education, mandatory and improved front-of-package labeling, legislative initiatives to establish maximum sodium content limits in foods and ingredients, strengthening regulation and enforcement of food advertising restrictions, and integrating nutrition education into school curriculum. We found that implementation and scale-up of the Nigeria NMSAP priority actions are feasible and will require several implementation strategies ranging from community-focused education to strengthening current and planned regulation and enforcement, and improvement of front-of-package labeling quality, consistency, and use.

Advertising expenditures on child-targeted food and beverage products in two policy environments in Canada in 2016 and 2019.

The food industry advertises unhealthy foods intended for children which in turn fosters poor diets. This study characterized advertising expenditures on child-targeted products in Canada and compared these expenditures between Quebec, where commercial advertising to children under 13 is restricted, and the rest of Canada, where food advertising to children is self-regulated. Advertising expenditures data for 2016 and 2019 for 57 select food categories and five media channels were licensed from Numerator. Products and brands targeted to children were identified based on their nature and the advertising techniques used to promote them. Advertising expenditures were classified as healthy/unhealthy using Health Canada's nutrient profile model. Expenditures per child capita aged 2-12 years were calculated and expenditures from 2016 were adjusted for inflation. Advertising expenditures were described by media, food category, year, and geographic region. Overall, $57.2 million CAD was spent advertising child-targeted products in Canada in 2019. Television accounted for 77% of expenditures followed by digital media (18%), and the food categories with the highest expenditures were candy/chocolate (30%) and restaurants (16%). The totality of expenditures (99.9%-100%) in both Quebec and the rest of Canada in 2016 and 2019 were considered 'unhealthy'. Across all media channels (excluding digital), advertising expenditures were 9% lower in 2019 versus 2016. Advertising expenditures per capita were 32% lower in Quebec ($9.40/capita) compared to the rest of the country ($13.91/capita). In Canada, millions are spent promoting child-targeted products considered inappropriate for advertising to children. While per capita advertising expenditures for these products are lower in Quebec compared to the rest of Canada, they remain high, suggesting that Quebec's commercial advertising restrictions directed to children are likely not sufficiently protecting them from unhealthy food advertising.

Alcohol and Cigarette Advertising Restriction in China and Malaysia

Alcohol and Cigarette Advertising Restriction in China and Malaysia

The health, cost and equity impacts of restrictions on the advertisement of high fat, salt and sugar products across the transport for London network: a health economic modelling study

BackgroundPolicies aimed at restricting the marketing of high fat, salt and sugar products have been proposed as one way of improving population diet and reducing obesity. In 2019, Transport for London implemented advertising restrictions on high fat, salt and sugar products. A controlled interrupted time-series analysis comparing London with a north of England control, suggested that the advertising restrictions had resulted in a reduction in household energy purchases. The aim of the study presented here was to estimate the health benefits, cost savings and equity impacts of the Transport for London policy using a health economic modelling approach, from an English National Health Service and personal social services perspective.MethodsA diabetes prevention microsimulation model was modified to incorporate the London population and Transport for London advertising intervention. Conversion of calorie to body mass index reduction was mediated through an approximation of a mathematical model estimating weight loss. Outcomes gathered included incremental obesity, long-term diabetes and cardiovascular disease events, quality-adjusted life years, healthcare costs saved and net monetary benefit. Slope index of inequality was calculated for proportion of people with obesity across socioeconomic groups to assess equity impacts.ResultsThe results show that the Transport for London policy was estimated to have resulted in 94,867 (4.8%) fewer individuals with obesity, and to reduce incidence of diabetes and cardiovascular disease by 2,857 and 1,915 cases respectively within three years post intervention. The policy would produce an estimated 16,394 additional quality-adjusted life-years and save £218 m in NHS and social care costs over the lifetime of the current population. Greater benefits (e.g. a 37% higher gain in quality-adjusted life-years) were expected to accrue to individuals from the most socioeconomically deprived groups compared to the least deprived.ConclusionsThis analysis suggests that there are considerable potential health and economic gains from restricting the advertisement of high fat, salt and sugar products. The population health and economic impacts of the Transport for London advertising restrictions are likely to have reduced health inequalities in London.

Evidence of Youth-Appealing Cigarette Advertising Tactics from a Randomized, Controlled Experiment.

Receptivity to tobacco advertising is an important component in the progression from exposure to advertising to use behavior, yet little is known about current tobacco advertising tactics that increase receptivity. This study tests the effect of three advertising features identified in earlier work as potentially appealing to adolescents and young adults: flora imagery, eco-friendly language, and sweepstakes. We conducted an online survey in which 1,000 US adolescents (age 15-17) and 1,000 US young adults (age 18-24), equally stratified by smoking status, were exposed to three experimental modules manipulating presence/absence of each feature of interest on cigarette ads. After viewing each ad, participants reported their receptivity to the advertisement. Bivariable analysis and multivariable logistic regression analyses were used to assess the effect of each appeal's presence on receptivity. Adolescents (aOR = 1.55, 95%CI: 1.12-2.14) and young adults (aOR = 1.43, 95%CI: 1.06-1.93) were more likely to be receptive to ads with flora imagery. The effect of sweepstakes on receptivity was modified by the specific ad for young adults. Ecofriendly language did not significantly impact receptivity among either group. Exploratory subgroup analysis found a significant ad by sweepstakes interaction among young adult noncurrent smokers. These findings provide evidence that use of flora imagery increases cigarette advertising receptivity among adolescents and young adults, while the effect of sweepstakes on young adults might additionally depend on the ad shown. Restrictions on youth appealing advertising tactics, such as those identified in this study, as well as broader content-neutral advertising restriction policies, should be considered. This study provides evidence for the appeal of flora imagery in cigarette advertising for both adolescents and young adults, as well as the complexity of how use of sweepstakes interacts with branding in specific ads to predict receptivity among young adults. Because receptivity to cigarette advertising is a documented step in the pathway between advertising exposure and product use, restrictions on use of these tactics should be implemented, and broader content-neutral advertising restriction policies should be considered.

A Content Analysis of Cannabis Company Adherence to Marketing Requirements in Four States

Marketing messages can influence adolescents' attitudes and behaviors toward alcohol and tobacco. In the era of legalized cannabis use, retail cannabis companies often use social media marketing on platforms popular among youth. The purpose of this study was to evaluate adherence to state-based regulations for restricted and required content across social media from recreational cannabis businesses. A retrospective content analysis was used to evaluate one year of publicly displayed posts by retail cannabis companies on Facebook and Instagram from four states in which recreational cannabis use is legal (Alaska, Colorado, Oregon, and Washington State). We evaluated restricted content including the following: (a) business practices, such as avoiding discounts/promotions or promoting branded products; (b) modeling cannabis use or overconsumption; (c) youth-focused messaging; and (d) health benefits. We evaluated required content including three types of warnings: (a) limiting cannabis use to those age 21 and over, (b) avoiding impaired driving, and (c) describing health risks. A total of 2,660 posts were evaluated from 14 businesses. In the area of restricted content, discounts/promotions were present in approximately 35% of all posts. Another common category was overconsumption, found in 12% of posts. Required content regarding warnings was present in less than half of all social media posts. Despite state-based advertising restrictions, recreational cannabis business pages use messages with youth appeal. Required safety message adherence is not typical on social media business pages.

Alcohol Advertising in Pacific Islands Countries and Territories: A Scoping Review

Introduction: Alcohol has become embedded into the cultural, economic, and social fabric of Pacific Island Countries and Territories (PICT); however, it continues to be a neglected health issue for many PICT. This scoping literature review explores current alcohol advertising policies in each PICT.&#x0D; Methods: This review utilises the 'Preferred Reporting Items for Systematic Review and Meta-Analyses for Scoping reviews' to identify literature on alcohol advertising policies. Twenty-five sources, ranging from 1963 to 2020, form the final data synthesis.&#x0D; Findings: The results of this review reveal that not all PICT have alcohol advertising restrictions in place. Health warning labels as a means of deterring alcohol use are also inconsistent across PICT but aid in consumer decisions. A notable concern in alcohol advertising is the use of culture as a marketing ploy.&#x0D; Conclusion: This review provides essential information on alcohol advertising in PICT. Nine PICT enforce some form of alcohol advertising prohibition, and ten do not. In countries with alcohol advertising, drinking behaviours vary, demonstrating a need for further research on the implementation efforts of current policies. In countries with no alcohol advertising, alcohol use is normalised and portrayed as unproblematic. The use of health warning labels is also not consistent amongst PICT. The use of culture as a marketing ploy is unacceptable as it belittles culture and is disrespectful to leaders. Understanding the alcohol advertising restrictions that work in each PICT can help decrease alcohol consumption and the harms associated with its misuse across all PICT.&#x0D; Keywords: Alcohol, Advertising, Pacific.

Corporate political activity in the context of unhealthy food advertising restrictions across Transport for London: A qualitative case study.

BackgroundDiets with high proportions of foods high in fat, sugar, and/or salt (HFSS) contribute to malnutrition and rising rates of childhood obesity, with effects throughout the life course. Given compelling evidence on the detrimental impact HFSS advertising has on children’s diets, the World Health Organization unequivocally supports the adoption of restrictions on HFSS marketing and advertising. In February 2019, the Greater London Authority introduced novel restrictions on HFSS advertising across Transport for London (TfL), one of the most valuable out-of-home advertising estates. In this study, we examined whether and how commercial actors attempted to influence the development of these advertising restrictions.Methods and findingsUsing requests under the Freedom of Information Act, we obtained industry responses to the London Food Strategy consultation, correspondence between officials and key industry actors, and information on meetings. We used an existing model of corporate political activity, the Policy Dystopia Model, to systematically analyse arguments and activities used to counter the policy. The majority of food and advertising industry consultation respondents opposed the proposed advertising restrictions, many promoting voluntary approaches instead. Industry actors who supported the policy were predominantly smaller businesses. To oppose the policy, industry respondents deployed a range of strategies. They exaggerated potential costs and underplayed potential benefits of the policy, for instance, warning of negative economic consequences and questioning the evidence underlying the proposal. Despite challenging the evidence for the policy, they offered little evidence in support of their own claims. Commercial actors had significant access to the policy process and officials through the consultation and numerous meetings, yet attempted to increase access, for example, in applying to join the London Child Obesity Taskforce and inviting its members to events. They also employed coalition management, engaging directly and through business associations to amplify their arguments. Some advertising industry actors also raised the potential of legal challenges. The key limitation of this study is that our data focused on industry–policymaker interactions; thus, our findings are unable to present a comprehensive picture of political activity.ConclusionsIn this study, we identified substantial opposition from food and advertising industry actors to the TfL advertising restrictions. We mapped arguments and activities used to oppose the policy, which might help other public authorities anticipate industry efforts to prevent similar restrictions in HFSS advertising. Given the potential consequences of commercial influence in these kinds of policy spaces, public bodies should consider how they engage with industry actors.

Trailer Park Boys and the Promotional Cultures of Cannabis in Canada: Audiences, Influencers, and Imminent Commodities

While Canada, like most other nation states, has adopted various aspects of neoliberalism, the recent Cannabis Act presents ideological tensions and practical concerns given its advertising and promotional restrictions. Given the rise of neoliberalism within the dominant social, economic, and cultural system of consumer capitalism, it seems contradictory for the Canadian state to develop legislation that creates (or at least, legalizes) a new market wherein advertising and promotions (i.e., the driving forces of consumer capitalism) are effectively made absent. This article identifies and interrogates the existing tensions and contradictions between the Cannabis Act and the promotional cultures of consumer capitalism, as well as the ways in which the Trailer Park Boys (TPB) “brand” and performers (as promotional intermediaries) have attempted to circumvent the existing promotional restrictions. Beginning with a review of the existing literature regarding relevant theoretical perspectives and key concepts, the article provides a brief overview of the Cannabis Act, its promotional restrictions, and the exemptions and legal loopholes thereof. Finally, in presenting and engaging with a case study, this article concludes that the TPB brand has, effectively, circumvented the Cannabis Act’s existing restrictions and subsequently become a multi-platform promotional intermediary.

Young people's reflections on the factors contributing to the normalisation of gambling in Australia

ObjectivesTo explore young people's perceptions of the factors that may normalise gambling, and their opinions about the messages they see about gambling in their environments. MethodsAn analysis of qualitative data from a mixed methods study of n=111 young people aged 11–16 years in Victoria, Australia. Questions investigated: i) the normalisation of gambling in sport; ii) the impact of advertising on young people; and iii) potential strategies to alert young people about the risks associated with gambling. An inductive approach was used to analyse the data. ResultsParticipants perceived that gambling was a regular and everyday activity and that gambling was becoming normalised in sport. However, some directly challenged this alignment. They were particularly critical that gambling advertising may influence young people's current and future gambling‐related attitudes and intentions. Most participants supported public health interventions, including more advertising restrictions. ConclusionYoung people's awareness of gambling and gambling marketing may be increasing their perceptions of the alignment between gambling and sport. Implications for public healthStrategies should be developed to increase young people's awareness of the risks associated with gambling. Young people's voices and views should be considered by policy makers in responding to this new public health issue.

First Amendment Commercial Speech Claims in Dentistry: How the Dental Profession's Specialty Advertising Restrictions Have Come Back to Bite the ADA and State Dental Boards

First Amendment Commercial Speech Claims in Dentistry: How the Dental Profession's Specialty Advertising Restrictions Have Come Back to Bite the ADA and State Dental Boards

Regulating autologous stem cell interventions in Australia: updated review of the direct-to-consumer advertising restrictions.

Objective This paper provides an update and overview of the law governing direct-to-consumer (DTC) advertising of autologous stem cell interventions (ASCIs) in Australia. It follows significant changes to the advertising regulations made in 2018. Methods The paper reviews the three primary sources or 'centres' of law regulating ASCIs in Australia, together with the relevant guidance documents that supplement these sources. It provides analysis of how the post-2018 advertising regulations, contained in the Therapeutic Goods Act 1989 (Cwlth), apply to all 'biologicals', including ASCIs. It demonstrates how these three sources of law interact with one another and outlines the new tiered offence regime that applies to contraventions of these prohibitions. Results The analysis demonstrates that DTC advertising of ASCIs in Australia is strictly controlled, with primary legislation prohibiting the advertising of biologicals altogether. Conclusions The polycentric legal regime regulating biologicals in Australia clearly makes DTC advertising of ASCIs unlawful. Health practitioners who promote ASCIs, either online, in print or in other media forms, may be penalised in different ways and by different authorities. What is known about the topic? Although several analyses have examined the regulation of ASCIs in Australia, no analysis has studied the reforms made in 2018 relating to the advertising of biologicals. As such, this analysis contributes a fresh examination of these relatively recent reforms. What does this paper add? This analysis clarifies the effects of these new advertising regulations, providing clear guidance on the relevant legal provisions for the benefit of health practitioners and health professionals more generally. What are the implications for practitioners? Health practitioners, especially those who offer ASCIs, should be aware that civil and criminal penalties are likely to be imposed on individuals who promote biologicals in Australia by any means.