Exposure to advertising of tobacco products at points of sale and consumption of tobacco in adolescents from 3 large cities in Argentina. Cross-sectional study

Background Several researches have demonstrated a strong association between exposure tobacco advertising at point of sale (PoS) and tobacco susceptibility, experimentation and adolescent uptake. However, there are no local studies demonstrating this association.Our objective was to explore the association between exposure to tobacco advertising in PoS located near secondary schools and smoking in early adolescents in 3 Argentinean cities: Córdoba, Tucumán and Buenos Aires Methods This is a cross-sectional study with two descriptive sources: information about tobacco consumption was obtained through a survey of adolescents from 33 secondary schools in Buenos Aires, Córdoba and Tucumán. In addition, data on cigarette advertising in the PoS were relayed within 300 meters of each selected school. An exposition index was derived by multiplying the frequency of going to tobacco shops and a marketing index of each PoS (obtained by adding the number of signs, visibility from outside and displaying tobacco less than 1m from children's products). We explored the association between exposure to PoS advertising and smoking at individual and school level through multilevel logistic regression, adjusting for sociodemographics, social network smoking, and sensation seeking. Results The questionnaire was completed by 1680 students, 158 (9.4%) smokers, 895 (53%) no susceptible non-smokers, 389 (23%) susceptible non-smokers and 274 (16.3%) experimenters. We surveyed 340 PoS, 88 (25.88%) in Tucumán, 80 (23.53%) in Córdoba and 170 (50%) in Buenos Aires. Exposure to PoS advertising was significantly associated with being an experimenter (OR = 1.58, 95% CI 1.16-2.14) and susceptible (OR = 1.65, 95% CI 1.2-2.25) in the highest quartile of exposure. Smokers OR (95% IC) Experimenters OR (95% IC) Susceptibles OR (95% IC) Quartile 2 1.19 (0.838 - 1.685) 1.16 (0.873 - 1.534) 1.33 (0.983 - 1.792) Quartile 3 1.32 (0.930 - 1.874) 1.32 (0.996 - 1.754) 1.15 (0.839 - 1.584) Quartile 4 1.22 (0.848 - 1.758) 1.58 (1.160 - 2.147)§ 1.65 (1.207 - 2.250)§ OR= Odds Ratio § p