Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, Fourth Floor, Baltimore, MD, 21205, USA.
Int J Equity Health. 2021 Oct 30;20(1):238. doi: 10.1186/s12939-021-01576-2.
Disparities in exposure to and density of tobacco advertising are well established; however, it is still unclear how e-cigarette and heated tobacco product (HTP) advertising vary by age, education, sex, gender identity, race/ethnicity, sexual orientation, socioeconomic status (SES), and/or urban/rural area. Through a scoping review, we sought to identify potential disparities in exposure to e-cigarette and HTP advertising and promotion across populations.
In January 2020, a systematic literature search was conducted in five databases: PubMed, Scopus, Embase, Web of Science, and the Cochrane Library. The search was updated in October 2020. Articles reporting on exposure to e-cigarette and/or HTP advertising and promotion across age, education, sex, gender identity, race/ethnicity, sexual orientation, SES, and/or urban/rural areas were included for full-text review (n = 25). Of those, 15 were deemed relevant for data extraction.
The majority of the studies were from the U.S. (n = 12) and cross-sectional (n = 14). Studies were published between 2014 and 2020 and focused on determining causal relationships that underlie disparities; only one study assessed HTP advertising and promotion. Exposure to e-cigarette and HTP advertising was assessed at the individual-level (e.g., recall seeing ads on television) and at the neighborhood-level (e.g., ad density at the point-of-sale). Studies addressed differences across age (n = 6), education (n = 2), sex (n = 6), gender identity and sexual orientation (n = 3), race/ethnicity (n = 11), SES (n = 5), and urban/rural (n = 2). The following populations were more likely to be exposed to e-cigarette advertising: youth, those with more than a high school diploma, males, sexual and gender minorities, Whites, and urban residents. At the neighborhood-level, e-cigarette advertisements were more prevalent in non-White neighborhoods.
Exposure to e-cigarette/HTP advertising varies based on sociodemographic characteristics, although the literature is limited especially regarding HTPs. Higher exposure among youth might increase tobacco-related disparities since it can lead to nicotine/tobacco use. Research should incorporate and apply a health equity lens from its inception to obtain data to inform the elimination of those disparities.
烟草广告的暴露程度和密度存在差异，这一点已得到充分证实；然而，电子烟和加热烟草产品（HTP）广告的差异如何因年龄、教育程度、性别、性别认同、种族/民族、性取向、社会经济地位（SES）以及/或城乡地区而变化，目前仍不清楚。通过范围界定审查，我们试图确定在人口中电子烟和 HTP 广告和促销方面潜在的差异。
2020 年 1 月，在五个数据库中进行了系统文献检索：PubMed、Scopus、Embase、Web of Science 和 Cochrane 图书馆。2020 年 10 月进行了更新。纳入了报告电子烟和/或 HTP 广告和促销在年龄、教育程度、性别、性别认同、种族/民族、性取向、SES 以及/或城乡地区之间的暴露情况的全文审查文章（n=25）。其中，有 15 篇被认为与数据提取相关。
大多数研究来自美国（n=12），且为横断面研究（n=14）。研究发表于 2014 年至 2020 年之间，重点是确定导致差异的根本因果关系；只有一项研究评估了 HTP 广告和促销。电子烟和 HTP 广告的暴露情况是在个体层面（例如，回忆在电视上看到广告）和邻里层面（例如，销售点的广告密度）进行评估的。研究涉及年龄（n=6）、教育程度（n=2）、性别（n=6）、性别认同和性取向（n=3）、种族/民族（n=11）、SES（n=5）和城乡（n=2）差异。以下人群更有可能接触到电子烟广告：年轻人、受过高中以上教育的人、男性、性和性别少数群体、白人以及城市居民。在邻里层面，电子烟广告在非白人社区更为普遍。
电子烟/HTP 广告的暴露程度因社会人口特征而异，尽管有关 HTP 的文献有限。由于年轻人可能会增加与烟草相关的差异，因为它会导致尼古丁/烟草使用，因此，年轻人的暴露率较高可能会导致这种差异。研究应从一开始就纳入并应用健康公平视角，以获取数据来消除这些差异。
