Neighborhood-based tobacco advertising targeting adolescents.

Adolescent tobacco use remains a serious problem, and adolescents may be particularly receptive to the glamorous images tobacco companies use in advertisements. A relatively new form of neighborhood-based outdoor advertising, the illuminated bus-stop-shelter billboard, was studied to determine tobacco companies' use of this medium. We hypothesized that in 2 distinct San Francisco, California, neighborhoods, 1 predominantly white and the other mostly Latino, we would find a predominance of tobacco advertising on these billboards in both neighborhoods, that tobacco advertisements would be more prevalent in the minority Latino neighborhood, and that tobacco advertising would target adolescents in both neighborhoods. Each bus-stop-shelter billboard advertisement in the study areas from April 1992 to March 1993 was recorded. The type and frequency of products advertised and qualitative content of tobacco advertisements were analyzed. Adolescents' possible exposure to these advertisements was noted. Our main outcome measures were the percentage of tobacco advertising, possible adolescent exposure to this advertising, and themes of the tobacco advertisements. About 10% of all bus-stop-shelter billboard advertisements in each area promoted tobacco use. Possible exposures to these advertisements were greater in the Latino neighborhood because of a greater adolescent population. Qualitative analyses of tobacco advertisements suggested that adolescents are the primary targets. We urge physicians and educators to explicitly address this form of tobacco advertising, and we urge a ban on neighborhood-based tobacco advertising.