Commercial determinants of youth smoking in ASEAN countries: A narrative review of research investigating the influence of tobacco advertising, promotion, and sponsorship
Thomas Stubbs
Abstract
People's Democratic Republic (Lao PDR), Myanmar, Vietnam, Indonesia, the Philippines, Thailand, Malaysia, Brunei Darussalam, and Singapore 3 . The ASEAN region is home to approximately 10% of the world's one billion smokers 4 . The range of noncommunicable diseases and economic costs associated with tobacco use are a major burden to developing countries throughout this region One factor contributing to this issue is the continued uptake of smoking among youth, defined by the ABSTRACT INTRODUCTION Tobacco smoking is one of the leading causes of death and disability in the Association of Southeast Asian Nations (ASEAN). Despite implementation of some tobacco control measures, youth continue to initiate smoking. This narrative review outlines how tobacco advertising, promotion, and sponsorship (TAPS) may influence smoking attitudes and uptake among youth in the region. METHODS Nine electronic databases were searched on EBSCOhost to identify studies published up until December 2019. All studies published in English that investigated youth smoking and TAPS in ASEAN countries were included. Thematic analysis was used to investigate the influence of TAPS on youth smoking. RESULTS Thirty-seven studies were identified. This research showed that youth were exposed and receptive to tobacco advertising, which may contribute to positive attitudes towards tobacco brands and smoking. Studies also demonstrated that youth were exposed to point-of-sale (POS) advertisements or promotions and individual sales promotions. However, little research has explored how these strategies influence attitudes and consumption behaviors among youth, or, how online advertising and cigarette packet branding may influence youth smoking. CONCLUSIONS Youth in ASEAN countries continue to be exposed to TAPS, particularly through POS advertisements or promotions and individual sales promotions. There is also cause for concern about 'below-the-line' advertising and the increasing role of cigarette packaging as a promotional tool. These findings support calls for all ASEAN countries to ratify the Framework Convention on Tobacco Control (FCTC), introduce comprehensive bans on all forms of tobacco advertising, including POS advertising and cigarette pack displays, and implement plain packaging legislation for tobacco products.