The relationship between tobacco advertisements and smoking status of youth in India

To examine the relationship between tobacco advertisements, counter-advertisements, and smoking status among Indian youth.

Global Youth Tobacco Survey (GYTS) data was used; the data encompassed a representative two-stage probability sample of 60,001 students aged 13-15 years in 24 states in India. These students were interviewed with an anonymous, self-administered questionnaire. Binary logistic regression analyses were performed with smoking status as the dependent variable, and exposure to cigarette advertisements or counter-advertisements as independent variables.

Students watching anti-smoking media messages were less likely to be current smokers, which was true for both boys [OR = 0.89, 95% CI (0.81-0.98)] and girls [OR = 0.79, 95% CI (0.69-.90)]. This relationship was stronger among past smokers for boys [OR = 0.56, 95%CI (0.52-0.60)] and girls [OR = 0.49, 95% CI (0.45-0.53)]. On the other hand, students who were exposed to cigarette brand names during sports events and other televised programs, newspapers or magazines, and being offered free cigarette or cigarette-branded merchandise promotions were significantly more likely to be smokers, with effects ranging from moderate (OR=1.19) to very strong (OR=3.83).

This is the first attempt from India to investigate the relationship between smoking and advertising. When the data were collected, cigarette advertising was legal and highly correlated with smoking behavior. Today, indirect surrogate advertising still exists; future research should examine its effect, as it is likely to have the same impact as direct advertising on smoking behavior. Finally, counter-advertising has a protective effect on youth and may function as a cessation aid.