Improving legislation is a necessity: A multi-method quantitative analysis of tobacco sponsorship and publicity in...

Although the WHO Framework Convention on Tobacco Control (FCTC) mandates a comprehensive ban, tobacco sponsorship persists as a significant challenge in China. Focusing on this issue, this study aims to describe, identify, and understand the amounts, publicity, and influencing mechanism of tobacco sponsorship in China.

This multi-method quantitative study collected data from the China Tobacco Yearbooks for provincial tobacco sponsorship and production data, the Chinalawinfo Open Platform for anti-smoking regulations, and four tobacco industry websites for publicity materials, covering 2015 to 2022. Using ArcMap, STATA, and Python, we integrated spatial autocorrelation analysis, topic modeling, content analysis, and statistical modeling.

Tobacco sponsorship amounts nationwide plummeted in 2017, followed by a gradual recovery until another decline in 2021. Spatial analysis revealed significant positive spatial autocorrelation from 2016-2020 and in 2022 (Global Moran's I>0.1, p<0.05). Sponsorship publicity predominantly centered on four topics: natural and health disaster response, tobacco product production and manufacturing, poverty alleviation and policy response, and customer service and brand building. OLS regression indicated that smoke-free law efficacy was negatively associated with sponsorship amounts (β= -0.149; 95% CI: -0.238 - -0.060; p<0.01), while cigarette production showed a positive association (β=0.001; 95% CI: 0.001-0.002; p<0.01). These associations remained robust after controlled for government-industry connection and production chain linkage. Mediation analysis further suggested that 'Mentioning tobacco farmers' served as a significant negative mediator for the impact of SLE (indirect effect= -0.351; 95% CI: -0.603 - -0.099; p<0.01) and a significant positive mediator for cigarette production (indirect effect=0.001; 95% CI: 0.000-0.001; p<0.05), government-industry connection (indirect effect=0.138; 95% CI: 0.084-0.192; p<0.01), and production chain linkage (indirect effect=0.338; 95% CI: 0.255-0.420; p<0.01). Robustness checks using heteroscedasticity-consistent and province-clustered standard errors confirmed the stability of these findings.

Tobacco sponsorship is fundamentally profit-driven because it mainly funds and publicizes components of the production chain, particularly tobacco farmers. As its severity may be constrained by anti-tobacco legislation, future studies are needed to continuously monitor these evolving strategies, thereby accumulating sufficient evidence to support the introduction and implementation of comprehensive, nationwide legislation that clearly defines and penalizes all sponsorship activities in China.