title: Changes in tobacco industry advertising around high schools in Greece following an outdoor advertising ban: a follow-up study.
abstract: BACKGROUND
  As tobacco advertising bans are enacted in accordance with the Framework Convention on Tobacco Control, it is essential to assess enforcement and how the industry may circumvent such measures.
  
  
  OBJECTIVE
  During this longitudinal study, we compared the characteristics of points-of-sale (POS) advertising within 300 m of all high schools in Heraklion, Greece before (n=101 POS and 44 billboards in 2007) and after (n=106 POS in 2011) an outdoor advertising ban was implemented in 2009. Cigarette advertisements in all retailers near all high schools were assessed.
  
  
  RESULTS
  Following the ban, tobacco industry billboards around schools were eradicated (from 44 to 0). The proportion of POS that had external advertisements dropped from 98% to 66% (p<0.001), more so in regulated convenience stores (from 97% to 35%, p<0.001) than in kiosks (98% to 92%, p=0.192), which were exempt from the ban. The proportion of convenience stores that had advertisements on the door (79.5% to 20.4%, p<0.001), ads that could be seen from the street (92.3% to 22.4%, p<0.001) or illuminated exterior ads (46.2% to 10.2%, p<0.001) was also significantly reduced. Overall, the average number of exterior advertisements per POS fell from 7.4 to 3.9 (p<0.05). This reduction was noted in regulated convenience stores (4.8±3.0 vs 0.9±2.1, p<0.001) and in unregulated kiosks (9.0±6.7 vs 6.5±4.5, p=0.019).
  
  
  CONCLUSIONS
  The outdoor advertising restriction in Greece has led to a reduced number of tobacco advertisements per POS, and the eradication of billboard advertising. Nevertheless, there is a need to regulate kiosks, which were identified as a key vector for tobacco advertising, and to increase compliance among regulated convenience stores.
authors.affiliation: Department of Social Medicine, Clinic of Social and Family Medicine, University of Crete, Heraklion, Greece. vardavas@hsph.harvard.edu
authors.forename: Constantine I
authors.initials: CI
authors.lastname: Vardavas
authors.forename: Charis
authors.initials: C
authors.lastname: Girvalaki
authors.forename: Lambros
authors.initials: L
authors.lastname: Lazuras
authors.forename: Danai
authors.initials: D
authors.lastname: Triantafylli
authors.forename: Christos
authors.initials: C
authors.lastname: Lionis
authors.forename: Gregory N
authors.initials: GN
authors.lastname: Connolly
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Behrakis
mesh_terms: D000329:Advertising / Q000331:legislation & jurisprudence*; D005500:Follow-Up Studies; D006115:Greece; D006801:Humans; D008137:Longitudinal Studies; D012574:Schools; D000074606:Smoking Prevention; D019460:Tobacco Industry / Q000331:legislation & jurisprudence*; D062789:Tobacco Products
keywords: Advertising and Promotion; Prevention; Priority/special populations; Surveillance and monitoring