title: The environmental profile of a community's health: a cross-sectional study on tobacco marketing in 16 countries.
abstract: OBJECTIVE
  To examine and compare tobacco marketing in 16 countries while the Framework Convention on Tobacco Control requires parties to implement a comprehensive ban on such marketing.
  
  
  METHODS
  Between 2009 and 2012, a kilometre-long walk was completed by trained investigators in 462 communities across 16 countries to collect data on tobacco marketing. We interviewed community members about their exposure to traditional and non-traditional marketing in the previous six months. To examine differences in marketing between urban and rural communities and between high-, middle- and low-income countries, we used multilevel regression models controlling for potential confounders.
  
  
  RESULTS
  Compared with high-income countries, the number of tobacco advertisements observed was 81 times higher in low-income countries (incidence rate ratio, IRR: 80.98; 95% confidence interval, CI: 4.15-1578.42) and the number of tobacco outlets was 2.5 times higher in both low- and lower-middle-income countries (IRR: 2.58; 95% CI: 1.17-5.67 and IRR: 2.52; CI: 1.23-5.17, respectively). Of the 11,842 interviewees, 1184 (10%) reported seeing at least five types of tobacco marketing. Self-reported exposure to at least one type of traditional marketing was 10 times higher in low-income countries than in high-income countries (odds ratio, OR: 9.77; 95% CI: 1.24-76.77). For almost all measures, marketing exposure was significantly lower in the rural communities than in the urban communities.
  
  
  CONCLUSIONS
  Despite global legislation to limit tobacco marketing, it appears ubiquitous. The frequency and type of tobacco marketing varies on the national level by income group and by community type, appearing to be greatest in low-income countries and urban communities.
authors.affiliation: Department for Health, University of Bath, Bath, England .
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mesh_terms: D006801:Humans; D000329:Advertising / Q000379:methods / Q000706:statistics & numerical data; D001211:Asia, Western; D002170:Canada; D003430:Cross-Sectional Studies; D007407:Interviews as Topic; D016015:Logistic Models; D040541:Marketing; D012111:Residence Characteristics; D012424:Rural Population / Q000706:statistics & numerical data; D012931:Social Environment; D012959:Socioeconomic Factors; D013020:South America; D013548:Sweden; D019460:Tobacco Industry; D014479:United Arab Emirates; D014505:Urban Population / Q000706:statistics & numerical data; D062789:Tobacco Products