Assessing tobacco marketing receptivity among youth: integrating point of sale marketing, cigarette package branding and branded merchandise

Background As countries prohibit tobacco marketing through traditional channels, marketing at point of sale (PoS) and through tobacco packaging is increasingly important for promoting tobacco consumption. Objectives Assess the validity of a novel marketing receptivity index that considers frequency of PoS exposures, tobacco brand recall and ownership of branded merchandise. Methods Data come from a cross-sectional survey of 3172 secondary school students in Argentina. Questions assessed frequency of going to stores where tobacco is often sold; cued recall of brand names for 3 cigarette packages with brand name removed and ownership of branded merchandise. A four-level marketing receptivity index was derived: low PoS exposure only; high PoS exposure or recall of 1 brand; recall of 2 or more brands; and ownership of branded merchandise. Indicators of marketing receptivity and smoking involvement were regressed on the index, including in adjusted models that controlled for sociodemographics, social influences and sensation seeking. Findings Among never-smokers, the index had independent positive associations with smoking susceptibility (ie, adjusted OR (AOR)(2v1)=1.66; AOR(3v1)=1.64; AOR(4v1)=2.95), willingness to try a specific brand (ie, AOR(2v1)=1.45; AOR(3v1)=2.38; AOR(4v1)=2.20) and positive smoking expectancies (ie, Badj(2v1)=0.09; Badj(3v1)=0.18; Badj(4v1)=0.34). A more marked dose-response independent association was found with current smoking behaviour (ie, AOR(2v1)=2.47; AOR(3v1)=3.16; AOR(4v1)=3.62). Conclusions The marketing receptivity index was associated with important variation in smoking-related perceptions, intentions and behaviour among Argentine adolescents. Future research should determine the predictive validity and generalisability of this measure to other contexts, including the explanatory power gained by integrating cigarette package brand recognition tasks.