Disparities in Exposure to Pro-Tobacco and anti-Tobacco Advertisements in the United States.

Objectives: This study investigates the prevalence of exposure to pro- and anti-tobacco advertisements across different sociodemographic groups and sources of exposure in the United States.

Methods: The study included 6252 participants from the Health Information National Trends Survey. Binary logistic regression was used to examine associations between exposure to pro and anti-tobacco advertisements, the sources of exposure, and demographic factors.

Results: 10% of our sample were current smokers. A rate of 48.14% reported exposure to pro-tobacco ads, and 61.28% reported exposure to anti-tobacco ads. Findings reveal notable disparities in exposure to both pro and anti-tobacco advertisements. Exposure to pro-tobacco ads was more common among current smokers (OR = 0.53 (95% CI 0.44-0.64), p < 0.001), male participants (female: OR = 0.85 (95% CI 0.77-0.95), p = 0.003), and younger adults. Reported exposure to anti-tobacco ads was more common among younger adults, individuals with lower levels of education and income, and current smokers. Radio, TV, and billboards were among the most common sources of ad exposure for both types. Stores were among the most common sources of exposure to pro-tobacco ads (stores: 35.58% (18-34), 39.58% (35-49), and online sources (21.71%) were among the sources where people encountered anti-tobacco messages most frequently.

Conclusions: The findings underscore the importance of understanding the changing media consumption patterns and advertising awareness across various demographic groups. They also highlight the urgent need for targeted tobacco prevention interventions, especially via Radio, TV, billboards, and stores, particularly among younger adults, racial minorities, and current smokers who show higher exposure to pro-tobacco ads.