Effectiveness of tobacco advertising, promotion and sponsorship bans on smoking prevalence, initiation and cessation: a systematic review and meta-analysis

Background: Bans on tobacco advertising, promotion and sponsorship (TAPS) have the potential to influence smoking behaviour. However, many countries are yet to implement such strategies.

Objective: This study aimed to synthesise contemporary evidence on the effectiveness of TAPS bans on smoking prevalence, initiation and cessation.

Data sources: Medline, EMBASE, Scopus, Cochrane Library and Web of Science databases were searched up to 11 April 2024. Sixteen eligible studies were included.

Data selection and extraction: Two reviewers independently screened each study and extracted relevant data. Quality assessment was performed in duplicate using the ROBINS-I tool. Discrepancies were resolved via consensus or a third reviewer. Random effects meta-analyses were conducted for reasonably comparable studies.

Data synthesis: The meta-analyses showed that TAPS bans were associated with a lower prevalence of current smoking (pooled OR= 0.80, 95% CI 0.68 to 0.95, I ²=98.7%) and a reduced risk of smoking initiation (pooled HR=0.63, 95% CI 0.48 to 0.82, I ²=95%). There was no association between TAPS bans and smoking cessation (pooled OR=1.10, 95% CI 0.86 to 1.40, I² =58.5%). Subgroup analyses revealed the effects of TAPS bans on smoking prevalence differed by duration of evaluation (p<0.01).

Conclusions: This review showed that TAPS bans were associated with a 20% lower odds of current smoking and a 37% reduced risk of smoking initiation. The available evidence suggests that TAPS bans influence smoking behaviour, which strengthens calls for the implementation and enforcement of these policies.