Educational inequalities in exposure to tobacco promotion at the point of sale among adolescents in four Dutch cities

• Published in: Health & place 2022-07, Vol.76, p.102824, Article 102824
• Main Authors: Zijp, Anne, van Deelen, Tessa R.D., van den Putte, Bas, Kunst, Anton E., Kuipers, Mirte A.G.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Cities; Education; Educational Status; Exposure; Humans; Inequality; Tobacco outlet; Tobacco Products; Tobacco promotion; Tobacco Use
• ISSN: 1353-8292; 1873-2054; 1873-2054
• DOI: 10.1016/j.healthplace.2022.102824

This study aimed to assess educational differences in adolescents’ exposure to tobacco outlets. Data were collected among 312 13-17-year-old non-smoking secondary school students in four Dutch cities. In a smartphone app, exposure (≤10 m from outlet) was measured using GPS and participants reported their educational track (pre-vocational vs. pre-university). Associations were estimated in negative binomial regression models. Mean exposure to tobacco outlet was 16.6 times in 14 days. Pre-vocational education was associated with higher exposure compared to pre-university education (IRR:1.46, 95%CI:1.08–1.98), especially around school (IRR:2.61,95%CI:1.50–4.55). These differences may contribute to socioeconomic inequalities in smoking. •Adolescents' exposure to tobacco points of sale (POS) was measured using GPS.•On average, adolescents were exposed to tobacco POS 16.6 times in 14 days.•Pre-vocational students was associated ca.50% higher exposure than pre-university.•500 m around the school pre-vocational students were exposed 2.6 times more often.•The educational differences were largest for supermarkets and hospitality venues.