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, I2=98.7%) and a reduced risk of smoking initiation (pooled HR=0.63, 95% CI 0.48 to 0.82, I2=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.