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

Health Place. 2022 Jul:76:102824. doi: 10.1016/j.healthplace.2022.102824. Epub 2022 May 31.


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.

Keywords: Adolescents; Education; Exposure; Inequality; Tobacco outlet; Tobacco promotion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cities
  • Educational Status
  • Humans
  • Nicotiana*
  • Tobacco Products*
  • Tobacco Use