Spatial analysis of outdoor tobacco advertisement around children and adolescents in Indonesia

There is a major gap of action by the Indonesian government to control tobacco advertisement. This study aimed to compare outdoor tobacco advertisements (OTAs) in locations with and without OTA bans in relation to their proximity to children and adolescents. Global positioning system coordinates of all OTAs visible from the streets in Banyuwangi and Surabaya in East Java province were collected and analysed to determine their density at 0-100, >100-300 and >300-500 m from facilities used by children and adolescents. Hotspot analysis was conducted to identify places with exceptionally high densities of OTAs. The number and density of OTAs in Surabaya, where there was no policy for controlling OTAs, were greater than those in Banyuwangi, where OTAs were partially banned. Regardless of the existence of a ban, OTAs were 2.6-3.4 times denser in areas closer to facilities used by children and adolescents than further apart. The OTA point hotspots approximated the hotspots of tobacco retailers and facilities used by children and adolescents in both locations. A partial ban may only have a small impact. A total advertising ban, including at point of sale, should be encouraged for both locations for optimal protection of children and adolescents.