Patterns in Tobacco, E-Cigarette, and Cannabis Advertising Exposure Among California Adolescents and Associations With Future Use Expectations.

BACKGROUND: Exposure to tobacco, e-cigarette, or cannabis marketing is associated with adolescent use. Few studies have examined advertising exposure prevalence and patterns across these products concurrently. METHODS: This study assessed past 30-day recalled exposure to promotional messages about tobacco, e-cigarettes ("vapes" on the survey), and cannabis ("marijuana") from various sources among California adolescents (ages 12-17) in the 2022 Teens, Nicotine, and Tobacco Online Survey (N = 2530). Principal components analysis (PCA) was conducted to examine the underlying structure and patterns in advertising exposure sources. Multivariable logistic regression was used to evaluate associations between any advertising exposure and future use expectations (a susceptibility measure) in one year and at age 25 among current never-users. RESULTS: Overall, 65.9% of participants recently noticed at least one tobacco (52.5%), vape (51.5%), or marijuana (45.6%) advertisement. Gas stations or convenience stores were the most common source for tobacco or vape ads; billboards were for marijuana ads. In PCA, advertising exposure patterns correlated with advertising source, not the type of product. Exposures from tobacco-specific sources and nearer point of sale were associated with current use, older age, LGBTQ + identity, and sensation seeking. Among never-users, advertising exposure was associated with one-year and age-25 use expectations for cigarettes (one-year expectations adjusted odds ratio: 1.7; 95% CI: 1.1, 2.5), vapes (2.3; 1.5, 3.5), and marijuana (2.1; 1.5, 3.0). CONCLUSION: California adolescents' exposure to tobacco, e-cigarette, and cannabis marketing is common, follows similar patterns, and is associated with use susceptibility. Comprehensive restrictions on marketing accessible to adolescents could help prevent youth use.

Differences in child and adolescent exposure to unhealthy food and beverage advertising on television in a self-regulatory environment.

BACKGROUND: Food and beverage promotion is a contributor to children's dietary behaviours, and ultimately, downstream health consequences. Broadcast television remains an important source of such advertising. The objective of this study was to examine and compare children and adolescent's exposure to food advertising on television in Canada over an entire year in a self-regulatory environment. METHODS: Television advertising data for 57 selected food and beverage categories were licensed from Numerator for 36 stations in Toronto, for 2019. The estimated average number of advertisements viewed by children aged 2-11 and adolescents aged 12-17 was determined overall, by food category, and by marketing technique. The healthfulness of advertisements was also assessed using Health Canada's Nutrient Profile Model. RESULTS: Overall in 2019, children viewed 2234.4 food ads/person/yr while adolescents viewed 1631.7 ads, exposure for both groups stemmed primarily from stations with general appeal, and both age groups were exposed to a range of powerful marketing techniques. Exposure to advertising for restaurants, snacks, breakfast food and candy and chocolate was high among both age groups and the healthfulness of most advertised products was considered poor. Adolescents were exposed to 36.4% more food products classified as unhealthy, had higher exposure to all marketing techniques examined, and were exposed to substantially more child-related marketing techniques compared to children. CONCLUSION: Children and adolescents were heavily exposed to food advertisements on television in 2019. Despite current self-regulatory policies, children's exposure to unhealthy food and beverages remains high. Differences in exposure to food advertisements by food category and healthfulness may suggest that adolescents are being disproportionately targeted by food companies as a result of self-regulatory marketing restrictions.

Newspaper Campaign to Promote Deceased Organ Donation: Who Can Appeal to the General Japanese Population?

BACKGROUND: Various interventions are reportedly effective in promoting organ donor registration. However, the identity of those who best serve as presenters to appeal to the general public is not known. METHODS: A campaign for organ donor registration was conducted through a local newspaper advertisement in Japan. The advertisement appeared in 439,733 copies of the newspaper on January 9, 2021. In addition to the main message, 6 different presenters with photos of their faces and quick response codes were listed in the advertisement, namely a urologist, transplant physician, nephrologist, dialysis physician, ophthalmologist, and kidney transplant recipient who was a nephrologist himself (ie, a recipient and nephrologist). Newspaper readers watched each video about deceased organ donation via the quick response codes, and the number of video views acquired 30 days after the appearance was the main outcome, which was assessed using YouTube analytics. The proportions (95% CI) of people who watched each video among 439,733 newspaper readers were compared among the 6 presenters. RESULTS: The analyzed videos were viewed 262 times. The video produced by the recipient and nephrologist had the highest number of views among the 6 presenters (proportion: 0.019% [95% CI, 0.015-0.023]), followed by the one produced by the dialysis physician (0.011% [95% CI, 0.008-0.014]), the nephrologist (0.010% [95% CI, 0.007-0.014]), the urologist (0.008% [95% CI, 0.006-0.012]), the transplant physician (0.006% [95% CI, 0.004-0.009]), and the ophthalmologist (0.005% [95% CI, 0.004-0.008]). CONCLUSIONS: The appeal by the recipient and the nephrologist reached the highest proportion of people who watched the video about deceased organ donation in Japan.

National Trends of Adolescent Exposure to Tobacco Advertisements: 2012-2020.

BACKGROUND AND OBJECTIVES: The objective of the current study is to evaluate the temporal trends in the prevalence of cigarette and electronic cigarette (e-cigarette) advertisement exposure by venue and sociodemographic correlates among US adolescents from 2012 to 2020. METHODS: We conducted a serial cross-sectional analysis of nationally representative samples of middle and high school youth from the 2012-2020 National Youth Tobacco Survey. Advertisement exposure was defined as self-report of seeing advertisements "sometimes," "most of the time," and "always." The prevalence of cigarette (and other tobacco products) and e-cigarette advertisement exposure, including overall and at specific venues (Internet, press, screen, and retail stores), was estimated by survey year. RESULTS: A total of 139 795 adolescents aged 11 to 19 years old were included in the analysis. The prevalence of exposure to combustible cigarette marketing remained high across all years (any venue ranging from 77.0% [2018] to 91.1% [2014]). An increasing trend for cigarette advertisement exposure was observed from 2017 to 2020 after a drop in 2015 (ß2012-2015 = 2.8, P for trend < .001; ß2017-2020 = .7, P for trend = .03), driven by retail store-based and Internet-based exposure. A similar increasing pattern in the estimated prevalence of e-cigarette marketing was observed (ß2014-2016 = 4.6, P for trend < .001; ß2017-2020 = 5.1, P for trend < .001). CONCLUSIONS: Given the high estimated prevalence of cigarette and e-cigarette marketing exposure among US adolescents, further regulation efforts for both off-line and online tobacco marketing are needed to mitigate adolescent exposure to content regarding these products, reducing susceptibility to uptake.

An evaluation of the evidence submitted to Australian alcohol advertising policy consultations.

BACKGROUND: Industry self-regulation is the dominant approach to managing alcohol advertising in Australia and many other countries. There is a need to explore the barriers to government adoption of more effective regulatory approaches. This study examined relevance and quality features of evidence cited by industry and non-industry actors in their submissions to Australian alcohol advertising policy consultations. METHODS: Submissions to two public consultations with a primary focus on alcohol advertising policy were analysed. Submissions (n = 71) were classified into their actor type (industry or non-industry) and according to their expressed support for, or opposition to, increased regulation of alcohol advertising. Details of cited evidence were extracted and coded against a framework adapted from previous research (primary codes: subject matter relevance, type of publication, time since publication, and independence from industry). Evidence was also classified as featuring indicators of higher quality if it was either published in a peer-reviewed journal or academic source, published within 10 years of the consultation, and/or had no apparent industry connection. RESULTS: Almost two-thirds of submissions were from industry actors (n = 45 submissions from alcohol, advertising, or sporting industries). With few exceptions, industry actor submissions opposed increased regulation of alcohol advertising and non-industry actor submissions supported increased regulation. Industry actors cited substantially less evidence than non-industry actors, both per submission and in total. Only 27% of evidence cited by industry actors was highly relevant and featured at least two indicators of higher quality compared to 58% of evidence cited by non-industry actors. CONCLUSIONS: Evaluation of the value of the evidentiary contribution of industry actors to consultations on alcohol advertising policy appears to be limited. Modifications to consultation processes, such as exclusion of industry actors, quality requirements for submitted evidence, minimum standards for referencing evidence, and requirements to declare potential conflicts, may improve the public health outcomes of policy consultations.

Characterization of US Hospital Advertising and Association With Hospital Performance, 2008-2016.

Importance: Hospital advertising has been touted as a tool to improve consumer decision-making, but little is known about its association with objective measures of hospital quality. Objective: To document recent trends in hospital advertising in the US and examine the association between concurrent measures of hospital advertising and quality. Design, Setting, and Participants: Retrospective cross-sectional study of all general acute care hospitals operating in the US between January 2008 and December 2016. Data were analyzed from December 6, 2019, to July 15, 2020. Exposure: Annualized advertising spending for each hospital as measured by a market research firm. Main Outcomes and Measures: Four composites of hospital performance from the Centers for Medicare & Medicaid Services Hospital Compare database were used: risk-standardized mortality rate, risk-standardized readmission rate, Consumer Assessment of Healthcare Providers & Systems (CAHPS) Overall Patient Experience Rating (scale of 1-5; higher scores indicate a more positive patient experience rating), and overall 5-star rating. Linear models adjusted for hospital bed size, hospital revenue, and geographic census region. Results: The study sample included, on average, 4569 general acute care hospitals per year between 2008 and 2016. During this time, approximately half of acute care hospitals (2239 of 4569 [49%]) advertised their services to consumers and spent a total of $3.39 billion. Relative to hospitals that never advertised, advertising hospitals were more likely to be nonprofit facilities (mean [SD], 66% [47%] vs 51% [50%]; P < .001), had larger bed sizes (mean [SD], 234.3 [210.7] beds vs 84.8 [110.6] beds; P < .001), and had higher net incomes (mean [SD], $17 800 000 [$49 000 000] vs $134 099 [$51 600 000]; P < .001). There was no observed association between hospital advertising and performance. For example, hospitals that advertised had a mean (SD) CAHPS 5-star rating of 3.2 (0.9) stars compared with 3.3 (1.0) stars among hospitals that did not advertise, an insignificant difference (P = .92). We observed no difference in performance between advertising and nonadvertising hospitals in 30-day readmission rates (mean [SD], 15.5% [0.8%] vs 15.6% [1.0%]; P = .25), mortality rates (mean [SD], 12.7% [4.0%] vs 12.0% [4.1%]; P = .46), and overall 5-star hospital ratings (mean [SD], 3.1 [0.8] stars vs 3.0 [0.9] stars; P = .50). A significant difference was observed in adjusted mortality rates across terciles of advertising spending, with lower mortality rates for the hospitals with higher ad spending (2016, mean [SD] mortality composite for hospitals in the highest tercile, 11.2% [4.2%] vs hospitals in the middle tercile, 12.0% [3.8%], and for hospitals in the lowest tercile, 12.7% [4.1%]; P = .003). Conclusions and Relevance: The results of this cross-sectional study suggest that the amount hospitals spent on direct-to-consumer advertising was not associated with publicly reported measures of hospital quality; instead, hospital advertising spending was higher for financially stable hospitals with higher net incomes.

Are bottle shops using Twitter to increase advertising or encourage drinking during COVID-19?

OBJECTIVE: Preliminary reports suggested that liquor retailers used COVID-19 to promote alcohol through sponsored posts on Facebook and Instagram. To further understand the advertising practices during this period, we aimed to determine whether packaged liquor retailers increased their posts during COVID-19 or used COVID-19 to promote alcohol on Twitter. METHODS: 'Tweets' (Twitter posts) from all packaged liquor retailers in NSW written since 2018 were collected. Tweets written during the first COVID-19 lockdown period were coded for: references of COVID-19, types of marketing message, use of links to online stores and use of an alcohol-related 'meme'. RESULTS: There was no evidence of increased tweet frequency, however, some COVID-specific alcohol advertising was detected that leveraged the pandemic (4.0%) or referencing the pandemic without explicitly promoting alcohol (12.0%). The most popular market messages used in the tweets were encouraging alcohol use (15.4%) and easy access to alcohol at home (9.5%). CONCLUSIONS: At least on Twitter, there was no marked increase in posts from packaged liquor retailers in NSW and only some tweets used COVID-19 to promote alcohol. Implications for public health: The use of COVID-specific alcohol marketing on social media raises important considerations for legislative and regulatory requirements, particularly during major health events such as a pandemic.

Relationship between Drug Overdose Mortality and Coverage of Drug-Related Issues in US Television Political Campaign Advertising in the 2012 and 2016 Election Cycles.

CONTEXT: Understanding the role of drug-related issues in political campaign advertising can provide insight on the salience of this issue and the priorities of candidates for elected office. This study sought to quantify the share of campaign advertising mentioning drugs in the 2012 and 2016 election cycles and to estimate the association between local drug overdose mortality and drug mentions in campaign advertising across US media markets. METHODS: The analysis used descriptive and spatial statistics to examine geographic variation in campaign advertising mentions of drugs across all 210 US media markets, and it used multivariable regression to assess area-level factors associated with that variation. FINDINGS: The share of campaign ads mentioning drugs grew from 0.5% in the 2012 election cycle to 1.6% in the 2016 cycle. In the 2016 cycle, ads airing in media markets with overdose mortality rates in the 95th percentile were more than three times as likely to mention drugs as ads airing in areas with overdose mortality rates in the 5th percentile. CONCLUSIONS: A small proportion of campaign advertising mentioned drug-related issues. In the 2016 cycle, the issue was more prominent in advertising in areas hardest hit by the drug overdose crisis and in advertising for local races.

Breakfast Food Advertising and Prevention of Obesity: Analysis of the Nutritional Value of the Products and Discursive Strategies Used in the Breakfast Ads from 2015 to 2019.

Breakfast is widely considered the most important meal of the day. Despite this, the consumption of ready to eat industrial products with low nutritional value is increasing. This study correlated longitudinally the nutritional value of breakfast products with advertising discursive strategies. The research design applied quantitative analysis to compile all media advertising data from 2015 to 2019, qualitative analysis of the content, and a study of the adverts' discourse. Moreover, a Nutri-score analysis was used to determine the products' nutritional value. Results indicated that breakfast products advertised in Spain presented a low or very low nutritional value. In addition, they showed that the lower the nutritional value of the product, the greater the proportion of positive emotions or moods that emerge from the discourse used in the advertisement. To establish effective policies for the prevention of obesity, greater involvement of the government, and better self-regulation mechanisms for the food industry, communication agencies, and advertisers are needed. In this sense, the hedonistic language used in advertisements for unhealthy food must treated as a priority. This measure would have the aim not only of protecting minors from ads for unhealthy food that are broadcast during breakfast time but would also generate healthy eating patterns within the family.

Examining how changes in provincial policy on vape marketing impacted the distribution of vaping advertisements near secondary schools in London, Ontario.

OBJECTIVES: On January 1, 2020, the Government of Ontario passed a regulation banning vaping advertisements by retailers, apart from specialty shops. A motivation for this ban was to limit youth exposure to vaping advertisements. The primary goal of this research was to evaluate the impact of this ban on the number and density of vaping advertisements surrounding secondary schools. Additionally, we examined whether the number of vaping advertisements varied by school socio-demographic characteristics. METHODS: This study used a pre-post design. Audits were conducted December 2019 (pre-ban) and again January to February 2020 (post-ban), to identify vaping advertisements within 800 m surrounding secondary schools (n = 18) in London, Ontario. RESULTS: Prior to the ban, there were 266 vaping advertisements within 800 m of secondary schools. After the ban, this was reduced to 58, a 78.2% reduction. The mean number of vaping advertisements surrounding schools significantly decreased from 18.1 before the ban to 3.6 after the ban (p < 0.001). A significant positive correlation was found, prior to the ban, between the number of vaping advertisements surrounding schools and school-level residential instability (r = 0.42, p = 0.02). After the ban, no significant correlations were found between the number of vaping advertisements and school socio-demographic characteristics. CONCLUSION: The provincial ban of vaping advertisements in select retail settings significantly reduced the number of vaping advertisements in the areas surrounding secondary schools in London, Ontario. The ban also reduced socio-demographic inequities in youths' potential exposure to marketing of vaping products. Continued monitoring of the geographic accessibility and promotion of vaping products is warranted.

RéSUMé: OBJECTIFS: Le 1er janvier 2020, le gouvernement de l'Ontario adoptait un règlement interdisant les annonces publicitaires sur le vapotage dans les magasins de détail, sauf dans les boutiques spécialisées. L'une des raisons de cette interdiction était de limiter l'exposition des jeunes à la publicité sur le vapotage. Notre étude visait principalement à évaluer les incidences de l'interdiction sur le nombre et la densité des annonces publicitaires sur le vapotage autour des écoles secondaires. Nous avons aussi cherché à déterminer si le nombre d'annonces publicitaires sur le vapotage variait selon le profil sociodémographique des écoles. MéTHODE: Un protocole avant-après été utilisé pour cette étude. Des audits ont été menés en décembre 2019 (avant l'interdiction), puis de nouveau en janvier et février 2020 (après l'interdiction) pour dénombrer les annonces publicitaires sur le vapotage dans un rayon de 800 m des écoles secondaires (n = 18) de London, en Ontario. RéSULTATS: Avant l'interdiction, il y avait 266 annonces publicitaires sur le vapotage dans un rayon de 800 m des écoles secondaires. Après l'interdiction, ce nombre n'était plus que de 58, soit une baisse de 78,2 %. Le nombre moyen d'annonces publicitaires sur le vapotage autour des écoles a diminué de façon significative, passant de 18,1 avant l'interdiction à 3,6 après (p < 0,001). Une corrélation positive significative a été observée, avant l'interdiction, entre le nombre d'annonces publicitaires sur le vapotage autour des écoles et l'instabilité résidentielle au niveau des écoles (r = 0,42, p = 0,02). Après l'interdiction, aucune corrélation significative n'a été observée entre le nombre d'annonces publicitaires sur le vapotage et le profil sociodémographique des écoles. CONCLUSIONS: L'interdiction provinciale des annonces publicitaires sur le vapotage dans certains magasins de détail a considérablement réduit le nombre de ces annonces dans les environs des écoles secondaires de London, en Ontario. L'interdiction a aussi réduit les iniquités sociodémographiques de l'exposition potentielle des jeunes au marketing des produits de vapotage. Il est justifié d'assurer une surveillance continue de l'accessibilité géographique et de la promotion des produits de vapotage.

Estimated televised alcohol advertising exposure in the past year and associations with past 30-day drinking behavior among American adults: results from a secondary analysis of large-scale advertising and survey data.

AIMS: To estimate the volume of past-year televised alcohol advertising exposure by product category and demographic group among adults living in the United States and test associations between estimated alcohol advertising exposure and past 30-day drinking behavior. DESIGN: Secondary analysis of data from two national-level US data sets: Kantar data on appearances of televised alcohol advertisements and data from the Simmons National Consumer Survey (NCS), a large national mail survey on television viewing patterns and consumer behavior. SETTING: United States. PARTICIPANTS: A total of 54 671 adults, aged 21 years and older, who were randomly selected to participate in the Simmons NCS. MEASUREMENTS: Estimated exposure to televised advertisements for beer, wine and spirits, self-reported alcohol use in the past year and number of drinks consumed in the past 30 days. FINDINGS: The average respondent was exposed to an estimated 576 [95% confidence interval (CI) = 570-582] televised alcohol advertisements in the year preceding their survey. Exposure was higher among males versus females and African Americans versus whites. A 1% increase in the estimated volume of advertisement exposure was associated with a 0.11 (95% CI = 0.08-0.13) percentage point increase in the odds of having at least one drink in the last 30 days and, among past 30-day drinkers, a 0.05 (95% CI = 0.04-0.07) per cent increase in the number of alcoholic drinks consumed. Associations were consistent across product categories and demographics. CONCLUSIONS: There appears to be a small but consistent positive association between alcohol advertising exposure and drinking behavior among American adults.

Truth-in-Advertising Laws: Are They Working? A Cross-Sectional Analysis of a "Plastic Surgeon" Patient Search Simulation.

BACKGROUND: Non-board-certified plastic surgeons performing cosmetic procedures and advertising as plastic surgeons may have an adverse effect on a patient's understanding of their practitioner's medical training and patient safety. The authors aim to assess (1) the impact of city size and locations and (2) the impact of health care transparency acts on the ratio of board-certified and non-American Board of Plastic Surgeons physicians. METHODS: The authors performed a systematic Google search for the term "plastic surgeon [city name]" to simulate a patient search of online providers. Comparisons of board certification status between the top hits for each city were made. Data gathered included city population, regional location, practice setting, and states with the passage of truth-in-advertising laws. RESULTS: One thousand six hundred seventy-seven unique practitioners were extracted. Of these, 1289 practitioners (76.9 percent) were American Board of Plastic Surgery-certified plastic surgeons. When comparing states with truth-in-advertising laws and states without such laws, the authors found no significant differences in board-certification rates among "plastic surgery" practitioners (88.9 percent versus 92.0 percent; p = 0.170). There was a significant difference between board-certified "plastic surgeons" versus out-of-scope practitioners on Google search between large, medium, and small cities (100 percent versus 92.9 percent versus 86.5; p < 0.001). CONCLUSIONS: Non-board-certified providers tend to localize to smaller cities. Truth-in-advertising laws have not yet had an impact on the way a number of non-American Board of Plastic Surgery-certified practitioners market themselves. There may be room to expand the scope of truth-in-advertising laws to the online world and to smaller cities.

Weight stigma and media: An examination of the effect of advertising campaigns on weight bias, internalized weight bias, self-esteem, body image, and affect.

While some media perpetuate weight stigma and an ideal of thinness, certain advertising campaigns, such as Aerie Real and Dove Real Beauty, have attempted to promote body acceptance. The current study evaluated the influence of exposure to these campaigns on weight bias, internalized weight bias (IWB), self-esteem, body image, and affect relative to exposure to a campaign perpetuating the thin ideal and a documentary on weight stigma. 475 female participants were randomized to one of five conditions: Aerie, Dove, Victoria's Secret, an HBO documentary, or control (i.e., neutral video clip). Participants completed measures of weight bias, IWB, self-esteem, body image, and affect one week prior to and immediately after watching the assigned video clip. Results showed positive effects of the Aerie and Dove campaigns on women. While global measures of weight bias and IWB were unchanged, women who viewed the Dove and Aerie campaigns reported significantly improved self-esteem and positive affect. Further, women found the campaigns to have positive, uplifting, and empowering messages. Aerie's and Dove's acceptance-promoting advertising campaigns positively influenced self-esteem and mood, and they are potential tools for weight bias reduction. Advertisements and media have the potential to impact weight-based attitudes in society.

Television advertisements for high-sugar foods and beverages: effect on children's snack food intake.

Energy-dense food advertising affects children's eating behaviour. However, the impact of high-sugar food advertising specifically on the intake of sweet foods is underexplored. This study sought to determine whether children would increase their intake of sugar and total energy following high-sugar food advertising (relative to toy advertising) and whether dental health, weight status and socio-economic status (SES) would moderate any effect. In a crossover, randomised controlled trial, 101 UK children (forty male) aged 8-10 years were exposed to high-sugar food/beverage and toy advertisements embedded within a cartoon. Their subsequent intake of snack foods and beverages varying in sugar content was measured. A dental examination was performed, and height and weight measurements were taken. Home postcode provided by parents was used to assign participants to SES quintiles. Children consumed a significantly greater amount of energy (203·3 (95 % CI 56·5, 350·2) kJ (48·6 (95 % CI 13·5, 83·7) kcal); P = 0·007) and sugar (6·0 (95 % CI 1·3, 10·7) g; P = 0·012) following food advertisements compared with after toy advertisements. This was driven by increased intake of the items with most sugar (chocolate and jelly sweets). Children of healthy weight and with dental caries had the greatest intake response to food advertising exposure, but there were no differences by SES. Acute experimental food advertising exposure increases food intake in children. Specifically, high-sugar food and beverage advertising promotes the consumption of high-sugar food items. The debate around the negative health effects of food advertising on children should be widened to include dental health as well as overall dietary health and obesity.

Targeting of Enrollment Assistance Resources in Health Insurance Television Advertising: A Comparison of Spanish- Vs. English-Language Ads.

Latinx adults, especially immigrants, face higher uninsurance and lower awareness of the Affordable Care Act's (ACA) provisions and resources compared to other racial/ethnic groups. Television advertising of ACA health plans has directed many consumers to application assistance and enrollment, but little is known about how ads targeted Latinx consumers. We used Kantar Media/CMAG data from the Wesleyan Media Project to assess Spanish- vs. English-language ad targeting strategies and to assess which enrollment assistance resources (in person/telephone vs. online) were emphasized across three Open Enrollment Periods (OEP) (2013-14, 2014-15, 2015-16). We examined differences in advertisement sponsorship and volume of Spanish- versus English-language ads across the three OEPs. State-based Marketplaces sponsored 47% of Spanish-language airings; insurance companies sponsored 55% of English-language airings. The proportion of Spanish-language airings increased over time (8.8% in OEP1, 11.1% in OEP2, 12.0% in OEP3, p <.001). Spanish-language airings had 49% lower (95%CI: 0.50,0.53) and 2.20 times higher odds (95%CI: 2.17,2.24) of mentioning online and telephone/in-person enrollment assistance resources, respectively. While there was a significant decrease in mention of telephone/in-person assistance over time for English-language airings, these mentions increased significantly in Spanish-language airings. Future research should examine the impact of the drastic federal cuts to ACA outreach and marketing.

[Sex Work during the COVID-19 Pandemic Period in the Ibero-American Context: analysis of advertisements on websites]. / Trabalho sexual em período de pandemia por COVID-19 no contexto íbero-americano: análise de anúncios em websites.

Sex workers become increasingly economically vulnerable due to the restrictive measures implemented to combat the coronavirus pandemic. In this respect, the scope of this study is to analyze the content of prostitution websites and advertisements regarding measures related to the COVID-19 pandemic. It involved a description of the visits and analysis of content of communications on websites that advertise commercial sex transactions. The percentage change in the number of visits for three periods from 02/2019 to 04/2020 was calculated. Subsequently, ads with the terms "corona," "pandemic" and "quarantine" on websites that offer search engines were extracted. The Bardin method was then used for content analysis. There was an increase in the number of visits to prostitution websites between 2019 and 2020, followed by a decrease with the advent of the coronavirus pandemic crisis. With regard to the protection measures during the pandemic, health recommendations and the incentive to engage in virtual sex are highlighted. Of the 1,991,014 advertisements, 0.51% mention the COVID-19 crisis regarding noncompliance with social distancing, protection measures and the offer of online sex.

Trabalhadores do sexo tornam-se cada vez mais vulneráveis economicamente como resultado das medidas restritivas implementadas para responder à pandemia de coronavírus. Nesse sentido, o objetivo deste estudo é analisar o conteúdo dos websites e anúncios de prostituição sobre medidas relacionadas à pandemia por COVID-19. Trata-se de descrição do fluxo de visitas e análise de conteúdo das comunicações em websites que anunciam transações de sexo comercial. Realizou-se cálculo de variação percentual do número de visitas para três períodos compreendidos entre 02/2019 a 04/2020. Posteriormente, extraíram-se anúncios com os termos "corona", "pandemia" e "quarentena" em websites que oferecem mecanismo de busca. Para análise de conteúdo, utilizou-se o método de Bardin. Houve aumento no número de acessos nos websites de prostituição entre o ano de 2019 e 2020, seguido de queda com a advento da crise pandêmica por coronavírus. Dentre as medidas de proteção durante a pandemia, destacam-se as recomendações de saúde e o incentivo ao sexo virtual. Dentre 1.991.014 anúncios, 0,51% mencionam a crise por COVID-19 quanto ao descumprimento do distanciamento social, medidas de proteção e oferta de sexo on-line.

Trabalho sexual em período de pandemia por COVID-19 no contexto íbero-americano: análise de anúncios em websites / Sex Work during the COVID-19 Pandemic Period in the Ibero-American Context: analysis of advertisements on websites

Resumo Trabalhadores do sexo tornam-se cada vez mais vulneráveis economicamente como resultado das medidas restritivas implementadas para responder à pandemia de coronavírus. Nesse sentido, o objetivo deste estudo é analisar o conteúdo dos websites e anúncios de prostituição sobre medidas relacionadas à pandemia por COVID-19. Trata-se de descrição do fluxo de visitas e análise de conteúdo das comunicações em websites que anunciam transações de sexo comercial. Realizou-se cálculo de variação percentual do número de visitas para três períodos compreendidos entre 02/2019 a 04/2020. Posteriormente, extraíram-se anúncios com os termos "corona", "pandemia" e "quarentena" em websites que oferecem mecanismo de busca. Para análise de conteúdo, utilizou-se o método de Bardin. Houve aumento no número de acessos nos websites de prostituição entre o ano de 2019 e 2020, seguido de queda com a advento da crise pandêmica por coronavírus. Dentre as medidas de proteção durante a pandemia, destacam-se as recomendações de saúde e o incentivo ao sexo virtual. Dentre 1.991.014 anúncios, 0,51% mencionam a crise por COVID-19 quanto ao descumprimento do distanciamento social, medidas de proteção e oferta de sexo on-line.

Abstract Sex workers become increasingly economically vulnerable due to the restrictive measures implemented to combat the coronavirus pandemic. In this respect, the scope of this study is to analyze the content of prostitution websites and advertisements regarding measures related to the COVID-19 pandemic. It involved a description of the visits and analysis of content of communications on websites that advertise commercial sex transactions. The percentage change in the number of visits for three periods from 02/2019 to 04/2020 was calculated. Subsequently, ads with the terms "corona," "pandemic" and "quarantine" on websites that offer search engines were extracted. The Bardin method was then used for content analysis. There was an increase in the number of visits to prostitution websites between 2019 and 2020, followed by a decrease with the advent of the coronavirus pandemic crisis. With regard to the protection measures during the pandemic, health recommendations and the incentive to engage in virtual sex are highlighted. Of the 1,991,014 advertisements, 0.51% mention the COVID-19 crisis regarding noncompliance with social distancing, protection measures and the offer of online sex.