Factors Associated with The Compliance of Tobacco Advertisement, Promotion and Sponsorship (TAPS) Ban in Bali, Indonesia

Abstract

Introduction: Indonesia is one of the countries with the highest number of tobacco advertisements, promotion, and sponsorship (TAPS) across the globe, which play a significant role in increasing smoking prevalence. Since 2019, Klungkung District has adopted a TAPS ban at point of sale (PoS). Accordingly, this study aims to evaluate compliance with the total TAPS ban at PoS in Klungkung and the factors associated. Methods: This cross-sectional study was conducted in the Klungkung district from August to October 2021. The survey involved 200 samples of PoS and also the managers, which selected using stratified simple random sampling for registered PoS and a walking protocol for unregistered PoS. Data was collected through observation using a checklist and interview using a structured questionnaire by eight well-trained enumerators. Data were analyzed using SPSS. Results: The study successfully observed 200 PoS and also interviewed 200 PoS managers. The result showed the compliance was 72.5%. Of 9 factors analyzed using regression analysis, it was found that factors associated with the compliance were knowledge and attitude PoS manager toward TAPS ban (OR=11.3; CI:1.233-103.414; p=0.008), perceived of socio-economic impact factor (OR=8.1; CI:3.584-18.400; p<0.01), and tobacco industry interference (OR=2.8; CI:1.441-5.594; p=0,003). Conclusions: Compliance with the TAPS ban at PoS remain sufficient, even though it has not reached the target. Factors mainly associated with the compliance were the attitude of PoS manager, and tobacco industry interference. Hence, socialization and enforcement should be improved and sustained.