Consumption of four unhealthy commodities and exposure to advertising, sponsorship, and promotion in Bamako, Mali

Non-communicable diseases (NCDs) are the leading cause of death and disability globally and risks for many NCDs are associated with commercial determinants of health for tobacco, alcohol, ultra-processed foods (UPFs), and sugar-sweetened beverages (SSBs). Our aim was to understand reported consumption patterns of these four commodities along with reported exposure to advertising, promotion, and sponsorship (APS), focusing on vulnerable groups including young adults (18-24), less wealthy (quintiles 1 and 2), and women. We conducted a systematic randomized household survey of adults at two sites in Bamako, Mali to collect socio-demographic factors and measure reported consumption and exposure to APS for the commodities. We calculated descriptive statistics and performed χ2 tests to assess differences by three vulnerable groups. We surveyed 984 participants and found high reported consumption of SSBs (78%) and UPFs (67%) at least once per week, together with low reported current tobacco use (11%) and low reported alcohol use (1%) in the past 30 days. More than half of participants reported exposure to APS in the past 30 days for SSBs (76%) and UPFs (57%) while tobacco and alcohol reported exposure was lower (38% each). Young adults had higher reported consumption of SSBs and UPFs and higher reported APS exposure for both commodities compared with older groups. Systems-level interventions are recommended including increasing the SSB tax, adding a UPF tax, and strengthening enforcement of the APS ban for tobacco. These findings suggest further research on the usefulness of an APS ban for SSBs and UPFs targeted to young adults.