Mapping loopholes in the current regulation of tobacco advertising, promotion, and sponsorship in Europe: a scoping review

OBJECTIVE: To review and synthesise European evidence identifying loopholes in 'Tobacco Advertising, Promotion and Sponsorship' (TAPS) regulations and actions undertaken by European countries to curb TAPS. DATA SOURCES: We conducted a comprehensive search across seven databases (Medline/PubMed, Embase, Web of Science, Sociological abstracts, Global health, CINAHL and PsycInfo) along with grey literature from relevant tobacco control organisation websites. Searches were restricted by publication date (2005-2023), geographical setting (EU & European Free Trade Association countries) and language (English). STUDY SELECTION: All reviewers independently screened titles and abstracts using a purpose-designed Excel spreadsheet to identify sources addressing loopholes in national or supranational settings, deciding on inclusion accordingly. DATA EXTRACTION: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist, we extracted data based on the 'Population, Concept and Context' framework, covering tobacco product type, media communication channel and findings indicating TAPS loopholes. Two reviewers used an Excel sheet to extract data. DATA SYNTHESIS: Of 1477 sources, 140 were included in the review. Analysis identified five key loopholes: (a) smoking depictions and tobacco advertising in traditional mass media (films and television), (b) cross-border branding and sponsorships, (c) point-of-sale marketing, (d) e-cigarette and tobacco advertising and promotion on the internet and (e) promotion and advertising of tobacco and novel nicotine products on social media. CONCLUSIONS: Curbing TAPS through comprehensive national bans and cross-border cooperation remains challenging because of the permeability of mass media, social media and other digital tools. Further research is necessary to develop strategies for effective implementation and enforcement to ensure compliance with TAPS regulations.