Tobacco point-of-sale advertising in Guatemala City,
Guatemala and Buenos Aires, Argentina
Joaquin Barnoya,1,2Raul Mejia,3Debora Szeinman,3Carlos E Kummerfeldt4
Objectives To determine tobacco point of sale
advertising prevalence in Guatemala City, Guatemala and
Buenos Aires, Argentina.
Methods Convenience stores (120 per city) were
chosen from randomly selected blocks in low, middle and
high socioeconomic neighbourhoods. To assess tobacco
point of sale advertising we used a checklist developed
in Canada that was translated into Spanish and validated
in both countries studied. Analysis was conducted by
neighbourhood and store type.
Results All stores sold cigarettes and most had tobacco
products in close proximity to confectionery. In
Guatemala, 60% of stores had cigarette ads. High and
middle socioeconomic status neighbourhood stores had
more indoor cigarette ads, but these differences were
determined by store type: gas stations and supermarkets
were more prevalent in high socioeconomic status
neighbourhoods and had more indoor cigarette ads. In
poorer areas, however, more ads could be seen from
outside the stores, more stores were located within 100
metres of schools and fewer stores had ‘No smoking’ or
‘No sales to minors’ signs. In Argentina, 80% of stores
had cigarette ads and few differences were observed by
neighbourhood socioeconomic status. Compared to
Guatemala, ‘No sales to minors’ signs were more
prevalent in Argentina.
Conclusions Tobacco point of sale advertising is highly
prevalent in these two cities of Guatemala and
Argentina. An advertising ban should also include this
type of advertising.
Tobacco industry marketing campaigns have been
instrumental in spreading the tobacco epidemic
government tobacco advertising bans the industry
noted that their brands would be ‘dominantly
displayed and advertised’ at the point of sale.1 2
This type of advertising has been found to increase
brand recognition, decrease smoking cessation
attempts and to increase smoking relapse in former
smokers.3e8In adolescents, advertising at the point
of sale increase smoking susceptibility, experimen-
tation, and uptake.9It has also been found to
increase students’ perception about the ease of
purchasing cigarettes and decrease the likelihood of
requiring proof of age.10The USA, Australia,
Canada, New Zealand and Malaysia have docu-
mented a high prevalence of tobacco point of sale
advertising.3 11e15In the Americas region, aside
Mexico, Peru, Venezuela and the USA, most coun-
tries lack any government enforced advertising ban.
Of these countries, only the Bahamas has banned
early 1970s, forseeing
point of sale advertising.16In addition, tobacco
point of sale advertising has not yet been docu-
mented in this region.
As of February 2009, Guatemala and Argentina
lack comprehensive tobacco advertising bans. In
Guatemala, advertising (written, graphic, radio,
television, films and other electric or electronic
media) requires prior authorisation of the Ministry
of Public Health and Social Aid. In addition,
tobacco billboards are banned within 500 metres of
entrances and exits of pre-school, elementary or
high schools.17However, the tobacco industry
(Philip Morris (PM) and British American Tobacco
(BAT)) has voluntarily removed radio and television
advertising. In Argentina, there is no national
advertising ban and advertising is still allowed in
newspapers, magazines, television and billboards.16
Since October 2005, the City of Buenos Aires has
a tobacco advertising ban that includes newspapers,
television, radio and billboards.18This ban does not
apply to the rest of the country. Regarding the
point of sale, neither Guatemala nor Argentina has
an advertising ban and retailers do not need
a government licence to sell tobacco.
The objective of this study is to document the
prevalence of tobacco point-of-sale advertising in
the capital city of Guatemala (Guatemala City) and
Argentina (Buenos Aires).
From March to May 2008, we selected 240 (120 per
country) convenience stores in Guatemala City,
Guatemala, and Buenos Aires, Argentina, without
any prior knowledge of whether they sell cigarettes
or about the presence of tobacco point-of-sale
advertising. Because others have found tobacco
point-of-sale advertising is more prevalent in less
privileged neighbourhoods, we selected our sample
based on socioeconomic neighbourhood.19 20To get
stores from high, middle and low socioeconomic
status (SES) neighbourhoods, we selected one
neighbourhood from each of these three rankings.
In Guatemala, to define neighbourhood SES, we
used the average unit price of land defined by the
Municipalidad de Guatemala. We then located the
three different SES neighbourhoods in Mapquest.
In Argentina, we used the 2007 Encuesta Nacional
de Hogares de Buenos Aires (National Home Survey
of Buenos Aires). We then used a random digit
generator to identify 30 blocks per SES neighbour-
hood in each city where stores would be evaluated.
Every store in each block was evaluated, and when
a block had no store, the next adjacent block was
chosen. All stores in each block were evaluated.
To assess the prevalence and characteristics of
point of sale advertising in stores we used
1Cardiovascular Unit of
2Washington University in St
Louis, School of Medicine,
3Hospital de Clinicas, University
of Buenos Aires. Buenos Aires,
4Aldo Castan ˜eda Foundation.
Dr Joaquin Barnoya,
Cardiovascular Unit of
Guatemala, 6a Ave 8-71 zona
10, Clinica #3, Ala Sur 01010,
Received 4 June 2009
Accepted 22 March 2010
Published Online First
7 June 2010
This paper is freely available
online under the BMJ Journals
unlocked scheme, see http://
338Tobacco Control 2010;19:338e341. doi:10.1136/tc.2009.031898
a checklist developed by Cohen and Di Nardo in Canada.11The
checklist, designed to be completed in no more than 10 minutes,
assesses the tobacco advertising type, feature, brand, location
and displays within each store. In addition, the observer esti-
mated the percentage of space in front of the client occupied by
tobacco advertising and if tobacco products or advertising were
located less than 50 centimetres of confectionary. After
obtaining permission from the authors, we translated and
adapted the checklist to Spanish. Then it was pilot tested in
Argentina and Guatemala and found to be appropriate.
We used SPSS (version 11.0, 2001) to enter and analyse data.
Analyses were done primarily with c2testing (nominal variables)
and analysis of variance (ANOVA, interval variables). Percentage
of space in front of the client occupied by tobacco advertising is
In Guatemala, data were first analysed by SES and then by store
type. In Argentina, given that there were only two types of stores
surveyed (small (15%) and big (85%) stores) and the location of
these stores did not differ by neighbourhood, data were only
analysed by neighbourhood SES.
A total of 120 stores were surveyed in each city. All stores in
Guatemala and Argentina sold cigarettes. Sixty per cent of stores
in Guatemala and 78% in Argentina had cigarette advertising
(p¼0.003). In Guatemala, in the high SES neighbourhoods, most
stores evaluated were gas stations; while in the middle and low
SES neighbourhoods they were small stores (table 1).
In Guatemala, very few stores had exterior ads and the
proportion did not vary by neighbourhood (p¼0.08). By
contrast, most had interior ads and tobacco products in close
proximity to confectionary (table 2). The number of interior ads
differed significantly by area with a tendency for more ads in the
higher SES neighbourhood (table 2). Yet ‘No smoking’ or ‘No
sales to minors’ signs were also more frequent in this neigh-
bourhood. By contrast the low SES neighbourhood had a signif-
icantly greater proportion of ads that could be seen from outside
the store and were more likely to have stores within 100 metres
of a school. Most stores had tobacco products close to confec-
tionary, except stores in the middle SES where only 38% of
stores did (p¼0.002). It appears, however, that these neigh-
bourhood differences were largely determined by store type,
notably the predominance of gas stations in the high SES
neighbourhood and small stores in low and middle SES neigh-
bourhoods (table 3). Gas stations had significantly greater
Store type by city and socioeconomic neighbourhood, 2008
Percentage of stores in each neighbourhood*
No of stores
*Percentages do not add up to 100 owing to rounding.
yIn Guatemala: A small store is wooden, made and located on sidewalks. Big stores are
permanent constructions and have a larger variety of products. In Argentina: In small stores
purchase is made through a window while the customer stands on the sidewalk. Only in big
stores customers walk through the store to pick up groceries.
Tobacco point-of-sale advertising prevalence. 2008
Guatemala City, Guatemala
Buenos Aires, Argentina
Neighbourhood socioeconomic status
Neighbourhood socioeconomic status
Stores (%) with exterior ads
Stores (%y) with interior ads
Stores (%) with interior ads that can be
seen from the outside
Mean (%,SDz) of the total percentage of
space occupied in front of the client
Stores (%) with tobacco ads/products
<50 cm of confectionary
Stores (%) with ‘No smoking’ signs
Stores (%) with ‘No sales to minors’ sign
Stores (%) within 100 metres of a school
*p Value for difference between socioeconomic status.
yPercentages do not add up to 100% owing to rounding.
z%, SD: Refers to the mean and the SD of the total percentage of space that the cigarette counter occupied in front of the client.
Tobacco Control 2010;19:338e341. doi:10.1136/tc.2009.031898339
numbers of large, indoor ads occupying more space while most
small stores did not have ‘No sales to minors’ signs, but were
more likely to be located within 100 metres of a school.
In Argentina, few stores had exterior ads and the percentage of
stores with interior ads did not differ significantly by neigh-
bourhood SES (table 2). However, a lower percentage of stores in
high and middle SES did not have any interior ads compared to
stores in the low SES. In all the different SES neighbourhoods,
most stores have interior ads that can be seen from the outside.
The percentage of space in front of the client occupied by
tobacco ads did not differ across neighbourhood SES. More
stores in the high and middle SES neighbourhoods did have ‘No
sales to minor’ signs compared to stores in the low SES (p¼0.1).
Half the stores in high and low SES neighbourhoods have
tobacco products in close proximity to confectionary compared
to 28% of those in the middle SES (p¼0.03). Regarding store
location in relation to schools, most stores were not located
within 100 metres of a school. Analysis by store type did not
yield any significant differences (results not shown).
In Guatemala, cigarettes were displayed on top of the counter
in 100% of big stores, 54% of small stores and 83% of super-
markets. Only in gas stations, most (56%) cigarettes were
displayed behind the counter, but still in sight. In Argentina,
cigarettes were displayed on top of the counter in 90% of big
stores and in 77% of small stores.
In Guatemala, most of the advertising was dominated by BAT
(Pall Mall was the most common brand advertised) as opposed
to Argentina, where it was dominated by PM (Marlboro was the
most common brand advertised).
In these two Latin American cities in Guatemala and Argentina,
Guatemala prevalence appears to be related to store type rather
than neighbourhood SES. In the USA, convenience, conve-
nience/gas and liquor stores have been found to have higher
prevalence of tobacco point-of-sale advertising compared to
grocery stores and pharmacies.21Similarly, in Canada, chain
convenience stores had the largest amount of tobacco point-of-
Tobacco product placement in close proximity to confec-
tionary was highly prevalent in both cities. It has been suggested
that such placement encourages the young to see tobacco as
benign and commonplace in the market like confectionary.2In
addition, cigarettes were placed in prime locations, behind the
cashier and on the counter-top, positions for which retailers
usually charge a premium.1
is highly prevalent.In
to minors’ signage. In Guatemala, fewer stores had the signage
compared to Argentina where most stores did. In the USA, PM
requires the placement of this signage in stores that participate in
the Retail Leaders Program. Given that PM brands dominated the
Argentinian point-of-sale environment, this might help explain
the difference with Guatemala. However, these youth access
programmes do not affect teen smoking prevalence.22 23
Our study has strengths and limitations. To our knowledge, it
is the first study to document the prevalence of tobacco point of
sale advertising in two Latin American countries. We randomly
selected stores from different SES neighbourhoods but used
neighbourhood as a proxy for SES, when it may, in fact, vary by
block. In Guatemala, where the WHO Framework Convention
on Tobacco Control (FCTC) has been ratified, we do not have
data pre-FCTC and post-FCTC ratification to assess whether the
prevalence of point of sale advertising has changed since ratifi-
cation. Regardless of these limitations, none of them should be
a source of bias or limit the policy implications of our study.
In conclusion, tobacco point-of-sale advertising is highly
prevalent in the capital cities of Guatemala and Argentina. Both
countries as FCTC signatories should be committed to apply
Article 13 and ‘undertake a comprehensive ban of all tobacco
advertising, promotion and sponsorship.’(emphasis added).24
Our data underline the importance of ensuring that point-of-sale
advertising is included when a tobacco advertising ban is
proposed in either country.
Acknowledgements We thank Jose Carlos Monzo ´n who collaborated with data
collection in Guatemala. Maria Alegre provided information regarding marketing
strategies. In addition, Joanna Cohen granted us permission to use the point-of-sale
Point-of-sale advertising by store type in Guatemala City. 2008
Stores with exterior ads (%)
Stores (%*) with interior ads.
Stores (%) with interior ads than can be seen from the outside.
Mean (%,SDy) of space occupied in front of the client
Stores (%) with tobacco ads or products <50 cm of candy
Stores (%) with ‘No smoking’ signs
Stores (%) with ‘No sales to minors’ signs
Stores (%) within 100 metres of a school
*Percentages do not add up to 100% owing to rounding.
y%, SD: Refers to the mean and the SD of the total percentage of space that the cigarette counter occupied in front of the client.
What this paper adds
Tobacco point-of-sale advertising has been found to increase
brand recognition and adolescents’ perception about the ease of
purchasing cigarettes. In the USA, Canada, Australia and
Malaysia, a high prevalence of tobacco point-of-sale advertising
has been documented. Guatemala and Argentina are two Latin
American countries that lack comprehensive advertising bans.
Consistent with findings elsewhere, we document a high preva-
lence of tobacco point-of-sale advertising in Guatemala and
Argentina. These countries need comprehensive advertising bans
that include point-of-sale restrictions.
340Tobacco Control 2010;19:338e341. doi:10.1136/tc.2009.031898
Funding This work was carried out with the aid of a grant from the Research for
International Tobacco Control (RITC) program of the International Development
Research Centre (IDRC) in Ottawa, Canada. Joaquin Barnoya is partially supported by
an unrestricted grant from the American Cancer Society.
Competing interests None.
Contributors RM and JB conceived the study and lead the data analysis. JB took the
lead in manuscript writing. DS and CK pilot tested the survey and contributed to data
analysis. All authors have approved the final version of the manuscript.
Provenance and peer review Not commissioned; externally peer reviewed.
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