Across all sampled countries, children were exposed to high volumes of television advertising for unhealthy foods, featuring child-oriented persuasive techniques. Because of the proven connections between food advertising, preferences, and consumption, our findings lend support to calls for regulation of food advertising during children's peak viewing times.

BackgroundIn the United States, more than 600 municipalities have smoke-free parks, and more than 100 have smoke-free beaches. Nevertheless, adoption of outdoor smoke-free policies has been slow in certain regions. Critical to widespread adoption is the sharing of knowledge about the policy development and implementation process. In this article, we describe our experience in making City of Philadelphia recreation centers and playgrounds smoke-free.Community ContextOf the 10 largest US cities, Philadelphia has among the highest rates of adult and youth smoking. Our objectives for an outdoor smoke-free policy included protecting against secondhand smoke, supporting a normative message that smoking is harmful, motivating smokers to quit, and mitigating tobacco-related sanitation costs.MethodsThe Philadelphia Department of Public Health and the Department of Parks and Recreation engaged civic leaders, agency staff, and community stakeholders in the following steps: 1) making the policy case, 2) vetting policy options and engaging stakeholders, and 3) implementing policy. Near-term policy impacts were assessed through available data sources.OutcomeMore than 220 recreation centers, playgrounds, and outdoor pools became smoke-free through a combined mayoral executive order and agency regulation. Support for the policy was high. Estimates suggest a policy reach of 3.6 million annual visitors and almost 850 acres of new smoke-free municipal property.InterpretationLocalities can successfully implement outdoor smoke-free policies with careful planning and execution. Such policies hold great potential for reducing exposure to secondhand smoke, promoting nonsmoking norms, and providing additional motivation for residents to quit smoking.

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In Reply We are grateful to Mahmood and Leung for their interest in our article. 1 They argue that there are more efficient ways to test for the MT-RNR1 m.1555A>G variant than the rapid point-of-care test (POCT) used in our study. They correctly state that m.1555A>G is subject to mitochondrial inheritance, and therefore knowing whether the mother was a carrier prior to delivery would negate the need for a rapid POCT. This biological assessment is sound, and testing every expectant mother for the variant would theoretically remove the need for rapid testing. However, this is neither cost-effective nor practicable. 2 The authors outline several mechanisms by which mothers might be preemptively tested for m.1555A>G. The first is that mothers could be tested when they meet certain criteria, Letters 828

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