[Should advertising for electronic cigarettes and heated tobacco products be banned in Germany? Results of a representative survey (DEBRA study)]

'Stopping the start': support for proposed tobacco control policies - a population-based survey in Great Britain 2021-2023

OBJECTIVES

This study assessed public support for four proposed tobacco control policies in Great Britain: (1) Raising the sales age of tobacco by 1 year every year (Smokefree Generation); (2) Raising the sales age of tobacco from 18 years to 21 years; (3) Providing prescription e-cigarettes as smoking cessation aids to adults who smoke; (4) Restricting e-cigarette advertising to prevent youth uptake.

DESIGN

Repeat cross-sectional population-based survey weighted to match the population of Great Britain.

SETTING

The survey was conducted in England, Scotland and Wales in September 2021, October 2022 and October 2023.

PARTICIPANTS

6541 adults living in Great Britain.

MAIN OUTCOME MEASURES

Support for each policy and year and prevalence ratios (PRs) comparing support between years and subgroups.

RESULTS

The most popular policy each year was restricting e-cigarette advertising (74%/79%/85%), followed by raising the sales age to 21 years (50%/58%/64%), providing prescription e-cigarettes (45%/44%/47%) and Smokefree Generation (34%/44%/49%). The largest increases were for policies about the age of sale (Smokefree Generation: 2021/2022 PR=1.28, 95% CI 1.18 to 1.40, 2022/2023 PR=1.12, 95% CI 1.04 to 1.20; raising the age to 21 years: 2021/2022 PR=1.16, 95% CI 1.09 to 1.23, 2022/2023 PR=1.11, 95% CI 1.05 to 1.17). Only 30% opposed Smokefree Generation in 2023 down from 41% in 2021.

CONCLUSIONS

Support for each policy increased each year, except for providing prescription e-cigarettes. Restricting e-cigarette advertising was the most popular policy, while support for age of sale policies, in particular for a Smokefree Generation, grew most.

TRIAL REGISTRATION

The study protocol was published on the Open Science Framework (https://osf.io/46z2c/) prior to starting the analysis.

[Smoking in Movies: Implementation Status of the World Health Organization Recommendations on the Protection of Minors]

BACKGROUND

 To reduce the exposure of young people to smoking scenes in films, the World Health Organization has recommended classifying films with smoking scenes as unsuitable for children and adolescents.

AIM

 To examine the question whether this recommendation is being implemented in Germany and the USA by comparing the ratings for films with and without smoking scenes in both countries.

METHOD

 The selection criterion for the films was the box office result in German theaters in 2019. The 50 most successful US productions and the 50 most successful productions from Germany were content analyzed. The questions raised were: (1) how high the proportion of smoke-free films was in these two film samples, and (2) how high the proportion of films with smoking scenes was that were classified as unsuitable for young people. All films with an age rating below 16 years were considered suitable for children and adolescents.

RESULTS

 A total of 52 of the 100 films were smokefree. The rate was 64 % for US productions, compared to 40 % for German productions (p = 0.016). According to the German Self-regulatory Organization for the Cinema (FSK) rating system, 87 % of the films were suitable for young people. Overall, the proportion of smokefree films was higher for films suitable for young people than for films not suitable for young people (56 % vs. 23 %; p = 0.025). Of the 48 films with smoking, the FSK classified 79 % as suitable for minors. With regard to the age ratings for films with smoking scenes, there was no difference between the MPAA and FSK ratings for the top 50 US productions.

CONCLUSIONS

 Neither the USA nor Germany has implemented the recommendation of the World Health Organization to protect young people from smoking scenes in films in a satisfactory manner. In Germany, films with smoking scenes are largely classified as suitable for minors.