Forecasting future tobacco control policy: where to next?

Do singles or couples live healthier lifestyles? Trends in Queensland between 2005-2014

Objectives

To compare the frequency of and trends in healthy lifestyle factors between singles and couples.

Methods

Cross-sectional data from annual surveys conducted from 2005–2014 were used. The pooled sample included 15,001 Australian adults (mean age: 52.9 years, 50% male, 74% couples) who participated in the annual Queensland Social Survey via computer-assisted telephone interviews. Relationship status was dichotomised into single and couple. Binary logistic regression was used to assess associations between relationship status, and the frequency of and trends in healthy lifestyle factors.

Results

Compared to singles, couples were significantly more likely to be a non-smoker (OR = 1.82), and meet recommendations for limited fast food (OR = 1.12), alcohol consumption (OR = 1.27) and fruit and vegetable intake (OR = 1.24). Fruit and vegetable intake was not significantly associated with relationship status after adjusting for the other healthy lifestyle factors. Conversely, couples were significantly less likely to be within a normal weight range (OR = 0.81). In both singles and couples, the trend data revealed significant declines in the rates of normal weight (singles: OR = 0.97, couples: OR = 0.97) and viewing TV for less than 14 hours per week (singles: OR = 0.85, couples: OR = 0.84), whilst non-smoking rates significantly increased (singles: OR = 1.12, couples: OR = 1.03). The BMI trend was no longer significant when adjusting for health behaviours. Further, in couples, rates of meeting recommendations for physical activity and fruit/vegetable consumption significantly decreased (OR = 0.97 and OR = 0.95, respectively), as did rates of eating no fast food (OR = 0.96). These trends were not significant when adjusting for the other healthy lifestyle factors. In singles, rates of meeting alcohol recommendations significantly increased (OR = 1.08).

Conclusions

Health behaviour interventions are needed in both singles and couples, but relationship status needs to be considered in interventions targeting alcohol, fast food, smoking and BMI. Further research is needed to understand why health behaviours differ by relationship status in order to further improve interventions.

Tobacco manufacturer brand strategy following plain packaging in Australia: implications for social responsibility and policy

Purpose

This paper aims to inform social responsibility and social policy by describing the brand strategy of Australia’s largest tobacco manufacturer, British American Tobacco Australia (BATA), the year following the introduction of plain packaging and other regulation. Tobacco controls are a proven catalyst for reducing smoking, but manufacturers adapt swiftly seeking to minimise the impact of regulatory change.

Design/methodology/approach

BATA’s strategy was determined using 2012-2014 tobacco ingredient reports, recommended retail price lists and a supermarket retail audit.

Findings

The research identified over 70 BATA brand variants, offered in diverse packaging options, with new products and modified names appearing since 2012. In total 14 main brands are highly differentiated by price, with 45 per cent difference between the cheapest and the most expensive. Volume discounting occurs across packaging ranges, with twin packs offering best value and prices up to 10 per cent lower than those of single packs.

Originality/value

The research originality stems from the triangulation of three different data resources to establish brand strategy following increased regulation. The study confirms ongoing market segmentation using highly differentiated ranges, and it reveals the unintended consequences of corporate responses to regulation. Evolving variant names communicate product information and imagery previously imparted by pack design. Pricing strategies enable smokers to offset substantial excise increases through brand switching and volume buying. The research, therefore, reveals the potential for regulating these as yet unrestricted elements to enhance the impact of plain packaging and other tobacco controls, thereby further reducing the social impact of smoking.

Adolescents Perceptions of Pro- and Antitobacco Imagery and Marketing: Qualitative Study of Students from Suva, Fiji

BACKGROUND

Many studies examining smoking uptake among young people in the Pacific have not included their exposure to tobacco control promotions in the media in their assessment. This study examines how Fijian students view tobacco and tobacco-related media depictions to gain insight into both drivers of smoking uptake and potential directions for prevention interventions.

METHODS

A sample of thirty Fijian students (15 male and 15 female) aged 14-17 years, was recruited from a Suva school between September and October 2013 and participated in a one-to-one in-depth interview about their views on tobacco use, media consumption patterns and preferences and awareness of tobacco use in media.

RESULTS

Despite radical developments in access to media, television remains the most popular. Yet, the majority of participants were unaware of any protobacco imagery on television or other entertainment media. Tobacco-related imagery was more likely to be seen in connection with point of sale advertising and branding. The advertising potential of the shop counter was acutely apparent to some participants and this space was considered highly influential.

CONCLUSIONS

Despite the fact that the recently introduced graphic health warnings were generally well received, more can be done to extend the use of media for tobacco control benefits in Fiji.

Transnational corporations and health: a research agenda

Transnational corporations (TNCs) are part of an economic system of global capitalism that operates under a neoliberal regime underpinned by strong support from international organisations such as the World Trade Organization, World Bank, and most nation states. Although TNCs have grown in power and influence and have had a significant impact on population health over the past three decades, public health has not developed an integrated research agenda to study them. This article outlines the shape of such an agenda and argues that it is vital that research into the public health impact of TNCs be pursued and funded as a matter of priority. The four areas of the agenda are: assessing the health and equity impacts of TNCs; evaluating the effectiveness of government regulation to mitigate health and equity impacts of TNCs; studying the work of activist groups and networks that highlight adverse impacts of TNCs; and considering how regulation of capitalism could better promote a healthier and more equitable corporate sector.

The potential of shame as a message appeal in antismoking television advertisements

BACKGROUND

As smoking is increasingly de-normalised, different messages may become more appropriate for use in tobacco control advertisements to reflect the changing social environment. To date, more commonly used messages have included fear appeals relating to physical health and guilt appeals focusing on the effects of smoking on loved ones.

OBJECTIVE

This study investigated the relative effectiveness of varying advertising appeals to promote smoking cessation. The study was conducted in Australia, where only 12% of the population smokes and legislation restricts smoking in many public places. The aim was to provide insight into ways to motivate the small segment of existing smokers to consider quitting.

METHODS

Across a qualitative phase and an ad testing phase, shame was found to be highly salient to current smokers and those who had quit recently. On the basis of these results, a television advertisement featuring a shame appeal was developed and broadcast. The ad featured various scenarios of individuals hiding their smoking from others. The campaign was evaluated using the measures of awareness, believability, perceived relevance and smoking behaviours.

RESULTS

The shame appeal television advertisement was found to resonate with smokers and encourage quitting/reducing behaviours. Around 4 in 5 (78%) smokers surveyed recalled seeing the ad, almost all of whom could nominate at least one correct take-out message (94%). Around three-quarters (72%) found the ad to be personally relevant and half (53%) reported that they had successfully quit, attempted to quit or cut down the number of cigarettes they smoked since the start of the campaign.

CONCLUSIONS

The use of shame appeals may be an effective method of motivating smokers to quit in an environment where they are members of a small minority and supportive legislation exists to discourage smoking in public places.

Developing cancer warning statements for alcoholic beverages

Background

There is growing evidence of the increased cancer risk associated with alcohol consumption, but this is not well understood by the general public. This study investigated the acceptability among drinkers of cancer warning statements for alcoholic beverages.

Methods

Six focus groups were conducted with Australian drinkers to develop a series of cancer-related warning statements for alcohol products. Eleven cancer warning statements and one general health warning statement were subsequently tested on 2,168 drinkers via an online survey. The statements varied by message frame (positive vs negative), cancer reference (general vs specific), and the way causality was communicated (‘increases risk of cancer’ vs ‘can cause cancer’).

Results

Overall, responses to the cancer statements were neutral to favorable, indicating that they are unlikely to encounter high levels of negative reaction from the community if introduced on alcoholic beverages. Females, younger respondents, and those with higher levels of education generally found the statements to be more believable, convincing, and personally relevant. Positively framed messages, those referring to specific forms of cancer, and those using ‘increases risk of cancer’ performed better than negatively framed messages, those referring to cancer in general, and those using the term ‘can cause cancer’.

Conclusion

Cancer warning statements on alcoholic beverages constitute a potential means of increasing awareness about the relationship between alcohol consumption and cancer risk.

Public support for tobacco control policy extensions in Western Australia: a cross-sectional study

OBJECTIVES

Policy makers seeking to introduce new tobacco control measures need to anticipate community support to assist them in planning appropriate implementation strategies. This study assessed community support for plain packaging and smoking bans in outdoor locations in Australia.

DESIGN

Analytical cross-sectional survey.

SETTING AND PARTICIPANTS

2005 Western Australian adults participated in a computer-assisted telephone interview. Random household telephone numbers were used to obtain a representative sample.

OUTCOME MEASURES

Support for plain packaging of cigarettes and smoking bans at outdoor venues by demographic characteristics.

RESULTS

Around half of the survey respondents supported plain packaging and almost a further quarter reported being neutral on the issue. Only one in three smokers disagreed with the introduction of a plain packaging policy. A majority of respondents supported smoking bans at five of the six nominated venues, with support being strongest among those with children under the age of 15 years. The venues with the highest levels of support were those where smoke-free policies had already been voluntarily introduced by the venue managers, where children were most likely to be in attendance, and that were more limited in size.

CONCLUSIONS

The study results demonstrate community support for new tobacco control policies. This evidence can be used by public policy makers in their deliberations relating to the introduction of more extensive tobacco control regulations.