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Liu J, Roberts J, Winickoff JP, Hanby EP, Reynolds MJ, Gundersen DA, Emmons KM, Tan AS. Education, organizational changes, and enforcement challenges of the 2019 flavored tobacco sales restriction in Massachusetts. Drug Alcohol Depend 2024; 262:111394. [PMID: 39024798 PMCID: PMC11363149 DOI: 10.1016/j.drugalcdep.2024.111394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 06/30/2024] [Accepted: 07/04/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVES In November 2019, the Massachusetts legislature passed An Act Modernizing Tobacco Control and became the first state to restrict retail sales of all flavored (including menthol) cigarettes, e-cigarettes, and other tobacco products (the Act). Additional tobacco control policies and health insurance coverage for tobacco treatment were included as part of the Act. Implementation of these policies occurred between November 2019 and June 2020. This study explored challenges and facilitators during the implementation of the Act experienced by public health officials, school personnel, and healthcare providers. METHODS We conducted in-depth interviews with a purposive sample of 9 public health officials and advocates, 9 school personnel, and 8 healthcare providers from March to December 2021. We conducted thematic analysis of interview transcripts using inductive codes of key themes emerging from the interviews. RESULTS Interviewees highlighted three key themes that impacted the implementation of the Act: 1) Education of those impacted by the Act, 2) Organizational-level changes to incorporate the Act, and 3) Enforcement challenges. Examples of challenges to the implementation of the Act included COVID-19 pandemic restrictions, navigating tobacco industry tactics around naming flavors, and confusion regarding health insurance coverage for tobacco use cessation programs. Examples of facilitators were enforcement leading to retailer compliance, committed advocacy efforts of leadership/champions, and strong coordination within and between organizations. CONCLUSIONS These findings of Massachusetts's experience in policy implementation can inform the preparation to implement similar tobacco control policies in other states.
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Affiliation(s)
- Jessica Liu
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, United States
| | - Jane Roberts
- Dana-Farber Cancer Institute, Survey and Qualitative Methods Core, Boston, MA, United States
| | - Jonathan P Winickoff
- MassGeneral Hospital Division of General Academic Pediatrics, Boston, MA, United States; MGH Tobacco Research and Treatment Center, Boston, MA, United States; American Academy of Pediatrics Julius B. Richmond Center, Itasca, IL, United States
| | - Elaine P Hanby
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, United States
| | | | - Daniel A Gundersen
- Rutgers Institute for Nicotine and Tobacco Studies, New Brunswick, NJ, United States; Division of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Karen M Emmons
- Harvard T.H. Chan School of Public Health, Social and Behavioral Sciences Department, Boston MA, United States
| | - Andy Sl Tan
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, United States; University of Pennsylvania, Leonard Davis Institute of Health Economics, Philadelphia, PA, United States; Abramson Cancer Center, Tobacco and Environmental Carcinogenesis Program, Philadelphia, PA, United States.
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Small R, Nugent R, Webb D, Hutchinson B, Spencer G, Ngongo C, Chestnov R, Tarlton D. Advancing progress on tobacco control in low-income and middle-income countries through economic analysis. Tob Control 2024; 33:s3-s9. [PMID: 38697661 PMCID: PMC11103286 DOI: 10.1136/tc-2023-058335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/29/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND More than 80% of the world's 1.3 billion tobacco users live in low-income and middle-income countries (LMICs), where progress to address tobacco and its harms has been slow. The perception that tobacco control detracts from economic priorities has impeded progress. The Secretariat of the WHO Framework Convention on Tobacco Control (FCTC) is leading the FCTC 2030 project, which includes technical assistance to LMICs to analyse the economic costs of tobacco use and the benefits of tobacco control. METHODS The Secretariat of the WHO FCTC, United Nations Development Programme and WHO supported 21 LMICs between 2017 and 2022 to complete national investment cases to guide country implementation of the WHO FCTC, with analytical support provided by RTI International. These country-level cases combine customised estimates of tobacco's economic impact with qualitative analysis of socio-political factors influencing tobacco control. This paper overviews the approach, observed tobacco control advancements and learnings from 21 countries: Armenia, Cabo Verde, Cambodia, Chad, Colombia, Costa Rica, El Salvador, Eswatini, Georgia, Ghana, Jordan, Laos, Madagascar, Myanmar, Nepal, Samoa, Sierra Leone, Sri Lanka, Suriname, Tunisia and Zambia. RESULTS Tobacco control advancements in line with investment case findings and recommendations have been observed in 17 of the 21 countries, and many have improved collaboration and policy coherence between health and economic stakeholders. CONCLUSIONS Tobacco control must be seen as more than a health concern. Tobacco control leads to economic benefits and contributes to sustainable development. National investment cases can support country ownership and leadership to advance tobacco control.
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Affiliation(s)
- Roy Small
- HIV, Health and Development Group, United Nations Development Programme, New York, New York, USA
| | - Rachel Nugent
- Department of Global Health, University of Washington, Seattle, Washington, USA
- RTI International, Research Triangle Park, North Carolina, USA
| | - Douglas Webb
- United Nations Development Programme, Tbilsi, Georgia
| | | | | | - Carrie Ngongo
- RTI International, Research Triangle Park, North Carolina, USA
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Lee Y, Kim S, Kim MK, Kawachi I, Oh J. Association between Tobacco Industry Interference Index (TIII) and MPOWER measures and adult daily smoking prevalence rate in 30 countries. Global Health 2024; 20:6. [PMID: 38172937 PMCID: PMC10765652 DOI: 10.1186/s12992-023-01003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND This study aimed to investigate the impact of tobacco industry interference on the implementation and management of tobacco control and the tobacco epidemic using the Tobacco Industry Interference Index (TIII) and MPOWER-a package of measures for tobacco control-and adult daily smoking prevalence in 30 countries. METHODS The TIII was extracted from the Global Tobacco Industry Interference Index 2019 and Global Center for Good Governance in Tobacco Control (GGTC). MPOWER measures and adult daily smoking prevalence rate were extracted from the World Health Organization (WHO) report on the global tobacco epidemic in 2021. We assessed the ecological cross-lagged association between TIII and MPOWER scores and between TIII and age-standardized prevalence rates for adult daily tobacco users. RESULTS Tobacco industry interference was inversely correlated with a country's package of tobacco control measures (β = -0.088, P = 0.035). The TIII was correlated with weaker warnings about the dangers of tobacco (β = -0.016, P = 0.078) and lack of enforcement of bans on tobacco advertising promotion and sponsorship (β = -0.023, P = 0.026). In turn, the higher the TIII, the higher the age-standardized prevalence of adult daily tobacco smokers for both sexes (β = 0.170, P = 0.036). Adult daily smoking prevalence in males (β = 0.417, P = 0.004) was higher in countries where the tobacco industry received incentives that benefited its business. CONCLUSION Where the interference of the tobacco industries was high, national compliance with the Framework Convention on Tobacco Control (FCTC) was lower, and the prevalence of adult daily smokers higher. National governments and global society must work together to minimize the tobacco industry's efforts to interfere with tobacco control policies.
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Affiliation(s)
- Yuri Lee
- Department of Health and Medical Information, Myongji College, Seoul, Republic of Korea
| | - Siwoo Kim
- Institute of Environmental Medicine, SNU Medical Research Center, 103 Daehakro, Seoul, Republic of Korea
| | - Min Kyung Kim
- Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Ichiro Kawachi
- John L. Loeb & Frances Lehman Loeb Professor of Social Epidemiology, Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Ave., 7th floor, Boston, MA, 02115, USA.
| | - Juhwan Oh
- Department of Medicine, Seoul National University College of Medicine, 103 Daehakro, Seoul, Republic of Korea.
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Meier BM, Raw M, Shelley D, Bostic C, Gupta A, Romeo-Stuppy K, Huber L. Could international human rights obligations motivate countries to implement tobacco cessation support? Addiction 2023; 118:399-406. [PMID: 35792059 DOI: 10.1111/add.15990] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/20/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) seeks to realize the right to health through national tobacco control policies. However, few states have met their obligations under Article 14 of the FCTC to develop evidence-based policies to support tobacco cessation. This article examines how human rights obligations could provide a legal and moral basis for states to implement greater support for individuals to overcome their addiction to tobacco. ANALYSIS The United Nations (UN) has a well-established legal framework for promoting human rights, looking to the right to health to realize health autonomy. Where addiction undermines autonomy, it is widely acknowledged that addiction presents a significant barrier to cessation for individuals who use tobacco, undermining the right to health. The UN human rights system could, therefore, provide a complementary basis for monitoring state obligations under Article 14 of the FCTC, identifying challenges to FCTC implementation and motivating states to support tobacco cessation. CONCLUSIONS The United Nations' human rights system offers a mechanism that could be used to monitor Framework Convention on Tobacco Control implementation in national policy, facilitating accountability for the progressive realization of cessation support.
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Affiliation(s)
- Benjamin Mason Meier
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA
| | - Martin Raw
- School of Global Public Health, New York University, New York, NY, USA
- International Centre for Tobacco Cessation, UK
| | - Donna Shelley
- School of Global Public Health, New York University, New York, NY, USA
| | - Chris Bostic
- Action on Smoking and Health (ASH), Washington, DC, USA
| | - Anahita Gupta
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA
| | | | - Laurent Huber
- Action on Smoking and Health (ASH), Washington, DC, USA
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Hebbar PB, Dsouza V, Bhojani U, Prashanth NS, van Schayck OC, Babu GR, Nagelhout GE. How do tobacco control policies work in low-income and middle-income countries? A realist synthesis. BMJ Glob Health 2022; 7:e008859. [PMID: 36351683 PMCID: PMC9644319 DOI: 10.1136/bmjgh-2022-008859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 09/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The burden of tobacco use is disproportionately high in low- and middle-income countries (LMICs). There is scarce theorisation on what works with respect to implementation of tobacco control policies in these settings. Given the complex nature of tobacco control policy implementation, diversity in outcomes of widely implemented policies and the defining role of the context, we conducted a realist synthesis to examine tobacco control policy implementation in LMICs. METHODS We conducted a systematic realist literature review to test an initial programme theory developed by the research team. We searched EBSCOHost and Web of Science, containing 19 databases. We included studies on implementation of government tobacco control policies in LMICs. RESULTS We included 47 studies that described several contextual factors, mechanisms and outcomes related to implementing tobacco control policies to varying depth. Our initial programme theory identified three overarching strategies: awareness, enforcement, and review systems involved in implementation. The refined programme theory identifies the plausible mechanisms through which these strategies could work. We found 30 mechanisms that could lead to varying implementation outcomes including normalisation of smoking in public places, stigmatisation of the smoker, citizen participation in the programme, fear of public opposition, feeling of kinship among violators and the rest of the community, empowerment of authorised officials, friction among different agencies, group identity among staff, shared learning, manipulation, intimidation and feeling left out in the policy-making process. CONCLUSIONS The synthesis provides an overview of the interplay of several contextual factors and mechanisms leading to varied implementation outcomes in LMICs. Decision-makers and other actors may benefit from examining the role of one or more of these mechanisms in their particular contexts to improve programme implementation. Further research into specific tobacco control policies and testing particular mechanisms will help deepen our understanding of tobacco control implementation in LMICs. PROSPERO REGISTRATION NUMBER CRD42020191541.
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Affiliation(s)
- Pragati Bhaskar Hebbar
- Cluster on Chronic conditions and public policies, Institute of Public Health Bengaluru, Bangalore, Karnataka, India
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
| | - Vivek Dsouza
- Cluster on Chronic conditions and public policies, Institute of Public Health Bengaluru, Bangalore, Karnataka, India
| | - Upendra Bhojani
- Cluster on Chronic conditions and public policies, Institute of Public Health Bengaluru, Bangalore, Karnataka, India
| | | | - Onno Cp van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University Faculty of Health Medicine and Life Sciences, Maastricht, Netherlands
| | - Giridhara R Babu
- Epidemiology, Public Health Foundation of India, Bangalore, India
| | - Gera E Nagelhout
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
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Sawyer K, Burke C, Ng RLY, Freeman TP, Adams S, Taylor G. Effectiveness of Mental Health Warnings on Tobacco Packaging in People With and Without Common Mental Health Conditions: An Online Randomised Experiment. Front Psychiatry 2022; 13:869158. [PMID: 35911223 PMCID: PMC9331922 DOI: 10.3389/fpsyt.2022.869158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Health warning labels on tobacco packaging are a cost-effective means of health risk communication. However, while an extensive range of physical health risks are well-portrayed via current tobacco health warnings in the UK, there are none that currently portray the negative impact of smoking on mental health. Aims (i) develop novel mental health warning labels for tobacco packaging and (ii) test perceptions of these warnings in smokers and non-smokers, with and without mental health problems. Methods Six mental health warning labels were developed with a consultancy focus group. These warning labels were tested in an online randomised experiment, where respondents (N = 687) rated six Mental Health Warning Labels (MHWLs) and six Physical Health Warning Labels (PHWLs) on measures of perceived effectiveness, believability, arousal, valence, acceptability, reactance and novelty of information. Results MHWLs were perceived as low to moderately effective (mean = 4.02, SD = 2.40), but less effective than PHWLs (mean = 5.78, SD = 2.55, p < 0.001, η p 2 = 0.63). MHWLs were perceived as less believable, arousing, unpleasant, and acceptable than PHWLs. MHWLs evoked more reactance and were rated as more novel. Perceptions of MHWLs did not differ in people with and without mental health problems except for reactance and acceptability, but consistent with the PHWL literature, perceptions of MHWLs differed between non-smokers and smokers. Conclusion MHWLs could be an effective means to communicate novel information about the effects of smoking on mental health. MHWLs are perceived as less effective, believable, arousing, unpleasant, and acceptable than PHWLs, but MHWLs evoke more reactance and are rated as more novel.
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Affiliation(s)
- Katherine Sawyer
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Chloe Burke
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Ronnie Long Yee Ng
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Tom P. Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Sally Adams
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Gemma Taylor
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
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Nganabashaka JP, Ntawuyirushintege S, Niyibizi JB, Umwali G, Bavuma CM, Byiringiro JC, Rulisa S, Burns J, Rehfuess E, Young T, Tumusiime DK. Population-Level Interventions Targeting Risk Factors for Hypertension and Diabetes in Rwanda: A Situational Analysis. Front Public Health 2022; 10:882033. [PMID: 35844869 PMCID: PMC9283981 DOI: 10.3389/fpubh.2022.882033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022] Open
Abstract
Background Eighty percent (80%) of global Non-Communicable Diseases attributed deaths occur in low- and middle-income countries (LMIC) with hypertension and diabetes being key contributors. The overall prevalence of hypertension was 15.3% the national prevalence of diabetes in rural and urban was 7.5 and 9.7%, respectively among 15–64 years. Hypertension represents a leading cause of death (43%) among hospitalized patients at the University teaching hospital of Kigali. This study aimed to identify ongoing population-level interventions targeting risk factors for diabetes and hypertension and to explore perceived barriers and facilitators for their implementation in Rwanda. Methods This situational analysis comprised a desk review, key informant interviews, and stakeholders' consultation. Ongoing population-level interventions were identified through searches of government websites, complemented by one-on-one consultations with 60 individuals nominated by their respective organizations involved with prevention efforts. Semi-structured interviews with purposively selected key informants sought to identify perceived barriers and facilitators for the implementation of population-level interventions. A consultative workshop with stakeholders was organized to validate and consolidate the findings. Results We identified a range of policies in the areas of food and nutrition, physical activity promotion, and tobacco control. Supporting program and environment interventions were mainly awareness campaigns to improve knowledge, attitudes, and practices toward healthy eating, physical activity, and alcohol and tobacco use reduction, healthy food production, physical activity infrastructure, smoke-free areas, limits on tobacco production and bans on non-standardized alcohol production. Perceived barriers included limited stakeholder involvement, misbeliefs about ongoing interventions, insufficient funding, inconsistency in intervention implementation, weak policy enforcement, and conflicts between commercial and public health interests. Perceived facilitators were strengthened multi-sectoral collaboration and involvement in ongoing interventions, enhanced community awareness of ongoing interventions, special attention paid to the elderly, and increased funds for population-level interventions and policy enforcement. Conclusion There are many ongoing population-level interventions in Rwanda targeting risk factors for diabetes and hypertension. Identified gaps, perceived barriers, and facilitators provide a useful starting point for strengthening efforts to address the significant burden of disease attributable to diabetes and hypertension.
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Affiliation(s)
- Jean Pierre Nganabashaka
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- *Correspondence: Jean Pierre Nganabashaka
| | | | | | - Ghislaine Umwali
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Charlotte M. Bavuma
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Stephen Rulisa
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jacob Burns
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Taryn Young
- Centre for Evidence-Based Health Care, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - David K. Tumusiime
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
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Puljević C, Morphett K, Hefler M, Edwards R, Walker N, Thomas DP, Khan MA, Perusco A, Le Grande M, Cullerton K, Ait Ouakrim D, Carstensen G, Sellars D, Hoek J, Borland R, Bonevski B, Blakely T, Brolan C, Gartner CE. Closing the gaps in tobacco endgame evidence: a scoping review. Tob Control 2022; 31:365-375. [PMID: 35241614 DOI: 10.1136/tobaccocontrol-2021-056579] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/12/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Tobacco endgame policies aim to rapidly and permanently reduce smoking to minimal levels. We reviewed evidence syntheses for: (1) endgame policies, (2) evidence gaps, and (3) future research priorities. DATA SOURCES Guided by JBI scoping review methodology, we searched five databases (PubMed, CINAHL, Scopus, Embase and Web of Science) for evidence syntheses published in English since 1990 on 12 policies, and Google for publications from key national and international organisations. Reference lists of included publications were hand searched. STUDY SELECTION Two reviewers independently screened titles and abstracts. Inclusion criteria were broad to capture policy impacts (including unintended), feasibility, public and stakeholder acceptability and other aspects of policy implementation. DATA EXTRACTION We report the results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. DATA SYNTHESIS Eight policies have progressed to evidence synthesis stage (49 publications): mandatory very low nicotine content (VLNC) standard (n=26); product standards to substantially reduce consumer appeal or remove the most toxic products from the market (n=1); moving consumers to reduced risk products (n=8); tobacco-free generation (n=4); ending sales (n=2); sinking lid (n=2); tax increases (n=7); and restrictions on tobacco retailers (n=10). Based on published evidence syntheses, the evidence base was most developed for a VLNC standard, with a wide range of evidence synthesised. CONCLUSIONS VLNC cigarettes have attracted the most attention, in terms of synthesised evidence. Additional focus on policies that reduce the availability of tobacco is warranted given these measures are being implemented in some jurisdictions.
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Affiliation(s)
- Cheneal Puljević
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Kylie Morphett
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Marita Hefler
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Richard Edwards
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Natalie Walker
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Addiction Research, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - David P Thomas
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Md Arifuzzaman Khan
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrew Perusco
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Michael Le Grande
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Katherine Cullerton
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Driss Ait Ouakrim
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Georgia Carstensen
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - David Sellars
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Janet Hoek
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ron Borland
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Billie Bonevski
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- College for Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Tony Blakely
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Claire Brolan
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Coral E Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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Polanska K, Kaleta D. Tobacco and E-Cigarettes Point of Sale Advertising-Assessing Compliance with Tobacco Advertising, Promotion and Sponsorship Bans in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1976. [PMID: 33670741 PMCID: PMC7922205 DOI: 10.3390/ijerph18041976] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/15/2021] [Accepted: 02/15/2021] [Indexed: 11/17/2022]
Abstract
The objective of this study was to evaluate compliance with the ban on tobacco and e-cigarette products advertising at point of sale (POS) before and after amendment of the Polish Tobacco Control Act. Data were collected, using an observation checklist, between March and October 2014 (n = 1450 POS) and between March and October 2019 (n = 1320 POS). Ban on tobacco and e-cigarette advertising at POS is commonly violated in Poland. In all POS, at least one form (including tobacco products display) of tobacco advertising was found in 2014 and in 2019. The most common types of tobacco advertising in 2014 were change and counter mats (61%, 42%), posters (38%) and illuminated banners (37%). In 2019, a decrease in promoting tobacco products in the form of mats (p ≤ 0.001), posters and boards (p < 0.001) but an increase in video screens were observed (from 8% in 2014 to 30% in 2019; p < 0.001). A significant increase in the presence of any e-cigarette ads, including e-cigarette displays, illuminated banners and video screens, was observed in 2019 as compared to 2014 (90% vs. 30%; 89% vs. 20%; 31% vs. 2%; 31% vs. 0.5%; p < 0.001). The minimum age or a no-sale-to-minors signs for tobacco and e-cigarettes were not sufficiently placed in POS to comply with the Act. Poor enforcement of the ban on tobacco and e-cigarette ads at POS provides the tobacco industry with an opportunity to promote their products using unlawful ways. There is a need to educate the public, retailers and civil society with respect to their legal responsibilities and roles.
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Affiliation(s)
- Kinga Polanska
- Department of Hygiene and Epidemiology, Medical University of Lodz, 90-752 Lodz, Poland;
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