Erectile dysfunction and smoking: subverting tobacco industry images of masculine potency

A Medical Student-Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Brazil: Study Protocol for a Randomized Trial

BACKGROUND

Smoking is the largest preventable cause of morbidity and mortality in Brazil. Education Against Tobacco (EAT) is a large network of medical students in 13 countries who volunteer for school-based prevention in the classroom setting. A recent quasi-experimental EAT study conducted in Germany showed significant short-term smoking cessation effects on 11- to 15-year-old adolescents.

OBJECTIVE

The aim of this study is both to describe and to provide the first randomized long-term evaluation of the EAT intervention involving a photoaging app for its effectiveness to reduce the smoking prevalence among 12- to 17-year-old pupils in Brazilian public schools.

METHODS

A randomized controlled trial will be conducted among approximately 1500 adolescents aged 12 to 17 years in grades 7-11 of public secondary schools in Brazil. The prospective experimental study design includes measurements at baseline and at 6 and 12 months postintervention. The study groups will consist of randomized classes receiving the standardized EAT intervention (90 minutes of mentoring in a classroom setting) and control classes within the same schools (no intervention). The questionnaire measures smoking status, gender, social, and cultural aspects as well as predictors of smoking. Biochemical validation of smoking status is conducted via random carbon monoxide measurements. The primary end point is the difference of the change in smoking prevalence in the intervention group versus the difference in the control group at 12 months of follow-up. The differences in smoking behavior (smoking onset, quitting) between the 2 groups as well as effects on the different genders will be studied as secondary outcomes.

RESULTS

The recruitment of schools, participating adolescents, and medical students was conducted from August 2016 until January 2017. The planned period of data collection is February 2017 until June 2018. Data analysis will follow in July 2018 and data presentation/publication will follow shortly thereafter.

CONCLUSIONS

This is the first evaluative study of a medical student-delivered tobacco prevention program in Brazil and the first randomized trial on the long-term effectiveness of a school-based medical student-delivered tobacco prevention program in general.

CLINICALTRIAL

ClinicalTrials.gov NCT02725021; https://clinicaltrials.gov/ct2/show/NCT02725021 (archived by WebCite at http://www.webcitation.org/6njy3nNml).

A qualitative content analysis of cigarette health warning labels in Australia, Canada, the United Kingdom, and the United States

The legislation of health warning labels on cigarette packaging is a major focus for tobacco control internationally and is a key component of the World Health Organization's Framework Convention on Tobacco Control. This population-level intervention is broadly supported as a vital measure for warning people about the health consequences of smoking. However, some components of this approach warrant close critical inspection. Through a qualitative content analysis of the imagery used on health warning labels from 4 countries, we consider how this imagery depicts people that smoke. By critically analyzing this aspect of the visual culture of tobacco control, we argue that this imagery has the potential for unintended consequences, and obscures the social and embodied contexts in which smoking is experienced.

Smoking spaces as enabling spaces of wellbeing

A persistent emphasis on the negative biomedical effects of cigarette smoking effectively glosses over the affectual-sensual and social wellbeing that smoking can enable. In addition, while tobacco research has recently been more attuned to the stigmatizing affects brought about by smoking de-normalization efforts, a lot less attention has been placed on how smokers negotiate these feelings of stigmatization so as to restore their personal spaces of wellbeing. In this paper, I situate my investigation of smoking geographies in the burgeoning literature on enabling spaces which focuses on how places co-constitute our ability to act/affect in empowering ways. By deploying qualitative research methods such as in-depth interviews, I argue that an acknowledgment of how smoking spaces in Singapore can be enabling along affectual, sensorial and social registers is long overdue. While it is not my purpose to systematically downplay the damaging health effects that smoking can engender, a focus on enabling smoking spaces emphasizes the role of smokers as creative agents capable of (re)fashioning their own holistic and subjective versions of wellbeing. In so doing, I hope to contribute to the existing research on smoking spaces and a recent profusion of work on relational geographies of affect.