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Jetly K, Ismail A, Hassan N, Mohammed Nawi A. Mechanism Linking Cigarette Pack Factors, Point-of-Sale Marketing and Individual Factors With Smoking Intention Among School-Going Adolescents. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024:00124784-990000000-00335. [PMID: 39236215 DOI: 10.1097/phh.0000000000001960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
CONTEXT Tobacco usage accounts for one of the most preventable causes of death. OBJECTIVE This study aimed to explore mechanisms linking cigarette pack factors, point-of-sale marketing, and individual factors (psychological reactant trait) to predict smoking intention among school-going adolescents. DESIGN, SETTING, AND PARTICIPANTS This was a cross-sectional study conducted among 6 urban secondary schools. A pretested and validated self-administered questionnaire was used. Data analysis for structural equation modeling was done using SMART-PLS v3.2.8. MAIN OUTCOME MEASURE The main outcome measure was to determine the direct and indirect effects of cigarette pack factors, point-of-sale marketing, and individual factors (psychological reactant trait) to predict smoking intention among school-going adolescents in a theory-based model. RESULTS A total of 386 adolescents fulfilling the inclusion criteria participated. Pictorial warning message reactance (β = .153, P ≤ .001), pack receptivity of conventional pack (β = .297, P = .004), and psychological reactant trait (β = .174, P ≤ .001) were positively related to smoking intention. Pictorial warning negative affect (β = -.153, P = .001) was negatively related to smoking intention. The psychological reactant trait was positively related to message reactance (β = .340, P ≤ .001). However, recall exposure to point-of-sale marketing and pack appraisal of conventional pack was not positively related to smoking intention (β = .038, P = .215 and β = -.026, P = .39, respectively). Pictorial warning message reactance also positively mediates the relationship between psychological reactant trait and smoking intention (β = 0.05, p = .001). The model has strong predictive power. CONCLUSION In conclusion, cigarette pack factors and psychological reactant traits are essential in predicting smoking intention. Hence, policymakers should consider these factors in developing smoking policies.
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Affiliation(s)
- Kavita Jetly
- Author Affiliations: Herbal Medicine Research Centre, Institute of Medical Research, National Institutes of Health, Shah Alam Selangor, Malaysia (Dr Jetly); Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia (Dr Ismail and Nawi); and Non-Communicable Disease Section, Disease Control Division (NCD), Ministry of Health Malaysia, Wilayah Persekutuan Putrajaya, Malaysia (Dr Hassan) Faculty of Public Health, Universitas Sumatera Utara, Indonesia(Dr Ismail)
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Bar-Zeev Y, Berg CJ, Khayat A, Abroms LC, Wang Y, Duan Z, LoParco CR, Cui Y, Elbaz D, Levine H. Low compliance and proliferation of IQOS purchase cues at points-of-sale: a comparative study before and after Israel's display ban. Tob Control 2024:tc-2023-058509. [PMID: 38862232 DOI: 10.1136/tc-2023-058509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 05/07/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION It is unclear how tobacco companies respond to increasing restrictions on points-of-sale (POS) (eg, advertisement ban, display ban), especially regarding newer products, such as IQOS, a heated tobacco product. This study compared POS marketing strategies for IQOS (and HEETS tobacco sticks) before and after Israel implemented a display ban and plain packaging. METHODS Audits of stores selling IQOS (n=87) in four Israeli cities were conducted, 16-20 months post display ban and plain packaging introduction, including previously audited stores (n=60) (prior to the implementation of these measures). Descriptive analyses and matched pre-post comparisons were conducted to assess regulatory compliance and marketing strategies over time. RESULTS Almost all stores (90.8%) were non-compliant with the display ban; but most were compliant with plain packaging (81.6%) and advertisement ban (83.5%) regulations. Following the display ban, there was a significant increase in the number of IQOS/HEETS internal advertisements (21.7% vs 41.7%, p=0.023). These were mostly compliant with the advertisement ban (ie, did not mention the brand name explicitly), and appeared in the form of generic signs or flags and/or special displays. The percentage of stores featuring the IQOS device increased (1.7% to 20.0%, p=0.003), as did the percentage carrying at least four HEETS flavours (36.7% to 63.3%, p=0.006). CONCLUSION This sample of Israeli stores selling IQOS showed low compliance with the display ban. The increase in signs/special displays, mostly compliant with the advertisement ban, could serve as purchase cues circumventing the intent of the legislation. Regulatory efforts should consider more specific legislative language and comprehensive enforcement plans.
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Affiliation(s)
- Yael Bar-Zeev
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem - Hadassah Medical Centre, Jerusalem, Israel
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- GW Cancer Center, George Washington University, Washington, DC, USA
| | - Amal Khayat
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem - Hadassah Medical Centre, Jerusalem, Israel
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- GW Cancer Center, George Washington University, Washington, DC, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- GW Cancer Center, George Washington University, Washington, DC, USA
| | - Zongshuan Duan
- Population Health Sciences, Georgia State University, Atlanta, Georgia, USA
| | - Cassidy R LoParco
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Yuxian Cui
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Daniel Elbaz
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem - Hadassah Medical Centre, Jerusalem, Israel
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem - Hadassah Medical Centre, Jerusalem, Israel
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Hoek J, Lee E, Teddy L, Fenton E, Ball J, Edwards R. How do New Zealand youth perceive the smoke-free generation policy? A qualitative analysis. Tob Control 2024; 33:346-352. [PMID: 36283832 DOI: 10.1136/tc-2022-057658] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/19/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Aotearoa New Zealand (NZ) plans to introduce a smoke-free generation (SFG) policy, alongside denicotinisation and reducing the availability of tobacco products. The SFG has a clear rationale, yet we know little about how young people, those the policy targets, perceive it. To inform policy design, communication and implementation, we explored how NZ youth perceived the SFG. METHODS We undertook in-depth interviews with a sample of 20 youth aged 17 or 18 and explored their knowledge of the SFG, and how they perceived its individual and societal implications. We interpreted the data using a reflexive thematic analysis approach. RESULTS We identified two overarching themes. The first theme, 'societal good and protection from harm', reflected benefits participants associated with the SFG, which outweighed perceptions of lost freedoms. The second theme, 'privileging personal choice', corresponded to two small groups within the sample. The first preferred measures they considered less restrictive, such as increasing the purchase age, and some came to support the SFG as they rationalised their views. The second subgroup expressed more entrenched opposition and felt the SFG deprived them of a choice. CONCLUSIONS Young people's deep reflection on the SFG led most to view it as liberating rather than restrictive. Communications that avoid prompting heuristic-based responses could encourage youth to reflect on the policy and elicit strong support from the group the SFG aims to benefit.
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Affiliation(s)
- Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ell Lee
- University of Otago Medical School, Dunedin, New Zealand
| | - Lani Teddy
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Elizabeth Fenton
- Bioethics Centre, University of Otago Bioethics Centre, Dunedin, New Zealand
| | - Jude Ball
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Richard Edwards
- Department of Public Health, University of Otago, Wellington, New Zealand
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Hoek J, Rowse B. Point-of-sale displays: a comparison of tobacco and vaping product retail strategies. Tob Control 2023:tc-2023-058211. [PMID: 37827843 DOI: 10.1136/tc-2023-058211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/06/2023] [Indexed: 10/14/2023]
Affiliation(s)
- Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
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Usidame B, Xie Y, Thrasher JF, Lozano P, Elliott MR, Fong GT, Fleischer NL. Differential impact of the Canadian point-of-sale tobacco display bans on quit attempts and smoking cessation outcomes by sex, income and education: longitudinal findings from the ITC Canada Survey. Tob Control 2023; 32:599-606. [PMID: 35017260 PMCID: PMC9271527 DOI: 10.1136/tobaccocontrol-2021-056805] [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: 05/25/2021] [Accepted: 12/27/2021] [Indexed: 11/04/2022]
Abstract
SIGNIFICANCE This study examines the differential effects of Canadian point-of-sale (POS) tobacco display bans across provinces on quit attempts and smoking cessation, by sex, education and income. METHODS We analysed survey data from five waves (waves 4-8) of the International Tobacco Control Canada Survey, a population-based, longitudinal survey, where provinces implemented display bans between 2004 and 2010. Primary outcomes were quit attempts and successful cessation. We used generalised estimating equation Poisson regression models to estimate associations between living in a province with or without a POS ban (with a 24-month threshold) and smoking outcomes. We tested whether these associations varied by sex, education and income by including interaction terms. RESULTS Across survey waves, the percentage of participants in provinces with POS bans established for more than 24 months increased from 5.0% to 95.8%. There was no association between POS bans and quit attempts for provinces with bans in place for 0-24 months or more than 24 months, respectively (adjusted relative risk (aRR)=0.99, 95% CI: 0.89 to 1.10; 1.03, 95% CI: 0.88 to 1.20). However, we found a differential impact of POS bans on quit attempts by sex, whereby bans were more effective for women than men for bans of 0-24 months. Participants living in a province with a POS ban for at least 24 months had a higher chance of successful cessation (aRR=1.49; 95% CI: 1.08 to 2.05) compared with those in a province without a ban. We found no differences in the association between POS bans and quit attempts or cessation by education or income, and no differences by sex for cessation. CONCLUSION POS bans are associated with increased smoking cessation overall and more quit attempts among women than men.
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Affiliation(s)
- Bukola Usidame
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yanmei Xie
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - James F Thrasher
- Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
- National Institute of Public Health, Cuernavaca, Mexico
| | - Paula Lozano
- Center for Asian Health Equity, The University of Chicago Medicine, Chicago, Illinois, USA
| | - Michael R Elliott
- Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Blackwell AKM, Pilling MA, De-Loyde K, Morris RW, Brocklebank LA, Marteau TM, Munafò MR. Impact of e-cigarette retail displays on attitudes to smoking and vaping in children: an online experimental study. Tob Control 2023; 32:e220-e227. [PMID: 35418506 PMCID: PMC10423515 DOI: 10.1136/tobaccocontrol-2021-056980] [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: 08/12/2021] [Accepted: 03/29/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To estimate the impact of electronic cigarette (e-cigarette) retail display exposure on attitudes to smoking and vaping (susceptibility to tobacco smoking and using e-cigarettes, and perceptions of the harms of smoking and e-cigarette use). DESIGN Between-subjects randomised experiment using a 2 (e-cigarette retail display visibility: high vs low)×2 (proportion of e-cigarette images: 75% vs 25%) factorial design. SETTING Online via the Qualtrics survey platform. PARTICIPANTS UK children aged 13-17 years (n=1034), recruited through a research agency. INTERVENTION Participants viewed 12 images of retail displays that contained e-cigarette display images or unrelated product images. E-cigarette display images were either high or low visibility, based on a conspicuousness score. Participants were randomised to one of four groups, with e-cigarette display visibility and proportion of e-cigarette images, compared with images of unrelated products, manipulated: (1) 75% e-cigarettes, high visibility; (2) 25% e-cigarettes, high visibility; (3) 75% e-cigarettes, low visibility; (4) 25% e-cigarettes, low visibility. MAIN OUTCOME MEASURES The primary outcome was susceptibility to smoking (among never smokers only). Secondary outcomes were susceptibility to using e-cigarettes (among never vapers only), and perceptions of smoking and e-cigarette harm (all participants). RESULTS Neither e-cigarette retail display visibility, nor the proportion of e-cigarette images displayed, appeared to influence susceptibility to smoking (visibility: OR=0.84, 95% CI 0.62 to 1.13, p=0.24; proportion: OR=1.34, 95% CI 1.00 to 1.82, p=0.054 (reference: low visibility, not susceptible)).Planned subgroup analyses indicated that exposure to a higher proportion of e-cigarette images increased susceptibility to smoking among children who visited retail stores more regularly (n=524, OR=1.59, 95% CI 1.04 to 2.43, p=0.034), and those who passed the attention check (n=880, OR=1.43, 95% CI 1.03 to 1.98, p=0.031).In addition, neither e-cigarette retail display visibility nor the proportion of e-cigarette images displayed, appeared to influence susceptibility to using e-cigarettes (visibility: OR=1.07, 95% CI 0.80 to 1.43, p=0.65; proportion: OR=1.22, 95% CI 0.91 to 1.64, p=0.18).Greater visibility of e-cigarette retail displays reduced perceived harm of smoking (mean difference (MD)=-0.19, 95% CI -0.34 to -0.04, p=0.016). There was no evidence that the proportion of e-cigarette images displayed had an effect (MD=-0.07, 95% CI -0.22 to 0.09, p=0.40).Perceived harm of e-cigarette use did not appear to be affected by e-cigarette retail display visibility (MD=-0.12, 95% CI -0.28 to 0.05, p=0.16) or by the proportion of e-cigarette images displayed (MD=-0.10, 95% CI -0.26 to 0.07, p=0.24). CONCLUSIONS There is no evidence in the full sample to suggest that children's susceptibility to smoking is increased by exposure to higher visibility e-cigarette retail displays, or to a higher proportion of e-cigarette images. However, for regular store visitors or those paying more attention, viewing a higher proportion of e-cigarette images increased susceptibility to smoking. In addition, viewing higher visibility e-cigarette images reduced perceived harm of smoking. A review of the current regulatory discrepancy between tobacco and e-cigarette point-of-sale marketing is warranted. TRIAL REGISTRATION NUMBER ISRCTN18215632.
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Affiliation(s)
| | - Mark A Pilling
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Katie De-Loyde
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Richard W Morris
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - Laura A Brocklebank
- Department of Behavioural Science and Health, University College London, London, UK
| | - Theresa M Marteau
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Marcus R Munafò
- School of Psychological Science, University of Bristol, Bristol, UK
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Travis N, Levy DT, McDaniel PA, Henriksen L. Tobacco retail availability and cigarette and e-cigarette use among youth and adults: a scoping review. Tob Control 2022; 31:e175-e188. [PMID: 34301839 PMCID: PMC9126034 DOI: 10.1136/tobaccocontrol-2020-056376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/28/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE States and localities are formulating strategies to reduce the widespread retail availability of tobacco products. Evidence of associations between retailer density/proximity and tobacco use outcomes can help inform those strategies. We conducted a scoping review on tobacco retail availability and cigarette/e-cigarette use in adults and youth, and considered variations in spatial units, measures of retailer exposure and outcomes across studies. METHODS A systematic search for studies examining the association between retailer density/proximity and youth and adult cigarette/e-cigarette use was conducted across MEDLINE (PubMed), Web of Science and Google Scholar through 27 August 2020 with no restrictions. RESULTS Thirty-five studies were included in our qualitative synthesis. While there were differences in neighbourhood definitions (eg, egocentric vs administrative), there is evidence for a positive association between higher retailer density in egocentric neighbourhoods around homes and current smoking in adults and adolescents. Administrative unit measures in some studies showed associations with adult current smoking, and adolescent lifetime and current smoking. Studies on tobacco outlet proximity to homes obtained mixed results. Density/proximity of tobacco outlets around schools showed no or inverse association with adolescent smoking, but suggests higher susceptibility to smoking. Evidence of an association between e-cigarette retail availability and e-cigarette use is limited due to a small number of studies. CONCLUSION The current literature provides limited empirical evidence of the association between tobacco retailer availability and smoking or e-cigarette use. More research with uniform measures of environmental exposure to tobacco retailers is needed to allow for greater comparability between studies.
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Affiliation(s)
- Nargiz Travis
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Patricia A McDaniel
- Department of Social and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California, USA
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van Deelen TRD, Arnott D, Hitchman S, van den Putte B, Kunst AE, Kuipers MAG. Tobacco Retailers' Support for Point-of-Sale Tobacco Control Policies in England: Association Study of Retailers' Perceived Importance of Tobacco Sales, Contact with the Tobacco Industry, and the Perceived Impact of the Policy. Nicotine Tob Res 2022; 24:813-819. [PMID: 34850937 DOI: 10.1093/ntr/ntab244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 10/06/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Political acceptability and successful implementation of tobacco control policies at the point of sale may depend on, among other factors, tobacco retailers' level of support for these policies. This study quantified the level of support among small tobacco retailers for four point-of-sale tobacco control policies and its association with three predictors. METHODS We used cross-sectional telephone survey data (August 2019) of 508 small tobacco retailers in England. Weighted logistic regression analyses examined associations between support for the product display ban, price display ban, minimum pack size, and standardized packaging, and self-reported importance of tobacco sales for a business, contact with the tobacco industry, and the perceived impact of the policy on their overall business. RESULTS A majority of retailers support minimum pack size (66%), product display ban (65%), price display ban (54%), and standardized packaging (55%). The importance of tobacco sales was not associated with support for the policies. More frequent contact with the tobacco industry was associated with higher odds of support for minimum pack size (OR: 2.01, 95%CI:1.25-3.21), but not with the other three policies. The negative perceived impact of the policies, compared with neutral, was associated with 1.5 to three times lower odds of support for all four policies. CONCLUSION In England, small retailers' support for the four point-of-sale tobacco control policies varied between 54% and 66%. Support seems unrelated to the perceived importance of tobacco sales, and contact with the tobacco industry, but seems strongly related to the perceived impact of tobacco control policies on their business. IMPLICATIONS This study shows that small independent retailers' support for point-of-sale (PoS) tobacco control policies is fairly high and that the lack of support voiced by retail trade organizations is not representative of the views of retailers in England. Support rates may be further improved by addressing retailers' perceptions of the impact of policies on their business. Support was not related to retailers' perceived importance of tobacco sales for their business and their contact with the tobacco industry. The industry rhetoric is not supported by our findings, as the majority of small independent retailers in England support tobacco control regulations.
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Affiliation(s)
- Tessa R D van Deelen
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Deborah Arnott
- Action on Smoking & Health, London, UK
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, UK
| | - Sara Hitchman
- Department of Communication and Media Research, University of Zurich, Zurich, Switzerland
| | - Bas van den Putte
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, the Netherlands
| | - Anton E Kunst
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Mirte A G Kuipers
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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Boston A, Robertson L, Hoek J. Specialist vape store developments during the implementation of New Zealand's Smokefree Environments and Regulated Products (Vaping) Amendment Act 2020. Tob Control 2022:tobaccocontrol-2021-057123. [PMID: 35228319 DOI: 10.1136/tobaccocontrol-2021-057123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/17/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Andrea Boston
- Regional Public Health, Hutt Valley District Health Board, Hutt Valley, Wellington, New Zealand
| | - Lindsay Robertson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
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Kong AY, King BA. Boosting the Tobacco Control Vaccine: recognizing the role of the retail environment in addressing tobacco use and disparities. Tob Control 2021; 30:e162-e168. [PMID: 32967986 PMCID: PMC9377406 DOI: 10.1136/tobaccocontrol-2020-055722] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/22/2020] [Accepted: 07/28/2020] [Indexed: 01/18/2023]
Abstract
Much of the progress in reducing cigarette smoking and tobacco-related morbidity and mortality among youth and adults is attributable to population-level strategies previously described in the context of the Tobacco Control Vaccine. The retail environment is used heavily by the tobacco industry to promote and advertise its products, and variations in exposure to and characteristics of the retail environment exist across demographic groups. It is therefore also an essential environment for further reducing smoking, as well as ameliorating racial, ethnic and socioeconomic tobacco-related disparities. This commentary provides an overview of the importance of incorporating strategies focused on the tobacco retailer environment (availability; pricing and promotion; advertising and display; age of sale; and retail licensure) as part of a comprehensive approach to tobacco prevention and control. To reach tobacco endgame targets, such innovative strategies are a complement to, but not a replacement for, long-standing evidence-based components of the Tobacco Control Vaccine.
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Affiliation(s)
- Amanda Y Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brian A King
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Brocklebank LA, Blackwell AKM, Marteau TM, De-Loyde K, Morris RW, Burgoine T, Hobson A, Ventsel M, Munafo MR. Electronic cigarette and smoking paraphernalia point of sale displays: an observational study in England. Tob Control 2021; 31:e201-e206. [PMID: 34518335 DOI: 10.1136/tobaccocontrol-2020-056314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 04/19/2021] [Accepted: 04/26/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Tobacco point of sale (POS) retail displays are banned in many countries, including in England, due in part to evidence linking them to greater susceptibility to smoking in children. There is no equivalent ban on displays of electronic cigarettes (e-cigarettes) or smoking paraphernalia (eg, cigarette lighters) in England, which are often positioned alongside covered tobacco storage units. This observational study describes the visibility and placement of e-cigarette and smoking paraphernalia POS displays in major tobacco retailers in two cities in England to inform future research examining their possible links to susceptibility to tobacco smoking, particularly in children. METHODS Researchers visited all small- and large-format stores of four supermarket chains and a randomly selected sample of convenience stores, in Bristol and Cambridge. A standardised checklist was used to create a total visibility score for POS displays of (a) e-cigarettes and (b) smoking paraphernalia, plus other measures of visibility and placement. These were described for the total sample and compared between areas of low, medium, and high deprivation using general linear models adjusting for store location and store type. RESULTS The visibility checklist was completed in 133 of 166 stores (80% completion rate). Both e-cigarette and smoking paraphernalia POS displays were present in 96% of stores. POS displays were highly visible across all stores: mean (SD) total visibility scores, out of 17, were 14.7 (1.8) for e-cigarettes and 12.7 (1.8) for smoking paraphernalia. There was no clear evidence of differences in visibility by area of deprivation. CONCLUSION E-cigarette and smoking paraphernalia POS displays are near ubiquitous and highly visible in major tobacco retailers in two cities in England. The impact of these displays on tobacco smoking in children and adults is unknown, meriting urgent research to assess their effect on susceptibility to tobacco smoking in children.
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Affiliation(s)
- Laura A Brocklebank
- School of Psychological Science, University of Bristol, Bristol, UK .,Department of Behavioural Science and Health, University College London, London, UK
| | | | - Theresa M Marteau
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Katie De-Loyde
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Richard W Morris
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Thomas Burgoine
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alice Hobson
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Minna Ventsel
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Marcus R Munafo
- School of Psychological Science, University of Bristol, Bristol, UK
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12
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Barnoya J, Monzon D, Pinetta J, Grilo G, Cohen JE. New tobacco products, old advertising strategies: point-of-sale advertising in Guatemala. Tob Control 2021; 30:591-593. [PMID: 32817571 PMCID: PMC8394754 DOI: 10.1136/tobaccocontrol-2020-055681] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/13/2020] [Accepted: 06/16/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Capsule cigarettes, electronic cigarettes (e-cigarettes) and heated tobacco products (HTPs) are now readily available in Guatemala. As in most countries, the point-of-sale (POS) remains an important marketing channel for the tobacco industry. Therefore, we sought to characterise the POS marketing of these products in the two largest cities in Guatemala. METHODS Convenience stores were randomly surveyed in mid and high socioeconomic status (SES) neighbourhoods in Guatemala City (n=60) and Quetzaltenango (n=15) in 2019. We adapted a previously implemented checklist to assess the availability of interior advertising of capsule cigarettes, e-cigarettes and HTP. Data entry was done in Kobo toolbox and analysis in STATA. RESULTS All stores sold conventional and flavoured capsule cigarettes, 78% e-cigarettes and 68% HTP. Most cigarette advertising was for capsule cigarettes. E-cigarettes were more likely to be sold in Guatemala City (96%) than in Quetzaltenango (13%). HTPs were only found in Guatemala City (85%), with no difference between high and medium SES neighbourhoods. Median number of ads for cigarettes and capsule cigarettes was higher in the high SES neighbourhood. Most e-cigarettes (83%) and HTP (74%) were found <50 cm from candy. E-cigarettes and HTP were available in a wide range of flavours. All stores that sold HTP had flavoured HEETS (amber, bronze, turquoise, yellow, blue and purple). CONCLUSION We found a high prevalence of advertising for capsule cigarettes, e-cigarettes and HTP at the POS. The POS, a crucial advertising channel for the tobacco industry, is now being used for new products and therefore needs to be urgently regulated.
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Affiliation(s)
- Joaquin Barnoya
- Departamento de Investigacion, Unidad de Cirugia Cardiovascular, Guatemala, Guatemala
- Research Department, Integra Cancer Institute, Guatemala, Guatemala
| | - Diego Monzon
- Departamento de Investigacion, Unidad de Cirugia Cardiovascular, Guatemala, Guatemala
| | - Jose Pinetta
- Departamento de Investigacion, Unidad de Cirugia Cardiovascular, Guatemala, Guatemala
| | - Graziele Grilo
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Li S, Keogan S, Clancy L. Does smoke-free legislation work for teens too? A logistic regression analysis of smoking prevalence and gender among 16 years old in Ireland, using the 1995-2015 ESPAD school surveys. BMJ Open 2020; 10:e032630. [PMID: 32801188 PMCID: PMC7430408 DOI: 10.1136/bmjopen-2019-032630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 02/27/2020] [Accepted: 04/21/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To assess the role of tobacco control legislation (TCL) in youth smoking in Ireland. To examine the effects of smoke-free legislation in youth. To consider whether TCL contributed to the gender equalisation in prevalence in 16 years old seen between 2003 and 2015. SETTING Data are from the 4 yearly European School Survey Project on Alcohol and Other Drugs from 1995 to 2015. Total sample size was 12.394. A logistic regression model on grouped data was used. Dependent variable is whether a student was a smoker in last 30 days. Independent variables are time, gender and the policy indicators, workplace ban on smoking, point-of-sale (POS) display ban, the introduction of graphical images on packs and the average real price of cigarettes. RESULTS Smoking prevalence dropped from 41% in 1995 to 13% in 2015. The effects of policies differed between boys and girls. For girls, estimates for workplace bans, graphical images on packs and a unit real (Consumer Price Index adjusted) price increase reduced prevalence by 7.31% (95% CI 2.94% to 11.68%), 8.80% (95% CI 2.60% to 15.01%) and 5.87 (95% CI 2.96 to 8.79), respectively. The POS ban did not have a significant effect in girls. For boys, estimates for workplace bans and a unit real price increase, reduced prevalence by 8.41% (95% CI 5.16% to 11.66%) and 4.93% (95% CI 0.77% to 9.08%), respectively, POS gave an increase of 7.02% (95% CI 1.96% to 12.40%). The introduction of graphical images had an insignificant effect. CONCLUSIONS TC legislation helps to explain the out-of-trend reduction in youth smoking prevalence. The estimated differential effects of the workplace ban, POS displays, real price changes and graphical images on packs help to explain the sharper decline in girls than boys. These findings should remind policy-makers to give increased consideration to the possible effects on young people of any legislative changes aimed at adults in TCL.
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Affiliation(s)
- Shasha Li
- TU Dublin, TobaccoFree Research Institute Ireland, Kevin Street, Dublin 8, Dublin, Ireland
| | - Sheila Keogan
- TU Dublin, TobaccoFree Research Institute Ireland, Kevin Street, Dublin 8, Dublin, Ireland
| | - Luke Clancy
- TU Dublin, TobaccoFree Research Institute Ireland, Kevin Street, Dublin 8, Dublin, Ireland
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Ford A, MacKintosh AM, Moodie C, Kuipers MAG, Hastings GB, Bauld L. Impact of a ban on the open display of tobacco products in retail outlets on never smoking youth in the UK: findings from a repeat cross-sectional survey before, during and after implementation. Tob Control 2020; 29:282-288. [PMID: 31088915 PMCID: PMC7231456 DOI: 10.1136/tobaccocontrol-2018-054831] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/14/2019] [Accepted: 03/20/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND In the UK, a ban on the open display of tobacco products at the point of sale (POS) was phased in between 2012 and 2015. We explored any impact of the ban on youth before, during and after implementation. METHODS A repeat cross-sectional in-home survey with young people aged 11-16 years old in the UK was conducted preban (2011, n=1373), mid-ban (2014, n=1205) and postban (2016, n=1213). The analysis focuses on the never-smokers in the sample (n=2953 in total). Preban, we quantified the associations of noticing cigarettes displayed at POS and cigarette brand awareness with smoking susceptibility. We measured any change in noticing cigarettes displayed at POS, cigarette brand awareness and smoking susceptibility between preban, mid-ban and postban. Postban, we assessed support for a display ban, perceived appeal of cigarettes and perceived acceptability of smoking as a result of closed displays. RESULTS Preban, noticing cigarettes displayed at POS (adjusted OR [AOR]=1.97, 95% CI 1.30 to 2.98) and higher brand awareness (AOR=1.15, 95% CI 1.03 to 1.29) were positively associated with smoking susceptibility. The mean number of brands recalled declined from 0.97 preban to 0.69 postban (p<0.001). Smoking susceptibility decreased from 28% preban to 23% mid-ban and 18% postban (p for trend <0.001). Postban, 90% of never-smokers supported the display ban and indicated that it made cigarettes seem unappealing (77%) and made smoking seem unacceptable (87%). CONCLUSIONS Both partial and full implementation of a display ban were followed by a reduction in smoking susceptibility among adolescents, which may be driven by decreases in brand awareness.
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Affiliation(s)
- Allison Ford
- Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| | - Anne Marie MacKintosh
- Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| | - Crawford Moodie
- Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| | - Mirte A G Kuipers
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Gerard B Hastings
- Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| | - Linda Bauld
- UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
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15
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Kuipers MAG, Best C, Wilson M, Currie D, Ozakinci G, MacKintosh AM, Stead M, Eadie D, MacGregor A, Pearce J, Amos A, Haw S. Adolescents' perceptions of tobacco accessibility and smoking norms and attitudes in response to the tobacco point-of-sale display ban in Scotland: results from the DISPLAY Study. Tob Control 2020; 29:348-356. [PMID: 31053651 PMCID: PMC7231455 DOI: 10.1136/tobaccocontrol-2018-054702] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 03/20/2019] [Accepted: 04/08/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Scotland implemented a ban on open display of tobacco products in supermarkets in April 2013, and small shops in April 2015. This study aimed to quantify changes in perceived tobacco accessibility, smoking norms and smoking attitudes among adolescents in Scotland, following the implementation of partial and comprehensive point-of-sale (POS) tobacco display bans. METHODS From the Determining the Impact of Smoking Point of Sale Legislation Among Youth (DISPLAY) Study's 2013-2017 annual surveys we retrieved data comprising 6202 observations on 4836 12-17-year-old adolescents from four schools. Applying generalised estimating equations, associations between time (postban: 2016-2017 vs preban:2013) and three outcomes were estimated. Outcomes were perceived commercial access to tobacco, perceived positive smoking norm (friends think it's OK to smoke) and positive smoking attitude (you think it's OK to smoke). Analyses were adjusted for sociodemographics, smoking status, family smoking, friend smoking and e-cigarette use. RESULTS Crude trends showed an increase over time in perceived accessibility, norms and attitudes. However, after adjustment for confounders, mainly e-cigarette use, we found significant declines in perceived access (OR = 0.72, 95% CI 0.57 to 0.90) and in positive smoking attitude (OR = 0.67, 95% CI = 0.49 to 0.91), but no change in perceived positive smoking norm (OR = 1.00, 95% CI 0.78 to 1.29). Current/past occasional or regular e-cigarette use was associated with higher odds of perceived access (OR = 3.12, 95% CI 2.32 to 4.21), positive norm (OR = 2.94, 95% CI 2.16 to 4.02) and positive attitude (OR = 3.38, 95% CI 2.35 to 4.87). CONCLUSION Only when taking into account that the use of e-cigarettes increased in 2013-2017 did we find that the POS tobacco display ban in supermarkets and small shops in Scotland was followed by reductions in adolescents' perceived accessibility of tobacco and positive attitudes towards smoking.
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Affiliation(s)
- Mirte AG Kuipers
- Department of Public Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Catherine Best
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Michael Wilson
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Dorothy Currie
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Gozde Ozakinci
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Anne-Marie MacKintosh
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Martine Stead
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Douglas Eadie
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Andy MacGregor
- Head of Policy Research, Scotcen Social Research, Edinburgh, UK
| | - Jamie Pearce
- Centre for Research on Environment Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Amanda Amos
- The Usher Institute of Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Sally Haw
- Faculty of Health Sciences and Sport, University of Stirlings, Stirling, UK
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Haw S, Currie D, Eadie D, Pearce J, MacGregor A, Stead M, Amos A, Best C, Wilson M, Cherrie M, Purves R, Ozakinci G, MacKintosh AM. The impact of the point-of-sale tobacco display ban on young people in Scotland: before-and-after study. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background
Tobacco displays at point of sale have been shown to increase young people’s pro-smoking attitudes, susceptibility to smoking and smoking initiation. In Scotland, legislation that prohibited tobacco point-of-sale displays was implemented in large stores (i.e. those > 280 m2) in April 2013 and in small retailers in April 2015.
Objective
To assess the impact of the point-of-sale tobacco display ban on young people’s exposure to tobacco advertising, their attitudes to smoking and smoking susceptibility, and their risk of smoking initiation.
Design
Multimodal before-and-after study design using mixed methods to collect data at baseline (2013) and then longitudinally for 4 years.
Setting
Four main study communities in the central belt of mainland Scotland, UK, purposively selected to reflect two levels of urbanity (urban vs. small town) and two levels of deprivation (high vs. medium/low). Four matched communities.
Participants
In the main study communities, 94 tobacco retail outlets. All Secondary 2 (aged 13 years) and Secondary 4 (aged 15 years) pupils in 2013 and 2014 together with all Secondary 1 to Secondary 6 (aged 12–17 years) pupils in 2015–17. This included 6612 pupils who completed 14,344 questionnaires over 5 years. Three hundred and eighty-two participants in 80 focus groups who were recruited from Secondary 2 and Secondary 4 in 2013–17. In matched communities, 24 retail panel members in 2013–17.
Main outcome measures
Tobacco product and tobacco storage visibility, density of retail outlets (the number of retailers in a pre-defined area such as a residential neighbourhood), tobacco product exposure, brand awareness, perceived accessibility of tobacco, pro-smoking attitudes, pro-smoking norms, smoking susceptibility and smoking initiation.
Data platform and methods
The study had four components – a mapping and spatial analysis of retail outlets; a tobacco marketing audit, including retail panel interviews in matched communities; school surveys; and focus group discussions with secondary school pupils.
Limitations
The study was based on a small number of communities and did not include communities in remote areas.
Results
Compliance with the point-of-sale legislation in Scotland was high. This led to a large reduction in the visibility of tobacco products in retail outlets. However, when the results were stratified by socioeconomic status, declines in retailer density, weighted by total product visibility, were restricted to the least disadvantaged tertile of participants. Nevertheless, the implementation of the legislation was associated with a reduction in risk of both smoking susceptibility and smoking initiation in young people, as well as a reduction in the perceived accessibility of tobacco and in pro-smoking attitudes after both the partial and the comprehensive bans were introduced.
Conclusions
The Scottish point-of-sale legislation has been successful in reducing the overall visibility of tobacco products and is associated with improvements in attitudinal and behavioural outcomes in young people. However, cues that tobacco is for sale are still highly visible, particularly in retail outlets in areas of deprivation. In addition, the increase in retailer density that was observed after 2015 increased inequalities in product visibility. There was also evidence that the emergence of e-cigarettes may have disrupted the full impact of the legislation.
Future work
Our research indicates that further research is needed to examine the longitudinal relationships between tobacco outlet availability and product visibility inequalities; and the impact of e-cigarettes and standardised packaging on smoking initiation and prevalence.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 1. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Sally Haw
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Dorothy Currie
- Centre for Adolescent and Child Health Research, School of Medicine, University of St Andrews, St Andrews, UK
| | - Douglas Eadie
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Jamie Pearce
- Institute of Geography, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | | | - Martine Stead
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Amanda Amos
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Catherine Best
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Michael Wilson
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Mark Cherrie
- Institute of Geography, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Richard Purves
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Gozde Ozakinci
- School of Medicine, Medical & Biological Sciences, University of St Andrews, St Andrews, UK
| | - Anne Marie MacKintosh
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
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Hwang JE, Oh YM, Yang YS, Lee SY, Lee JE, Cho SI. Tobacco company strategies for maintaining cigarette advertisements and displays in retail chain stores: In-depth interviews with Korean convenience store owners. Tob Induc Dis 2019; 16:46. [PMID: 31516444 PMCID: PMC6659565 DOI: 10.18332/tid/94829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 08/04/2018] [Accepted: 09/03/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION This study gathered data from store owners regarding the advertising and display of, and the contractual arrangements and promotional activities related to, the sale of tobacco products in convenience stores. METHODS In-depth interviews were conducted with three owners of convenience stores in South Korea: to examine the procedures for managing the sale of tobacco products; for allocating the advertising allowance for such products; and for coordinating the promotional activities of tobacco companies. RESULTS All tobacco advertisements and displays in convenience stores are installed and managed in accordance with the contract between the tobacco companies and the convenience store headquarters. The headquarters receives an allowance from the tobacco company in return for maintaining and displaying their product and promotional materials. The headquarters then pays a monthly advertising allowance to each franchisee as an operating subsidy. However, the owners also stated that tobacco companies provide financial incentives directly to them to engage in illegal promotional activities. CONCLUSIONS Because tobacco advertisements and displays at convenience stores are related to the profitability of these products, the participants in these relationships have become increasingly entangled. Illegal promotional activities must be monitored to limit tobacco sales and advertising. Furthermore, efforts to ban the advertising and display of tobacco products at the point of sale must be based on the development of policies emerging from an understanding of the roles of the major stakeholders.
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Affiliation(s)
- Ji-Eun Hwang
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Yu-Mi Oh
- Korea Health Promotion Institute, Seoul, South Korea
| | - Yu-Seon Yang
- Korea Health Promotion Institute, Seoul, South Korea
| | - Seon-Young Lee
- Gyeonggi Infectious Disease Control Center, Gyeonggi-do, South Korea
| | - Joung-Eun Lee
- Korea Health Promotion Institute, Seoul, South Korea
| | - Sung-Il Cho
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, South Korea.,Institute of Health and Environment, Seoul National University, Seoul, South Korea
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Astuti PAS, Kurniasari NMD, Mulyawan KH, Sebayang SK, Freeman B. From glass boxes to social media engagement: an audit of tobacco retail marketing in Indonesia. Tob Control 2019; 28:e133-e140. [PMID: 31147480 DOI: 10.1136/tobaccocontrol-2018-054833] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/05/2019] [Accepted: 03/20/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To assess tobacco promotion intensity, retailer behaviours and tobacco company efforts to link retailer marketing to online channels. METHODS We completed an audit of tobacco advertisements and promotions at 1000 randomly selected cigarette retailers in Denpasar, Bali, Indonesia that included an observation checklist, digital photos and structured interviews with retailers. We then calculated the tobacco promotion index for each retailer and made comparisons based on store types. Next, we conducted a photo analysis from 100 randomly selected retailers to explore links to online channels and other promotional cues to engage young people. RESULTS Mini-markets have both the highest total number of promotions and the highest indoor promotion index with a mean score of 5.1 and 3.7, respectively. Kiosks have the highest outdoor promotion index with a mean score of 1.6. Most of the retailers (98.9%) displayed cigarettes, more than half of kiosk retailers (54.8%) and mini-market retailers (56.3%) admitted selling cigarettes to young people, and 74% of kiosk retailers sell single stick cigarettes. We found links to online marketing, including two hashtags and a company website. Promotional materials also included youth-focused content such as English taglines, new products and small packs. CONCLUSION Tobacco companies in Indonesia have strategically differentiated their advertisements based on retailer type and have bridged conventional retailer marketing to online channels. Reforming Indonesian tobacco laws to include bans on single sticks and small pack sales, point-of-sale advertising, including displays, and enforcement of laws on sales to minors is urgently required.
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Affiliation(s)
- Putu Ayu Swandewi Astuti
- Department of Public Health and Preventive Medicine, Udayana University Faculty of Medicine, Denpasar, Indonesia .,School of Public Health, The University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia
| | - Ni Made Dian Kurniasari
- Department of Public Health and Preventive Medicine, Udayana University Faculty of Medicine, Denpasar, Indonesia.,Udayana Center for NCDs, Tobacco Control and Lung Health, Udayana University Sudirman Campus, Denpasar, Indonesia
| | - Ketut Hari Mulyawan
- Department of Public Health and Preventive Medicine, Udayana University Faculty of Medicine, Denpasar, Indonesia.,Udayana Center for NCDs, Tobacco Control and Lung Health, Udayana University Sudirman Campus, Denpasar, Indonesia
| | - Susy K Sebayang
- Biostatistics and Population Studies, Universitas Airlangga, Banyuwangi, Indonesia
| | - Becky Freeman
- School of Public Health, The University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia.,Prevention Research Collaboration (PRC), Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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19
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Kinnunen JM, Ollila H, Linnansaari A, Timberlake DS, Kuipers MAG, Rimpelä AH. Adolescents notice fewer tobacco displays after implementation of the point-of-sale tobacco display ban in Finland. Tob Prev Cessat 2019; 5:8. [PMID: 32411873 PMCID: PMC7205050 DOI: 10.18332/tpc/104433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/17/2019] [Accepted: 02/15/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Finland implemented a point-of-sale (POS) display ban for tobacco products and their trademarks in 2012, and for electronic cigarettes in 2016. In this study we examine whether noticing tobacco products changed among adolescents after the implementation of the display ban and describe the noticing of e-cigarette displays post-implementation. METHODS Repeated cross-sectional national survey data of 12-to 16-year-olds from years 2011, 2013, 2015 and 2017 were used. Measures included adolescent self-report on noticing displays of tobacco and e-cigarettes in shops, kiosks and service stations. Adjusting for age, gender, smoking and academic achievement, logistic regression analyses were conducted by retailer type to test the association between survey year and noticing POS tobacco displays. RESULTS The proportions of adolescents noticing tobacco displayed in shops, kiosks and service stations decreased from 2011 to 2013 (from over 80% to about 30%). Between 2013 and 2017, exposure to tobacco displays decreased for kiosks but slightly increased for shops and service stations. However, in all retailer types, rates in 2017 were still well below the pre-ban levels of 2011. In 2017, noticing e-cigarette displays by 12- to16-year-old adolescents was reported by 5.6% in shops, 20.5% in kiosks and 5.1% in service stations. CONCLUSIONS The pronounced decline in adolescents’ exposure to tobacco products at POS observed in the current study implies adherence to the ban, as intended by the law. We encourage more countries to enact POS tobacco advertising and display bans, and to enforce the POS regulations to all tobacco products and novel nicotine delivery systems.
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Affiliation(s)
- Jaana M Kinnunen
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
| | - Hanna Ollila
- Alcohol, Drugs and Addictions Unit, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Anu Linnansaari
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
| | - David S Timberlake
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland.,Program in Public Health, College of Health Sciences, University of California, Irvine, United States
| | - Mirte A G Kuipers
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Arja H Rimpelä
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland.,PERLA - Tampere Centre for Childhood, Youth and Family Research, Tampere University, Tampere, Finland.,Department of Adolescent Psychiatry, Pitkäniemi Hospital, Tampere University Hospital, Nokia, Finland
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20
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Sebayang SK, Dewi DMSK, Lailiyah S, Ahsan A. Mixed-methods evaluation of a ban on tobacco advertising and promotion in Banyuwangi District, Indonesia. Tob Control 2018; 28:651-656. [DOI: 10.1136/tobaccocontrol-2018-054443] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/30/2018] [Accepted: 09/26/2018] [Indexed: 11/04/2022]
Abstract
IntroductionTobacco advertisement bans in Indonesia are rare and seldom evaluated. The recent introduction of an outdoor tobacco advertisement (OTA) ban in Banyuwangi District, East Java, Indonesia provided an opportunity to evaluate such policy.MethodsUsing a mixed-methods approach, we undertook an observational study of OTA in 15 locations where such advertising had been prohibited. We also interviewed a sample of 114 store-owners/storekeepers and 131 community members, and conducted indepth interviews with government officials and the Public Order Agency (POA), the designated enforcement agency.ResultsIn phase 1 we found only one location was free of advertisements. We identified 667 advertisement points and 1283 advertisement materials in the study location; of these, 7% and 7.8% were within 25 m of schools and religious sites, respectively. Phase 2 showed that 68% of the respondents were unaware of the regulation, but many supported an OTA ban. Indepth interviews revealed that not all members of the POA were familiar with the regulation. POA members believed they will enforce the regulation better if higher level regulation for ban on tobacco advertisements, promotions and sponsorships was made and digital application is available to support surveillance.ConclusionPolicy violations were evident 1 year after the launch of OTA ban in Banyuwangi. Tobacco advertisements are still visible, including near schools and religious sites, potentially stimulating adolescents to smoke. Regional regulation and setting specific violation reductions as a performance indicator for POA could improve compliance. App-based technology could assist violation surveillance and reporting, as could awareness-raising campaigns that encouraged community support to report violation through the apps.
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21
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Nuyts PAW, Kuipers MAG, Cakir A, Willemsen MC, Veldhuizen EM, Kunst AE. Visibility of tobacco products and advertisement at the point of sale: a systematic audit of retailers in Amsterdam. BMJ Open 2018; 8:e022017. [PMID: 30297346 PMCID: PMC6194460 DOI: 10.1136/bmjopen-2018-022017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Visibility of tobacco products at the point of sale (PoS), in settings where open display of tobacco is allowed, is one of the last remaining ways in which the tobacco industry can legally promote their products. The aim of this study was to map the visibility of tobacco products and advertisement both inside and outside retailers, among different types of retailers. SETTING The study was conducted in two districts in Amsterdam, the Netherlands. PARTICIPANTS All potential tobacco retailers were visited within the districts, and were mapped using Global Positioning System (GPS) coordinates. INTERVENTION Observational data was collected for each tobacco retailer using a checklist with characteristics of the internal and external visibility of tobacco products and advertisement. Retailers were categorised into supermarkets, hospitality industry, tobacconists and 'other retailers' (convenience stores, office supply stores, gas stations, drug stores and telephone communication stores). Data were collected in April-May 2017. RESULTS Eighty-two tobacco retailers were identified. Among all retailers, 52.4% had external and 91.5% internal visibility of tobacco products. Tobacconists had the highest level of internal and external visibility of tobacco products (both 100%), followed by 'other retailers' (100% and 56% respectively) and supermarkets (79% and 47%, respectively). Retailers in the hospitality industry had low external visibility (28%), but high internal visibility (90%), as 83% sold tobacco through vending machines. CONCLUSION Visibility of tobacco products was high among all types of retailers, including those previous studies show are commonly visited by youth.
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Affiliation(s)
- Paulien A W Nuyts
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirte A G Kuipers
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Alp Cakir
- Department of Human Geography, Planning and International Development Studies, University of Amsterdam, Amsterdam, The Netherlands
| | - Marc C Willemsen
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands
- Netherlands Expertise Center for Tobacco Control (NET), Trimbos Instituut, Utrecht, The Netherlands
| | - Eleonore M Veldhuizen
- Department of Human Geography, Planning and International Development Studies, University of Amsterdam, Amsterdam, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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22
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Been JV, Sheikh A. Tobacco control policies in relation to child health and perinatal health outcomes. Arch Dis Child 2018; 103:817-819. [PMID: 29615392 PMCID: PMC6104674 DOI: 10.1136/archdischild-2017-313680] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 01/26/2018] [Accepted: 01/31/2018] [Indexed: 01/11/2023]
Affiliation(s)
- Jasper V Been
- Division of Neonatology, Department of Paediatrics, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands,Department of Obstetrics and Gynaecology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands,Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK,Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital/Harvard Medical School, Boston, Massachusetts, USA
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23
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Van Hurck MM, Nuyts PAW, Monshouwer K, Kunst AE, Kuipers MAG. Impact of removing point-of-sale tobacco displays on smoking behaviour among adolescents in Europe: a quasi-experimental study. Tob Control 2018; 28:401-408. [PMID: 30030407 DOI: 10.1136/tobaccocontrol-2018-054271] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 06/20/2018] [Accepted: 06/28/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND An increasing number of European countries implemented a point-of-sale (PoS) display ban on tobacco products. This study assessed the association between PoS display bans in Europe and adolescent smoking and perceived accessibility of tobacco, 2-6 years after PoS display ban implementation. METHODS In a quasi-experimental design, we compared individuals in countries that did and countries that did not implement a PoS display ban, before and after implementation. We used repeated cross-sectional data of 174 878 15-year-old and 16-year-old adolescents from 25 countries from the 2007, 2011 and 2015 European Survey Project on Alcohol and Other Drugs surveys. Multilevel logistic regression models examined smoking behaviour (regular smoking vs other) and perceived access (easy vs difficult) as a function of display ban implementation and controlled for survey year, gender, parental education and implementation of other tobacco control policies. Interaction with gender was tested. RESULTS The implementation of a PoS display ban was associated with a 15% larger drop in the odds of regular smoking (OR 0.85, 95% CI 0.79 to 0.91), but was not significantly associated with perceived accessibility of tobacco (OR 0.97, 95% CI 0.892 to 1.03). Associations were similar in males and females (cross-level interactions of gender with display ban were not statistically significant for either outcome). CONCLUSION The implementation of PoS display bans in Europe was associated with a stronger decrease in regular smoking among adolescents. This decrease does not appear to be driven by a decreasing accessibility of tobacco, but might be caused by further de-normalisation of tobacco as a result of PoS display bans.
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Affiliation(s)
- Maureen M Van Hurck
- Department of Public Health, Amsterdam Public Health research institute, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands.,Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Paulien A W Nuyts
- Department of Public Health, Amsterdam Public Health research institute, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands
| | - Karin Monshouwer
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands.,Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Amsterdam Public Health research institute, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands
| | - Mirte A G Kuipers
- Department of Public Health, Amsterdam Public Health research institute, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands
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24
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Cheung YTD, Ho SY, Wang MP, Kwong A, Lai V, Lam TH. Pro-smoking responses and attitudes due to point-of-sale tobacco displays in never smokers: A cross-sectional study in Hong Kong. Tob Induc Dis 2018; 16:32. [PMID: 31516431 PMCID: PMC6659512 DOI: 10.18332/tid/92585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/25/2018] [Accepted: 06/25/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Never smokers' responses to tobacco control policy are often overshadowed by the opposition from smokers and tobacco industry during policy advocacy and legislation. Very few studies have examined never smokers' exposure to point-of-sale (POS) tobacco displays and their effects. Therefore, we investigated the exposure, pro-smoking responses due to and attitudes towards such displays in never smokers in Hong Kong. METHODS We conducted two-stage, randomized cross-sectional telephone-based surveys in 2015 and 2016 of 1833 never-smoking adults. They were asked how often they noticed POS displays in the past 30 days (often, sometimes, never), whether they found POS displays attractive, felt encouraged to smoke, perceived POS displays as advertisements, and if they supported banning them. The distributions of the outcomes were analyzed by descriptive statistics with weighting to the general population. Risk ratios (RR) from Poisson regression models adjusted for sociodemographic characteristics were used to analyze the associations. RESULTS Our results showed that, in never smokers, the younger were more likely to often notice POS displays (RR=0.80, 95% CI: 0.72-0.89, p<0.01). Finding POS displays attractive was associated with primary (RR=2.52, 95% CI: 1.51-4.22, p<0.01) and secondary education (RR=1.68, 95% CI: 1.16- 2.44, p=0.01) versus tertiary education. Often noticing displays was associated with perceived attractiveness (RR=1.90, 95% CI: 1.32-2.75, p<0.01). The positive association between often noticing displays and being encouraged to smoke was marginally significant (RR=4.05, 95% CI: 0.98-16.85, p=0.054). Respondents who often noticed POS displays (RR=0.87, 95% CI: 0.77-0.98, p=0.02) and did not perceive them as advertisements (RR=0.70, 95% CI: 0.61-0.98, p<0.01) showed less support on banning them than those who did not notice them. CONCLUSIONS Frequent exposure to POS displays was associated with greater perceived attractiveness and lower support for banning them. A total ban on POS displays is needed to eliminate the advertising and normalization effect of POS displays.
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Affiliation(s)
| | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Antonio Kwong
- The Hong Kong Council on Smoking and Health, Hong Kong, China
| | - Vienna Lai
- The Hong Kong Council on Smoking and Health, Hong Kong, China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
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25
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Mistry R, Pednekar MS, McCarthy WJ, Resnicow K, Pimple SA, Hsieh HF, Mishra GA, Gupta PC. Compliance with point-of-sale tobacco control policies and student tobacco use in Mumbai, India. Tob Control 2018; 28:220-226. [PMID: 29743339 DOI: 10.1136/tobaccocontrol-2018-054290] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/09/2018] [Accepted: 04/21/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND We measured how student tobacco use and psychological risk factors (intention to use and perceived ease of access to tobacco products) were associated with tobacco vendor compliance with India's Cigarettes and Other Tobacco Products Act provisions regulating the point-of-sale (POS) environment. METHODS We conducted a population-based cross-sectional survey of high school students (n=1373) and tobacco vendors (n=436) in school-adjacent communities (n=26) in Mumbai, India. We used in-class self-administered questionnaires of high school students, face-to-face interviews with tobacco vendors and compliance checks of tobacco POS environments. Logistic regression models with adjustments for clustering were used to measure associations between student tobacco use, psychological risk factors and tobacco POS compliance. RESULTS Compliance with POS laws was low overall and was associated with lower risk of student current tobacco use (OR 0.48, 95% CI 0.26 to 0.91) and current smokeless tobacco use (OR 0.40, 95% CI 0.21 to 0.77), when controlling for student-level and community-level tobacco use risk factors. Compliance was not associated with student intention to use tobacco (OR 0.50; 95% CI 0.21 to 1.18) and perceived ease of access to tobacco (OR 0.73; 95% CI 0.53 to 1.00). CONCLUSIONS Improving vendor compliance with tobacco POS laws may reduce student tobacco use. Future studies should test strategies to improve compliance with tobacco POS laws, particularly in low-income and middle-income country settings like urban India.
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Affiliation(s)
- Ritesh Mistry
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan, USA
| | | | - William J McCarthy
- Department of Health Policy and Management, University of California, Los Angeles, California, USA
| | - Ken Resnicow
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan, USA
| | - Sharmila A Pimple
- Department of Preventive Oncology, Tata Memorial Hospital, Mumbai, India
| | - Hsing-Fang Hsieh
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan, USA
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26
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Kim J, Lee S, Kimm H, Jee SH. The necessity of introducing plain packaging of tobacco products in Korea. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2018. [DOI: 10.5124/jkma.2018.61.3.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jinyoung Kim
- Southern Gyeonggi Regional Smoking Cessation Center, Hallym University, Anyang, Korea
| | - Sungkyu Lee
- National Tobacco Control Center, Korea Health Promotion Institute, Seoul, Korea
| | - Heejin Kimm
- Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Sun Ha Jee
- Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
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27
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Huong LTT, Long TK, Van Anh TT, Tuyet-Hanh TT, Giang KB, Hai PT, Huyen DT, Khue LN, Lam NT, Nga PQ, Quan NT, Linh TNQ, Ha NT, Van Minh H. Exposure to Tobacco Advertising, Promotion Among the Adult Population in Vietnam and Its Implications for Public Health. Asia Pac J Public Health 2017; 29:569-579. [PMID: 29037054 DOI: 10.1177/1010539517735630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The Law on Tobacco Control and the Law on Advertisement prohibit the advertising of any tobacco product in Vietnam. Tobacco promotion and marketing are alsostrictly prohibited. However, the violation of tobacco adverting and promotion is still common in Vietnam. OBJECTIVES This article aims at describing the exposure to tobacco advertising and promotion among the population aged 15+ years in Vietnam based on the data from the Global Adult Tobacco Survey 2015 from the view of the community, identifying any possible associations between the exposure to tobacco advertising and promotion and other individual factors, and discussing its possible public health implications. METHOD A cross-sectional study with the nationwide scale. Secondary data from the Global Adult Tobacco Survey 2015 was explored and analyzed. Chi-square test and multivariate logistic regressions were applied in the data analysis. RESULTS The most common type of adults' exposure to tobacco advertising and promotion was points of sale (8.6%); 9.8% adults exposure to one source of tobacco advertising and 4.0% of them exposed to one source of tobacco promotion. Around 13.3% of Vietnamese adults were exposed to tobacco advertisement, while 2.0% were exposed to tobacco promotion, 5.3% were exposed to both tobacco advertising and promotion, and 16.6% were exposed to tobacco advertising or promotion. Gender, educational level, age, occupation, marital status, socioeconomic status, location (urban, rural), and current smoking status were associated with the exposure to tobacco advertising, tobacco promotion, tobacco advertising and promotion, and tobacco advertising or promotion. CONCLUSION AND RECOMMENDATION Although there are comprehensive bans on tobacco advertising and promotion in Vietnam, adults aged 15+ years still reported their exposure to tobacco advertising and promotion. There should be a strict enforcement of the ban on tobacco advertising and promotion in Vietnam.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Pham Quynh Nga
- 4 World Health Organization, Vietnam Office, Hanoi, Vietnam
| | | | - Tran Nu Quy Linh
- 6 Ha Tinh Provincial Department of Preventive Medicine, Hatinh City, Vietnam
| | - Nguyen Thanh Ha
- 7 Vietnam Health Environment Management Agency, Ministry of Health of Vietnam, Hanoi, Viet Nam
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28
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Toebes B, Gispen ME, Been JV, Sheikh A. A missing voice: the human rights of children to a tobacco-free environment. Tob Control 2017; 27:3-5. [PMID: 28701584 PMCID: PMC5801650 DOI: 10.1136/tobaccocontrol-2017-053657] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In this commentary, we flag the importance of taking a child-rights approach in the context of tobacco control, which is thus far unprecedented. This text was written in response to the Seventh Conference of States Parties of WHOs Framework Convention on Tobacco Control held in India from 7 to 12 November 2016. While the links between tobacco control and human rights were emphasised at this conference, a child-rights approach was missing. We argue that this novel angle provides important legal tools to protect the health and well-being of children. Because children are seen as ‘replacement smokers’ by the tobacco industry, protecting children in this context is key to haltering the devastating effects of tobacco use and exposure worldwide.
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Affiliation(s)
- Brigit Toebes
- Department of International Law, Faculty of Law, Global Health Law Groningen Research Centre, University of Groningen, Groningen, The Netherlands
| | - Marie Elske Gispen
- Department of International Law, Faculty of Law, Global Health Law Groningen Research Centre, University of Groningen, Groningen, The Netherlands
| | - Jasper V Been
- Department of Pediatrics, and Department of Obstetrics and Gynaecology, Division of Neonatology, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Asthma UK Centre for Applied Research, Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.,Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts, USA
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29
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Bogdanovica I, McNeill A, Britton J. Cohort study investigating the effects of first stage of the English tobacco point-of-sale display ban on awareness, susceptibility and smoking uptake among adolescents. BMJ Open 2017; 7:e012451. [PMID: 28115330 PMCID: PMC5278284 DOI: 10.1136/bmjopen-2016-012451] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE A prospective evaluation of the effect of 2012 point-of-sale (PoS) display ban in supermarkets in England on perceived exposure to PoS displays, and on changes in susceptibility and smoking uptake among young people. DESIGN Cohort study. SETTINGS Seven schools in Nottinghamshire, England. PARTICIPANTS 1035 11-16-year-old school children. PRIMARY AND SECONDARY OUTCOME MEASURES Changes in reported exposure to PoS displays before and after prohibition, and the association between exposure to and awareness of PoS displays and change in susceptibility to smoking and smoking status between 2011 and 2012 (before the ban) and 2012 and 2013 (after the ban). RESULTS The proportion of children noticing tobacco PoS displays in supermarkets most or every time they visited a shop changed little between 2011 and 2012 (59.6% (95% CI 56.6% to 62.6%) and 58.8% (95% CI 55.8% to 61.8%), respectively); but decreased by about 13 percentage points to 45.7% (95% CI 42.7% to 48.7%) in 2013, after the ban. However, after adjusting for confounders, implementation of the first stage of the PoS ban in 2012 did not result in significant changes in the relation between susceptibility to smoking and smoking status and exposure to and awareness of PoS displays. CONCLUSIONS Prohibition of PoS in large supermarkets resulted in a decline in the proportion of young people noticing PoS displays in large shops, but little or no change in smoking uptake or susceptibility. It remains to be seen whether extension of the PoS ban to all shops in 2015 has a more marked effect.
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Affiliation(s)
- Ilze Bogdanovica
- Division of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK
| | - Ann McNeill
- UK Centre for Tobacco and Alcohol Studies, Addictions Department, Institute of Psychiatry, King's College London, London, UK
| | - John Britton
- Division of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK
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