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Martín-Álvarez JM, Almeida A, Golpe AA, Asensio E. Electronic device or regulated tobacco product? Learning from the diffusion of heated tobacco products in Spain. Public Health 2023; 219:61-66. [PMID: 37119795 DOI: 10.1016/j.puhe.2023.03.017] [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: 07/13/2022] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVES Tobacco companies have introduced heated tobacco product (HTP) in many countries and marketed it on the grounds that it is a less harmful alternative to health. However, tobacco companies have been widely criticized for taking advantage of a loophole that allows electronic devices to circumvent regulations limiting tobacco advertising. This work aims to determine whether HTPs respected the rules that regulate tobacco advertising when it was introduced in Spain. STUDY DESIGN This is an observational epidemiological study. METHODS Using monthly time series data from September 2016 to June 2020, we analyzed whether the adoption of HTPs has followed the same behavior patterns as other brands that were introduced under the same conditions of use. The Bass model is used to analyze the diffusion of HTPs, and 30 other traditional cigarette brands introduced under the same conditions as this HTPs. RESULTS The adoption of HTPs in Spain has been like that of brands of slim cigarettes that are mistakenly considered to be healthier than traditional cigarettes. The results indicate that the use of HTPs has spread in the same way as additive-free and ultra-slim cigarette brands. CONCLUSIONS Policymakers should keep in mind that laws should restrict any marketing of tobacco products that promotes positive connotations between tobacco use and being healthy. If manufacturers are allowed to classify a category and/or brand of tobacco products as less harmful to health, the imitation effect is very high, leading to the proliferation of smoking.
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Affiliation(s)
- J M Martín-Álvarez
- Department of Quantitative Analysis International University of La Rioja Spain
| | - A Almeida
- Department of Quantitative Analysis International University of La Rioja Spain
| | - A A Golpe
- Department of Economics and Centro de Estudios Avanzados en Física, Matemáticas y Computación, University of Huelva, Spain.
| | - E Asensio
- Department of Quantitative Analysis International University of La Rioja Spain
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Gravely S, Meng G, Hammond D, Hyland A, Michael Cummings K, Borland R, Kasza KA, Yong HH, Thompson ME, Quah ACK, Ouimet J, Martin N, O'Connor RJ, East KA, McNeill A, Boudreau C, Levy DT, Sweanor DT, Fong GT. Differences in cigarette smoking quit attempts and cessation between adults who did and did not take up nicotine vaping: Findings from the ITC four country smoking and vaping surveys. Addict Behav 2022; 132:107339. [PMID: 35605409 PMCID: PMC9202449 DOI: 10.1016/j.addbeh.2022.107339] [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: 10/19/2021] [Revised: 03/10/2022] [Accepted: 04/17/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION There is mixed evidence as to whether nicotine vaping products (NVPs) can help adults who smoke transition away from cigarettes. This study investigated if self-reported attempts to quit smoking and smoking cessation, over a period of either 18 or 24 months, differed between respondents who initiated nicotine vaping versus those who did not. Outcome comparisons were made between those who: (1) initiated vaping vs. those who did not; (2) initiated daily or non-daily vaping vs. those who did not; and (3) initiated daily or non-daily vaping between surveys and continued to vape at follow-up (daily or non-daily) vs. those who did not initiate vaping. METHODS This cohort study included 3516 respondents from the ITC Four Country Smoking and Vaping Surveys (Australia, Canada, England, United Sates), recruited at Wave 1 (2016) or 2 (2018) and followed up at Wave 2 (18 months) and/or 3 (2020, 24 months). Adults who smoked daily at baseline and did not have a history of regular vaping were included. Initiation of vaping was defined as beginning to vape at least monthly between surveys. Respondents indicated whether they made an attempt to quit smoking between surveys. Smoking cessation was defined as those who self-reported no longer smoking cigarettes at follow-up. RESULTS Relative to those who did not initiate vaping, initiation of any daily vaping between surveys was associated with a greater likelihood of smokers making a cigarette quit attempt (p < 0.001) and quitting smoking (p < 0.001). Among smokers who attempted to quit smoking, initiation of daily vaping was associated with a greater likelihood of being abstinent from smoking at follow-up (p = 0.001). Respondents who initiated vaping between surveys and were vaping daily at follow up were significantly more likely to have attempted to quit smoking (p < 0.001) and to have quit smoking (p < 0.001) than those who did not initiate vaping. Respondents who initiated non-daily vaping did not differ significantly from those who did not initiate vaping on any of the outcome measures. CONCLUSIONS Daily NVP use was associated with increased attempts to quit smoking and abstinence from smoking cigarettes. These findings are consistent with the concept that complete cigarette substitution may be more likely to be achieved when smokers vape nicotine daily.
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Affiliation(s)
| | - Gang Meng
- Department of Psychology, University of Waterloo, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Canada
| | - Andrew Hyland
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, USA
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, USA
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Australia
| | - Karin A Kasza
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, USA
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Australia
| | - Mary E Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Canada
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Canada
| | - Janine Ouimet
- Department of Psychology, University of Waterloo, Canada
| | - Nadia Martin
- Department of Psychology, University of Waterloo, Canada
| | - Richard J O'Connor
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, USA
| | - Katherine A East
- School of Public Health Sciences, University of Waterloo, Canada; Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King's College London, England
| | - Ann McNeill
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King's College London, England; Shaping Public Health Policies to Reduce Inequalities & Harm (SPECTRUM), UK
| | - Christian Boudreau
- Department of Statistics and Actuarial Science, University of Waterloo, Canada
| | - David T Levy
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, USA
| | | | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Canada; School of Public Health Sciences, University of Waterloo, Canada; Ontario Institute for Cancer Research, Canada
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Golpe AA, Martín-Álvarez JM, Galiano A, Asensio E. Effect of IQOS introduction on Philip Morris International cigarette sales in Spain: a Logarithmic Mean Divisa Index decomposition approach. GACETA SANITARIA 2022; 36:293-300. [PMID: 35219532 DOI: 10.1016/j.gaceta.2021.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/22/2021] [Accepted: 12/29/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Philip Morris International, has already introduced its heated tobacco product, IQOS, in many countries and marketed it on the grounds that it is a less harmful alternative to health. The company claims that its intention is for its brand's traditional cigarette smokers to replace these with IQOS has rarely been independently tested. METHOD Using time series data from September 2016 to June 2020, we analyze whether Heets sales have been accompanied by an improvement in the position of Philip Morris International in the market or if they have merely replaced lost sales of the rest of the brands sold by that tobacco company. RESULTS Sales of traditional cigarettes of all the brands marketed by PMI have been replaced by IQOS since the introduction of this heated tobacco product in Spain. Almost all of the variations observed in IQOS sales are due to the positioning of this product as a substitute for the range of traditional cigarettes marketed by Philip Morris International. CONCLUSIONS As there is still no consensus that HTPs are explicitly less harmful to health, health authorities must control messages suggesting improved health outcomes thanks to HTP usage when compared to traditional cigarettes. Such messages could generate a false sense of security and lead to an increase in the consumption of tobacco. In Spain Heets in a category that has a lower tax burden than the category of traditional cigarettes. Tax authorities must consider this migration and the impact this may have on tax collection.
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Affiliation(s)
- Antonio A Golpe
- Department of Economics, University of Huelva, Huelva, Spain
| | - Juan M Martín-Álvarez
- Quantitative Methods for Economics and Business, Universidad Internacional de La Rioja, Logroño, Spain.
| | - Aida Galiano
- Quantitative Methods for Economics and Business, Universidad Internacional de La Rioja, Logroño, Spain
| | - Eva Asensio
- Quantitative Methods for Economics and Business, Universidad Internacional de La Rioja, Logroño, Spain
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Chan GCK, Stjepanović D, Lim C, Sun T, Shanmuga Anandan A, Connor JP, Gartner C, Hall WD, Leung J. A systematic review of randomized controlled trials and network meta-analysis of e-cigarettes for smoking cessation. Addict Behav 2021; 119:106912. [PMID: 33798919 DOI: 10.1016/j.addbeh.2021.106912] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 01/14/2023]
Abstract
AIM E-cigarettes, or nicotine vaping products, are potential smoking cessation aids that provide both nicotine and behavioural substitution for combustible cigarette smoking. This review aims to compare the effectiveness of nicotine e-cigarettes for smoking cessation with licensed nicotine replacement therapies (NRT) and nicotine-free based control conditions by using network meta-analysis (NMA). METHODS We searched PubMed, Web of Science and PsycINFO for randomised controlled trials (RCTs) that allocated individuals to use nicotine e-cigarettes, compared to those that used licensed NRT (e.g., nicotine patches, nicotine gums, etc), or a nicotine-free control condition such as receiving placebo (nicotine-free) e-cigarettes or usual care. We only included studies of healthy individuals who smoked. Furthermore, we identified the latest Cochrane review on NRT and searched NRT trials that were published in similar periods as the e-cigarette trials we identified. NMA was conducted to compare the effect of e-cigarettes on cessation relative to NRT and control condition. Cochrane risk-of-bias tool for randomized trials Version 2 was used to access study bias. RESULTS For the e-cigarette trials, our initial search identified 4,717 studies and we included 7 trials for NMA after removal of duplicates, record screening and assessment of eligibility (Total N = 5,674). For NRT trials, our initial search identified 1,014 studies and we included 9 trials that satisfied our inclusion criteria (Total N = 6,080). Results from NMA indicated that participants assigned to use nicotine e-cigarettes were more likely to remain abstinent from smoking than those in the control condition (pooled Risk Ratio (RR) = 2.08, 97.5% CI = [1.39, 3.15]) and those who were assigned to use NRT (pooled RR = 1.49, 97.5% CI = [1.04, 2.14]. There was a moderate heterogeneity between studies (I2 = 42%). Most of the e-cigarette trials has moderate or high risk of bias. CONCLUSION Smokers assigned to use nicotine e-cigarettes were more likely to remain abstinent from smoking than those assigned to use licensed NRT, and both were more effective than usual care or placebo conditions. More high quality studies are required to ascertain the effect of e-cigarette on smoking cessation due to risk of bias in the included studies.
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Affiliation(s)
- Gary C K Chan
- Centre for Youth Substance Abuse Research, The University of Queensland, Australia.
| | - Daniel Stjepanović
- Centre for Youth Substance Abuse Research, The University of Queensland, Australia
| | - Carmen Lim
- Centre for Youth Substance Abuse Research, The University of Queensland, Australia
| | - Tianze Sun
- Centre for Youth Substance Abuse Research, The University of Queensland, Australia
| | | | - Jason P Connor
- Centre for Youth Substance Abuse Research, The University of Queensland, Australia; Discipline of Psychiatry, The University of Queensland, Australia
| | - Coral Gartner
- School of Public Health, The University of Queensland, Australia
| | - Wayne D Hall
- Centre for Youth Substance Abuse Research, The University of Queensland, Australia
| | - Janni Leung
- Centre for Youth Substance Abuse Research, The University of Queensland, Australia
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Pacek LR, Villanti AC, Mcclernon FJ. Not Quite the Rule, But No Longer the Exception: Multiple Tobacco Product Use and Implications for Treatment, Research, and Regulation. Nicotine Tob Res 2021; 22:2114-2117. [PMID: 31789377 DOI: 10.1093/ntr/ntz221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 11/29/2019] [Indexed: 11/14/2022]
Abstract
The patterns of tobacco product use in the United States have changed during the past several decades. Currently, a large proportion of tobacco users report using multiple tobacco products (MTPs). The prevalence of MTP use varies significantly by cigarette smoking frequency, as well: nearly half (46.9%) of all non-daily smokers report using other tobacco products within the past 30 days. Despite this, much of extant tobacco dependence treatment efforts, tobacco regulatory science research, and tobacco product research, in general, has focused largely on single product use (ie, cigarette smoking). To effectively design interventions and model the potential impact of regulations on tobacco products aimed at reducing tobacco use, as well as effectively study tobacco users, it is essential to consider actual use patterns in the population of tobacco users. Implications: MTP use is increasingly common in the United States. This commentary highlights the impact that MTP use has for efforts to treat tobacco dependence, tobacco regulatory science efforts, as well as on tobacco research, in general.
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Affiliation(s)
- Lauren R Pacek
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Durham, NC
| | - Andrea C Villanti
- University of Vermont College of Medicine, Vermont Center on Behavior and Health, Department of Psychiatry, Burlington, VT
| | - F Joseph Mcclernon
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Durham, NC
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Kim YH, An YJ, Shin JW. Carbonyl Compounds Containing Formaldehyde Produced from the Heated Mouthpiece of Tobacco Sticks for Heated Tobacco Products. Molecules 2020; 25:E5612. [PMID: 33260680 PMCID: PMC7730480 DOI: 10.3390/molecules25235612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/22/2020] [Accepted: 11/25/2020] [Indexed: 12/03/2022] Open
Abstract
Diverse harmful compounds can be emitted during the heating of tobacco sticks for heated tobacco products (HTPs). In this study, the generation of harmful compounds from the filter, instead of tobacco in tobacco sticks, was confirmed. The heat of a heated tobacco product device can be transferred to the tobacco stick filter, resulting in the generation of harmful compounds from the heated filter. Since the heating materials (tobacco consumable) of the tobacco sticks evaluated in this study were different depending on the brand, the harmful compounds emitted from the heated tobacco stick filters were examined by focusing on the carbonyl compounds, using three different tobacco stick parts. Acetaldehyde and propionaldehyde exhibited the highest concentrations in HTP aerosols produced by heating the tobacco consumable (conventional case) (63.5 ± 18.4 µg/stick and 1.71 ± 0.123 µg/stick, respectively). The aerosols produced by heating tobacco stick filters had higher formaldehyde and acrolein concentrations (0.945 ± 0.214 µg/stick and 0.519 ± 0.379 µg/stick) than the aerosols generated from heated tobacco consumable (0.641 ± 0.092 µg/stick and 0.220 ± 0.102 µg/stick). As such, formaldehyde and acrolein were produced by heating small parts of the mouthpiece of a tobacco stick, regardless of the heated tobacco product brand. In addition, acetone was only detected in the aerosols generated from heated filters (0.580 ± 0.305 µg/stick). Thus, safety evaluations of heated tobacco products should include considerations of the harmful compounds generated by heating tobacco stick mouthpieces for heated tobacco products in addition to those found in heated tobacco product aerosols.
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Affiliation(s)
- Yong-Hyun Kim
- Jeonbuk Department of Inhalation Research, Korea Institute of Toxicology, Jeongeup 56212, Korea;
- Human and Environmental Toxicology, University of Science and Technology, Daejeon 34113, Korea
| | - Young-Ji An
- Department of Toxicology Evaluation, Konyang University, Daejeon 35365, Korea;
| | - Jae-Won Shin
- Jeonbuk Department of Inhalation Research, Korea Institute of Toxicology, Jeongeup 56212, Korea;
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Spears CA, Jones DM, Weaver SR, Huang J, Yang B, Pechacek TF, Eriksen MP. Sociodemographic Correlates of Electronic Nicotine Delivery Systems (ENDS) Use in the United States, 2016-2017. Am J Public Health 2019; 109:1224-1232. [PMID: 31318599 DOI: 10.2105/ajph.2019.305158] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objectives. To investigate use of electronic nicotine delivery systems (ENDS) among priority populations.Methods. Using 2016 through 2017 US nationally representative surveys (n = 11 688), we examined ENDS use by sociodemographic variables (age, education, poverty status, insurance, employment, race/ethnicity, sexual orientation) and combustible tobacco use.Results. Among individuals who currently use noncigarette combustible tobacco, those from certain backgrounds (young adults, those living below the poverty level, those less educated, sexual minorities, Blacks, Hispanics, and those without health insurance) were more likely to use ENDS. Among current cigarette smokers, those who were younger, living at or above poverty (ever use), with higher education (current use), sexual minority, and non-Black were more likely to use ENDS.Conclusions. Associations between sociodemographic variables and ENDS use varied depending on combustible tobacco use status, highlighting the need to consider multiple types of tobacco products to understand ENDS use among priority populations. The impact on tobacco disparities will ultimately depend on whether ENDS are used to transition completely away from combustible tobacco products and how this may differ across priority populations who use diverse tobacco products.
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Affiliation(s)
- Claire Adams Spears
- All of the authors are with the School of Public Health, Georgia State University, Atlanta
| | - Dina M Jones
- All of the authors are with the School of Public Health, Georgia State University, Atlanta
| | - Scott R Weaver
- All of the authors are with the School of Public Health, Georgia State University, Atlanta
| | - Jidong Huang
- All of the authors are with the School of Public Health, Georgia State University, Atlanta
| | - Bo Yang
- All of the authors are with the School of Public Health, Georgia State University, Atlanta
| | - Terry F Pechacek
- All of the authors are with the School of Public Health, Georgia State University, Atlanta
| | - Michael P Eriksen
- All of the authors are with the School of Public Health, Georgia State University, Atlanta
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A critical analysis of Australia’s ban on the sale of electronic nicotine delivery systems. NEUROETHICS-NETH 2019. [DOI: 10.1007/s12152-019-09402-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Spears CA, Jones DM, Weaver SR, Yang B, Pechacek TF, Eriksen MP. Electronic nicotine delivery system (ENDS) use in relation to mental health conditions, past-month serious psychological distress and cigarette smoking status, 2017. Addiction 2019; 114:315-325. [PMID: 30291763 PMCID: PMC6314897 DOI: 10.1111/add.14464] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/29/2018] [Accepted: 09/28/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Adults with mental health conditions (MHC) exhibit disproportionately high smoking prevalence and experience profound tobacco-related disparities. US nationally representative surveys from 2012 to 2015 found relatively high usage of electronic nicotine delivery systems (ENDS; e.g. e-cigarettes) among adults with MHC. However, research has not examined these associations specifically among never smokers. Aims were to examine associations among MHC diagnosis, serious psychological distress (SPD) and ENDS use and to test whether associations varied by cigarette smoking status. DESIGN Cross-sectional US nationally representative survey. SETTING United States, 2017. PARTICIPANTS A total of 5762 adults (52.0% female; 64.8% non-Hispanic white, 11.4% non-Hispanic black, 15.9% Hispanic, 7.9% non-Hispanic other). MEASUREMENTS Outcomes were lifetime, current and current daily ENDS use. Predictors were lifetime MHC, past-month SPD and cigarette smoking status, and covariates were gender, age, race/ethnicity, education and annual household income. FINDINGS lifetime MHC and past-month SPD were each associated with higher likelihood of having ever used ENDS (P ≤ 0.001), currently using ENDS (P ≤ 0.001) and currently using ENDS daily (P < 0.05). There were interactions between MHC and smoking status in predicting ENDS use, such that MHC status predicted higher lifetime and current ENDS use specifically among never and current smokers. Never smokers with MHC had 2.62 higher odds [95% confidence interval, (CI) = 1.54, 4.45] of current ENDS use than those without MHC. Among never smokers, those with MHC indicated higher expectations that ENDS would improve relaxation and concentration (P < 0.05). CONCLUSIONS In 2017, US adults with versus without mental health conditions (MHC) were more likely to use electronic nicotine delivery systems (ENDS). In particular, both never and current smokers with MHC reported disproportionately high rates of current ENDS use.
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Affiliation(s)
- Claire Adams Spears
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA,Division of Health Promotion and Behavior, School of Public Health, Georgia State University, Atlanta, GA, USA,Correspondence: Claire Adams Spears, Ph.D., Assistant Professor, Health Promotion and Behavior, School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA 30302-3995.
| | - Dina M. Jones
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Scott R. Weaver
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA,Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Bo Yang
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Terry F. Pechacek
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA,Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Michael P. Eriksen
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA,Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, GA, USA
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Lempert LK, Glantz SA. Heated tobacco product regulation under US law and the FCTC. Tob Control 2018; 27:s118-s125. [PMID: 30291201 PMCID: PMC6204223 DOI: 10.1136/tobaccocontrol-2018-054560] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 09/17/2018] [Indexed: 01/08/2023]
Abstract
Tobacco companies are marketing new 'heated tobacco products' (HTPs) composed of battery-powered holders, chargers and tobacco plugs or sticks. The non-tobacco HTP components have escaped effective regulation under many countries' tobacco control laws because they are packaged and sold separately from the tobacco-containing components. In the USA, HTPs cannot be marketed unless the Food and Drug Administration determines that allowing their sale would be 'appropriate for the protection of the public health'. Philip Morris International (PMI) is seeking permission to market its IQOS HTP in the USA with 'modified risk tobacco product' (MRTP) claims that it reduces exposure to harmful substances and is less harmful than other tobacco products. However, PMI has not submitted adequate scientific evidence required by US law to demonstrate that the product is significantly less harmful to users than other tobacco products, that its labelling would not mislead consumers, or that its marketing-with or without MRTP claims-would benefit the health of the population as a whole. Parties to the WHO Framework Convention on Tobacco Control (FCTC) must take measures to reduce tobacco use and nicotine addiction, and prevent false or misleading tobacco product labelling, advertising and promotions; the introduction of new HTPs must be assessed according to these goals. All components of HTPs should be regulated at least as stringently as existing tobacco products, including restrictions on labelling, advertising, promotion and sponsorship, sales to minors, price and taxation policies and smokefree measures. There is nothing in US law or the FCTC that prevents authorities from prohibiting HTPs.
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Affiliation(s)
- Lauren Kass Lempert
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
| | - Stanton A Glantz
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
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Robertson L, Cameron C, Hoek JA, Sullivan T, Marsh L, Peterson E, Gendall P. Prevalence and characteristics of tobacco purchases in convenience stores: results of a postpurchase intercept survey in Dunedin, New Zealand. Tob Control 2018; 28:696-700. [DOI: 10.1136/tobaccocontrol-2018-054643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 09/24/2018] [Accepted: 09/28/2018] [Indexed: 11/03/2022]
Abstract
IntroductionArguments regarding the importance of tobacco to convenience stores could impede the adoption of tobacco retail reduction policies. Although trade associations argue tobacco constitutes two-thirds of convenience store sales and drives footfall, few studies have tested these claims. We therefore examined the prevalence and characteristics of tobacco purchases at convenience stores in Dunedin, New Zealand.MethodsWe conducted a postpurchase survey at 20 convenience stores, each visited for three 60 min intervals over a 4-week period. We used descriptive statistics to determine proportions and 95% CIs of transactions that contained tobacco and those that contained only non-tobacco items. We estimated the mean number of items purchased, the mean number of non-tobacco items purchased and mean expenditure on non-tobacco items.ResultsFourteen per cent of transactions contained tobacco (n=95/679); of those, 64% comprised tobacco only. Only 5% of all transactions included both tobacco and non-tobacco products. The mean number of non-tobacco items purchased was 1.9 for transactions containing only non-tobacco products and 1.7 for transactions containing both tobacco and non-tobacco products. After excluding the cost of tobacco, people who purchased tobacco and non-tobacco products spent on average $5.11 on non-tobacco items, whereas people who purchased only non-tobacco items spent on average $6.85.ConclusionsTobacco products constitute a small proportion of items purchased from Dunedin convenience stores and are typically not purchased with non-tobacco items. Our findings are inconsistent with arguments that most small retailers rely on tobacco sales.
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David P. Basic economic gap related to smoking: reconciling tobacco tax receipts and economic costs of smoking-attributable diseases. Tob Control 2018; 28:558-561. [PMID: 30282775 DOI: 10.1136/tobaccocontrol-2018-054307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 09/11/2018] [Accepted: 09/11/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Tobacco tax rates set by various governments are not based on the idea that tax receipts should cover the costs incurred by smoking. It can be assumed that tobacco tax receipts (TTR) differ from the costs of smoking. The aim is to determine the global basic economic gap (BEG) between TTR and the economic costs of smoking-attributable diseases (ECS). METHODS BEG is described as the difference between the ECS and TTR. A total of 124 countries representing 94% of global tobacco consumption were included in the research by means of the creation of a database, the adjustment of input data and the identification of their intersection. RESULTS The global BEG reaches US$1438 billion per year. The global ECS are US$1911 billion per year. The global TTR are US$473 billion per year and compensate for only one quarter of the ECS. Within countries with the highest consumption of cigarettes, especially the USA but also Russia and Germany, the proportion of the ECS covered by the TTR is even lower, although private health expenditures have been taken into account. CONCLUSIONS Our findings suggest that tobacco taxes would have to be globally increased by more than four times on average in order to cover the ECS or between two and two-and-a-half times if we take private health expenditures into account. The informational pressure concerning health risks associated with smoking aimed at reducing harmful consumption and improving global health can also be supported with these economic facts.
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Collishaw N. This should change everything: using the toxic profile of heat-not-burn products as a performance standard to phase out combustible cigarettes. Tob Control 2018; 28:245-248. [PMID: 30032098 DOI: 10.1136/tobaccocontrol-2017-054219] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mathers A, Schwartz R, O’Connor S, Fung M, Diemert L. Marketing IQOS in a dark market. Tob Control 2018; 28:237-238. [DOI: 10.1136/tobaccocontrol-2017-054216] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 11/03/2022]
Abstract
IntroductionPhillip Morris International (PMI) is pushing hard to promote IQOS heat-not-burn cigarettes in Ontario, Canada. Canada regulates IQOS as a tobacco product so that the robust tobacco marketing ban creates challenges to its promotion.MethodsWe collected data on IQOS promotion in 49 retail outlets, and through interviews with clerks and observations outside an IQOS store.ResultsThe dominant marketing channel is the visible availability of IQOS in a large number of tobacco retail outlets—1029 across Ontario. Several stores display the price of ‘heated tobacco’ on one of three price signs which are permitted despite Ontario’s total display ban. IQOS boutique stores are the locus of aggressive promotion including exchanging a pack of cigarettes or lighter for an IQOS device, launch parties, ‘meet and greet’ lunches and after-hour events. Outside the store, promotion includes a prominent IQOS sign, a sandwich board sign reading ‘Building a Smoke-Free Future’ and sales representatives regularly smoking IQOS. Membership services: Upon acquiring an IQOS device one can register to access the IQOS website store5 and receive customer support services, a map of retail locations and a product catalogue. Members receive regular email invitations to complete surveys with opportunities to win prizes.ConclusionsThese promotion activities have undoubtedly made substantial numbers of Ontarians aware of IQOS. Yet, the government has not provided guidance as to absolute and relative potential harms. Our observations of tactics to promote a new tobacco product in a dark market may inform government regulatory policy and non-governmental organisation efforts wherever heat-not-burn products are introduced.
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Malone RE. ‘Stop me before I kill again’: why Philip Morris International needs governments’ help to quit smoking, and why governments need more pressure to do so. Tob Control 2018; 27:121-122. [DOI: 10.1136/tobaccocontrol-2018-054294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Affiliation(s)
- Coral E Gartner
- The Faculty of Medicine, School of Public Health, University of Queensland, Herston, Queensland, Australia
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