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De Jans S, Hudders L, Newall P. Gambling advertising still exists in Belgium despite a widely reported 'ban'. Addiction 2024; 119:1324-1326. [PMID: 38433492 DOI: 10.1111/add.16458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/28/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Steffi De Jans
- Department of Communication Sciences, Ghent University, Ghent, Belgium
| | - Liselot Hudders
- Department of Communication Sciences, Ghent University, Ghent, Belgium
| | - Philip Newall
- School of Psychological Science, University of Bristol, Bristol, UK
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2
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Rodríguez-Lesmes P, Góngora-Salazar P, Mentzakis E, Buckley N, Gallego JM, Guindon GE, Martínez JP, Paraje G. Would plain packaging and health warning labels reduce smoking in the presence of informal markets? A choice experiment in Colombia. Soc Sci Med 2024; 354:117069. [PMID: 38971045 DOI: 10.1016/j.socscimed.2024.117069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 06/19/2024] [Accepted: 06/21/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Despite progress made by many countries on the adoption of plain tobacco packaging laws over the last years, low- and middle-income countries, with a large supply of loose cigarettes via informal vendors, remain far behind. AIM To study the potential effectiveness of plain tobacco packaging and dissuasive cigarette sticks, via willingness-to-pay estimates, when illicit cigarette options are available. METHODS We conducted a discrete choice experiment (DCE) in which respondents chose licit and illicit products with three attributes: packaging (standard vs. plain packaging), stick design (branded stick vs. stick with warning), and price level. The sample, collected on 12/2021, consisted of 1761 respondents from an internet panel involving smokers and nonsmokers. Conditional logit and latent class models were used to estimate the willingness-to-pay (WTP) to avoid restrictive packaging elements. RESULTS Nonsmokers are willing to pay USD $5.63 for a pack of cigarettes to avoid plain packaging, which is higher than the actual commercial price of illicit cigarettes (USD $2.40). The WTP increases to USD $12.14 in the presence of illicit alternatives. Smokers are also willing to pay to avoid illicit options, which they also deem riskier, and the presence of such options increases the WTP to avoid plain packaging. However, nonsmokers do not perceive the illicit option as riskier. The dissuasive stick (stick with warning) does not affect perceptions of risk and plays a small role in terms of choice for both smokers and nonsmokers. CONCLUSIONS Even in the presence of illicit tobacco alternatives, plain packaging seems to be as effective in reducing the attractiveness of tobacco products in Colombia as in other countries that have already adopted it. Given conflicting results on the case for dissuasive sticks, there is a need for more research.
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Affiliation(s)
| | - Pamela Góngora-Salazar
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Social Protection and Health Division, Inter-American Development Bank, Washington DC, United States.
| | - Emmanouil Mentzakis
- School of Policy and Global Affairs, City, University of London, London, United Kingdom.
| | - Neil Buckley
- Department of Economics, York University, Toronto, Canada.
| | | | - G Emmanuel Guindon
- Centre for Health Economics and Policy Analysis, McMaster University, Ontario, Canada.
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3
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Bigwanto M, Ramadhan FA, Wijayanto XA. Online e-cigarette promotion in Indonesia. Tob Control 2024; 33:406-409. [PMID: 36344256 DOI: 10.1136/tc-2022-057568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The decline in the global prevalence of cigarette smoking has prompted tobacco companies to expand their business by producing and marketing new nicotine-based products in various countries, including Indonesia. The study aims to assess e-cigarette promotional frequency and content on social media in Indonesia. METHODS Monitoring was conducted on Instagram in October 2021. A total of 45 Instagram influencer accounts were monitored to assess the frequency of posting and interactions from 4 to 20 October for InstaStories and from 4 to 31 October for Instagram Feeds. Content analysis was carried out on 310 posts collected from 10 randomly selected accounts from 1 to 31 October (one post per account per day) to evaluate the form, type and characteristics of the promotions. RESULTS There were a total of 2 897 327 followers across the 45 Instagram accounts. On average, the 45 accounts posted about 185 stories and 43 feed posts per day. Of the 310 feed posts analysed from 10 randomly selected accounts, 64% featured images of women; 50% highlighted or displayed the product; and 32% showed enjoyment of the product flavours. CONCLUSIONS The tobacco industry has successfully taken advantage of the e-cigarette promotion regulatory void. The Indonesian government needs to ban the promotion of these products, including those on online platforms.
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Affiliation(s)
- Mouhamad Bigwanto
- Doctoral School of Psychology. Faculty of Education and Psychology, Eotvos Lorand University, Budapest, Hungary
- Faculty of Health Sciences, University of Muhammadiyah Prof Dr Hamka, Jakarta Selatan, Indonesia
- Institute of Psychology, Eotvos Lorand University, Budapest, Hungary
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Jancey J, Crawford G, Bowman E, Wolf K, Leaver T, Bialous S, McCausland K. Perceptions of social media harms and potential management strategies: vaping case study. BMC Public Health 2024; 24:876. [PMID: 38515083 PMCID: PMC10958968 DOI: 10.1186/s12889-024-18362-8] [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: 12/11/2023] [Accepted: 03/14/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND The social media landscape is now ubiquitous in people's everyday lives. It is a space where culture, politics, economics and sociological and public health discourses occur. There is mounting evidence that e-cigarette products are being promoted and advertised on social media, a media platform particularly popular with young people. Our research aimed to understand industry professionals' perceptions of social media harms and potential management strategies using vaping as a case study. METHODS A critical realist perspective guided reflexive thematic analysis of the qualitative in depth, semi structured interviews. Data collection occurred in January and February 2023 with 13 participants working in the areas of public health, digital media, law, governance, tobacco control and advocacy. RESULTS Two superordinate themes emerged from the data: (1) Fathoming a complex system (social media) that contained the subordinate themes of Traversing Boundaries (crossing borders, crossing sectors) and Ungovernable (global and local landscapes, vested interests, self-regulation and opacity). (2) Addressing complexity (social media)- that contained the subordinate themes of Strengthening Institutions (global to local, policy and legislation, individuals and organisations); Defanging Industry (responsibility and transparency, moderation and algorithms, complaints); and Engaging Citizens (raising awareness, framing messaging). CONCLUSIONS There was consensus among participants that e-cigarette related social media content can be harmful and government action is urgently needed. There was an identified need for the development of government led national-level regulatory frameworks, with government led appropriate legislation; identification of an organisation or organisations with suitable levels of regulatory power and resources to monitor, enforce and penalise noncompliant social media companies; accompanied by increased community awareness raising of harmful social media content and improved digital literacy.
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Affiliation(s)
- Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA, 6102, Australia.
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Elizabeth Bowman
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Katharina Wolf
- School of Management and Marketing, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Tama Leaver
- School of Media, Creative Arts and Social Inquiry, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Stella Bialous
- School of Nursing, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA, 6102, Australia
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5
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Lee Y, Kim S, Kim MK, Kawachi I, Oh J. Association between Tobacco Industry Interference Index (TIII) and MPOWER measures and adult daily smoking prevalence rate in 30 countries. Global Health 2024; 20:6. [PMID: 38172937 PMCID: PMC10765652 DOI: 10.1186/s12992-023-01003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND This study aimed to investigate the impact of tobacco industry interference on the implementation and management of tobacco control and the tobacco epidemic using the Tobacco Industry Interference Index (TIII) and MPOWER-a package of measures for tobacco control-and adult daily smoking prevalence in 30 countries. METHODS The TIII was extracted from the Global Tobacco Industry Interference Index 2019 and Global Center for Good Governance in Tobacco Control (GGTC). MPOWER measures and adult daily smoking prevalence rate were extracted from the World Health Organization (WHO) report on the global tobacco epidemic in 2021. We assessed the ecological cross-lagged association between TIII and MPOWER scores and between TIII and age-standardized prevalence rates for adult daily tobacco users. RESULTS Tobacco industry interference was inversely correlated with a country's package of tobacco control measures (β = -0.088, P = 0.035). The TIII was correlated with weaker warnings about the dangers of tobacco (β = -0.016, P = 0.078) and lack of enforcement of bans on tobacco advertising promotion and sponsorship (β = -0.023, P = 0.026). In turn, the higher the TIII, the higher the age-standardized prevalence of adult daily tobacco smokers for both sexes (β = 0.170, P = 0.036). Adult daily smoking prevalence in males (β = 0.417, P = 0.004) was higher in countries where the tobacco industry received incentives that benefited its business. CONCLUSION Where the interference of the tobacco industries was high, national compliance with the Framework Convention on Tobacco Control (FCTC) was lower, and the prevalence of adult daily smokers higher. National governments and global society must work together to minimize the tobacco industry's efforts to interfere with tobacco control policies.
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Affiliation(s)
- Yuri Lee
- Department of Health and Medical Information, Myongji College, Seoul, Republic of Korea
| | - Siwoo Kim
- Institute of Environmental Medicine, SNU Medical Research Center, 103 Daehakro, Seoul, Republic of Korea
| | - Min Kyung Kim
- Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Ichiro Kawachi
- John L. Loeb & Frances Lehman Loeb Professor of Social Epidemiology, Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Ave., 7th floor, Boston, MA, 02115, USA.
| | - Juhwan Oh
- Department of Medicine, Seoul National University College of Medicine, 103 Daehakro, Seoul, Republic of Korea.
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Laestadius L, Van Hoorn K, Vassey J, Ozga J, Stanton C, Li D, Han E, Romer D. Tobacco, nicotine and counter-marketing promotions using Instagram's branded content tool. Tob Control 2023:tc-2023-058301. [PMID: 38160057 PMCID: PMC11214637 DOI: 10.1136/tc-2023-058301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The social media conglomerate, Meta, has a policy prohibiting promotion of tobacco products, vaporisers, electronic cigarettes or other products that simulate smoking via their branded content tools. This study examines if branded Instagram posts comply with these self-regulatory efforts. METHODS We analysed the presence and content of tobacco/nicotine promotion, as well as counter-marketing, in a sample of 400 branded/paid partnership-labelled Instagram posts with tobacco/nicotine-related terms made between 31 July 2022 and 31 March 2023, gathered from Meta's CrowdTangle tool and classified by CrowdTangle as being in English. RESULTS Of the 217 active branded posts that mentioned or depicted tobacco/nicotine products, most promoted rather than countered the sale of such products (84.3% vs 15.7%, respectively). Posts originating from US Instagram users accounted for 42.6% of promotional content. After the USA, posts from Indonesia (19.1%), Pakistan (9.8%) and India (8.2%) were most frequent. Most posts were fully in English (74.9%). Posts featured hookah (39.4%), electronic nicotine delivery systems (ENDS) accessories (17.5%), ENDS devices and e-liquids (16.9%) and various types of cigars (15.3%). The majority of US posts promoted venues or events where tobacco/nicotine products were featured (71.8%). Almost half of all promotional posts (47.0%) were sponsored by tobacco industry accounts. Posts that encouraged cessation were primarily (47.1%) sponsored by non-government organisations. CONCLUSION Despite attempts at self-regulation, paid partnership posts promoting tobacco and nicotine products are present on Instagram, especially posts promoting venues and events that feature tobacco and nicotine use. Self-regulation of this content shows limited success, suggesting a need for federal oversight and additional counter-marketing in social media settings.
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Affiliation(s)
- Linnea Laestadius
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Kelsey Van Hoorn
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Julia Vassey
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Jenny Ozga
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, Maryland, USA
| | - Cassandra Stanton
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, Maryland, USA
| | - Dongmei Li
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, New York, USA
| | - Eileen Han
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
| | - Daniel Romer
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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7
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Gannon J, Bach K, Cattaruzza MS, Bar-Zeev Y, Forberger S, Kilibarda B, Azari R, Okwor U, Lomazzi M, Borisch B. Big tobacco's dirty tricks: Seven key tactics of the tobacco industry. Tob Prev Cessat 2023; 9:39. [PMID: 38124801 PMCID: PMC10731746 DOI: 10.18332/tpc/176336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Affiliation(s)
- John Gannon
- World Federation of Public Health Associations
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Ylitörmänen T, Tarasenko YN, Ruokolainen O, Hiilamo H, Pekka P, Ollila H. Implementation of the Article 13 WHO FCTC measures and changes in cigarette smoking among youth in 42 countries. BMJ Glob Health 2023; 8:e013255. [PMID: 38084494 PMCID: PMC10711898 DOI: 10.1136/bmjgh-2023-013255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/12/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Despite a decline in global smoking prevalence among adolescents, around 21 million youth report current cigarette smoking. Exposure to tobacco advertising, promotion and sponsorship (TAPS) is a risk factor for smoking initiation, and therefore the Article 13 of the WHO Framework Convention on Tobacco Control (WHO FCTC) requires comprehensive TAPS bans. We examined the associations between changes in youth cigarette smoking and implementation of Article 13. METHODS We used two rounds of cross-sectional data from the Global Youth Tobacco Survey (GYTS) for 42 countries: first between 2006 and 2015, and second between 2017 and 2020. The GYTS data were linked with the WHO FCTC implementation reports from 2016 and 2018. The outcome was current smoking. Multilevel binary logistic regression models, stratified by country income level, were used to test the prevalence differences between the latest and previous GYTS rounds and their associations with TAPS bans with postestimations using marginal analyses. RESULTS The percentage of students currently smoking decreased from 10.0% (95% CI 8.0 to 12.1) to 7.7% (95% CI 6.1 to 9.3) from first to second GYTS rounds (p<0.001), adjusting for country clustering. In low-income and lower-middle-income countries, the degree of decrease significantly differed between countries with versus without bans on display, partial internet TAPS ban, ban on depiction of tobacco products and by number of TAPS measures, adjusting for age and sex of the respondents. In high-income and upper-middle-income countries, the degree of decrease significantly differed by presence (or absence) of partial or full internet TAPS ban, ban on product placement and by number of TAPS measures. CONCLUSION Implementation of TAPS bans is associated with decreased smoking among adolescents both in high-income and low-income countries. Enhanced and continuous efforts are necessary to protect youth from the promotion of tobacco and nicotine products.
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Affiliation(s)
- Tuija Ylitörmänen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Yelena N Tarasenko
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Otto Ruokolainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Heikki Hiilamo
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Puska Pekka
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hanna Ollila
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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Leung J, Lim C, McClure-Thomas C, Foo S, Sebayang S, Farassania G, Fausiah F, Gartner C, Chan GCK. Adolescent Exposure to Online Advertisements and Promotions for Tobacco Products on the Internet-A Cross-Sectional Analysis of the Global Youth Tobacco Surveys. J Adolesc Health 2023; 73:1138-1144. [PMID: 37737754 DOI: 10.1016/j.jadohealth.2023.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 05/04/2023] [Accepted: 07/07/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Although many countries have banned tobacco advertising on traditional media platforms, the tobacco industry actively promotes their products via online channels. Adolescents are at high risk of exposure due to spending substantial time online. We examined the prevalence of adolescent exposure to online tobacco advertisements and promotions. METHODS We analyzed data from the Global Youth Tobacco Surveys (GYTS; 2013-2018; average response rate = 76.8%). We included 15 countries in four regions that measured self-reported exposure to tobacco advertising on the internet in the past month (N = 111,356, adolescents aged 11-18): Region of the Americas (Argentina, Costa Rica, Cuba, Ecuador, Panama, Paraguay, Peru), African (Mauritius, Zimbabwe), European (Czech Republic, Turkey), and the Western Pacific (Micronesia, Macao, Papua New Guinea, Samoa). We calculated the prevalence of online exposure to tobacco advertising by past-month cigarette use. RESULTS Prevalence of adolescent exposure to online advertisements for tobacco products ranged from 18.2%-34.3% and 12.3%-34.4% for tobacco advertisements that "looked fun or cool". Exposure to online tobacco product advertisements was prevalent across countries, including those with advertising bans in place, and included adolescents who have never smoked (14.4%-28.4% exposed to any, 9.1%-31.0% exposed to fun or cool advertisements). Reporting seeing tobacco advertising online that looked fun or cool was positively associated with the prevalence of past-month smoking (r = 0.64, p = .010). DISCUSSION A substantial proportion of adolescents in countries that have banned tobacco advertising are still exposed to advertisements for tobacco products online. Internet tobacco advertising needs better enforcement to prevent adolescent tobacco use and uptake worldwide.
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Affiliation(s)
- Janni Leung
- National Centre for Youth Substance Use Research, University of Queensland, Brisbane, Queensland, Australia; School of Psychology, University of Queensland, Brisbane, Queensland, Australia.
| | - Carmen Lim
- National Centre for Youth Substance Use Research, University of Queensland, Brisbane, Queensland, Australia; School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Caitlin McClure-Thomas
- National Centre for Youth Substance Use Research, University of Queensland, Brisbane, Queensland, Australia; School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Shaun Foo
- National Centre for Youth Substance Use Research, University of Queensland, Brisbane, Queensland, Australia
| | - Susy Sebayang
- School of Health and Life Sciences, Universitas Airlangga, Banyuwangi, Indonesia
| | - Ghea Farassania
- School of Psychology, Universitas Indonesia, Jakarta, Indonesia
| | - Fitri Fausiah
- School of Psychology, Universitas Indonesia, Jakarta, Indonesia
| | - Coral Gartner
- School of Public Heath, University of Queensland, Brisbane, Queensland, Australia
| | - Gary C K Chan
- National Centre for Youth Substance Use Research, University of Queensland, Brisbane, Queensland, Australia
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Hiscock R, Alaouie H, Matthes BK, Mehegan J, Bloomfield MJ. Hosting the Tobacco Industry Supply Chain and Political Interference. Nicotine Tob Res 2023; 25:1847-1855. [PMID: 37707978 PMCID: PMC10664082 DOI: 10.1093/ntr/ntad178] [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: 10/07/2022] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION We found no comprehensive studies on the location of transnational tobacco and leaf company (TTLC) subsidiaries (business entities they control) or the consequences of their presence on health policy. AIMS AND METHODS Here we assess (1) the global reach of TTLCs by mapping their tobacco growing and manufacturing subsidiaries and (2) the relationship between in-country presence of the tobacco industry and their power and interference. Data on subsidiaries were collated through systematic searching for countries' supply chain activities in documents and web pages. Cross-sectional multiple regression analysis was used to assess the association between the number of agricultural and manufacturing TTLCs and the Tobacco Industry Interference score, and the degree to which these were mediated by tobacco control, good governance, and economic importance of tobacco. RESULTS TTLC supply chain activity had global reach. As the number of TTLCs with tobacco growing and manufacturing activities rose, interference increased significantly. Interference was associated with poorer tobacco control. The association with more TTLCs undertaking final product manufacturing was related to higher-value tobacco exports but was not related to tobacco making a bigger contribution to the economy. CONCLUSIONS TTLCs continue to control the global tobacco supply chain through their globe-spanning subsidiaries. The presence of TTLCs in a country is associated with political interference. Countries should consider their participation in the tobacco supply chain alongside the understanding that they are likely to cede political power to TTLCs, potentially undermining the health of their populations. IMPLICATIONS Tobacco control research has traditionally concentrated on the demand side of tobacco. Our results lend support to calls for more research on the supply of tobacco. Governments should require tobacco companies to provide detailed, up-to-date information in an easily accessible format on in-country supply chain activities. Policymakers should take the likelihood of political interference in health and environmental policy into account when making decisions about foreign direct investment offered by the tobacco industry.
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Affiliation(s)
- Rosemary Hiscock
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Hala Alaouie
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Britta K Matthes
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
- Centre for Development Studies, University of Bath, Bath, UK
| | - John Mehegan
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Michael J Bloomfield
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
- Department of Social and Policy Sciences, University of Bath, Bath, UK
- Centre for Development Studies, University of Bath, Bath, UK
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11
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Kang H, Cheon E, Ha J, Cho SI. Use of geographically weighted regression models to inform retail endgame strategies in South Korea: application to cigarette and ENDS prevalence. Tob Control 2023:tc-2023-058117. [PMID: 37816592 DOI: 10.1136/tc-2023-058117] [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: 04/21/2023] [Accepted: 09/18/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Reducing tobacco retailer availability is a key tobacco endgame policy. The development and evaluation of retail-based policies require spatial methodologies. We modelled the prevalence of adult cigarette and electronic nicotine delivery system (ENDS) use according to tobacco retailer density, considering geographical variations. METHODS Registration data for tobacco retail businesses, a population-representative survey of South Koreans aged ≥19 years, and population and land area data were used. We merged the datasets according to geographical units. Ordinary least squares (OLS) and geographically weighted regression (GWR) analyses were conducted to model cigarette and ENDS use prevalence, respectively. FINDINGS Tobacco retailer density was associated with increased cigarette use prevalence in the OLS model (β=2.19, p=0.02). A 1.9-fold difference by region was identified for the coefficient, indicating an association with tobacco retailer density (minimum 1.39, maximum 2.65), in the GWR analysis. No significant association was present between tobacco retailer density and ENDS prevalence in either the OLS (β=0.24, p=0.37) or the GWR model (minimum 0.20, maximum 0.28). CONCLUSION Our results suggest the importance of using spatial methods to develop and evaluate retail-based endgame policies. The establishment of tobacco retailer databases by the introduction of licensing is necessary to develop and evaluate the effectiveness of tobacco retailer regulations.
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Affiliation(s)
- Heewon Kang
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, University of Queensland, Herston, Queensland, Australia
| | - Eunsil Cheon
- Department of Public Health Sciences, Seoul National University Graduate School of Public Health, Seoul, South Korea
| | - Jaeyoung Ha
- Department of Public Health Sciences, Seoul National University Graduate School of Public Health, Seoul, South Korea
| | - Sung-Il Cho
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
- Department of Public Health Sciences, Seoul National University Graduate School of Public Health, Seoul, South Korea
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12
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Mathes S, Lindwedel KS, Nilsen LT, Kaiser I, Pfahlberg AB, Gefeller O. Global Tanning Bed Advertising: A Comparison of Legal Regulations on Three Continents. Cancers (Basel) 2023; 15:4362. [PMID: 37686637 PMCID: PMC10486637 DOI: 10.3390/cancers15174362] [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: 08/12/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
Artificial ultraviolet radiation from tanning beds has been classified as carcinogenic by the International Agency for Research on Cancer in 2009. Several countries have subsequently introduced comprehensive legislation regulating commercial indoor tanning. Specific aspects of these regulations address tanning bed advertising and information requirements for tanning bed customers, which have been previously neglected in international comparisons of indoor tanning regulations. We performed a systematic search regarding legislation on these aspects in 131 legislative units across three continents (North America, Australia/New Zealand, Europe). The legal restrictions found varied widely in type and content. In 49 legislative units we identified total (n = 8) or partial legal bans (n = 41) on advertising for indoor tanning, while 64 legislative units enacted 5regulations that necessitate the dissemination of different types of specific health information to tanning bed customers. Nearly 40% of the legislative units of the study region lacked any legislation on these issues altogether. The heterogenous results emphasize the need for an international dialogue between health authorities and governments to harmonize the regulatory framework for tanning bed advertising and information requirements to a level better protecting the public from skin cancer. Our comprehensive international comparison can serve as a starting point for such a harmonization process that may ultimately protect the public worldwide from misleading tanning bed advertising.
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Affiliation(s)
- Sonja Mathes
- Department of Dermatology and Allergy, Technical University of Munich, 80802 Munich, Germany;
| | - Karla S. Lindwedel
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.S.L.); (I.K.); (A.B.P.)
| | - Lill Tove Nilsen
- Section for Environmental Monitoring and Radon- and UV-Protection, Norwegian Radiation and Nuclears Safety Authority, NO-1332 Østeras, Norway;
| | - Isabelle Kaiser
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.S.L.); (I.K.); (A.B.P.)
| | - Annette B. Pfahlberg
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.S.L.); (I.K.); (A.B.P.)
| | - Olaf Gefeller
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.S.L.); (I.K.); (A.B.P.)
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Crosbie E, Erinoso O, Machin N, Fuss C, Sebrié EM. Progress, Gaps, and Tobacco Industry Opposition to Tobacco Advertising, Promotion, and Sponsorship Bans in the World Health Organization African Region. Nicotine Tob Res 2023; 25:1619-1622. [PMID: 37042281 DOI: 10.1093/ntr/ntad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/24/2023] [Accepted: 04/10/2023] [Indexed: 04/13/2023]
Affiliation(s)
- Eric Crosbie
- School of Public Health, University of Nevada Reno Reno, NV, USA
- Ozmen Institute for Global Studies, University of Nevada Reno Reno, NV, USA
| | - Olufemi Erinoso
- School of Public Health, University of Nevada Reno Reno, NV, USA
| | - Nina Machin
- School of Public Health, University of Nevada Reno Reno, NV, USA
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van Deelen TRD, Veldhuizen EM, van den Putte B, Kunst AE, Kuipers MAG. Socioeconomic differences in tobacco outlet presence, density, and proximity in four cities in the Netherlands. BMC Public Health 2023; 23:1515. [PMID: 37558979 PMCID: PMC10413623 DOI: 10.1186/s12889-023-16347-7] [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: 03/21/2023] [Accepted: 07/19/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Previous studies found that tobacco outlets were unevenly distributed by area socioeconomic status (SES). However, evidence from continental Europe is limited. This study aims to assess differences in tobacco outlet presence, density and proximity by area SES in the Netherlands. METHODS All tobacco outlets in four Dutch cities (Amsterdam, and medium-sized cities Eindhoven, Haarlem, and Zwolle) were mapped between September 2019 and June 2020. We estimated associations between average property value of neighbourhoods (as an indicator of SES, grouped into quintiles) and (1) tobacco outlet presence in the neighbourhood (yes/no), (2) density (per km2), and (3) proximity to the closest outlet (in meters), using logistic and linear regression models. RESULTS 46% of neighbourhoods contained at least one tobacco outlet. Tobacco outlets were mostly situated in city centres, but the distribution of tobacco outlets varied per city due to differences in urban structures and functions. In the medium-sized cities, each quintile higher neighbourhood-SES was associated with lower tobacco outlet presence (OR:0.71, 95%CI:0.59;0.85), lower density (B:-1.20 outlets/km2, 95%CI:-2.20;-0.20) and less proximity (B:40.2 m, 95%CI 36.58;43.83). Associations were the other way around for Amsterdam (OR:1.22, 95%CI:1.05;1.40, B:3.50, 95%CI:0.81;6.20, and B:-18.45, 95%CI:-20.41;-16.49, respectively). Results were similar for most types of tobacco outlets. CONCLUSION In medium-sized cities in the Netherlands, tobacco outlets were more often located in low-SES neighbourhoods than high-SES. Amsterdam presented a reverse pattern, possibly due to its unique urban structure. We discuss how licensing might contribute to reducing tobacco outlets in low-SES neighbourhoods.
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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, Postbus, Amsterdam, 22660, 1100 DD, the Netherlands.
| | - Els M Veldhuizen
- Department of Geography and Planning, University of Amsterdam, Amsterdam, Postbus, Amsterdam, 15629, 1001 NC, The Netherlands
| | - Bas van den Putte
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Postbus, Amsterdam, 15791, 1001 NG, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Postbus, Amsterdam, 22660, 1100 DD, the Netherlands
| | - Mirte A G Kuipers
- Department of Public Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Postbus, Amsterdam, 22660, 1100 DD, the Netherlands
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Siegel LN, Cook S, Oh H, Liber AC, Levy DT, Fleischer NL. The longitudinal association between coupon receipt and established cigarette smoking initiation among young adults in USA. Tob Control 2023:tc-2023-058065. [PMID: 37468154 PMCID: PMC10796848 DOI: 10.1136/tc-2023-058065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION Tobacco companies frequently distribute coupons for their products. This marketing tactic may be particularly effective among young adults, who tend to be especially price-sensitive. Young adulthood is also a stage during which many individuals initiate established cigarette smoking and are especially vulnerable to the effects of tobacco marketing. METHODS We used five waves of data from the US Population Assessment on Tobacco and Health Study (2013-2019) to assess the longitudinal relationship between cigarette coupon receipt and initiation of established cigarette smoking among young adults (18-24 years) who did not report current smoking and had smoked <100 cigarettes in their lifetime at baseline. Initiation of established cigarette smoking was defined as reporting current cigarette use and having smoked ≥100 cigarettes at follow-up. To test this relationship, we fit four discrete time survival models to an unbalanced person-period data set. The first model included our time-varying coupon receipt variable, which was lagged one wave. Subsequent models added sociodemographic, cigarette smoking exposure and other tobacco use variables. RESULTS Adopting the model adjusting for sociodemographic variables, respondents who received a coupon were found to be more likely to initiate established cigarette smoking at follow-up (adjusted HR (aHR): 2.31, 95% CI 1.41 to 3.80). This relationship remained significant when controlling for all covariates in the fully adjusted model (aHR: 1.96, 95% CI 1.18 to 3.26). CONCLUSIONS These findings show that receiving tobacco coupons may increase the likelihood that young adults will initiate established cigarette smoking, underscoring the need to address the effects of this tobacco marketing tactic.
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Affiliation(s)
- Leeann Nicole Siegel
- Tobacco Control Research Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Steven Cook
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Hayoung Oh
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Alex C Liber
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Nancy L Fleischer
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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16
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Bassi S, Arora M, Thapliyal N, Kulkarni MM, Bhagawath R, Bogdanovica I, Kamath VG, Britton J, Bains M. Programme and policy perspectives towards a tobacco-free generation in India: findings from a qualitative study. BMJ Open 2023; 13:e067779. [PMID: 37419637 PMCID: PMC10335429 DOI: 10.1136/bmjopen-2022-067779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 03/29/2023] [Indexed: 07/09/2023] Open
Abstract
OBJECTIVE This study explored multistakeholder perspectives on existing adolescent-specific tobacco control policies and programmes, to advance India's transition towards a tobacco-free generation. DESIGN Qualitative semi-structured interviews. SETTING Interviews were conducted with officials involved in tobacco control at the national (India), state (Karnataka), district (Udupi) and village level. Interviews were audio recorded, transcribed verbatim and analysed thematically. PARTICIPANTS Thirty-eight individuals representing national (n=9), state (n=9), district (n=14) and village (n=6) levels, participated. RESULTS The study findings highlighted the need to strengthen and amend the existing Tobacco Control Law (2003) provisions, particularly in the vicinity of schools (Sections 6a and 6b). Increasing the minimum legal age to buy tobacco from 18 to 21 years, developing an 'application' for 'compliance and monitoring indicators' in Tobacco-Free Educational Institution guidelines were proposed. Policies to address smokeless tobacco use, stricter enforcement including regular monitoring of existing programmes, and robust evaluation of policies was underscored. Engaging adolescents to co-create interventions was advocated, along with integrating national tobacco control programmes into existing school and adolescent health programmes, using both an intersectoral and whole-societal approach to prevent tobacco use, were recommended. Finally, stakeholders mentioned that when drafting and implementing a comprehensive national tobacco control policy, there is a need to adopt a vision striving toward a tobacco-free generation. CONCLUSION Strengthening and developing tobacco control programmes and policies are warranted which are monitored and evaluated rigorously, and where adolescents should be involved, accordingly.
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Affiliation(s)
- Shalini Bassi
- Health Promotion Division, Public Health Foundation of India, Gurugram, India
- HRIDAY, New Delhi, India
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India, Gurugram, India
- HRIDAY, New Delhi, India
| | - Nishibha Thapliyal
- Health Promotion Division, Public Health Foundation of India, Gurugram, India
| | - Muralidhar M Kulkarni
- Community Medicine, Kasturba Medical College, Manipal Acadamy of Higher Education, Manipal, Karnataka, India
| | - Rohith Bhagawath
- Community Medicine, Kasturba Medical College, Manipal Acadamy of Higher Education, Manipal, Karnataka, India
| | | | - Veena G Kamath
- Community Medicine, Kasturba Medical College, Manipal Acadamy of Higher Education, Manipal, Karnataka, India
| | - John Britton
- Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Manpreet Bains
- School of Medicine, University of Nottingham, Nottingham, UK
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17
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Marshman B, Wolf K, McCausland K, Daube M, Jancey J. Tobacco companies, corporate social responsibility and the use of third-party awards: a framing analysis. Tob Control 2023:tc-2022-057854. [PMID: 37369562 DOI: 10.1136/tc-2022-057854] [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: 11/15/2022] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE Corporate social responsibility activities, such as third-party awards, provide an opportunity for tobacco companies (TCs) to promote themselves as socially, economically and environmentally responsible organisations. This study aimed to determine how TCs are using third-party awards to frame themselves and their core activities via company-controlled communication channels. METHODS TC-owned media coverage promoting third-party awards was identified from company-owned media channels, including websites, reports, press releases and Twitter. Using framing theory and thematic analysis, frames and broader themes were identified using a process of inductive coding. RESULTS TC-produced media content promoting third-party awards framed the companies as socially and environmentally responsible organisations, which excel at business and are innovative and transformative. Dominant frames identified included excellent workplace culture, championing diversity and inclusion and action on the environment. CONCLUSION TCs are capitalising on the perceived credibility and objectivity of third-party awards using these 'honours' as a promotional strategy to justify their continuing role in society and enhance their perceived legitimacy in relation to claims of ethical and responsible behaviour. The results of this study have implications for tobacco control advocacy, as continuing to allow the promotion of these awards appears to contravene or conflict with the WHO Framework Convention on Tobacco Control.
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Affiliation(s)
- Briony Marshman
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Katharina Wolf
- School of Management and Marketing, Curtin University, Perth, Western Australia, Australia
| | - Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Mike Daube
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Western Australia, Australia
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O'Connor RC, Worthman CM, Abanga M, Athanassopoulou N, Boyce N, Chan LF, Christensen H, Das-Munshi J, Downs J, Koenen KC, Moutier CY, Templeton P, Batterham P, Brakspear K, Frank RG, Gilbody S, Gureje O, Henderson D, John A, Kabagambe W, Khan M, Kessler D, Kirtley OJ, Kline S, Kohrt B, Lincoln AK, Lund C, Mendenhall E, Miranda R, Mondelli V, Niederkrotenthaler T, Osborn D, Pirkis J, Pisani AR, Prawira B, Rachidi H, Seedat S, Siskind D, Vijayakumar L, Yip PSF. Gone Too Soon: priorities for action to prevent premature mortality associated with mental illness and mental distress. Lancet Psychiatry 2023; 10:452-464. [PMID: 37182526 DOI: 10.1016/s2215-0366(23)00058-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 05/16/2023]
Abstract
Globally, too many people die prematurely from suicide and the physical comorbidities associated with mental illness and mental distress. The purpose of this Review is to mobilise the translation of evidence into prioritised actions that reduce this inequity. The mental health research charity, MQ Mental Health Research, convened an international panel that used roadmapping methods and review evidence to identify key factors, mechanisms, and solutions for premature mortality across the social-ecological system. We identified 12 key overarching risk factors and mechanisms, with more commonalities than differences across the suicide and physical comorbidities domains. We also identified 18 actionable solutions across three organising principles: the integration of mental and physical health care; the prioritisation of prevention while strengthening treatment; and the optimisation of intervention synergies across social-ecological levels and the intervention cycle. These solutions included accessible, integrated high-quality primary care; early life, workplace, and community-based interventions co-designed by the people they should serve; decriminalisation of suicide and restriction of access to lethal means; stigma reduction; reduction of income, gender, and racial inequality; and increased investment. The time to act is now, to rebuild health-care systems, leverage changes in funding landscapes, and address the effects of stigma, discrimination, marginalisation, gender violence, and victimisation.
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Affiliation(s)
- Rory C O'Connor
- Suicidal Behaviour Research Laboratory, School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
| | | | - Marie Abanga
- Hope for the Abused and Battered, Douala, Cameroon
| | | | | | - Lai Fong Chan
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Helen Christensen
- Faculty of Medicine & Health, University of New South Wales, Sydney and the Black Dog Institute, Sydney, NSW, Australia
| | - Jayati Das-Munshi
- Department of Psychological Medicine, King's College London, London, UK; Institute of Psychiatry, Psychology, and Neuroscience, and Centre for Society and Mental Health, King's College London, London, UK; South London and Maudsley NHS Trust, London, UK
| | - James Downs
- Royal College of Psychiatrists, UK and Faculty of Wellbeing, Education, and Language Studies, Open University, Milton Keynes, UK
| | | | | | - Peter Templeton
- The William Templeton Foundation for Young People's Mental Health, Cambridge, UK
| | - Philip Batterham
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | | | | | - Simon Gilbody
- York Mental Health and Addictions Research Group, University of York, York, UK
| | - Oye Gureje
- WHO Collaborating Centre for Research and Training in Mental Health, Neuroscience, Drug and Alcohol Abuse, University of Ibadan, Ibadan, Nigeria
| | - David Henderson
- Department of Psychiatry, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
| | - Ann John
- Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Murad Khan
- Brain & Mind Institute, Aga Khan University, Karachi, Pakistan
| | - David Kessler
- Bristol Population Health Science Institute, Centre for Academic Mental Health, Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Olivia J Kirtley
- Center for Contextual Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | - Brandon Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
| | - Alisa K Lincoln
- Institute for Health Equity and Social Justice Research, Northeastern University, Boston, MA, USA
| | - Crick Lund
- Health Services and Population Research Department, King's College London, London, UK; Centre for Global Mental Health, King's College London, London, UK
| | - Emily Mendenhall
- Edmund A Walsh School of Foreign Service, Georgetown University, Washington, DC, USA
| | - Regina Miranda
- Hunter College, Department of Psychology, The Graduate Center, City University of New York, New York, NY, USA
| | - Valeria Mondelli
- Department of Psychological Medicine, King's College London, London, UK
| | - Thomas Niederkrotenthaler
- Department of Social and Preventive Medicine, Suicide Research & Mental Health Promotion Unit, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - David Osborn
- Division of Psychiatry, University College London and Camden and Islington NHS Foundation Trust, London, UK
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Anthony R Pisani
- University of Rochester Center for the Study and Prevention of Suicide, SafeSide Prevention, Rochester, NY, USA
| | | | | | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, SAMRC Genomics of Brain Disorders Unit, Stellenbosch University, Cape Town, South Africa
| | - Dan Siskind
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | | | - Paul S F Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Ma C, Yang H, Sun J, Zhao M, Magnussen CG, Xi B. Proportions of and trends in exposure to pro-tobacco and anti-tobacco advertisements among young adolescents aged 12-16 years in 142 countries and territories, 1999-2018: an analysis of repeated cross-sectional surveys. Lancet Glob Health 2023; 11:e586-e596. [PMID: 36925178 DOI: 10.1016/s2214-109x(23)00041-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND The proportions and trends in exposure to pro-tobacco and anti-tobacco advertisements among young people remain unknown globally. We determined recent (2010-18) proportions of exposure to pro-tobacco and anti-tobacco advertisements among young adolescents and their secular trends from 1999 to 2018. METHODS In this analysis of repeated cross-sectional surveys, we used the most recent data from 142 countries and territories (hereafter referred to as countries) collected between Jan 1, 2010, and Dec 31, 2018, comprising 710 191 participants, to assess the proportions of exposure to pro-tobacco and anti-tobacco advertisements among young adolescents aged 12-16 years. Data from 120 countries that had performed two or more Global Youth Tobacco Surveys between Jan 1, 1999, and Dec 31, 2018, comprising 1 482 031 participants, were used to assess trends in the proportions of exposure to pro-tobacco and anti-tobacco advertisements over time. A χ2 test analysis was used for proportion comparisons between subgroups. Exposure to pro-tobacco and anti-tobacco advertisements were calculated as proportions using sampling weights, strata, and primary sampling units. FINDINGS The most recent global proportion of past 30-day exposure to tobacco advertisements among young adolescents was 433 585 (64·6%) of 710 191 (95% CI 63·5-65·7; all final percentages were weighted) for messages on electronic media, 206 766 (33·1%) of 710 191 (31·9-34·4) for exposure at the point of sale, and 63 385 (10·2%) of 710 191 (9·7-10·6) for owning something with a tobacco brand logo. The most recent global proportion of exposure to anti-tobacco advertisements was 431 862 (63·6%) of 710 191 (62·3-64·9) for messages on electronic media and 227 658 (34·1%) of 710 191 (32·8-35·3) for exposure to gathering activities. The majority of included countries showed a decreasing trend in exposure to tobacco advertisements (111 [93%] of 120) and anti-tobacco advertisements (110 [92%] of 120) between 1999 and 2018. INTERPRETATION Among young adolescents, exposure to tobacco advertisements remains high, and exposure to anti-tobacco advertisements is not high enough. The proportion of young adolescents exposed to pro-tobacco and anti-tobacco advertisements had decreased over time in the majority of included countries. These findings underscore the importance of strict implementation of regulation on tobacco control including strengthening anti-tobacco marketing and prohibiting tobacco marketing. FUNDING Youth Team of Humanistic and Social Science of Shandong University. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Chuanwei Ma
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hui Yang
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jiahong Sun
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Costan G Magnussen
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
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20
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Freeman B, Owen K, Rickards S, Brooks A, Clare PJ, Dessaix A. E-cigarette use by people who smoke or have recently quit, New South Wales, 2016-2020. Med J Aust 2023; 218:131-137. [PMID: 36494187 DOI: 10.5694/mja2.51811] [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: 06/24/2022] [Revised: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To examine e-cigarette use by adults who smoke or have recently quit, and demographic characteristics associated with their use; to assess reasons for using e-cigarettes. DESIGN The Cancer Institute NSW Tobacco Tracking Survey (CITTS) is an ongoing, serial, cross-sectional telephone survey study (40 interviews each week). This report is based on interviews during 4 January 2016 - 31 December 2020. SETTING, PARTICIPANTS Randomly selected New South Wales adults who are current smokers (smoked cigarettes, pipes, or other tobacco products daily, weekly, or less often) or recent quitters (smoked tobacco products in the past twelve months but who no longer smoked). MAIN OUTCOMES E-cigarette use by age group; reasons for using e-cigarettes. RESULTS CITTS callers rang 1 494 233 randomly selected numbers; in 203 203 answered calls (13.6%), 11 125 people were eligible for the survey (5.5% of answered calls), of whom 10 004 completed the survey interview, including the question about whether they used e-cigarettes (89.9%). Overall e-cigarette use increased from 6.6% of respondents in 2016 to 13.0% in 2020 (adjusted odds ratio, 1.86; 95% confidence interval [CI], 1.47-2.36). The proportion of respondents aged 18-24 years who reported e-cigarette use increased from 18.4% (95% CI, 12.9-23.9%) in 2018 to 27.2% (95% CI, 20.5-33.9%) in 2020, a larger proportion than for any other age group. The leading reasons offered for e-cigarette use were "to help me quit smoking" (33%; 95% CI, 30-37%) and "to cut down on the number of cigarettes I smoke" (25%; 95% CI, 22-28%). CONCLUSION The increase between 2016 and 2020 in the proportions of young adults who smoke or have recently quit who use e-cigarettes undermines claims that these products are designed for older smokers who have struggled to quit using other methods.
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Affiliation(s)
- Becky Freeman
- Sydney School of Public Health, the University of Sydney, Sydney, NSW
| | - Katherine Owen
- Sydney School of Public Health, the University of Sydney, Sydney, NSW
| | | | | | - Philip J Clare
- Sydney School of Public Health, the University of Sydney, Sydney, NSW
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21
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Lee E, Hoek J, Fenton E, Joshi A, Evans-Reeves K, Robertson L. An Analysis of Arguments Advanced via Twitter in an Advocacy Campaign to Promote Electronic Nicotine Delivery Systems. Nicotine Tob Res 2023; 25:533-540. [PMID: 36269978 PMCID: PMC9910155 DOI: 10.1093/ntr/ntac237] [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: 11/09/2021] [Revised: 08/25/2022] [Accepted: 10/21/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Advocates of electronic nicotine delivery systems (ENDS) increasingly use Twitter to promote liberal ENDS policies. "World Vape Day" (WVD) is an annual campaign organized by pro-ENDS advocacy groups, some of which have links to the nicotine industry (eg, via funding from the "Foundation for a Smoke-Free World"). In 2020, the campaign used dedicated social media accounts to disseminate WVD-branded images and campaign messages. We examined tweets posted as part of WVD 2020 to identify and analyze pro-ENDS policy arguments. AIMS AND METHODS We extracted tweets posted between 26 May and 3 June 2020 that included the hashtag #WorldVapeDay. We used qualitative thematic analysis to code a random sample (n = 2200) of approximately half the original English language tweets (n = 4387) and used descriptive analysis to identify the most frequently used co-hashtags. RESULTS Arguments related to four themes: harm reduction, smoking cessation, rights and justice, and opposition to ENDS restrictions. Tweets criticized individuals and groups perceived as opposing liberal ENDS regulation, and used personal testimonials to frame ENDS as a harm reduction tool and life-saving smoking cessation aid. Tweets also advanced rights-based arguments, such as privileging adults' rights over children's rights, and calling for greater recognition of consumers' voices. Tweets frequently used hashtags associated with the WHO and World No Tobacco Day (WNTD). CONCLUSIONS The WVD campaign presented a series of linked pro-ENDS arguments seemingly aimed at policy-makers, and strategically integrated with the WHO's WNTD campaign. Critically assessing pro-ENDS arguments and the campaigns used to promote these is vital to helping policy actors develop proportionate ENDS policy. IMPLICATIONS Social media platforms have considerable potential to influence policy actors. Tweets are easily generated and duplicated, creating an impression of sizeable and influential stakeholders. Evidence that the "World Vape Day" campaign was supported by groups with industry links, and targeted-at least in part-at WHO officials and those who follow the WHO World No Tobacco Day campaign, highlights the importance of critically reviewing such campaigns. Further research could examine how health advocates could engage in pro-ENDS campaigns to support balanced messaging and informed policy-making.
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Affiliation(s)
- Ell Lee
- Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
| | | | - Ayush Joshi
- Tobacco Control Research Group, Department for Health, University of Bath, UK
| | - Karen Evans-Reeves
- Tobacco Control Research Group, Department for Health, University of Bath, UK
| | - Lindsay Robertson
- Tobacco Control Research Group, Department for Health, University of Bath, UK
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Hardie L, McCool J, Freeman B. E-Cigarette Retailers' Use of Instagram in New Zealand: A Content Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1897. [PMID: 36767263 PMCID: PMC9914635 DOI: 10.3390/ijerph20031897] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
E-cigarette companies claim their products are key to improving health outcomes by providing smokers with lower-risk alternatives. However, the rapid uptake of e-cigarettes among young people has prompted concern about company marketing practices. In 2019, there was no legislation to govern e-cigarette marketing in New Zealand. This period provides an ideal context for examining how e-cigarette companies promoted their products before the introduction of marketing regulations. We conducted a content analysis of the Instagram accounts of five prominent e-cigarette retailers based in New Zealand during 2019-2020. We assessed health- and risk-related claims and marketing techniques. Less than 10% of Instagram posts refer to smoking alternatives or risk of nicotine addiction. E-cigarette devices were more likely to be promoted for stylistic features such as colours and ease of use (29.7%). Music festival sponsorship (19.1%), social media influencers (9.2%), and lifestyle marketing (41.5%) were identified as youth-oriented promotional strategies. E-cigarette retailers claim to promote harm-reduction tools to smokers, yet this study finds few references to smoking alternatives in any content. Instead, retailers utilised strategies to engage with a young audience, including festival sponsorship and stylish influencers. This youth-oriented marketing, in combination with weak and delayed government action, may have contributed to the high use of e-cigarettes among young New Zealanders.
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Affiliation(s)
- Lucy Hardie
- School of Population Health, University of Auckland, Auckland 1142, New Zealand
| | - Judith McCool
- School of Population Health, University of Auckland, Auckland 1142, New Zealand
| | - Becky Freeman
- School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia
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Argefa TG, Carnegie T, Kassa SA, Kitonyo-Devotsu R, Mdege ND. Tobacco advertising, promotion, and sponsorship (TAPS) in Ethiopia: a scoping review and narrative synthesis. JOURNAL OF GLOBAL HEALTH REPORTS 2023. [DOI: 10.29392/001c.57372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Tobacco advertising, promotion and sponsorship (TAPS) has been shown to increase tobacco use in both adults and young people. In Ethiopia, TAPS is recognised as a top priority for the government, and all tobacco advertising, promotion, and sponsorship forms are prohibited. There is recognition that there are gaps in the evidence needed to inform policy and practice on TAPS, but the extent and nature of these gaps have not been explored. This review was aimed at understanding the extent and nature of the evidence gaps on TAPS in Ethiopia and identifying primary research priorities to inform future research direction. Methods Systematic searches were conducted in February 2022 in the following research databases: Medline, EMBASE, and PsycInfo. Two reviewers independently screened the study reports for eligibility and extracted data from the eligible studies. The extracted data was collated and summarised descriptively and policy, practice, and research recommendations were drawn. Research topics on TAPS in Ethiopia that stakeholders perceived to be priorities for primary research were identified through a consultation workshop. Results 579 research reports were identified, and only six studies were included in the scoping review. The included studies explored the following topics: the use of tobacco imagery in movies/films (two studies); the association between mass media exposure or home internet access and tobacco use (two studies), watching of televised football and tobacco smoking in adolescents (one study), exposure to point-of-sale advertising of tobacco products and daily occurrence of smoking or second-hand smoke exposure in the home among women (one study), and exposure to anti-smoking messages through mass media and disparities in risk perceptions across socio-economic and urban-rural subgroups (one study). None of the included studies investigated tobacco-related sponsorship. The top research priority topics identified by stakeholders in Ethiopia were: 1) barriers and facilitators to TAPS policy implementation, enforcement, and compliance monitoring; and 2) developing and testing effective, low-cost, and scalable strategies for TAPS enforcement and compliance monitoring. Conclusions There is a need for research evidence to inform policy and practice on TAPS in Ethiopia, particularly on barriers and facilitators to TAPS policy implementation, enforcement, compliance monitoring, and effective, low-cost, and scalable strategies for TAPS enforcement and compliance monitoring.
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Affiliation(s)
- Terefe G. Argefa
- ICAP at Columbia University Mailman School of Public Health, Addis Ababa, Ethiopia
- Development Gateway: an IREX Venture, Washington, DC, United States
| | - Tyryn Carnegie
- Development Gateway: an IREX Venture, Washington, DC, United States
| | - Selam A. Kassa
- Development Gateway: an IREX Venture, Washington, DC, United States
| | | | - Noreen D. Mdege
- Development Gateway: an IREX Venture, Washington, DC, United States
- Department of Health Sciences, University of York, York, United Kingdom
- Centre for Research in Health and Development, Amos Drive, York, United Kingdom
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24
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Satpathy N, Jena PK, Epari V. Gender dimensions of youth vulnerability toward access to cigarettes in South-East Asia: Evidence from global youth tobacco survey. Front Public Health 2022; 10:976440. [PMID: 36438271 PMCID: PMC9687093 DOI: 10.3389/fpubh.2022.976440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/13/2022] [Indexed: 11/12/2022] Open
Abstract
Background Youths are lured to smoking to make them tobacco customers. Limiting access to tobacco products by youths is a proven strategy to reduce youth tobacco use. This study aimed to examine the burden of cigarette smoking and access to tobacco by youth in South-East Asia (SEA). Methods The burden along with the physical (methods of obtaining cigarettes), financial (cigarette affordability by pocket money), and illegal (sale to minors) access to cigarettes among school-going boys and girls were examined by analyzing the Global Youth Tobacco Survey (GYTS) data (2013-2016) from seven SEA member countries. Descriptive statistics using country-specific GYTS sample weight was used to estimate parameters with 95% confidence intervals. Results The proportion of youths reporting cigarette smoking was highest in East Timor [boys: 55.57 % (51.93-59.21) and girls: 11.35% (9.12-13.59)] and lowest in Sri Lanka [boys: 2.96% (2.91-3.0) and girls: 0%]. Smoking prevalence was higher among boys than girls. Smoking among boys and girls was positively correlated (r = 0.849, p = 0.032). The most common method of obtaining cigarettes was "buying it from a store/kiosk/street hawker" and "other sources." Except in Indonesia, financial access was limited for most youths. Financial access had a positive but negligible influence on cigarette smoking. Despite legal restrictions on sales to minors, students could obtain cigarettes from vendors. Conclusion Contextual cigarette smoking and access to cigarettes by youths despite the legal ban and unaffordability is a concern. Country-specific socio-cultural-economic and legal dimensions need to be examined to limit cigarette use among youths.
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Affiliation(s)
- Nancy Satpathy
- Department of Community Medicine, Institute of Medical Sciences and SUM Hospital, Siksha ‘O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Pratap Kumar Jena
- School of Public Health, Kalinga Institute of Industrial Technology Deemed to be University, Bhubaneswar, Odisha, India
| | - Venkatarao Epari
- Department of Community Medicine, Institute of Medical Sciences and SUM Hospital, Siksha ‘O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India,*Correspondence: Venkatarao Epari
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