Influence of household demographic and socio-economic factors on household expenditure on tobacco in six New Independent States

Barriers to Tobacco Control in China: A Narrative Review

This research chooses the method of narrative literature review to analyze the barriers in implementing tobacco regulatory policies in China and explore the strategies that can overcome these challenges. China is the world’s largest producer and consumer of tobacco products. Although the prevalence of cigarette smoking declined from 34.5% to 27.7% between 1984 and 2015, the reduction over the 30 years has been slow. Therefore, effective tobacco regulatory policies are necessary. However, as the tobacco industry is one of the major sources of government revenue and an indispensable part of the national economy, the implementation of tobacco regulatory policies faces many challenges. In terms of the institutional dimension, the ambiguous attitude of national institutions and tobacco companies’ development strategies impede the enforcement of tobacco policies. In addition, the primary economic barrier to tobacco control is the unwillingness of the government to raise value-added tax on tobacco. Finally, the social customs of exchanging individual cigarettes and gifting packaged cigarettes among adults and juveniles in China hinder the implementation of tobacco regulatory policies. In this case, a combined strategy of top-down and bottom-up approaches can remove these barriers, such as using the authoritative power to control tobacco use and raising non-smokers’ awareness of smoking risks and public education.

A Qualitative Analysis of Selected Stakeholders’ Viewpoints on Tobacco Control in Nigeria

Nigeria is a signatory to the Framework Convention on Tobacco Control. However, tobacco control efforts have been fraught with challenges. These challenges cannot be presumed to be independent of tobacco industry manipulation. We examined submissions and viewpoints from prominent tobacco control stakeholders across social, administrative, and political strata to identify convergence with tobacco industry viewpoints. We illustrate how these convergences pose a threat to effective tobacco control in Nigeria. A thematic analysis of stakeholder viewpoints was conducted on submissions to the national assembly during the Tobacco Control Bill public hearings and various industry documents. Areas of convergence with tobacco industry narratives were then explored. Significant convergence in views was observed between government agencies, social groups, and the tobacco industry. These were for narratives on constitution of a National Tobacco Control Committee, use of automated vending machines, designation of smoking areas, report to regulatory agencies, and negative effect of tobacco control on trade and poverty. There was evidence of tobacco industry interference in tobacco control efforts, which manifested in some prominent tobacco control stakeholders adopting the narratives of the tobacco industry. We advocate a constant watchfulness over the activities of these stakeholders and a proactive engagement with evidence-based antitobacco dialogue.

Socioeconomic status and cigarette expenditure among US households: results from 2010 to 2015 Consumer Expenditure Survey

OBJECTIVES

To examine (1) the association between household socioeconomic status (SES) and whether a household spends money on cigarettes and (2) socioeconomic variations in proportion of total household expenditure spent on cigarettes among smoking households.

METHODS

We pooled data from six consecutive years, 2010-2015, of the Consumer Expenditure Interview Survey. The interviews involved a structured questionnaire about household income, demographics and expenditures including expenditure on cigarettes. Households that reported cigarette expenditure in the previous 3 months were distinguished as smoking households. SES indicators were household poverty status, education and occupation of the head of household. Logistic regression was used to assess the association of household smoking status with SES. Fractional logistic regression was used to assess the association of cigarette expenditure as a proportion of total household expenditure with SES. The analysis sample size was 39 218.

RESULTS

The probability of spending money on cigarettes was higher among lower SES households. Households in poverty compared with those above 300% of poverty threshold had 1.86 (95% CI 1.61 to 2.16), households headed by a person with less than high school education compared with those headed by a person with at least a bachelor's degree had 3.37 (95% CI 2.92 to 3.89) and households headed by a blue-collar work compared with those headed by a person in a managerial occupation had 1.45 (95% CI 1.26 to 1.66) higher odds of spending money on cigarettes. Similarly, the proportion of total household expenditure spent on cigarettes was higher among lower SES smoking households.

CONCLUSION

Lower SES households are more likely to spend money on cigarettes and spend a larger proportion of their total expenditure on cigarettes. We recommend strategies effective in reducing smoking among low SES smokers.

Adult tobacco use practice and its correlates in eastern Ethiopia: a cross-sectional study

Background

There is paucity of data on the smoking habits of rural populations in developing countries. This study aimed to explore cigarette smoking practices of a rural community in Ethiopia.

Methods

A community based cross-sectional study was conducted among 548 individuals from a random sample of households in a rural town and its surrounding rural districts. Descriptive statistics and logistic regression were performed.

Results

Twenty-eight percent (95% CI: 24.3% - 31.6%) of the respondents were current smokers. A total of 105 (68%) smokers expressed an interest to quit while 37 (34%) had tried to quit previously but without success. There was high exposure to second-hand smoke: 285 (52%) homes allowed indoor smoking, and in 181 (33%) indoor smoking took place daily. Current smoking was strongly associated with male sex (OR = 83.0; 95% CI: 11.5 – 599.0), and being a student was found to be protective of smoking (OR = 0.04; 95% CI: 0.005 – 0.05).

Conclusion

Cigarette smoking is prevalent among the male rural town population in Ethiopia. In addition, a high level of exposure to indoor second-hand smoke exists. There is a need for investment in rural tobacco control, including educational campaigns and cost-effective smoking cessation services.

Prevalence of cigarette smoking and associated factors among secondary school teachers in Malaysia

OBJECTIVE

The smoking prevalence in Malaysia is high, especially among men and adolescents. This study aimed to determine the prevalence and associated factors towards cigarette smoking among school teachers in Malaysia.

METHODOLOGY

This study was a school-based cross-sectional study conducted among 495 secondary school teachers. The questionnaire used in this study consisted of 29 questions categorized into two sections: socio-demographic characteristics and smoking behaviour. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) program 13.0. ANOVA; t-tests were used in univariate analysis; multiple linear regression was applied for multivariate analysis.

RESULTS

The majority of the participants were female (81.6%), in the age group ranged between 30-39 years (44%), Malay (90.1%), married (89.7%), degree holders (85.1%), with monthly income ranged between 3000-3999 Ringgit Malaysia (33.5%), from urban areas (94.7%), their specialty is social studies (33.9%) and with no family history of cancer (83.6%). The prevalence of smoking among school teachers in Malaysia was found to be 7.8%. Regarding reasons to start smoking among school teachers: the major reason was found to be relaxation (33.3%), followed by stress-relief (28.2%). Univariate analysis showed that sex, educational status, monthly income and residency were significantly associated with smoking among school teachers (p<0.001, p=0.004, p=0.031, p=0.010; respectively). Multivariate analysis showed that gender and marital status were significantly associated with smoking among school teachers (p<0.001, p=0.033; respectively).

CONCLUSION

The prevalence of smoking among school teachers in Malaysia was found to be relatively low. Sex, marital status, educational status, monthly income and residency were significantly associated with smoking among school teachers.

Health and health systems in the Commonwealth of Independent States

The countries of the Commonwealth of Independent States differ substantially in their post-Soviet economic development but face many of the same challenges to health and health systems. Life expectancies dropped steeply in the 1990s, and several countries have yet to recover the levels noted before the dissolution of the Soviet Union. Cardiovascular disease is a much bigger killer in the Commonwealth of Independent States than in western Europe because of hazardous alcohol consumption and high smoking rates in men, the breakdown of social safety nets, rising social inequality, and inadequate health services. These former Soviet countries have embarked on reforms to their health systems, often aiming to strengthen primary care, scale back hospital capacities, reform mechanisms for paying providers and pooling funds, and address the overall shortage of public funding for health. However, major challenges remain, such as frequent private out-of-pocket payments for health care and underdeveloped systems for improvement of quality of care.

The social and economic determinants of smoking in Moscow, Russia

BACKGROUND

Despite a high prevalence of smoking for decades, recent research has documented an increase in the rates of both male and female smoking in post-Soviet Russia. As yet, however, little research has taken place on smoking at the subnational level. The current study addresses this deficit by examining smoking in Moscow -- the city that has been at the forefront of the entry into the Russian market of transnational tobacco corporations (TTCs) in the transition period.

METHODS

Data were obtained from the Moscow Health Survey 2004 -- a stratified random sample of 1190 people representative of Moscow's larger population. Information was obtained about subjects' smoking habits and age of smoking initiation.

RESULTS

The prevalence of smoking was high among both men (55.5%) and women (26.9%), with significantly higher rates in the younger age groups. There was also a high prevalence of smoking initiation before age 15 years, especially in the youngest women (18-30 years). Logistic regression analysis showed that respondents' age, binge drinking, locus of control and economic situation were important determinants of smoking.

CONCLUSIONS

Although lifestyle factors seem to underpin the generally high levels of smoking, other things, such as its high prevalence in the younger generations and the factors associated with smoking (locus of control), nevertheless suggest that the TTCs may have played an important role in the spread of smoking in transitional Russia's changing social environment.