Policies that limit youth access and exposure to tobacco: a scientific neglect of the first stages of the policy process

Perceptions of Tobacco Price Policy among Students from Sapienza University of Rome: Can This Policy Mitigate Smoking Addiction and Its Health Impacts?

Tobacco use is one of the main risk factors for non-communicable diseases. Avoiding youth initiation and treating addiction are fundamental public health issues to ensure better health. Among tobacco control policies, increasing tobacco price is the single most effective intervention. It reduces tobacco consumption, especially among youths, while representing a government financing source. This study aimed to assess the agreement with the proposal of a one-euro increase in tobacco price earmarked to health issues among students at Sapienza University. Two convenience samples were surveyed, five years apart, on World No Tobacco Days. Smoking habits, agreement with the proposal and reasons for it were collected. Results from the 208 questionnaires (107 in 2014, 101 in 2019) showed 46.6% of agreement with the proposal (53.3% in 2014, 39.2% in 2019, p = 0.044). Main predictive factor for agreement was being a non-smoker (OR = 6.33 p < 0.001), main reason (64.8%) was it could trigger smokers to quit or reduce consumption. Several factors might have influenced this finding, including the introduction of novel tobacco products and their increased advertisement on social media. In 2024, European Union is planning to update the Tobacco Taxation Directive which could greatly contribute to the reduction of non-communicable diseases and premature deaths.

Personal determinants of change agents' decision-making behavior in community health promotion: a qualitative study

BACKGROUND

Implementing environmental changes to promote healthier communities requires initial positive decisions by change agents from local politics and government. However, there is little research on what influences the change agents' decisions. This explorative, qualitative study aims to identify the personal determinants of the decision-making behavior of local change agents.

METHODS

We conducted semi-structured interviews to assess the personal determinants of decision-making behavior among 22 change agents from local politics and government. Relevant determinants were identified through a structured content analysis of the interview transcripts using the software MAXQDA 2020.

RESULTS

We found the following seven essential clusters of personal determinants of the decision-making behavior of change agents from local politics and government: Imprinting, socialization, and biography; experiences and involvement; attitudes and outcome expectations towards important issues and aspects; knowledge; emotions; personal benefits; and the perceived influences of others.

CONCLUSIONS

The identified personal determinants might serve as a source of understanding the decision-making behavior of change agents in community decision-making processes. Our findings can contribute to the effective planning and implementation of evidence-based multilevel interventions related to changing environmental conditions in communities and provide important information on which personal determinants should be considered when derive strategies for community health promotion within a systematic approach of developing an intervention program theory.

Tobacco retail licencing systems in Europe

Tobacco retailer licencing has been recommended as an effective tobacco control strategy. In most European countries, however, retailers do not need a licence to sell tobacco products. We aimed to stimulate a discussion on the potential for tobacco retail licencing in Europe by describing (1) potential public health benefits, (2) licencing methods and (3) barriers and success factors in adoption of licencing systems. There is limited scientific evidence, but tobacco retail licencing may reduce smoking in three ways: (1) improved enforcement of and compliance to existing point-of-sale tobacco control policies (eg, minimum age of sale), (2) a reduction in the number and/or density of tobacco retail outlets and (3) denormalisation of tobacco. Licencing systems may take diverse forms. Systems may make licences expensive, and set criteria for purchasing a licence and retaining the licence after first purchase. In Europe, licencing systems have been implemented in Finland, Hungary, France, Italy and Spain. Licencing in Finland and Hungary was adopted for public health reasons; in Finland, with strong public support. In France, Italy and Spain, tobacco sales were state-monopolised, driven by economic motives. The cases of Norway and Scotland show that adoption of retail licencing may fail when political support is insufficient and tobacco retailers organise opposition with support from the tobacco industry. In conclusion, tobacco retailer licencing is a promising method to contribute to tobacco control efforts. Placing tobacco retailer licencing in a child protection framework may help generate the strong political and public support needed to effectively adopt licencing systems.

Tobacco control partnership capacity: An overview and comparison of 18 European partnerships

INTRODUCTION

In most countries, public health partnerships exist to advance national tobacco control. We assessed characteristics related to tobacco control partnership capacity across Europe.

METHODS

We developed a tool to assess partnership characteristics related to their theoretical capacity to influence policy. The tool was based on an existing framework in the literature, which we adapted for the tobacco control field, through an expert panel, insights from the literature and pilot tests. The tool consists of three dimensions: resources (8 items), member characteristics (2 items), and organizational characteristics (8 items) and was administered to 18 European partnerships across 17 European countries in 2019.

RESULTS

Whereas several characteristics likely related to tobacco control partnership capacity were highly prevalent across European partnerships, some were not. Of all 18 partnerships, 5 did not include professional lobbyists, 7 did not have access to national information on tobacco industry presence and lobbying, 9 had no influence on national research agendas, and 7 did not maintain working relationships with the relevant Minister or Secretary of State. Furthermore, 5 of 18 partnerships had no agreement on roles and responsibilities of member organizations, and 6 had no agreement on how credits are divided across member organizations. A leadership figure was absent in 6 of 18 partnerships.

CONCLUSIONS

This study confirms that tobacco control partnerships vary greatly in the extent to which they possess characteristics associated with their ability to advance tobacco control. There is much room for improvement of European tobacco control partnerships.