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Kuijper LEN, Lacroix E, Singh G, Champagne M, Beardy B, Dubois R, Wood L, Harper MJ, Muench K, Kisselgoff M, Mann K, Waugh A, Thériault C, Tait M, Bombak A, Riediger ND. Experiences and perspectives of sugar-sweetened beverage consumption among Indigenous adults living in Manitoba. Appetite 2024; 202:107637. [PMID: 39208478 DOI: 10.1016/j.appet.2024.107637] [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: 02/21/2024] [Revised: 08/14/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024]
Abstract
Sugar-sweetened beverages (SSB) are a health policy target. Indigenous populations are among the highest consumers of SSB in Canada. However, the Truth and Reconciliation Commission calls on governments to recognize health disparities among Indigenous populations as a consequence of colonialism and governmental policies. The purpose of this analysis was to explore emergent perspectives of Indigenous adults on experiences and perspectives of SSB consumption. We conducted a community-based participatory study in partnership with three Indigenous-led organizations. From 2019 to 2022, we completed qualitative interviews with Indigenous adults living in Island Lake Anisininew First Nation, Flin Flon, and Winnipeg's North End, a neighbourhood with high concentration of Indigenous people. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Seventy-four adults participated in interviews, including 46 women, 26 men, and two identifying as two-spirit. Many participants, across all three locations, repeatedly and consistently described SSB or sugar as an addiction, which formed the primary theme for this analysis: addictive-like consumption of SSB. Addictive-like SSB consumption included comparison to other addictive substances, loss of control, and physical symptoms resulting from SSB intake (both positive and adverse) or attempting to reduce SSB intake. We identified two other secondary themes, i) perceived drivers and contexts of SSB consumption, and ii) health outcomes as a motivator for change. Perceived drivers or contexts included consuming SSB as a means to cope with stress, boredom, and poverty; SSB intake as being intertwined with other addictions or addictive substances; and drinking alone. In conclusion, addictive-like SSB consumption was reported by Indigenous adults. To address SSB intake among Indigenous populations, trauma-informed approaches should be explored that consider the colonial context.
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Affiliation(s)
| | - Emilie Lacroix
- Department of Psychology, University of New Brunswick, 38 Dineen Drive, Fredericton, NB, E3C 1N8, Canada.
| | - Gurismrandeep Singh
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Michael Champagne
- Fearless R2W, PO Box 44095 Redwood Centre Postal Outlet Winnipeg, MB, Canada, R2W 5M3.
| | - Byron Beardy
- Four Arrows Regional Health Authority, Wasagamack Health Authority, General Delivery, Wasagamack, MB R0B Z0, Winnipeg Office: 500-338 Broadway, Winnipeg, MB, Canada.
| | - Riel Dubois
- Fearless R2W, PO Box 44095 Redwood Centre Postal Outlet Winnipeg, MB, Canada, R2W 5M3
| | - Larry Wood
- Four Arrows Regional Health Authority, Wasagamack Health Authority, General Delivery, Wasagamack, MB R0B Z0, Winnipeg Office: 500-338 Broadway, Winnipeg, MB, Canada
| | - Mary Jane Harper
- Four Arrows Regional Health Authority, Wasagamack Health Authority, General Delivery, Wasagamack, MB R0B Z0, Winnipeg Office: 500-338 Broadway, Winnipeg, MB, Canada
| | - Krista Muench
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Maria Kisselgoff
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Kelsey Mann
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Anne Waugh
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Céleste Thériault
- National Indigenous Diabetes Association, 160 Provencher Blvd, Unit 202, Winnipeg, MB, R2H 0G3, Canada.
| | | | - Andrea Bombak
- Department of Sociology, University of New Brunswick, 9 Macaulay Ln, Fredericton, NB, E3C 1N8, Canada.
| | - Natalie D Riediger
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
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Waugh A, Thille P, Roger K, Bombak A, Mann K, Riediger N. "Coke's not a food": A critical discourse analysis of sugar-sweetened beverage tax acceptability by white residents from an upper-middle class neighborhood in Winnipeg Manitoba. Heliyon 2024; 10:e30089. [PMID: 38707291 PMCID: PMC11066379 DOI: 10.1016/j.heliyon.2024.e30089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/11/2024] [Accepted: 04/19/2024] [Indexed: 05/07/2024] Open
Abstract
Increasing concerns about the health impacts of sugar consumption has led to the proposition of a sugar-sweetened beverage (SSB) tax in Canada. However, competing concerns related to stigma and equity remain and have not been explored in a Canadian context. As part of a broader study examining the perspectives of various populations on SSB tax acceptability, we examined how residents of an upper-middle class neighborhood conceptualize SSB tax acceptability, and we explored the discourses that inform their discussion. We conducted and analyzed qualitative, semi-structured interviews with residents of an upper-middle class neighborhood in Winnipeg, Manitoba, Canada. Recruitment criteria were residence, adults, and English speaking. Critical discourse analysis methodology was used, and healthism (health moralism) and tax psychology informed the analysis. Eighteen participants volunteered: 15 females and 3 males; all self-identified as white, and all spoke about (grand)parenting. Healthist discourse was utilized in supportive discussion of SSB taxation. With the mobilization of healthism, ideal citizens and parents were described as "health conscious" and those who might be likely to reduce SSB intake because of taxation. Healthism also contributed to their identification of beverages targeted by a tax, versus those they deemed as having redeeming nutritional qualities. Limits to SSB tax support were expressed as fairness concerns, with a focus on the procedural justice of the tax. Participants supported SSB taxation and the discourses they employed suggested support for the tax was perceived as contributing to their construction of the kind of ideal, health-valuing citizens they hoped to embody. However, participants were also concerned about the fairness of implementation, although this did not outweigh the prioritization of good health.
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Affiliation(s)
- Anne Waugh
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, R3T 2N2, Canada
| | - Patricia Thille
- Department of Physical Therapy, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada
| | - Kerstin Roger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3T 2N2, Canada
| | - Andrea Bombak
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, E3B 5A3, Canada
| | - Kelsey Mann
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, R3T 2N2, Canada
| | - Natalie Riediger
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, R3T 2N2, Canada
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Smith BT, Warren CM, Anderson LN, Hammond D, Manuel DG, Li Y, Andreacchi AT, Rosella LC, Fu SH, Hobin E. The equitable impact of sugary drink taxation structures on sugary drink consumption among Canadians: a modelling study using the 2015 Canadian Community Health Survey-Nutrition. Public Health Nutr 2024; 27:e121. [PMID: 38618932 PMCID: PMC11075107 DOI: 10.1017/s1368980024000545] [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: 05/25/2023] [Revised: 11/09/2023] [Accepted: 02/12/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Estimate the impact of 20 % flat-rate and tiered sugary drink tax structures on the consumption of sugary drinks, sugar-sweetened beverages and 100 % juice by age, sex and socio-economic position. DESIGN We modelled the impact of price changes - for each tax structure - on the demand for sugary drinks by applying own- and cross-price elasticities to self-report sugary drink consumption measured using single-day 24-h dietary recalls from the cross-sectional, nationally representative 2015 Canadian Community Health Survey-Nutrition. For both 20 % flat-rate and tiered sugary drink tax scenarios, we used linear regression to estimate differences in mean energy intake and proportion of energy intake from sugary drinks by age, sex, education, food security and income. SETTING Canada. PARTICIPANTS 19 742 respondents aged 2 and over. RESULTS In the 20 % flat-rate scenario, we estimated mean energy intake and proportion of daily energy intake from sugary drinks on a given day would be reduced by 29 kcal/d (95 % UI: 18, 41) and 1·3 % (95 % UI: 0·8, 1·8), respectively. Similarly, in the tiered tax scenario, additional small, but meaningful reductions were estimated in mean energy intake (40 kcal/d, 95 % UI: 24, 55) and proportion of daily energy intake (1·8 %, 95 % UI: 1·1, 2·5). Both tax structures reduced, but did not eliminate, inequities in mean energy intake from sugary drinks despite larger consumption reductions in children/adolescents, males and individuals with lower education, food security and income. CONCLUSIONS Sugary drink taxation, including the additional benefit of taxing 100 % juice, could reduce overall and inequities in mean energy intake from sugary drinks in Canada.
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Affiliation(s)
- Brendan T Smith
- Public Health Ontario, 661 University Avenue, Suite 1701,
Toronto, ON, Canada
- Dalla Lana School of Public Health, University of
Toronto, 155 College St Room 500, Toronto, ON,
Canada
| | - Christine M Warren
- Public Health Ontario, 661 University Avenue, Suite 1701,
Toronto, ON, Canada
| | - Laura N Anderson
- Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON,
Canada
- Child Health Evaluative Sciences, Sickkids Research
Institute, Toronto, ON,
Canada
| | - David Hammond
- School of Public Health Sciences, University of
Waterloo, Waterloo, ON,
Canada
| | - Douglas G Manuel
- Ottawa Hospital Research Institute, Clinical Epidemiology, 501
Smyth Box 511, Ottawa, ON, Canada
- Department of Family Medicine, and School of Epidemiology and Public
Health, University of Ottawa, Ottawa,
ON, Canada
- Bruyère Research Institute, OttawaON, Canada
| | - Ye Li
- Public Health Ontario, 661 University Avenue, Suite 1701,
Toronto, ON, Canada
- Dalla Lana School of Public Health, University of
Toronto, 155 College St Room 500, Toronto, ON,
Canada
| | - Alessandra T Andreacchi
- Public Health Ontario, 661 University Avenue, Suite 1701,
Toronto, ON, Canada
- Dalla Lana School of Public Health, University of
Toronto, 155 College St Room 500, Toronto, ON,
Canada
| | - Laura C Rosella
- Dalla Lana School of Public Health, University of
Toronto, 155 College St Room 500, Toronto, ON,
Canada
- Institute for Better Health, Trillium Health Partners,
MississaugaON, Canada
- Department of Laboratory Medicine and Pathobiology, Temerty Faculty of
Medicine, University of Toronto, Toronto,
ON, Canada
| | - Sze Hang Fu
- Public Health Ontario, 661 University Avenue, Suite 1701,
Toronto, ON, Canada
| | - Erin Hobin
- Public Health Ontario, 661 University Avenue, Suite 1701,
Toronto, ON, Canada
- Dalla Lana School of Public Health, University of
Toronto, 155 College St Room 500, Toronto, ON,
Canada
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Button BLG, McEachern LW, Martin G, Gilliland JA. Intake of Fruits, Vegetables, and Sugar-Sweetened Beverages among a Sample of Children in Rural Northern Ontario, Canada. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1028. [PMID: 35884012 PMCID: PMC9320505 DOI: 10.3390/children9071028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/02/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022]
Abstract
There is evidence to suggest that dietary intake of children differs by rural/urban place of residence: rural children may have a higher intake of foods high in fat and sugar than those living in urban environments. The aim of this study was to examine the intake of fruits and vegetables (FV) and the frequency of sugar-sweetened beverage (SSB) consumption, among a sample of rural children in Northern Ontario, Canada, in two different seasons. Sociodemographic factors and children's FV and SSB intake were measured using two repeated cross-sectional surveys, and seasonal information was based on the month of data collection. Logistic regressions were used to examine the odds of children eating five or more FVs, and the odds of 'frequently or always' consuming SSBs. During the fall, children reported eating five or more FV more often, when compared to winter (53.9% vs. 48.3%). In the fall, 25.8% of children reported 'frequently or always' drinking SSB, compared with 16.9% in winter. Indigenous children were less likely to eat five or more FV (OR 0.34 (95% CI 0.12-0.95)) in the fall when compared to non-Indigenous children. Findings indicate that intake of FV among rural students in this region is low, and the frequency of SSB is high, when compared with national recommendations.
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Affiliation(s)
- Brenton L. G. Button
- Human Environments Analysis Laboratory, Department of Geography and Environment, Western University, London, ON N6A 5C2, Canada; (L.W.M.); (G.M.); (J.A.G.)
- Faculty of Education, University of Winnipeg, Winnipeg, MB R3B 2E9, Canada
| | - Louise W. McEachern
- Human Environments Analysis Laboratory, Department of Geography and Environment, Western University, London, ON N6A 5C2, Canada; (L.W.M.); (G.M.); (J.A.G.)
- Children’s Health Research Institute, London, ON N6C 2V5, Canada
| | - Gina Martin
- Human Environments Analysis Laboratory, Department of Geography and Environment, Western University, London, ON N6A 5C2, Canada; (L.W.M.); (G.M.); (J.A.G.)
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB T9S 3A3, Canada
| | - Jason A. Gilliland
- Human Environments Analysis Laboratory, Department of Geography and Environment, Western University, London, ON N6A 5C2, Canada; (L.W.M.); (G.M.); (J.A.G.)
- Children’s Health Research Institute, London, ON N6C 2V5, Canada
- Lawson Health Research Institute, London, ON N6A 4V2, Canada
- School of Health Studies, Western University, London, ON N6A 3K7, Canada
- Department of Paediatrics, Western University, London, ON N6A 5C1, Canada
- Department of Epidemiology & Biostatistics, Western University, London, ON N6A 5C1, Canada
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Kao KE, Jones AC, Ohinmaa A, Paulden M. The health and financial impacts of a sugary drink tax across different income groups in Canada. ECONOMICS AND HUMAN BIOLOGY 2020; 38:100869. [PMID: 32442926 DOI: 10.1016/j.ehb.2020.100869] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 03/16/2020] [Accepted: 03/20/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Overconsumption of sugar-sweetened beverages (SSBs) contributes to childhood and adult obesity and numerous related diseases, including heart disease, strokes, cancers, and type 2 diabetes. It also increases healthcare costs. Sugary drink taxes have been implemented in several countries to curb sugar intake. However, there is a concern that sugary drink taxes are regressive. This study assessed the health and financial impacts of a simulated sugary drink tax across different income groups in Canada. METHODS A proportional multi-state life table-based Markov model simulated the 2016 Canadian population by income quintile. The model applied a 20 % tax on sugary drinks and determined the effects on type 2 diabetes and BMI-related diseases compared to no intervention. The income-specific parameters modelled included: population demographics; cross- and own-price elasticities; mean BMI; sugary drink consumption; mortality; and disease epidemiology. RESULTS A 20 % sugary drink tax was estimated to reduce the consumption of sugary drinks by an average of around 15 %, with a greater reduction in the lowest income quintile. The estimated mean reduction in BMI ranged from 0.21 to 0.33, dependent upon sex and income quintile; these reductions were greater among the lower income quintiles for both females and males. The 20 % sugary drink tax was estimated to avert approximately 690,000 DALYs over a lifetime among the 2016 Canadian adult population; estimated DALYs averted were approximately 156,000, 140,000, 137,000, 134,000, and 125,000 for the lowest through to the highest income quintile, respectively. Lifetime health care savings were estimated to be $2.27bn, $2.16bn, $2.17bn, $2.12bn, and $1.98bn for the lowest through to the highest income quintile, respectively. The estimated annual tax burden for the 2016 Canadian population was $1.4bn. The average absolute tax burden was estimated to be $39.00 to $44.30 per person, with the middle-income quintile bearing the heaviest absolute tax burden. The lowest income quintile would pay the highest proportion of income in tax, implying that the tax is regressive. CONCLUSIONS Low-income Canadians would gain the most health benefit from a sugary drinks tax. However, the lowest income quintile would also pay the largest proportion of income in tax. A tax on sugary drinks is therefore financially regressive but forecast to reduce health disparities across Canada.
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Affiliation(s)
- Kai-Erh Kao
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, Alberta, T6G 1C9, Canada
| | - Amanda C Jones
- Department of Public Health, University of Otago, PO Box 7343, Newtown, Wellington 6242, New Zealand
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, Alberta, T6G 1C9, Canada
| | - Mike Paulden
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, Alberta, T6G 1C9, Canada.
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Wippold GM, Tucker CM, Hogan ML, Bellamy PL. Motivators of and Barriers to Drinking Healthy Beverages among a Sample of Diverse Adults in Bronx, NY. AMERICAN JOURNAL OF HEALTH EDUCATION 2020. [DOI: 10.1080/19325037.2020.1740118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Bombak AE, Colotti T, Riediger ND, Raji D, Eckhart N. Fizzy foibles: examining attitudes toward sugar-sweetened beverages in Michigan. CRITICAL PUBLIC HEALTH 2019. [DOI: 10.1080/09581596.2019.1680804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Andrea E. Bombak
- Department of Sociology, University of New Brunswick, Fredericton, NB, Canada
| | - Taylor Colotti
- School of Health Sciences, Community Health Division, Central Michigan University, Mt Pleasant, MI, USA
| | - Natalie D. Riediger
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Dolapo Raji
- School of Health Sciences, Community Health Division, Central Michigan University, Mt Pleasant, MI, USA
| | - Nicholas Eckhart
- College of Communication & Information Sciences, University of Alabama, Tuscaloosa, AL, USA
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Feldman M, Pound C. Sugary drinks and pediatric health: reflections from a tertiary care hospital. CMAJ 2018; 190:E993. [PMID: 30127042 PMCID: PMC6102108 DOI: 10.1503/cmaj.69949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Matthew Feldman
- Pediatrics resident, Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - Catherine Pound
- Pediatrician, Children's Hospital of Eastern Ontario, Ottawa, Ont
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Arango M. A made-in-Canada sugary drink levy can help reduce intake while being mindful of addressing health disparities. CMAJ 2018; 190:E992. [PMID: 30127041 PMCID: PMC6102112 DOI: 10.1503/cmaj.69859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Manuel Arango
- Director, Health Policy & Advocacy, Heart & Stroke Foundation, Ottawa, Ont
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Scott CA. Successful in the United Kingdom, adaptable to Canada. CMAJ 2018; 190:E991. [PMID: 30127040 PMCID: PMC6102109 DOI: 10.1503/cmaj.69700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Affiliation(s)
- Tom Warshawski
- Pediatrician and chair, Childhood Obesity Foundation, Vancouver, BC
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12
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Junek ML. When the perfect is the enemy of the good. CMAJ 2018; 190:E965. [PMID: 30104192 PMCID: PMC6089940 DOI: 10.1503/cmaj.69691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Mats L Junek
- Internal medicine resident, McMaster University, Hamilton, Ont
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Hammond D, Reid JL, Jones AC. Setting the record straight on taxation and disparities in smoking. CMAJ 2018; 190:E964. [PMID: 30104191 PMCID: PMC6089948 DOI: 10.1503/cmaj.69581] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
| | | | - Amanda C Jones
- Research fellow, University of Otago, North Dunedin, New Zealand
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