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Parnham JC, Vrinten C, Cheeseman H, Bunce L, Hopkinson NS, Filippidis FT, Laverty AA. Changing awareness and sources of tobacco and e-cigarettes among children and adolescents in Great Britain. Tob Control 2023:tc-2023-058011. [PMID: 37524388 DOI: 10.1136/tc-2023-058011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 07/15/2023] [Indexed: 08/02/2023]
Abstract
INTRODUCTION It is illegal in the UK to sell tobacco or nicotine e-cigarettes to people under the age of 18 years, as is displaying tobacco cigarettes at the point of sale. This paper examined changes in exposure to display of these products in shops and sources of these products among children and adolescent users over time METHODS: Data from representative repeated online cross-sectional surveys of youth in Great Britain (11-18 years) were used (2018-2022; n=12 445). Outcome measures included noticing product displays and sources of e-cigarettes and tobacco cigarettes. Logistic regressions examined the associations of these outcome variables over time and with sociodemographic variables. RESULTS Of 12 040 participants with complete data, 10.1% used some form of nicotine product (4.2% cigarettes, 2.9% e-cigarettes, 3.0% both) at least occasionally. The likelihood of noticing tobacco cigarettes on display fell over time for both supermarkets (2018: 67.1% to 2022: 58.5%) and small shops (2018: 81.3% to 2022: 66.3%), but the likelihood of noticing e-cigarettes in supermarkets rose (2018: 57.4% to 2022: 66.5%). Sources of tobacco cigarettes did not differ over time, but e-cigarette users were more likely to get their e-cigarettes from small shops in 2022 (51.2%) vs 2019 (34.2%) (OR 2.02, 95% CI 1.24, 3.29). CONCLUSION This study provides evidence that current policies to limit awareness of and access to both tobacco and e-cigarettes among adolescents in the UK may not be effective. UK policies on the advertising, promotion and sale of both tobacco and e-cigarettes need to be reinforced to deter use among children and adolescents.
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Affiliation(s)
- Jennie C Parnham
- Public Health Policy Evaluation Unit, Imperial College London, London, UK
| | - Charlotte Vrinten
- Public Health Policy Evaluation Unit, Imperial College London, London, UK
| | | | - Laura Bunce
- Action on Smoking and Health (ASH), London, UK
| | - Nicholas S Hopkinson
- NIHR Respiratory Biomedical Research Unit at the Royal Brompton & Harefield NHS Foundation Trust and Imperial College, London, UK
| | | | - Anthony A Laverty
- Public Health Policy Evaluation Unit, Imperial College London, London, UK
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Spillane TE, Madar A, Cohen JE, Welding K, Clegg Smith K. Tobacco companies' creation of additional communication space: a content analysis of cigarette pack inserts and onserts. Tob Control 2023:tc-2023-057982. [PMID: 37380350 DOI: 10.1136/tc-2023-057982] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES Pack inserts and onserts-removable items placed inside or on the outside of packs-are a communicative strategy used by tobacco companies that provide them with additional marketing space. A content analysis of these items was conducted across several years, countries and brands to assess how these items are used to communicate with consumers. METHODS Between 2013 and 2020, cigarette packs were systematically collected using the Tobacco Pack Surveillance System protocol. Packs with inserts or onserts (n=178) were identified from 11 low and middle-income countries. Packs were coded for tobacco company strategies, physical pack characteristics and imagery and lexical marketing appeals. RESULTS Of the 5903 packs, 3% (n=178) had an insert or onsert. 171 of these (96%) were inserts. While most (78%) pack exteriors were entirely in English, over half (51%) of the inserts/onserts were entirely in the local (non-English) language from where the pack was collected. The most common appeals on the inserts/onserts were product dependability (64%), luxury/aspirational (55%) and machinery/technology (37%). Product images were prevalent as well as images or words mentioning filters (22%). The most used appeals involved featuring aspects of a product (66%), addressing customers directly (52%) and informing customers about new aspects of a product (31%). CONCLUSIONS Cigarette pack inserts/onserts are unregulated in many countries and provide additional space for tobacco companies to extend and innovate their advertising. Tobacco advertising and packaging policies such as plain and standardised packaging should expand to address inserts/onserts to protect consumers more fully from industry promotion of deadly products.
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Affiliation(s)
- Torra E Spillane
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Alena Madar
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kevin Welding
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Katherine Clegg Smith
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Galstyan E, Galimov A, Meza L, Huh J, Berg CJ, Unger JB, Baezconde-Garbanati L, Sussman S. An Assessment of Vape Shop Products in California before and after Implementation of FDA and State Regulations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15827. [PMID: 36497899 PMCID: PMC9738621 DOI: 10.3390/ijerph192315827] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/20/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Vape shops specialize in sales of e-cigarettes and related products. This study examines whether vape shops adapted their products and services in response to changes in federal and state policies that affect the tobacco retail environment between 2014-2022. In this multicohort study, four waves of study data were used to examine the trends in products sold in vape shops in Southern California. Items sold were assessed through systematic store product observations and included categories of e-cigarettes, device modification equipment, and other products (e.g., Cannabidiol (CBD), paraphernalia). Descriptive statistics are reported. The availability of disposable devices increased from 18% at Wave 1 to 98% of shops at Wave 4. Pod mods were first observed in 79% of the shops beginning at Wave 3. Device modification drills later become obsolete, from 60% at Wave 1 to 0 by Wave 4; self-service sampling displays declined from 83% of shops to 9%. Vape shops did not carry CBD products until Wave 3 (2017/2018), when 19.0% of shops carried CBD products and 72.9% at Wave 4. Future research should examine how e-cigarette retailers and manufacturers respond to changing state and federal regulations to better understand the implications of regulatory efforts.
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Affiliation(s)
- Ellen Galstyan
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Artur Galimov
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Leah Meza
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Jimi Huh
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, GW Cancer Center, George Washington University, Science & Engineering Hall, 800 22nd St. NW, #7000C, Washington, DC 20052, USA
| | - Jennifer B. Unger
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Lourdes Baezconde-Garbanati
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Steve Sussman
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
- Department of Psychology, University of Southern California, Los Angeles, CA 90007, USA
- School of Social Work, University of Southern California, Los Angeles, CA 90007, USA
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Karriker-Jaffe KJ, Henriksen L, Smith EA, McDaniel PA, Malone RE, Kerr WC. Relapse to problem drinking or trading up to spirits? Using U.S. national cross-sectional survey data to highlight possible negative impacts of potential tobacco retail changes. Subst Abuse Treat Prev Policy 2022; 17:72. [PMID: 36320048 PMCID: PMC9623940 DOI: 10.1186/s13011-022-00498-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/01/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND According to the National Alcohol Beverage Control Association, twelve states in the United States (U.S.) have government retail monopolies on spirits/liquor sales. With a new federal minimum legal sales age for tobacco (raised from 18 to 21, the minimum legal sales age for alcohol), we examine possible unintended consequences of a hypothetical policy change restricting retail tobacco sales to state-run spirits/liquor stores in alcohol control states, which has been proposed as a tobacco endgame strategy. METHODS We used cross-sectional survey data from 14,821 randomly-selected adults ages 21 and older who responded to the 2015 or 2020 U.S. National Alcohol Survey (51.8% female; 65.8% identified as non-Hispanic White, 12.4% as Black or African American, 14.2% as Hispanic or Latinx; 34.0% had a low level of education), including 2,274 respondents (18.9%) residing in one of the alcohol control states (representing 42.2 million (M) adults ages 21+). We estimated associations between tobacco measures (lifetime smoking status, lifetime daily smoking, past-year daily smoking) and alcohol measures (drinking status, beverage choices, lifetime alcohol use disorder (AUD) status, recovery status) overall and for specific subgroups. RESULTS In control states, 55.1% of people who smoked daily in the past year also reported lifetime AUD, including an estimated 3.56 M adults ages 21 + who reported prior (but not current) AUD. The association of daily smoking with lifetime AUD was stronger among those with low education compared to those with higher education. Further, 58.8% of people in recovery from an alcohol and/or drug problem (1.49 M adults ages 21+) smoked daily, and this was more marked among women than men in control states. CONCLUSION There could be negative consequences of an endgame strategy to restructure tobacco retail sales, including increased risk for relapse to drinking among people who smoke daily, especially among women and people with low levels of education. Strategies to mitigate unintended harms would be needed if such a policy were implemented.
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Affiliation(s)
- Katherine J Karriker-Jaffe
- Center on Behavioral Health Epidemiology, Implementation & Evaluation Research, RTI International, 2150 Shattuck Avenue, Suite 800, 94704, Berkeley, CA, USA.
| | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, 94305, Stanford, CA, USA
| | - Elizabeth A Smith
- Department of Social & Behavioral Sciences, School of Nursing, University of California, San Francisco, 94143, San Francisco, CA, USA
| | - Patricia A McDaniel
- Department of Social & Behavioral Sciences, School of Nursing, University of California, San Francisco, 94143, San Francisco, CA, USA
| | - Ruth E Malone
- Department of Social & Behavioral Sciences, School of Nursing, University of California, San Francisco, 94143, San Francisco, CA, USA
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, 94608, Emeryville, CA, USA
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Krishnan N, Berg CJ, Elmi A, Klemperer EM, Sherman SE, Abroms LC. Predictors of electronic nicotine product quit attempts and cessation: Analysis of waves 3 and 4 of the PATH study. Addict Behav 2022; 134:107419. [PMID: 35810644 DOI: 10.1016/j.addbeh.2022.107419] [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: 04/18/2022] [Revised: 06/17/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Identifying theory-based predictors of electronic nicotine product (ENP) quit attempts and cessation can guide the development of effective vaping cessation interventions, which are currently limited. This study examined predictors of ENP quit attempts and cessation among adult ENP users. METHODS Using data from wave 3 (W3; 2015-2016) current established ENP users in the Population Assessment of Tobacco and Health study, we used multivariable logistic regression to identify predictors of (i) wave 4 (W4; 2016-2018) quit attempts (unweighted n = 1,135); and (ii) W4 cessation among those who made a quit attempt (unweighted n = 610). Predictors included Social Cognitive Theory (SCT)-based cognitive (interest in quitting, self-efficacy to quit, outcome expectancies, risk perception), behavioral (smoking status, and use of combustibles, non-combustibles, cannabis, and alcohol), and socio-environmental (perceived disapproval, household rules, exposure to advertising) factors. RESULTS Between W3 and W4, 51.7% of W3 ENP users made a quit attempt. Among those who tried quitting, 68.4% stopped using ENPs. SCT-based predictors of ENP quit attempts included higher interest in quitting ENPs (aOR = 1.18), greater self-efficacy to quit ENPs (aOR = 1.31), and currently using cigarettes (vs non-smoker; aOR = 1.71), non-combustibles (aOR = 2.25), and cannabis (aOR = 1.80). Predictors of ENP cessation included greater self-efficacy to quit ENPs (aOR = 1.33), greater perceived risk of ENPs (aOR = 1.35), and being a current smoker (vs non-smoker; aOR = 3.28). CONCLUSIONS ENP cessation interventions should address cognitive factors, particularly self-efficacy, as it predicted quit attempts and cessation. Cigarette smoking among dual users should be monitored and addressed to ensure that those who quit using ENPs do not maintain cigarette use.
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Affiliation(s)
- Nandita Krishnan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Angelo Elmi
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Elias M Klemperer
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Scott E Sherman
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
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6
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Rose SW, Annabathula A, Westneat S, van de Venne J, Hrywna M, Ackerman C, Lee JG, Sesay M, Giovenco DP, Spillane T, Hudson SV, Delnevo CD. Neighborhood distribution of availability of newer tobacco products: A US four-site study, 2021. Prev Med Rep 2022; 30:102028. [PMID: 36325253 PMCID: PMC9619027 DOI: 10.1016/j.pmedr.2022.102028] [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: 06/05/2022] [Revised: 09/15/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
Audits of tobacco retailers can identify marketing patterns as newer tobacco products are introduced in the US. Our study examined store and neighborhood correlates of availability of nicotine pouches and disposable e-cigarettes in four US sites. We conducted standardized store audits of n = 242 tobacco retailers in 2021 in different states: New Jersey, Kentucky, North Carolina, and New York. We geocoded stores linking them with census tract demographics. We conducted unadjusted and adjusted Poisson regression of availability of each product with correlates of the proportion of Non-Hispanic White residents, households under poverty, proximity to schools, site, and store type. Nicotine pouches and disposable e-cigarettes were each available in around half the stores overall, but availability differed across sites (range: 76 %-32 %). In adjusted analyses, nicotine pouches were less likely to be available in each store type vs chain convenience (IRR range 0.2-0.6) and more likely in stores in census tracts with a greater percentage of non-Hispanic White residents (IRR range 1.8-2.3). In contrast, disposable e-cigarettes were more likely to be available in tobacco/vape shops (IRR 1.9 (1.4-2.5) than convenience stores and less likely in non-specialty store types like groceries (IRR 0.2 (0.1-0.4). Newer tobacco products like nicotine pouches and disposable e-cigarettes were widely available in stores across sites, but retail marketing patterns appear to differ. As these product types become subject to increased regulation as they go through the FDA pre-market authorization process, understanding patterns and changes in the retail environment is critical to inform potential policies regulating their sale and marketing.
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Affiliation(s)
- Shyanika W. Rose
- University of Kentucky, College of Medicine, Behavioral Science and Center for Health Equity Transformation, Lexington, KY, USA,University of Kentucky, Markey Cancer Center, Lexington, KY, USA,Corresponding author.
| | - Arati Annabathula
- University of Kentucky, College of Medicine, Behavioral Science and Center for Health Equity Transformation, Lexington, KY, USA
| | - Susan Westneat
- University of Kentucky, College of Medicine, Behavioral Science and Center for Health Equity Transformation, Lexington, KY, USA,University of Kentucky, College of Public Health, Epidemiology and Biostatistics, Lexington, KY, USA
| | - Judy van de Venne
- University of Kentucky, College of Medicine, Behavioral Science and Center for Health Equity Transformation, Lexington, KY, USA
| | - Mary Hrywna
- Rutgers Center for Tobacco Studies, New Brunswick, NJ, USA,Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, New Brunswick, NJ, USA,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | - Joseph G.L. Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, USA
| | - Mahdi Sesay
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, USA
| | - Daniel P. Giovenco
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York City, NY, USA
| | - Torra Spillane
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York City, NY, USA
| | - Shawna V. Hudson
- Dept of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Cristine D. Delnevo
- Rutgers Center for Tobacco Studies, New Brunswick, NJ, USA,Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, New Brunswick, NJ, USA,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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The Reshaping of the E-Cigarette Retail Environment: Its Evolution and Public Health Concerns. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148518. [PMID: 35886373 PMCID: PMC9319677 DOI: 10.3390/ijerph19148518] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/27/2022] [Accepted: 07/02/2022] [Indexed: 02/04/2023]
Abstract
E-cigarette use represents a public health controversy in the US and globally. Despite the potential of e-cigarettes to support cigarette cessation, their use increases health risks and risk for addiction, particularly in young people. Various federal, state, and local laws have impacted tobacco retail in general and e-cigarettes in particular. In the US, 2019–2020 federal laws increased in the minimum legal sales age for tobacco to 21 and banned flavored cartridge-based e-cigarettes. Many states and localities were early adopters of Tobacco 21 and implemented more comprehensive flavor restrictions than the federal ban. Meanwhile, cannabis retail is increasingly being legalized in the US—while cannabis-based product regulation has notable gaps at the federal, state, and local levels. These regulatory complexities have impacted specialized retailers selling e-cigarettes, including “vape shops” that exclusively sell e-cigarettes, “smoke shops” that sell e-cigarettes and other tobacco (and potentially CBD/THC and other un- or under-regulated products), and online retail. This commentary outlines public health concerns related to: (1) youth access; (2) consumer exposure to a broader range of tobacco products and marketing in retail settings where they may seek products to aid in cigarette cessation (i.e., such broad product exposure could hinder cessation attempts); (3) consumer exposure to un-/under-regulated products (e.g., delta-8-THC, kratom); and (4) federal, state, and local regulations being undermined by consumer access to prohibited products online and via the mail. These concerns underscore the need for ongoing surveillance of how retailers and consumers respond to regulations.
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Glasser AM, Nemeth JM, Quisenberry AJ, Shoben AB, Trapl ES, Klein EG. Cigarillo Flavor and Motivation to Quit among Co-Users of Cigarillos and Cannabis: A Structural Equation Modeling Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5727. [PMID: 35565122 PMCID: PMC9101063 DOI: 10.3390/ijerph19095727] [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] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022]
Abstract
Flavored cigar restrictions have the potential to benefit public health. Flavor availability facilitates cigarillo use, but it is unknown if flavor impacts patterns of co-use of cigarillos and cannabis, an increasingly prevalent behavior among young adults. Data were collected (2020-2021) in a cross-sectional online survey administered to a convenience sample of young adults who smoked cigarillos from 15 areas with high cigar use prevalence. We assessed the relationship between flavored cigarillo use and motivation to quit cannabis and cigarillo use among past 30-day co-users (N = 218), as well as several covariates (e.g., cigarillo price and flavor/cannabis policy). Flavored cigarillo perceived appeal and harm were hypothesized parallel mediators. Most co-users reported usually using flavored cigarillos (79.5%), which was not significantly associated with motivation to quit cigarillos or cannabis. Perceived cigarillo harm (β = 0.17, 95% CI = 0.00, 0.33), advertising exposure (β = 0.12, 95% CI = 0.00, 0.24), and income (among racial/ethnic minorities; β = -0.13, 95% CI = -0.25, -0.02) were significant predictors of motivation to quit cigarillos. There were no significant predictors of motivation to quit cannabis. Cigarillo flavor was not associated with motivation to quit, so findings could suggest that banning flavors in cigars may have a neutral impact on co-use with cannabis among young adults.
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Affiliation(s)
- Allison M. Glasser
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA; (J.M.N.); (E.G.K.)
| | - Julianna M. Nemeth
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA; (J.M.N.); (E.G.K.)
| | - Amanda J. Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA;
| | - Abigail B. Shoben
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA;
| | - Erika S. Trapl
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Elizabeth G. Klein
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA; (J.M.N.); (E.G.K.)
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9
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Zhu Y, Pasch KE, Loukas A, Sterling KL, Perry CL. Exposure to cigar Point-of-Sale marketing and use of cigars and cigarettes among young adults. Addict Behav 2021; 116:106821. [PMID: 33482429 DOI: 10.1016/j.addbeh.2021.106821] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/16/2020] [Accepted: 01/05/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Few studies examine the impact of objective exposure to point-of-sale (POS) marketing for cigars including little cigars and cigarillos (LCCs) on tobacco use. The present study aimed to examine the relationship between exposure to LCC marketing at the POS and current and future use of LCCs and cigarettes among young adult college students. METHOD Data on LCC and cigarette use from 4201 young adult students (mean age = 22.8 [SD = 2.3]; 35.9% non-Hispanic whites) attending 24 Texas colleges was linked to objective assessments of POS marketing at 220 tobacco retail outlets within one mile of the colleges. Multilevel logistic regression analyses examined the impact of LCC marketing at the POS on use of LCCs and cigarettes currently and 6-months later. RESULTS Participants were, on average, exposed to 43 LCC marketing materials per week. Results from cross-sectional analyses indicated that exposure to LCC POS marketing was associated with higher odds of current use of LCCs (AOR = 1.003, 95% CI = 1.0002, 1.0053) and cigarettes (AOR = 1.006, 95% CI = 1.0050, 1.0075). The relationship between LCC POS marketing exposure and LCC use was not significant in longitudinal models; however, exposure to LCC POS marketing at baseline did predict current cigarette use at 6-month follow-up (AOR = 1.004, 95% CI = 1.0021, 1.0052). CONCLUSION Findings suggest a substantial influence of LCC marketing exposure at the POS. Regulations on LCC marketing at the POS, especially around college campuses, should be considered.
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Affiliation(s)
- Yenan Zhu
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto D3700, Austin, TX 78712, USA
| | - Keryn E Pasch
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto D3700, Austin, TX 78712, USA.
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto D3700, Austin, TX 78712, USA
| | - Kimberle L Sterling
- School of Public Health, The University of Texas Health Science Center at Houston Dallas Campus, 6011 Harry Hines Blvd V8.112, Dallas, TX 75235, USA
| | - Cheryl L Perry
- School of Public Health, The University of Texas Health Science Center at Houston Austin Campus 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701, USA
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10
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Brooks MM, Siegel SD, Curriero FC. Characterizing the spatial relationship between smoking status and tobacco retail exposure: Implications for policy development and evaluation. Health Place 2021; 68:102530. [PMID: 33609995 PMCID: PMC7986985 DOI: 10.1016/j.healthplace.2021.102530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 11/20/2022]
Abstract
Tobacco retail density and smoking prevalence remain elevated in marginalized communities, underscoring the need for strategies to address these place-based disparities. The spatial variation of smokers and tobacco retailers is often measured by aggregating them to area-level units (e.g., census tracts), but spatial statistical methods that use point-level data, such as spatial intensity and K-functions, can better describe their geographic patterns. We applied these methods to a case study in New Castle County, DE to characterize the cross-sectional spatial relationship between tobacco retailers and smokers, finding that current smokers experience greater tobacco retail exposure and clustering relative to former smokers. We discuss how analysis at different geographic scales can provide complementary insights for tobacco control policy.
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Affiliation(s)
- Madeline M Brooks
- Value Institute, Christiana Care Health System, Newark, DE, United States.
| | - Scott D Siegel
- Value Institute, Christiana Care Health System, Newark, DE, United States; Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, Newark, DE, United States
| | - Frank C Curriero
- Johns Hopkins Spatial Science for Public Health Center, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Giovenco DP, Spillane TE, Baig SA, Dumas SE, Dongchung TY, Sanderson M, Sisti JS, Farley SM, Jasek JP, Seligson AL. Demographic and psychological moderators of the relationship between neighborhood cigarette advertising and current smoking in New York City. Health Place 2020; 66:102441. [PMID: 32947186 PMCID: PMC7686046 DOI: 10.1016/j.healthplace.2020.102441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 08/24/2020] [Accepted: 09/02/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Tobacco advertising in retailers influences smoking, but little research has examined how this relationship differs among population subgroups. This study merged data on neighborhood cigarette advertising with geocoded survey data to assess the association between advertising prevalence and current smoking among New York City (NYC) residents, and whether demographic and psychological characteristics moderate this relationship. METHODS Audit data from a stratified, random sample of 796 NYC tobacco retailers generated neighborhood prevalence estimates of cigarette advertising, which were linked with unweighted 2017 NYC Community Health Survey data (n = 7837 adult respondents with residential geocodes). Multilevel regression estimated adjusted odds ratios (aOR) of current smoking by level of neighborhood cigarette advertising (quartiles). Interactions assessed differences in this relationship by demographic characteristics and current depression (analyses conducted in 2019). RESULTS There was no main effect of advertising on smoking status or significant interactions with demographic variables, but current depression was an effect modifier (p = 0.045). Cigarette advertising was associated with current smoking among those with current depression (p = 0.023), not those without (p = 0.920). Specifically, respondents with depression who resided in neighborhoods in the highest quartile for cigarette advertising prevalence had higher odds of current smoking, compared to those living in the lowest advertising quartile [aOR: 1.72 (1.04, 2.86)]. CONCLUSION Retail cigarette advertising may serve as an environmental cue to smoke among adults with depression. Efforts to restrict or counteract this practice, such as the development of community-level public health interventions and counter-marketing programs, may particularly benefit those with depression and, perhaps, other mental health disorders.
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Affiliation(s)
- Daniel P Giovenco
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, 10032, USA.
| | - Torra E Spillane
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, 10032, USA
| | - Sabeeh A Baig
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, 10032, USA
| | - Sarah E Dumas
- Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
| | - Tenzin Yangchen Dongchung
- Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
| | - Mike Sanderson
- Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
| | - Julia S Sisti
- Bureau of Chronic Disease Prevention and Tobacco Control, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
| | - Shannon M Farley
- Bureau of Chronic Disease Prevention and Tobacco Control, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
| | - John P Jasek
- Bureau of Chronic Disease Prevention and Tobacco Control, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
| | - Amber Levanon Seligson
- Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
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12
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Weiger CV, Smith K, Hong AY, Cohen JE. Cigarette Packs With URLs Leading to Tobacco Company Websites: Content Analysis. J Med Internet Res 2020; 22:e15160. [PMID: 32459649 PMCID: PMC7312247 DOI: 10.2196/15160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 01/22/2020] [Accepted: 02/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Tobacco companies include on the packaging of their products URLs directing consumers to websites that contain protobacco messages. Online media tend to be underregulated and provide the industry with an opportunity to present users with protobacco communication. OBJECTIVE The objective of our study was to document the content of websites that were advertised on tobacco packs in 14 low- and middle-income countries. METHODS We purchased tobacco packs from 14 low- and middle-income countries in 2013 and examined them for the presence of URLs. We visited unique URLs on multiple occasions between October 1, 2016 and August 9, 2017. We developed a coding checklist and used it to conduct a content analysis of active corporate websites to identify types of protobacco communication. The coding checklist included the presence of regulatory controls and warnings, engagement strategies, marketing appeals (eg, description of product popularity, luxury/quality, taste), corporate social responsibility programs, and image management. We coded brand websites separately and also described social media and other website types. RESULTS We identified 89 unique URLs, of which 54 were active during the search period. We assessed 26 corporate websites, 21 brand websites, 2 nontobacco websites, and 5 social media pages. We excluded 2 corporate websites and 14 brand websites due to limited accessible content or incomplete content. Corporate social responsibility was discussed on all corporate websites, and marketing appeals were also common. Corporate websites were also more likely to include more nonspecific (12/24, 50%) than specific (7/24, 29%) health warnings. Promotions (6/7, 86%) and sociability appeals (3/7, 43%) were common on brand websites. The small number of social media webpages in our sample used gendered marketing. CONCLUSIONS URLs appearing on tobacco packs direct consumers to websites where users are exposed to marketing that highlights the "positive" contributions of tobacco companies on corporate websites, and extensive promotions and marketing appeals on brand websites and social media pages. It is essential that marketing regulations become more comprehensive and ban all protobacco communication, a policy that is in line with articles 5.3 and 13 of the World Health Organization Framework Convention on Tobacco Control. For countries that already ban internet tobacco advertising, enforcement efforts should be strengthened. Tobacco companies' use of URLs on packs may also be compelling for plain packaging advocacy, where all branding is removed from the pack and large graphic health warning labels are the only communication on the tobacco packaging. Future research should consider including tobacco websites in marketing surveillance.
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Affiliation(s)
- Caitlin Victoria Weiger
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Katherine Smith
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Amy Y Hong
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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13
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Peer crowd-based targeting in E-cigarette advertisements: a qualitative study to inform counter-marketing. BMC Public Health 2020; 20:32. [PMID: 31969114 PMCID: PMC6977342 DOI: 10.1186/s12889-019-8126-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 12/24/2019] [Indexed: 12/01/2022] Open
Abstract
Background Cigarette lifestyle marketing with psychographic targeting has been well documented, but few studies address non-cigarette tobacco products. This study examined how young adults respond to e-cigarette advertisements featuring diverse peer crowds – peer groups with shared identities and lifestyles – to inform tobacco counter-marketing design. Methods Fifty-nine young adult tobacco users in California participated in interviews and viewed four to five e-cigarette advertisements that featured characters from various peer crowd groups. For each participant, half of the advertisements they viewed showed characters from the same peer crowd as their own, and the other half of the advertisements featured characters from a different peer crowd. Advertisements were presented in random order. Questions probed what types of cues are noticed in the advertisements, and whether and how much participants liked or disliked the advertisements. Results Results suggest that participants liked and provided richer descriptions of characters and social situations in the advertisements featuring their own peer crowd more than the advertisements featuring a different peer crowd. Mismatching age or device type was also noted: participants reported advertisements showing older adults were not intended for them. Participants who used larger vaporizers tended to dislike cigalike advertisements even if they featured a matching peer crowd. Conclusion Peer crowd and lifestyle cues, age and device type are all salient features of e-cigarette advertising for young adults. Similarly, educational campaigns about e-cigarettes should employ peer crowd-based targeting to engage young adults, though messages should be carefully tested to ensure authentic and realistic portrayals.
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14
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Mantey DS, Pasch KE, Loukas A, Perry CL. Exposure to Point-of-Sale Marketing of Cigarettes and E-Cigarettes as Predictors of Smoking Cessation Behaviors. Nicotine Tob Res 2020; 21:212-219. [PMID: 29126126 DOI: 10.1093/ntr/ntx246] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 11/02/2017] [Indexed: 11/13/2022]
Abstract
Introduction Cue-reactivity theory suggests that smoking-related visual cues such as point-of-sale (POS) marketing (eg, advertising, product displays) may undermine cessation attempts by causing an increase in nicotine cravings among users. This study examined the relationship between recall of exposure to POS marketing and subsequent cessation behaviors among young adult cigarette smokers. Methods Participants included 813, 18-29 year old (m = 21.1, SD = 2.70), current cigarette smokers attending 24 Texas colleges. Multivariable logistic regression models examined the impact of baseline self-reported exposure to cigarette and e-cigarette advertising and product displays, on using e-cigarettes for cessation and successful cigarette cessation at 6-month follow-up. Two-way interactions between product-specific advertising and between product-specific displays were examined to determine if the marketing of one product strengthened the cue reactivity of the other. Baseline covariates included sociodemographic factors, past quit attempts, intentions to quit smoking, and nicotine dependence. Results Exposure to e-cigarette displays was associated with lower odds of cigarette smoking cessation, controlling for covariates and conventional cigarette display exposure. E-cigarette advertising was positively associated with the use of e-cigarettes for cigarette cessation among participants exposed to low (ie, at least 1 SD below the mean) levels of cigarette advertising. Cigarette advertising was associated with the use of e-cigarettes for cigarette cessation only among those exposed to low levels of e-cigarette advertising. Exposure to cigarette displays was not associated with either outcome. Conclusion Smoking-related cues at POS may undermine successful cigarette cessation. Exposure to product displays decrease odds of cessation. Advertising exposure increased odds for using e-cigarettes for cessation attempts, but may have guided smokers towards an unproven cessation aid. Implications By examining the interaction of conventional cigarette and e-cigarette marketing exposure, this study adds a unique insight into the impact of retail tobacco marketing on cigarette smoking cessation behavior among young adults. These findings suggest that policies that balance encouraging cigarette smoking cessation while limiting marketing strategies should be considered, such as POS product displays, that may undermine successful cessation attempts.
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Affiliation(s)
- Dale S Mantey
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX
| | - Keryn E Pasch
- Department of Kinesiology & Health Education, University of Texas at Austin, Austin, TX
| | - Alexandra Loukas
- Department of Kinesiology & Health Education, University of Texas at Austin, Austin, TX
| | - Cheryl L Perry
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX
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15
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Dutra LM, Nonnemaker J, Bradfield B, Taylor N, Guillory J, Feld A, Kim A. Antismoking Advertisements and Price Promotions and Their Association With the Urge to Smoke and Purchases in a Virtual Convenience Store: Randomized Experiment. J Med Internet Res 2019; 21:e14143. [PMID: 31647468 PMCID: PMC6914233 DOI: 10.2196/14143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/07/2019] [Accepted: 08/19/2019] [Indexed: 11/13/2022] Open
Abstract
Background Point of sale (POS) advertising is associated with smoking initiation, current smoking, and relapse among former smokers. Price promotion bans and antismoking advertisements (ads) are 2 possible interventions for combating POS advertising. Objective The purpose of this analysis was to determine the influence of antismoking ads and promotions on urges to smoke and tobacco purchases. Methods This analysis examined exposure to graphic (graphic images depicting physical consequences of tobacco use) and supportive (pictures of and supportive messages from former smokers) antismoking ads and promotions in a virtual convenience store as predictors of urge to smoke and buying tobacco products among 1200 current cigarette smokers and 800 recent quitters recruited via a Web-based panel (analytical n=1970). We constructed linear regression models for urge to smoke and logistic regression models for the odds of purchasing tobacco products, stratified by smoking status. Results The only significant finding was a significant negative relationship between exposure to supportive antismoking ads and urge to smoke among current smokers (beta coefficient=−5.04, 95% CI −9.85 to −0.22; P=.04). There was no significant relationship between graphic antismoking ads and urge to smoke among current smokers (coefficient=−3.77, 95% CI −8.56 to 1.02; P=.12). Neither relationship was significant for recent quitters (graphic: coefficient=−3.42, 95% CI −8.65 to 1.81; P=.15 or supportive: coefficient=−3.82, 95% CI −8.99 to 1.36; P=.20). There were no significant differences in urge to smoke by exposure to promotions for current smokers (coefficient=−1.06, 95% CI −4.53 to 2.41; P=.55) or recent quitters (coefficient=1.76, 95% CI −2.07 to 5.59; P=.37). There were also no differences in tobacco purchases by exposure to graphic (current smokers: coefficient=0.93, 95% CI 0.67 to 1.29; P=.66 and recent quitters: coefficient=0.73, 95% CI 0.44 to 1.19; P=.20) or supportive (current smokers: coefficient=1.05, 95% CI 0.75 to 1.46; P=.78 and recent quitters: coefficient=0.73, 95% CI 0.45 to 1.18; P=.20) antismoking ads or price promotions (current smokers: coefficient=1.09, 95% CI 0.86 to 1.38; P=.49 and recent quitters: coefficient=0.90, 95% CI 0.62 to 1.31; P=.60). Conclusions The results of this analysis support future research on the ability of supportive antismoking ads to reduce urges to smoke among current cigarette smokers. Research on urges to smoke has important tobacco control implications, given the relationship between urge to smoke and smoking cigarettes, time to next smoke, and amount smoked.
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Affiliation(s)
- Lauren McCarl Dutra
- Center for Health Policy Science and Tobacco Research, RTI International, Berkeley, CA, United States
| | - James Nonnemaker
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC, United States
| | - Brian Bradfield
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC, United States
| | - Nathaniel Taylor
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC, United States
| | | | - Ashley Feld
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC, United States
| | - Annice Kim
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC, United States
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16
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The Association of Physical Activity and Mortality Risk Reduction Among Smokers: Results From 1998-2009 National Health Interview Surveys-National Death Index Linkage. J Phys Act Health 2019; 16:865-871. [PMID: 31387083 DOI: 10.1123/jpah.2018-0263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 04/21/2019] [Accepted: 06/16/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND The mortality benefits of meeting the US federal guidelines for physical activity, which includes recommendations for both aerobic and muscle-strengthening activities, have never been examined among smokers. Our aim was to investigate the association between reporting to meet the guidelines and all-cause, cancer, cardiovascular disease, and respiratory disease mortality among smokers. METHODS We pooled data from the 1998-2009 National Health Interview Survey, which were linked to records in the National Death Index (n = 68,706). Hazard ratios (HR) were computed to estimate the effect of meeting the physical activity guidelines on mortality. RESULTS Smokers who reported meeting the guidelines for physical activity had 29% lower risk of all-cause mortality (HR: 0.71; 95% confidence interval [CI], 0.62-0.81), 46% lower risk of mortality from cardiovascular disease (HR: 0.54; 95% CI, 0.39-0.76), and 26% lower risk of mortality from cancer (HR: 0.74; 95% CI, 0.59-0.93), compared with those who reported meeting neither the aerobic nor the muscle-strengthening recommendations of the guidelines. Meeting the aerobic recommendation of the guidelines was associated with a 42% decline in that risk (HR: 0.58; 95% CI, 0.44-0.77). CONCLUSION Smokers who adhere to physical activity guidelines show a significant reduction in mortality.
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17
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Residential environments and smoking behaviour patterns among young adults: A prospective study using data from the Interdisciplinary Study of Inequalities in Smoking cohort. Prev Med 2019; 123:48-54. [PMID: 30844498 DOI: 10.1016/j.ypmed.2019.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 02/25/2019] [Accepted: 03/02/2019] [Indexed: 11/22/2022]
Abstract
Young adults have the highest prevalence of smoking among all age groups. Studies have shown associations between presence/density of tobacco retail and presence of smoker accommodation and smoking prevalence. However, little is known about their potential to influence different smoking patterns including initiation, maintenance, or cessation. This is important because smoking behaviour patterns in young adults may be subject to ongoing changes. Moreover, smoking pattern determinants may be different to those of smoking prevalence, and feature-pattern associations may be scale-dependent, requiring the consideration of different analytical spatial units. We examined associations between prospectively-measured smoking behaviour patterns and presence/density of tobacco retail, and presence of smoker accommodation facilities across 2 nested spatial units in Montreal, Canada. Data were from 18 to 25 year-old Montreal residents who had participated in the Interdisciplinary Study of Inequalities in Smoking cohort both at baseline in 2011-2012 and follow-up in 2014 and resided in the same area at follow-up. 2-year smoking behaviour patterns were assessed for 2 cohorts based on participants' smoking status at baseline. Associations were examined using multilevel logistic models. Young adults who were smokers at baseline residing in areas with higher local-level presence of tobacco retail were less likely to quit smoking (i.e.: to be non-smokers for fewer than 2 years). Higher presence of smoker accommodation was not associated with smoking patterns at any scale. Findings provide evidence of scale-specific associations between residential environment features and smoking behaviour patterns in young adults, which may point to specific exposure-outcome processes underlying these associations.
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18
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Giovenco DP, Spillane TE, Wong BA, Wackowski OA. Characteristics of storefront tobacco advertisements and differences by product type: A content analysis of retailers in New York City, USA. Prev Med 2019; 123:204-207. [PMID: 30930262 PMCID: PMC6534426 DOI: 10.1016/j.ypmed.2019.03.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/19/2019] [Accepted: 03/28/2019] [Indexed: 11/16/2022]
Abstract
Tobacco companies in the U.S. spend billions of dollars advertising at the point-of-sale. Using photographs of storefront tobacco ads in New York City (NYC), we conducted a content analysis to describe the prevalence of common features across four product categories and illuminate ways in which they may influence behavior. In 2017, data collectors photographed exterior ads from a representative sample of tobacco retailers in NYC (n = 796). We coded each ad (n = 976) for the presence of various characteristics (e.g., brand, price displays, warning labels, menthol/flavors, size, location). Chi-square tests examined differences by product type. Most ads were for cigarettes (40%), followed by electronic nicotine delivery systems (ENDS, 27.9%), cigars (26.9%), and smokeless tobacco (5.2%). Over half of cigarette and smokeless tobacco ads promoted a menthol or flavored style (61% each), compared to about a quarter of cigar (25.9%) and ENDS ads (30.3%, p < .0001). Cigar and ENDS ads, however, were more frequently placed directly on the door of entry (49.4% and 46.7%, respectively, p < .001). Only 5% of ENDS ads displayed a standard warning label. Notably, a quarter of all tobacco ads (23.4%) were for the brand Newport. Cigarette ads still dominate at the point-of-sale with regard to volume and size. Across all products, ad features did not always align with local and federal policies (e.g., flavor bans, warning label mandates). Continued surveillance of advertising strategies and policy compliance can help provide the evidence base needed to inform marketing regulations that reduce the deadly burden of tobacco use.
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Affiliation(s)
- Daniel P Giovenco
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722 West 168th Street, 9th Floor, New York, NY 10032, USA.
| | - Torra E Spillane
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722 West 168th Street, 9th Floor, New York, NY 10032, USA
| | - Bryce A Wong
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722 West 168th Street, 9th Floor, New York, NY 10032, USA
| | - Olivia A Wackowski
- Rutgers School of Public Health, Center for Tobacco Studies, 112 Paterson Street, New Brunswick, NJ 08901, USA
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19
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Beverage marketing in retail outlets and The Balance Calories Initiative. Prev Med 2018; 115:1-7. [PMID: 30055198 DOI: 10.1016/j.ypmed.2018.07.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/24/2018] [Accepted: 07/21/2018] [Indexed: 11/20/2022]
Abstract
We quantified the placement and promotion of beverages in groceries, supermarket and convenience stores in the communities targeted by The Balance Calories Initiative, a campaign launched by the top three American beverage companies to help Americans reduce consumption of sugar from beverages by 20% by 2025. The companies promised to drive interest in low- and no-calorie beverages through promotional efforts such as product placement, featured merchandising, couponing and other incentives, with more intensive efforts in low-income communities in communities in Alabama, Mississippi, and Southern California. We also measured two comparison communities not specifically targeted by The Balance Calories Initiative, observing 69 retail outlets in 5 localities in 2016-2017. We found that sugar-sweetened beverages (SSBs) were the most common beverage in all outlets, and the brands of the companies pledging changes in marketing strategies the most dominant. SSBs were placed in an average of 25 separate locations in groceries vs. 15 for low/no-calorie beverages and 11 for water. No differences were noted between East LA stores observed 2 years after the initiative vs. stores in the North Mississippi Delta, Montgomery or the comparison stores. Given prior evidence that exposure to point-of-sale displays influences purchases, reducing the number and location of displays of SSBs should be considered to reduce SSB consumption.
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20
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Laverty AA, Vamos EP, Millett C, Chang KCM, Filippidis FT, Hopkinson NS. Child awareness of and access to cigarettes: impacts of the point-of-sale display ban in England. Tob Control 2018; 28:526-531. [PMID: 30237314 DOI: 10.1136/tobaccocontrol-2018-054511] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/02/2018] [Accepted: 08/17/2018] [Indexed: 12/25/2022]
Abstract
INTRODUCTION England introduced a tobacco display ban for shops with >280 m2 floor area ('partial ban') in 2012, then a total ban in 2015. This study assessed whether these were linked to child awareness of and access to cigarettes. METHODS Data come from the Smoking, Drinking and Drug Use survey, an annual survey of children aged 11-15 years for 2010-2014 and 2016. Multivariate logistic regression models assessed changes in having seen cigarettes on display, usual sources and ease of access to cigarettes in shops RESULTS: During the partial display ban in 2012, 89.9% of children reported seeing cigarettes on display in the last year, which was reduced to 86.0% in 2016 after the total ban (adjusted OR 0.58, 95% CI 0.50 to 0.66). Reductions were similar in small shops (84.1% to 79.3%)%) and supermarkets (62.6% to 57.3%)%). Although the ban was associated with a reduction in the proportion of regular child smokers reporting that they bought cigarettes in shops (57.0% in 2010 to 39.8% in 2016), we did not find evidence of changes in perceived difficulty or being refused sale among those who still did. DISCUSSION Tobacco point-of-sale display bans in England reduced the exposure of children to cigarettes in shops and coincided with a decrease in buying cigarettes in shops. However, children do not report increased difficulty in obtaining cigarettes from shops, highlighting the need for additional measures to tackle tobacco advertising, stronger enforcement of existing laws and measures such as licencing for tobacco retailers.
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Affiliation(s)
- Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Eszter Panna Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Kiara C-M Chang
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Filippos T Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Nicholas S Hopkinson
- NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK
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21
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Cheung YTD, Ho SY, Wang MP, Kwong A, Lai V, Lam TH. Pro-smoking responses and attitudes due to point-of-sale tobacco displays in never smokers: A cross-sectional study in Hong Kong. Tob Induc Dis 2018; 16:32. [PMID: 31516431 PMCID: PMC6659512 DOI: 10.18332/tid/92585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/25/2018] [Accepted: 06/25/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Never smokers' responses to tobacco control policy are often overshadowed by the opposition from smokers and tobacco industry during policy advocacy and legislation. Very few studies have examined never smokers' exposure to point-of-sale (POS) tobacco displays and their effects. Therefore, we investigated the exposure, pro-smoking responses due to and attitudes towards such displays in never smokers in Hong Kong. METHODS We conducted two-stage, randomized cross-sectional telephone-based surveys in 2015 and 2016 of 1833 never-smoking adults. They were asked how often they noticed POS displays in the past 30 days (often, sometimes, never), whether they found POS displays attractive, felt encouraged to smoke, perceived POS displays as advertisements, and if they supported banning them. The distributions of the outcomes were analyzed by descriptive statistics with weighting to the general population. Risk ratios (RR) from Poisson regression models adjusted for sociodemographic characteristics were used to analyze the associations. RESULTS Our results showed that, in never smokers, the younger were more likely to often notice POS displays (RR=0.80, 95% CI: 0.72-0.89, p<0.01). Finding POS displays attractive was associated with primary (RR=2.52, 95% CI: 1.51-4.22, p<0.01) and secondary education (RR=1.68, 95% CI: 1.16- 2.44, p=0.01) versus tertiary education. Often noticing displays was associated with perceived attractiveness (RR=1.90, 95% CI: 1.32-2.75, p<0.01). The positive association between often noticing displays and being encouraged to smoke was marginally significant (RR=4.05, 95% CI: 0.98-16.85, p=0.054). Respondents who often noticed POS displays (RR=0.87, 95% CI: 0.77-0.98, p=0.02) and did not perceive them as advertisements (RR=0.70, 95% CI: 0.61-0.98, p<0.01) showed less support on banning them than those who did not notice them. CONCLUSIONS Frequent exposure to POS displays was associated with greater perceived attractiveness and lower support for banning them. A total ban on POS displays is needed to eliminate the advertising and normalization effect of POS displays.
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Affiliation(s)
| | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Antonio Kwong
- The Hong Kong Council on Smoking and Health, Hong Kong, China
| | - Vienna Lai
- The Hong Kong Council on Smoking and Health, Hong Kong, China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
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Fleischer NL, Lozano P, Wu YH, Hardin JW, Meng G, Liese AD, Fong GT, Thrasher JF. Disentangling the roles of point-of-sale ban, tobacco retailer density and proximity on cessation and relapse among a cohort of smokers: findings from ITC Canada Survey. Tob Control 2018. [PMID: 29519935 DOI: 10.1136/tobaccocontrol-2017-054081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine how point-of-sale (POS) display bans, tobacco retailer density and tobacco retailer proximity were associated with smoking cessation and relapse in a cohort of smokers in Canada, where provincial POS bans were implemented differentially over time from 2004 to 2010. METHODS Data from the 2005 to 2011 administrations of the International Tobacco Control (ITC) Canada Survey, a nationally representative cohort of adult smokers, were linked via residential geocoding with tobacco retailer data to derive for each smoker a measure of retailer density and proximity. An indicator variable identified whether the smoker's province banned POS displays at the time of the interview. Outcomes included cessation for at least 1 month at follow-up among smokers from the previous wave and relapse at follow-up among smokers who had quit at the previous wave. Logistic generalised estimating equation models were used to determine the relationship between living in a province with a POS display ban, tobacco retailer density and tobacco retailer proximity with cessation (n=4388) and relapse (n=866). RESULTS Provincial POS display bans were not associated with cessation. In adjusted models, POS display bans were associated with lower odds of relapse which strengthened after adjusting for retailer density and proximity, although results were not statistically significant (OR 0.66, 95% CI 0.41 to 1.07, p=0.089). Neither tobacco retailer density nor proximity was associated with cessation or relapse. CONCLUSIONS Banning POS retail displays shows promise as an additional tool to prevent relapse, although these results need to be confirmed in larger longitudinal studies.
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Affiliation(s)
- Nancy L Fleischer
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Paula Lozano
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Yun-Hsuan Wu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - James W Hardin
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Gang Meng
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada.,School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.,Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
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23
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Rose SW, Mayo A, Ganz O, Perreras L, D'Silva J, Cohn A. Perceived racial/ethnic discrimination, marketing, and substance use among young adults. J Ethn Subst Abuse 2018; 18:558-577. [PMID: 29424638 DOI: 10.1080/15332640.2018.1425949] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Perceived experiences of discrimination have been linked to negative health behaviors including tobacco, alcohol, and marijuana use across various racial/ethnic groups. Tobacco and alcohol marketing exposure have also been linked with substance use. This study examined the independent and interacting effects of perceived experiences of discrimination and exposure to alcohol and tobacco marketing, and receptivity to marijuana marketing on substance use in an online survey of a multiethnic sample of young adults in 6 metropolitan areas (n = 505). African Americans (mean (M) = 1.96, 9% 5CI [1.84, 2.09]) and Hispanics (M = 1.98, 95% CI [1.87, 2.09]) reported higher levels of perceived discrimination than Whites (M = 1.52, 95% CI [1.40, 1.64]), p < .001. African Americans had higher levels of exposure to tobacco and alcohol marketing; Hispanics reported higher levels of exposure to alcohol marketing and receptivity to marijuana promotion. Discrimination and marketing exposure were independently associated with higher odds of all 3 outcomes, controlling for covariates (AOR from 2.1 to 3.4 for discrimination; AOR from 1.4 to 13.8 for marketing). Models showed a significant interaction of discrimination and tobacco marketing on past 30-day cigarette use (F = 5.5; p = .02). Individuals with high levels of tobacco marketing exposure were likely to report high past 30-day cigarette use regardless of level of discrimination, while those with low exposure were only at increased risk of reporting cigarette use at higher levels of discrimination. Both perceived discrimination and marketing exposure play a role in substance use. Interventions should consider discrimination as a significant risk factor underlying vulnerability to substance use among young adults.
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Affiliation(s)
| | - Ashley Mayo
- Truth Initiative Schroeder Institute , Washington , DC
| | - Ollie Ganz
- Truth Initiative Schroeder Institute , Washington , DC.,George Washington University Milken Institute School of Public Health , Washington , DC
| | | | - Joanne D'Silva
- Truth Initiative Schroeder Institute , Washington , DC.,University of Maryland School of Public Health , College Park , Maryland
| | - Amy Cohn
- Battelle Memorial Institute , Arlington , Virginia.,Georgetown University Medical Center , Washington , DC
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24
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Kahnert S, Demjén T, Tountas Y, Trofor AC, Przewoźniak K, Zatoński WA, Fernández E, McNeill A, Willemsen M, Kyriakos CN, Fong GT, Vardavas CI, Mons U. Extent and correlates of self-reported exposure to tobacco advertising, promotion, and sponsorship in smokers: Findings from the EUREST-PLUS ITC Europe Surveys. Tob Induc Dis 2018; 16:A7. [PMID: 31105981 PMCID: PMC6519076 DOI: 10.18332/tid/94828] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/01/2018] [Accepted: 09/03/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Tobacco advertising, promotion, and sponsorship (TAPS) are known to promote tobacco consumption and to discourage smoking cessation. Consequently, comprehensive TAPS bans are effective measures to reduce smoking. The objective of this study was to investigate to what extent smokers are exposed to TAPS in general, and in various media and localities, in different European countries. METHODS A Cross-sectional analysis of national representative samples of adult smokers in 2016 from Germany, Greece, Hungary, Poland, Romania, and Spain (EUREST-PLUS Project, n=6,011), as well as England (n=3,503) and the Netherlands (n=1,213) (ITC Europe Surveys) was conducted. Prevalence of self-reported TAPS exposure is reported by country, and socio-economic correlates were investigated using logistic regression models. RESULTS Self-reported exposure to TAPS varied widely among the countries, from 15.4 % in Hungary to 69.2 % in the Netherlands. In most countries, tobacco advertising was most commonly seen at the point of sale, and rarely noticed in mass media. The multivariate analysis revealed some variation in exposure to TAPS by sociodemographic factors. Age showed the greatest consistency across countries with younger smokers (18-24-year-olds) being more likely to notice TAPS than older smokers. CONCLUSIONS TAPS exposure tended to be higher in countries with less restrictive regulation but was also reported in countries with more comprehensive bans, although at lower levels. The findings indicate the need for a comprehensive ban on TAPS to avoid a shift of marketing efforts to less regulated channels, and for stronger enforcement of existing bans.
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Affiliation(s)
- Sarah Kahnert
- Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Tibor Demjén
- Smoking or Health Hungarian Foundation (SHHF), Budapest, Hungary
| | - Yannis Tountas
- National and Kapodistrian University of Athens (UoA), Athens, Greece
| | - Antigona C. Trofor
- University of Medicine and Pharmacy “Grigore T. Popa” Iasi, Iasi, Romania
- Aer Pur Romania, Bucharest, Romania
| | - Krzysztof Przewoźniak
- Health Promotion Foundation (HPF), Warsaw, Poland
- Oncology Center, Maria Sklodowska-Curie Institute, Warsaw, Poland
| | - Witold A. Zatoński
- Health Promotion Foundation (HPF), Warsaw, Poland
- European Observatory of Health Inequalities, President Stanisław Wojciechowski State University of Applied Sciences, Kalisz, Poland
| | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), Catalonia, Spain
- Cancer Control and Prevention Group, Bellvitge Biomedical Research Institute (IDIBELL), Catalonia, Spain
| | - Ann McNeill
- King’s College London (KCL), London, United Kingdom
| | - Marc Willemsen
- Maastricht University, Maastricht, the Netherlands
- Netherlands Expertise Center for Tobacco Control (Trimbos Institute), Utrecht, the Netherlands
| | - Christina N. Kyriakos
- European Network for Smoking and Tobacco Prevention (ENSP), Brussels, Belgium
- University of Crete (UoC), Heraklion, Greece
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo (UW), Waterloo, Canada
- School of Public Health and Health Systems, University of Waterloo (UW), Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, Canada
| | - Constantine I. Vardavas
- European Network for Smoking and Tobacco Prevention (ENSP), Brussels, Belgium
- University of Crete (UoC), Heraklion, Greece
| | - Ute Mons
- Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany
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25
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Siahpush M, Tibbits M, Soliman GA, Grimm B, Shaikh RA, McCarthy M, Wan N, Ramos AK, Correa A. Neighbourhood exposure to point-of-sale price promotions for cigarettes is associated with financial stress among smokers: results from a population-based study. Tob Control 2017; 26:703-708. [PMID: 28119499 PMCID: PMC5577380 DOI: 10.1136/tobaccocontrol-2016-053339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 12/21/2016] [Accepted: 12/29/2016] [Indexed: 11/04/2022]
Abstract
AIM To examine the association between neighbourhood exposure to point-of-sale (POS) cigarette price promotions and financial stress among smokers in a Midwestern metropolitan area in the USA. METHODS Survey data from 888 smokers provided information on sociodemographic and smoking related variables. Financial stress was measured with the question: 'In the last six months, because of lack of money, was there a time when you were unable to buy food or pay any important bills on time, such as electricity, telephone, credit card, rent or your mortgage? (Yes/No).' Using audit data from 504 tobacco retailers, we estimated a score of POS price promotions for each respondent by summing the different types of promotion in each store in their neighbourhood, as defined by a 1-km roadway buffer. RESULTS Adjusted results provided strong support for an association between higher scores of neighbourhood POS cigarette price promotions and a higher probability of financial stress (p=0.007). CONCLUSION Exposure to POS cigarette price promotions is associated with financial stress. This finding, coupled with previous reports that smokers with financial stress are less likely to attempt to quit or succeed in quitting smoking, suggests that POS cigarette price promotions may act as an impediment to smoking cessation.
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Affiliation(s)
- Mohammad Siahpush
- Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Melissa Tibbits
- Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Ghada A Soliman
- Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Brandon Grimm
- Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Raees A Shaikh
- Oklahoma Tobacco Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Molly McCarthy
- Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Neng Wan
- Department of Geography, University of Utah, Salt Lake City, Utah, USA
| | - Athena K Ramos
- Center for Reducing Health Disparities, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Antonia Correa
- Center for Reducing Health Disparities, University of Nebraska Medical Center, Omaha, Nebraska, USA
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26
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Bayly M, Scollo M, White S, Lindorff K, Wakefield M. Tobacco price boards as a promotional strategy-a longitudinal observational study in Australian retailers. Tob Control 2017; 27:427-433. [PMID: 28735275 DOI: 10.1136/tobaccocontrol-2017-053753] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/24/2017] [Accepted: 05/30/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND Price boards in tobacco retailers are one of the few forms of tobacco promotion remaining in Australia. This study aimed to examine how these boards were used to promote products over a period of rapidly rising taxes. METHODS Observations were made in a panel of 350 stores in Melbourne, Australia, in November of 2013 (just before) and in 2014 and 2015 (after 12.5% increases in tobacco duty). Fieldworkers unobtrusively noted the presence and characteristics of price boards, and the brand name, size and price of the product at the top of each board. RESULTS Price boards were common in all store types apart from newsagent/lottery agents. The characteristics of the top-listed product changed notably over time: premium brands accounted for 66% of top-listed products in 2013, significantly declining to 43% in 2015, while packs of 20 cigarettes increased in prominence from 32% to 45%. The prevalence of packs of 20 cigarettes in budget market segments tripled from 2013 (13%) and 2014 (11%) to 32% in 2015, with no change in the proportion of packs that were under $A20 from 2014 (37%) to 2015 (36%). The rate of increase in the average price of the top-listed pack correspondingly flattened from 2014 to 2015 compared with 2013-2014. CONCLUSIONS Price boards promote tobacco products in ways that undermine the effectiveness of tax policy as a means of discouraging consumption. Communication to consumers about prices should be restricted to information sheets provided to adult smokers on request at the point of sale.
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Affiliation(s)
- Megan Bayly
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia
| | - Michelle Scollo
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia
| | - Sarah White
- Quit Victoria, Cancer Council Victoria, Melbourne, Australia
| | - Kylie Lindorff
- Quit Victoria, Cancer Council Victoria, Melbourne, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia
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27
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Henriksen L, Mahoney M. Tobacco industry's T.O.T.A.L. interference. Tob Control 2017; 27:234-236. [PMID: 28274990 DOI: 10.1136/tobaccocontrol-2016-053530] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/27/2017] [Accepted: 02/03/2017] [Indexed: 11/03/2022]
Affiliation(s)
- Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California, USA
| | - Maggie Mahoney
- Public Health Law Center, Tobacco Control Legal Consortium, St. Paul, Minnesota, USA
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28
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Siahpush M, Farazi PA, Kim J, Michaud TL, Yoder AM, Soliman G, Tibbits MK, Nguyen MN, Shaikh RA. Social Disparities in Exposure to Point-of-Sale Cigarette Marketing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1263. [PMID: 28009807 PMCID: PMC5201404 DOI: 10.3390/ijerph13121263] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 12/15/2016] [Accepted: 12/15/2016] [Indexed: 11/16/2022]
Abstract
While most ecological studies have shown that higher levels of point-of-sale (POS) cigarette marketing are associated with larger proportions of residents from lower socioeconomic and minority backgrounds in neighborhoods, there are no studies that examine individual-level social disparities in exposure to POS cigarette marketing among smokers in the United States. Our aim was to examine these disparities in a Midwestern metropolitan area in the United States. We conducted a telephone survey to collect data on 999 smokers. Cigarette marketing was measured by asking respondents three questions about noticing advertisements, promotions, and displays of cigarettes within their respective neighborhoods. The questions were combined to create a summated scale. We estimated ordered logistic regression models to examine the association of sociodemographic variables with exposure to POS cigarette marketing. Adjusted results showed that having a lower income (p < 0.003) and belonging to a race/ethnicity other than "non-Hispanic White" (p = 0.011) were associated with higher levels of exposure to POS cigarette marketing. The results highlight social disparities in exposure to POS cigarette marketing in the United States, which can potentially be eliminated by banning all forms of cigarette marketing.
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Affiliation(s)
- Mohammad Siahpush
- College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Paraskevi A Farazi
- College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Jungyoon Kim
- College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Tzeyu L Michaud
- College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Aaron M Yoder
- College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Ghada Soliman
- College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Melissa K Tibbits
- College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Minh N Nguyen
- College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Raees A Shaikh
- College of Public Health, University of Oklahoma Health Sciences Center, 801 N.E. 13th Street, Oklahoma City, OK 73104, USA.
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