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Akter S, Rahman MM, Rouyard T, Aktar S, Nsashiyi RS, Nakamura R. A systematic review and network meta-analysis of population-level interventions to tackle smoking behaviour. Nat Hum Behav 2024:10.1038/s41562-024-02002-7. [PMID: 39375543 DOI: 10.1038/s41562-024-02002-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/04/2024] [Indexed: 10/09/2024]
Abstract
This preregistered systematic review and meta-analysis (PROSPERO: CRD 42022311392) aimed to synthesize the effectiveness of all available population-level tobacco policies on smoking behaviour. Our search across 5 databases and leading organizational websites resulted in 9,925 records, with 476 studies meeting our inclusion criteria. In our narrative summary and both pairwise and network meta-analyses, we identified anti-smoking campaigns, health warnings and tax increases as the most effective tobacco policies for promoting smoking cessation. Flavour bans and free/discounted nicotine replacement therapy also showed statistically significant positive effects on quit rates. The network meta-analysis results further indicated that smoking bans, anti-tobacco campaigns and tax increases effectively reduced smoking prevalence. In addition, flavour bans significantly reduced e-cigarette consumption. Both the narrative summary and the meta-analyses revealed that smoking bans, tax increases and anti-tobacco campaigns were associated with reductions in tobacco consumption and sales. On the basis of the available evidence, anti-tobacco campaigns, smoking bans, health warnings and tax increases are probably the most effective policies for curbing smoking behaviour.
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Grants
- Health and Labour Sciences Research Grant 20FA1022 Ministry of Health, Labour and Welfare (Ministry of Health, Labour and Welfare, Japan)
- Health and Labour Sciences Research Grant 20FA1022 Ministry of Health, Labour and Welfare (Ministry of Health, Labour and Welfare, Japan)
- Health and Labour Sciences Research Grant 20FA1022 Ministry of Health, Labour and Welfare (Ministry of Health, Labour and Welfare, Japan)
- Health and Labour Sciences Research Grant 20FA1022 Ministry of Health, Labour and Welfare (Ministry of Health, Labour and Welfare, Japan)
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Affiliation(s)
- Shamima Akter
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Md Mizanur Rahman
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Thomas Rouyard
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
- Graduate School of Public Health & Health Policy, City University of New York, New York, NY, USA
| | - Sarmin Aktar
- Global Public Health Research Foundation, Dhaka, Bangladesh
| | | | - Ryota Nakamura
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan.
- Graduate School of Economics, Hitotsubashi University, Tokyo, Japan.
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2
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Reed D, Dangerfield T, Robinson R, Ray K, Danberry K, Tieman K. Breaking chains of tobacco: empowering African American churches in West Virginia for a healthier future. Front Public Health 2024; 12:1472654. [PMID: 39363979 PMCID: PMC11448452 DOI: 10.3389/fpubh.2024.1472654] [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: 07/29/2024] [Accepted: 09/09/2024] [Indexed: 10/05/2024] Open
Abstract
Across West Virginia, tobacco use continues to be a significant public health challenge. Specifically, tobacco use is linked to high poverty across the state and disproportionately affects African Americans. A faith-based tobacco prevention network was formed to address these concerns and increase education and cessation. The West Virginia African American Tobacco Prevention Network (WVAATPN) was formed in 2021 and since then has expanded its reach across the state, involving 22 congregations. The Network's model includes annual training for lay leaders on various tobacco-related topics, tailored educational curriculum for congregations, and collaboration with national experts to enhance program efficacy. The Network has run educational and cessation workshops and promoted events such as No Menthol Sunday. Workshops have yielded positive outcomes among participants, including increased awareness of tobacco marketing tactics, higher cessation rates, and improved understanding of the health impacts of tobacco. The WVAATPN continues to expand its reach and effectiveness by advocating for policy change, enhancing community engagement, and fostering partnerships to combat tobacco-related disparities in West Virginia's African American communities.
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Affiliation(s)
- Donald Reed
- School of Health Sciences, Public and Community Health, Liberty University, Lynchburg, VA, United States
| | - Truman Dangerfield
- Marriott School of Business (Student), Brigham Young University, Provo, UT, United States
| | - Rhonda Robinson
- West Virginia African American Tobacco Prevention Network, Beckley, WV, United States
| | - Kenneth Ray
- Center for Black Health and Equity, Atlanta, GA, United States
| | - Kathy Danberry
- West Virginia Division of Tobacco Prevention, Charleston, WV, United States
| | - Kim Tieman
- Claude Worthington Benedum Foundation, Pittsburgh, PA, United States
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Geboers C, Candel MJJM, Nagelhout GE, van den Putte B, Willemsen MC. Tax increases as an incentive to quit smoking: is thinking about quitting due to a tobacco tax increase associated with post-tax increase smoking cessation? BMC Public Health 2024; 24:1993. [PMID: 39054542 PMCID: PMC11270949 DOI: 10.1186/s12889-024-19530-6] [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: 12/05/2023] [Accepted: 07/18/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND The cost of tobacco is one of the most reported reasons to quit smoking. The Netherlands increased tobacco taxes twice in the span of nine months: a €1 increase per pack in April 2020, and a €0.12 increase per pack in January 2021. This study examines to what extent people report to think about quitting due to the upcoming tax increase(s), as well as how it relates to their age, income or educational level. Additionally, we examined whether thinking about quitting was associated with quit intention and quit behaviour, and whether these associations were different for the two tax increases. METHODS Longitudinal data from the International Tobacco Control (ITC) Netherlands Surveys, Cohort 2 were used (N = 5919 observations; wave 1 (February - March 2020): n = 2051; wave 2 (September - November 2020): n = 1919; wave 3 (June - July 2021): n = 1949). Generalised Estimating Equation (GEE) regressions were fit to test the associations between thinking about quitting due to the tax increase and post-tax increases in quit intention, serious quit attempts, and quitting smoking (≤ 1 cigarette a month), as well as sociodemographic variables. RESULTS Circa half of the people who smoke reported thinking about quitting smoking due to the upcoming tax increase (Wave 1 = 51.3% (n = 1052); Wave 2 = 47.3% (n = 849)). Individuals who reported thinking about quitting smoking due to upcoming tax increase(s) were more likely to have increased their quit intention (aOR: 2.00, p ≤ .001) or have carried out a serious quit attempt (aOR:1.48, p ≤ .001) post-tax increase. More people attempted to quit smoking between wave 2 and 3 (post 2021 increase) than between wave 1 and 2 (post 2020 increase). We did not find an interaction effect between wave and thinking about quitting for quit intention, quit attempts, and quitting smoking. CONCLUSIONS Tax increases stimulate people to think about quitting. Thinking about quitting due to an upcoming tax increase was associated with more positive quit intention and serious quit attempts.
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Affiliation(s)
- Cloé Geboers
- Department of Health Promotion (CAPHRI), Maastricht University, P. Debyeplein 1, 6221 HA, Maastricht, The Netherlands.
- The Netherlands Expertise Centre for Tobacco Control, Trimbos Institute, Utrecht, the Netherlands.
| | - Math J J M Candel
- Department of Methodology and Statistics (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Gera E Nagelhout
- Department of Health Promotion (CAPHRI), Maastricht University, P. Debyeplein 1, 6221 HA, Maastricht, The Netherlands
- Centre of Expertise Perspective in Health, Avans University of Applied Sciences, Breda, the Netherlands
| | - Bas van den Putte
- Department of Communication (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - Marc C Willemsen
- Department of Health Promotion (CAPHRI), Maastricht University, P. Debyeplein 1, 6221 HA, Maastricht, The Netherlands
- The Netherlands Expertise Centre for Tobacco Control, Trimbos Institute, Utrecht, the Netherlands
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Kalousova L, Xie Y, Levy D, Meza R, Thrasher JF, Elliott MR, Titus AR, Fleischer NL. Cigarette Prices and Disparities in Smoking Cessation in the United States. Nicotine Tob Res 2024; 26:1089-1096. [PMID: 38127643 PMCID: PMC11260891 DOI: 10.1093/ntr/ntad254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 11/30/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Achieving cessation in people with established smoking patterns remains a challenge. Increasing cigarette prices has been one of the most successful strategies for lowering smoking rates. The extent to which it has remained effective in encouraging cessation among adults in recent years and how the effectiveness has varied by sociodemographic characteristics is unclear. AIMS AND METHODS Using repeated cross-sectional data collected by the Tobacco Use Supplement of the Current Population Survey, we investigate the relationship between cigarette prices and cessation from 2003 to 2019 in adults at least 25 years old. We examine the associations between price and cessation in the population overall and by sex, race and ethnicity, and socioeconomic status. RESULTS We found mixed support for associations between greater local prices and cessation. Unadjusted models showed that greater local prices were associated with greater odds of cessation, but the associations did not persist after controlling for sociodemographic characteristics. The associations did not significantly differ by respondent characteristics. Sensitivity analysis using alternative specifications and retail state price as the main predictor showed similar results. Sensitivity analysis with controls for e-cigarette use in the 2014-2019 period showed that greater local price was associated with cessation among adults with less than a high school degree. When stratified by year of data collection, results show that greater local prices were associated with cessation after 2009. CONCLUSIONS Overall, the study adds to the conflicting evidence on the effectiveness of increasing prices on smoking cessation among adults with established smoking patterns. IMPLICATIONS Higher cigarette prices have been one of the most successful tools for lowering smoking prevalence. It remains unclear how effective they have been in recent years in encouraging adults with established smoking patterns to quit. The study's results show that greater local prices were associated with higher odds of cessation, but the association did not persist after sociodemographic adjustment. In a sensitivity analysis, greater local price was associated with cessation among people with less than a high school degree in models controlling for e-cigarette use. We also found evidence that greater local price was associated with cessation after 2009. More comprehensive smoke-free coverage was also associated with greater odds of cessation. The study's results highlight that encouraging cessation among adults with an established smoking pattern remains a challenging policy problem even when cigarette prices rise.
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Affiliation(s)
- Lucie Kalousova
- Department of Medicine, Health, and Society, Vanderbilt University, Nashville, TN, USA
- Department of Sociology, Vanderbilt University, Nashville, TN, USA
| | - Yanmei Xie
- Epidemiology Department, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - David Levy
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Rafael Meza
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Michael R Elliott
- Biostatistics Department, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Andrea R Titus
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Nancy L Fleischer
- Epidemiology Department, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Gunasekaran K, Singh P, Ng DX, Koh EYL, Lee HY, Tan R, Wang Y, Tan NC. Youths' awareness and attitudes towards raising the minimum legal age of smoking and passive smoking in Singapore. Front Public Health 2024; 12:1359929. [PMID: 39056076 PMCID: PMC11271020 DOI: 10.3389/fpubh.2024.1359929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 06/06/2024] [Indexed: 07/28/2024] Open
Abstract
Objectives Early smoking initiation has been associated with a higher risk of developing long-term smoking habit. There is a growing global consensus that demands raising the minimum legal age (MLA) for smoking as an approach to address this problem. Singapore successfully raised the MLA from 18 to 21 years in 2021. This study aimed to evaluate the awareness and attitude of multi-ethnic Asian youth (aged 15-24) on raising MLA to 21 and passive smoking. Methods A cross-sectional survey comprising of 23 items was circulated via a secure internet-based platform, FORMSG between September and November 2022. Data were analyzed for descriptive statistics. Categorical variables were compared for association with receptivity toward change in MLA using Chi-Squared test and multivariable logistic regression analysis using Rstudio. Post-hoc Bonferroni correction were further utilized for pairwise comparison. Results Majority (80.3%) of the 608 participants expressed their support for MLA 21 implementation. Participants' age was a significant variable as those aged 15-17 years old (OR = 2.1, 95%CI = 1.01-4.32, p = 0.048) showed a higher likelihood of supporting MLA implementation compared to those aged 21 and above. In addition, majority (89.8%) of them were also aware of the harmful effects of passive smoking. When it came to discouraging smoking among youth, family influence (64%) and school education (55.6%) emerged as the top strategies. Conclusion Most of the youth express strong support for raising the MLA to 21, with over 80% in favor of such change, reflects a significant harmony among youth in favor of tobacco-free environment.
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Affiliation(s)
| | - Prashwin Singh
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ding Xuan Ng
- Department of Research, SingHealth Polyclinics, Singapore, Singapore
| | | | | | - Rei Tan
- Hwa Chong Institution, Singapore, Singapore
| | - Yier Wang
- Hwa Chong Institution, Singapore, Singapore
| | - Ngiap Chuan Tan
- Department of Research, SingHealth Polyclinics, Singapore, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Program, Singapore, Singapore
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Burton R, Sharpe C, Bhuptani S, Jecks M, Henn C, Pearce-Smith N, Knight S, Regan M, Sheron N. The relationship between the price and demand of alcohol, tobacco, unhealthy food, sugar-sweetened beverages, and gambling: an umbrella review of systematic reviews. BMC Public Health 2024; 24:1286. [PMID: 38730332 PMCID: PMC11088175 DOI: 10.1186/s12889-024-18599-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND The WHO highlight alcohol, tobacco, unhealthy food, and sugar-sweetened beverage (SSB) taxes as one of the most effective policies for preventing and reducing the burden of non-communicable diseases. This umbrella review aimed to identify and summarise evidence from systematic reviews that report the relationship between price and demand or price and disease/death for alcohol, tobacco, unhealthy food, and SSBs. Given the recent recognition as gambling as a public health problem, we also included gambling. METHODS The protocol for this umbrella review was pre-registered (PROSPERO CRD42023447429). Seven electronic databases were searched between 2000-2023. Eligible systematic reviews were those published in any country, including adults or children, and which quantitatively examined the relationship between alcohol, tobacco, gambling, unhealthy food, or SSB price/tax and demand (sales/consumption) or disease/death. Two researchers undertook screening, eligibility, data extraction, and risk of bias assessment using the ROBIS tool. RESULTS We identified 50 reviews from 5,185 records, of which 31 reported on unhealthy food or SSBs, nine reported on tobacco, nine on alcohol, and one on multiple outcomes (alcohol, tobacco, unhealthy food, and SSBs). We did not identify any reviews on gambling. Higher prices were consistently associated with lower demand, notwithstanding variation in the size of effect across commodities or populations. Reductions in demand were large enough to be considered meaningful for policy. CONCLUSIONS Increases in the price of alcohol, tobacco, unhealthy food, and SSBs are consistently associated with decreases in demand. Moreover, increasing taxes can be expected to increase tax revenue. There may be potential in joining up approaches to taxation across the harm-causing commodities.
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Affiliation(s)
- Robyn Burton
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England.
- Institute for Social Marketing and Health UK, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
| | - Casey Sharpe
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Saloni Bhuptani
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Mike Jecks
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Clive Henn
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Nicola Pearce-Smith
- UK Health Security Agency (UKHSA), 10 South Colonnade, Canary Wharf, London, England
| | - Sandy Knight
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Marguerite Regan
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Nick Sheron
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
- The Roger Williams Institute of Hepatology, Kings College London, London, England
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Antinozzi M, Caminada S, Amendola M, Cammalleri V, Dorelli B, Giffi M, Giordano F, Marani A, Pocino RN, Renzi D, Sindoni A, Cattaruzza MS. Perceptions of Tobacco Price Policy among Students from Sapienza University of Rome: Can This Policy Mitigate Smoking Addiction and Its Health Impacts? Healthcare (Basel) 2024; 12:944. [PMID: 38727502 PMCID: PMC11083090 DOI: 10.3390/healthcare12090944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Tobacco use is one of the main risk factors for non-communicable diseases. Avoiding youth initiation and treating addiction are fundamental public health issues to ensure better health. Among tobacco control policies, increasing tobacco price is the single most effective intervention. It reduces tobacco consumption, especially among youths, while representing a government financing source. This study aimed to assess the agreement with the proposal of a one-euro increase in tobacco price earmarked to health issues among students at Sapienza University. Two convenience samples were surveyed, five years apart, on World No Tobacco Days. Smoking habits, agreement with the proposal and reasons for it were collected. Results from the 208 questionnaires (107 in 2014, 101 in 2019) showed 46.6% of agreement with the proposal (53.3% in 2014, 39.2% in 2019, p = 0.044). Main predictive factor for agreement was being a non-smoker (OR = 6.33 p < 0.001), main reason (64.8%) was it could trigger smokers to quit or reduce consumption. Several factors might have influenced this finding, including the introduction of novel tobacco products and their increased advertisement on social media. In 2024, European Union is planning to update the Tobacco Taxation Directive which could greatly contribute to the reduction of non-communicable diseases and premature deaths.
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Affiliation(s)
- Martina Antinozzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (S.C.); (V.C.); (B.D.); (M.G.); (R.N.P.); (A.S.); (M.S.C.)
| | - Susanna Caminada
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (S.C.); (V.C.); (B.D.); (M.G.); (R.N.P.); (A.S.); (M.S.C.)
| | | | - Vittoria Cammalleri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (S.C.); (V.C.); (B.D.); (M.G.); (R.N.P.); (A.S.); (M.S.C.)
| | - Barbara Dorelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (S.C.); (V.C.); (B.D.); (M.G.); (R.N.P.); (A.S.); (M.S.C.)
| | - Monica Giffi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (S.C.); (V.C.); (B.D.); (M.G.); (R.N.P.); (A.S.); (M.S.C.)
| | - Felice Giordano
- National Institute of Health (Istituto Superiore di Sanità), 00162 Roma, Italy;
| | - Alessandra Marani
- Lazzaro Spallanzani National Institute for Infectious Diseases, 00149 Roma, Italy;
| | - Roberta Noemi Pocino
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (S.C.); (V.C.); (B.D.); (M.G.); (R.N.P.); (A.S.); (M.S.C.)
| | - Davide Renzi
- District 1, Local Health Unit Roma 1, 00185 Rome, Italy;
| | - Alessandro Sindoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (S.C.); (V.C.); (B.D.); (M.G.); (R.N.P.); (A.S.); (M.S.C.)
| | - Maria Sofia Cattaruzza
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (S.C.); (V.C.); (B.D.); (M.G.); (R.N.P.); (A.S.); (M.S.C.)
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8
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Mena AC, Paraje G. Tobacco price elasticity by socioeconomic characteristics in Ecuador. PLoS One 2024; 19:e0302293. [PMID: 38640122 PMCID: PMC11029633 DOI: 10.1371/journal.pone.0302293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/01/2024] [Indexed: 04/21/2024] Open
Abstract
Smoking is a worldwide epidemic and increased prices are one of the most cost-effective measures to reduce tobacco consumption. This article aims to estimate the price and income elasticity of cigarettes for different population groups in Ecuador. The National Survey of Urban and Rural Household Income and Expenditures (ENIGHUR) 2011-2012 was used, which has information on household cigarette consumption and its sociodemographic characteristics. Deaton's Almost Ideal Demand System, which decouples the effect of quality on the price of the good, was applied. The elasticities were calculated for several groups: urban/rural, income levels (tertiles), education level, sex and age ranges of the household head, and frequency of cigarette purchases in households. The estimated price elasticity nationwide is -0.89 and the income elasticity is 0.41, both statistically significant. Households headed by women (-2.22) are more sensitive to an increase in cigarette prices than those headed by men (-0.65) and households headed by people between 20 and 40 years of age (-2.32) have a higher price elasticity compared to country-level estimations. Differences within other groups are not statistically significant.
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Affiliation(s)
- Ana Cristina Mena
- Business School, Universidad de Las Américas, Escuela de Negocios, Quito, Ecuador
| | - Guillermo Paraje
- Business School, Universidad Adolfo Ibanez, Santiago de Chile, Chile
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9
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Ngo A, Drope J, Guerrero-López CM, Siu E, Chaloupka FJ. As countries improve their cigarette tax policy, cigarette consumption declines. Tob Control 2024; 33:e91-e96. [PMID: 36539293 PMCID: PMC10958272 DOI: 10.1136/tc-2022-057486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study examines the association between the Tobacconomics cigarette tax scores and cigarette consumption in 97 countries during the period of 2014-2020. METHODS Data on countries' retail cigarette sales and overall cigarette tax scores from 2014 to 2020 are drawn from the proprietary Euromonitor International database and the Tobacconomics Cigarette Tax Scorecard (second edition). Information on countries' tobacco control environments and demographic characteristics is from the relevant years' WHO Report on the Global Tobacco Epidemic, and the World Bank's World Development Indicators database. Ordinary least squares regressions are employed to examine the link between countries' overall cigarette tax scores and cigarette consumption. All regressions control for countries' tobacco control environments, countries' demographic characteristics, year indicators and country fixed effects. RESULTS Each unit increase in the overall cigarette tax scores is significantly associated with a reduction of 9% in countries' per-capita cigarette consumption during 2014-2020. The reduction is more pronounced in low and middle-income countries (9%) than in high-income countries (6%). The modest improvement in scores from 2014 to 2020 is associated with a reduction of 3.27% in consumption, while consumption could have been reduced by 20.74% had countries implemented optimal tax policies that would earn the highest score of 5. CONCLUSIONS Our results provide evidence on the association between higher cigarette tax scores and lower cigarette consumption. To reduce tobacco consumption, governments must strive to implement all four components in the Cigarette Tax Scorecard at the highest level.
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Affiliation(s)
- Anh Ngo
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, Illinois, USA
| | - Jeffrey Drope
- Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | | | - Erika Siu
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, Illinois, USA
| | - Frank J Chaloupka
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, Illinois, USA
- Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
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10
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Reiter A, Hébert-Losier A, Mylocopos G, Filion KB, Windle SB, O'Loughlin JL, Grad R, Eisenberg MJ. Regulatory Strategies for Preventing and Reducing Nicotine Vaping Among Youth: A Systematic Review. Am J Prev Med 2024; 66:169-181. [PMID: 37553038 DOI: 10.1016/j.amepre.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 08/01/2023] [Accepted: 08/01/2023] [Indexed: 08/10/2023]
Abstract
INTRODUCTION Many jurisdictions have implemented different regulatory strategies to reduce vaping among youth. The objective of this systematic review is to synthesize the evidence of the effectiveness of different regulatory strategies for preventing and reducing nicotine vaping among youth. METHODS Five electronic databases were searched from January 1, 2004 to July 17, 2022 for primary studies examining state/provincial or national regulations targeting vaping among youth (aged 12-21 years) in high-income countries. The primary outcome was vaping prevalence. Included studies were qualitatively synthesized through systematic review. RESULTS The systematic review included 30 studies. There was insufficient evidence to recommend age restrictions (n=16), restrictions on location of use (n=1), and mixed/combined regulations (n=3). Flavor bans (n=4), sales licenses (n=2), and taxation (n=2) were generally shown to be associated with decreased rates of youth vaping. Warning labels (n=2) were associated with a decreased desire to initiate vaping. Included studies had moderate-to-serious risks of bias. DISCUSSION Although several regulatory interventions have been shown to be effective at reducing vaping among youth, evidence is insufficient to recommend a specific type of regulation. Regulatory authorities could implement various regulations targeting the price, accessibility, and desirability (i.e., flavors and packaging) of E-cigarettes.
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Affiliation(s)
- Anna Reiter
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Center for Clinical Epidemiology (CCE), Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Andréa Hébert-Losier
- Center for Clinical Epidemiology (CCE), Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Genevieve Mylocopos
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Center for Clinical Epidemiology (CCE), Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Kristian B Filion
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Center for Clinical Epidemiology (CCE), Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Sarah B Windle
- Center for Clinical Epidemiology (CCE), Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | - Jennifer L O'Loughlin
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada; Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Roland Grad
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Mark J Eisenberg
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Center for Clinical Epidemiology (CCE), Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Division of Cardiology, Jewish General Hospital, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
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11
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Visscher K, Everaars B, Suijkerbuijk AW, Lambooij M, de Wit GA. Intended changes in smoking behaviour of Dutch young adults after an increase in excise tax: a cross-sectional survey. BMJ Open 2023; 13:e065535. [PMID: 38154901 PMCID: PMC10759063 DOI: 10.1136/bmjopen-2022-065535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/17/2023] [Indexed: 12/30/2023] Open
Abstract
OBJECTIVES Increasing the price of tobacco is one of the most effective measures to reduce the prevalence of smoking. In the Netherlands, the excise tax on tobacco increased by €1.14 in 2020, raising the price of a standard package of cigarettes to €8.00. This study investigates how young adults intend to change their smoking behaviour in the case of hypothetical price increases of a pack of cigarettes, and which background characteristics are associated with intended behaviour change. DESIGN A cross-sectional online survey was carried out between September and November 2020. Smokers indicated how they would react to several hypothetical increases in price. Four behavioural options were investigated: smoking less, quitting smoking, switching to another/cheaper product and buying cheaper cigarettes cross-border. PARTICIPANTS Data were obtained from 776 Dutch smokers between 15 and 25 years. RESULTS At a hypothetical price of €10 per package, most respondents reported an intention to smoke less (67%), followed by switching to another/cheaper product (61%), quitting smoking (49%) and shopping for cigarettes cross-border (47%). Prior quit attempts, agreeing with the increase in excise tax and the intention to quit smoking in the future increased the odds of changing behaviour. Higher self-efficacy decreased the odds of behavioural change. CONCLUSION Many young adults intend to change their smoking behaviour in the event of increased prices. Although intended behaviour can deviate significantly from actual behaviour, an increase in excise tax may result in a significant amount of quit attempts and reduced smoking among young adults.
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Affiliation(s)
- Kirsten Visscher
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Babette Everaars
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Anita Wm Suijkerbuijk
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Mattijs Lambooij
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Erasmus Universiteit Rotterdam Erasmus School of Health Policy and Management, Rotterdam, The Netherlands
| | - G Ardine de Wit
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Health Sciences, VU Amsterdam, Amsterdam, The Netherlands
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12
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Jirjees F, Dallal Bashi YH, Kharaba Z, Ahmadi K, Barakat M, AlObaidi H. Public awareness, prevalence, and regulations for the sale of electronic cigarettes in Arab countries: A narrative review. Tob Induc Dis 2023; 21:143. [PMID: 37901882 PMCID: PMC10603825 DOI: 10.18332/tid/168435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 10/31/2023] Open
Abstract
The majority of the Arab countries have high records of daily tobacco smoking. Electronic cigarettes (e-cigarettes) use has exponentially increased in the past decade in Arab countries. Consumers' willingness to quit smoking traditional cigarettes and their perception of e-cigarettes as a safer alternative to conventional cigarettes have increased the demand for these devices. This narrative review aimed to gather and discuss the available literature on the awareness, prevalence, and sales regulations of e-cigarettes in Arab countries. A search was conducted on electronic databases such as PubMed, Medline, Scopus, and Google Scholar with no time limits until the end of 2021. Some of the recent studies (2019-2021) considered in this review have reported that more than 25% of participants were e-cigarettes users. The prevalence of e-cigarettes has increased drastically with raised awareness of e-cigarettes among the population in these Arab countries. Most of the users of e-cigarettes are young males. In addition, an increase in e-cigarettes use has been reported in females. The policies which regulate trade and sale of e-cigarettes and related products were issued in only three Arab countries. In contrast, regulations for the trade and sale of traditional cigarette products are also applied in some countries to e-cigarette products, banning the sale of e-cigarettes to minors and/or amend smoke-free laws to restrict public use of e-cigarettes. There is a need for a concerted effort to assess the prevalence and significant rise of e-cigarettes consumption in Arab societies to help implement and improve harm reduction policies.
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Affiliation(s)
- Feras Jirjees
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Zelal Kharaba
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Keivan Ahmadi
- NIHR Applied Research Collaboration Northwest London, Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, School of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Hala AlObaidi
- School of Pharmacy, Queen’s University Belfast, Belfast, United Kingdom
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13
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Hong Q, Su J, Hong P. Tobacco excise tax reform: From the perspective of "tax to control tobacco" policy in China. HEALTH ECONOMICS 2023; 32:2260-2277. [PMID: 37365696 DOI: 10.1002/hec.4728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 06/06/2023] [Accepted: 06/10/2023] [Indexed: 06/28/2023]
Abstract
The consumption of tobacco is harmful to health and has huge social costs. "Tax to control tobacco" is a widely implemented tobacco control measure all over the world. In order to examine the achievements of two tobacco excise tax reforms in China in 2009 and 2015 on controlling tobacco consumption, we first establish an intertemporal consumption model for addictive goods, and then validate the effectiveness of the two tobacco excise tax reforms using a Continuous Difference-in-Differences Model based on the panel data from 294 cities in China from 2007 to 2018. The results show that the tobacco excise tax reform in 2015 considerably reduced tobacco consumption, while the reform in 2009 did not, providing empirical evidence on the importance of "price links to tax" for tobacco control. Additionally, the study discovers that the tax reform has a heterogeneous effect on the age of smokers, the price of cigarettes, and city size.
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Affiliation(s)
| | - Jie Su
- Peking University, Beijing, China
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14
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Guindon GE, Abbas U, Trivedi R, Garasia S, Johnson S, John RM. Socioeconomic differences in the impact of prices and taxes on tobacco use in low- and middle-income countries-A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002342. [PMID: 37756265 PMCID: PMC10529577 DOI: 10.1371/journal.pgph.0002342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/07/2023] [Indexed: 09/29/2023]
Abstract
There is indisputable evidence that increases in taxes that raise tobacco prices reduce tobacco use. Consumption taxes on manufactured tobacco products, however, can be regressive in socioeconomic status (e.g., when the ratio of tax paid to income is lower for higher-income groups than for lower-income groups). Nevertheless, if the poor or less educated are more price responsive, a change in tobacco tax may be progressive in socioeconomic status. Existing reviews clearly indicate that populations with lower income or education are more responsive to tobacco tax and price changes than higher-income and more educated populations in high-income countries. Research pertaining to low- and middle-income countries was, however, limited and inconclusive. We conducted a review of quantitative studies that examined if socioeconomic status modified the association between prices and taxes and tobacco use in low- and middle-income countries. We searched two electronic databases, two search engines, and two working paper repositories. At least two reviewers independently screened articles for inclusion, extracted detailed characteristics, and assessed the risk of bias of each included study. Thirty-two studies met our inclusion criteria. Overall, we found that the evidence in low- and middle-income countries was too limited and methodologically weak to make any conclusive statements. Our review highlights a number of data and methodological limitations in existing studies. The most important limitation was the lack of formal assessment of socioeconomic differences in price responsiveness. Only seven of 32 studies assessed statistically whether own-price effects were modified by socioeconomic status. Many modelling studies have examined the distributional effect of a tax increase on tobacco use, while assuming a strong own-price elasticity gradient in income. The poor were generally assumed to be more responsive to price by a factor of two to five, relative to the wealthy. Although there are theoretical reasons to expect poorer individuals to be more responsive to monetary prices than wealthy ones in low- and middle-income countries, our review provides little empirical support.
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Affiliation(s)
- G. Emmanuel Guindon
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Economics, McMaster University, Hamilton, Ontario, Canada
| | - Umaima Abbas
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Riya Trivedi
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Sophiya Garasia
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sydney Johnson
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Rijo M. John
- Rajagiri College of Social Sciences, Rajagiri PO, Kochi, Kerala, India
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15
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DeBolt CL, Popovich JJ, Widere JC, Wibberly KH, Harris D. Rurality as a Risk Factor for Pulmonary Health Disparities. Clin Chest Med 2023; 44:501-508. [PMID: 37517830 DOI: 10.1016/j.ccm.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Rural populations experience significant pulmonary health disparities compared with urban populations. Patients in rural communities experience health determinants including high smoking prevalence, worse nutrition, lower educational attainment, specific occupational exposures, decreased health-care access, as well as unique cultural and political drivers of health. This article describes social determinants of pulmonary health relevant in rural communities, describes examples of existing pulmonary disparities in rural populations, and highlights health policies with potential to mitigate disparities.
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Affiliation(s)
| | - John J Popovich
- Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - J Christian Widere
- Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Katharine Hsu Wibberly
- Mid-Atlantic Telehealth Resource Center, University of Virginia, Charlottesville, VA, USA
| | - Drew Harris
- Department of Medicine, University of Virginia, Charlottesville, VA, USA
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16
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Schauer GL, Johnson JK, Rak DJ, Dodson L, Steinfeld N, Sheehy TJ, Nakata M, Collins SP. A Research Agenda to Inform Cannabis Regulation: How Science Can Shape Policy. Clin Ther 2023; 45:506-514. [PMID: 37414500 DOI: 10.1016/j.clinthera.2023.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 07/08/2023]
Abstract
In the United States, changes to cannabis policy have outpaced scientific knowledge about cannabis, its effects, and the impacts of different policy approaches. Research barriers stem from key federal policies, including strict drug scheduling of cannabis, which comprehensively hinder the ability to conduct cannabis research, affecting state markets, evidence-based regulation, and scientific gains that could more effectively shape policy moving forward. The Cannabis Regulators Association (CANNRA) is a nonpartisan nonprofit organization that convenes and supports government agencies to facilitate information exchange and learning from existing cannabis regulations across US states and territories and other governmental jurisdictions. This commentary outlines a research agenda that, if implemented, would address critical gaps in the science that cannabis regulators have identified in terms of knowledge regarding: (1) medicinal use of cannabis; (2) cannabis product safety; (3) cannabis consumer behaviors; (4) policies to promote equity and reduce disparities, both in the industry and more broadly in communities affected by the past criminalization of cannabis; (5) policies to prevent youth consumption and promote public health and safety; and (6) policies to reduce the illicit market and associated harms. The research agenda outlined here is the result of both formal discussions through CANNRA-wide meetings and informal discussions cannabis regulators have had as part of CANNRA committees. This research agenda is not all encompassing but rather highlights areas of research that have vital importance for cannabis regulation and policy implementation. Although many organizations weigh in on research needs related to cannabis, cannabis regulators (ie, the individuals implementing policies legalizing cannabis in states and territories) have generally not had a voice at the table advocating for specific research to be conducted. Their perspective representing the government agencies closest to the ground in terms of experiencing the impacts of current cannabis policy is essential to furthering quality, practical research that can advance informed and effective policy.
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Affiliation(s)
- Gillian L Schauer
- Cannabis Regulators Association, Lexington, Kentucky, USA; Addictions, Drug, & Alcohol Institute, University of Washington.
| | | | - David J Rak
- Medical Cannabis Program, Minnesota Department of Public Health
| | | | | | | | - Michele Nakata
- Medical Cannabis Program, Hawaii Department of Public Health
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17
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Geboers C, Candel MJJM, Nagelhout GE, de Vries H, van den Putte B, Fong GT, Willemsen MC. Smokers' strategies to reduce tobacco spending: self-reported use and differences across subgroups. Findings from the International Tobacco Control (ITC) Netherlands Survey. BMC Public Health 2023; 23:738. [PMID: 37085828 PMCID: PMC10119824 DOI: 10.1186/s12889-023-15678-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/14/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND The cost of tobacco is one of the most reported reasons for smoking cessation. Rather than quitting, smokers can use also strategies to reduce tobacco expenditure while continuing smoking, such as smoking less or using price-minimising strategies. The Netherlands announced to increase the price of a pack cigarettes from seven (2018) to ten euros (2023), to reduce tobacco prevalence and consumption. This study explores the self-reported strategies to reduce tobacco spending among Dutch smokers, and whether this differed per age, income, and education. Additionally, we analysed among quitters in these subgroups whether price played a role in their decision to quit. METHODS Cross-sectional survey data from the International Tobacco Control (ITC) Netherlands Wave 2 (September-November 2020, N = 1915) was used. Strategies to reduce spending among smokers (N = 1790) were: reducing consumption, bulk buying, switching to cheaper products or buying from low-taxed sources. These were collapsed into: reducing consumption (solely or in combination with other behaviours), solely price-minimising behaviours (such as buying cheaper brands), or no strategies to reduce spending. Associations between strategies and characteristics were analysed through multinomial and binary logistic regression models. Second, we explored which subgroups were more likely to report that price played a role in their decision to quit among quitters (N = 125). RESULTS The majority of smokers used strategies to reduce tobacco spending: 35.6% reduced consumption and 19.3% used solely price-minimising strategies. 82.1% of quitters reported that price played a role in their decision to quit. Low-income individuals were more likely to report price as a reason for quitting and reduce consumption, but also to buy cheaper products. Highly nicotine dependent smokers were more likely to use price-minimising behaviours, and less likely to reduce consumption. CONCLUSIONS The majority reported using strategies to reduce spending or that price played a role in their decision to quit. Reducing consumption was the most reported strategy. Low-income smokers were more likely to reportedly reduce consumption, buy cheaper products, or quit. Price policies have the potential to reduce socioeconomic inequalities in smoking. To discourage price-minimising behaviours, such as switching to cheaper products, reducing price differences between products should be prioritized.
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Grants
- #2.1.19.004 Longfonds (Lung Foundation Netherlands), Hartstichting (Netherlands Heart Foundation), KWF Kankerbestrijding (Dutch Cancer Society), Trombosestichting Nederland (Thrombosis Foundation), Diabetesfonds (Diabetes Funds)
- #2.1.19.004 Longfonds (Lung Foundation Netherlands), Hartstichting (Netherlands Heart Foundation), KWF Kankerbestrijding (Dutch Cancer Society), Trombosestichting Nederland (Thrombosis Foundation), Diabetesfonds (Diabetes Funds)
- #2.1.19.004 Longfonds (Lung Foundation Netherlands), Hartstichting (Netherlands Heart Foundation), KWF Kankerbestrijding (Dutch Cancer Society), Trombosestichting Nederland (Thrombosis Foundation), Diabetesfonds (Diabetes Funds)
- #2.1.19.004 Longfonds (Lung Foundation Netherlands), Hartstichting (Netherlands Heart Foundation), KWF Kankerbestrijding (Dutch Cancer Society), Trombosestichting Nederland (Thrombosis Foundation), Diabetesfonds (Diabetes Funds)
- #2.1.19.004 Longfonds (Lung Foundation Netherlands), Hartstichting (Netherlands Heart Foundation), KWF Kankerbestrijding (Dutch Cancer Society), Trombosestichting Nederland (Thrombosis Foundation), Diabetesfonds (Diabetes Funds)
- #2.1.19.004 Longfonds (Lung Foundation Netherlands), Hartstichting (Netherlands Heart Foundation), KWF Kankerbestrijding (Dutch Cancer Society), Trombosestichting Nederland (Thrombosis Foundation), Diabetesfonds (Diabetes Funds)
- FDN-148477 Canadian Institutes for Health Research
- Senior Investigator Grant Ontario Institute for Cancer Research
- O. Harold Warwick Prize Canadian Cancer Society
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Affiliation(s)
- Cloé Geboers
- Department of Health Promotion (CAPHRI), Maastricht University, P. Debyeplein 1, 6221 HA, Maastricht, The Netherlands.
- The Netherlands Expertise Centre for Tobacco Control, Trimbos Institute, Utrecht, the Netherlands.
| | - Math J J M Candel
- Department of Methodology and Statistics (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Gera E Nagelhout
- Department of Health Promotion (CAPHRI), Maastricht University, P. Debyeplein 1, 6221 HA, Maastricht, The Netherlands
- IVO Research Institute, The Hague, the Netherlands
| | - Hein de Vries
- Department of Health Promotion (CAPHRI), Maastricht University, P. Debyeplein 1, 6221 HA, Maastricht, The Netherlands
| | - Bas van den Putte
- Department of Communication (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Marc C Willemsen
- Department of Health Promotion (CAPHRI), Maastricht University, P. Debyeplein 1, 6221 HA, Maastricht, The Netherlands
- The Netherlands Expertise Centre for Tobacco Control, Trimbos Institute, Utrecht, the Netherlands
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Cho A, Chan G, Gartner C. Motivations to Change Smoking Behaviors Between 2007 and 2019 in Australia: A Repeated Cross-sectional Study. Nicotine Tob Res 2023; 25:674-681. [PMID: 35973439 DOI: 10.1093/ntr/ntac176] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 05/23/2022] [Accepted: 07/21/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION In 2010, Australian tobacco excise (administered federally) increased by 25%, and by 12.5% annually from 2013 to 2020, with additional increases on roll-your-own (RYO) tobacco between 2017 and 2020. We estimated past year changes in smoking behavior among Australian adults who smoked (daily and non-daily) in the past year, and the association between consumer characteristics and stated motivations to change/attempt to change smoking behavior between 2007 and 2019. METHODS Logistic regression analysis of combined data from national representative triennial cross-sectional surveys in Australia (N = 22 977). RESULTS The main motivation cited for changing smoking behavior switched from health-related from 2007 to 2010 to cost-related from 2013 to 2019. Among those who quit between one and 12 months ago, living in a lower socioeconomic area (odds ratio (OR) = 1.61, 95% CI = 1.18% to -2.18%), was associated with reporting the cost of smoking motivated them to quit. Among those who reduced their smoking, smoking daily and >20 cigarettes/day vs. non-daily smoking (OR = 2.11, 95% CI = 1.60% to 2.78%), having high/very high psychological distress (OR = 1.33, 95% CI = 1.12% to 1.59%), and alcohol consumption (ORdaily drinking = 1.38, 95% CI = 1.05% to 1.81%) was associated with cost as a motivation. Exclusive (OR = 0.65, 95% CI = 0.53% to 0.80%) and non-exclusive (OR = 0.77, 95% CI = 0.65% to 0.91%) RYO use was associated with being less likely to report the cost of tobacco as motivation for cutting down. CONCLUSIONS The cost of smoking became the most cited motivator to change smoking behavior (eg, quitting and cutting down), particularly for those who lived in low socioeconomic areas, smoked more cigarettes per day, drank alcohol, and had high/very high psychological distress. IMPLICATIONS A change in the main federal tobacco control intervention implemented in Australia from mass-media campaigns to tobacco tax increases has likely led to cost, rather than health, being the main motivation cited for changing smoking behavior in Australia since 2013. Further monitoring is needed to ensure the harmonization in tax rates for RYO and factory-made cigarettes has effectively reduced the price difference between these products because the lower cost of RYO may have reduced the effectiveness of tax increases as a motivator to change smoking behavior.
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Affiliation(s)
- Ara Cho
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Gary Chan
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia
| | - Coral Gartner
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Australia
- School of Public Health, The University of Queensland, Brisbane, Australia
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19
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Mazi A. Determinants of ever smoking and active smoking among school-aged children in Jeddah. J Taibah Univ Med Sci 2023; 18:1124-1137. [DOI: 10.1016/j.jtumed.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/17/2023] [Accepted: 03/12/2023] [Indexed: 03/31/2023] Open
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Mugharbil S, Tleis M, Romani M, Salloum RG, Nakkash R. Understanding Determinants of Electronic Cigarette and Heated Tobacco Product Use among Young Adults in Lebanon: Prevention and Policy Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4273. [PMID: 36901283 PMCID: PMC10001978 DOI: 10.3390/ijerph20054273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
In line with the global trends, electronic cigarettes (e-cigarettes) and heated tobacco products (HTPs) have found their way to the Lebanese market. The present study aims to explore the determinants of e-cigarette and HTP use among young adults in Lebanon. Convenience and snowball sampling were used to recruit participants aged 18-30 residing in Lebanon, who were familiar with e-cigarettes products. Twenty-one consenting participants were interviewed via Zoom and the verbatim transcriptions were analyzed thematically. The outcome expectancy theory was used to categorize the results into determinants and deterrents of use. HTPs were viewed by participants as another mode of smoking. The results showed that most participants perceived e-cigarettes and HTPs to be healthier alternatives to cigarettes/waterpipes and to be used as smoking cessation tools. Both e-cigarettes and HTPs were found to be easily accessible in Lebanon; although, in the recent economic crisis, e-cigarettes have become unaffordable. More research is needed to investigate the motivations and behaviors of e-cigarette and HTP users if effective policies and regulations are to be developed and enforced. Furthermore, greater public health efforts need to be made to increase awareness of the harmful impacts of e-cigarettes and HTPs and to implement evidence-based cessation programs tailored to those modes of smoking.
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Affiliation(s)
- Sanaa Mugharbil
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 11-0236, Lebanon
| | - Malak Tleis
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 11-0236, Lebanon
| | - Maya Romani
- Department of Family Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut 11-0236, Lebanon
| | - Ramzi G. Salloum
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 11-0236, Lebanon
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA
| | - Rima Nakkash
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 11-0236, Lebanon
- Global and Community Health Department, College of Public Health, George Mason University, Fairfax, VA 22030, USA
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Azmin M, Mohebi F, Yoosefi M, Ahmadi N, Shirazi S, Modirian M, Farzadfar F. The incremental cost of implementing the world health organization Package of essential non-communicable (PEN) diseases interventions in Iran. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000449. [PMID: 36962715 PMCID: PMC10021820 DOI: 10.1371/journal.pgph.0000449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 12/15/2022] [Indexed: 02/11/2023]
Abstract
World-Health-Organization's PEN package proposes a minimum set of cost-effective interventions for early diagnosis and management of Non-Communicable-Disease (NCD). IraPEN (the PEN package implemented in Iran), adopted from PEN and Iran National Action Plans for NCDs, addresses challenges regarding NCD prevention and control. IraPEN was piloted in four districts of Iran. In this research, we estimate incremental per-capita cost of IraPEN program implementation in two of the pilot districts. We utilized a bottom-up, ingredient-based costing approach. Institutional expenditure data was collected via information forms. Information pertaining to personnel costs was gathered by performing task time measurements using Direct Observation Method. An individual-level survey was conducted in under-study districts to determine program coverage and its users' demographic information via systematic random cluster sampling. Sampling of districts was based on systematic random cluster sampling. In each district, 250 families in 25 clusters proportional to urban or rural populations were randomly selected by postal codes. All family members eligible for the program were interviewed. Interviews were organized and conducted in each district by NCD experts in provincial Universities of Medical Sciences. Costs were re-categorized into fixed and variable costs based on their dependency on the program's coverage. Fixed and variable costs were, respectively, divided by total eligible populations and covered populations in each district to calculate cost per-capita for each protocol. Total per-capita cost per-service was then calculated for each protocol and whole program by adding these figures. All costs are reported in US$ 2015-2016. The incremental costs of IraPEN implementation per user, with and without introduction cost, were US$24.90 and US$25.32, respectively. Total incremental cost per-capita for each protocol ranged between US$1.05 to US$7.45. The human resources and supplies had the highest contribution in total program cost (74.97% and 15.76%, respectively). The present study shows that IraPEN program implementation to be a high-cost package within Iranian context, that necessitates cautions in other similar contexts for implementation. It is, however, difficult to make decisions on implementation of NCD prevention and control programs purely based on their cost. Informed decision making requires assessment of a programs' effectiveness and justifications and alterations to the current package could reduce the costs, leading to increased efficiency of the program.
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Affiliation(s)
- Mehrdad Azmin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnam Mohebi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Haas School of Business, University of California, Berkeley, California, United States of America
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Shirazi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Gagné T, Pelekanakis A, O'Loughlin JL. Do demographic and socioeconomic characteristics underpin differences in youth smoking initiation across Canadian provinces? Evidence from the Canadian Community Health Survey (2015-2018). Health Promot Chronic Dis Prev Can 2022; 42:457-465. [PMID: 36383157 PMCID: PMC9903853 DOI: 10.24095/hpcdp.42.11/12.01] [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] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Youth initiation may drive differences in smoking prevalence across Canadian provinces. Provincial differences in initiation relate to tobacco control strategies and public health funding, but have also been attributed to population characteristics. We test this hypothesis by examining the extent to which seven characteristics-immigration, language, family structure, education, income, home ownership and at-school status-explain differences in initiation across provinces. METHODS We used data from 16 897 youth aged 12 to 17 years in the Canadian Community Health Survey collected from 2015 to 2018. To examine the proportion of provincial differences explained by population characteristics, we compared average marginal effects (AMEs) from partially and fully adjusted models regressing "having ever initiated" on province and other characteristics. We also tested interactions to examine differences in the association between population characteristics and initiation across provinces. RESULTS Initiation varied from 4% in British Columbia to 10% in Quebec. Being born in Canada, speaking French, not living in a two-parent household, being in the lowest household income quintile, having parents without postsecondary education, living in rented accommodation and not being in school were each associated with initiation. Taking these results into consideration, the AME of residing in another province compared with Quebec was attenuated by between 3% and 9%. Family structure and household income were more strongly associated with initiation in the Atlantic region and Manitoba, but not in Quebec. CONCLUSION Differences in initiation between Quebec and other provinces are unlikely to be substantially explained by their demographic or socioeconomic composition. Reprioritizing tobacco control and public health funding are likely key in attaining the "tobacco endgame" across provinces.
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Affiliation(s)
- Thierry Gagné
- ESRC International Centre for Lifecourse Studies in Society and Health, University College London, London, United Kingdom
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Annie Pelekanakis
- Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada
- Department of Social and Preventive Medicine, University of Montréal, Montréal, Quebec, Canada
| | - Jennifer L O'Loughlin
- Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada
- Department of Social and Preventive Medicine, University of Montréal, Montréal, Quebec, Canada
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Boachie MK, Ayifah RNY, Immurana M, Agyemang JK, Singh A, Ross H. Effect of cigarette prices on cigarette consumption in Ghana. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 5:100102. [PMID: 36844153 PMCID: PMC9949322 DOI: 10.1016/j.dadr.2022.100102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 08/31/2022] [Accepted: 09/15/2022] [Indexed: 12/23/2022]
Abstract
Introduction Noncommunicable diseases are on the rise globally, with tobacco consumption being a major risk factor. Reducing tobacco consumption is an important step towards reducing the incidence and prevalence of many noncommunicable diseases. Tax and price measures have been proposed as tobacco control tools. This study investigated the link between cigarette prices and cigarette consumption in Ghana. Methods Annual time series data for the period 1980-2016 were used. The data came from diverse sources, including WHO, World Bank, and tobacco industry documents. Dynamic Ordinary Least Squares (DOLS), cointegration techniques, and three-stage least squares (3SLS) were used to analyze the data. Results After controlling for education, income, and population growth, we estimated that the price elasticity of cigarette demand is between -0.35 and -0.52 and statistically significant at 1% level. In the short run, the price elasticity is -0.1. Another variable that significantly reduced cigarette consumption during the period was education, with an elasticity between -1.7 and -2.7. Conclusion Cigarette demand in Ghana is influenced by cigarette prices and education. We conclude that tobacco taxes that significantly raise retail prices of cigarettes and higher education (including health education) will help reduce cigarette consumption.
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Affiliation(s)
- Micheal Kofi Boachie
- SAMRC/Wits Centre for Health Economics and Decision Science – PRICELESS SA, Faculty of Health Sciences, Wits School of Public Health, University of the Witwatersrand, Parktown, Johannesburg, 2193, South Africa,Research Unit on the Economics of Excisable Products (REEP), School of Economics, University of Cape Town, Cape Town 7700, South Africa,Corresponding author.
| | - Rebecca Nana Yaa Ayifah
- Department of Economics, University of Ghana, Legon, Ghana,Centre for Economic and Social Research, African Institute for Development Research and Evaluation, Accra, Ghana
| | - Mustapha Immurana
- Institute of Health Research, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - John Kwaku Agyemang
- School of Public Health, KNUST, Kumasi, Ghana,Internal Audit Department, KNUST, Kumasi, Ghana
| | - Arti Singh
- School of Public Health, KNUST, Kumasi, Ghana
| | - Hana Ross
- Research Unit on the Economics of Excisable Products (REEP), School of Economics, University of Cape Town, Cape Town 7700, South Africa
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Factors associated with smoking quit attempts among tobacco smokers. EUREKA: HEALTH SCIENCES 2022. [DOI: 10.21303/2504-5679.2022.002657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Despite more than one-third of tobacco users attempting to quit tobacco each year, only 4–6 % of them succeed to remains abstinent after one year.
The aim: This study aims to estimate the proportion of smokers who attempt to quit tobacco smoking and determine factors associated with quitting behaviour.
Methods: This community-based, cross-sectional study was conducted among 720 smokers aged 18 years and above residing in a rural area of Haryana state of India. A chi-square test determined the association between various variables under study and quitting attempts among study subjects. Factors found to be statistically significant using a chi-square test were entered into a binary logistic regression analysis to obtain determinants of smoking quitting attempts among the respondents.
Results: 28.5 % of the respondents had attempted to quit smoking during the past 1 year. The majority of them, i.e., 73.7 %, had attempted once, whereas 21.0 % and 5.4 % of respondents had made 2 and 3 attempts, respectively, to quit smoking during the last 1 year. Factors independently associated with quitting behaviour were educational level (AOR=1.851, p=0.028), age of initiation (AOR=0.620, p=0.026), reasons for smoking (AOR=1.681, p=0.016), money spent on smoking (AOR=1.700, p=0.003), family pressure to quit smoking (AOR=1.725, p=0.006) and advice from health professionals to quit smoking (AOR=2.104, p<0.001).
Conclusion: Around one-third of smokers have attempted to quit tobacco smoking in the past year. Hence there is a need to formulate policies towards a targeted intervention for smokers who have not attempted to quit smoking in the past 1 year for effective tobacco control
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Abstract
Although many of the tenets of harm reduction have been around for centuries and more traditional harm reduction services such as syringe services programs have been in existence for decades, there has been a recent increase in interest and acceptance of harm reduction as an essential component of a public health approach to substance use. This article provides an overview of harm reduction and its application to alcohol, tobacco, and drug use. It discusses the importance of integrating harm reduction principles and services with traditional psychiatric, medical, and addiction treatment programs.
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Affiliation(s)
- Avinash Ramprashad
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, 701 W Pratt St, 2nd Floor Suite 289, Baltimore, MD 21201, USA
| | - Gregory Malik Burnett
- Center for Addiction Medicine, University of Maryland Midtown Campus, 827 Linden Avenue 4th Floor, Suite 405, Baltimore MD 21201 USA; Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, 22 S. Greene Street S-1-D-04, Baltimore, MD 21201, USA.
| | - Christopher Welsh
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, 22 S. Greene Street S-1-D-04, Baltimore, MD 21201, USA
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26
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Opoczyńska-Świeżewska D, Raciborski F, Samoliński B. Reduction in the prevalence of tobacco use accompanying legislative changes in tobacco policy in Poland in the years 2010-2019. Int J Occup Med Environ Health 2022; 35:393-405. [PMID: 35289337 PMCID: PMC10464804 DOI: 10.13075/ijomeh.1896.01867] [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: 05/03/2021] [Accepted: 12/22/2021] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES Tobacco use is one of the most serious public health problems. Each year, it contributes to preventable disability and death of 8 million people worldwide. The aim of the study was to determine the change in the prevalence of tobacco and e-cigarettes use among Polish adults in the years 2010-2019 and the potential impact of legislative interventions on tobacco consumption in Poland. MATERIAL AND METHODS The research was based on an analysis of secondary data obtained from a cross-sectional study as part of the public opinion monitoring in Poland. The study was carried out in 2 editions (2010 and 2019) on representative samples of approximately 1000 Polish residents >18 years of age. RESULTS The proportion of traditional cigarette smokers decreased from 30.4% to 26.0% in the years 2010-2019 (p < 0.05). In the male group decreased from 40.3% to 31.0% (p < 0.001); among females, the values remained at the same level (21.3%). The greatest change in the percentage of current smokers was recorded in cities with ≥500 000 inhabitants (from 30.3% to 17.1%) and <100 000 inhabitants (from 31.5% to 24.6%) (p < 0.05). The total support for the new legal regulations increased from 73.9% to 89.8% (p < 0.001). The use of e-cigarettes in 2019 declared only 1.9%. CONCLUSIONS The percentage of adult traditional cigarette smokers decreased significantly between 2010 and 2019 (mainly among men). Among women, the percentage of cigarette smokers remained the same. The most significant declines in cigarette smoking were also observed among residents of the largest cities (≥500 000 inhabitants). During the same period, there was a further increase in the acceptance of legal restrictions on smoking cigarettes in public places. E-cigarette use among adults is a niche phenomenon in Poland, but it is much more prevalent among women than men. Int J Occup Med Environ Health. 2022;35(4):393-405.
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Affiliation(s)
- Dagmara Opoczyńska-Świeżewska
- Medical University of Warsaw, Department of Prevention of Environmental Hazards, Allergology and Immunology, Warsaw, Poland
| | - Filip Raciborski
- Medical University of Warsaw, Department of Prevention of Environmental Hazards, Allergology and Immunology, Warsaw, Poland
| | - Bolesław Samoliński
- Medical University of Warsaw, Department of Prevention of Environmental Hazards, Allergology and Immunology, Warsaw, Poland
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Shao L, Zhang T, Chen Y, Ghose B, Ji L. Exposure to Electronic Media, Smoking and Alcohol Drinking Among Guyanese Adults. Front Public Health 2022; 10:862975. [PMID: 35795706 PMCID: PMC9251173 DOI: 10.3389/fpubh.2022.862975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/13/2022] [Indexed: 12/02/2022] Open
Abstract
Use of electronic media has been shown to be associated with tobacco and alcohol consumption behavior among adult population. Currently, not much is known about the risk factors of tobacco and alcohol consumption in Guyana. The present study aimed to explore the association between exposure to electronic media and tobacco and alcohol consumption by adjusting for the sociodemographic correlates.
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Affiliation(s)
- Liming Shao
- Planning and Development Department, Hangzhou Medical College, Hangzhou, China
| | - Ting Zhang
- Zhejiang Business College, Hangzhou, China
| | | | - Bishwajit Ghose
- Organisation pour l'environnement et Développement Durable, Lomé, Togo
| | - Lu Ji
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Lu Ji
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28
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Torrence C, Truong K, Sivaraj LBM. Healthcare Utilization and Smoking among South Carolina’s Long-Term Uninsured. Healthcare (Basel) 2022; 10:healthcare10061079. [PMID: 35742129 PMCID: PMC9222968 DOI: 10.3390/healthcare10061079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 11/17/2022] Open
Abstract
Cigarette smoking and tobacco-related health conditions have continued to rise among persons of low social economic status. This study explored the association between healthcare utilization and smoking among the long-term uninsured (LTU). The sample consisted of South Carolina residents who had been without healthcare insurance for at least 24 months. Multivariable logistic regression was used to estimate differences in the likelihood of delaying healthcare due to cost and/or not filling a needed prescription between smokers and non-smokers. Among LTU, smoking was a significant predictor of delaying healthcare at the 10% level (AOR = 1.36, 95% CI = 0.99–1.86); the sensitivity analysis strengthened this association at the 5% level (AOR = 1.43, 95% CI = 1.06–1.93). Smoking was a significant predictor of not filling needed prescriptions (AOR = 1.44, 95% CI = 1.06–1.96). While neglected healthcare utilization was common among the LTU, this problem was more severe among smokers. The wider gap in access to healthcare services among the LTU, especially LTU who smoke, warrants further attention from the research community and policy makers.
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Affiliation(s)
- Caitlin Torrence
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA; (C.T.); (L.B.M.S.)
- Office of Research and Organizational Development, Clemson University, Clemson, SC 29634, USA
| | - Khoa Truong
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA; (C.T.); (L.B.M.S.)
- Correspondence: ; Tel.: +1-(864)-656-4704
| | - Laksika B. M. Sivaraj
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA; (C.T.); (L.B.M.S.)
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Ahmed MU, Pulok MH, Hashmi R, Hajizadeh M, Nargis N. Price and Income Elasticities of Cigarette Smoking Demand in Bangladesh: Evidence from Urban Adolescents and Young Adults. Nicotine Tob Res 2022; 24:826-833. [PMID: 34962282 DOI: 10.1093/ntr/ntab270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 12/18/2021] [Accepted: 12/22/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Understanding the elasticities of cigarette smoking demand among the youth could help improve the effectiveness of tobacco control interventions. The objective of this study is to measure the price and income elasticities of cigarette smoking demand among urban Bangladeshi male adolescents and young adults aged 10-24 years. METHOD Using data from a cross-sectional survey conducted in seven urban districts of Bangladesh, we applied probit and ordinary least square (OLS) models to examine the effect of price and income on smoking participation (decision to smoke) and intensity (number of cigarettes smoked). RESULTS Our results showed that price was not significantly associated with the decision to smoke, while income was a significant determinant of smoking participation. Both price and income determined the smoking intensity. The positive income elasticity (0.39) indicated that participants with greater access to money were more likely to participate in cigarette smoking and smoked more cigarettes. Negative price elasticity (-0.62) implied that increasing prices could lead to a reduction in smoking intensity among adolescents and young adults in urban Bangladesh. CONCLUSION The inelastic price demand for cigarette smoking suggests that there is scope for increasing tax on cigarettes without compromising the tax revenue. IMPLICATIONS This is the first study to investigate price and income elasticities among urban adolescents and young adults in Bangladesh. The study found no evidence that increasing the price of cigarettes discourages smoking participation but did show that increasing the price reduces the intensity of smoking among existing smokers. The results also suggest that economic measures such as taxation that increase the price of cigarettes could be a useful policy tool to limit smoking intensity without compromising government tax revenue.
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Affiliation(s)
- Moin Uddin Ahmed
- Institute of Health Economics, University of Dhaka, Dhaka, Bangladesh
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| | - Mohammad Habibullah Pulok
- Geriatric Medicine Research, Nova Scotia Health, Halifax, NS, Canada
- School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Rubayyat Hashmi
- School of Advertising, Marketing and Public Relations, Queensland University of Technology, Brisbane, QLD, Australia
| | - Mohammad Hajizadeh
- School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Nigar Nargis
- Economic and Health Policy Research, American Cancer Society, Inc., Atlanta, GA, USA
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van Meurs T, Çoban FR, de Koster W, van der Waal J, Oude Groeniger J. Why are anti-smoking health-information interventions less effective among low-socioeconomic status groups? A systematic scoping review. Drug Alcohol Rev 2022; 41:1195-1205. [PMID: 35384097 DOI: 10.1111/dar.13466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 03/10/2022] [Accepted: 03/15/2022] [Indexed: 11/29/2022]
Abstract
ISSUES This paper identifies and synthesises explanations proposed in the literature for the (in)effectiveness of institutional anti-smoking health-information interventions (HII) among low-socioeconomic status (SES) adults in high-income countries. APPROACH We searched eight databases for relevant papers from various disciplines: Studies published in English since 2009, on the effectiveness among low-SES adults of anti-smoking HIIs, aimed at changing knowledge/behaviour, and conducted by official institutions, were included. Through a scoping review, we synthesised: study design, SES indicator, intervention type, intervention source, study population, outcomes, low-SES effects, equity effects, proposed explanations and whether these were studied empirically. KEY FINDINGS Thirty-eight studies were included in this scoping review. Seventeen suggested explanations for the (in)effectiveness of the HIIs in low-SES adults, but only nine assessed them empirically. Thematic analysis yielded six themes: message engagement, material conditions, cognition, risk perception, social environment and self-efficacy. IMPLICATIONS Explanations for intervention results are not always present, and empirical evidence for explanations is often not provided. Including such explanations and testing their empirical merits in future research can provide the crucial information needed for developing more effective anti-smoking HIIs for low-SES adults. CONCLUSIONS To our knowledge, this is the first review to explore the explanations proposed for why anti-smoking HIIs are (in)effective among low-SES adults. It contains insights for future studies aiming to provide empirical evidence on the causes of this (in)effectiveness, and concludes that such research is yet largely missing, but crucial to the quest for more effective and equitable anti-smoking interventions.
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Affiliation(s)
- Tim van Meurs
- Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Feray R Çoban
- Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, The Netherlands.,Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Willem de Koster
- Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jeroen van der Waal
- Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Joost Oude Groeniger
- Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, The Netherlands.,Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
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Luo T, Li MS, Williams D, Fritz J, Beiter K, Phillippi S, Yu Q, Kantrow S, Lin WT, Kao YH, Chen Y, Chen L, Tseng TS. A WeChat-based smoking cessation intervention for Chinese smokers: A pilot study. Internet Interv 2022; 28:100511. [PMID: 35646606 PMCID: PMC9136339 DOI: 10.1016/j.invent.2022.100511] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 10/29/2022] Open
Abstract
Background China is the largest tobacco producer and has the highest number of tobacco consumers in the world. Extensive research has demonstrated the utility of social media for smoking cessation. WeChat is the most commonly used social media platform in China, but has not yet been utilized for smoking cessation interventions. The objectives of this study are (1) to evaluate the efficacy of a WeChat-based smoking cessation intervention; and (2) to examine a possible additive effect of integrating oral health and smoking-related information into a tailored, Transtheoretical Model (TTM) guided smoking cessation intervention. Methods Eligible adults were recruited through WeChat from July 1 to August 6, 2019, to participate in a 3-arm, single-blinded, randomized controlled trial. We enrolled and randomized 403 participants into three groups: the Standard Group, Enhanced Group, or a Waitlist-Control Group. Participants in the Standard Group received 20 smoking cessation-related messages for 2 weeks; participants in the Enhanced Group received this same protocol plus 6 oral health-related messages over an additional week. Participants in the Control Group received smoking cessation-related messages, after the post-intervention assessment. The primary outcome was TTM Stage of Change, and the secondary outcomes were 7-day Point Prevalence Abstinence (PPA), 24-h PPA, daily cigarette use, and nicotine dependence at 4 weeks follow-up post intervention, comparing intervention groups with the control group. The overall program attrition rate was 46%. Paired t-tests, McNemar tests, and linear and logistic regression were used to examine differences in smoking cessation outcomes within and between groups. Results Participants in the Enhanced Group (β = -1.28, 95%CI: -2.13, -0.44) and the Standard Group (β = -1.13, 95%CI: -1.95, -0.30) reported larger changes in nicotine dependence scores, compared to participants in the Waitlist Group. No statistically significant differences were found between the Enhanced Group and the Standard Group. Discussion This WeChat-based intervention was effective for smoking cessation overall. The addition of oral health information did not significantly improve the intervention.
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Affiliation(s)
- Ting Luo
- Moores Cancer Center, University of California San Diego, La Jolla, California 92122, USA
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA
| | - Mirandy S. Li
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA
- School of Medicine, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA
| | - Donna Williams
- Moores Cancer Center, University of California San Diego, La Jolla, California 92122, USA
| | - Jackson Fritz
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA
- School of Medicine, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA
| | - Kaylin Beiter
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA
- School of Medicine, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA
| | - Stephen Phillippi
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA
| | - Qingzhao Yu
- Biostatistics, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA
| | - Stephen Kantrow
- School of Medicine, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA
| | - Wei-Ting Lin
- Department of Global Community Health and Behavioral Sciences, School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA 70122, USA
| | - Yu-Hsiang Kao
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA
| | - Yongchun Chen
- Department of Clinical Nutrition, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan 450003, China
| | - Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California 900095, USA
| | - Tung-Sung Tseng
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA 70122, USA
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Kim S, Cho SI. Smoking-related behaviour changes among Korean men after the 2015 tobacco price increase: assessing the implications for the tobacco endgame using a reconstructed retrospective cohort study. BMJ Open 2022; 12:e051712. [PMID: 34983761 PMCID: PMC8728404 DOI: 10.1136/bmjopen-2021-051712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 11/22/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To examine the effect of Korea's 2015 tax policy, discuss its effectiveness and limitations and present future directions for tax policy in the context of the tobacco endgame. DESIGN A retrospectively reconstructed cohort study. SETTING Korea, August 2014-October 2015. PARTICIPANTS The study examined 41,605 male smokers aged 19 years and older who participated in the 2015 Korea Community Health Survey. MEASURES AND ANALYSIS Binary and multinomial logistic regression was used to assess the impact of the tax policy on smoking-related behaviour. We adjusted for demographic and health-related variables. RESULTS Among 41,605 men who were smokers in 2014, 15,499 (35.85%, weighted) reported being affected by the price increase. Of all smokers, 1,772 (3.96%, weighted) reported quitting smoking because of the tobacco price increase. Others reduced their smoking amount (n=9,714, 22.48%, weighted) or made other changes such as switching brands (n=4,013, 9.41%, weighted). An additional 2,401 smokers (5.72%, weighted) quit smoking for reasons other than the tobacco price increase. Compared with those in the highest quintile of household income, the odds that those in the lowest quintile quit smoking due to the price increase were almost twice as high (OR=1.98, 95% CI 1.54 to 2.54). CONCLUSIONS Korea's 2015 tobacco price increase affected a significant number of smokers within a year, especially in the lowest income group, inducing some to quit or reduce their smoking amount. However, more smokers quit for reasons independent of the price change. Tax policy can effectively reduce smoking, but needs to be combined with other policies for optimal results.
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Affiliation(s)
- Seulgi Kim
- Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Sung-Il Cho
- Graduate School of Public Health, Seoul National University, Seoul, South Korea
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
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33
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Lee K, Freudenberg N. Public Health Roles in Addressing Commercial Determinants of Health. Annu Rev Public Health 2022; 43:375-395. [DOI: 10.1146/annurev-publhealth-052220-020447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The shared challenges posed by the production and distribution of health-harming products have led to growing recognition of the need for policy learning and transfer across problems, populations, and social contexts. The commercial determinants of health (CDoH) can serve as a unifying concept to describe the population health consequences arising from for-profit actors and activities, along with the social structures that sustain them. Strategies to mitigate harms from CDoH have focused on behavioral change, regulation, fiscal policies, consumer and citizen activism, and litigation. While there is evidence of effective measures for each strategy, approaches that combine strategies are generally more impactful. Filling gaps in evidence can inform ways of adapting these strategies to specific populations and social contexts. Overall, CDoH are addressed most effectively not through siloed efforts to reduce consumption of health-harming products, but instead as a set of integrated strategies to reduce exposures to health-harming commercial actors and activities. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Nicholas Freudenberg
- School of Public Health and Health Policy, City University of New York, New York, NY, USA
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Viet Nguyen C, Le TT, Nguyen NH. The impact of cigarette prices on smoking participation and tobacco expenditure in Vietnam. PLoS One 2021; 16:e0260415. [PMID: 34905542 PMCID: PMC8670683 DOI: 10.1371/journal.pone.0260415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 11/09/2021] [Indexed: 11/18/2022] Open
Abstract
Vietnam is one of countries with the highest number of smokers in the world and the high smoking prevalence among men in the region. Although the real cigarette prices increased by around 4% during the 2010-2015 period, the prevalence of daily cigarette smoking among men decreased slightly from 31.3% to 30.7% during this period. This raises the question of whether cigarette consumption is sensitive to price. In this study, we estimated the effect of cigarette prices on smoking participation and tobacco expenditure in Vietnam. We found that a one-percent increase in the real cigarette price reduced the probability of cigarette smoking among males by 0.08 percentage points (95% CI from -0.06 to -0.10), equivalent to the price elasticity of the smoking prevalence at -0.26 (95% CI from -0.16% to -0.33%). Using this estimate, we predict that if the cigarette price is increased by 10%, the daily cigarette smoking prevalence among men would decrease from 30.7% to 29.9% and the number of male smokers would decline by around 270 thousand. Higher cigarette prices also reduced per capita tobacco expenditure of households. A one-percent increase in the cigarette price decreased per capita expenditure on tobacco consumption expenditure of households by 0.43 percent (the 95% CI from -0.029 to 0.822). This finding suggests that raising tobacco taxes and prices can be an effective measure to reduce tobacco use.
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Affiliation(s)
- Cuong Viet Nguyen
- International School, Vietnam National University, Hanoi, Vietnam
- IPAG Business School, Paris, France
| | - Thu Thi Le
- HealthBridge Foundation of Canada, Hanoi, Vietnam
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Kim SCJ, Martinez JE, Liu Y, Friedman TC. US Tobacco 21 is Paving the Way for a Tobacco Endgame. Tob Use Insights 2021; 14:1179173X211050396. [PMID: 34866950 PMCID: PMC8637783 DOI: 10.1177/1179173x211050396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/13/2021] [Indexed: 01/27/2023] Open
Abstract
The battle against tobacco usage is being fought on all fronts. On December 19, 2019, a measure to raise the minimum age to buy tobacco products to 21 from 18 was passed by the United States Congress and signed by President Donald Trump. This instated banning the sale of all tobacco products and electronic cigarettes to anyone in the US under the age of 21. This follows the raising of the age to buy tobacco in California to 21 in 2016. According to the California Tobacco Control Program: in 2016, roughly 10% of high-school students were smoking cigarettes, but by 2018, only 2%. The percentage of retailers selling tobacco to underaged youth dropped dramatically. These data show that the CA Tobacco 21 law was effective in decreasing the obtainability and usage of tobacco by youth. We expect that US Tobacco 21 will be similarly effective in reducing tobacco use by youth leading to less tobacco addiction in the US.
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Affiliation(s)
- Samuel C J Kim
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Jason E Martinez
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Yanjun Liu
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA.,David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Theodore C Friedman
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA.,David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.,Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
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Obieche O, Lee M, Salehi N. Exploring attitudes towards smoking behaviour and cessation among hospitalised smokers via a socio-ecological framework: A scoping review. Addict Behav 2021; 122:107040. [PMID: 34246988 DOI: 10.1016/j.addbeh.2021.107040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/10/2021] [Accepted: 06/30/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Cigarette smoking is a leading cause of preventable mortality and disability. Smoke-free policies in healthcare settings have been implemented as a public health measure. This scoping review aims to explore attitudes on smokers' cessation in smoke-free healthcare settings using a socio-ecological framework. METHODS Four databases were searched for terms: smoking cessation, patient attitudes, and smoke-free policy. Of 420 studies, 17 met full inclusion criteria. RESULTS The review identified four socio-ecological aspects of smoking cessation in smoke-free healthcare settings: Intrapersonal factors (health literacy, health conditions, and self-efficacy), interpersonal factors (social support, peer pressure, and social responsibility), healthcare factors (perceived mixed messages, healthcare setting, clinical, psychosocial and health promotion supports), and societal factors (restrictions on smoking in a public place and social acceptability of smoking). Smoke-free policies effectively encouraged cessation in some patients but were ineffective in those that felt a loss of autonomy. Provision of smoke breaks within smoke-free policies was considered a mixed message. CONCLUSIONS Holistic strategies are required to interconnect the four socio-ecological dimensions for successful smoking cessation.
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Gunadi C, Benmarhnia T, White M, Pierce JP, McMenamin SB, Leas EC, Shi Y. Tobacco price and use following California Proposition 56 tobacco tax increase. PLoS One 2021; 16:e0257553. [PMID: 34644338 PMCID: PMC8513910 DOI: 10.1371/journal.pone.0257553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/03/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND California Proposition 56 increased cigarette excise tax by $2 per pack with equivalent increases on non-cigarette tobacco products. We estimated the changes in cigarette price, cigarette use, and non-cigarette use following the implementation of Proposition 56 in California in 2017. METHODS Seven waves of Tobacco Use Supplements to the Current Population Survey (TUS-CPS) 2011-2019 data were used to obtain state-level aggregate self-reported outcomes, including cigarette price per pack, current and daily cigarette use, cigarette consumption per day, and current and daily use of non-cigarette tobacco products (hookah, pipe, cigar, and smokeless tobacco). A modified version of a synthetic control method was used to create a "synthetic" California that best resembled pre-policy sociodemographic characteristics and outcome trends in California while correcting time-invariant pre-policy differences. Various sensitivity analyses were also conducted. RESULTS The implementation of Proposition 56 was associated with an increase in self-reported cigarette price per pack in California ($1.844, 95%CI: $0.153, $3.534; p = 0.032). No evidence suggested that Proposition 56 was associated with the changes in the prevalence of current or daily cigarette use, cigarette consumption per day, or the prevalence of current or daily use of non-cigarette tobacco products. CONCLUSION Most of the cigarette tax increase following Proposition 56 in California was passed on to consumers. There is a lack of evidence that the implementation of Proposition 56 was associated with the changes in the use of cigarettes and other tobacco products such as hookah, pipe, cigar, and smokeless tobacco.
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Affiliation(s)
- Christian Gunadi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, United States of America
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, United States of America
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, California, United States of America
| | - Martha White
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, United States of America
| | - John P. Pierce
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, United States of America
| | - Sara B. McMenamin
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, United States of America
| | - Eric C. Leas
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, United States of America
| | - Yuyan Shi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, United States of America
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Gagné T, O'Loughlin JL. Tobacco smoking prevention and control in Canada: where do we go from here? Health Promot Chronic Dis Prev Can 2021; 41:279-281. [PMID: 34668682 PMCID: PMC8565862 DOI: 10.24095/hpcdp.41.10.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Thierry Gagné
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Jennifer L O'Loughlin
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
- Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal, Montréal, Quebec, Canada
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Lung Disease in Central Appalachia: It's More than Coal Dust that Drives Disparities. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2021; 94:477-486. [PMID: 34602885 PMCID: PMC8461577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The population living in Central Appalachia is disproportionately impacted by lung disease. This is driven, in part, by occupational hazards and environmental exposures. However, it is more than coal dust that is driving the ongoing disparity of lung disease in the region. This review describes how the decline of the coal mine industry and subsequent rise of unemployment, poverty, and educational disparities have increased risk for worse pulmonary health outcomes in the region. Additional challenges related to healthcare access, substance use, cultural characteristics, and social capital are highlighted in their relation to pulmonary health within Central Appalachia. Lastly, the review describes strategies that hold promise to reduce regional health disparities. Several healthcare and community-centered initiatives are highlighted as successful examples of collaborative efforts working towards improving pulmonary health outcomes in the region. However, significant challenges related to social, economic, and environmental factors remain. Addressing these social determinants of health must be a paramount concern for healthcare, community and political leaders seeking to impact change and improve the health and well-being of this vulnerable population.
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Sheira LA, Frongillo EA, Hahn J, Palar K, Riley ED, Wilson TE, Adedimeji A, Merenstein D, Cohen M, Wentz EL, Adimora AA, Ofotokun I, Metsch L, Turan JM, Tien PC, Weiser SD. Relationship between food insecurity and smoking status among women living with and at risk for HIV in the USA: a cohort study. BMJ Open 2021; 11:e054903. [PMID: 34489299 PMCID: PMC8422493 DOI: 10.1136/bmjopen-2021-054903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES People living with HIV (PLHIV) in the USA, particularly women, have a higher prevalence of food insecurity than the general population. Cigarette smoking among PLHIV is common (42%), and PLHIV are 6-13 times more likely to die from lung cancer than AIDS-related causes. This study sought to investigate the associations between food security status and smoking status and severity among a cohort of predominantly low-income women of colour living with and without HIV in the USA. DESIGN Women enrolled in an ongoing longitudinal cohort study from 2013 to 2015. SETTING Nine participating sites across the USA. PARTICIPANTS 2553 participants enrolled in the Food Insecurity Sub-Study of the Women's Interagency HIV Study, a multisite cohort study of US women living with HIV and demographically similar HIV-seronegative women. OUTCOMES Current cigarette smoking status and intensity were self-reported. We used cross-sectional and longitudinal logistic and Tobit regressions to assess associations of food security status and changes in food security status with smoking status and intensity. RESULTS The median age was 48. Most respondents were African-American/black (72%) and living with HIV (71%). Over half had annual incomes ≤US$12 000 (52%). Food insecurity (44%) and cigarette smoking (42%) were prevalent. In analyses adjusting for common sociodemographic characteristics, all categories of food insecurity were associated with greater odds of current smoking compared with food-secure women. Changes in food insecurity were also associated with increased odds of smoking. Any food insecurity was associated with higher smoking intensity. CONCLUSIONS Food insecurity over time was associated with smoking in this cohort of predominantly low-income women of colour living with or at risk of HIV. Integrating alleviation of food insecurity into smoking cessation programmes may be an effective method to reduce the smoking prevalence and disproportionate lung cancer mortality rate particularly among PLHIV.
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Affiliation(s)
- Lila A Sheira
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina System, Columbia, South Carolina, USA
| | - Judith Hahn
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California, USA
| | - Kartika Palar
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California, USA
| | - Elise D Riley
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California, USA
| | - Tracey E Wilson
- Community Health Sciences, School of Public Health, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Daniel Merenstein
- Family Medicine, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Mardge Cohen
- Medicine, John H Stroger Hospital of Cook County, Chicago, Illinois, USA
| | - Eryka L Wentz
- School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Adaora A Adimora
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Lisa Metsch
- Sociomedical Sciences, Columbia University Mailman School of Public Health, New York City, New York, USA
| | - Janet M Turan
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Phyllis C Tien
- Department of Medicine, University of California, San Francisco, California, USA
- Department of Veteran Affairs Medical Center, San Francisco, California, USA
| | - Sheri D Weiser
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California, USA
- Center for AIDS Prevention Studies, University of California, San Francisco, California, USA
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41
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D'Cruz A. World No Tobacco Day 2021: Joining forces for tobacco control. Tob Prev Cessat 2021; 7:41. [PMID: 34124414 PMCID: PMC8164441 DOI: 10.18332/tpc/138268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Anil D'Cruz
- Union for International Cancer Control, Geneva, Switzerland
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Fleischer NL, Donahoe JT, McLeod MC, Thrasher JF, Levy DT, Elliott MR, Meza R, Patrick ME. Taxation reduces smoking but may not reduce smoking disparities in youth. Tob Control 2021; 30:264-272. [PMID: 32269173 PMCID: PMC7546443 DOI: 10.1136/tobaccocontrol-2019-055478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/24/2020] [Accepted: 03/11/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study examines the extent to which cigarette taxes affect smoking behaviour and disparities in smoking among adolescents by gender, socioeconomic status (SES) and race/ethnicity. METHODS We used US nationally representative, repeated cross-sectional data from the 2005 to 2016 Monitoring the Future study to evaluate the relationship between state cigarette taxes and past 30-day current smoking, smoking intensity, and first cigarette and daily smoking initiation using modified Poisson and linear regression models, stratified by grade. We tested for interactions between tax and gender, SES and race/ethnicity on the additive scale using average marginal effects. RESULTS We found that higher taxes were associated with lower smoking outcomes, with variation by grade. Across nearly all of our specifications, there were no statistically significant interactions between tax and gender, SES or race/ethnicity for any grades/outcomes. One exception is that among 12th graders, there was a statistically significant interaction between tax and college plans, with taxes being associated with a lower probability of 30-day smoking among students who definitely planned to attend college compared with those who did not. CONCLUSION We conclude that higher taxes were associated with reduced smoking among adolescents, with little difference by gender, SES and racial/ethnicity groups. While effective at reducing adolescent smoking, taxes appear unlikely to reduce smoking disparities among youth.
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Affiliation(s)
- Nancy L Fleischer
- Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - J Travis Donahoe
- Graduate School of Arts & Sciences, Harvard University, Cambridge, Massachusetts, USA
| | - M Chandler McLeod
- Biostatistics Core, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
| | - James F Thrasher
- Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - David T Levy
- Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Michael R Elliott
- Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Rafael Meza
- Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Megan E Patrick
- Institute of Child Development and Institute for Translational Research in Children's Mental Health, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
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Immurana M, Boachie MK, Iddrisu AA. The effects of tobacco taxation and pricing on the prevalence of smoking in Africa. Glob Health Res Policy 2021; 6:14. [PMID: 33926580 PMCID: PMC8082915 DOI: 10.1186/s41256-021-00197-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 04/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco use continues to kill millions of people globally, making it one of the major causes of preventable deaths. Notwithstanding, there has been a very marginal fall in the prevalence of tobacco smoking in Africa. Since taxes (hence prices) are part of the main measures suggested to decrease the demand for tobacco products, this study investigates how tobacco taxation and pricing influence the prevalence of smoking in 24 African countries. METHODS Using panel data on 24 African countries sourced from the World Health Organization (WHO) and the World Bank databases for the period 2010 to 2016, this study employs the system Generalized Method of Moments (GMM) estimator to investigate the effects of tobacco taxation and pricing on the prevalence of smoking. The system GMM estimator is used due its ability to deal with potential endogeneity of tobacco taxation and pricing: the likelihood that the prevalence of smoking can influence tobacco taxation and pricing which may lead to biased estimates. RESULTS Tobacco taxation and pricing have negative significant effects on the prevalence of smoking among the selected countries after controlling for growth of Gross Domestic Product (GDP) per capita, urbanization, death rate and net inflows of Foreign Direct Investment (FDI). Specifically, a percentage increase in tobacco price is found to decrease the prevalence of smoking by between 0.11 to 0.14%, while a percentage increase in tobacco tax decreases the prevalence of smoking by between 0.25 to 0.36%, all at 1% level of significance. CONCLUSION Since tobacco taxation and pricing are found to have negative significant effects on the prevalence of smoking, the implication is that, their use can be intensified by African policy makers towards achieving the WHO Framework Convention on Tobacco Control (FCTC) recommended targets and hence decrease the prevalence of tobacco smoking in Africa. Doing so may therefore help in achieving the Sustainable Development Goal (SDG) 3.5 (prevention and treatment of substance abuse), thereby reducing the colossal number of smoking attributable deaths.
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Affiliation(s)
- Mustapha Immurana
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Micheal Kofi Boachie
- Department of Health Policy Planning and Management, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Abdul-Aziz Iddrisu
- Banking Technology and Finance Department, Kumasi Technical University, Kumasi, Ghana
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Parks MJ, Patrick ME, Levy DT, Thrasher JF, Elliott MR, Fleischer NL. Tobacco Taxation and Its Prospective Impact on Disparities in Smoking Initiation and Progression Among Young Adults. J Adolesc Health 2021; 68:765-772. [PMID: 33041205 PMCID: PMC8012213 DOI: 10.1016/j.jadohealth.2020.08.031] [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: 06/21/2020] [Revised: 08/13/2020] [Accepted: 08/28/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Limited research exists on tobacco taxes and cigarette smoking initiation and progression, particularly across different sociodemographic groups in young adulthood. This project examines how cigarette pack price in late adolescence prospectively relates to smoking initiation and progression by 21 years of age, focusing on differences across demographics. METHODS Data are from the longitudinal Monitoring the Future project (2001-2017). Monitoring the Future examines drug use behaviors with nationally representative samples of 12th graders annually. Subsamples of 12th graders are followed up longitudinally. We examined past 30-day cigarette smoking among baseline never smokers (N = 9,232) and daily smoking among youths who were not daily cigarette smokers at baseline (N = 15,141). Using logistic regression, we examined state-level cigarette pack price at a modal age of 18 years and smoking at follow-up ages 19-20 years; we used interaction terms to assess differences across sociodemographic groups (by gender, race/ethnicity, and parental education). RESULTS For each dollar increase in price at baseline, the odds of initiation by age 19-20 years were reduced by 12% (adjusted odds ratio = .88; 95% confidence interval = .78, .99) and the odds of progression to daily smoking were reduced by 16% (adjusted odds ratio = .84; 95% confidence interval = .76, .92). After adjusting for multiple testing, for both outcomes there were no statistically significant interactions between price and demographics. CONCLUSIONS Cigarette prices in late adolescence were associated with a prospective reduction in cigarette smoking initiation and progression among young adults, with limited differences across sociodemographic characteristics. Higher cigarette prices can prevent smoking initiation and progression; however, complementary interventions are needed to reduce initiation and progression among subgroups disproportionately affected by tobacco.
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Affiliation(s)
- Michael J Parks
- Institute for Translational Research in Children's Mental Health, University of Minnesota, Minneapolis, Minnesota.
| | - Megan E Patrick
- Institute for Translational Research in Children's Mental Health, University of Minnesota, Minneapolis, Minnesota; Institute of Child Development, University of Minnesota, Minneapolis, Minnesota
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Michael R Elliott
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan; Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Nancy L Fleischer
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
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Ji X, Cox S, Grosse SD, Barfield WD, Armour BS, Courtney‐Long EA, Li R. Association of smoke-free laws with preterm or low birth weight deliveries-A multistate analysis. Health Serv Res 2021; 56:61-72. [PMID: 32875549 PMCID: PMC10581330 DOI: 10.1111/1475-6773.13552] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To assess the association between the change in statewide smoke-free laws and the rate of preterm or low birth weight delivery hospitalizations. DATA SOURCE 2002-2013 Healthcare Cost and Utilization Project State Inpatient Databases. STUDY DESIGN Quasi-experimental difference-in-differences design. We used multivariate logistic models to estimate the association between the change in state smoke-free laws and preterm or low birth weight delivery hospitalizations. The analyses were also stratified by maternal race/ethnicity to examine the differential effects by racial/ethnic groups. DATA COLLECTION/EXTRACTION METHODS Delivery hospitalizations among women aged 15-49 years were extracted using the International Classification of Diseases, Ninth Revision, and Diagnosis-Related Group codes. PRINCIPAL FINDINGS Non-Hispanic black mothers had a higher rate of preterm or low birth weight delivery hospitalization than other racial/ethnic groups. Overall, there was no association between the change in smoke-free laws and preterm or low birth weight delivery rate. Among non-Hispanic black mothers, the change in statewide smoke-free laws was associated with a 0.9-1.9 percentage point (P < .05) reduction in preterm or low birth weight delivery rate beginning in the third year after the laws took effect. There was no association among non-Hispanic white mothers. A decline in the black-white disparity of 0.6-1.6 percentage points (P < .05) in preterm or low birth weight delivery rates was associated with the change in state smoke-free laws. CONCLUSION The change in state smoke-free laws was associated with a reduction in racial/ethnic disparities in preterm or low birth weight delivery hospitalizations in selected US states.
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Affiliation(s)
- Xu Ji
- Department of PediatricsEmory University School of Medicine/Children's Healthcare of AtlantaAtlantaGeorgiaUSA
| | - Shanna Cox
- Division of Reproductive HealthNational Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Scott D. Grosse
- National Center on Birth Defects and Developmental DisabilitiesCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Wanda D. Barfield
- Division of Reproductive HealthNational Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Brian S. Armour
- Office on Smoking and HealthNational Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Elizabeth A. Courtney‐Long
- Office on Smoking and HealthNational Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Rui Li
- Division of Reproductive HealthNational Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
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Apollonio DE, Glantz S. Tobacco manufacturer lobbying to undercut minimum price laws: an analysis of internal industry documents. Tob Control 2020; 29:e10-e17. [PMID: 31969381 PMCID: PMC7374022 DOI: 10.1136/tobaccocontrol-2019-055354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/19/2019] [Accepted: 12/11/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND Increasing the price of tobacco products has the potential to reduce tobacco consumption. As other forms of promotion have been increasingly restricted over time, tobacco manufacturers have relied more on trade discounts. Minimum price laws that prevented the use of manufacturer promotions were once common; however in most US jurisdictions these discounts are now legally protected. METHODS We collected tobacco industry documents, state legislation and court cases between 1987 and 2016 to review tobacco manufacturer strategies to change minimum price laws in the USA. RESULTS Beginning in 2000, tobacco manufacturers lobbied to amend minimum price legislation after state regulators indicated that manufacturer promotions were illegal under existing laws. Companies viewed changing these laws as critical to maintaining tobacco sales, and after the initiation of an industry lobbying campaign, at least 20 states changed the way they calculated tobacco prices. CONCLUSIONS Modifying existing minimum price laws so that manufacturer discounts are no longer protected, and implementing new minimum price policies with comparable scope, would likely increase prices and reduce tobacco use.
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Affiliation(s)
- Dorie E Apollonio
- Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California, USA
| | - Stanton Glantz
- Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA
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Association of state tobacco control policies with active smoking at the time of intervention for intermittent claudication. J Vasc Surg 2020; 73:1759-1768.e1. [PMID: 33098941 DOI: 10.1016/j.jvs.2020.08.156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/31/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Active smoking among patients undergoing interventions for intermittent claudication (IC) is associated with poor outcomes. Notwithstanding, current levels of active smoking in these patients are high. State-level tobacco control policies have been shown to reduce smoking in the general US population. We evaluated whether state cigarette taxes and 100% smoke-free workplace legislation are associated with active smoking among patients undergoing interventions for IC. METHODS We queried the Vascular Quality Initiative database for peripheral endovascular interventions, infrainguinal bypasses, and suprainguinal bypasses for IC. Active smoking at the time of intervention was defined as smoking within one month of intervention. We implemented difference-in-differences analysis to isolate changes in active smoking owing to cigarette taxes (adjusted for inflation) and implementation of smoke-free workplace legislation. The difference-in-differences models estimated the causal effects of tobacco policies by adjusting for concurrent temporal trends in active smoking unrelated to cigarette taxes or smoke-free workplace legislation. The models controlled for age, sex, race/ethnicity, insurance type, diabetes, chronic obstructive pulmonary disease, state, and year. We tested interactions of taxes with age and insurance. RESULTS Data were available for 59,847 patients undergoing interventions for IC in 25 states from 2011 to 2019. Across the study period, active smoking at the time of intervention decreased from 48% to 40%. Every $1.00 cigarette tax increase was associated with a 6-percentage point decrease in active smoking (95% confidence interval, -10 to -1 percentage points; P = .02), representing an 11% decrease relative to the baseline proportion of patients actively smoking. The effect of cigarettes taxes was greater in older patients and those on Medicare. Among patients aged 60 to 69 and 70 to 79 years, every $1.00 tax increase resulted in 14% and 21% reductions in active smoking relative to baseline subgroup prevalences of 53% and 29%, respectively (P < .05 for both); however, younger age groups were not affected by tax increases. Among insurance groups, only patients on Medicare exhibited a significant change in active smoking with every $1.00 tax increase (an 18% decrease relative to a 33% baseline prevalence; P = .01). The number of states implementing smoke-free workplace legislation increased from 9 to 14 by 2019; however, this policy was not significantly associated with active smoking prevalence. At follow-up (median, 12.9 months), $1.00 tax increases were still associated with decreased smoking prevalence (a 25% decrease relative to a 33% baseline prevalence; P < .001). CONCLUSIONS Cigarette tax increases seem to be an effective strategy to decrease active smoking among patients undergoing interventions for IC. Older patients and Medicare recipients are the most responsive to tax increases.
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Pavlikova B, van Dijk JP. The Framework Convention on Tobacco Control in Slovakia and in Finland: one law, two different practices? BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2020; 20:26. [PMID: 32993626 PMCID: PMC7523304 DOI: 10.1186/s12914-020-00243-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 09/06/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Framework Convention on Tobacco Control (FCTC) was ratified in 2004 in Slovakia and in 2005 in Finland. The aim of this study was to compare the implementation of the FCTC in the national laws and policies regarding smoking in Finland and Slovakia. METHODS In this case study the following areas are compared: the legal framework; the monitoring system and health promotion; treatment; and policies aimed at reducing tobacco consumption. We report on these in this order after a short historical introduction. RESULTS The legal frameworks are similar in Slovakia and in Finland. Finland far exceeds the minimum legal requirements. Slovakian regulations reflect the FCTC requirements; however, social tolerance is very high. In Finland the monitoring system and health promotion are aimed more at tobacco consumption. Slovakia does not follow the surveillance plans recommended by WHO so strictly; often there are no current data available. No additional documents regarding the FCTC have been adopted in Slovakia. The financial contribution to treatment is very low. Slovakian tobacco control policy is more focused on repression than on prevention, in contrast to Finland. Smoking bans meet European standards. Excise duties rise regularly in both countries. CONCLUSION Implementation of the FCTC is at different levels in the compared countries. Finland has a clear plan for achieving the goal of a smoking-free country. Slovakia meets only the minimum standard required for fulfillment of its international obligations. Its policy should become more transparent by making more up-to-date data available.
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Affiliation(s)
- Barbara Pavlikova
- Department of Labor Law and Social Security Law, Faculty of Law, Comenius University, Šafárikovo námestie č. 6, P. O. BOX 313, 810 00, Bratislava, Slovak Republic.
| | - Jitse P van Dijk
- Department of Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Kosice, Slovak Republic
- Olomouc University Social Health Institute, Theological Faculty, Palacky University, Olomouc, Czech Republic
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Skeete J, Connell K, Ordunez P, DiPette DJ. Approaches to the Management of Hypertension in Resource-Limited Settings: Strategies to Overcome the Hypertension Crisis in the Post-COVID Era. Integr Blood Press Control 2020; 13:125-133. [PMID: 33061561 PMCID: PMC7532072 DOI: 10.2147/ibpc.s261031] [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: 05/07/2020] [Accepted: 08/15/2020] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic has changed most aspects of everyday life in both the non-medical and medical settings. In the medical world, the pandemic has altered how healthcare is delivered and has necessitated an aggressive and new coordinated public health approach to limit its spread and reduce its disease burden and socioeconomic impact. This pandemic has resulted in a staggering morbidity and mortality and massive economic and physical hardships. Meanwhile, non-communicable diseases such as hypertension, diabetes mellitus, and cardiovascular disease in general continue to cause significant disease burden globally in the background. Though presently receiving less attention in the public eye than the COVID-19 pandemic, the hypertension crisis cannot be separated from the minds of healthcare providers, policymakers and the general public, as it continues to wreak havoc, particularly in vulnerable populations in resource limited settings. On this background, many of the strategies being employed to combat the COVID-19 pandemic can be used to re-energize and galvanize the fight against hypertension and hopefully bring the public health crisis associated with uncontrolled hypertension to an end.
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Affiliation(s)
- Jamario Skeete
- Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Kenneth Connell
- Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, St. Michael, Barbados
| | - Pedro Ordunez
- Department of Non-Communicable Diseases and Mental Health, Pan-American Health Organization, Washington, DC, USA
| | - Donald J DiPette
- Department of Internal Medicine, University of South Carolina School of Medicine, University of South Carolina, Columbia, SC, USA
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Toebes B, Hesselman M, Mierau JO, van Dijk JP. A renewed call for transdisciplinary action on NCDs. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2020; 20:22. [PMID: 32859194 PMCID: PMC7453365 DOI: 10.1186/s12914-020-00241-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Notwithstanding COVID-19, non-communicable diseases (NCDs) will be the leading cause of death in every region in the world by 2030. This contribution, which forms an introduction to our collection of articles in this journal, identifies elements for a transdisciplinary research agenda between law, public health, health economics and international relations aimed at designing concrete interventions to curb the NCD pandemic, both globally and domestically.
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Affiliation(s)
- Brigit Toebes
- Global Health Law Groningen Research Centre, Department of Transboundary Legal Studies, Department of International Law, Faculty of Law, Aletta Jacobs School of Public Health, University of Groningen, PO Box 716, 9712 EK Groningen, the Netherlands
| | - Marlies Hesselman
- Department of Transboundary Legal Studies, Faculty of Law, University of Groningen, Oude Kijk in‘t Jatstraat 26, 9712 EK Groningen, the Netherlands
| | - Jochen O. Mierau
- Aletta Jacobs School of Public Health & Faculty of Economics and Business, University of Groningen, Nettelbosje 2, 9747 AE Groningen, The Netherlands
| | - Jitse P. van Dijk
- Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Ant. Deusinglaan 1, 9713 AV Groningen, the Netherlands
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