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Laestadius L, Vassey J, Kim M, Ozga J, Li D, Stanton C, Wipfli H, Unger JB. Themes in e-liquid concept names as a marketing tactic: evidence from Premarket Tobacco Product Applications in the USA. Tob Control 2024; 33:412-413. [PMID: 36171148 PMCID: PMC10043038 DOI: 10.1136/tc-2022-057657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/16/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Linnea Laestadius
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Julia Vassey
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Minji Kim
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
| | - Jenny Ozga
- Behavioral Health and Health Policy Practice, Westat, Inc, Rockville, Maryland, USA
| | - Dongmei Li
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, New York, USA
| | - Cassandra Stanton
- Behavioral Health and Health Policy Practice, Westat, Inc, Rockville, Maryland, USA
| | - Heather Wipfli
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
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Hirano T. Japan Tobacco corporate social responsibility activities misleadingly claim to advance Sustainable Development Goals. Tob Control 2024; 33:417-418. [PMID: 36167827 DOI: 10.1136/tc-2022-057630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Tomoyasu Hirano
- Institute for Cancer Control, National Cancer Center, Tokyo, Japan
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Hefler M. Tobacco control policy and regulation from diverse perspectives and contexts. Tob Control 2024; 33:e1-e2. [PMID: 38503442 PMCID: PMC10958273 DOI: 10.1136/tc-2024-058662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
- Marita Hefler
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
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Berg CJ, Duan Z, Wang Y, Thrasher JF, Bar-Zeev Y, Abroms LC, Romm KF, Khayat A, Levine H. Impact of FDA endorsement and modified risk versus exposure messaging in IQOS ads: a randomised factorial experiment among US and Israeli adults. Tob Control 2024; 33:e69-e77. [PMID: 36428095 DOI: 10.1136/tc-2022-057639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND IQOS was the first heated tobacco product to receive Food and Drug Administration (FDA) authorisation for 'reduced exposure' marketing claims, which has been exploited globally. METHODS In November-December 2021, we conducted a survey-based 3×3 factorial experiment among US (n=1128) and Israeli adults (n=1094). We presented: (1) reduced exposure, reduced risk and control messaging and (2) 2 variations of FDA endorsement and control messaging. Each participant was randomly assigned to evaluate 2 ads (displayed on different ad imagery), then completed assessments of perceived relative harm, exposure and disease risk and likelihood of personally trying or suggesting IQOS to smokers. Ordinal logistic regression examined messaging conditions and their interactions, on the 5 outcomes, respectively, adjusting for covariates. RESULTS Control (vs reduced exposure) messaging resulted in higher perceived relative harm (adjusted OR (aOR)=1.29, 95% CI=1.12 to 1.48), exposure (aOR=1.34, 95% CI=1.17 to 1.54) and disease risk (aOR=1.23; 95% CI=1.08 to 1.40), and lower likelihood of suggesting IQOS to smokers (aOR=0.85; 95% CI=0.74 to 0.97). Reduced risk (vs exposure) messaging resulted in lower perceived relative harm (aOR=0.86; 95% CI=0.75 to 0.99). One FDA endorsement message ('IQOS (completed) the US FDA examination of tobacco products. FDA concluded that IQOS is a better choice for adult smokers') was associated with greater likelihood of suggesting IQOS to smokers, relative to control (aOR=1.19; 95% CI=1.04 to 1.37). No interactions between risk/exposure messaging and FDA endorsement messaging were found. Additionally, Israeli participants, cigarette users and men perceived lower relative harm and exposure and greater likelihood of trying or suggesting IQOS to smokers. CONCLUSIONS Regulators must monitor direct and indirect advertising content of modified risk tobacco product-authorised products and prevent potentially harmful misinterpretations.
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Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Zongshuan Duan
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Yan Wang
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
| | - Yael Bar-Zeev
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah, Jerusalem, Israel
| | - Lorien C Abroms
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Katelyn F Romm
- Department of Pediatrics, College of Medicine; TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Amal Khayat
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah, Jerusalem, Israel
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah, Jerusalem, Israel
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Duan Z, Henriksen L, Vallone D, Rath JM, Evans WD, Romm KF, Wysota C, Berg CJ. Nicotine pouch marketing strategies in the USA: an analysis of Zyn, On! and Velo. Tob Control 2024; 33:154-163. [PMID: 35817549 DOI: 10.1136/tc-2022-057360] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/27/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Nicotine pouches are gaining popularity, yet their marketing is understudied. METHODS Using Numerator advertising data from January 2019 to September 2021 regarding three popular brands of nicotine pouch in the USA-Zyn (by Swedish Match, introduced in the USA in July 2016), On! (Altria, August 2016) and Velo (RJ Reynolds, July 2019)-we examined (1) general advertising characteristics (eg, media type, year); (2) ad content (ie, headlines and imagery themes); (3) prominent media channels (ie, specific websites, magazines, etc); and (4) ad expenditures. RESULTS There were 286 unique ads (Zyn: 44.4%; On!: 2.8%; Velo: 52.8%), 119 143 occurrences (Zyn: 3.5%; On!: 0.5%; Velo: 96.0%) and $24 774 650 total expenditures (Zyn: 4.7%; On!: 0.6%; Velo: 94.7%). The greatest proportion of ad occurrences and expenditures were accounted for by radio (75.9% and 28.2%, respectively) and television (16.2% and 56.5%), followed by mobile (0.5% and 7.2%) and online display (6.7% and 3.6%). Across ad occurrences and expenditures, prominent headline themes included 'freedom' (26.0% and 17.1%, respectively), 'brand' (9.6% and 18.6%) and 'flavour' (16.4% and 7.6%); images mainly featured the product alone (61.4% and 56.1%), text (16.2% and 24.6%) or men (8.7% and 8.6%); and prominent channel themes were entertainment (34.7% and 37.3%), news/weather (14.3% and 21.7%), business/finance (12.9% and 9.0%) and sports (9.5% and 1.0%). Zyn and On! prioritised online display and print; Velo prioritised radio and television. Zyn's and Velo's headlines focused on 'freedom', with Zyn also emphasising 'brand' and Velo 'innovation'; On!'s headlines emphasised 'flavour'. CONCLUSIONS Regulatory efforts must be informed by surveillance of nicotine pouch marketing and impacts on consumer subgroups (eg, young people).
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Affiliation(s)
- Zongshuan Duan
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California, USA
| | - Donna Vallone
- Truth Initiative Schroeder Institute, Washington, District of Columbia, USA
- School of Global Public Health, New York University, New York, New York, USA
| | - Jessica M Rath
- Truth Initiative Schroeder Institute, Washington, District of Columbia, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - W Douglas Evans
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
- Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Katelyn F Romm
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Christina Wysota
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Carla J Berg
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
- Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
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Nowicka J, Balwicki L. Heated tobacco products and cigarette marketing in nightclubs in Gdansk, Poland: A mixed-methods analysis. Tob Prev Cessat 2024; 10:TPC-10-01. [PMID: 38188060 PMCID: PMC10768186 DOI: 10.18332/tpc/174573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/21/2023] [Accepted: 10/26/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Although advertising and promotion of tobacco products in Poland are prohibited, tobacco companies exploit legal loopholes and insufficient enforcement of the laws to conduct their marketing. To reach young adults, advertisements are placed in entertainment and social venues. This aspect of tobacco product marketing in Poland remains under-researched. The main aim of this study was to investigate the occurrence and characteristics of advertising and promotion of tobacco products in nightclubs in Gdansk, a large city in northern Poland. METHODS We conducted a single-center observational study of nightclubs in Gdansk, between July and October 2022. Two independent observers visited 30 nightclubs and collected information using pre-prepared research form. The occurrences of tobacco branded bar accessories, logo signs, package displays and other forms of advertising and promotion were recorded. Where possible, photographs of visible marketing displays were taken. RESULTS Advertising of tobacco products was present in 2/3 of the nightclubs observed. The most commonly advertised product category were heated tobacco products. Tobacco brand representatives promoted and offered consumers free tobacco product samples. Multi-level marketing activities were observed, including tobacco branded bar accessories, prominent sale points and tobacco brand logo signs. CONCLUSIONS The majority of nightclubs observed in Gdansk advertise and promote tobacco products. The ban on tobacco advertising and promotion is being violated in nightclubs, where the most commonly advertised products are heated tobacco products. The authorities should take steps to extend the bans to cover private promotion and enforce the law to protect high-risk individuals from smoking initiation and relapse.
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Affiliation(s)
- Julia Nowicka
- Department of Public Health and Social Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Lukasz Balwicki
- Department of Public Health and Social Medicine, Medical University of Gdansk, Gdansk, Poland
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Chen-Sankey J, Jeong M, Wackowski OA, Unger JB, Niederdeppe J, Bernat E, Bansal-Travers M, Moran M, Kennedy RD, Broun A, Hacker K, Choi K. Noticing people, discounts and non-tobacco flavours in e-cigarette ads may increase e-cigarette product appeal among non-tobacco-using young adults. Tob Control 2023; 33:30-37. [PMID: 35672144 PMCID: PMC9726993 DOI: 10.1136/tobaccocontrol-2022-057269] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/31/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Young adults new to tobacco (including e-cigarettes) are at an increased risk of e-cigarette use after e-cigarette exposure. This study examined the association between noticing e-cigarette advertising features and perceived product appeal among non-tobacco-using young adults. METHODS A sample of non-tobacco-using young adults (ages 18-29 years; n=1993) completed an online survey in 2021. We content analysed visible features from 12 e-cigarette ads that represented commonly used e-cigarette brands. Participants viewed the ads and clicked on the areas of the ads that drew their attention. Participants reported e-cigarette product appeal for each ad, including ad liking, product curiosity and use interest. We used generalised estimating equations to examine within-person associations between noticing specific ad features and reporting each and any type of product appeal, adjusting for noticing other features and participant characteristics. RESULTS Noticing people, discounts, non-tobacco (menthol and mint/fruit) flavours, positive experience claims or product images was positively associated with having any e-cigarette product appeal. Noticing discounts or mint/fruit flavours was also positively associated with e-cigarette use interest. In contrast, noticing nicotine warnings or smoking cessation claims was negatively associated with ad liking and product curiosity. CONCLUSIONS Attention to several e-cigarette ad features (eg, people, discounts, non-tobacco flavours) was associated with increased e-cigarette product appeal, whereas attention to nicotine warnings and smoking cessation claims was associated with reduced appeal among non-tobacco-using young adults. Restricting appeal-promoting features while strengthening the effects of nicotine warnings and smoker-targeted claims in e-cigarette ads may potentially reduce e-cigarettes' overall appeal among this priority population.
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Affiliation(s)
- Julia Chen-Sankey
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Michelle Jeong
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Olivia A Wackowski
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Jeff Niederdeppe
- Department of Communication, Cornell University, Ithaca, New York, USA
| | - Edward Bernat
- Department of Psychology, University of Maryland College Park, College Park, Maryland, USA
| | | | - Meghan Moran
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ryan David Kennedy
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Aaron Broun
- School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Kiana Hacker
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
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González-Marrón A, Koprivnikar H, Tisza J, Cselkó Z, Lambrou A, Peruga A, Kilibarda B, Lidón-Moyano C, Carnicer-Pont D, Papachristou E, Nunes E, Carreras G, Gorini G, Pérez-Martín H, Martínez-Sánchez JM, Spizzichino L, Karekla M, Mulcahy M, Vasic M, Ruokolainen O, Guignard R, Schoretsaniti S, Laatikainen T, Nguyen-Thanh V, Ollila H. Tobacco endgame in the WHO European Region: Feasibility in light of current tobacco control status. Tob Induc Dis 2023; 21:151. [PMID: 38026503 PMCID: PMC10647070 DOI: 10.18332/tid/174360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION To assess the feasibility of developing World Health Organization (WHO) European Region countries' goals and measures in line with tobacco endgame objectives, information on the current tobacco control context and capacity is needed. The aim of this study was to assess the implementation of the Framework Convention on Tobacco Control (WHO FCTC) and MPOWER measures in the region. METHODS In this cross-sectional study we used data from the WHO FCTC implementation reports and MPOWER from 2020 in 53 WHO European Region countries. Six domains (i.e. capacity, taxation and price policies, other national key regulations, public awareness raising and communication, tobacco use cessation, and monitoring) were formed. Subsequently, available indicators under these domains were scored and the level of implementation was computed for each country. Mann-Whitney tests were carried out to compare the scores between the group of countries with and without official endgame goals. RESULTS Overall, implementation of the WHO FCTC with the selected indicators at the country level ranged from 28% to 86%, and of MPOWER from 31% to 96%. Full implementation was achieved by 28% of WHO FCTC Parties in the region in taxation and price policies, 12% in public awareness raising and communication, and 42% in monitoring. In capacity, tobacco use cessation and other national key regulations, none of the Parties in the region reached full implementation. Overall median WHO FCTC scores were significantly higher in countries with official endgame goals than in those without (p<0.001). CONCLUSIONS There is unequal implementation of both WHO FCTC and MPOWER measures among WHO European Region countries. MPOWER and WHO FCTC provide all the measures for the necessary first steps, followed by innovative measures, to accomplish tobacco endgame goals.
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Affiliation(s)
- Adrián González-Marrón
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
- Department of Health Technology Assessment and Health Economics, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | | | - Judit Tisza
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Zsuzsa Cselkó
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Angeliki Lambrou
- Directorate of Epidemiology and Prevention of Non-Communicable Diseases and Injuries, National Public Health Organization (NPHO), Athens, Greece
| | - Armando Peruga
- Grupo de Investigación en Control del Tabaco, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, (CIBERES), Madrid, España
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Biljana Kilibarda
- Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Belgrade, Serbia
| | - Cristina Lidón-Moyano
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Dolors Carnicer-Pont
- Grupo de Investigación en Control del Tabaco, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, (CIBERES), Madrid, España
- Programa de Prevenció i Control del Càncer, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, España
| | - Efstathios Papachristou
- Directorate of Epidemiology and Prevention of Non-Communicable Diseases and Injuries, National Public Health Organization (NPHO), Athens, Greece
| | - Emilia Nunes
- General Directorate of Health, Ministry of Health, Lisbon, Portugal
| | - Giulia Carreras
- Clinical Epidemiology Unit, Oncologic network, prevention and research institute (ISPRO), Florence, Italy
| | - Giuseppe Gorini
- Clinical Epidemiology Unit, Oncologic network, prevention and research institute (ISPRO), Florence, Italy
| | - Hipólito Pérez-Martín
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Jose M. Martínez-Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | | | | | - Maurice Mulcahy
- National Environmental Health Service, Health Service Executive (HSE), Galway Business Park, Dangan, Ireland
| | - Milena Vasic
- Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Belgrade, Serbia
- Faculty of Dentistry, Pancevo, Serbia
| | | | - Romain Guignard
- Santé Publique France, the French National Public Health Agency, Saint-Maurice, France
| | - Sotiria Schoretsaniti
- Directorate of Epidemiology and Prevention of Non-Communicable Diseases and Injuries, National Public Health Organization (NPHO), Athens, Greece
| | - Tiina Laatikainen
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Viêt Nguyen-Thanh
- Santé Publique France, the French National Public Health Agency, Saint-Maurice, France
| | - Hanna Ollila
- Finnish Institute for Health and Welfare, Helsinki, Finland
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Andrews M, Cooper N, Mattan BD, Carreras-Tartak J, Paul AM, Strasser AA, Henriksen L, Falk EB. Causal effects of point-of-sale cigarette promotions and subjective social status on cigarette craving: a randomised within-person experiment. Tob Control 2023:tc-2023-058069. [PMID: 37949653 DOI: 10.1136/tc-2023-058069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 10/17/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Cigarette smoking continues to be a leading cause of preventable deaths in the USA, in part because the USA has not adopted the WHO Framework Convention on Tobacco Control. One way the tobacco industry counteracts tobacco control policies is by heavily advertising cigarettes at the point of sale in retailers (eg, at the cash register) and by offering discounts on cigarettes. DESIGN A within-subject experimental design with adults who smoke cigarettes daily (n=281) investigated whether: (1) exposure to images of cigarette promotions in an online experiment is associated with greater cigarette craving relative to viewing images of non-smoking cues, and (2) if exposure to images of point-of-sale cigarette promotions with a discount (vs without) increases cigarette craving. The study also examined how participants' subjective social status (compared with others in the USA) relates to cigarette craving after exposure to images of cigarette promotions with and without a discount. RESULTS In an online experiment, exposure to images of smoking cues, including point-of-sale cigarette promotions, elicited greater craving relative to non-smoking cues (all p<0.001). In addition, images of promotions with a discount elicited higher levels of craving compared with those without a discount (b=0.09, p=0.001). Although participants with a higher (vs lower) subjective social status craved cigarettes less overall (b=-0.12, p=0.012), there was no difference in their craving between images of promotions with and without a discount, while craving was higher for images of promotions with a discount than without for participants with higher subjective social status (b=0.06, p=0.021). CONCLUSION Viewing images of point-of-sale cigarette promotions can causally increase cravings to smoke, which may also apply to real-world retail settings that display cigarette promotions. Restricting point-of-sale promotions generally, and discounts specifically, could help reduce cigarette smoking and address tobacco use disparities in the USA.
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Affiliation(s)
- Mary Andrews
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nicole Cooper
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Bradley D Mattan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - José Carreras-Tartak
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alexandra M Paul
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Andrew A Strasser
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
| | - Emily B Falk
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Wharton Marketing Department, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Koval R, Dorrler N, Schillo B. Tobacco industry advertising: efforts to shift public perception of big tobacco with paid media in the USA. Tob Control 2023; 32:801-802. [PMID: 35577402 DOI: 10.1136/tobaccocontrol-2021-057189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Robin Koval
- Truth Initiative, Washington, District of Columbia, USA
| | | | - Barbara Schillo
- Truth Initiative Schroeder Institute, Washington, District of Columbia, USA
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Do EK, O'Connor K, Diaz MC, Schillo BA, Kreslake JM, Hair EC. Relative increases in direct-to-consumer menthol ads following 2020 FDA guidance on flavoured e-cigarettes. Tob Control 2023; 32:779-781. [PMID: 35184047 DOI: 10.1136/tobaccocontrol-2021-057069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/07/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine potential changes in email and direct mail advertisements for flavoured e-cigarettes following the 2020 Food and Drug Administration (FDA) flavour guidance. METHODS Digital copies of e-cigarette advertisements were obtained from Mintel Comperemedia (November 2019-May 2020) and coded for the presence of flavours. Χ2 tests were used to determine changes in the prevalence of email and direct mail advertisements for e-cigarettes with menthol, non-menthol and no flavours. RESULTS Following FDA guidance, the relative proportion of menthol-flavoured e-cigarette advertisements sent via email significantly increased from 22.5% to 52.2%. No changes were found for e-cigarette advertisements mentioning no flavours, nor non-menthol-flavoured e-cigarettes, sent via email or direct mail. CONCLUSIONS The 2020 FDA flavour guidance was followed by an increased proportion of direct-to-consumer email advertisements of menthol-flavoured e-cigarette products.
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Affiliation(s)
- Elizabeth K Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Epidemiology, The George Washington University Milken Institute of Public Health, Washington, DC, USA
| | - Katie O'Connor
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | - Megan C Diaz
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | | | - Jennifer M Kreslake
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth C Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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12
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Grilo G, Cohen JE, Reynales-Shigematsu LM, Welding K, Flores Escartin MG, Madar A, Clegg Smith K. Cultural appropriation on Marlboro packs in Mexico: ofrenda symbolism a cruel irony. Tob Control 2023; 32:806-808. [PMID: 35217595 PMCID: PMC10646926 DOI: 10.1136/tobaccocontrol-2021-057215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/07/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Graziele Grilo
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Luz Myriam Reynales-Shigematsu
- Departamento de Prevención y Control de Tabaquismo, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Kevin Welding
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Maria Guadalupe Flores Escartin
- Departamento de Prevención y Control de Tabaquismo, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Alena Madar
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Katherine Clegg Smith
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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13
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Amul GGH, Mallari EU, Arda JRY, Santiago AJA. Graphic health warnings and plain packaging in the Philippines: results of online and household surveys. Front Public Health 2023; 11:1207779. [PMID: 37822542 PMCID: PMC10562603 DOI: 10.3389/fpubh.2023.1207779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/29/2023] [Indexed: 10/13/2023] Open
Abstract
In line with Article 11 of the WHO Framework Convention on Tobacco Control, the Philippines has implemented graphic health warnings on cigarette packs. To date, there has been no published literature evaluating the perceived effectiveness of GHWs in the Philippines. This study aims to contribute to the evidence on the perceived effects of graphic health warnings (GHWs) in cigarette packaging and the potential impact of plain packaging in the Philippines. The study involved an online convenience survey and a nationwide household survey. Mock-up sets of cigarette packs based on the Philippines' law on GHWs, and Thailand's and Singapore's plain packaging were shown to respondents to rate their attractiveness, quality, taste, cost, social appeal, appeal to youth, noticeability, appeal to non-smokers, attempt to quit, ease of quitting, discouraging smoking, and perceived harm to health on a five-point Lickert scale. The online and household surveys recruited 2,701 respondents in total. Online and household survey respondents considered plain packaging with larger graphic health warnings and visible quitlines from Thailand and Singapore to be more effective in discouraging them from smoking. Both sets of survey respondents also found mock-ups from Thailand and Singapore more motivating for them to attempt quitting than cigarette pack mock-ups from the Philippines. The study concludes that current graphic health warnings in the Philippines are ineffective in instilling health consciousness among Filipinos. Policymakers should consider larger graphic health warnings and plain packaging of cigarettes to motivate smokers to quit and discourage Filipinos from smoking.
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Affiliation(s)
- Gianna Gayle H. Amul
- Ateneo Policy Center, School of Government, Ateneo de Manila University, Quezon City, Philippines
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14
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Stubbs T, White VM, Kong M, Toumbourou JW. Uncovering the advertising and promotional strategies of tobacco companies in Cambodia: recall of below-the-line marketing among young male smokers. Tob Control 2023; 32:614-619. [PMID: 35177539 DOI: 10.1136/tobaccocontrol-2021-057063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/28/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Tobacco companies have used below-the-line marketing in novel ways to promote their brands to youth in low/middle-income countries in Southeast Asia. This study explores how young male smokers in Cambodia experience below-the-line marketing strategies. METHODS Convenience sampling was used to recruit 147 young male smokers (18-24 years) in Cambodia in early 2020. Local research assistants conducted mixed-methods interviews with participants in Khmer or English. Participants recalled exposure to below-the-line marketing strategies and provided in-depth descriptions about their experiences with individual sales promotions. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using thematic analysis. RESULTS 54% of participants recalled exposure to at least one below-the-line marketing strategy, including point-of-sale promotions (32.7%), individual sales promotions (27.9%) and online advertising (14.3%). Participants described individual sales promotions in public settings, and recalled that promoters were mostly female, attractive and targeted young males. Tactics used to encourage young people to accept promotional offers included free cigarettes and sample packets, swapping current cigarettes for new brands and collecting consumer details after interviewing. The brands and product features of cigarettes being promoted were readily described by participants. CONCLUSION This study provides evidence that illegal below-the-line marketing is still occurring in Cambodia, and increased monitoring and enforcement of advertising restrictions is needed.
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Affiliation(s)
- Thomas Stubbs
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Victoria M White
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Mom Kong
- Cambodian Movement for Health, Phnom Penh, Cambodia
| | - John W Toumbourou
- Centre for Drug use, Addictive and Anti-social behaviour Research, School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
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15
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Usidame B, Xie Y, Thrasher JF, Lozano P, Elliott MR, Fong GT, Fleischer NL. Differential impact of the Canadian point-of-sale tobacco display bans on quit attempts and smoking cessation outcomes by sex, income and education: longitudinal findings from the ITC Canada Survey. Tob Control 2023; 32:599-606. [PMID: 35017260 PMCID: PMC9271527 DOI: 10.1136/tobaccocontrol-2021-056805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 12/27/2021] [Indexed: 11/04/2022]
Abstract
SIGNIFICANCE This study examines the differential effects of Canadian point-of-sale (POS) tobacco display bans across provinces on quit attempts and smoking cessation, by sex, education and income. METHODS We analysed survey data from five waves (waves 4-8) of the International Tobacco Control Canada Survey, a population-based, longitudinal survey, where provinces implemented display bans between 2004 and 2010. Primary outcomes were quit attempts and successful cessation. We used generalised estimating equation Poisson regression models to estimate associations between living in a province with or without a POS ban (with a 24-month threshold) and smoking outcomes. We tested whether these associations varied by sex, education and income by including interaction terms. RESULTS Across survey waves, the percentage of participants in provinces with POS bans established for more than 24 months increased from 5.0% to 95.8%. There was no association between POS bans and quit attempts for provinces with bans in place for 0-24 months or more than 24 months, respectively (adjusted relative risk (aRR)=0.99, 95% CI: 0.89 to 1.10; 1.03, 95% CI: 0.88 to 1.20). However, we found a differential impact of POS bans on quit attempts by sex, whereby bans were more effective for women than men for bans of 0-24 months. Participants living in a province with a POS ban for at least 24 months had a higher chance of successful cessation (aRR=1.49; 95% CI: 1.08 to 2.05) compared with those in a province without a ban. We found no differences in the association between POS bans and quit attempts or cessation by education or income, and no differences by sex for cessation. CONCLUSION POS bans are associated with increased smoking cessation overall and more quit attempts among women than men.
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Affiliation(s)
- Bukola Usidame
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yanmei Xie
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - James F Thrasher
- Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
- National Institute of Public Health, Cuernavaca, Mexico
| | - Paula Lozano
- Center for Asian Health Equity, The University of Chicago Medicine, Chicago, Illinois, USA
| | - Michael R Elliott
- Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Kc S, Filippidis FT, Laverty AA. Legislative provisions for standardised tobacco packaging and changes in public support in 27 European countries. Tob Control 2023; 32:664-666. [PMID: 35017263 DOI: 10.1136/tobaccocontrol-2021-057068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/19/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Global adoption of standardised packaging requirements for tobacco products is a victory for public health, but their proliferation and impacts rely partly on public support. How this is related to legislation remains underassessed. This study explored change over time in public support for standardised packaging in countries with varying degrees of legislative provisions. METHODS We used data from 27 European countries, collected from 2017 (n=28, 300) and 2020 (n=27, 901) waves of the Eurobarometer survey, to assess self-reported support for standardised packaging regulations among both smokers and non-smokers. Countries were grouped into three categories of policy adoption (policy implemented; policy legislated; no legislation) and changes in support were assessed using multilevel Poisson regression models. RESULTS In 2020, public support for standardised packaging was 71% (95% CI 68% to 74%) in countries that implemented standardised packaging legislation, 57% (55% to 60%) in countries that had legislated but not yet implemented legislation and 41% (40%to 42%) in countries with no legislation. Compared with 2017, this represented a relative change of +8% (1% to 15%), +12% (5% to 21%) and -5% (95% CI -2% to -8%), respectively, in the three country categories. Among smokers, there was no indication of change in support across the three groups. Among non-smokers, support increased in countries with existing legislation (adjusted prevalence ratio [aPR]=1.14, 95% CI 1.06 to 1.23) and decreased in countries with no legislation (aPR=0.93, 0.90 to 0.97). CONCLUSIONS Public support for standardised packaging regulations increased in countries implementing and legislating for these measures, particularly among non-smokers. An overall increase in support provides reassurance for policymakers defending policy action on tobacco packaging, as well as for those seeking to implement standardised packaging in their own countries. .
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Affiliation(s)
- Sukriti Kc
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Filippos T Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
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17
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Reimold AE, Lee JGL, Ribisl KM. Tobacco company agreements with tobacco retailers for price discounts and prime placement of products and advertising: a scoping review. Tob Control 2023; 32:635-644. [PMID: 35074932 PMCID: PMC9359804 DOI: 10.1136/tobaccocontrol-2021-057026] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/05/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE The objectives of this scoping review are to examine existing research on the often-secretive contracts between tobacco manufacturers and retailers, to identify contract requirements and incentives, and to assess the impact of contracts on the sales and marketing of tobacco products in the retail setting. DATA SOURCES The systematic search was conducted in PubMed/MEDLINE, Web of Science, Scopus, ProQuest Political Science Database, Business Source Premier, ProQuest Agricultural & Environmental Science Collection, and Global Health through December 2020. STUDY SELECTION We included studies that collected and analysed empirical data related to tobacco contracts, tobacco manufacturers, and tobacco retailers. Two reviewers independently screened all 2786 studies, excluding 2694 titles and abstracts and 65 full texts resulting in 27 (0.97%) included studies. DATA EXTRACTION Study characteristics, contract prevalence, contract requirements and incentives, and the influence of contracts on the retail environment were extracted from each study. DATA SYNTHESIS We created an evidence table and conducted a narrative review of included studies. CONCLUSIONS Contracts are prevalent around the world and handsomely incentivise tobacco retailers in exchange for substantial manufacturer control of tobacco product availability, placement, pricing and promotion in the retail setting. Contracts allow tobacco companies to promote their products and undermine tobacco control efforts in the retail setting through discounted prices, promotions and highly visible placement of marketing materials and products. Policy recommendations include banning tobacco manufacturer contracts and retailer incentives along with more transparent reporting of contract incentives given to retailers.
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Affiliation(s)
- Alexandria E Reimold
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Joseph G L Lee
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, USA
| | - Kurt M Ribisl
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
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18
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van Deelen TRD, Kunst AE, van den Putte B, Veldhuizen EM, Kuipers MAG. Ex ante evaluation of the impact of tobacco control policy measures aimed at the point of sale in the Netherlands. Tob Control 2023; 32:620-626. [PMID: 35512850 PMCID: PMC10447367 DOI: 10.1136/tobaccocontrol-2021-057205] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/29/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The Netherlands aims to implement stricter tobacco control policies targeting the retail environment. This paper is an ex ante policy evaluation of the potential impact of the current tobacco display and advertising ban as well as future tobacco sales bans on tobacco outlet visibility and availability. METHODS Between September 2019 and June 2020, all potential tobacco retailers in four Dutch cities (Amsterdam, Eindhoven, Haarlem and Zwolle) were visited and mapped using Global Positioning System. For each retailer selling tobacco, we completed a checklist on the visibility of tobacco products and advertising. Expected reductions in tobacco outlet visibility and availability were calculated per policy measure in absolute numbers (percentage or percentage point decrease) as well as density and proximity. RESULTS Out of 870 tobacco outlets, 690 were identified with visible tobacco products/advertising. The display ban in supermarkets and small outlets (respectively) is expected to decrease the number (-15; -42 percentage points), outlet density per 10 000 capita (-0.9; -2.6) and proximity in metres (+27 m; +400 m) of outlets with visible products/advertising. The upcoming bans on vending machines and sales in supermarkets are expected to decrease the number (-12%; -31%), density (-0.7; -1.9) and proximity (+12 m; +68 m) of tobacco outlets. Further changes in the number, density and proximity (respectively) of tobacco outlets may be achieved with future sales bans in petrol stations (-7%; -0.4; +60 m) and particularly with a ban on sales in small outlets (-43%; -2.7; +970 m). CONCLUSION A display ban and a sales ban in small outlets will contribute most to reducing tobacco outlet visibility and availability, assuming that no market shift towards other tobacco outlets will take place.
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Affiliation(s)
- Tessa R D van Deelen
- Public and Occupational Health, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Anton E Kunst
- Public and Occupational Health, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Bas van den Putte
- Amsterdam School of Communication Research, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Els M Veldhuizen
- Department of Geography and Planning, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirte A G Kuipers
- Public and Occupational Health, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
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Noar SM, Gottfredson N, Vereen RN, Kurtzman R, Sheldon JM, Adams E, Hall MG, Brewer NT. Development of the UNC Perceived Message Effectiveness Scale for Youth. Tob Control 2023; 32:553-558. [PMID: 34930810 PMCID: PMC9238328 DOI: 10.1136/tobaccocontrol-2021-056929] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/26/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE Tobacco prevention media campaigns are an important tool to address youth tobacco use. We developed a theory-based perceived message effectiveness (PME) Scale to use when vetting messages for campaigns. METHODS Participants were a national sample of N=623 US adolescents (ages 13-17 years) recruited from a national probability-based panel. In an online experiment, we randomised adolescents to view tobacco prevention ads. All participants viewed an ad on smoking or vaping from the US Food and Drug Administration's The Real Cost campaign and a control video, in a random order. After ad exposure, we assessed PME using nine candidate items and constructs for convergent and criterion validity analyses. We used confirmatory factor analysis and examined information curves to select the scale items. RESULTS A brief PME scale with three items (α=0.95) worked equally well for demographically diverse adolescents with different patterns of tobacco use. The Real Cost ads generated higher PME scores than the control videos for both vaping and smoking (convergent validity; p<0.05). Higher PME scores were associated with greater attention, fear, cognitive elaboration and anticipated social interactions (convergent validity; r=0.31-0.66), as well as more negative attitudes toward and lower susceptibility to vaping and smoking (criterion validity; r=-0.14 to -0.37). A single-item PME measure performed similarly to the three-item version. CONCLUSIONS The University of North Carolina PME Scale for Youth is a reliable and valid measure of the potential effectiveness of vaping and smoking prevention ads. Employing PME scales during message development and selection may help youth tobacco prevention campaigns deploy more effective ads.
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Affiliation(s)
- Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Nisha Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rhyan N Vereen
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rachel Kurtzman
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jennifer Mendel Sheldon
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Elizabeth Adams
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Marissa G Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Noel T Brewer
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
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20
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Gratale SK, Ganz O, Wackowski OA, Lewis MJ. Naturally leading: a content analysis of terms, themes and word associations in Natural American Spirit advertising, 2000-2020. Tob Control 2023; 32:583-588. [PMID: 35022329 PMCID: PMC9273802 DOI: 10.1136/tobaccocontrol-2021-056938] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/22/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Natural American Spirit (NAS) is a cigarette brand distinguished by supposed 'natural', 'additive-free' characteristics, marketing of which is tied to misperceptions of reduced harm. In 2017, NAS's manufacturer agreed (with the Food and Drug Administration) to remove 'natural'/'additive-free' from US marketing. Prior research has explored NAS marketing immediately post-agreement. This study sought to identify prominent post-agreement terms and themes and analyse how they had been used in pre-agreement ads. METHODS We conducted a content analysis of NAS ads from 2000 to 2020 (N=176), documenting prominent pre-agreement and post-agreement terms/themes and examining how they are used in NAS ads. We coded for descriptors, themes, imagery and promotions, and extended prior research by analysing how leading post-agreement terms were used in conjunction and thematically associated with 'additive-free' and 'natural' before the agreement. RESULTS Results indicated 'tobacco and water' and 'Real. Simple. Different.' increased post-agreement, as did environmental imagery. 'Organic' was prominent pre-agreement and post-agreement. The descriptors used most often in post-agreement ads almost always appeared in conjunction with (and were thematically linked to) 'natural' and 'additive-free' in pre-agreement ads. CONCLUSIONS In the years since the agreement, NAS ads have heavily relied on still-allowable descriptors that may invite reduced risk misperceptions. Notably, these descriptors were consistently used alongside the banned terminology before the agreement and presented as if affiliated conceptually, possibly prompting similar connotations. Findings indicate a continuing need for research into NAS advertising effects and a potential role for additional regulatory action.
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Affiliation(s)
- Stefanie K Gratale
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
| | - Ollie Ganz
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Olivia A Wackowski
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - M Jane Lewis
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
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Levy DT, Liber AC, Cadham C, Sanchez-Romero LM, Hyland A, Cummings M, Douglas C, Meza R, Henriksen L. Follow the money: a closer look at US tobacco industry marketing expenditures. Tob Control 2023; 32:575-582. [PMID: 35074930 PMCID: PMC9346571 DOI: 10.1136/tobaccocontrol-2021-056971] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 12/12/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION While much of the concern with tobacco industry marketing has focused on direct media advertising, a less explored form of marketing strategy is to discount prices. Price discounting is important because it keeps the purchase price low and can undermine the impact of tax increases. METHODS We examine annual US marketing expenditures from 1975 to 2019 by the largest cigarette and smokeless tobacco companies as reported to the Federal Trade Commission. We consider three categories: direct advertising, promotional allowances and price discounting. In addition to considering trends in these expenditures, we examine how price discounting expenditures relate to changes in product prices and excise taxes. RESULTS US direct advertising expenditures for cigarettes fell from 80% of total industry marketing expenditures in 1975 to less than 3% in 2019, while falling from 39% in 1985 to 6% in 2019 for smokeless tobacco. Price discounting expenditures for cigarettes became prominent after the Master Settlement Agreement and related tax increases in 2002. By 2019, 87% of cigarette marketing expenditures were for price discounts and 7% for promotional allowances. Smokeless marketing expenditures were similar: 72% for price promotions and 13% for promotional allowances. Price discounting increased with prices and taxes until reaching their currently high levels. CONCLUSIONS Between 1975 and 2019, direct advertising dramatically fell while price discounting and promotional expenditures increased. Local, state and federal policies are needed that apply non-tax mechanisms to increase tobacco prices and restrict industry contracts to offset industry marketing strategies. Further study is needed to better understand industry decisions about marketing expenditures.
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Affiliation(s)
- David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Alex C Liber
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Christopher Cadham
- Department of Health Management and Policy, University of Michigan School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Andrew Hyland
- Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Michael Cummings
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Cliff Douglas
- Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Rafael Meza
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
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Donaldson SI, Beard T, Dormanesh A, Pérez C, Escobedo P, Unger JB, Wipfli HL, Galimov A, Allem JP. Monitoring website marketing among leading e-cigarette brands and vendors in California: content analysis. Tob Control 2023:tc-2023-058000. [PMID: 37643863 DOI: 10.1136/tc-2023-058000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Electronic cigarette (e-cigarette) brands and vendors use websites to promote pro-tobacco messages that may increase susceptibility to use e-cigarettes among never users or help sustain continued e-cigarette use among current users. E-cigarette website marketing is lightly regulated, and little is known about promotional strategies used on e-cigarette companies' websites. This study conducted a content analysis of website marketing from leading e-cigarette companies selling products in California. METHODS This study identified 20 e-cigarette vendors and 6 e-cigarette brands that had products available for purchase online in California. Two coders visited 26 websites between 06 February 2022 and 17 April 2022. Websites were coded for marketing themes, promotional and interactive content, availability of flavoured e-cigarette products, presence of health warnings, and reference to tobacco control policies. RESULTS Marketing themes related to physical health benefits of e-cigarette use were found on 50.0% of the websites. 57.7% of the websites had sales/discounts/coupons. 65.4% of the websites had fruit-flavoured disposable e-cigarettes, while 73.1% of the websites had fruit-flavoured e-liquids available for purchase. 69.2% of the websites allowed users to sign up for email newsletters, and 88.9% of such websites did not require users to create an age-verified account to receive email newsletters. CONCLUSIONS Findings from this study can be used to inform statewide regulations of promotional communications found on e-cigarette companies' websites and encourage enforcement of age-verification procedures. This may help reduce susceptibility to use, or continued use of, e-cigarette products among price-sensitive populations, such as adolescents and young adults.
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Affiliation(s)
- Scott I Donaldson
- Department of Population and Public Health Sciences, USC Keck School of Medicine, Los Angeles, California, USA
| | - Trista Beard
- Department of Population and Public Health Sciences, USC Keck School of Medicine, Los Angeles, California, USA
| | - Allison Dormanesh
- Department of Population and Public Health Sciences, USC Keck School of Medicine, Los Angeles, California, USA
| | - Cindy Pérez
- Department of Population and Public Health Sciences, USC Keck School of Medicine, Los Angeles, California, USA
| | - Patricia Escobedo
- Department of Psychology, California State University Northridge, Northridge, California, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, USC Keck School of Medicine, Los Angeles, California, USA
| | - Heather Lynn Wipfli
- Department of Population and Public Health Sciences, USC Keck School of Medicine, Los Angeles, California, USA
| | - Artur Galimov
- Department of Population and Public Health Sciences, USC Keck School of Medicine, Los Angeles, California, USA
| | - Jon-Patrick Allem
- Department of Population and Public Health Sciences, USC Keck School of Medicine, Los Angeles, California, USA
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Kostygina G, Tran H, Czaplicki L, Perks SN, Vallone D, Emery SL, Hair EC. Developing a theoretical marketing framework to analyse JUUL and compatible e-cigarette product promotion on Instagram. Tob Control 2023; 32:e192-e197. [PMID: 35190395 PMCID: PMC9942712 DOI: 10.1136/tobaccocontrol-2021-057120] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/22/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND E-cigarette promotion on social media coincided with the rapid growth of e-cigarette use among American youth, particularly with the increased JUUL pod vaporiser use. We examined commercial JUUL-related messages on Instagram to identify marketing appeals used to target users along the continuum of e-cigarette use; we mapped the appeals to existing theoretical marketing frameworks to better understand industry strategies. METHODS Hashtag-based keyword rules were used to collect JUUL-related posts from the Instagram application programming interface, 1 March-13 November 2018. Posts were classified as commercial or non-commercial. A combination of machine learning methods, keyword algorithms and human coding were used to characterise message themes in commercial posts. RESULTS Keyword filters captured 50 817 relevant posts and 41% were commercial. Among commercial posts, 91% contained recruitment/trial-based appeals (eg, combustible tobacco cessation; product sampling; giveaways) and 71% featured reinforcement/addiction-related appeals (eg, loyalty programmes). None of the commercial messages contained e-cigarette cessation-related appeals and less than 25% mentioned quitting combustible tobacco as a recruitment appeal. CONCLUSIONS Instagram posts featuring e-cigarette related marketing can increase exposure to persuasive messages encouraging e-cigarette trial and use particularly among susceptible youth. Stronger regulations are needed to prevent exposure to social media marketing among young social media users.
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Affiliation(s)
- Ganna Kostygina
- Department of Public Health, National Opinion Research Center, Chicago, Illinois, USA
| | - Hy Tran
- Department of Public Health, National Opinion Research Center, Chicago, Illinois, USA
| | - Lauren Czaplicki
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Donna Vallone
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- College of Global Public Health, New York University, New York, New York, USA
| | - Sherry L Emery
- Department of Public Health, National Opinion Research Center, Chicago, Illinois, USA
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24
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Braznell S, Branston JR, Gilmore AB. Corporate communication of the relative health risks of IQOS through a webchat service. Tob Control 2023; 32:e205-e211. [PMID: 35241501 PMCID: PMC10423550 DOI: 10.1136/tobaccocontrol-2021-056999] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/31/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Communication of the relative health risks of IQOS can attract potential consumers, aiding its commercial success. However, health-related claims need to be used cautiously to avoid inaccuracies and attracting non-smokers. We used the live webchat service on the IQOS website to identify information and claims on the relative risks of IQOS made directly to potential consumers in different countries. METHODS The study was promoted through authors' networks and conducted between 1 August and 30 November 2020. Participants collected webchat conversation responses to three queries regarding the safety of IQOS relative to cigarettes and e-cigarettes using step-by-step guidance and a predesigned form. Responses were analysed to identify health-related claims and information provided. RESULTS 70 webchat attempts were recorded across 27 countries, 54 of which (in 22 countries) were successful webchat conversations. In 48 of these, one or more claims were used to indicate IQOS is safer than cigarettes, such as IQOS is smoke free, emits less harmful substances or reduces harm. Four conversations contained statements indicating IQOS is safer than e-cigarettes. Some statements provided were contradictory. Participant age was consistently requested on accessing the website, but tobacco/nicotine use was not. Other information provided included referral to the 2020 US Food and Drug Administration Modified Risk Tobacco Product decision, IQOS or Philip Morris International web pages and claims that IQOS is not risk free nor a cessation device. CONCLUSIONS A variety of claims and information on the relative safety of IQOS were used in webchat communications. Response variation highlights that clearer regulation is needed to appropriately control corporate communications via live webchat services.
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25
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Vassey J, Valente T, Barker J, Stanton C, Li D, Laestadius L, Cruz TB, Unger JB. E-cigarette brands and social media influencers on Instagram: a social network analysis. Tob Control 2023; 32:e184-e191. [PMID: 35131947 PMCID: PMC9473311 DOI: 10.1136/tobaccocontrol-2021-057053] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/22/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Exposure to visual posts featuring e-cigarette products on social media is associated with increased e-cigarette use among US adolescents. Instagram is the largest source of e-cigarette social media marketing, where influencers-for example, bloggers, brand ambassadors-post promotional materials. This study analysed the network of e-cigarette brands and influencers on Instagram, characterising the most central players in e-cigarette social media marketing. METHODS We tracked influencers with public profiles on Instagram who posted promotional e-cigarette content in 2020, had over 1000 followers and high user engagement rate (ratio of likes and comments to followers) of 1%-25% per post. By conducting a social network analysis, we identified the most central (highly involved in promotional activities) influencers and e-cigarette brands. The number of the influencers' followers aged 13-17 years old and the age verification practices restricting youth access were also assessed. RESULTS There is a highly interconnected network of engaging e-cigarette influencers (n=55) worldwide who collaborated with over 600 e-cigarette brands in 2020. The Asian and US influencers had five to six times more teenage followers compared with the European influencers. 75% of the influencers did not restrict youth access to their promotional content on Instagram. The brands Voopotech, Innokin, Geekvape, Lost Vape, Smok and Vaporesso collaborated with the largest number of influencers (mean n=20). CONCLUSIONS It is important to understand associations among influencers and e-cigarette use behaviours, especially youth, to inform effective public health communication and potential policies that could regulate social media marketing sponsored by e-cigarette companies.
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Affiliation(s)
- Julia Vassey
- Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Tom Valente
- Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Joshua Barker
- Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Cassandra Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, Maryland, USA
| | - Dongmei Li
- Clinical and Translational Science Institute, University of Rochester, Rochester, New York, USA
| | - Linnea Laestadius
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Tess Boley Cruz
- Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Jennifer B Unger
- Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
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26
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Henderson KC, Van Do V, Wang Y, Duan Z, Popova L, Spears CA, Weaver SR, Ashley DL, Barker DC, Huang J. Brief report on IQOS point-of-sale marketing, promotion and pricing in IQOS retail partner stores in Atlanta, Georgia, USA. Tob Control 2023; 32:e260-e264. [PMID: 35918133 PMCID: PMC9923501 DOI: 10.1136/tc-2022-057285] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/16/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Philip Morris has a history of aggressive marketing tactics in its global pursuit of IQOS sales, which extant literature suggests may appeal to non-smokers and young adults. This study was the first to examine point-of-sale (POS) marketing and pricing of IQOS after it entered the US market in October 2019. METHODS Trained field staff assessed 75 retail partner stores selling IQOS/HeatSticks in the Atlanta area in February-November 2020 using an IQOS-tailored, standardised assessment tool. The tool assessed store characteristics, product availability and accessibility, marketing and promotions and pricing for each store. RESULTS All stores assessed sold HeatSticks in at least one of the three flavours (tobacco, smooth menthol, fresh menthol), but did not sell the IQOS device. IQOS/HeatSticks marketing was present inside 98.5% and outside 17.3% of stores assessed. Marketing for other tobacco products was present inside 98.5% and outside 32% of stores. The average price per HeatSticks pack was US$6.40 compared with US$6.08 for Marlboro Red cigarettes. CONCLUSION Our study revealed a considerable amount of POS marketing and promotion for IQOS/HeatSticks at retail partner locations, visible to all retail consumers, including youth and non-smokers. This study was the first to examine IQOS POS marketing and promotion in the US context and findings add to the extant literature on IQOS global marketing strategies. As additional novel tobacco/nicotine products continue to enter the market, targeted monitoring of the POS marketing and promotion for these new products is warranted.
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Affiliation(s)
- Katherine C Henderson
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Vuong Van Do
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Yu Wang
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Zongshuan Duan
- Department of Prevention and Community Health, School of Public Health, The George Washington University Milken Institute of Public Health, Washington, District of Columbia, USA
| | - Lucy Popova
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Claire Adams Spears
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Scott R Weaver
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - David L Ashley
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Dianne C Barker
- Barker Bi-Coastal Health Consultant, Inc, Newport, Rhode Island, USA
| | - Jidong Huang
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA
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27
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Meza LR, Galimov A, Sussman S, Goniewicz ML, Page MK, Leventhal A. Proliferation of 'non-menthol' cigarettes amid a state-wide flavour ban. Tob Control 2023:tc-2023-058074. [PMID: 37474314 DOI: 10.1136/tc-2023-058074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023]
Affiliation(s)
- Leah R Meza
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Artur Galimov
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Steve Sussman
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Department of Psychology, and School of Social Work, University of Southern California, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Maciej Lukasz Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Michelle K Page
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Adam Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
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28
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Siegel LN, Cook S, Oh H, Liber AC, Levy DT, Fleischer NL. The longitudinal association between coupon receipt and established cigarette smoking initiation among young adults in USA. Tob Control 2023:tc-2023-058065. [PMID: 37468154 PMCID: PMC10796848 DOI: 10.1136/tc-2023-058065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION Tobacco companies frequently distribute coupons for their products. This marketing tactic may be particularly effective among young adults, who tend to be especially price-sensitive. Young adulthood is also a stage during which many individuals initiate established cigarette smoking and are especially vulnerable to the effects of tobacco marketing. METHODS We used five waves of data from the US Population Assessment on Tobacco and Health Study (2013-2019) to assess the longitudinal relationship between cigarette coupon receipt and initiation of established cigarette smoking among young adults (18-24 years) who did not report current smoking and had smoked <100 cigarettes in their lifetime at baseline. Initiation of established cigarette smoking was defined as reporting current cigarette use and having smoked ≥100 cigarettes at follow-up. To test this relationship, we fit four discrete time survival models to an unbalanced person-period data set. The first model included our time-varying coupon receipt variable, which was lagged one wave. Subsequent models added sociodemographic, cigarette smoking exposure and other tobacco use variables. RESULTS Adopting the model adjusting for sociodemographic variables, respondents who received a coupon were found to be more likely to initiate established cigarette smoking at follow-up (adjusted HR (aHR): 2.31, 95% CI 1.41 to 3.80). This relationship remained significant when controlling for all covariates in the fully adjusted model (aHR: 1.96, 95% CI 1.18 to 3.26). CONCLUSIONS These findings show that receiving tobacco coupons may increase the likelihood that young adults will initiate established cigarette smoking, underscoring the need to address the effects of this tobacco marketing tactic.
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Affiliation(s)
- Leeann Nicole Siegel
- Tobacco Control Research Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Steven Cook
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Hayoung Oh
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Alex C Liber
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Nancy L Fleischer
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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29
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Lempert LK. TAAT and the rise of hemp cigarettes. Tob Control 2023:tc-2023-058123. [PMID: 37419680 DOI: 10.1136/tc-2023-058123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023]
Affiliation(s)
- Lauren Kass Lempert
- Department of Social and Behavioral Sciences, UCSF School of Nursing, University of California San Francisco, San Francisco, California, USA
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30
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Affiliation(s)
- Eugene M Talbot
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
| | - Daniel P Giovenco
- Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Rachel Grana
- National Cancer Institute, Division of Cancer Control and Population Sciences, National Institutes of Health, Bethesda, Maryland, USA
| | - Mary Hrywna
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Ollie Ganz
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
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31
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Robertson L, Hoek J, Silver K. PMI New Zealand conflates IQOS heated tobacco products with electronic nicotine delivery systems. Tob Control 2023; 32:534-536. [PMID: 34799435 DOI: 10.1136/tobaccocontrol-2021-056964] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/08/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Lindsay Robertson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Dunedin, New Zealand
| | - Karin Silver
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
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32
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Chen-Sankey J, Ganz O, Seidenberg A, Choi K. Effect of a 'tobacco-free nicotine' claim on intentions and perceptions of Puff Bar e-cigarette use among non-tobacco-using young adults. Tob Control 2023; 32:501-504. [PMID: 34697090 PMCID: PMC9035474 DOI: 10.1136/tobaccocontrol-2021-056957] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/13/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Puff Bar disposable e-cigarettes are now marketed with a 'tobacco-free nicotine' claim. We assessed the effect of this claim on non-tobacco-using young adults' perceptions of and intentions of using Puff Bar. METHODS We conducted an online randomised between-subjects experiment among non-tobacco-using young adults (ages 18-29 years; n=1822). Participants viewed depictions of Puff Bar e-cigarettes with the claim that the product contains 'tobacco-free nicotine' (experimental group; n=909) or simply 'nicotine' (control group; n=913). Multivariable regressions were used to assess the associations between experimental conditions and Puff Bar use intentions, harm perceptions, use expectancies and perceived relative use of Puff Bar versus other e-cigarettes, controlling for participant characteristics. RESULTS Compared with the control group, the experimental group who saw the 'tobacco-free nicotine' claim reported higher intentions of using Puff Bar (coefficient=0.17, p<0.001). The experimental group had a lower likelihood of perceiving Puff Bar use as 'extremely or very harmful' (OR=0.63, p<0.001) and 'strongly or somewhat' agreeing with the negative expectancy of using Puff Bar (OR=0.67, p<0.001). Additionally, the experimental group reported being 'much more or more likely' to use Puff Bar over other e-cigarettes (OR=1.67, p<0.001). DISCUSSION Puff Bar's tobacco-free nicotine claim may increase non-tobacco-using young adults' intentions of using Puff Bar and reduce harm perceptions and negative expectancy towards using Puff Bar. The claim may also prompt the use of Puff Bar over other e-cigarette brands and types. These findings are concerning given the health effects and regulations for tobacco-free nicotine products are not immediately clear.
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Affiliation(s)
- Julia Chen-Sankey
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Ollie Ganz
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Andrew Seidenberg
- Division of Cancer Control and Population Sciences, Behavioral Research Program, National Cancer Institute, Bethesda, Maryland, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
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33
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Kowitt SD, Finan LJ, Lipperman-Kreda S. Objective and perceived measures of tobacco marketing are uniquely associated with cigar use. Tob Control 2023; 32:428-434. [PMID: 34615738 PMCID: PMC9444056 DOI: 10.1136/tobaccocontrol-2021-056601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 09/28/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Few studies have examined associations between perceived and objective exposure to tobacco marketing and cigar use, which is the second most commonly used tobacco product by youth. METHODS We used Geographic Ecological Momentary Assessment data over 14 days from youth aged 16-20 years (n=83 participants, n=948 observations; 34% past month users of any tobacco product) in eight city areas in California. Tobacco outlets in study cities were visited by trained observers to record outlet Global Positioning System (GPS) point locations and outdoor tobacco marketing. We assessed daily perceived exposure to tobacco marketing within participants' activity spaces; daily objective exposure to tobacco outlets with outdoor marketing within 50 m of activity space polylines (number of outlets and time spent near outlets) and daily cigar use excluding and including blunts. RESULTS Controlling for demographics and baseline tobacco use, results from mixed logistic regression models showed that greater perceived exposure to tobacco marketing was positively associated with higher odds of cigar use each day, excluding blunts (adjusted odds ratios (aOR): 2.00; 95% CI 1.03 to 3.87) and including blunts (aOR: 1.87; 95% CI 1.26 to 2.77). Also, exposure to a greater number of tobacco outlets with outdoor marketing was associated with higher odds of cigar use each day, excluding blunts (aOR: 1.34; 95% CI 1.01 to 1.78), but not including blunts. CONCLUSIONS Tobacco control efforts should consider both perceived and objective exposure to tobacco marketing and unique associations with blunt use to prevent cigar use.
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Affiliation(s)
- Sarah D Kowitt
- Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Laura J Finan
- Department of Psychology, Illinois State University, Normal, Illinois, USA
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California, USA
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34
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Heley K, Popova L, Moran MB, Ben Taleb Z, Hart JL, Wackowski OA, Westling E, Smiley SL, Stanton CA. Targeted tobacco marketing in 2020: the case of #BlackLivesMatter. Tob Control 2023; 32:530-533. [PMID: 34907090 PMCID: PMC9295306 DOI: 10.1136/tobaccocontrol-2021-056838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Kathryn Heley
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Meghan Bridgid Moran
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas, USA
| | - Joy L Hart
- Department of Communication, University of Louisville, Louisville, Kentucky, USA
| | - Olivia A Wackowski
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
| | | | - Sabrina L Smiley
- Tobacco Center of Regulatory Science, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Cassandra A Stanton
- Behavioral Health & Health Policy, Westat, Rockville, Maryland, USA
- Georgetown University Medical Center, Washington, District of Columbia, USA
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35
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Berg CJ, Romm KF, Bar-Zeev Y, Abroms LC, Klinkhammer K, Wysota CN, Khayat A, Broniatowski DA, Levine H. IQOS marketing strategies in the USA before and after US FDA modified risk tobacco product authorisation. Tob Control 2023; 32:418-427. [PMID: 34667105 PMCID: PMC9016087 DOI: 10.1136/tobaccocontrol-2021-056819] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 09/27/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Given that the US Food and Drug Administration (FDA) authorised reduced exposure messaging to be used in IQOS marketing, we examined: (1) IQOS ad content; (2) advertising media channels and (3) changes in advertising efforts over time. METHODS We conducted a mixed-methods study regarding IQOS ad content (headlines, themes, images), ad occurrence characteristics (including content, media channels and adspend) in the USA from August 2019 to April 2021 using Numerator advertising/marketing data. RESULTS Across 24 unique ads and 591 occurrences (84.6% online, 8.0% print, 7.4% mobile), there was $4 902 110 total adspend (98.9% allocated to print). Across unique ads, occurrences and adspend, prominent themes included 'real tobacco' (45.8%, 47.4%, 30.1%, respectively), less odour/ash (29.2%, 21.0%, 29.9%) and switching from cigarettes (25.0%, 19.5%, 69.4%), and images mainly featured the product alone (58.2%, 61.4%, 99.5%) or with women (25.0%, 19.1%, 0.3%). Per occurrences and adspend, the most prominent media channel themes (eg, magazine/website topics) were technology (19.3%, 10.6%), women's fashion (18.1%, 26.2%), weather/news (9.0%, 15.3%) and entertainment/pop culture/gaming (8.5%, 23.1%). Ad themes appearing only post-FDA authorisation included switching from traditional cigarettes, same-day/home-delivery, convenience (eg, use indoors), reduced exposure to some dangerous substances, science/research and distinction from e-cigarettes. Overall adspend per occurrence increased postauthorisation (p=0.016); the highest adspend per unique ad (69.3% of total) focused on ads featuring reduced exposure. CONCLUSIONS Regulatory efforts must be informed by ongoing surveillance of IQOS marketing efforts and its impacts, particularly how specific consumer subgroups (eg, tobacco non-users, women, young people) are impacted by marketing exposure.
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Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
- GW Cancer Center, The George Washington University, Washington, DC, USA
| | - Katelyn F Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Yael Bar-Zeev
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem and Hadassah Medical Organization, Jerusalem, Israel
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
- GW Cancer Center, The George Washington University, Washington, DC, USA
| | - Katharina Klinkhammer
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Christina N Wysota
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Amal Khayat
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem and Hadassah Medical Organization, Jerusalem, Israel
| | - David A Broniatowski
- Department of Engineering Management and Systems Engineering, School of Engineering and Applied Science, The George Washington University, Washington, DC, USA
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem and Hadassah Medical Organization, Jerusalem, Israel
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Brown JL, Parra N, Cohen JE, Carmona MG, Hurley M, Rosen D. Moving hearts and minds: how the Big Tobacco, Tiny Targets campaign builds support for tobacco control policy. Tob Control 2023:tc-2022-057917. [PMID: 37321851 DOI: 10.1136/tc-2022-057917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/24/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Jennifer L Brown
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Joanna E Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Mark Hurley
- Campaign for Tobacco-Free Kids, Washington, DC, USA
| | - Debra Rosen
- Campaign for Tobacco-Free Kids, Washington, DC, USA
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Grundy Q. Industry influences on science and policy: identifying levers for independence. Tob Control 2023:tc-2023-058085. [PMID: 37253587 DOI: 10.1136/tc-2023-058085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Quinn Grundy
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Deng H, Fang L, Zhang L, Yan X, Wang F, Hao X, Zheng P. A comprehensive content analysis of 104 Chinese electronic cigarette manufacturing enterprise official websites. Tob Control 2023:tc-2022-057759. [PMID: 37137701 DOI: 10.1136/tc-2022-057759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 04/20/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The goal was to analyse website content of Chinese electronic (e) cigarette manufacturing enterprises and understand the marketing strategies to provide evidence for decision-makers to regulate manufacturers. METHODS Through QCC.com, one of the largest enterprise information query platforms in China, we identified 104 official manufacturer websites in 2021. A codebook including 6 sections with 31 items was developed and all webpages were coded separately by two trained researchers. RESULTS Over half of the websites (56.7%) did not have age verification for entry. Thirty-two (30.8%) websites had no restriction for minors to use or purchase e-cigarettes, and 79 (76.0%) had no health warning. Overall, 99 websites (95.2%) displayed their products, and 72 (69.2%) displayed e-flavours. The most frequently used descriptions of products included good taste (68.3%), positive mood (62.5%), leakage resistance (56.7%), enjoyment (47.1%), reduced harm (45.2%), alternatives to cigarettes (43.3%) and long battery life (42.3%). Additionally, 75 websites (72.1%) provided contact information on different channels, including WeChat (59.6%), Weibo (41.3%), Facebook (13.5%), Instagram (12.5%) and brand apps (2.9%). Manufacturers provided investment and franchise information (59.6%) and offline store information (17.3%). In addition, 41.3% websites included content regarding corporate social responsibility. CONCLUSIONS Chinese e-cigarette manufacturers' official websites have become a platform for presenting product and brand information, establishing online and offline marketing loops, and displaying corporate social responsibility with weak age restrictions on access and a lack of health warnings. The Chinese government should implement strict regulatory measures on e-cigarette enterprises.
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Affiliation(s)
- Hui Deng
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
- Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ling Fang
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
| | - Lingyun Zhang
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
| | - Xiaotao Yan
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
| | - Fan Wang
- Fudan Development Institute, Fudan University, Shanghai, China
| | - Xinyu Hao
- School of Politics and International Relations, East China Normal University, Shanghai, China
| | - Pinpin Zheng
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
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Affiliation(s)
- Jennifer Pearson
- Division of Social and Behavioral Health/Health Administration and Policy, University of Nevada Reno, Reno, Nevada, USA
| | - Daniel P Giovenco
- Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - M Jane Lewis
- Rutgers Center for Tobacco Studies, Rutgers School of Public Health, Piscataway, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Meghan Moran
- Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ollie Ganz
- Rutgers Center for Tobacco Studies, Rutgers School of Public Health, Piscataway, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
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Peruga A, Urrejola O, Delgado I, Matute I, Castillo-Laborde C, Molina X, Hirmas M, Olea A, González C, Aguilera X, Sargent JD. Exposure of 4-year to 24-year olds to tobacco imagery on prime-time Chilean television. Tob Control 2023; 32:323-329. [PMID: 34607886 PMCID: PMC10176395 DOI: 10.1136/tobaccocontrol-2021-056735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/27/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The extent of the population's exposure to tobacco imagery across all genres of regular TV programming and the contribution of each of these genres is unknown, except for UK broadcast channels. The objective of this study is to estimate the exposure of young people to tobacco imagery on Chilean prime-time television and the programme source contributing to such exposure. METHODS Programmes aired during 3 weeks in 2019 from the 15 highest audience channels in Chile were content-analysed for the occurrence of tobacco categorised as actual use, implied use, tobacco paraphernalia, tobacco brand appearances and whether they violated Chilean smoke-free law for each 1 min interval (92 639). The exposure of young people to tobacco content was estimated using media viewership figures. RESULTS Young people received 29, 11 and 4 million tobacco impressions of any type, explicit use and smoke-free violation, respectively, at a rate of 21.8, 8.0 and 2.1 thousand impressions per hour of TV viewing. The main sources of exposure to tobacco impressions were feature films and animated productions, which were almost entirely non-Chilean. Finally, young people were exposed to tobacco brand impressions primarily through films, effectively circumventing the advertising ban in Chile. DISCUSSION Television programming is a source of significant youth exposure to tobacco imagery, including branding impressions. To conform to the WHO FCTC, Chile should prohibit tobacco branding in any TV programme and require strong anti-tobacco advertisements prior to any TV programme portraying tobacco.
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Affiliation(s)
- Armando Peruga
- Centro de Epidemiología y Políticas de Salud, Universidad del Desarrollo Facultad de Medicina Clínica Alemana, Las Condes, Chile
- Tobacco Control Research Group, IDIBELL, Barcelona, Spain
- Consorcio de Investigación Biomédica en Enfermedades Respiratorias-CIBERES, Madrid, Spain
| | - Oscar Urrejola
- Centro de Epidemiología y Políticas de Salud, Universidad del Desarrollo Facultad de Medicina Clínica Alemana, Las Condes, Chile
- Subdirección de investigación, Teletón, Santiago, Chile
| | - Iris Delgado
- Centro de Epidemiología y Políticas de Salud, Universidad del Desarrollo Facultad de Medicina Clínica Alemana, Las Condes, Chile
| | - Isabel Matute
- Centro de Epidemiología y Políticas de Salud, Universidad del Desarrollo Facultad de Medicina Clínica Alemana, Las Condes, Chile
| | - Carla Castillo-Laborde
- Centro de Epidemiología y Políticas de Salud, Universidad del Desarrollo Facultad de Medicina Clínica Alemana, Las Condes, Chile
| | - Xaviera Molina
- Centro de Epidemiología y Políticas de Salud, Universidad del Desarrollo Facultad de Medicina Clínica Alemana, Las Condes, Chile
| | - Macarena Hirmas
- Centro de Epidemiología y Políticas de Salud, Universidad del Desarrollo Facultad de Medicina Clínica Alemana, Las Condes, Chile
| | - Andrea Olea
- Centro de Epidemiología y Políticas de Salud, Universidad del Desarrollo Facultad de Medicina Clínica Alemana, Las Condes, Chile
| | - Claudia González
- Centro de Epidemiología y Políticas de Salud, Universidad del Desarrollo Facultad de Medicina Clínica Alemana, Las Condes, Chile
| | - Ximena Aguilera
- Centro de Epidemiología y Políticas de Salud, Universidad del Desarrollo Facultad de Medicina Clínica Alemana, Las Condes, Chile
| | - James D Sargent
- C Everett Koop Institute, Geisel School of Medicine, Lebanon, New Hampshire, USA
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
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Abstract
BACKGROUND Few studies have investigated tobacco industry interference in the tobacco control policies of Arab nations. This paper explores the tactics used by the industry to subvert tobacco control policies in Oman and offers lessons on how to prevent such interference in the future. METHODS We searched the Truth Tobacco Industry Documents Archive using the word 'Oman', names of government institutions, policymakers and local tobacco distributors. Extracted data were noted chronologically by key elements of tobacco control measures. Gulf Cooperation Council (GCC) Health Ministers' Council resolutions on tobacco control were also reviewed. RESULTS Out of 1020 tobacco documents located, 327 were closely related to policy interference. Documents revealed that the industry met key government officials, offered in-kind services, used local diplomatic missions to influence Omani policymakers, opposed smoking bans, delayed regulations to lower tar and nicotine content of cigarettes, and to require effective health warnings, circumvented a tobacco advertising, promotion and sponsorship ban and provided voluntary codes as an alternative to effective regulations. Additionally, industry representatives lobbied individual countries in the GCC to veto tax increments and defeat consensus on agreed resolutions of the Health Ministers' Council. CONCLUSION The tobacco industry interfered in all key public health policies aimed to reduce tobacco use in Oman. There is an urgent need for the Omani government to enforce the Civil Code of Conduct and develop guidelines for all policymakers through implementing Article 5.3 of the WHO Framework Convention on Tobacco Control to curb the tobacco epidemic.
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Affiliation(s)
| | - Stella A Bialous
- Center for Tobacco Control, UCSF, San Francisco, California, USA
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Hendlin YH, Small S, Ling PM. 'No-Barriers' tobacco product? Selling smokeless tobacco to women, people of colour and the LGBTQ+ community in the USA. Tob Control 2023; 32:330-337. [PMID: 34599083 PMCID: PMC10171187 DOI: 10.1136/tobaccocontrol-2020-056178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/28/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND In both Sweden and the USA, smokeless tobacco (ST) is legal and used predominantly by men. Starting in the 1970s, US tobacco companies attempted to expand the ST market to women, African Americans, Hispanic Americans and lesbian, gay, bisexual, transgender, queer and other sexual orientation (LGBTQ+) people. DESIGN We analysed industry documents from the Truth Tobacco Industry Documents Library triangulating findings with recent ST advertising and publicly available literature. FINDINGS We found tobacco companies used design innovations such as pouched moist snuff, snus and dissolvable products to expand the market. In addition, diverse advertising campaigns targeted women, people of colour (Hispanic, African American) and LGBTQ+ communities with identity-targeted messages emphasising novelty, convenience, cleanliness and use in smoke-free environments. However, stereotypes of ST users as rural white males endured, perpetuated by continued marketing aimed at this customer base, which created cognitive dissonance and stymied marketer's hopes that pouch products would 'democratize' ST. CONCLUSION These failed campaigns suggest novel products such as nicotine pouch products may provide a 'clean slate' to similarly target women and other low-ST-using groups. Based on this history, the risk of new tobacco and nicotine products to increase health disparities should be closely monitored.
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Affiliation(s)
- Yogi Hale Hendlin
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
- Dynamics of Inclusive Prosperity Initiative, Erasmus University Rotterdam, Rotterdam, South Holland, Netherlands
| | - Sarah Small
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
| | - Pamela M Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, California, USA
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van der Eijk Y, Teo KW, Tan GPP, Chua WM. Tobacco industry strategies for flavour capsule cigarettes: analysis of patents and internal industry documents. Tob Control 2023; 32:e53-e61. [PMID: 34611048 DOI: 10.1136/tobaccocontrol-2021-056792] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/08/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The global market for flavour capsule variants (FCVs), cigarettes with a crushable flavour capsule, has grown exponentially. To inform further regulatory efforts, it is important to understand tobacco industry strategies for FCVs. METHODS Analysis of data from 65 patents and 179 internal tobacco industry documents, retrieved via snowball searches in Patsnap and the Truth Tobacco Industry Documents Library, describing tobacco industry developments related to FCVs. We used an inductive coding method to identify themes relating to FCV features or developments. RESULTS Tobacco companies were developing FCVs since the 1960s, with little market success until the 2000s following the launch of Camel Crush, a brand which targeted millennials (in their teens or early 20s at the time). Tobacco companies have patented, but not yet marketed, FCVs with microcapsule surface coatings, adjustable or heat-triggered flavour release systems, airflow manipulation features, transparent filters to visualise flavour release, and various flavours and additives for capsules including nicotine/tobacco extracts for an on-demand nicotine hit. Tobacco companies developed FCVs purported to be reduced harm, although their own tests showed that FCVs have higher toxicant concentrations. They have also developed loose flavour capsule units designed to fit into cigarettes, packs, or recessed filters to enable users to customise cigarettes and circumvent tobacco flavour bans. CONCLUSIONS To prevent tobacco companies from targeting young people and exploiting regulatory loopholes, regulations on tobacco products should ban flavours and consider the broad variety of FCV designs, additives and loose products designed to impart flavour into tobacco products.
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Affiliation(s)
- Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ken Wah Teo
- Preventive Medicine, National University Health System, Singapore
| | - Grace Ping Ping Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Wee Meng Chua
- Department of Biological Sciences, National University of Singapore, Singapore
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Affiliation(s)
- Ilana G Raskind
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
| | - Anna E Epperson
- Department of Psychological Sciences, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, California, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
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Ramamurthi D, Chau C, Berke HY, Tolba AM, Yuan L, Kanchan V, Santos G, Jackler RK. Flavour spectrum of the Puff family of disposable e-cigarettes. Tob Control 2023; 32:e71-e77. [PMID: 35017264 DOI: 10.1136/tobaccocontrol-2021-056780] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 12/22/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND In January 2020, the US Food and Drug Administration prohibited the sale of flavours (except for menthol and tobacco) in prefilled pod devices such as JUUL to decrease youth vaping. Excluded from the prohibition were disposable devices. OBJECTIVES To determine the scope and scale of flavours marketed by Puff Bar, a leading disposable brand, and related products. METHODS Disposable e-cigarette flavours were identified via online searches encompassing vendor websites, wholesale distributors, manufacturers (eg, made-in-china.com), and social media channel, Instagram, between June and August 2020. RESULTS The 'Puff' brand name and iconic cloud logo appear on a variety of products of differing sizes and nicotine e-liquid volumes. Among Puff Bar and its copycats (Puff-a-Likes), 139 flavours were identified. Fruit flavours predominated comprising 82.2% of the flavour varieties (fruit 50%, fruit and menthol/mint 23.6%, and fruity drinks 8.6%). A prevalent new flavour category which combines fruit with menthol/mint (Ice) was offered in 33 varieties such as Lychee Ice, Lush Ice and Banana Ice. Disposable e-cigarette brands are undertaking measures to escape tobacco regulation (eg, non-tobacco-sourced nicotine) and flavour limitations via post-market flavour additions to unflavoured nicotine e-liquid. CONCLUSIONS The proliferation of flavoured disposable e-cigarette products, many of which are designed to emulate popular pod devices, illustrates that narrowly limited flavour regulations covering only a single category are destined to fail. To be effective in youth protection, flavour regulations need to apply to all recreational nicotine-containing products and need to include measures to counter post-market flavour addition.
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Affiliation(s)
- Divya Ramamurthi
- Stanford Research into the Impact of Tobacco Advertising, Stanford University, Stanford, California, USA
| | - Cindy Chau
- Stanford Research into the Impact of Tobacco Advertising, Stanford University, Stanford, California, USA
| | - Hannah Y Berke
- Stanford Research into the Impact of Tobacco Advertising, Stanford University, Stanford, California, USA
| | - Afnan M Tolba
- Stanford Research into the Impact of Tobacco Advertising, Stanford University, Stanford, California, USA
| | - Lu Yuan
- Stanford Research into the Impact of Tobacco Advertising, Stanford University, Stanford, California, USA
| | - Vedika Kanchan
- Stanford Research into the Impact of Tobacco Advertising, Stanford University, Stanford, California, USA
| | - Giulia Santos
- Stanford Research into the Impact of Tobacco Advertising, Stanford University, Stanford, California, USA
| | - Robert K Jackler
- Stanford Research into the Impact of Tobacco Advertising, Stanford University, Stanford, California, USA
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Abstract
OBJECTIVE This systematic review aims to identify marketing elements of flavour capsule variants (FCVs), cigarettes that release flavour when a capsule(s) embedded in the filter is crushed. DATA SOURCES A search of original research without restrictions in publication year, population, study design or language using a combination of cigarette and capsule terms was conducted across four databases (Medline, Embase, Web of Science and Scopus), indexed until 13 December 2021, along with a citation search. STUDY SELECTION Studies were included if they presented original research relevant to marketing features of FCVs. DATA EXTRACTION One author performed data extraction and coded outcomes based on '4Ps' of marketing mix theory: product, place, price and promotion. The second author conducted a cross-check. DATA SYNTHESIS Of 2436 unduplicated database records and 30 records from other sources, 40 studies were included in the review. Studies were published between 2009 and 2021. Study methodologies primarily included content analysis of cigarette packs/sticks, review of tobacco industry documents and content analysis of advertising information. Findings suggest FCVs are marketed using a mix of strategies, particularly characterised by product innovation, timing market launches around tobacco policies, point-of-sale advertising and packaging to communicate a high-tech, customisable and flavourful product. CONCLUSION Findings illuminate the marketing strategies of FCVs that are likely driving their global growth, particularly among young people and in low and middle-income countries. Comprehensive tobacco control regulations are needed to close loopholes and curb industry efforts to circumvent existing policies in order to mitigate uptake of FCVs and other product innovations.
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Affiliation(s)
- Christina N Kyriakos
- Department of Primary Care and Public Health, Imperial College London School of Public Health, London, UK
| | - Mateusz Zygmunt Zatoński
- Department for Health, University of Bath, Bath, UK
- European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
| | - Filippos T Filippidis
- Department of Primary Care and Public Health, Imperial College London School of Public Health, London, UK
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48
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Dewhirst T. Interplay of food and tobacco product descriptors and health claims. Tob Control 2023; 32:e130-e131. [PMID: 34511406 DOI: 10.1136/tobaccocontrol-2021-056831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Timothy Dewhirst
- Department of Marketing and Consumer Studies, Gordon S. Lang School of Business and Economics, University of Guelph, Guelph, Ontario, Canada
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Affiliation(s)
| | - Lindsay Robertson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Janet Hoek
- Public Health, University of Otago, Dunedin, New Zealand
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Nazar GP, Arora M, Sharma N, Shrivastava S, Rawal T, Chugh A, Sinha P, Munish VG, Tullu FT, Schotte K, Polansky JR, Glantz S. Changes in tobacco depictions after implementation of tobacco-free film and TV rules in Bollywood films in India: a trend analysis. Tob Control 2023; 32:218-224. [PMID: 34312318 DOI: 10.1136/tobaccocontrol-2021-056629] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/07/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND India's tobacco-free film and TV rules were implemented from 2012. To assess the effect of the rules, we studied tobacco depictions in top-grossing Bollywood films released between 2006 and 2017 and rule compliance after 2012. METHODS Tobacco incidents and brand appearances were coded in 240 top-grossing Bollywood films (2006-2017) using the Breathe California method. Trends in number of tobacco incidents per film per year were studied before and after implementation of the rules using Poisson regression analysis. Compliance with rules over the years was studied using Pearson product-moment correlations. RESULTS Forty-five films were U-rated (all ages), 162 were UA-rated (below age 12 years must be adult-accompanied), and 33 were A-rated (age 18+ years only). Before implementation of the rules, the number of tobacco incidents per film was increasing by a factor of 1.1/year (95% CI 1.0 to 1.2, p=0.002). However, beginning year 2013, the number of incidents per film started falling significantly by a factor of 0.7/year (95% CI 0.6 to 0.9; p=0.012) compared with the previous increasing trend. The percentage of youth-rated (U and UA) films with any tobacco incidents also declined from a peak of 76% in 2012 to 35% in 2017. The percentage of films complying with the rules (audio-visual disclaimers, health spots, static warnings) did not change significantly from 2012 to 2017. CONCLUSION India's 2012 rules were followed by a reduction in tobacco depictions in Bollywood films. Enhanced monitoring of compliance is needed to ensure the continued effectiveness of the rules.
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Affiliation(s)
- Gaurang P Nazar
- HRIDAY, New Delhi, Delhi, India
- Health Promotion Division, Public Health Foundation of India, Gurugram, Haryana, India
| | - Monika Arora
- HRIDAY, New Delhi, Delhi, India
- Health Promotion Division, Public Health Foundation of India, Gurugram, Haryana, India
| | | | | | - Tina Rawal
- HRIDAY, New Delhi, Delhi, India
- Health Promotion Division, Public Health Foundation of India, Gurugram, Haryana, India
| | | | - Praveen Sinha
- World Health Organization, Country Office, New Delhi, India
| | | | | | - Kerstin Schotte
- Tobacco Free Initiative, World Health Organization, Geneva, Switzerland
| | | | - Stanton Glantz
- Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA
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