1
|
He Y, Liber A, Driezen P, Thompson ME, Levy DT, Fong GT, Cummings KM, Shang C. How do users compare the costs between nicotine vaping products and cigarettes? Findings from the 2016-2020 International Tobacco Control United States surveys. Addiction 2024; 119:885-897. [PMID: 38186201 PMCID: PMC11009094 DOI: 10.1111/add.16425] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/23/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND AND AIMS Nicotine vaping products (NVPs) can potentially help adult tobacco users quit smoking. This study evaluated how adult consumers compare the costs between NVPs and cigarettes. METHOD We used data from the US arm of the 2016-2020 International Tobacco Control Four Country Smoking and Vaping (ITC 4CV) surveys to perform a multinomial logit model with two-way fixed effects to measure how perceived cost comparisons are associated with NVP and cigarette taxes, use patterns, NVP device types and individual sociodemographic factors. RESULTS Higher cigarette taxes are associated with a greater likelihood of perceiving NVPs and cigarettes as costing the same for the overall population and among people who exclusively smoke, and a lower likelihood of perceiving NVPs as more expensive among people who exclusively vape, compared with lower cigarette taxes. Pre-filled cartridge and tank users are more likely to perceive NVPs as less expensive than cigarettes, compared with people who use other types of NVPs. The associations between taxes and perceived cost comparison were more pronounced among males, younger and low-income populations. CONCLUSIONS Higher cigarette taxes are associated with perceived financial incentives for nicotine vaping products (NVPs) over cigarettes, whereas NVP taxes are not associated with perceived cost comparison between NVPs and cigarettes.
Collapse
Affiliation(s)
- Yanyun He
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Alex Liber
- Department of Oncology, School of Medicine, Georgetown University, Washington, DC, USA
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Mary E. Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - David T. Levy
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Ce Shang
- Department of Internal Medicine, Medical Oncology Division, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
2
|
Wei LC. Concerns About the Safety of Electronic Cigarettes and Recent Amendments to Taiwan's Tobacco Control Law. Nicotine Tob Res 2024; 26:649. [PMID: 37934590 DOI: 10.1093/ntr/ntad215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Indexed: 11/09/2023]
Affiliation(s)
- Lien-Chung Wei
- Department of Addiction Psychiatry, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan City, Taiwan (ROC)
| |
Collapse
|
3
|
Nguenha N, Rodriguez C, Drope J, Bialous SA, Cunguara B, Lencucha R. Tobacco policy (in)coherence in Mozambique: an examination of national and subnational stakeholder perspectives. Health Policy Plan 2024; 39:333-343. [PMID: 38459919 PMCID: PMC11005848 DOI: 10.1093/heapol/czae010] [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: 06/28/2023] [Revised: 01/18/2024] [Accepted: 02/19/2024] [Indexed: 03/11/2024] Open
Abstract
Mozambique ranks fifth on the list of tobacco producing countries in Africa, while also being a Party to the WHO Framework Convention on Tobacco Control (FCTC). Tobacco farming is regarded by some governments as a strategic economic commodity for export and remains deeply entrenched within Mozambique's political and economic landscape. This study uses a qualitative description methodology to identify tensions, conflicts and alignment or misalignment in policy on tobacco across government sectors and levels in Mozambique. We conducted semi-structured qualitative interviews with 33 key informants from sectors across national and subnational levels including health, agriculture, economic and commercial sectors, as well as non-state actors from civil society organizations, the tobacco industry, farmers unions and associations and individual farmers. Incoherence was present across sectoral mandates, perspectives on industry's presence in the country and regions and between FCTC provisions and informant perceptions of tobacco production as a development strategy. Despite tobacco being viewed as an important economic commodity by many informants, there was also widespread dissatisfaction with tobacco from both farmers and some government officials. There were indications of an openness to shifting to a policy that emphasizes alternatives to tobacco growing. The findings also illustrate where points of convergence exist across sectors and where opportunities for aligning tobacco policy with the provisions of the FCTC can occur.
Collapse
Affiliation(s)
- Nicole Nguenha
- Global Alliance for Tobacco Control, 1 Nicholas St, Suite 1004, Ottawa, Ontario K1N 7B7, Canada
| | - Charo Rodriguez
- Department of Family Medicine, McGill University, 5858, chemin de la Côte-des-Neiges, Montreal, Quebec H3S 1Z1, Canada
| | - Jeffrey Drope
- Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, Maryland 21205, USA
| | - Stella Aguinaga Bialous
- School of Nursing and Center for Tobacco Control Research and Education, University of California San Francisco, 2 Koret Way, San Francisco, California 94143, USA
| | - Benedito Cunguara
- Ministry of Economy and Finance, Gabinete de Desenvolvimento do Compacto II, Avenida 10 de Novembro, Praça da Marinha, Nº 929, Maputo 929, Mozambique
| | - Raphael Lencucha
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3630 Promenade Sir William Osler, Montreal, Quebec H3G 1Y5, Canada
| |
Collapse
|
4
|
Driezen P, Gravely S, Kasza KA, Thompson ME, Cummings KM, Hyland A, Fong GT. Prevalence of menthol cigarette use among adults who smoke from the United States by census division and demographic subgroup, 2002-2020: findings from the International Tobacco Control (ITC) project. Popul Health Metr 2024; 22:6. [PMID: 38594706 PMCID: PMC11005135 DOI: 10.1186/s12963-024-00326-0] [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: 11/29/2023] [Accepted: 03/31/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Targeted marketing of menthol cigarettes in the US influences disparities in the prevalence of menthol smoking. There has been no analysis of sub-national data documenting differences in use across demographic subgroups. This study estimated trends in the prevalence of menthol use among adults who smoke in the nine US census divisions by sex, age, and race/ethnicity from 2002 to 2020. METHODS Data from 12 waves of the US ITC Survey were used to estimate the prevalence of menthol cigarette use across census divisions and demographic subgroups using multilevel regression and post-stratification (n = 12,020). Multilevel logistic regression was used to predict the prevalence of menthol cigarette use in 72 cross-classified groups of adults who smoke defined by sex, age, race/ethnicity, and socioeconomic status; division-level effects were fit with a random intercept. Predicted prevalence was weighted by the total number of adults who smoke in each cross-classified group and aggregated to divisions within demographic subgroup. Estimates were validated against the Tobacco Use Supplement to the Current Population Survey (TUS-CPS). RESULTS Overall modeled prevalence of menthol cigarette use was similar to TUS-CPS estimates. Prevalence among adults who smoke increased in each division from 2002 to 2020. By 2020, prevalence was highest in the Middle (46.3%) and South Atlantic (42.7%) and lowest in the Pacific (25.9%) and Mountain (24.2%) divisions. Prevalence was higher among adults aged 18-29 (vs. 50+) and females (vs. males). Prevalence among non-Hispanic Black people exceeded 80% in the Middle Atlantic, East North Central, West North Central, and South Atlantic in all years and varied most among Hispanic people in 2020 (Pacific: 26.5%, New England: 55.1%). CONCLUSIONS Significant geographic variation in the prevalence of menthol cigarette use among adults who smoke suggests the proposed US Food and Drug Administration (FDA) menthol cigarette ban will exert differential public health benefits and challenges across geographic and demographic subgroups.
Collapse
Affiliation(s)
- Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada.
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada.
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Mary E Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - K Michael Cummings
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| |
Collapse
|
5
|
Nonnemaker J, Mann N, MacMonegle AJ, Gaber J, Fajobi O. Estimating the return on investment of the New York Tobacco Control Programme: a synthetic control study. BMJ Open 2024; 14:e080525. [PMID: 38569704 PMCID: PMC10989166 DOI: 10.1136/bmjopen-2023-080525] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/08/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE To assess the return on investment (ROI) of the New York Tobacco Control Programme (NY TCP). SETTING New York and other states of the USA. INTERVENTIONS NY TCP. OUTCOMES Smoking prevalence, smoking-attributable healthcare expenditures (SAEs), smoking-attributable mortality, years of life lost (YLL), the dollar value of YLL and the ROI for healthcare expenditures and mortality. DESIGN AND METHODS We used a synthetic control method to estimate the effectiveness of NY TCP funding on smoking prevalence. The synthetic control method created a comparison group that best matched the adult smoking prevalence trend in New York state in the period prior to implementation of the NY TCP and compared smoking prevalence in the state to smoking prevalence in the synthetic control in the period after treatment (2001-2019). The synthetic control group represents what the trend in smoking prevalence in New York would have been had there been no tobacco control expenditures. The ROI was calculated as net savings for each outcome divided by net programme expenditures. RESULTS Cumulative savings in SAE in New York from 2001 to 2019 amounted to US$13.2 billion. An estimated 41 771 smoking-attributable deaths (SADs) were averted in New York from 2001 to 2019, and an estimated 672 141 YLL averted as a result of NY TCP funding in the same period. From 2001 to 2019, the ROI for SAE in New York was approximately 14, the economic value ROI of the YLL due to SAD was nearly 145 and the combined ROI was almost 160. CONCLUSIONS In this study, we found relatively large ROIs for the NY TCP, which suggests that the programme-which lowers SAE and saves lives-is an efficient use of public funds.
Collapse
Affiliation(s)
| | - Nathan Mann
- RTI International, Research Triangle Park, North Carolina, USA
| | | | - Jennifer Gaber
- RTI International, Research Triangle Park, North Carolina, USA
| | | |
Collapse
|
6
|
Smallwood N. Blowing in the wind- Tobacco control legislation. Respirology 2024; 29:344-345. [PMID: 38331587 DOI: 10.1111/resp.14677] [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] [Received: 12/22/2023] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Affiliation(s)
- Natasha Smallwood
- Department of Respiratory & Sleep Medicine, The Alfred Hospital, Prahran, Victoria, Australia
- Respiratory Research @Alfred, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
7
|
Langley T. Tobacco Content and Marketing Online and Beyond-New and Ongoing Challenges for Tobacco Control Research and Policy. Nicotine Tob Res 2024; 26:411-412. [PMID: 38168708 DOI: 10.1093/ntr/ntad263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Indexed: 01/05/2024]
Affiliation(s)
- Tessa Langley
- School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, UK
- SPECTRUM Consortium, London, UK
| |
Collapse
|
8
|
Katanoda K, Togawa K, Nakamura M. [Is "tobacco harm reduction" possible? Other countries' experiences and perspectives, and how they could inform tobacco control in Japan]. Nihon Koshu Eisei Zasshi 2024; 71:141-152. [PMID: 38123330 DOI: 10.11236/jph.23-076] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
"Tobacco harm reduction" is defined as a method to minimize harm and risk of death and disease without eliminating tobacco and nicotine use. In Japan, where heated tobacco products (HTPs) are prevalent, the tobacco industry is progressively endorsing the concept of "tobacco harm reduction." Therefore, stakeholders in tobacco control must urgently share perspectives and experiences surrounding this issue. This discussion paper aimed to propose four requirements for effectively implementing "tobacco harm reduction" as a public health measure: (1) disease risk reduction, (2) cigarette smoking cessation, (3) no additional public health concerns, and (4) regulatory authorities held by health agencies, and compile information on them regarding nicotine-containing electronic cigarettes (e-cigarettes) and HTPs. Another aim was to summarize policies related to "tobacco harm reduction" adopted by an international organization (World Health Organization (WHO) and health authorities in foreign countries (the United States of America (USA), the United Kingdom (UK), Australia, Italy, and the Republic of Korea) to explore the implications of these requirements on Japan's approach. Regarding the first three requirements, scientific evidence indicated that e-cigarettes offers some level of risk reduction and can assist with cigarette smoking cessation. The potential uptake of e-cigarettes among youth and their possibility to serve as a gateway to combusted cigarette use is a concern, though a definitive causal link is yet to be established between the uptake of e-cigarette in youth and the subsequent use of different tobacco products. There is insufficient scientific evidence for any of the three requirements for HTPs. Regarding the official policies, WHO took the position that the same regulations should be applied to all tobacco products. Only the UK and USA officially established a health system based on the concept of "tobacco harm reduction"; even in Italy and the Republic of Korea, where HTPs are relatively widespread, health authorities denied any risk reduction by introducing HTPs. The UK officially adopted a smoking cessation policy with e-cigarettes. The USA established a modified risk tobacco product system under federal legislation enacted in 2009, whereas of June 2023, no HTP or e-cigarettes were recognized as explicitly reducing health risk. Regarding the fourth requirement, the UK and USA institutionalized "tobacco harm reduction" under health authorities' regulation independent of the tobacco industry. The introduction of a tobacco harm reduction policy in Japan should be considered only in line with health authorities' regulation and implementation of comprehensive tobacco control measures independent of the tobacco industry.
Collapse
Affiliation(s)
- Kota Katanoda
- Division of Population Data Science, National Cancer Center Institute for Cancer Control
| | - Kayo Togawa
- Division of Population Data Science, National Cancer Center Institute for Cancer Control
| | - Masakazu Nakamura
- Health Promotion Research Center, Japan Association for Development of Community Medicine
| |
Collapse
|
9
|
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
| |
Collapse
|
10
|
Kite J, Grunseit A, Mitchell G, Cooper P, Chan L, Huang BH, Thomas M, O'Hara B, Smith A. Impact of Traditional and New Media on Smoking Intentions and Behaviors: Secondary Analysis of Tasmania's Tobacco Control Mass Media Campaign Program, 2019-2021. J Med Internet Res 2024; 26:e47128. [PMID: 38441941 PMCID: PMC10951829 DOI: 10.2196/47128] [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: 03/09/2023] [Revised: 08/09/2023] [Accepted: 12/29/2023] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Tasmania, the smallest state by population in Australia, has a comprehensive tobacco control mass media campaign program that includes traditional (eg, television) and "new" channels (eg, social media), run by Quit Tasmania. The campaign targets adult smokers, in particular men aged 18-44 years, and people from low socioeconomic areas. OBJECTIVE This study assesses the impact of the 2019-2021 campaign program on smokers' awareness of the campaign program, use of Quitline, and smoking-related intentions and behaviors. METHODS We used a tracking survey (conducted 8 times per year, immediately following a burst of campaign activity) to assess campaign recall and recognition, intentions to quit, and behavioral actions taken in response to the campaigns. The sample size was approximately 125 participants at each survey wave, giving a total sample size of 2000 participants over the 2 years. We merged these data with metrics including television target audience rating points, digital and Facebook (Meta) analytics, and Quitline activity data, and conducted regression and time-series modeling. RESULTS Over the evaluation period, unprompted recall of any Quit Tasmania campaign was 18%, while prompted recognition of the most recent campaign was 50%. Over half (52%) of those who recognized a Quit Tasmania campaign reported that they had performed or considered a quitting-related behavioral action in response to the campaign. In the regression analyses, we found having different creatives within a single campaign burst was associated with higher campaign recall and recognition and an increase in the strength of behavioral actions taken. Higher target audience rating points were associated with higher campaign recall (but not recognition) and an increase in quit intentions, but not an increase in behavioral actions taken. Higher Facebook advertisement reach was associated with lower recall among survey participants, but recognition was higher when digital channels were used. The time-series analyses showed no systematic trends in Quitline activity over the evaluation period, but Quitline activity was higher when Facebook reach and advertisement spending were higher. CONCLUSIONS Our evaluation suggests that a variety of creatives should be used simultaneously and supports the continued use of traditional broadcast channels, including television. However, the impact of television on awareness and behavior may be weakening. Future campaign evaluations should closely monitor the effectiveness of television as a result. We are also one of the first studies to explicitly examine the impact of digital and social media, finding some evidence that they influence quitting-related outcomes. While this evidence is promising for campaign implementation, future evaluations should consider adopting rigorous methods to further investigate this relationship.
Collapse
Affiliation(s)
- James Kite
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Anne Grunseit
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Glenn Mitchell
- Quit Tasmania, Cancer Council Tasmania, Hobart, Australia
| | - Pip Cooper
- Quit Tasmania, Cancer Council Tasmania, Hobart, Australia
| | - Lilian Chan
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Bo-Huei Huang
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Margaret Thomas
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Blythe O'Hara
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Abby Smith
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- Quit Tasmania, Cancer Council Tasmania, Hobart, Australia
| |
Collapse
|
11
|
Paraje G, Flores Muñoz M, Wu DC, Jha P. Reductions in smoking due to ratification of the Framework Convention for Tobacco Control in 171 countries. Nat Med 2024; 30:683-689. [PMID: 38321222 PMCID: PMC10957467 DOI: 10.1038/s41591-024-02806-0] [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: 08/07/2023] [Accepted: 01/04/2024] [Indexed: 02/08/2024]
Abstract
Smoking globally kills over half of long-term smokers and causes about 7 million annual deaths. The World Health Organization Framework Convention for Tobacco Control (FCTC) is the main global policy strategy to combat smoking, but its effectiveness is uncertain. Our interrupted time series analyses compared before- and after-FCTC trends in the numbers and prevalence of smokers below the age of 25 years (when smoking initiation occurs and during which response to interventions is greatest) and on cessation at 45-59 years (when quitting probably occurs) in 170 countries, excluding China. Contrasting the 10 years after FCTC ratification with the income-specific before-FCTC trends, we observed cumulative decreases of 15.5% (95% confidence interval = -33.2 to -0.7) for the numbers of current smokers and decreases of -7.5% (95% CI = -10.6 to -4.5) for the prevalence of smoking below age 25 years. The quit ratio (comparing the numbers of former and ever smokers) at 45-59 years increased by 1.8% (1.2 to 2.3) 10 years after FCTC ratification. Countries raising taxes by at least 10 percentage points concurrent with ratification observed steeper decreases in all three outcomes than countries that did not. Over a decade across 170 countries, the FCTC was associated with 24 million fewer young smokers and 2 million more quitters.
Collapse
Affiliation(s)
- Guillermo Paraje
- Business School, Universidad Adolfo Ibáñez, Santiago, Chile.
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies, Santiago, Chile.
| | | | - Daphne C Wu
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Prabhat Jha
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
12
|
Taheri N, Fattahi P, Saeedi E, Sayyari M, Abdi S, Khaki M, Rahimi N, Motamedi RK, Lotfi F, Vand Rajabpour M, Nemati S. A decade of tobacco control efforts: Implications for tobacco smoking prevalence in Eastern Mediterranean countries. PLoS One 2024; 19:e0297045. [PMID: 38394166 PMCID: PMC10889639 DOI: 10.1371/journal.pone.0297045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/27/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES This study aimed to assess the association between the 10-year implementation of tobacco control policies, cigarette affordability index and changes in tobacco smoking prevalence across Eastern Mediterranean (EMR) countries. MATERIALS AND METHODS An ecologic study was conducted using EMR countries as the analytical unit. Data from three sources were utilized: the MPOWER scale to measure tobacco control policy implementation (2010-2020), the tobacco affordability index (expressed as a percentage of GDP per capita required to purchase 2000 cigarettes, from 2010 to 2020), and national tobacco smoking prevalence data for EMR countries (2010-2023). Linear Fixed-effect regression was employed to investigate associations between changes in MPOWER scores, the cigarette affordability index, and alterations in tobacco prevalence over a decade. RESULTS Statistically significant inverse associations were observed between changes in MPOWER scores and tobacco smoking prevalence among both men and women in EMR countries (P-value<0.05). Each unit increase in MPOWER score corresponded to a 0.26% reduction in tobacco prevalence among men and a 0.12% reduction among women. The regression model revealed that each unit increase in the cigarette affordability index was linked to a 0.9% decrease in tobacco smoking prevalence across EMR countries (P-value<0.05). Furthermore, even after adjusting for multiple confounders, significant inverse associations were noted between tobacco monitoring (β = -0.41), health warning (β = -0.45), and changes in tobacco smoking prevalence (P-value<0.05). CONCLUSION This study underscored the effectiveness of enhancing the implementation of tobacco control policies and increasing the cigarette affordability index as preventive measures to reduce tobacco smoking prevalence in EMR countries over the past decade.
Collapse
Affiliation(s)
- Negar Taheri
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Pedram Fattahi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Student research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Elnaz Saeedi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Sayyari
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Abdi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Khaki
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Navid Rahimi
- Department of Physical Medicine and Rehabilitation, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rouhollah K. Motamedi
- Medical Genomic Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Fereshte Lotfi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Vand Rajabpour
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Nemati
- Department of Biostatistics and Epidemiology, School of public health, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
13
|
Kock L, Shahab L, Moore G, Shortt NK, Pearce J, Brown J. Assessing the profile of support for potential tobacco control policies targeting availability in Great Britain: a cross-sectional population survey. Tob Control 2024; 33:221-231. [PMID: 36008128 DOI: 10.1136/tc-2022-057508] [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: 05/04/2022] [Accepted: 08/04/2022] [Indexed: 11/04/2022]
Abstract
AIM To examine the level of support for tobacco availability policies across Great Britain (GB) and associations between support for policy and sociodemographic, smoking and quitting characteristics. METHODS A cross-sectional representative survey (the Smoking Toolkit Study) of adults in GB (n=2197) during September 2021. Logistic regressions estimated the associations between support for each policy and sociodemographic and smoking characteristics. FINDINGS There was majority support for requiring retailers to have a license which can be removed if they sell to those under-age (89.6%) and for restrictions on the sale of cigarettes and tobacco near schools (69.9%). More supported than opposed raising the legal age of sale of cigarettes and tobacco to 21 (49.2% supported; 30.7% opposed; 20.1% unsure) and reducing the number of retailers selling tobacco in neighbourhoods with a high density of tobacco retailers (46.5% supported; 23.3% opposed; 30.2% unsure). More opposed than supported a ban on the sale of cigarettes and tobacco to everyone born after a certain year from 2030 onward (a 'tobacco-free generation') (41.3% opposed; 34.5% supported; 24.2% unsure). Age was positively associated with support for raising the age of sale and inversely associated with requiring tobacco retailer licenses. Women were more likely to support raising the age of sale and reducing the number of retailers. CONCLUSIONS Requiring tobacco retailer licensing and restrictions on sales near schools received majority support. Other tobacco availability policies received substantial support despite considerable opposition.
Collapse
Affiliation(s)
- Loren Kock
- Department of Behavioural Science and Health, University College London, London, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
| | - Graham Moore
- School of Social Sciences, Cardiff University, Cardiff, UK
| | - Niamh K Shortt
- School of Geosciences, Univerity of Edinburgh, Edinburgh, UK
| | - Jamie Pearce
- School of Geosciences, Univerity of Edinburgh, Edinburgh, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
| |
Collapse
|
14
|
Hefler M. Progress, setbacks and changing perception of the possible: reflections on Aotearoa/New Zealand's changed political landscape and tobacco policy plans. Tob Control 2024; 33:141-142. [PMID: 38378208 DOI: 10.1136/tc-2024-058630] [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: 02/22/2024]
Affiliation(s)
- Marita Hefler
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| |
Collapse
|
15
|
Freeman B, Daube M. Reaching everyone: tobacco control must remain a health priority. Med J Aust 2024; 220:136-137. [PMID: 38368553 DOI: 10.5694/mja2.52214] [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] [Received: 11/22/2023] [Accepted: 12/18/2023] [Indexed: 02/19/2024]
Affiliation(s)
- Becky Freeman
- School of Public Health, University of Sydney, Sydney, NSW
| | | |
Collapse
|
16
|
Gannon J, Moreland-Russell S. A qualitative study examining the impact of COVID-19 on capacity for sustainability of tobacco control programs. BMC Health Serv Res 2024; 24:215. [PMID: 38365656 PMCID: PMC10874074 DOI: 10.1186/s12913-024-10633-9] [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: 05/30/2023] [Accepted: 01/24/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND The coronavirus (COVID-19) pandemic presented a significant stressor on the public health system in the United States. While we know the immediate effects of the pandemic on public health programming, no literature has examined the resultant long-term impact on programmatic capacity for sustainability. This paper aims to identify the impact that the COVID-19 pandemic had on state tobacco control program's capacity for sustainability. METHODS From December 2018 to January 2022, we conducted 46 technical assistance calls with tobacco control program employees from 11 states. Calls were audio recorded and professionally transcribed. We analyzed calls (n = 20) that took place during the COVID-19 pandemic. Thematic analysis focused on the impact the COVID-19 pandemic had on tobacco control program's capacity for sustainability. RESULTS We identified six domains of sustainability that were impacted by COVID-19: (1) funding stability; (2) organizational capacity; (3) partnerships; (4) communication; (5) strategic planning; and (6) program adaptation. CONCLUSIONS Our study is the first to identify the impact of the pandemic on capacity for sustainability of tobacco control programs. Having an understanding of COVID-19's influence on these sustainability domains could help with future public health programming during significant public health events and emergency preparedness. CLINICALTRIALS GOV IDENTIFIER NCT03598114. REGISTRATION DATE Retrospectively registered 02-07-2018.
Collapse
Affiliation(s)
- Jessica Gannon
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, USA.
| | - Sarah Moreland-Russell
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, USA
| |
Collapse
|
17
|
Han K, Gannon J, Moreland-Russell S. Barriers and Facilitators to Program Sustainability Among State Tobacco Control Programs. Prev Chronic Dis 2024; 21:E07. [PMID: 38300817 PMCID: PMC10833827 DOI: 10.5888/pcd21.230211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
Public health programs, particularly tobacco control programs (TCPs) in state health departments, face numerous barriers and facilitators to sustainability, which affect delivery and, consequently, health outcomes achieved. We used the Program Sustainability Framework to review and analyze qualitative interview data from states that received training and technical assistance during the Plans, Actions, and Capacity to Sustain Tobacco Control (PACT) study to better understand the barriers and facilitators to sustainability capacity that these public health programs face at the state level. The PACT study was a multiyear, randomized controlled trial to assess the effectiveness of an action planning workshop and technical assistance in improving capacity for sustainability among 11 intervention and 12 control TCPs. Technical assistance calls focused on the progress and barriers of implementing the sustainability action plan created during the in-person workshops. Calls were audio recorded and professionally transcribed. Thematic analysis focused on the codes describing barriers and facilitators faced by TCPs in increasing their capacity for sustainability. Barriers were reported in the Organization Capacity, Environmental Support, Partnerships, Communication, and Funding Stability domains of the Program Sustainability Framework. Facilitators to action planning and building capacity for program sustainability were primarily in the Strategic Planning, Program Evaluation, Program Adaptation, and Partnership domains. Our study is the first to identify barriers and facilitators to increasing the capacity of program sustainability in TCPs. This work advances the understanding of program sustainability capacity and technical assistance for public health programs.
Collapse
Affiliation(s)
- Karin Han
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Jessica Gannon
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Dr, MSC 1196-257-220, St. Louis, MO 63130
| | - Sarah Moreland-Russell
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri
| |
Collapse
|
18
|
Shruti T, Sharma P, Budukh A, Khanna D. Electronic nicotine delivery system: a narrative review on growing threat to tobacco control and health of the young Indian population. Int J Adolesc Med Health 2024; 36:17-24. [PMID: 38369380 DOI: 10.1515/ijamh-2023-0008] [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: 01/17/2023] [Accepted: 01/30/2024] [Indexed: 02/20/2024]
Abstract
The electronic cigarette (EC) was developed as an alternative to cigarette smoking. In less than a decade, the prevalence of past-month EC usage increased from 1.5 to 27.5 % among US high-school students. In the coming years, Asia-Pacific countries will have the highest sales of electronic nicotine/non-nicotine delivery systems (ENDS/ENNDS) after Western Europe. Based on the World Health Organization and Indian Council of Medical Research recommendations, India approved a complete ban on EC in 2019. Even though it has been three years since the ban, EC is still being sold in India's grey markets, where marketing is not regulated. In this narrative review, we discuss that vaping is not just a harm reduction strategy for tobacco smoking cessation but poses a serious threat to India's existing tobacco control efforts as well as the health of the country's young people.
Collapse
Affiliation(s)
- Tulika Shruti
- Department of Preventive Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India
| | - Priyanka Sharma
- Department of Preventive Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India
| | - Atul Budukh
- Centre for Cancer Epidemiology, ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Divya Khanna
- Department of Preventive Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India
| |
Collapse
|
19
|
Miech R, Heeringa SG, Molinaro S, Benedetti E. Cannabis reduction among adolescents as spillover from successful tobacco control. Int J Drug Policy 2024; 124:104315. [PMID: 38183859 PMCID: PMC10939814 DOI: 10.1016/j.drugpo.2023.104315] [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: 08/27/2023] [Revised: 10/27/2023] [Accepted: 12/22/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND National programs that reduce adolescent cannabis use warrant renewed attention in light of current discussions to reform cannabis legislation, including the possibility of legalization for recreational use. This study measures the size of a decrease in a country's prevalence of adolescent cannabis use that accompanies a decrease in its prevalence of adolescents who had ever smoked a cigarette. METHODS Data are from the European School Survey Project on Alcohol and Other Drugs (ESPAD), which is a collaborative effort of more than 40 European countries to surveil adolescent substance use. This study uses data from the seven survey administrations in 1995, 1999, 2003, 2007, 2011, 2015, and 2019. The main analysis is a fixed-effect regression analysis of country-level, four-year changes in adolescent lifetime cannabis use prevalence on country-level, four-year changes in adolescent lifetime cigarette use prevalence. RESULTS Decreases in the national prevalence of adolescents who had ever smoked a cigarette were accompanied by decreases half as large in national prevalence of adolescent lifetime cannabis use. CONCLUSION For European countries considering the legalization of adult recreational cannabis use, tobacco control can offer a tool to help counter potential increases in cannabis use among adolescents.
Collapse
Affiliation(s)
| | | | - Sabrina Molinaro
- Institute of Clinical Physiology, IFC, at the National Research Council of Italy - CNR, Via Moruzzi 1, 56124 Pisa, IT, Italy
| | - Elisa Benedetti
- Institute of Clinical Physiology, IFC, at the National Research Council of Italy - CNR, Via Moruzzi 1, 56124 Pisa, IT, Italy
| |
Collapse
|
20
|
Chen DTH, Grigg J, Filippidis FT. European Respiratory Society statement on novel nicotine and tobacco products, their role in tobacco control and "harm reduction". Eur Respir J 2024; 63:2301808. [PMID: 38316440 DOI: 10.1183/13993003.01808-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/27/2024] [Indexed: 02/07/2024]
Affiliation(s)
- Daniel Tzu-Hsuan Chen
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK
| | - Jonathan Grigg
- Centre for Child Health, Blizard Institute, Queen Mary University of London, London, UK
| | - Filippos T Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| |
Collapse
|
21
|
Li L, Borland R, Le Grande M, Gartner C. Future nicotine use preferences of current cigarette smokers: Findings from the 2020 International Tobacco Control Four Country Smoking and Vaping Survey. Drug Alcohol Rev 2024; 43:359-370. [PMID: 38113310 PMCID: PMC10922120 DOI: 10.1111/dar.13791] [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: 09/17/2022] [Revised: 10/21/2023] [Accepted: 11/12/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Consumer preferences should be important factors that are considered when developing health policies and interventions. This paper examines the prevalence of, and factors associated with, consumer preferences regarding smoking behaviour 1 to 2 years in the future. METHODS At least weekly cigarette smokers in the 2020 wave of the International Tobacco Control Four Country Smoking and Vaping Survey (USA, Canada, England and Australia) (N = 8642) were asked if they preferred to continue to smoke or to quit with or without an alternative nicotine product (ANP) over the next 1-2 years. RESULTS Country-specific weighted data showed 21.5% preferred to continue smoking and 8.0% were uncertain, leaving 70.6% preferring to quit: 13.7% using an ANP and 56.9% completely quitting nicotine. Apart from interest in quitting, the main predictors of preferring to quit were history of vaping, being aged 55 and over, smoking weekly, worrying about smoking harms, regretting starting and believing vaping is less harmful relative to smoking. Among those preferring to quit, preferring to use ANPs in future was very strongly associated with current vaping (especially daily), being younger, living in England, reporting strong urges to smoke, believing vaping is much less harmful than smoking, and not strongly regretting starting to smoke, and not wanting to quit. DISCUSSION AND CONCLUSIONS A significant minority of smokers preferred not to quit, at least in the next year or two. Both interest in quitting and preference for ANPs over complete cessation were associated with similar covariates, including interest in vaping.
Collapse
Affiliation(s)
- Lin Li
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Michael Le Grande
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Coral Gartner
- School of Public Heath, The University of Queensland, Brisbane, Australia
| |
Collapse
|
22
|
Orenstein L, Chetrit A, Kalter-Leibovici O. Factors associated with attempting and succeeding in smoking cessation following a National Tobacco Control Plan: Analysis of two nationwide surveys (2010 and 2017). Addict Behav 2024; 149:107912. [PMID: 37979463 DOI: 10.1016/j.addbeh.2023.107912] [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: 08/17/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 11/20/2023]
Abstract
INTRODUCTION Lower rates of smoking cessation among disadvantaged groups contribute to widening health-disparities. With this recognition, in 2010 free-of-charge/subsidized smoking cessation services became available to all Israeli residents through the not-for-profit health plans. METHODS Based on two cross-sectional National Social Surveys, data on adult ever-smokers were used (n = 2,998 in 2010 and 2,859 in 2017). The outcome variable comprised three categories: no quit attempt, unsuccessful quit attempt and successful quit attempt. Changes over-time and demographic, socioeconomic, health- and smoking-related factors associated with quitting attempts and success were tested in the pooled sample, using multivariable multinomial logistic regression models. RESULTS The pooled sample of the two surveys included 2,611 participants (44.2%) who were successful quitters, 1,941 (32.7%) who reported an unsuccessful quit attempt, and 1,305 (23.1%) smokers who did not attempt to quit. Compared to 2010, ever-smokers in 2017 were less likely to report an unsuccessful quit attempt (adjusted OR = 0.81, 95%CI: 0.70-0.94). The likelihood of successfully quitting was similar in both surveys. Older age and self-reported health problem were associated with higher likelihood of quitting attempt. Meeting living expenses, being overweight/obese, engaging in physical activity and heavy smoking were associated with higher likelihood of successful smoking cessation; while environmental tobacco exposure was associated with 43% lower likelihood of successful cessation. Finally, there was an interaction between education and ethnicity. Higher education level was associated with a greater likelihood both to attempt to quit smoking and to succeed among Jewish participants, while the opposite phenomenon was observed among Arab smokers. CONCLUSIONS Despite the availability of subsidized smoking cessation services, social disparities in smoking cessation rates persist. Efforts should focus on proactively reaching subpopulations with low cessation rates, using tailored strategies for successful smoking cessation. Promoting smoke free homes and workplaces should be prioritized.
Collapse
Affiliation(s)
- Liat Orenstein
- Research Center for Population Health, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Ramat-Gan 52621, Israel; Epidemiology & Preventive Medicine Department, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel.
| | - Angela Chetrit
- Research Center for Population Health, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Ramat-Gan 52621, Israel; School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel.
| | - Ofra Kalter-Leibovici
- Research Center for Population Health, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Ramat-Gan 52621, Israel; Epidemiology & Preventive Medicine Department, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel.
| |
Collapse
|
23
|
Jiang J, Zheng Z. A Critical Review of E-Cigarette Regulation in China: Challenges and Prospects for Youth Prevention and Tobacco Control. Nicotine Tob Res 2024; 26:126-134. [PMID: 37718628 DOI: 10.1093/ntr/ntad180] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/16/2023] [Accepted: 09/15/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION The increasing popularity of electronic cigarettes (e-cigarettes) has led to the emergence of public health concerns, particularly among the youth. As a major producer and exporter of e-cigarettes, China has faced public health challenges in regulating the unregulated e-cigarette industry. AIMS AND METHODS This study aims to evaluate the regulatory development of e-cigarettes in China. We searched and obtained national policy documents related to e-cigarettes and subnational smoke-free laws from LexisNexis on August 2, 2023, which were enacted between January 1, 2023 and July 31, 2023. We used 99 policy documents for the final analysis, specifically 68 national policy documents on e-cigarettes and 31 subnational smoke-free laws. We chronologically reviewed these policy documents in full text and summarized them on the basis of their content and the requirements of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). RESULTS Chinese policymakers established the current regulatory framework for e-cigarettes by amending, enacting, and enforcing laws and regulations. E-cigarettes are categorized as tobacco products, and the State Tobacco Monopoly Administration regulates the e-cigarette industry. The Chinese authorities prioritize youth prevention in strengthening the regulation on e-cigarettes. China adopts various tobacco control measures for e-cigarettes and cigarettes. CONCLUSIONS China gained certain degrees of progress on tobacco control by regulating e-cigarettes and adopting measures required by the WHO FCTC. However, tobacco monopoly hinders the full realization of tobacco control goals, which necessitates the National Health Commission to assume its responsibility for the complete implementation of the WHO FCTC. IMPLICATIONS This study presents a critical review of the development of e-cigarette regulation in China by reviewing relevant policy documents and analyzing tobacco control measures. It recognizes the degrees of progress of tobacco control measures and highlights tobacco monopoly as a significant hindrance of the full implementation of the WHO FCTC. Furthermore, empirical studies are required on the enforcement of tobacco control measures in China.
Collapse
Affiliation(s)
- Jiayi Jiang
- Law School, Central South University, Changsha, China
| | - Zexing Zheng
- Law School, Central South University, Changsha, China
| |
Collapse
|
24
|
Kamaludin IS, How LS, Yee A, Kaai SC, Yan M, Danaee M, Amer Nordin AS, Mohd Hairi F, Ahmad Tajuddin NA, Hasan SI, Quah ACK, Fong GT. Intentions to Quit, Quit Attempts, and the Use of Cessation Aids Among Malaysian Adult Smokers: Findings From the 2020 International Tobacco Control (ITC) Malaysia Survey. Asia Pac J Public Health 2024; 36:69-77. [PMID: 38197364 DOI: 10.1177/10105395231220465] [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] [Indexed: 01/11/2024]
Abstract
This study examined quitting behavior and use of cessation aids (CAs) among Malaysian adult smokers aged ≥18 years (n = 1,047). Data were from the 2020 International Tobacco Control (ITC) Malaysia Survey were analyzed. A total of 79.9% of Malaysian smokers attempted to quit in the past 12 months and 85.2% intended to quit in the next 6 months. The most common CAs were e-cigarettes (ECs) (61.4%), medication/nicotine replacement therapies (NRTs; 51.0%), and printed materials (36.7%); the least common CA was infoline/quitline services (8.1%). Multivariable logistic regression analysis was performed to examine the association between sociodemographic variables and CAs use. Male smokers were more likely to use infoline/quitline services (adjusted odds ratio [aOR] = 3.27; P = .034). Malay smokers were more likely to use infoline/quitline services (aOR = 3.36; P = .002), ECs (aOR = 1.90; P = .004), printed materials (aOR = 1.79; P = .009), and in-person services (aOR = 1.75; P = .043). Most Malaysian smokers wanted to quit smoking. Furthermore, ECs were the most popular CAs, highlighting the need to assess the effectiveness of ECs for quitting smoking in Malaysia.
Collapse
Affiliation(s)
- Ina Sharyn Kamaludin
- Nicotine Addiction Research Collaborating Group, Universiti Malaya Centre for Addiction Science Studies, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Lim Sin How
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Anne Yee
- Nicotine Addiction Research Collaborating Group, Universiti Malaya Centre for Addiction Science Studies, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Susan C Kaai
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Mi Yan
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Mahmoud Danaee
- Nicotine Addiction Research Collaborating Group, Universiti Malaya Centre for Addiction Science Studies, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Amer Siddiq Amer Nordin
- Nicotine Addiction Research Collaborating Group, Universiti Malaya Centre for Addiction Science Studies, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Nicotine Addiction Research Collaborating Group, Universiti Malaya Centre for Addiction Science Studies, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nur Amani Ahmad Tajuddin
- Nicotine Addiction Research Collaborating Group, Universiti Malaya Centre for Addiction Science Studies, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Siti Idayu Hasan
- Nicotine Addiction Research Collaborating Group, Universiti Malaya Centre for Addiction Science Studies, Universiti Malaya, Kuala Lumpur, Malaysia
- Universiti Malaya Community Engagement Centre, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| |
Collapse
|
25
|
Bryant J, Noble N, Eades S, Sanson‐Fisher R. Delivery of tobacco control programs by Aboriginal Community Controlled Health Organisations in New South Wales, Australia: A cross-sectional survey. Health Promot J Austr 2024; 35:235-241. [PMID: 37012613 PMCID: PMC10952781 DOI: 10.1002/hpja.725] [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: 07/29/2022] [Revised: 02/16/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
ISSUE ADDRESSED To describe the characteristics of tobacco control programs (TCPs) delivered by Aboriginal Community Controlled Health Services (ACCHSs) in New South Wales (NSW), Australia. METHODS A key informant from each ACCHS in NSW completed a 30-item online survey. For each TCP, ACCHSs were asked to provide: the target population group, program aims and activities, funding source, and whether the program had been monitored or evaluated and reflected principles of community control and engagement. RESULTS Twenty-five of 38 eligible ACCHSs completed the survey (66% response rate). Overall, 64% of services reported currently delivering at least one TCP, almost all of which aimed to promote quitting (95%). Programs involved brief intervention for tobacco cessation (71%), referral to quit services (67%), or use of printed resources (67%). Funding sources included Local Health Districts (52% of programs), the Commonwealth Government (48%) and NSW Ministry of Health (43%). Most programs were aimed at all Aboriginal people who smoke (76%); 19% targeted women or families during pregnancy/birth. Many TCPs used culturally tailored resources (86%) and employed Aboriginal staff (86%), and 48% had been evaluated. CONCLUSIONS A third of participating ACCHS did not have a specific TCP to address smoking among Aboriginal people, and delivery of programs was characterised by an uncoordinated approach across the state. Aboriginal staff and culturally tailored messages were a focus of existing TCP programs. SO WHAT?: Findings highlight the need for more investment in TCPs for Aboriginal people to ensure all ACCHSs can deliver evidence-based programs.
Collapse
Affiliation(s)
- Jamie Bryant
- Health Behaviour Research CollaborativeUniversity of NewcastleCallaghanNSWAustralia
- College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNSWAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
| | - Natasha Noble
- Health Behaviour Research CollaborativeUniversity of NewcastleCallaghanNSWAustralia
- College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNSWAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
| | - Sandra Eades
- Curtin Medical SchoolCurtin UniversityBentleyWAAustralia
- School of Population and Global HealthUniversity of MelbourneCarltonVic.Australia
| | - Rob Sanson‐Fisher
- Health Behaviour Research CollaborativeUniversity of NewcastleCallaghanNSWAustralia
- College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNSWAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
| |
Collapse
|
26
|
Casassus B. New French national tobacco control programme. Lancet Oncol 2024; 25:22. [PMID: 38071996 DOI: 10.1016/s1470-2045(23)00632-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
|
27
|
Saeedi E, Abdi S, Dardashti AR, Fattahi P, Taheri N, Lotfi F, Nemati S, Vand Rajabpour M. A comparative study of tobacco control scale score in the Eastern Mediterranean Region countries. East Mediterr Health J 2023; 29:966-979. [PMID: 38279865 DOI: 10.26719/emhj.23.120] [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] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 08/31/2023] [Indexed: 01/29/2024]
Abstract
Background The tobacco control scale (TCS) score is used widely in European countries to evaluate the adoption of anti-tobacco policies by countries, however, data on the adoption of tobacco control programmes in the Eastern Mediterranean Region (EMR) are limited to a 2009 survey. Aim To compare the TCS score for measuring national tobacco control programmes in the EMR countries in 2009 and 2021. Methods This cross-sectional survey compared data from 21 EMR countries on 6 major indicators, including the price of cigarettes, tobacco smoke-free public places, national budget for tobacco control activities, ban on tobacco advertising, health warning labels on tobacco packets, and support for treatment of tobacco dependence. The TCS scores at the country level in 2009 were extracted from a previous study. We then calculated the TCS score in 2021 for the same countries using the WHO report on the global tobacco epidemic 2021 and the World Bank data for 2020. Results The average TCS score (standard deviation) for EMR countries increased from 29.7 (16.8) in 2009 to 40.7 (17.3) in 2021. The highest TCS score (83.0) was reported in Islamic Republic of Iran, followed by Yemen (72.8) and Lebanon (62.0). Five countries (Djibouti, Syrian Arab Republic, Tunisia, Bahrain, and Oman) scored less than 30. Health warning labels, smoke-free public places, and tobacco control budgets as a percentage of Gross Domestic Product per capita had all increased, but tobacco prices and cessation treatments did not improve over the past decade. Conclusion Tobacco control policies have been implemented and improved in most EMR countries, but there is room for further improvement. Tobacco pricing and taxation, national tobacco control program budgets, and cessation treatments require more attention.
Collapse
Affiliation(s)
- Elnaz Saeedi
- Oxford Clinical Trial Research Unit, Center for Statistics in Medicine, Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sepideh Abdi
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Amir Reza Dardashti
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Pedram Fattahi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
- Student Research Center, Qazvin University of Medical Sciences, Qazvin, Islamic Republic of Iran
| | - Negar Taheri
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Fereshte Lotfi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Saeed Nemati
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mojtaba Vand Rajabpour
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| |
Collapse
|
28
|
Ralston R, Carlini G, Johns P, Lencucha R, Radvany R, Shah D, Collin J. Corporate interests and the UN treaty on plastic pollution: neglecting lessons from the WHO Framework Convention on Tobacco Control. Lancet 2023; 402:2272-2274. [PMID: 37804860 DOI: 10.1016/s0140-6736(23)02040-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/19/2023] [Indexed: 10/09/2023]
Affiliation(s)
- Rob Ralston
- UKPRP SPECTRUM Consortium and School of Social and Political Science, University of Edinburgh, Edinburgh EH8 9LD, UK.
| | - Giulia Carlini
- Center for International Environmental Law, Washington, DC, USA; Center for International Environmental Law, Geneva, Switzerland
| | | | - Raphael Lencucha
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Rachel Radvany
- Center for International Environmental Law, Washington, DC, USA; Center for International Environmental Law, Geneva, Switzerland
| | - Dharmesh Shah
- Center for International Environmental Law, Washington, DC, USA; Center for International Environmental Law, Geneva, Switzerland
| | - Jeff Collin
- UKPRP SPECTRUM Consortium and School of Social and Political Science, University of Edinburgh, Edinburgh EH8 9LD, UK
| |
Collapse
|
29
|
Strongin RM, Sharma E, Erythropel HC, El-Hellani A, Kassem NOF, Mikheev VB, Noël A, Peyton DH, Springer ML. Emerging ENDS products and challenges in tobacco control toxicity research. Tob Control 2023; 33:110-115. [PMID: 35715171 PMCID: PMC9758272 DOI: 10.1136/tobaccocontrol-2022-057268] [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: 01/30/2022] [Accepted: 06/03/2022] [Indexed: 11/04/2022]
Abstract
Electronic nicotine delivery systems (ENDS) continue to rapidly evolve. Current products pose unique challenges and opportunities for researchers and regulators. This commentary aims to highlight research gaps, particularly in toxicity research, and provide guidance on priority research questions for the tobacco regulatory community. Disposable flavoured ENDS have become the most popular device class among youth and may contain higher nicotine levels than JUUL devices. They also exhibit enhanced harmful and potentially harmful constituents production, contain elevated levels of synthetic coolants and pose environmental concerns. Synthetic nicotine and flavour capsules are innovations that have recently enabled the circumvention of Food and Drug Administration oversight. Coil-less ENDS offer the promise of delivering fewer toxicants due to the absence of heating coils, but initial studies show that these products exhibit similar toxicological profiles compared with JUULs. Each of these topic areas requires further research to understand and mitigate their impact on human health, especially their risks to young users.
Collapse
Affiliation(s)
| | - Eva Sharma
- Behavioral Health and Health Policy, Westat, Rockville, Maryland, USA
| | - Hanno C Erythropel
- Chemical and Environmental Engineering, Yale University, New Haven, Connecticut, USA
| | - Ahmad El-Hellani
- Center for Tobacco Research and the Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio, USA
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nada O F Kassem
- Division of Health Promotion and Behavioral Science, San Diego State University Research Foundation, San Diego, California, USA
| | - Vladimir B Mikheev
- Battelle Public Health Center for Tobacco Research, Battelle Memorial Institute, Columbus, Ohio, USA
| | - Alexandra Noël
- Department of Comparative Biomedical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - David H Peyton
- Chemistry, Portland State University, Portland, Oregon, USA
| | - Matthew L Springer
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| |
Collapse
|
30
|
Hefler M. Tobacco Control: a finite project with the end on the horizon. Tob Control 2023; 33:1-2. [PMID: 38149644 PMCID: PMC10803981 DOI: 10.1136/tc-2023-058514] [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: 12/28/2023]
Affiliation(s)
- Marita Hefler
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| |
Collapse
|
31
|
|
32
|
Ylitörmänen T, Tarasenko YN, Ruokolainen O, Hiilamo H, Pekka P, Ollila H. Implementation of the Article 13 WHO FCTC measures and changes in cigarette smoking among youth in 42 countries. BMJ Glob Health 2023; 8:e013255. [PMID: 38084494 PMCID: PMC10711898 DOI: 10.1136/bmjgh-2023-013255] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/12/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Despite a decline in global smoking prevalence among adolescents, around 21 million youth report current cigarette smoking. Exposure to tobacco advertising, promotion and sponsorship (TAPS) is a risk factor for smoking initiation, and therefore the Article 13 of the WHO Framework Convention on Tobacco Control (WHO FCTC) requires comprehensive TAPS bans. We examined the associations between changes in youth cigarette smoking and implementation of Article 13. METHODS We used two rounds of cross-sectional data from the Global Youth Tobacco Survey (GYTS) for 42 countries: first between 2006 and 2015, and second between 2017 and 2020. The GYTS data were linked with the WHO FCTC implementation reports from 2016 and 2018. The outcome was current smoking. Multilevel binary logistic regression models, stratified by country income level, were used to test the prevalence differences between the latest and previous GYTS rounds and their associations with TAPS bans with postestimations using marginal analyses. RESULTS The percentage of students currently smoking decreased from 10.0% (95% CI 8.0 to 12.1) to 7.7% (95% CI 6.1 to 9.3) from first to second GYTS rounds (p<0.001), adjusting for country clustering. In low-income and lower-middle-income countries, the degree of decrease significantly differed between countries with versus without bans on display, partial internet TAPS ban, ban on depiction of tobacco products and by number of TAPS measures, adjusting for age and sex of the respondents. In high-income and upper-middle-income countries, the degree of decrease significantly differed by presence (or absence) of partial or full internet TAPS ban, ban on product placement and by number of TAPS measures. CONCLUSION Implementation of TAPS bans is associated with decreased smoking among adolescents both in high-income and low-income countries. Enhanced and continuous efforts are necessary to protect youth from the promotion of tobacco and nicotine products.
Collapse
Affiliation(s)
- Tuija Ylitörmänen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Yelena N Tarasenko
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Otto Ruokolainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Heikki Hiilamo
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Puska Pekka
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hanna Ollila
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| |
Collapse
|
33
|
Chan KH, Xiao D, Zhou M, Peto R, Chen Z. Tobacco control in China. Lancet Public Health 2023; 8:e1006-e1015. [PMID: 38000880 DOI: 10.1016/s2468-2667(23)00242-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/15/2023] [Accepted: 09/28/2023] [Indexed: 11/26/2023]
Abstract
Chinese men consume around 40% of the world's cigarettes, causing a substantial and growing burden of tobacco-attributed death and disease. In 2005, the Chinese Government ratified the WHO Framework Convention on Tobacco Control, and tobacco control measures have since increased nationwide. To assess tobacco control progress, obstacles, and opportunities, this Review describes the long-term evolution of cigarette consumption and the associated disease burden in mainland China, and the implementation of five important tobacco control strategies advocated by WHO. These strategies covered tobacco taxation; package warnings; advertising, promotion, and sponsorship bans; public smoking bans; and cessation services. Although only 2% of women in China now smoke, half of all adult men smoke cigarettes. By the 2010s, smoking accounted for about a fifth of all adult male deaths, and this proportion is rising, following a trajectory similar to that seen in the USA 40 years earlier. The self-regulating national tobacco monopoly and its influence on policy, the country's relatively low tobacco tax, and its weak package warnings and enforcement of other tobacco control strategies all highlight challenges in tobacco control. However, these challenges can also provide opportunities to discourage smoking initiation in young women and encourage cessation in men, assisting China's long march towards better health.
Collapse
Affiliation(s)
- Ka Hung Chan
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Oxford British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, UK
| | - Dan Xiao
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, China-Japan Friendship Hospital, Beijing, China; National Center for Respiratory Medicine, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China; Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Richard Peto
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| |
Collapse
|
34
|
Kalan ME, Mejia R, Egbe CO, Chopra M, Bteddini D, Jebai R, Osibogun O, Wilkinson AV, Salloum RG. E-cigarette use in low-income and middle-income countries: opportunity or challenge for global tobacco control. Lancet Glob Health 2023; 11:e1855-e1856. [PMID: 37865111 DOI: 10.1016/s2214-109x(23)00450-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 09/12/2023] [Indexed: 10/23/2023]
Affiliation(s)
| | - Raul Mejia
- Centro de Estudio de Estado y Sociedad (CEDES), Buenos Aires, Argentina
| | - Catherine O Egbe
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Pretoria, South Africa; Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | | | - Dima Bteddini
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Rime Jebai
- Department of Health Law, Policy and Management, School of Public Health, Boston, MA, USA
| | - Olatokunbo Osibogun
- Department of Epidemiology, Florida International University, Miami, FL, USA
| | - Anna V Wilkinson
- University of Texas Health Science Center School of Public Health, Austin, TX, USA
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| |
Collapse
|
35
|
Kelly BC, Vuolo M, Orsini MM, Maggs JL, Staff J. Tobacco Policy and ENDS Policy Influences on Adolescent Vaping Across the U.S. States. Am J Prev Med 2023; 65:1026-1033. [PMID: 37482258 PMCID: PMC10799971 DOI: 10.1016/j.amepre.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
INTRODUCTION Although the use of tobacco has declined among youth, ENDS has the potential to disrupt or reverse these trends. Policies for tobacco and ENDS may have an impact on adolescent ENDS use. The impacts of state-level policies were examined for both tobacco and ENDS indoor use bans, excise taxes, and age-of-purchase laws on past-month adolescent ENDS use from 2013 to 2019. METHODS This study used cohort data from the Population Assessment of Tobacco and Health study and policy data from the Americans for Nonsmokers' Rights Foundation repository-3 policies for ENDS and 2 policies for tobacco products. Policies included comprehensive indoor vaping/smoking bans, purchase-age restrictions, and excise taxes. Hybrid panel models were estimated in 2022 using data merged from the 2 longitudinal sources on past-month vaping. The analytic sample (observations=26,008) included adolescents aged 12-17 years, yielding a total of 72,684 observations. RESULTS The odds of adolescent ENDS use were 21.4% lower when the state had an ENDS purchase-age restriction and 55.0% lower when the state had a comprehensive tobacco smoking ban than in the years when the state did not have the ban. CONCLUSIONS During a period of significant growth in ENDS use among U.S. youth, ENDS purchase-age restrictions and smoking bans reduced the odds of past-month vaping among adolescents. Wider implementation of policies may help intervene in youth vaping.
Collapse
Affiliation(s)
- Brian C Kelly
- Department of Sociology, College of Liberal Arts, Purdue University, West Lafayette, Indiana.
| | - Mike Vuolo
- Department of Sociology, College of Arts and Sciences, The Ohio State University, Columbus, Ohio
| | - Maria M Orsini
- Department of Sociology, College of Arts and Sciences, The Ohio State University, Columbus, Ohio
| | - Jennifer L Maggs
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, State College, Pennsylvania
| | - Jeremy Staff
- Department of Sociology and Criminology, College of Liberal Arts, The Pennsylvania State University, State College, Pennsylvania
| |
Collapse
|
36
|
Linnansaari A, Ollila H, Pisinger C, Scheffels J, Kinnunen JM, Rimpelä A. Towards Tobacco-Free Generation: implementation of preventive tobacco policies in the Nordic countries. Scand J Public Health 2023; 51:1108-1121. [PMID: 35799463 PMCID: PMC10642214 DOI: 10.1177/14034948221106867] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 03/15/2021] [Revised: 05/17/2021] [Accepted: 05/22/2022] [Indexed: 01/08/2023]
Abstract
AIMS Europe's Beating Cancer Plan set a goal of creating a Tobacco-Free Generation in Europe by 2040. Prevention is important for achieving this goal. We compare the Nordic countries' preventive tobacco policies, discuss the possible determinants for similarities and differences in policy implementation, and provide strategies for strengthening tobacco prevention. METHODS We used the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) to identify the key policies for this narrative review. We focused on Articles 6, 8, 9, 11, 13 and 16 of the WHO FCTC, and assessed the status of the required (core) and recommended (advanced) policies and their application to novel tobacco and nicotine products. Information on the implementation of strategies, acts and regulations were searched from global and national tobacco control databases, websites and scientific articles via PubMed and MEDLINE. RESULTS The WHO FCTC and European regulations have ensured that the core policies are mostly in place, but also contributed to the shared deficiencies that are seen especially in the regulations on smokeless tobacco and novel products. Strong national tobacco control actors have facilitated countries to implement some advanced policies - even as the first countries in the world: point-of-sale display bans (Iceland), outdoor smoking bans (Sweden), flavour bans on electronic cigarettes (Finland), plain packaging (Norway), and plain packaging on electronic cigarettes (Denmark). CONCLUSIONS Collaboration and participation in reinforcing the European regulations, resources for national networking between tobacco control actors, and national regulations to provide protection from the tobacco industry's interference are needed to strengthen comprehensive implementation of tobacco policies in the Nordic countries.
Collapse
Affiliation(s)
- Anu Linnansaari
- Faculty of Social Sciences, Unit of Health Sciences, Tampere, Finland
| | - Hanna Ollila
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Charlotta Pisinger
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Denmark
- Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Danish Heart Foundation, Copenhagen, Denmark
| | - Janne Scheffels
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Jaana M. Kinnunen
- Faculty of Social Sciences, Unit of Health Sciences, Tampere, Finland
| | - Arja Rimpelä
- Faculty of Social Sciences, Unit of Health Sciences, Tampere, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland
| |
Collapse
|
37
|
Liu C, Yong HH, Gravely S, East K, Kasza K, Gartner C, Cummings KM, Fong GT. Gender differences in cigarette smoking cessation attempts among adults who smoke and drink alcohol at high levels: Findings from the 2018-2020 International Tobacco Control Four Country Smoking and Vaping Surveys. Addict Behav 2023; 147:107817. [PMID: 37536221 PMCID: PMC10866688 DOI: 10.1016/j.addbeh.2023.107817] [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: 03/21/2023] [Revised: 07/16/2023] [Accepted: 07/27/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND This study examined the association between alcohol consumption and smoking cessation behaviour of adults who smoke in four countries. METHODS Data came from 4275 adults (≥18 years) who smoked tobacco ≥ monthly and participated in the 2018 and 2020 International Tobacco Control Four Country Smoking and Vaping Surveys (Australia: n = 720; Canada: n = 1250; US: n = 1011; England: n = 1294). The 2018 Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) survey data coded into three levels ('never/low', 'moderate' or 'heavy' consumption) were analysed using multivariable logistic regression models to predict any smoking cessation attempts and successful cessation by 2020 survey, and whether this differed by gender and country. RESULTS Compared to never/low alcohol consumers, only those who drink heavily were less likely to have made a quit smoking attempt (40.4 % vs. 43.8 %; AOR = 0.69, 95 % CI = 0.57-0.83, p < .001). The association differed by gender and country (3-way interaction, p < .001), with females who drink heavily being less likely to attempt to quit smoking in England (AOR = 0.27, 95 % CI = 0.15-0.49, p < .001) and Australia (AOR = 0.38, 95 % CI = 0.19-0.77, p = .008), but for males, those who drink moderately (AOR = 2.18, 95 % CI = 1.17-4.06, p = .014) or heavily (AOR = 2.61, 95 % CI = 1.45-4.68, p = .001) were more likely to make a quit attempt in England only. Alcohol consumption did not predict quit success. CONCLUSION Heavy alcohol use among adults who smoke appears to only undermine the likelihood of trying to quit smoking with some variation by gender and country of residence, but not their chances of succeeding if they tried.
Collapse
Affiliation(s)
- Chenyang Liu
- School of Psychology, Deakin University, Geelong, Victoria, Australia.
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Geelong, Victoria, Australia.
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
| | - Katherine East
- National Addiction Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Karin Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
| | - Coral Gartner
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada; School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada; Ontario Institute for Cancer Research, Toronto, Ontario M5G 0A3, Canada.
| |
Collapse
|
38
|
Hall W, Gartner C, Morphett K. How has the brain disease model of addiction contributed to tobacco control? Drug Alcohol Depend 2023; 253:111033. [PMID: 38006672 DOI: 10.1016/j.drugalcdep.2023.111033] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/09/2023] [Accepted: 11/13/2023] [Indexed: 11/27/2023]
Abstract
Our paper evaluates the extent to which the brain disease model of addiction (BDMA) has contributed to reducing the prevalence of tobacco smoking and tobacco-related harm over the past 20 years. We discuss the ways in which genetic and neuroscience research on nicotine addiction have contributed to our understanding of tobacco smoking. We then examine the extent to which the BDMA has produced more effective treatments to assist smoking cessation. We also assess the degree to which the BDMA has contributed to the tobacco control policies that have produced substantial reductions in tobacco-related morbidity and mortality in the two decades since the model was first proposed by Alan Leshner. We also assess whether the BDMA has reduced the stigmatisation of people who smoke tobacco.
Collapse
Affiliation(s)
- Wayne Hall
- The National Centre for Youth Substance Use Research, the University of Queensland, Australia.
| | - Coral Gartner
- The School of Public Health, The University of Queensland, Australia
| | - Kylie Morphett
- The School of Public Health, The University of Queensland, Australia
| |
Collapse
|
39
|
Nguyen Zarndt A, Guo M, Benoza G. The role of social media influencers as trusted messengers in tobacco control mass media campaigns. J Commun Healthc 2023; 16:344-346. [PMID: 37639540 PMCID: PMC10841044 DOI: 10.1080/17538068.2023.2249714] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Affiliation(s)
- Anh Nguyen Zarndt
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Merrybelle Guo
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Gem Benoza
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| |
Collapse
|
40
|
Dewhirst T, Lee WB, Czaplicki L. Philip Morris International's Formula 1 Sponsorship-Linked Marketing: Transformation From Marlboro to Mission Winnow. Nicotine Tob Res 2023; 25:1838-1846. [PMID: 37702346 PMCID: PMC10664078 DOI: 10.1093/ntr/ntad177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 07/08/2023] [Accepted: 09/11/2023] [Indexed: 09/14/2023]
Abstract
INTRODUCTION Transformation describes a dramatic modification in appearance or character. Philip Morris International (PMI)'s sponsorship-linked marketing of Formula 1 auto racing is illustrative of transformation. The company's flagship cigarette brand, Marlboro has been replaced as the identified partner by their newly developed brand, Mission Winnow. This study examines the tobacco company's marketing objectives for transforming the brand identity of its Formula 1 Ferrari race team partnership. AIMS AND METHODS We provide a case study, and our method of qualitative enquiry is textual analysis. We review marketing planning documents from Philip Morris, which would normally be proprietary, but are publicly accessible because of litigation. Additionally, we review Mission Winnow's social media posts, over a 3-year span, from the brand's Facebook, Instagram, and Twitter accounts. RESULTS PMI initiated its Formula 1 sponsorship in 1972. Through Marlboro, the company's sponsorship-linked marketing was largely centered on building brand image and reinforcing Marlboro's brand identity of rugged masculinity, independence, heroism, and adventure. When Mission Winnow replaced Marlboro as the identified brand sponsor in 2018, the company's marketing communication shifted to highlighting transformation, progress, open dialogue, teamwork, innovation, technology, and science. CONCLUSIONS Despite Article 5.3 of the World Health Organization's Framework Convention on Tobacco Control (WHO FCTC) calling for Parties to protect public health policies from the commercial and vested interests of tobacco companies, PMI still seeks to be an important stakeholder in such consultations, including those pertaining to harm reduction. Mission Winnow's sponsorship-linked marketing points to a larger company narrative about trying to gain or reclaim legitimacy and credibility. IMPLICATIONS PMI's continued sponsorship of Formula 1 is a strategic means of drawing attention to the company's "next-generation products" and communicating their supposed "transformation." The company's sponsorship-linked marketing initiatives point to a need for Parties to enforce Article 13 of the WHO FCTC, which calls for a comprehensive ban on tobacco advertising, promotion, and sponsorship.
Collapse
Affiliation(s)
- Timothy Dewhirst
- Department of Marketing and Consumer Studies, Gordon S. Lang School of Business and Economics, University of Guelph, Guelph, ON, Canada
| | - Wonkyong Beth Lee
- DAN Department of Management and Organizational Studies, Western University, London, ON, Canada
| | - Lauren Czaplicki
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
41
|
Smith MJ, Patterson C, Buckton C, Hilton S. Implementation of the polluter pay's principle in tobacco control in the UK: a stakeholder analysis. BMC Public Health 2023; 23:2271. [PMID: 37978482 PMCID: PMC10657032 DOI: 10.1186/s12889-023-17219-w] [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: 03/14/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The polluter's pay principle (PPP) aims to internalise external costs and assign liability to the polluter for the harmful cost of their products to society. Tobacco companies continue to manufacture and sell harmful cigarettes, earning billions in profits each year from these products. Meanwhile, governments and their people are left to 'clean up' and deal with the detrimental health consequences. This paper explores with expert stakeholders how the PPP could be implemented within the context of tobacco control in the United Kingdom (UK). METHODS Twenty-four semi-structured interviews and two follow-up discussion groups were conducted with UK and international experts on tobacco control, public health, economics, or law from the academic, public, private and third sector. Participants considered the facilitators and barriers to implementing the PPP to tobacco control in the UK. Thematic analysis was employed, aided by NVivo 12, and data were compared to examine the views expressed by the different types of experts. RESULTS Stakeholders favoured the implementation of the PPP in the context of tobacco control and indicated that it could be acceptable and feasible to implement and that it would likely have support from policymakers and the public alike. Stakeholders unanimously agreed that any legislation and administration should be free from tobacco industry influence; however, differences arose concerning who should oversee the implementation. CONCLUSION The PPP from environmental law was predominantly seen as an approach that could be usefully applied to the tobacco industry. However, there is no one size fits all template, therefore its implementation would need to be adapted to fit the UK context.
Collapse
Affiliation(s)
- Marissa J Smith
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, UK.
| | - Chris Patterson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, UK
| | - Christina Buckton
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, UK
| | - Shona Hilton
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, UK
| |
Collapse
|
42
|
Matthes BK, Alebshehy R, Gilmore AB. "They try to suppress us, but we should be louder": a qualitative exploration of intimidation in tobacco control. Global Health 2023; 19:88. [PMID: 37974216 PMCID: PMC10655405 DOI: 10.1186/s12992-023-00991-0] [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: 07/14/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Tobacco control advocates and researchers face powerful opponents who go to great lengths to protect their interests. While threats and attacks are documented in the grey literature, research into intimidation remains scarce. Building on previous exploratory research, this study seeks to offer in-depth insights into experiences of intimidation in the global tobacco control community. METHODS Using qualitative description, we conducted a focus group and semi-structured interviews with tobacco control advocates and researchers to explore their experiences, including forms of, and responses to, intimidation, and ways forward. Data were analysed using qualitative content analysis. RESULTS Twenty-nine individuals from across the globe participated in the study. They reported several forms of intimidation including attacks in the media; online harassment; legal threats; non-legal threats, including death threats; Freedom of Information requests; perceived or actual surveillance; as well as burglary and theft. Responses included non-action (i.e. ignoring attacks); withdrawal (i.e. abandoning a project, area or field); defensive adaptation, for example through self-censorship; and offensive measures, including exposing attacks or filing complaints. Responses were shaped by several factors, including type and level of support from within internal and external networks; as well as an individual's mindset, skills and experiences; and state-civil society relations. Participants suggested several measures that could help address intimidation: 1) report and monitor intimidation; 2) (better) prepare individuals through awareness raising and training (e.g. IT security, legal); 3) support those in need through legal advice, a peer-support network and involvement in response; and 4) look beyond tobacco control to learn and build connections. CONCLUSION Intimidation is a significant challenge to tobacco control that needs urgent attention. This study suggests measures to address intimidation that require commitment from, and collaboration amongst, multiple actors including governments, international organisations, funders, researchers and civil society. Moreover, collective action beyond tobacco control is needed to not only manage but move beyond intimidation.
Collapse
Affiliation(s)
- Britta K Matthes
- Department for Health, University of Bath, Claverton Down, Bath, BA27AY, UK.
| | - Raouf Alebshehy
- Department for Health, University of Bath, Claverton Down, Bath, BA27AY, UK
| | - Anna B Gilmore
- Department for Health, University of Bath, Claverton Down, Bath, BA27AY, UK
| |
Collapse
|
43
|
Hopkinson NS. E-Cigarettes as a Smoking Cessation Aid - Toward Common Ground and a Rational Approach. Am J Respir Crit Care Med 2023; 208:1007-1009. [PMID: 37769065 PMCID: PMC10867934 DOI: 10.1164/rccm.202309-1623ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 09/28/2023] [Indexed: 09/30/2023] Open
Affiliation(s)
- Nicholas S Hopkinson
- National Heart and Lung Institute Imperial College London London, United Kingdom
| |
Collapse
|
44
|
Lang AE, Kathuria H, Braillon A, Ewart G, Dagli E, Stepp EL, Galiatsatos P, Deepak J, Jordt SE, Hayes D. England Is Handing out E-Cigarettes: Is the "Swap to Stop" Tobacco Control Scheme Harm Reduction or Harm Production? Am J Respir Crit Care Med 2023; 208:1024-1025. [PMID: 37682082 PMCID: PMC10867939 DOI: 10.1164/rccm.202308-1354vp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/08/2023] [Indexed: 09/09/2023] Open
Affiliation(s)
- Adam Edward Lang
- Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Hasmeena Kathuria
- The Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | | | - Gary Ewart
- American Thoracic Society, Washington, DC
| | - Elif Dagli
- Marmara University, Health Institute Association, Istanbul, Turkey
| | - Evan L. Stepp
- Division of Pulmonary, Critical Care & Sleep Medicine, National Jewish Health, Highlands Ranch, Colorado
| | - Panagis Galiatsatos
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Janaki Deepak
- Veterans Affairs Maryland Health Care System, Baltimore Veterans Affairs Medical Center, Baltimore, Maryland
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Sven E. Jordt
- Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina; and
| | - Don Hayes
- Department of Pediatrics, Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| |
Collapse
|
45
|
Fagbule OF, Egbe CO, Ayo-Yusuf OA. Tobacco Vendors' Perceptions and Compliance with Tobacco Control Laws in Nigeria. Int J Environ Res Public Health 2023; 20:7054. [PMID: 37998285 PMCID: PMC10671655 DOI: 10.3390/ijerph20227054] [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] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/03/2023] [Accepted: 11/11/2023] [Indexed: 11/25/2023]
Abstract
Tobacco vendors are critical stakeholders in the tobacco supply chain. This study examined their perception, compliance, and potential economic impact of Nigeria's tobacco control laws related to the retail setting. This was a qualitative study involving in-depth interviews of 24 purposively selected tobacco vendors. The face-to-face interviews were aided by a semi-structured interview guide, audio-recorded, transcribed verbatim, and analyzed using thematic analysis with NVivo version 12. Five themes emerged, encompassing reasons for selling tobacco, awareness, perception, compliance with tobacco sales laws, the potential economic impact of the laws, and law enforcement activities. Vendors commenced tobacco sales due to consumers' demand, profit motives, and advice from close family relatives. They were unaware and non-compliant with most of the retail-related laws. Most participants had positive perceptions about the ban on sales to and by minors, were indifferent about the ban on Tobacco Advertising Promotion and Sponsorships (TAPS) and product display, and had negative perceptions about the ban on sales of single sticks. Most vendors stated quitting tobacco sales would not have a serious economic impact on their business. In conclusion, the vendors demonstrated limited awareness and non-compliance with various retail-oriented tobacco control laws in Nigeria. Addressing these gaps requires targeted educational campaigns and effective law enforcement strategies to enhance vendors' compliance.
Collapse
Affiliation(s)
- Omotayo F Fagbule
- Department of Public Health, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa
- Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan 200212, Nigeria
| | - Catherine O Egbe
- Department of Public Health, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Pretoria 0001, South Africa
| | - Olalekan A Ayo-Yusuf
- Africa Centre for Tobacco Industry Monitoring and Policy Research (ATIM), School of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa
| |
Collapse
|
46
|
Harsamizadeh Tehrani S, Trieu SL, Dao L, Samuel C, Lui CK. Engaging Students in Advancing Campus Tobacco-Free Policies: A Qualitative Study of California Community Colleges' Efforts. Prev Chronic Dis 2023; 20:E102. [PMID: 37943726 PMCID: PMC10684277 DOI: 10.5888/pcd20.230082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
Introduction Tobacco use remains a serious problem for young adults. Given the large number of young adults attending college, a tobacco-free campus is one strategy to reduce tobacco use. Young adult engagement is recognized as a common strategic practice in tobacco control policy efforts, especially in changing social norms around tobacco use. Community colleges can leverage and engage students in adoption of campus 100% tobacco-free policies. This qualitative study examines the importance of student engagement in advancing 100% tobacco-free policies in community colleges and identifies strategies for campuses to involve students in such efforts. Methods We selected 12 community colleges and conducted key informant interviews with campus and community-based organizations that were involved in campus policy adoption efforts. We conducted 33 semistructured interviews and transcribed, coded, and analyzed them by using a thematic analytic framework with inductive and deductive approaches to examine student engagement processes. Results Community colleges represented campuses with (n = 6) and without (n = 6) tobacco-free policy and varied by geography (urban vs rural) and student population size. Three main themes emerged: 1) no "wrong door" for students to engage in tobacco control work, 2) a myriad of ways for students to be involved in policy adoption, and 3) benefits of student engagement. Conclusion We found that students are doers, allies, and champions in adoption of 100% campus tobacco-free policy. Colleges should leverage their campuses' most important assets - students - to be agents of change and to involve them in the full spectrum of interventions and advocacy.
Collapse
Affiliation(s)
| | | | - Lien Dao
- Student Health Center, Ohlone College, Fremont, California
| | - Carissa Samuel
- Student Health Center, Ohlone College, Fremont, California
| | - Camillia K Lui
- Alcohol Research Group, Public Health Institute, Emeryville, California
| |
Collapse
|
47
|
Naznin E, George J, Driezen P, Palazzi K, Wynne O, Nargis N, Fong GT, Bonevski B. Trend over time on knowledge of the health effects of cigarette smoking and smokeless tobacco use in Bangladesh: Findings from the International Tobacco Control Policy Evaluation Bangladesh Surveys. Drug Alcohol Rev 2023; 42:1838-1849. [PMID: 37565295 PMCID: PMC11031133 DOI: 10.1111/dar.13735] [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: 01/13/2023] [Revised: 07/04/2023] [Accepted: 07/26/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION Cigarette smoking and smokeless tobacco (ST) use are prevalent in Bangladesh. This longitudinal study examined how knowledge of the health effects of smoking and ST use in Bangladesh has changed overtime with the country's acceleration of tobacco control efforts. METHODS Data were analysed from the International Tobacco Control Survey, a nationally representative longitudinal study of users and non-users of tobacco (aged 15 and older) in Bangladesh, across four waves conducted in 2009 (n = 4378), 2010 (n = 4359), 2012 (n = 4223) and 2015 (n = 4242). Generalised estimating equations assessed the level of knowledge about harms of tobacco use across four waves. Multivariable logistic regressions assessed whether knowledge of health effects from cigarette smoking and ST use in 2015 differed by user group. RESULTS In 2015 survey, most tobacco users were aware that cigarette smoking causes stroke (92%), lung cancer (97%), pulmonary tuberculosis (97%) and ST use causes mouth cancer (97%) and difficulty in opening mouth (80%). There were significant increases in the total knowledge score of smoking related health harm from 2010 to 2012 (mean difference = 0.640; 95% confidence interval [CI] 0.537, 0.742) and 2012 to 2015 (mean difference = 0.555; 95% CI 0.465, 0.645). Participants had greater odds of awareness for ST health effects from 2010 to 2015. DISCUSSION AND CONCLUSIONS The results suggest that increasing efforts of awareness policy interventions is having a positive effect on tobacco-related knowledge in Bangladesh. These policy initiatives should be continued to identify optimal methods to facilitate behaviour change and improve cessation of smoking and ST use.
Collapse
Affiliation(s)
- Eva Naznin
- Research higher degree, School of Medicine and Public Health, The University of Newcastle, University Drive Callaghan, NSW 2308, Australia
| | - Johnson George
- Senior lecturer, Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
| | - Pete Driezen
- Research Assistant Professor, Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Kerrin Palazzi
- Senior Statistician, Hunter Medical Research Institute (HMRI), Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Olivia Wynne
- Health Research Economist, Hunter Medical Research Institute (HMRI), Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Nigar Nargis
- Senior Scientific Director, Surveillance and Healthy Equity Science. American Cancer Society, 555 11th Street NW suite 300, Washington DC, 20004
| | - Geoffrey T. Fong
- Professor, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Billie Bonevski
- Professor and Lead of Public Health, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, Adelaide 5042, Australia
| |
Collapse
|
48
|
Kennedy H, Trujillo M, Ryan A, Cooley D, Martinez D, McNair B, Hunt C. Identifying Root Causes: Evaluation of a Program to Engage Youth in a Social Justice Approach to Tobacco Control. Health Promot Pract 2023; 24:1151-1162. [PMID: 36050932 DOI: 10.1177/15248399221112456] [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] [Indexed: 11/16/2022]
Abstract
Movements designed to engage youth in tobacco control have been an important part of tobacco prevention for decades. Today, young people are increasingly diverse, and their primary issues of concern are gun control, racism, mental health, and climate change. To engage today's young people, tobacco control programs need to draw connections between youth's identities, top issues, and tobacco. UpRISE is a social justice youth tobacco control movement that engages diverse youth in identifying the root causes of youth nicotine use. In 2018-2019, 21 youth-serving organizations and schools hosted youth coalitions. Coalitions engaged in a six-session workbook called "Getting to the root cause," and adults were provided training and reflective supervision. Pre/post surveys with youth participants (n = 180) and end-of-year interviews with adult facilitators (n = 22) were used to assess outcomes. The primary outcomes were supportive adult relationships, youth voice in decision-making, anti-tobacco industry attitudes and beliefs, psychological empowerment, critical consciousness, and global belief in a just world. Quantitative measures of supportive adult relationships, youth voice in decision-making, psychological empowerment, and anti-tobacco industry attitudes and beliefs all increased significantly over time (p < .0001, p < .0001, p < .0001, p = .0034, respectively). Critical consciousness and global belief in a just world did not change significantly. During interviews, adults reported learning how: to engage in youth-adult partnerships, the tobacco industry abused its power, to engage in critical reflection about power. Adults also felt empowered. UpRISE may be a promising approach to increase racially diverse youth's engagement in social justice-oriented tobacco control efforts that advance equity.
Collapse
Affiliation(s)
| | | | - Amy Ryan
- Colorado School of Public Health, Aurora, CO, USA
| | | | | | - Bryan McNair
- Colorado School of Public Health, Aurora, CO, USA
| | - Cerise Hunt
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| |
Collapse
|
49
|
Abstract
BACKGROUND Although outdoor smoke-free policies (SFPs) at sports clubs represent an important new area of tobacco control, the majority of sports clubs are not smoke free. This study aims to assess diffusion patterns of outdoor SFPs at sports clubs in the Netherlands. METHODS Using a retrospective, registry-based design, an inventory was made of football, field hockey, tennis and korfball clubs that became smoke free between 2016 and 2020. We determined the type of sports, number of members and proportion of youth members. The degree of urbanisation and density of smoke-free sports clubs were measured at the municipality level. The association between sports clubs' characteristics, degree of urbanisation and SFP adoption was analysed using multilevel regression analysis. Horizontal diffusion was tested by analysing the association between the density and annual incidence of smoke-free sports clubs. RESULTS Since 2016, the number of sports clubs with an outdoor SFP increased from 0.3% to 26.4%. Field hockey and korfball clubs and clubs with many (youth) members were more likely to be smoke-free. SFPs spread from the most urbanised to less urbanised municipalities, which could mostly be attributed to sports clubs' characteristics. A higher density of smoke-free sports clubs within municipalities was associated with an increased incidence of new SFPs in the following year. CONCLUSION Outdoor SFPs at sports clubs in the Netherlands diffused across horizontal and hierarchical lines. National strategies for smoke-free sports should monitor clubs that are more likely to stay behind, such as football and tennis clubs, smaller clubs and clubs in less urbanised areas.
Collapse
Affiliation(s)
- Rixt A Smit
- Department of Public and Occupational Health, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | - Heike H Garritsen
- Department of Public and Occupational Health, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | - Anton E Kunst
- Department of Public and Occupational Health, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| |
Collapse
|
50
|
Affiliation(s)
- Ruth E Malone
- Social and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| |
Collapse
|