Abstract PO-242: Viral hepatitis among foreign-born communities in the Washington- Baltimore metropolitan area: 5-year prevalence data and implications for linkage to care follow-up

Background: Viral hepatitis is a major public health problem around the world and in the United States, with significant morbidity and mortality. This research aimed to provide updated prevalence estimates and linkage-to-care rates for hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among foreign-born immigrants in the Washington-Baltimore metropolitan area. Methods: This retrospective cohort study analyzed screening data obtained from over 275 community-based outreach events held from 2015 to 2019. Through strategic collaborations and culturally-appropriate programs, the Hepatitis B Initiative of Washington DC was able to provide no-cost HBV and HCV testing, vaccination, and treatment linkage-to-care services to 9,489 and 9,427 individuals, respectively. We examined the prevalence of positive HBV (HBsAg+) and HCV (HCVAb+) infections and linkage-to-care with associated sociodemographic characteristics. Results: Overall, prevalence amongst foreign-born clients screened over the 5-year period was 4.3% for HBV and 1.1% for HCV. The highest HBV prevalence was among participants born in Malaysia (8.5%), Cambodia (7.7%), and Vietnam (6.9%), whereas HCV prevalence was highest among participants born in Mongolia (5.0%), Cameroon (3.2%), and Burma (1.5%). Among the 378 HBV- and 102 HCV-infected individuals who were referred to care, linkage- to-care rates were 87.0% (2016-2019) and 47.1% (2017-2019) respectively. Among those linked to care, an overwhelming proportion reported not having health insurance (74.8%) and/or a usual source of care (75.3%); the majority were also female (52.8%), over 30 years of age (96.6%), and born in Asia (78.0%). Conclusions: Foreign-born individuals from Asia and Africa had the highest prevalence of viral hepatitis. These results underscore the need to disaggregate screening data by country of birth to inform prevention and linkage-to-care programs and their impact. Additionally, optimal HBV and HCV screening and linkage-to-care can be achieved among harder-to-reach at-risk populations through partnerships with community organizations, health centers, and public health departments.

Citation Format: Daisy Le, Annie Coriolan, Jane Pan, Carla Jean Berg, Y. Alicia Hong, Angeline Nguyen, Hai Chi Le, Lorien Cindy Abroms, Hee-Soon Juon, Y. Tony Yang. Viral hepatitis among foreign-born communities in the Washington- Baltimore metropolitan area: 5-year prevalence data and implications for linkage to care follow-up [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-242.

IQOS point-of-sale marketing strategies at a time of legislation transition in Israel

Background

Heated tobacco products (HTP), such as Philip Morris IQOS, have penetrated the global tobacco market. Currently the only HTP on the market in Israel, IQOS was introduced in 2016. The device is sold in specialty stores and online; while the heat sticks (HEETS) are sold at traditional retailers. In 01/2019 a ban on advertisements in all media (excluding print media) and at the point-of-sale (POS) went into effect. In 01/2020, a POS display ban and plain packaging went into effect. Understanding the POS marketing strategies at a time of regulatory transition could aid regulatory efforts in other countries.

Methods

Observations were conducted in 80 retailers carrying HEETS in 4 large Israeli cities in 12/2019, before the POS display ban and plain packaging went into effect. Data were collected using an adapted version of the Standardized Tobacco Assessment for Retail Settings, which assessed store characteristics, product offerings, pricing, promotional strategies, and placement.

Results

All retailers sold cigarettes; 51% carried also electronic cigarettes. Only one retailer carried the IQOS device. HEETS packages were visible to customers in 47% of retailers. Over 60% carried at least 3 HEETS different flavours (out of 5 available). In all but one retailer, HEETS were sold at higher prices than cigarettes, on average 21% more expensive. Posted ads were uncommon. In 14.5% of retailers, a special IQOS product display cast was prominent. Additionally, 25% of retailers placed cigarettes and 14% placed HEETS near youth-oriented merchandise.

Conclusions

This study provides insights into IQOS marketing strategies during a period of regulatory transition. Findings suggest that IQOS-specific promotions were not common, but a proportion of retailers highlighted IQOS via displays and/or proximity to youth-oriented merchandise. Moreover, IQOS may be promoted to higher socio-economic status populations, as indicated by pricing and possibly by availability of products.

Key messages

Understanding IQOS marketing strategies at point-of-sale is critical to inform regulatory measures globally. IQOS marketing strategies in Israel at the point-of-sale suggest that IQOS is promoted to higher socio-economic status populations.

Text2Quit: An analysis of user experiences with a mobile smoking cessation program

INTRODUCTION

Studies have shown that Text2Quit and other mobile cessation programs increase quit rates in adult smokers, but the mechanism of effects and user experiences are not well understood.

AIMS

This study reports on participants' experiences with the program and explores aspects of the program that they liked and disliked.

METHODS

Self-reported experiences of the program were collected through a follow-up survey conducted one month after enrollment (n=185). Participant responses to open-ended items were dual coded by independent coders.

RESULTS

Overall participants agreed that they liked the program (4.2/5), that the program was helpful (4.1/5) and that they would recommend the program to a friend (4.3/5). Top reasons for liking the program included that it served as a constant reminder of quitting (17.8%), the content (16.7%), the encouragement provided (13.3%), and the on-demand tools (12.2%). Top reasons for disliking the program were message frequency (20.5%), content (7.0%), and the lack of personal interaction (7.0%).

CONCLUSIONS

The constancy of messaging was both liked as a reminder and disliked as an annoyance. Future programs might be improved by pre-testing and customizing the content based on user preferences, and by adding in human interactions, while keeping a supportive tone and offering on-demand tools.