[The plain packaging of tobacco products: a new strategy for tobacco control].

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Rey-Pino, Juan Miguel; Nerín, Isabel; Lacave-García, Ma Blanca

There is evidence that global tobacco smoking control policies contribute to decrease the prevalence of smoking among populations, so there is a need to effectively implement different measures in a coordinated way. The plain packaging and labelling of tobacco products is one of the measures proposed by the World Health Organisation Framework Convention on Tobacco Control. At the moment, leading countries are implementing this tobacco control measure, which involves a plain packaging for all tobacco products, i.e., the absence of any promotional or communication tool in the packaging, except the name of the brand, appearing with a standardised font, size, colour and placing in the pack. Australia was the first country to implement this measure in 2012 and recently other countries are legislating and approving it. In Spain, tobacco legislation (2005 and 2010), was an important advance in tobacco control policies. The introduction of plain packaging in Spain would mean the next step in the development of a global strategy for fighting this significant health problem. The aim of this article is to synthesise in a structured manner the role that the packaging of tobacco products has within marketing and communication strategies, as well as to describe the potential effects that the plain packaging has on some aspects of smoking behaviour, according to current literature. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

[WHO Framework Convention on Tobacco Control (FCTC) Article 11: packaging and labelling of tobacco products].

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Bekki, Kanae; Inaba, Yohei; Kunugita, Naoki

2015-01-01

The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) requires member countries to implement measures aimed at reducing the demand for tobacco products. FCTC article 11 describes the important forms of health communication and packaging regulations. And this article recommends on large pictorial health warnings and encourages more effective forms of disclosure on constituents and emissions. Furthermore, article 11 recognizes the importance of the package as a promotional vehicle for tobacco companies and requires the removal of potentially misleading packaging information, including the terms "light" and "mild." The Conference of the Parties (COP) adopted guidelines for implementation of article 11 on "Packaging and labelling of Tobacco Products". Some countries, such as Canada, the U.S.A., Australia, EU countries etc. positively promoted tobacco control by implementing countermeasures such as the graphic health warning labels and plain packages. These countermeasures showed the significant effects of decreasing smoking rate and preventing smoking initiation in young people. Furthermore, these warning labels were effective for the literally challenged. However, the Japanese government has not implemented these countermeasures, and only limited texts are shown on Japanese tobacco packaging. Therefore, Japan should emulate approaches taken by other countries, and promote the tobacco control policy in accordance with FCTC.

Improving the delivery of global tobacco control.

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Bitton, Asaf; Green, Carol; Colbert, James

2011-01-01

Tobacco control must remain a critical global health priority given the growing burden of tobacco-induced disease in the developing world. Insights from the emerging field of global health delivery suggest that tobacco control could be improved through a systematic, granular analysis of the processes through which it is promoted, implemented, and combated. Using this framework, a critical bottleneck to the delivery of proven health promotion emerges in the role that the tobacco industry plays in promoting tobacco use and blocking effective tobacco-control policies. This "corporate bottleneck" can also be understood as a root cause of massive disease and suffering upon vulnerable populations worldwide, for the goal of maximizing corporate profit. Naming, understanding, and responding to this corporate bottleneck is crucial to the success of tobacco-control policies. Three case studies of tobacco-control policy--South Africa, the Framework Convention on Tobacco Control, and Uruguay--are presented to explore and understand the implications of this analysis. © 2011 Mount Sinai School of Medicine.

Zambia Tobacco Control Campaign | CRDI - Centre de recherches ...

International Development Research Centre (IDRC) Digital Library (Canada)

The looming tobacco epidemic and its potential for thwarting development has prompted most governments in sub-Saharan Africa to ratify the World Health Organization's Framework Convention on Tobacco Control (WHO-FCTC). Ratifying countries must design and implement a national tobacco control action plan and ...

Strengthening Tobacco Control in South Africa | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

The looming tobacco epidemic and its potential for thwarting development has prompted most governments in sub-Saharan Africa to ratify the World Health Organization's Framework Convention on Tobacco Control (WHO-FCTC). Ratifying countries must design and implement a national tobacco control action plan and ...

From policy to practice: lessons from Karnataka about implementation of tobacco control laws

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Pragati B Hebbar

2017-01-01

Full Text Available Background: Tobacco use accounts for eight to nine lakh adult deaths annually in India. India enacted a national legislation “Cigarettes and Other Tobacco Products Act, 2003” (COTPA to protect health of non-smokers and reduce tobacco consumption. However, even a decade after enacting this law, its implementation remains suboptimal and variable across the Indian states. Karnataka has shown leadership on this front by enacting a state law and implementing COTPA at (sub- district levels. We, therefore, aim to analyze COTPA implementation processes in Karnataka to understand how COTPA can be effectively implemented. Methods: We developed a case study of COTPA implementation in Karnataka using reports from health, police, education, and transport departments as well as government orders and media reports related to COTPA. We analyzed these data to map and understand the role played by the government agencies in COTPA implementation. We used the proportion of the districts reporting COTPA violations, the number of COTPA violations cases reported, and the proportion of schools reporting compliance with COTPA as proxy measures for COTPA implementation. Results: We found that five government agencies (police, education, health, transport, and urban development played a major role in COTPA implementation. All the police districts reported COTPA violations with 59,594 cases in a year (April 2013–March 2014. Three of the district anti-tobacco cells and two of the transport divisions reported 1130 and 14,543 cases of COTPA violations, respectively, in the same year. In addition, 84.7% of schools complied with signage requirements of COTPA. COTPA reporting was made part of the reporting systems within health, police, and education departments. The health department created awareness on tobacco harms and COTPA. Conclusions: COTPA implementation in Karnataka was made possible through integrating COTPA implementation within structure/functions of five

WHO Framework Convention on Tobacco Control in China: barriers, challenges and recommendations.

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Hu, Teh-Wei; Lee, Anita H; Mao, Zhengzhong

2013-12-01

The aim of this study was to analyze the barriers in the implementation of the Framework Convention on Tobacco Control (FCTC) in China and present recommendations on ways to address these challenges in tobacco control in China. We review the available literature on progress and explore the barriers and challenges that impede a speedier pace in the adoption of the effective tobacco control measures, and present recommendations based on in-depth knowledge of decision-making process on the implementation of FCTC in China. The pace of progress in China is too slow. China faces intractable political, structural, economic and social barriers in tobacco control, which make the whole-hearted implementation of FCTC measures a painstaking process. The authors recommend a comprehensive approach to speed up the implementation of tobacco control measures. This includes strong political leadership from the top, structural changes to the tobacco industry and government oversight of the tobacco industry, as well as advocacy and support for tobacco control from civil society at the grassroots level.

What impact have tobacco control policies, cigarette price and tobacco control programme funding had on Australian adolescents' smoking? Findings over a 15-year period.

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White, Victoria M; Warne, Charles D; Spittal, Matthew J; Durkin, Sarah; Purcell, Kate; Wakefield, Melanie A

2011-08-01

To assess the impact of tobacco control policies relating to youth access, clean indoor air and tobacco advertising at point-of-sale and outdoors, in addition to cigarette price and per capita tobacco control spending, on adolescent smoking prevalence. Repeated cross-sectional surveys. Logistic regression analyses examined association between policies and smoking prevalence. Australia, 1990-2005. A nationally representative sample of secondary students (aged 12-17 years) participating in a triennial survey (sample size per survey range: 20 560 to 27 480). Students' report of past-month smoking. In each jurisdiction, extent of implementation of the three policies for the year of the survey was determined. For each survey year, national per capita tobacco control spending was determined and jurisdiction-specific 12-month change in cigarette price obtained. Extent of implementation of the three policy areas varied between states and over the survey years. Multivariate analyses that adjusted for demographic factors, year and all tobacco control variables showed that 12-month cigarette price increases [odds ratio (OR): 0.98, 95% confidence interval (CI): 0.97-0.99], greater per capita tobacco control spending (OR: 0.99, 95% CI: 0.98-0.99) and stronger implementation of clean indoor air policies (OR: 0.93, 95% CI: 0.92-0.94) were associated with reduced smoking prevalence. Adult-directed, population-based tobacco control policies such as clean indoor air laws and increased prices of cigarettes, implemented as part of a well-funded comprehensive tobacco control programme are associated with lower adolescent smoking. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Global and Regional Patterns of Tobacco Smoking and Tobacco Control Policies.

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Islami, Farhad; Stoklosa, Michal; Drope, Jeffrey; Jemal, Ahmedin

2015-08-01

Tobacco smoking is a major worldwide cause of morbidity and mortality from various diseases, including urologic diseases. We reviewed, at global and regional levels, the prevalence and trends of tobacco smoking and legislative and regulatory efforts around tobacco control. We also provided information about electronic cigarette (e-cigarette) use. We used several sources to present the most up-to-date information from national surveys, including the Global Adult Tobacco Survey, the Global Tobacco Control Report, and the Global Youth Tobacco Survey. Smoking prevalence has been decreasing globally, although trends in smoking vary substantially across countries and by gender. Among men, smoking prevalence in most high-income countries started to decrease in the mid-1990s, followed after a few decades by generally smaller decreases in some low- and middle-income countries (LMICs). However, there has been no change, or there has even been an increase, in smoking prevalence in many other LMICs. Countries with the highest male smoking prevalence are located in East Asia, Southeast Asia, and Eastern Europe. Similar to men, smoking prevalence for women has been decreasing in most high-income countries and some LMICs, although the decrease began later and was slower than that for men. Except in a few countries, smoking is much less common for women than for men. Most countries with the highest smoking prevalence in women are in Europe. Countries that have implemented the best practices for tobacco control, including monitoring, smoke-free policies, cessation programs, health warnings, advertising bans, and taxation, have been able to reduce smoking rates and related harms. E-cigarette use has rapidly increased since its introduction to the market. Health care providers should advise smoking patients about quitting smoking. Countries must improve the implementation and enforcement of tobacco control policies. Particular attention should be paid to preventing an increase in

An overview of tobacco control and prevention policy status in Africa.

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Husain, Muhammad Jami; English, Lorna McLeod; Ramanandraibe, Nivo

2016-10-01

Tobacco smoking prevalence remains low in many African countries. However, growing economies and the increased presence of multinational tobacco companies in the African Region have the potential to contribute to increasing tobacco use rates in the future. This paper used data from the 2014 Global Progress Report on implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), as well as the 2015 WHO report on the global tobacco epidemic, to describe the status of tobacco control and prevention efforts in countries in the WHO African Region relative to the provisions of the WHO FCTC and MPOWER package. Among the 23 countries in the African Region analyzed, there are large variations in the overall WHO FCTC implementation rates, ranging from 9% in Sierra Leone to 78% in Kenya. The analysis of MPOWER implementation status indicates that opportunities exist for the African countries to enhance compliance with WHO recommended best practices for monitoring tobacco use, protecting people from tobacco smoke, offering help to quit tobacco use, warning about the dangers of tobacco, enforcing bans on tobacco advertising and promotion, and raising taxes on tobacco products. If tobacco control interventions are successfully implemented, African nations could avert a tobacco-related epidemic, including premature death, disability, and the associated economic, development, and societal costs. Published by Elsevier Inc.

Controlling corporate influence in health policy making? An assessment of the implementation of article 5.3 of the World Health Organization framework convention on tobacco control.

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Fooks, Gary Jonas; Smith, Julia; Lee, Kelley; Holden, Chris

2017-03-08

The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) stands to significantly reduce tobacco-related mortality by accelerating the introduction of evidence-based tobacco control measures. However, the extent to which States Parties have implemented the Convention varies considerably. Article 5.3 of the FCTC, is intended to insulate policy-making from the tobacco industry's political influence, and aims to address barriers to strong implementation of the Convention associated with tobacco industry political activity. This paper quantitatively assesses implementation of Article 5.3's Guidelines for Implementation, evaluates the strength of Parties' efforts to implement specific recommendations, and explores how different approaches to implementation expose the policy process to continuing industry influence. We cross-referenced a broad range of documentary data (including FCTC Party reports and World Bank data on the governance of conflicts of interest in public administration) against Article 5.3 implementation guidelines (n = 24) for 155 Parties, and performed an in-depth thematic analysis to examine the strength of implementation for specific recommendations. Across all Parties, 16% of guideline recommendations reviewed have been implemented. Eighty-three percent of Parties that have taken some action under Article 5.3 have introduced less than a third of the guidelines. Most compliance with the guidelines is achieved through pre-existing policy instruments introduced independently of the FCTC, which rarely cover all relevant policy actors and fall short of the guideline recommendations. Measures introduced in response to the FCTC are typically restricted to health ministries and not explicit about third parties acting on behalf of the industry. Parties systematically overlook recommendations that facilitate industry monitoring. Highly selective and incomplete implementation of specific guideline recommendations facilitates

China: the tipping point in tobacco control.

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Mackay, Judith

2016-12-01

Tobacco control in China, the world's largest producer and consumer of tobacco, began in the 1980s with the first national prevalence survey and a conference on tobacco held in Tianjin. Since then, there have been dozens of research papers, partial restrictions on smoking and tobacco advertising, public education campaigns, and the ratification of the World Health Organization Framework Convention on Tobacco Control, but progress has been slow. The state-owned tobacco industry remains a major obstacle to tobacco control. In the last few years, tobacco control efforts have accelerated beyond expectations. The triggering event was the publication on tobacco by the Chinese Central Party School, the ideological think tank of the Communist Party, followed by a spate of activity: directives to government officials; regulations issued by the Ministry of Education, the People's Liberation Army and the Healthy City Standards; tobacco clauses in national advertising and philanthropy laws; the creation of a Smoke-free Beijing; an increase in tobacco taxation; and a national smoke-free law currently in draft. There is a crucial need for China to build upon these recent developments, in accepting the economic research evidence of the debit of tobacco to the economy; in implementing robust, comprehensive legislation; in increasing cigarette price through taxation and, most challenging of all, to tackle the power and influence of the state tobacco monopoly over tobacco control. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial.

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Amemori, Masamitsu; Korhonen, Tellervo; Kinnunen, Taru; Michie, Susan; Murtomaa, Heikki

2011-02-14

Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC) counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster randomised controlled design, we aim to provide further evidence on

Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial

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Michie Susan

2011-02-01

Full Text Available Abstract Background Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Methods Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. Discussion To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster

Understanding tobacco control policy at the national level: bridging the gap between public policy and tobacco control advocacy

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Marc C. Willemsen

2018-03-01

Full Text Available Background While some countries have advanced tobacco control policies, other countries struggle to adopt and implement FCTC's measures. This presentation uncovers the main factors that explain such variations, taking insights from public policy and political science as a starting point for a case study. Methods A case study of tobacco control policy making in the Netherlands, covering the period from the 1960s until the present. The study consisted of a systematic search and analysis of documents and proceedings of parliamentary debates on tobacco policy, supplemented with 22 interviews with key informants from the government, health organisations, politicians, and the tobacco industry. In addition, documents from the Truth Tobacco Industry Documents database, pertaining to the influence of the tobacco industry on Dutch policy making, were analysed. Results The Dutch government started relatively late to regulate tobacco. The choices in tobacco control policy making at the national level and the tempo in which they are made are explained by the interaction of the five main elements of the tobacco control policy making process: Relatively stable context factors (constitutional structures, 'rules of the policy making game', national cultural values Relatively dynamic context factors (regime changes, EU regulation and FCTC guidelines, changing social norms, public support Transfer of ideas (availability and interpretation of scientific evidence Pro and anti-tobacco control networks and coalitions (their organisational and lobby strength Agenda-setting (changes in problem definition, issue framing, media advocacy Conclusions Despite worldwide convergence of tobacco control policies, accelerated by the ratification of the FCTC treaty by most nations, governments develop approaches to tobacco control in line with cultural values, ideological preferences and specific national institutional arrangements. There is no one-size-fits-all approach. The

Trends in Point-of-Sale Tobacco Marketing around College Campuses: Opportunities for Enhanced Tobacco Control Efforts

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Wagoner, Kimberly G.; Sutfin, Erin L.; Song, Eunyoung Y.; King, Jessica L.; Egan, Kathleen L.; Reboussin, Beth; Debinski, Beata; Spangler, John; Wolfson, Mark

2018-01-01

Objective: Colleges have implemented policies to limit tobacco use on-campus; however, the off-campus environment is often overlooked in tobacco control efforts. We assessed availability, marketing, and promotion of cigarettes, snus, and traditional smokeless tobacco (SLT) in a sample of communities surrounding 11 college campuses in North…

[Impact of tobacco control policy on teenager population in Uruguay].

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Abascal, Winston; Lorenzo, Ana

2017-01-01

To analyze the evolution of the prevalence of tobacco use, comparing data obtained from the Global Youth Tobacco Survey in 2007 and 2014 editions. Data from the World Youth Tobacco Survey 2007 and 2014 were compared. Tobacco control measures implemented in the period under review were also analyzed. Data shows a decrease in 30-day cigarette consumption in population aged 13 to 15 years: from 20.2% in 2007 to 8.2% in 2014. No significant differences were found between the sexes. Susceptibility to become a smoker in the next year decreased from 25.8% in 2007 to 16.6% in 2014. The implementation, almost simultaneously, of measures included in WHO Framework Convention for Tobacco Control, is an effective strategy to achieve the objectives of reducing the prevalence of tobacco use.

The road to effective tobacco control in China.

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Yang, Gonghuan; Wang, Yu; Wu, Yiqun; Yang, Jie; Wan, Xia

2015-03-14

The non-communicable disease burden in China is enormous, with tobacco use a leading risk factor for the major non-communicable diseases. The prevalence of tobacco use in men is one of the highest in the world, with more than 300 million smokers and 740 million non-smokers exposed to second-hand smoke. In the past decade public awareness of the health hazards of tobacco use and exposure to second-hand smoke has grown, social customs and habits have changed, aggressive tactics used by the tobacco industry have been revealed, and serious tobacco control policies have been actively promoted. In 2014, national legislators in China began actively considering national bans on smoking in public and work places and tobacco advertising. However, tobacco control in China has remained particularly difficult because of interference by the tobacco industry. Changes to the interministerial coordinating mechanism for implementation of the WHO Framework Convention on Tobacco Control are now crucial. Progress towards a tobacco-free world will be dependent on more rapid action in China. Copyright © 2015 Elsevier Ltd. All rights reserved.

Measuring Armenia's progress on the Tobacco Control Scale: an evaluation of tobacco control in an economy in transition, 2005-2009.

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Movsisyan, Narine K; Connolly, Gregory N

2014-02-27

This study aimed to measure the 5-year progress in the implementation of WHO Framework Convention on Tobacco Control (FCTC) in Armenia by applying the Tobacco Control Scale, a rapid assessment tool developed to assess the strength of tobacco control policies in Europe. Armenia, an economy in transition, has extreme smoking rates among men (62.5%) despite acceding to FCTC in 2004. However, little research has been carried out to evaluate Armenia's progress in tobacco control. The Tobacco Control Scale total score was estimated for Armenia using the original methodology; however, a different source of data was used in estimating the subscores on tobacco price and tobacco control spending. Armenia's total score on Tobacco Control Scale has considerably improved from 2005 to 2009, mostly due to larger health warnings and advertising ban, and increased public spending on tobacco control. The scores for smoke-free public places, advertising ban, health warnings and treatment categories were below the European average in 2005 and 2007, while the price score was higher. Neither total tobacco control score nor any of its components showed a significant predictive value in a simple regression analysis using the total score and subscores as predictors for log-transformed per capita tobacco consumption. Higher than the European average price score for Armenia cannot be explained by the concept of affordability alone and may reflect a measurement error due to peculiarities of transition economies. The applicability of the Tobacco Control Scale could be limited to countries with mature economies, but not to transition countries such as Armenia with different social, political and economic environment. The scale modification, such as an adjustment for the policy enforcement and the effectiveness of public tobacco control spending along with alternative measures of affordability would be warranted to enhance its applicability in low-income and middle-income countries.

[Tobacco smoking and principles of the who framework convention on tobacco control: a review].

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Melkadze, N

2013-02-01

The aim of a review is to examine the current state of the relevant publications on tobacco smoking, the Guidelines on Protection from Exposure to Tobacco Smoke, and WHO Framework Convention on Tobacco Control (FCTC), which commits countries to protect the public's health by adopting various measures to reduce demand for tobacco. Georgia ratified the treaty in February 2006. In Georgia the implementation of the WHO FCTC is regulated by the "Law on Tobacco Control" (Law). It went into effect in September 2003. Changes and additions to the Law were approved by the Parliament in December 2008 (N 941 - rs) and in December 2010 (№4059-rs). According to Article 10 of the Law, smoking is prohibited at the educational and childcare institutions, medical and pharmaceutical facilities, at the entire area of petrol, gas and gas-distribution stations, in public transport, indoor areas of work and mass gathering... In spite of the legislation rights of non-smokers are very poorly preserved. With this in mind, the Welfare Foundation, the FCTC and the Tobacco Control Alliance, organized a public discussion on enforcing smoke-free laws in Georgia, in December 2012 at Tbilisi Marriott Courtyard Hotel. In order to make public libraries, educational, cultural institutions «de jure» and «de facto» free from tobacco smoke, the campaign against tobacco, which aims to strengthen implementation of the Tobacco Control Law and Regulation should be held in public libraries - not in the hotels. It is necessary to hang a poster - «Environment free from Smoke» at the entrance to buildings where smoking is prohibited throughout. In Rules and regulations for the use of the library there must be a note: smoking is prohibited in the library. We hope that Georgia in the nearest future will be in the list of countries with smoke-free public and work places.

Best practices in tobacco control in the South-East Asia Region.

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Zolty, B C; Sinha, P K; Sinha, D N

2012-01-01

The tobacco epidemic is an increasing threat to public health with the tobacco burden particularly high in WHO's South-East Asia Region (SEAR). The Region has many obstacles to tobacco control, but despite these challenges, significant progress has been made in many countries. Although much work still needs to be done, SEAR countries have nevertheless implemented strong and often innovative tobacco control measures that can be classified as "best practices," with some setting global precedents. The best practice measures implemented in SEAR include bans on gutka, reducing tobacco imagery in movies, and warning about the dangers of tobacco. In a time of scarce resources, countries in SEAR and elsewhere must ensure that the most effective and cost-efficient measures are implemented. It is hoped that countries can learn from these examples and as appropriate, adapt these measures to their own specific cultural, social and political realities.

Impact of tobacco control policy on teenager population in Uruguay

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Winston Abascal

2017-03-01

Full Text Available Objective. To analyze the evolution of the prevalence of tobacco use, comparing data obtained from the Global Youth Tobacco Survey in 2007 and 2014 editions. Materials and methods. Data from the World Youth Tobacco Survey 2007 and 2014 were compared. Tobacco control measures implemented in the period under review were also analyzed. Results. Data shows a decrease in 30-day cigarette consumption in population aged 13 to 15 years: from 20.2% in 2007 to 8.2% in 2014. No significant differences were found between the sexes. Susceptibility to become a smoker in the next year decreased from 25.8% in 2007 to 16.6% in 2014. Conclusions. The implementation, almost simultaneously, of measures included in WHO Framework Convention for Tobacco Control, is an effective strategy to achieve the objectives of reducing the prevalence of tobacco use.

Measuring Armenia's progress on the Tobacco Control Scale: an evaluation of tobacco control in an economy in transition, 2005–2009

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Movsisyan, Narine K; Connolly, Gregory N

2014-01-01

Objectives This study aimed to measure the 5-year progress in the implementation of WHO Framework Convention on Tobacco Control (FCTC) in Armenia by applying the Tobacco Control Scale, a rapid assessment tool developed to assess the strength of tobacco control policies in Europe. Setting Armenia, an economy in transition, has extreme smoking rates among men (62.5%) despite acceding to FCTC in 2004. However, little research has been carried out to evaluate Armenia's progress in tobacco control. Methods The Tobacco Control Scale total score was estimated for Armenia using the original methodology; however, a different source of data was used in estimating the subscores on tobacco price and tobacco control spending. Results Armenia's total score on Tobacco Control Scale has considerably improved from 2005 to 2009, mostly due to larger health warnings and advertising ban, and increased public spending on tobacco control. The scores for smoke-free public places, advertising ban, health warnings and treatment categories were below the European average in 2005 and 2007, while the price score was higher. Neither total tobacco control score nor any of its components showed a significant predictive value in a simple regression analysis using the total score and subscores as predictors for log-transformed per capita tobacco consumption. Conclusions Higher than the European average price score for Armenia cannot be explained by the concept of affordability alone and may reflect a measurement error due to peculiarities of transition economies. The applicability of the Tobacco Control Scale could be limited to countries with mature economies, but not to transition countries such as Armenia with different social, political and economic environment. The scale modification, such as an adjustment for the policy enforcement and the effectiveness of public tobacco control spending along with alternative measures of affordability would be warranted to enhance its applicability in low

FCTC guidelines on tobacco industry foreign investment would strengthen controls on tobacco supply and close loopholes in the tobacco treaty.

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Lo, Chang-fa

2010-08-01

The Framework Convention on Tobacco Control (FCTC) contains no provisions covering tobacco industry investments. This creates the potential for tobacco companies to benefit from investment liberalisation by using foreign investments to avoid tobacco tariffs, increase tobacco consumption and otherwise impair the implementation of FCTC-style measures. Reducing and ultimately eliminating foreign investment activities by tobacco companies can be justified on health grounds, even though it runs counter to current investment liberalisation trends. Through the FCTC process, non-binding guidelines can be elaborated to assist parties in recognising and responding to foreign investment strategies of tobacco companies, to support efforts to exclude the tobacco sector from investment liberalisation and otherwise would improve all countries' awareness of the threat from foreign investment strategies of tobacco companies and provide them with approaches to handle the problems.

Tobacco-control policies in tobacco-growing states: where tobacco was king.

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Fallin, Amanda; Glantz, Stanton A

2015-06-01

POLICY POINTS: The tobacco companies prioritized blocking tobacco-control policies in tobacco-growing states and partnered with tobacco farmers to oppose tobacco-control policies. The 1998 Master Settlement Agreement, which settled state litigation against the cigarette companies, the 2004 tobacco-quota buyout, and the companies' increasing use of foreign tobacco led to a rift between the companies and tobacco farmers. In 2003, the first comprehensive smoke-free local law was passed in a major tobacco-growing state, and there has been steady progress in the region since then. Health advocates should educate the public and policymakers on the changing reality in tobacco-growing states, notably the major reduction in the volume of tobacco produced. The 5 major tobacco-growing states (Kentucky, North Carolina, South Carolina, Tennessee, and Virginia) are disproportionately affected by the tobacco epidemic, with higher rates of smoking and smoking-induced disease. These states also have fewer smoke-free laws and lower tobacco taxes, 2 evidence-based policies that reduce tobacco use. Historically, the tobacco farmers and hospitality associations allied with the tobacco companies to oppose these policies. This research is based on 5 detailed case studies of these states, which included key informant interviews, previously secret tobacco industry documents (available at http://legacy.library.ucsf.edu), and media articles. This was supplemented with additional tobacco document and media searches specifically for this article. The tobacco companies were particularly concerned about blocking tobacco-control policies in the tobacco-growing states by promoting a pro-tobacco culture, beginning in the late 1960s. Nevertheless, since 2003, there has been rapid progress in the tobacco-growing states' passage of smoke-free laws. This progress came after the alliance between the tobacco companies and the tobacco farmers fractured and hospitality organizations stopped opposing smoke

Converging research needs across framework convention on tobacco control articles: making research relevant to global tobacco control practice and policy.

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Leischow, Scott J; Ayo-Yusuf, Olalekan; Backinger, Cathy L

2013-04-01

Much of the research used to support the ratification of the WHO Framework Convention on Tobacco Control (FCTC) was conducted in high-income countries or in highly controlled environments. Therefore, for the global tobacco control community to make informed decisions that will continue to effectively inform policy implementation, it is critical that the tobacco control community, policy makers, and funders have updated information on the state of the science as it pertains to provisions of the FCTC. Following the National Cancer Institute's process model used in identifying the research needs of the U.S. Food and Drug Administration's relatively new tobacco law, a core team of scientists from the Society for Research on Nicotine and Tobacco identified and commissioned internationally recognized scientific experts on the topics covered within the FCTC. These experts analyzed the relevant sections of the FCTC and identified critical gaps in research that is needed to inform policy and practice requirements of the FCTC. This paper summarizes the process and the common themes from the experts' recommendations about the research and related infrastructural needs. Research priorities in common across Articles include improving surveillance, fostering research communication/collaboration across organizations and across countries, and tracking tobacco industry activities. In addition, expanding research relevant to low- and middle-income countries (LMIC), was also identified as a priority, including identification of what existing research findings are transferable, what new country-specific data are needed, and the infrastructure needed to implement and disseminate research so as to inform policy in LMIC.

The challenge of tobacco control at a university hospital

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Natália Ferreira Cruz

Full Text Available Objective: To identify the actions taken by the Commission of Tobacco Control (CTC to control smoking in the hospital environment.Methods: Descriptive and exploratory retrospective documentary research conducted at a university hospital in southern Brazil, in 2014. The content of the minutes of CTC meetings was used to create a database, and the rounds reports were descriptively analyzed. We sought to identify the most relevant actions from 2005 to 2014.Results: The CTC implemented the Tobacco-Free Environment programme restricted cigarette smoking to designated areas and subsequently deactivated these areas. The only remaining outdoor smoking area in 2014 was deactivated.Conclusion: CTC actions have contributed to tobacco control in the hospital environment. This study will hopefully serve as a model to encourage other institutions to implement similar actions.

North Carolina Tobacco Farmers' Changing Perceptions of Tobacco Control and Tobacco Manufacturers

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Crankshaw, Erik C.; Beach, Robert H.; Austin, W. David; Altman, David G.; Jones, Alison Snow

2009-01-01

Purpose: To examine tobacco farmers' attitudes toward tobacco control, public health, and tobacco manufacturers in order to determine the extent to which rapidly changing economic conditions have influenced North Carolina tobacco farmer attitudes in ways that may provide tobacco control advocates with new opportunities to promote tobacco control…

Tobacco Control and Tobacco Farming: Separating Myth from Reality

International Development Research Centre (IDRC) Digital Library (Canada)

2014-09-10

Sep 10, 2014 ... The bulk of the world's tobacco is produced in low- and middle-income countries. In order to dissuade these countries from implementing policies aimed at curbing tobacco consumption (such as increased taxes, health warnings, advertising bans, and smoke-free environments), the tobacco industry claims ...

Tobacco Control and Tobacco Farming: Separating Myth from Reality

International Development Research Centre (IDRC) Digital Library (Canada)

10 sept. 2014 ... The bulk of the world's tobacco is produced in low- and middle-income countries. In order to dissuade these countries from implementing policies aimed at curbing tobacco consumption (such as increased taxes, health warnings, advertising bans, and smoke-free environments), the tobacco industry claims ...

Encouraging tobacco control using national multisectoral ministerial mandate and priorities in Indonesia

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Farrukh Qureshi

2018-03-01

In countries having strong tobacco industry influence, tobacco control issue needs to be brought forward within larger policy mandates of non-health sector ministries, using their national priorities. Intergovernmental organizations as well as other partners and organizations working on tobacco control should expand reach out to sectors beyond health, establish and encourage dialogue; and help develop ownership of these sectors on specific policy interventions that directly or indirectly support implementation of key policy measures for tobacco control.

From global agenda-setting to domestic implementation: successes and challenges of the global health network on tobacco control.

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Gneiting, Uwe

2016-04-01

Global policy attention to tobacco control has increased significantly since the 1990 s and culminated in the first international treaty negotiated under the auspices of the World Health Organization--the Framework Convention on Tobacco Control (FCTC). Although the political process that led to the creation of the FCTC has been extensively researched, the FCTC's progression from an aspirational treaty towards a global health governance framework with tangible policy effects within FCTC member countries has not been well-understood to date. This article analyses the role of the global health network of tobacco control advocates and scientists, which formed during the FCTC negotiations during the late 1990 s, in translating countries' commitment to the FCTC into domestic policy change. By comparing the network's influence around two central tobacco control interventions (smoke-free environments and taxation), the study identifies several scope conditions, which have shaped the network's effectiveness around the FCTC's implementation: the complexity of the policy issue and the relative importance of non-health expertise, the required scope of domestic political buy-in, the role of the general public as network allies, and the strength of policy opposition. These political factors had a greater influence on the network's success than the evidence base for the effectiveness of tobacco control interventions. The network's variable success points to a trade-off faced by global health networks between their need to maintain internal cohesion and their ability to form alliances with actors in their social environment. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

Update on Performance in Tobacco Control: A Longitudinal Analysis of the Impact of Tobacco Control Policy and the US Adult Smoking Rate, 2011-2013.

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Mader, Emily M; Lapin, Brittany; Cameron, Brianna J; Carr, Thomas A; Morley, Christopher P

2016-01-01

Tobacco use remains the leading cause of preventable death in the United States. States and municipalities have instituted a variety of tobacco control measures (TCMs) to address the significant impact tobacco use has on population health. The American Lung Association annually grades state performance of tobacco control using the State of Tobacco Control grading framework. To gain an updated understanding of how recent efforts in tobacco control have impacted tobacco use across the United States, using yearly State of Tobacco Control TCM assessments. The independent TCM variables of smoke-free air score, cessation score, excise tax, and percentage of recommended funding were selected from the American Lung Association State of Tobacco Control reports. Predictors of adult smoking rates were determined by a mixed-effects model. The 50 US states and District of Columbia. Adult smoking rate in each state from 2011 to 2013. The average adult smoking rate decreased significantly from 2011 to 2013 (21.3% [SD: 3.5] to 19.3% [SD: 3.5], P = .016). All forms of TCMs varied widely in implementation levels across states. Excise taxes (β = -.812, P = .006) and smoke-free air regulations (β = -.057, P = .008) were significant, negative predictors of adult smoking. Cessation services (β = .015, P = .46) did not have a measurable effect on adult smoking. Tobacco control measures with the strongest influence on adult smoking include the state excise tax and state smoke-free air regulations. The lack of robust funding for tobacco cessation services across the majority of US states highlights an important shortfall in current tobacco control policy.

Practices related to tobacco sale, promotion and protection from tobacco smoke exposure in restaurants and bars in Kampala before implementation of the Uganda tobacco control Act 2015

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Steven Ndugwa Kabwama

2017-06-01

Hospitality establishments in Kampala are not protecting the public from tobacco smoke exposure nor adequately limiting access to tobacco products. Effective dissemination of the Tobacco Control Act 2015 is important in ensuring that owners of public places are aware of their responsibility of complying with critical tobacco control laws. This would also likely increase self-enforcement among owners of hospitality establishments and public patrons of the no-smoking restrictions.

Trends in point-of-sale tobacco marketing around college campuses: Opportunities for enhanced tobacco control efforts.

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Wagoner, Kimberly G; Sutfin, Erin L; Song, Eunyoung Y; King, Jessica L; Egan, Kathleen L; Reboussin, Beth; Debinski, Beata; Spangler, John; Wolfson, Mark

2018-04-01

Colleges have implemented policies to limit tobacco use on-campus; however, the off-campus environment is often overlooked in tobacco control efforts. We assessed availability, marketing, and promotion of cigarettes, snus, and traditional smokeless tobacco (SLT) in a sample of communities surrounding 11 college campuses in North Carolina and Virginia. Between January-March of 2011, 2012 and 2013, 481 tobacco-selling retailers, including convenience stores, pharmacies and supermarkets, located near campuses were assessed. Trained observers completed annual point-of-sale assessments. The percentage of stores selling (81.4% to 58.6%; p < .0001) and advertising snus (80.1% to 53.11%; p < .0001) significantly decreased over time. Convenience stores increased promotions of cigarettes (65.4% to 72.8%; p = 0.04) and SLT (3.1% to 23.3%; p = 0.02). Off-campus environments have abundant tobacco availability and marketing. Colleges should collaborate with state and local tobacco control advocates to address tobacco promotion near campuses to potentially decrease product appeal and access among young adults.

Effectiveness of Tobacco Control Measures in Reducing Tobacco Use among Adolescents and Young Adults in Anuradhapura, Sri Lanka

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Waduarachchige Don Aruna Shantha De Silva

2012-12-01

Full Text Available Background: Sri Lanka became a signatory to the WHO Framework Convention on Tobacco Control in September 2003 and ratified in November 2003. Aiming to reduce tobacco burden in Sri Lanka, National Authority on Tobacco and Alcohol Act [NATA] No. 27 was authorized in 2006. The objective of this study was to assess the behavioral changes related to tobacco use among adolescents and young adults following the exposure to tobacco control measures implemented by NATA. Methods: A cross-sectional survey was conducted from October 2011 to November 2011 among adolescent (13-19 years and young adult (20-39 years males in Anuradhapura divisional secretary area in Sri Lanka. A self-administered questionnaire and focus group discussions were used for data collection. Confounding factors were controlled by stratification and randomization. Results: A total of 456 male respondents including 168 (37% adolescents and 288 (63% young adults participated in the study. Among the ever smokers 66 (14 % had already quitted smoking while 151 (33% were current smokers. The majority of the respondents (95.4% of quitters and 88.0% of current smokers were acquainted with the dangers of smoking through the mass media. Among the current smokers and quitters, the knowledge on health risks of smoking and exposure to secondhand smoke was quite satisfactory. The current smokers as well as the quitters were well aware of the tobacco control measures. Smokers as well as the non-smokers and quitters supported these measures. Conclusion: Tobacco control measures implemented by NATA had a favorable influence on reducing tobacco burden among adolescents and young adults in Sri Lanka      

Computational Models Used to Assess US Tobacco Control Policies.

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Feirman, Shari P; Glasser, Allison M; Rose, Shyanika; Niaura, Ray; Abrams, David B; Teplitskaya, Lyubov; Villanti, Andrea C

2017-11-01

Simulation models can be used to evaluate existing and potential tobacco control interventions, including policies. The purpose of this systematic review was to synthesize evidence from computational models used to project population-level effects of tobacco control interventions. We provide recommendations to strengthen simulation models that evaluate tobacco control interventions. Studies were eligible for review if they employed a computational model to predict the expected effects of a non-clinical US-based tobacco control intervention. We searched five electronic databases on July 1, 2013 with no date restrictions and synthesized studies qualitatively. Six primary non-clinical intervention types were examined across the 40 studies: taxation, youth prevention, smoke-free policies, mass media campaigns, marketing/advertising restrictions, and product regulation. Simulation models demonstrated the independent and combined effects of these interventions on decreasing projected future smoking prevalence. Taxation effects were the most robust, as studies examining other interventions exhibited substantial heterogeneity with regard to the outcomes and specific policies examined across models. Models should project the impact of interventions on overall tobacco use, including nicotine delivery product use, to estimate preventable health and cost-saving outcomes. Model validation, transparency, more sophisticated models, and modeling policy interactions are also needed to inform policymakers to make decisions that will minimize harm and maximize health. In this systematic review, evidence from multiple studies demonstrated the independent effect of taxation on decreasing future smoking prevalence, and models for other tobacco control interventions showed that these strategies are expected to decrease smoking, benefit population health, and are reasonable to implement from a cost perspective. Our recommendations aim to help policymakers and researchers minimize harm and

The progress and challenges of implementation of the Framework Convention on Tobacco Control (WHO FCTC) in Kyrgyz Republic

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Chinara Bekbasarova

2018-01-01

Background and challenges to implementation The Kyrgyz Republic is Party of the WHO FCTC since August 23, 2006. This abstract analyzes progress and challenges during 10 years of implementation of WHO´s FCTC Intervention or response National Tobacco Control (TC) Law was adopted on August 21, 2006, entered into force on December 19, 2006 and was amended and supplemented during 10 years 2 times. TC measures were included, as one of main priorities, in the National Program on Heal...

International trade agreements: a threat to tobacco control policy.

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Shaffer, E R; Brenner, J E; Houston, T P

2005-08-01

International covenants establish a role for governments in ensuring the conditions for human health and wellbeing, which has been recognised as a central human right. International trade agreements, conversely, prioritize the rights of corporations over health and human rights. International trade agreements are threatening existing tobacco control policies and restrict the possibility of implementing new controls. This situation is unrecognised by many tobacco control advocates in signatory nations, especially those in developing countries. Recent agreements on eliminating various trade restrictions, including those on tobacco, have expanded far beyond simply international movement of goods to include internal tobacco distribution regulations and intellectual property rules regulating advertising and labelling. Our analysis shows that to the extent trade agreements protect the tobacco industry, in itself a deadly enterprise, they erode human rights principles and contribute to ill health. The tobacco industry has used trade policy to undermine effective barriers to tobacco importation. Trade negotiations provide an unwarranted opportunity for the tobacco industry to assert its interests without public scrutiny. Trade agreements provide the industry with additional tools to obstruct control policies in both developed and developing countries and at every level. The health community should become involved in reversing these trends, and help promote additional measures to protect public health.

Prospects for tobacco control in Zimbabwe: a historical perspective.

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Woelk, G; Mtisi, S; Vaughan, J P

2001-09-01

Using a historical and political economy perspective, this paper explores the prospects for tobacco control in Zimbabwe, the world's sixth largest producer and third largest tobacco exporter. Tobacco production, which first began in the former Rhodesia in the early 1900s, is closely associated with colonial history and land occupation by white settlers. The Zimbabwe (formerly Rhodesia) Tobacco Association was formed in 1928 and soon became a powerful political force. Although land redistribution has always been a central issue, it was not adequately addressed after independence in 1980, largely due to the need for Zimbabwe to gain foreign currency and safeguard employment. However, by the mid-1990s political pressures forced the government to confront the mainly white, commercial farmers with a new land acquisition policy, but intense national and international lobbying prevented its implementation. With advent of global economic changes, and following the start of a structural adjustment programme in 1991, manufacturing began to decline and the government relied even more on the earnings from tobacco exports. Thus strengthening tobacco control policies has always had a low national and public health priority. Recent illegal occupation of predominantly white owned farms, under the guise of implementing the former land redistribution policy, was politically motivated as the government faced its first major challenge at the general elections in June 2000. It remains unclear whether this will lead to long term reductions in tobacco production, although future global declines in demand could weaken the tobacco lobby. However, since Zimbabwe is only a minor consumer of tobacco, a unique opportunity does exist to develop controls on domestic cigarette consumption. To achieve this the isolated ministry of health would need considerable support from international agencies, such as the World Health Organisation and World Bank.

State laws on tobacco control--United States, 1998.

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Fishman, J A; Allison, H; Knowles, S B; Fishburn, B A; Woollery, T A; Marx, W T; Shelton, D M; Husten, C G; Eriksen, M P

1999-06-25

's State Tobacco Activities Tracking and Evaluation (STATE) System; the laws are collected and updated every quarter. The STATE System also contains state-specific data on the prevalence of tobacco use, tobacco-related deaths, and the costs of tobacco use. Information from the STATE System is available for use by policy makers at the state and local levels to plan and implement initiatives to prevent and reduce tobacco use. In addition, CDC is using this information to assess the ongoing impact of tobacco-control programs and policies on tobacco use.

A neo-strategic planning approach to enhance local tobacco control programs.

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Douglas, Malinda R; Carter, Sara Sally R; Wilson, Andrew P; Chan, Andie

2015-01-01

Research in tobacco control demonstrating best practices is widely disseminated; however, application at the local level is often difficult. Translating research into practice requires a concerted effort to develop an understanding of the evidence and how it can be applied within diverse contexts. A strategic planning infrastructure was developed to support the translation of evidence-based interventions into community practice. This paper highlights the strategic process of turning "know-what" into "know-how" to facilitate the strategic planning and implementation of tobacco control best practices at the local level. The purpose, people, process, and product strategies of knowledge management and translation provided a framework for the strategic planning infrastructure. The knowledge translation concepts of audience, motivations, and mechanisms were synergized in the neo-strategic planning component design. The participants were 20 community coalitions funded to implement local tobacco control programs. From 2004 to 2011, the strategic planners facilitated a cyclical process to translate research into practice using a trio of integrated tools, skill-building workshops on strategic planning, and grantee-driven technical assistance and consultation. In the short term, the usefulness of the strategic planning components to the programs was measured. The intermediate outcome was the successful movement of the community programs from the planning stage to the implementation stage. The achievement of community-level changes in planned tobacco control efforts was the overall outcome measure for the success of the local coalitions. Seventeen of 20 communities that began the planning process implemented strategic plans. All 17 of the programs implemented evidence-based practices, resulting in numerous tobacco-free policies, increased cessation, and increased support from the media and community. Bridging the gap between research and practice can enhance the practicality

FCTC followed by accelerated implementation of tobacco advertising bans.

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Hiilamo, Heikki; Glantz, Stanton

2017-07-01

We sought to evaluate changes in countries' enacting advertising bans after the effect of ratifying the WHO Framework Convention on Tobacco Control (FCTC). We compared adoption of advertising bans on five areas (TV and radio, print media, billboards, point-of-sale, sponsorship) in countries that did versus did not ratify the FCTC, accounting for years since the ratification of the Convention. On average, passage of complete advertising bans accelerated after FCTC ratification. The development was strongest among lower middle-income countries. Lack of state capacity was associated with lower likelihood of countries implementing complete advertising bans. Implementation of complete advertising bans slowed after 2007. Implementation of FCTC Article 13 was followed by increased progress towards complete advertising bans, but progress is incomplete, especially among low-income countries. Low-income countries need comprehensive support to implement FCTC as part of a broad effort to reinvigorate progress on global implementation of the FCTC. Enforcing complete bans requires constant monitoring and attacking of tobacco industry efforts to circumvent them. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Availability of tobacco cessation services in substance use disorder treatment programs: Impact of state tobacco control policy.

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Abraham, Amanda J; Bagwell-Adams, Grace; Jayawardhana, Jayani

2017-08-01

Given the high prevalence of smoking among substance use disorder (SUD) patients, the specialty SUD treatment system is an important target for adoption and implementation of tobacco cessation (TC) services. While research has addressed the impact of tobacco control on individual tobacco consumption, largely overlooked in the literature is the potential impact of state tobacco control policies on availability of services for tobacco cessation. This paper examines the association between state tobacco control policy and availability of TC services in SUD treatment programs in the United States. State tobacco control and state demographic data (n=51) were merged with treatment program data from the 2012 National Survey of Substance Abuse Treatment Services (n=10.413) to examine availability of TC screening, counseling and pharmacotherapy services in SUD treatment programs using multivariate logistic regression models clustered at the state-level. Approximately 60% of SUD treatment programs offered TC screening services, 41% offered TC counseling services and 26% offered TC pharmacotherapy services. Results of multivariate logistic regression showed the odds of offering TC services were greater for SUD treatment programs located in states with higher cigarette excise taxes and greater spending on tobacco prevention and control. Findings indicate cigarette excise taxes and recommended funding levels may be effective policy tools for increasing access to TC services in SUD treatment programs. Coupled with changes to insurance coverage for TC under the Affordable Care Act, state tobacco control policy tools may further reduce tobacco use in the United States. Published by Elsevier Ltd.

Success Counteracting Tobacco Company Interference in Thailand: An Example of FCTC Implementation for Low- and Middle-income Countries

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Stephen L. Hamann

2012-03-01

Full Text Available Transnational tobacco companies (TTCs interfere regularly in policymaking in low- and middle-income countries (LMICs. The WHO Framework Convention for Tobacco Control provides mechanisms and guidance for dealing with TTC interference, but many countries still face ‘how to’ challenges of implementation. For more than two decades, Thailand’s public health community has been developing a system for identifying and counteracting strategies TTCs use to derail, delay and undermine tobacco control policymaking. Consequently, Thailand has already implemented most of the FCTC guidelines for counteracting TTC interference. In this study, our aims are to describe strategies TTCs have used in Thailand to interfere in policymaking, and to examine how the public health community in Thailand has counteracted TTC interference. We analyzed information reported by three groups with a stake in tobacco control policies: Thai tobacco control advocates, TTCs, and international tobacco control experts. To identify TTC viewpoints and strategies, we also extracted information from internal tobacco industry documents. We synthesized these data and identified six core strategies TTCs use to interfere in tobacco control policymaking: (1 doing business with ‘two faces’, (2 seeking to influence people in high places, (3 ‘buying’ advocates in grassroots organizations, (4 putting up a deceptive front, (5 intimidation, and (6 undermining controls on tobacco advertising, promotion and sponsorship. We present three case examples showing where TTCs have employed multiple interference strategies simultaneously, and showing how Thai tobacco control advocates have successfully counteracted those strategies by: (1 conducting vigilant surveillance, (2 excluding tobacco companies from policymaking, (3 restricting tobacco company sales, (4 sustaining pressure, and (5 dedicating resources to the effective enforcement of regulations. Policy implications from this study are

Dentists United to Extinguish Tobacco (DUET): a study protocol for a cluster randomized, controlled trial for enhancing implementation of clinical practice guidelines for treating tobacco dependence in dental care settings.

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Ostroff, Jamie S; Li, Yuelin; Shelley, Donna R

2014-02-21

Although dental care settings provide an exceptional opportunity to reach smokers and provide brief cessation advice and treatment to reduce oral and other tobacco-related health conditions, dental care providers demonstrate limited adherence to evidence-based guidelines for treatment of tobacco use and dependence. Guided by a multi-level, conceptual framework that emphasizes changes in provider beliefs and organizational characteristics as drivers of improvement in tobacco treatment delivery, the current protocol will use a cluster, randomized design and multiple data sources (patient exit interviews, provider surveys, site observations, chart audits, and semi-structured provider interviews) to study the process of implementing clinical practice guidelines for treating tobacco dependence in 18 public dental care clinics in New York City. The specific aims of this comparative-effectiveness research trial are to: compare the effectiveness of three promising strategies for implementation of tobacco use treatment guidelines-staff training and current best practices (CBP), CBP + provider performance feedback (PF), and CBP + PF + provider reimbursement for delivery of tobacco cessation treatment (pay-for-performance, or P4P); examine potential theory-driven mechanisms hypothesized to explain the comparative effectiveness of three strategies for implementation; and identify baseline organizational factors that influence the implementation of evidence-based tobacco use treatment practices in dental clinics. The primary outcome is change in providers' tobacco treatment practices and the secondary outcomes are cost per quit, use of tobacco cessation treatments, quit attempts, and smoking abstinence. We hypothesize that the value of these promising implementation strategies is additive and that incorporating all three strategies (CBP, PF, and P4P) will be superior to CBP alone and CBP + PF in improving delivery of cessation assistance to smokers. The findings

Impact of point-of-sale tobacco display bans: findings from the International Tobacco Control Four Country Survey

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Li, Lin; Borland, Ron; Fong, Geoffrey T.; Thrasher, James F.; Hammond, David; Cummings, Kenneth M.

2013-01-01

This study examined the impact of point-of-sale (POS) tobacco marketing restrictions in Australia and Canada, in relation to the United Kingdom and the United States where there were no such restrictions during the study period (2006–10). The data came from the International Tobacco Control Four Country Survey, a prospective multi-country cohort survey of adult smokers. In jurisdictions where POS display bans were implemented, smokers’ reported exposure to tobacco marketing declined markedly....

Implementation of graphic health warning labels on tobacco products in India: the interplay between the cigarette and the bidi industries.

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Sankaran, Sujatha; Hiilamo, Heikki; Glantz, Stanton A

2015-11-01

To understand the competition between and among tobacco companies and health groups that led to graphical health warning labels (GHWL) on all tobacco products in India. Analysis of internal tobacco industry documents in the Legacy Tobacco Document Library, documents obtained through India's Right to Information Act, and news reports. Implementation of GHWLs in India reflects a complex interplay between the government and the cigarette and bidi industries, who have shared as well as conflicting interests. Joint lobbying by national-level tobacco companies (that are foreign subsidiaries of multinationals) and local producers of other forms of tobacco blocked GHWLs for decades and delayed the implementation of effective GHWLs after they were mandated in 2007. Tobacco control activists used public interest lawsuits and the Right to Information Act to win government implementation of GHWLs on cigarette, bidi and smokeless tobacco packs in May 2009 and rotating GHWLs in December 2011. GHWLs in India illustrate how the presence of bidis and cigarettes in the same market creates a complex regulatory environment. The government imposing tobacco control on multinational cigarette companies led to the enforcement of regulation on local forms of tobacco. As other developing countries with high rates of alternate forms of tobacco use establish and enforce GHWL laws, the tobacco control advocacy community can use pressure on the multinational cigarette industry as an indirect tool to force implementation of regulations on other forms of tobacco. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Youth tobacco use in South-East Asia: Implications for tobacco epidemic and options for its control in the region.

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Rani, Manju; Thamarangsi, Thaksaphon; Agarwal, Naveen

2017-09-01

Nearly half of all male population and two in every five females in the WHO South-East Asia Region (SEAR) consume some form of tobacco. Preventing initiation among adolescents is critical for overall tobacco control. We assessed the trends in youth tobacco use and policies in SEAR. Data are used from school-based youth (Global Youth Tobacco Survey and global school student-based health survey) and adult (Global Adult Tobacco Survey, STEPS) tobacco surveys and the WHO Framework of Convention of Tobacco Control (FCTC) implementation database. More than 10% of 13-15-year-old adolescent students reported tobacco use in 8 out of 11 countries. The prevalence of smokeless tobacco exceeded that of cigarettes except in Indonesia, Thailand, and Timor-Leste. No consistent declining trends in tobacco use were observed in any of the countries with 3 or more data points. More than half of all daily smokers aged 20-34 years initiated "daily" smoking before 20 years of age. 19% (Bangladesh) to 55% (Timor-Leste) of 13-17-year old students tried their first cigarette before their 14th birthday. Majority of adolescent students in most of the SEAR countries reported purchasing their cigarettes from store/shop/vendor and as single sticks, with few exceptions and purchased them as "single" cigarette. There is a limited change in affordability of cigarettes in SEAR over time. Tobacco use remains high among youth in SEAR. Efforts should be strengthened to fully implement/enforce recommended policy measures (legal minimum age, fiscal measures to reduce tobacco affordability; prohibiting sale of single cigarettes, etc.) and to explore new measures (e.g., tobacco-free generation).

Linking Global Youth Tobacco Survey (GYTS) data to tobacco control policy in Turkey--2003 and 2009.

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Erguder, Toker; Polat, Halil; Arpad, Ceylan; Khoury, Rule Nabil; Warren, Charles W; Lee, Juliette; Lea, Veronica

2012-03-01

The purpose of this paper is to use data from the Global Youth Tobacco Survey (GYTS) conducted in Turkey in 2003 and 2009 to examine changes in tobacco use and important tobacco control measures. The GYTS were conducted in grades 7-9 in 2003 and 7-10 in 2009 in Turkey. Data in this paper are limited to 13 to 15 year old students. A total of 15,957 students from 202 schools participated in 2003 and 5,054 students from 69 schools participated in 2009. The overall response rate was 92.1% in 2003 and 87.5% in 2009. Between 2003 and 2009 current cigarette smoking did not change significantly for either boys (9.4% to 10.2%) or girls (3.5% to 5.3%). Current cigarette smoking was higher among boys than girls in 2003 and in 2009. In 2009, half of students reported they had been exposed to second hand smoking (SHS) at home and 80% reported they had been exposed to SHS in public places. Three in ten students reported they had been exposed to pro-tobacco advertising in newspapers or magazines; one in ten had an object with a cigarette brand logo on it; and 7% had been offered free cigarettes by a cigarette company representative. Two-thirds of current cigarette smokers reported that they wanted to stop smoking; and almost two-thirds had been taught in school in the past year about the dangers of smoking. Passing and implementing the Law No. 4207 on Prevention of Hazards of Tobacco Products, ratifying the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), raising tax on tobacco, and requiring pictorial warning labels were important steps forward for tobacco control in Turkey. However, as to the tobacco control much work yet to be accomplished including developing an effective enforcement plan for all tobacco control efforts.

Age and Educational Inequalities in Smoking Cessation Due to Three Population-Level Tobacco Control Interventions: Findings from the International Tobacco Control (ITC) Netherlands Survey

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Nagelhout, Gera E.; Crone, Matty R.; van den Putte, Bas; Willemsen, Marc C.; Fong, Geoffrey T.; de Vries, Hein

2013-01-01

This study aimed to examine age and educational inequalities in smoking cessation due to the implementation of a tobacco tax increase, smoke-free legislation and a cessation campaign. Longitudinal data from 962 smokers aged 15 years and older were used from three survey waves of the International Tobacco Control (ITC) Netherlands Survey. The 2008…

Political economy analysis for tobacco control in low- and middle-income countries.

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Bump, Jesse B; Reich, Michael R

2013-03-01

Tobacco is already the world's leading cause of preventable death, claiming over 5 million lives annually, and this toll is rising. Even though effective tobacco control policies are well researched and widely disseminated, they remain largely unimplemented in most low- and middle-income countries (LMICs). For the most part, control attempts by advocates and government regulators have been frustrated by transnational tobacco companies (TTCs) and their supporters. One reason tobacco is so difficult to control is that its political economy has yet to be adequately understood and addressed. We conducted a review of the literature on tobacco control in LMICs using the databases PubMed, EconLit, PsychInfo and AGRICOLA. Among the over 2500 papers and reports we identified, very few explicitly applied political economy analysis to tobacco control in an LMIC setting. The vast majority of papers characterized important aspects of the tobacco epidemic, including who smokes, the effects of smoking on health, the effectiveness of advertising bans, and the activities of TTCs and their allies. But the political and economic dynamics of policy adoption and implementation were not discussed in any but a handful of papers. To help control advocates better understand and manage the process of policy implementation, we identify how political economy analysis would differ from the traditional public health approaches that dominate the literature. We focus on five important problem areas: information problems and the risks of smoking; the roles of domestic producers; multinational corporations and trade disputes in consumption; smuggling; the barriers to raising taxes and establishing spatial restrictions on smoking; and incentive conflicts between government branches. We conclude by discussing the political economy of tobacco and its implications for control strategies.

A mire of highly subjective and ineffective voluntary guidelines: tobacco industry efforts to thwart tobacco control in Malaysia.

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Assunta, M; Chapman, S

2004-12-01

To describe tobacco industry efforts in Malaysia to thwart government efforts to regulate tobacco promotion and health warnings. Systematic keyword and opportunistic website searches of formerly private tobacco industry internal documents made available through the Master Settlement Agreement and secondary websites; relevant information from news articles and financial reports. Commencing in the 1970s, the industry began to systematically thwart government tobacco control. Guidelines were successfully promoted in the place of legislation for over two decades. Even when the government succeeded in implementing regulations such as health warnings and advertising bans they were compromised and acted effectively to retard further progress for years to come. Counter-measures to delay or thwart government efforts to regulate tobacco were initiated by the industry. Though not unique to Malaysia, the main difference lies in the degree to which strategies were used to successfully counter stringent tobacco control measures between 1970 and 1995.

Evaluation of the use of Global Youth Tobacco Survey (GYTS) data for developing evidence-based tobacco control policies in Turkey.

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Erguder, Toker; Cakir, Banu; Aslan, Dilek; Warren, Charles W; Jones, Nathan R; Asma, Samira

2008-12-15

The tobacco control effort in Turkey has made significant progress in recent years. Turkey initiated its tobacco control effort with the passing of Law 4207 (The Prevention of Harmful Effects of Tobacco Products) in 1996 and ratified the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in 2004. It is important to base policy decisions on valid and reliable evidence from population-based, representative studies that are periodically repeated to enable policy makers to monitor the results of their interventions and to appropriately tailor anti-tobacco activities towards future needs. The Global Youth Tobacco Survey (GYTS) was developed to track tobacco use among young people and enhance the capacity of countries to design, implement, and evaluate tobacco control and prevention programs. Turkey conducted the GYTS in 2003 and data from this survey can be used as baseline measures for evaluation of the tobacco control programs implemented by the Ministry of Health (MOH) of the Turkish government. The GYTS was conducted in 2003 on a representative sample of students aged 13 to 15 years. It indicated that almost 3 in 10 students in Turkey had ever smoked cigarettes, with significantly higher rates among boys. Current cigarette smoking rates were lower, at 9% for boys and 4% for girls. The prevalence of current use of other tobacco products was about half these figures for each gender. About 80% were exposed to secondhand smoke. Exposure to pro-smoking media messages was not rare. Almost half of the smokers 'usually' bought their tobacco from a store, despite the law prohibiting this. Exposure to teaching against smoking in schools was not universal. Findings from the GYTS, with periodic repeats of the survey, can be used to monitor the impact of enforcing various provisions of the present law (No: 4207), the progress made in achieving the goals of the WHO FCTC, and the effectiveness of various preventive interventions against smoking. Such

Implementation of a tobacco-free workplace program at a local mental health authority.

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Correa-Fernández, Virmarie; Wilson, William T; Shedrick, Deborah A; Kyburz, Bryce; L Samaha, Hannah; Stacey, Timothy; Williams, Teresa; Lam, Cho Y; Reitzel, Lorraine R

2017-06-01

Tobacco-free workplace policies that incorporate evidence-based practices can increase the reach and effectiveness of tobacco dependence treatment among underserved populations but may be underutilized due to limited knowledge about implementation processes. This paper describes the implementation of a comprehensive tobacco-free workplace program at a behavioral healthcare community center in Texas. The center participated in a tobacco-free workplace program implementation project that provided guidance and resources and allowed center autonomy in implementation. Six employee-based subcommittees guided implementation of program components including consumer and staff surveys, policy development, signage, tobacco use assessments, communication, and nicotine replacement distribution. Timeline development, successes, challenges, lessons learned, and sustainability initiatives are delineated. Concerns about the tobacco-free workplace policy from the center's staff and consumers were gradually replaced by strong support for the initiative. Program success was enabled by consistent support from the center's leadership, publicity of program efforts, and educational campaigns. The center surpassed the program expectations when it adopted a tobacco-free hiring policy, which was not an initial program goal. This center's path to a tobacco-free workplace provides an implementation and sustainability model for other behavioral health community centers and other organizations to become tobacco free.

Measuring interactivity on tobacco control websites.

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Freeman, Becky; Chapman, Simon

2012-08-01

With the increased reach of Web 2.0, Internet users expect webpages to be interactive. No studies have been conducted to assess whether tobacco control-relevant sites have implemented these features. The authors conducted an analysis of an international sample of tobacco control-relevant websites to determine their level of interactivity. The sample included 68 unique websites selected from Google searches in 5 countries, on each country's Google site, using the term smoking. The 68 sites were analyzed for 10 categories of interactive tools. The most common type of interactive content found on 46 (68%) of sites was for multimedia featuring content that was not primarily text based, such as photo galleries, videos, or podcasts. Only 11 (16%) websites-outside of media sites-allowed people to interact and engage with the site owners and other users by allowing posting comments on content and/or hosting forums/discussions. Linkages to social networking sites were low: 17 pages (25%) linked to Twitter, 15 (22%) to Facebook, and 11 (16%) to YouTube. Interactivity and connectedness to online social media appears to still be in its infancy among tobacco control-relevant sites.

Impact of point-of-sale tobacco display bans: findings from the International Tobacco Control Four Country Survey

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Li, Lin; Borland, Ron; Fong, Geoffrey T.; Thrasher, James F.; Hammond, David; Cummings, Kenneth M.

2013-01-01

This study examined the impact of point-of-sale (POS) tobacco marketing restrictions in Australia and Canada, in relation to the United Kingdom and the United States where there were no such restrictions during the study period (2006–10). The data came from the International Tobacco Control Four Country Survey, a prospective multi-country cohort survey of adult smokers. In jurisdictions where POS display bans were implemented, smokers’ reported exposure to tobacco marketing declined markedly. From 2006 to 2010, in Canada, the percentages noticing POS tobacco displays declined from 74.1 to 6.1% [adjusted odds ratio (OR) = 0.26, P advertising decreased from 40.3 to 14.1% (adjusted OR = 0.61, P marketing in the United States and United Kingdom remained high during this period. In parallel, there were declines in reported exposures to other forms of advertising/promotion in Canada and Australia, but again, not in the United States or United Kingdom. Impulse purchasing of cigarettes was lower in places that enacted POS display bans. These findings indicate that implementing POS tobacco display bans does result in lower exposure to tobacco marketing and less frequent impulse purchasing of cigarettes. PMID:23640986

[Tobacco control: an intersectorial experience in Tunja (Colombia)].

Science.gov (United States)

Panader-Torres, Adriana; Agudelo-Cely, Nancy Aurora; Bolívar-Suárez, Yolima; Cárdenas-Cárdenas, Luz Mery

2014-01-01

Tobacco control in Colombia is regulated by Law 1335 of 2009. The implementation and monitoring of the provisions of this law require strengthening of intersectorial work at the local level. This field note presents an intersectorial work experience that was carried out in the municipality of Tunja (Colombia) to improve tobacco control. The Respirarte Group was established. This group consists of an intersectorial team composed of 15 institutions. The Respirarte Group achieved the following political and community actions: signing of an agreement on tobacco control by government actors, expedition of a local decree to comply with Law 1335 in the municipality, provision of information and communication, and social mobilization and monitoring. This experience serves as a national and international reference and its lessons could be used in the approach to other public health problems. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

New media and tobacco control.

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Freeman, Becky

2012-03-01

This paper reviews how the tobacco industry is promoting its products online and examines possible regulation models to limit exposure to this form of marketing. Opportunities to use new media to advance tobacco control are also discussed and future research possibilities are proposed. Published articles and grey literature reports were identified through searches of the electronic databases, PUBMED and Google Scholar using a combination of the following search terms: tobacco or smoking and new media, online media, social media, internet media, Web 2.0, Facebook, YouTube and Twitter. A possible obstacle to fully realising the benefits of regulating tobacco marketing activities and effectively communicating tobacco control messages is the rapid evolution of the media landscape. New media also offer the tobacco industry a powerful and efficient channel for rapidly countering the denormalising strategies and policies of tobacco control. Evidence of tobacco promotion through online media is emerging, with YouTube being the most researched social media site in the tobacco control field. The explosive rise in Internet use and the shift to these new media being driven by consumer generated content through social platforms may mean that fresh approaches to regulating tobacco industry marketing are needed.

Global tobacco control and economic norms: an analysis of normative commitments in Kenya, Malawi and Zambia.

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Lencucha, Raphael; Reddy, Srikanth K; Labonte, Ronald; Drope, Jeffrey; Magati, Peter; Goma, Fastone; Zulu, Richard; Makoka, Donald

2018-04-01

Tobacco control norms have gained momentum over the past decade. To date 43 of 47 Sub-Saharan African countries are party to the Framework Convention on Tobacco Control (FCTC). The near universal adoption of the FCTC illustrates the increasing strength of these norms, although the level of commitment to implement the provisions varies widely. However, tobacco control is enmeshed in a web of international norms that has bearing on how governments implement and strengthen tobacco control measures. Given that economic arguments in favor of tobacco production remain a prominent barrier to tobacco control efforts, there is a continued need to examine how economic sectors frame and mobilize their policy commitments to tobacco production. This study explores the proposition that divergence of international norms fosters policy divergence within governments. This study was conducted in three African countries: Kenya, Malawi, and Zambia. These countries represent a continuum of tobacco control policy, whereby Kenya is one of the most advanced countries in Africa in this respect, whereas Malawi is one of the few countries that is not a party to the FCTC and has implemented few measures. We conducted 55 key informant interviews (Zambia = 23; Kenya = 17; Malawi = 15). Data analysis involved deductive coding of interview transcripts and notes to identify reference to international norms (i.e. commitments, agreements, institutions), coupled with an inductive analysis that sought to interpret the meaning participants ascribe to these norms. Our analysis suggests that commitments to tobacco control have yet to penetrate non-health sectors, who perceive tobacco control as largely in conflict with international economic norms. The reasons for this perceived conflict seems to include: (1) an entrenched and narrow conceptualization of economic development norms, (2) the power of economic interests to shape policy discourses, and (3) a structural divide between sectors in

The development of Tobacco Harm Prevention Law in Vietnam: stakeholder tensions over tobacco control legislation in a state owned industry.

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Higashi, Hideki; Khuong, Tuan A; Ngo, Anh D; Hill, Peter S

2011-09-18

Building on its National Tobacco Control Policy initiated in 2000, Vietnam is currently considering introducing a comprehensive law to strengthen the implementation of tobacco control policy. This study analyses the positions of key stakeholders in the development of tobacco control legislation in the context of a largely state-owned industry, and discusses their implications for the policy process. Several qualitative methods were employed for the study including: literature review and documentary analysis; key informant interview; focus groups discussion; and key stakeholders survey. The Ministry of Health, Ministry of Trade and Industry, and Ministry of Finance are key players in the tobacco control policy and legislation, representing competing bureaucratic interests over health, macro-economy and revenue. High-ranking officials, including the Communist Party and National Assembly members, take a rather relaxed position reflecting the low political stakes placed on tobacco issues. The state-owned tobacco industry is regarded as an important contributor to the government revenue and gross domestic product, and the relative weight on health and socioeconomic issues placed by stakeholders determine their positions on tobacco control. Overall, short-term economic interests have more immediate influence in setting policy directions, with the consequences of health gains perceived as relegated to a distant future. This was reflected in the position of tobacco control advocates, including MOH, that presented with reluctance in insisting on some tobacco control strategies revealing a mixture attitude of concessions to the socioeconomic uncertainties and a sense of bargaining to win the strategies that are more likely to be accepted. The state-ownership of tobacco industry poses a major paradox within the government that benefits from manufacturing of tobacco products and is also responsible for controlling tobacco consumption. The perceptions of negative implications

Effects of tobacco control policies on smoking prevalence and tobacco-attributable deaths in Mexico: the SimSmoke model

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Luz Myriam Reynales-Shigematsu

Full Text Available OBJECTIVE: To examine how policies adopted in Mexico in response to the Framework Convention on Tobacco Control affected smoking prevalence and smoking-attributable deaths. METHODS: The SimSmoke simulation model of tobacco control policy is applied to Mexico. This discrete time, first-order Markov model uses data on population size, smoking rates and tobacco control policy for Mexico. It assesses, individually and jointly, the effects of seven types of policies: cigarette taxes, smoke-free air laws, mass media campaigns, advertising bans, warning labels, cessation treatment, and youth tobacco access policies. RESULTS: The Mexico SimSmoke model estimates that smoking rates have been reduced by about 30% as a result of policies implemented since 2002, and that the number of smoking-attributable deaths will have been reduced by about 826 000 by 2053. Increases in cigarette prices are responsible for over 60% of the reductions, but health warnings, smoke-free air laws, marketing restrictions and cessation treatments also play important roles. CONCLUSIONS: Mexico has shown steady progress towards reducing smoking prevalence in a short period of time, as have other Latin American countries, such as Brazil, Panama and Uruguay. Tobacco control policies play an important role in continued efforts to reduce tobacco use and associated deaths in Mexico.

Overview of systematic reviews on the health-related effects of government tobacco control policies.

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Hoffman, Steven J; Tan, Charlie

2015-08-05

Government interventions are critical to addressing the global tobacco epidemic, a major public health problem that continues to deepen. We systematically synthesize research evidence on the effectiveness of government tobacco control policies promoted by the Framework Convention on Tobacco Control (FCTC), supporting the implementation of this international treaty on the tenth anniversary of it entering into force. An overview of systematic reviews was prepared through systematic searches of five electronic databases, published up to March 2014. Additional reviews were retrieved from monthly updates until August 2014, consultations with tobacco control experts and a targeted search for reviews on mass media interventions. Reviews were assessed according to predefined inclusion criteria, and ratings of methodological quality were either extracted from source databases or independently scored. Of 612 reviews retrieved, 45 reviews met the inclusion criteria and 14 more were identified from monthly updates, expert consultations and a targeted search, resulting in 59 included reviews summarizing over 1150 primary studies. The 38 strong and moderate quality reviews published since 2000 were prioritized in the qualitative synthesis. Protecting people from tobacco smoke was the most strongly supported government intervention, with smoke-free policies associated with decreased smoking behaviour, secondhand smoke exposure and adverse health outcomes. Raising taxes on tobacco products also consistently demonstrated reductions in smoking behaviour. Tobacco product packaging interventions and anti-tobacco mass media campaigns may decrease smoking behaviour, with the latter likely an important part of larger multicomponent programs. Financial interventions for smoking cessation are most effective when targeted at smokers to reduce the cost of cessation products, but incentivizing quitting may be effective as well. Although the findings for bans on tobacco advertising were

Attitudes towards Potential New Tobacco Control Regulations among U.S. Adults

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Allison M. Schmidt

2018-01-01

Full Text Available Favorable attitudes towards tobacco control policies can facilitate their implementation and success. We examined attitudes toward four potential U.S. Federal tobacco regulations (banning menthol from cigarettes, reducing nicotine levels in cigarettes, banning candy and fruit flavored electronic cigarettes, and banning candy and fruit flavored little cigars and cigarillos and associations with individual and state variables. A nationally representative phone survey of 4337 adults assessed attitudes toward potential policies. Weighted logistic regression was used to assess relationships between attitudes and demographic factors, smoking behavior, beliefs about the government (knowledge, trust, and credibility, exposure to tobacco control campaigns, and state variables from the US Centers for Disease Control and Prevention (CDC State Tobacco Activities Tracking and Evaluation (STATE System. Most respondents supported three out of four policies. Respondents that were female, non-white, Latino, living below the poverty line, had less than high school education, were of older age, did not smoke, had higher trust in government, and were exposed to national tobacco control campaigns had higher odds of expressing favorable attitudes toward potential new tobacco regulations than did their counterparts. No state-level effects were found. While differences in attitudes were observed by individual demographic characteristics, behaviors, and beliefs, a majority of participants supported most of the potential new tobacco regulations surveyed.

Index of tobacco control sustainability (ITCS): a tool to measure the sustainability of national tobacco control programmes.

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Jackson-Morris, Angela; Latif, Ehsan

2017-03-01

To produce a tool to assess and guide sustainability of national tobacco control programmes. A two-stage process adapting the Delphi and Nominal group techniques. A series of indicators of tobacco control sustainability were identified in grantee/country advisor reports to The International Union Against Tuberculosis and Lung Disease under the Bloomberg Initiative to Reduce Tobacco Control (2007-2015). Focus groups and key informant interviews in seven low and middle-income countries (52 government and civil society participants) provided consensus ratings of the indicators' relative importance. Data were reviewed and the indicators were accorded relative weightings to produce the 'Index of Tobacco Control Sustainability' (ITCS). All 31 indicators were considered 'Critical' or 'Important' by the great majority of participants. There was consensus that a tool to measure progress towards tobacco control sustainability was important. The most critical indicators related to financial policies and allocations, a national law, a dedicated national tobacco control unit and civil society tobacco control network, a national policy against tobacco industry 'Corporate Social Responsibility' (CSR), national mortality and morbidity data, and national policy evaluation mechanisms. The 31 indicators were agreed to be 'critical' or 'important' factors for tobacco control sustainability. The Index comprises the weighted indicators as a tool to identify aspects of national tobacco control programmes requiring further development to augment their sustainability and to measure and compare progress over time. The next step is to apply the ITCS and produce tobacco control sustainability assessments. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The development of Tobacco Harm Prevention Law in Vietnam: stakeholder tensions over tobacco control legislation in a state owned industry

Directory of Open Access Journals (Sweden)

Ngo Anh D

2011-09-01

Full Text Available Abstract Background Building on its National Tobacco Control Policy initiated in 2000, Vietnam is currently considering introducing a comprehensive law to strengthen the implementation of tobacco control policy. This study analyses the positions of key stakeholders in the development of tobacco control legislation in the context of a largely state-owned industry, and discusses their implications for the policy process. Methods Several qualitative methods were employed for the study including: literature review and documentary analysis; key informant interview; focus groups discussion; and key stakeholders survey. Findings The Ministry of Health, Ministry of Trade and Industry, and Ministry of Finance are key players in the tobacco control policy and legislation, representing competing bureaucratic interests over health, macro-economy and revenue. High-ranking officials, including the Communist Party and National Assembly members, take a rather relaxed position reflecting the low political stakes placed on tobacco issues. The state-owned tobacco industry is regarded as an important contributor to the government revenue and gross domestic product, and the relative weight on health and socioeconomic issues placed by stakeholders determine their positions on tobacco control. Overall, short-term economic interests have more immediate influence in setting policy directions, with the consequences of health gains perceived as relegated to a distant future. This was reflected in the position of tobacco control advocates, including MOH, that presented with reluctance in insisting on some tobacco control strategies revealing a mixture attitude of concessions to the socioeconomic uncertainties and a sense of bargaining to win the strategies that are more likely to be accepted. Conclusion The state-ownership of tobacco industry poses a major paradox within the government that benefits from manufacturing of tobacco products and is also responsible for

Smoking inequalities and tobacco control policies in Europe

NARCIS (Netherlands)

Kuipers, M.A.G.

2016-01-01

Smoking is the worlds’ leading avoidable cause of mortality and kills 6 million people each year. Individuals of lower socioeconomic status are more likely to initiate smoking and less likely to quit smoking. Tobacco control policies have been implemented in the last decades, but although smoking

Support for removal of point-of-purchase tobacco advertising and displays: findings from the International Tobacco Control (ITC) Canada survey.

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Brown, Abraham; Boudreau, Christian; Moodie, Crawford; Fong, Geoffrey T; Li, Grace Y; McNeill, Ann; Thompson, Mary E; Hassan, Louise M; Hyland, Andrew; Thrasher, James F; Yong, Hua-Hie; Borland, Ron; Hastings, Gerard; Hammond, David

2012-11-01

Although most countries now have at least some restrictions on tobacco marketing, the tobacco industry meet these restrictions by re-allocating expenditure to unregulated channels, such as at point-of-purchase. Longitudinal data from 10 Canadian provinces in the International Tobacco Control Survey was analysed to examine adult smokers' support for a ban on tobacco advertising and displays in stores and whether this support is associated with noticing either advertising or displays in stores, and quit intentions, over time. In total, there were 4580 respondents in wave 5 (October 2006 to February 2007), wave 6 (September 2007 to February 2008) and wave 7 (October 2008 to June 2009). The surveys were conducted before, during and in some cases after the implementation of display bans in most Canadian provinces and territories. Smokers in all provinces showed strong support for a ban on tobacco displays over the study period. Levels of support for an advertising and display ban were comparable between Canadian provinces over time, irrespective of whether they had been banned or not. Noticing tobacco displays and signs in-store was demonstrably less likely to predict support for display (OR=0.73, p=0.005) and advertising (OR=0.78, p=0.02) ban, respectively. Smokers intending to quit were more likely to support advertising and display bans over time. This study serves as a timely reminder that the implementation of tobacco control measures, such as the removal of tobacco displays, appear to sustain support among smokers, those most likely to oppose such measures.

Support for removal of point-of-purchase tobacco advertising and displays: findings from the International Tobacco Control (ITC) Canada survey

Science.gov (United States)

Brown, Abraham; Boudreau, Christian; Moodie, Crawford; Fong, Geoffrey T; Li, Grace Y; McNeill, Ann; Thompson, Mary E; Hassan, Louise M; Hyland, Andrew; Thrasher, James F; Yong, Hua-Hie; Borland, Ron; Hastings, Gerard; Hammond, David

2013-01-01

Background Although most countries now have at least some restrictions on tobacco marketing, the tobacco industry meet these restrictions by re-allocating expenditure to unregulated channels, such as at point-of-purchase. Methods Longitudinal data from 10 Canadian provinces in the International Tobacco Control Survey was analysed to examine adult smokers’ support for a ban on tobacco advertising and displays in stores and whether this support is associated with noticing either advertising or displays in stores, and quit intentions, over time. In total, there were 4580 respondents in wave 5 (October 2006 to February 2007), wave 6 (September 2007 to February 2008) and wave 7 (October 2008 to June 2009). The surveys were conducted before, during and in some cases after the implementation of display bans in most Canadian provinces and territories. Results Smokers in all provinces showed strong support for a ban on tobacco displays over the study period. Levels of support for an advertising and display ban were comparable between Canadian provinces over time, irrespective of whether they had been banned or not. Noticing tobacco displays and signs in-store was demonstrably less likely to predict support for displays (OR=0.73, p=0.005) and advertising (OR=0.78, p=0.02) ban, respectively. Smokers intending to quit were more likely to support advertising and display bans over time. Conclusion This study serves as a timely reminder that the implementation of tobacco control measures, such as the removal of tobacco displays, appear to sustain support among smokers, those most likely to oppose such measures. PMID:23076786

Adherence to the Tobacco Control Act, 2007: presence of a workplace policy on tobacco use in bars and restaurants in Nairobi, Kenya.

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Karimi, K J; Ayah, R; Olewe, T

2016-09-28

Despite extensive knowledge about effective tobacco control interventions, the prevalence of tobacco use in many middle- and low-income countries continues to rise. In these countries, public appreciation of levels of protection provided by laws and regulations on tobacco use and exposure to tobacco smoke is limited. After ratification of the Framework Convention on Tobacco Control, Kenya enacted the Tobacco Control Act, 2007, banning smoking in public places except in designated smoking areas. To assess adherence to the Tobacco Control Act, 2007 by determining the presence of a workplace policy on tobacco use in bars and restaurants. A survey of 176 liquor licensed bars and restaurants in Nairobi County was carried out. Their managers were asked about the presence of a workplace policy governing smoking of tobacco, and observations made on provisions that determine adherence to the Tobacco Control Act, 2007. Smoking took place in almost all bars and restaurants (150 (85%)). Half the establishments (86 (49%)) had a workplace policy governing tobacco use among employees, although a difference between bars (11 (23%)) and restaurants (75 (58%)) was recorded (pworkplace policy (p<0.001) and less likely to have 'no smoking' signs and designated smoking areas (p<0.005). Kenya's implementation of the Tobacco Control Act, 2007 does not provide sufficient protection of patrons and workers in bars and restaurants. It is important to sensitise hospitality workers to the dangers of tobacco smoke. Bar and restaurants managers should have a minimum post-secondary education level. The Tobacco Control Act, 2007 requires strengthening to ensure that bars and restaurants have a smoke-free environment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Tobacco control, global health policy and development: towards policy coherence in global governance

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Collin, Jeff

2015-01-01

The WHO Framework Convention on Tobacco Control (FCTC) demonstrates the international political will invested in combating the tobacco pandemic and a newfound prominence for tobacco control within the global health agenda. However, major difficulties exist in managing conflicts with foreign and trade policy priorities, and significant obstacles confront efforts to create synergies with development policy and avoid tensions with other health priorities. This paper uses the concept of policy coherence to explore congruence and inconsistencies in objectives, policy, and practice between tobacco control and trade, development and global health priorities. Following the inability of the FCTC negotiations to satisfactorily address the relationship between trade and health, several disputes highlight the challenges posed to tobacco control policies by multilateral and bilateral agreements. While the work of the World Bank has demonstrated the potential contribution of tobacco control to development, the absence of non-communicable diseases from the Millennium Development Goals has limited scope to offer developing countries support for FCTC implementation. Even within international health, tobacco control priorities may be hard to reconcile with other agendas. The paper concludes by discussing the extent to which tobacco control has been pursued via a model of governance very deliberately different from those used in other health issues, in what can be termed ‘tobacco exceptionalism’. The analysis developed here suggests that non-communicable disease (NCD) policies, global health, development and tobacco control would have much to gain from re-examining this presumption of difference. PMID:22345267

Program, policy, and price interventions for tobacco control: quantifying the return on investment of a state tobacco control program.

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Dilley, Julia A; Harris, Jeffrey R; Boysun, Michael J; Reid, Terry R

2012-02-01

We examined health effects associated with 3 tobacco control interventions in Washington State: a comprehensive state program, a state policy banning smoking in public places, and price increases. We used linear regression models to predict changes in smoking prevalence and specific tobacco-related health conditions associated with the interventions. We estimated dollars saved over 10 years (2000-2009) by the value of hospitalizations prevented, discounting for national trends. Smoking declines in the state exceeded declines in the nation. Of the interventions, the state program had the most consistent and largest effect on trends for heart disease, cerebrovascular disease, respiratory disease, and cancer. Over 10 years, implementation of the program was associated with prevention of nearly 36,000 hospitalizations, at a value of about $1.5 billion. The return on investment for the state program was more than $5 to $1. The combined program, policy, and price interventions resulted in reductions in smoking and related health effects, while saving money. Public health and other leaders should continue to invest in tobacco control, including comprehensive programs.

Tobacco commerce on the internet: a threat to comprehensive tobacco control.

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Cohen, J E; Sarabia, V; Ashley, M J

2001-12-01

Although internet use continues to increase and e-commerce sales are expected to exceed US$1 trillion by the end of 2001, there have been few assessments in the literature regarding the implications of this medium for tobacco control efforts. This commentary explores the challenges that the internet may pose to the key components of a comprehensive tobacco control strategy, and pinpoints potential approaches for addressing these challenges. Four key challenges that the internet presents for tobacco control are identified: unrestricted sales to minors; cheaper cigarettes through tax avoidance and smuggling; unfettered advertising, marketing and promotion; and continued normalisation of the tobacco industry and its products. Potential strategies for addressing these challenges include international tobacco control agreements, national and state regulation, and legal remedies.

The economics of tobacco control: evidence from the International Tobacco Control (ITC) Policy Evaluation Project.

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Tauras, John A; Chaloupka, Frank J; Quah, Anne Chiew Kin; Fong, Geoffrey T

2014-03-01

Over the past few decades, the importance of economic research in advancing tobacco control policies has become increasingly clear. Extensive research has demonstrated that increasing tobacco taxes and prices is the single most cost-effective tobacco control measure. The research contained in this supplement adds to this evidence and provides new insights into how smokers respond to tax and price changes using the rich data on purchase behaviours, brand choices, tax avoidance and evasion, and tobacco use collected systematically and consistently across countries and over time by the International Tobacco Control (ITC) Project. The findings from this research will help inform policymakers, public health professionals, advocates, and others seeking to maximise the public health and economic benefits from higher taxes.

The Gap between the Knowledge and Current Practices--A Case of Tobacco Control Programs in Croatia.

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Civljak, Marta; Tudor Car, Lorainne; Skara, Silvana; Oresković, Stipe

2015-09-01

Despite the availability of numerous evidence-based smoking prevention and cessation programs, many countries are still not implementing these research-proven programs. The primary aim of this paper is to summarize the extent to which evidence-based smoking control programs have been implemented in Croatia over the last two decades. Data from the systematic reviews of the Cochrane Tobacco Addiction Group, which are readily available worldwide, were used as criteria to evaluate whether effective, evidence-based programs have been implemented in Croatia. According to our findings, the most effective behavioral and pharmacological smoking cessation interventions have thus far been underutilized in Croatia. In addition, some interventions that have been continuously implemented in Croatia--such as using self-help materials, school-based programs and the celebration of World No Tobacco Day--have only small, short-term beneficial effects according to the Cochrane reviews. However, Croatia is a party to the World health Organization Framework Convention on Tobacco Control and therefore has effective national legislation on tobacco control. Croatia should develop and implement programs that integrate the existing high-quality empirical evidence on the effectiveness of various behavioral, pharmacological, and social interventions for smoking prevention and cessation. This programming should become a part of a continuous national strategy, and should be implemented throughout all of Croatia.

More money more motivation? Master Settlement Agreement and tobacco control funding in communities of color.

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Themba-Nixon, Makani; Sutton, Charyn D; Shorty, Lawrence; Lew, Rod; Baezconde-Garbanati, Lourdes

2004-07-01

This article examines state Master Settlement Agreement (MSA) funding of tobacco control in communities of color. The primary research question was whether MSA monies resulted in dedicated funding for communities of color at the state level. This article also explores some of the historical factors that shape the relationship of communities of color to MSA funding as well as some of the institutional barriers to implementing comprehensive tobacco control programs in these communities. Three model approaches to funding parity in tobacco control programs were examined as case studies. Because of the limited amount of research available in this area, the data on tobacco control funding for communities of color was collected in interviews with state tobacco control agencies during October 2003. Findings supported our hypothesis that there were few dedicated resources at the state level for tobacco control and prevention in communities of color.

Levels and correlates of awareness of tobacco promotional activities among adult smokers in Malaysia and Thailand: findings from the International Tobacco Control Southeast Asia (ITC-SEA) Survey.

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Yong, H-H; Borland, R; Hammond, D; Sirirassamee, B; Ritthiphakdee, B; Awang, R; Omar, M; Kin, F; Zain, Z bt M; Lee, W B; Siahpush, M; Fong, G T

2008-02-01

To examine the impact of tobacco advertising policy on adult smokers' awareness of tobacco promotion in two developing countries--Malaysia and Thailand. Data from 2004 Malaysian and 2000 Thai adult smokers who participated in the baseline wave of the International Tobacco Control Southeast Asia survey (ITC-SEA). Respondents were asked in a face-to-face interview conducted between January and March 2005 to indicate their levels of awareness of tobacco advertising and promotional activities in the last six months. Unprompted awareness of any tobacco marketing activities was very low in Thailand (20%) but significantly higher in Malaysia (53%; OR = 5.6, 95% CI: 3.5 to 8.9, ptobacco advertising where it was banned, being highest around point of sale, particularly street vendors (7.5%). In contrast, Malaysian adult smokers reported significantly higher levels of awareness of tobacco advertising in all locations (range = 17.7% noticing in disco lounges to 59.3% on posters) including where they are notionally banned (for example, billboards). These findings demonstrate that comprehensive tobacco advertising legislation when well implemented can lead to dramatic decline in awareness of tobacco promotion, thus supporting strong implementation of Article 13 of the Framework Convention on Tobacco Control.

The Tobacco Control Scale: a new scale to measure country activity.

Science.gov (United States)

Joossens, L; Raw, M

2006-06-01

To quantify the implementation of tobacco control policies at country level using a new Tobacco Control Scale and to report initial results using the scale. A questionnaire sent to correspondents in 30 European countries, using a scoring system designed with the help of a panel of international tobacco control experts. The 30 countries are ranked by their total score on the scale out of a maximum possible score of 100. Only four countries (Ireland, United Kingdom, Norway, Iceland) scored 70 or more, with an eight point gap (most differences in scores are small) to the fifth country, Malta, on 62. Only 13 countries scored above 50, 11 of them from the European Union (EU), and the second largest points gap occurs between Denmark on 45 and Portugal on 39, splitting the table into three groups: 70 and above, 45 to 62, 39 and below. Ireland had the highest overall score, 74 out of 100, and Luxembourg was bottom with 26 points. However even Ireland, much praised for their ban on smoking in public places, did not increase tobacco taxes in 2005, for the first time since 1995. Although the Tobacco Control Scale has limitations, this is the first time such a scale has been developed and applied to so many countries. We hope it will be useful in encouraging countries to strengthen currently weak areas of their tobacco control policy.

Attitudes towards Potential New Tobacco Control Regulations among U.S. Adults

OpenAIRE

Schmidt, Allison M.; Kowitt, Sarah D.; Myers, Allison E.; Goldstein, Adam O.

2018-01-01

Favorable attitudes towards tobacco control policies can facilitate their implementation and success. We examined attitudes toward four potential U.S. Federal tobacco regulations (banning menthol from cigarettes, reducing nicotine levels in cigarettes, banning candy and fruit flavored electronic cigarettes, and banning candy and fruit flavored little cigars and cigarillos) and associations with individual and state variables. A nationally representative phone survey of 4337 adults assessed at...

The landscape of tobacco control in Africa

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Mark Paracandola

2018-03-01

Full Text Available Background Tobacco use prevalence in Africa is projected to rise over the next 15 years without stronger tobacco control measures. However, little research details the scope of tobacco control research being conducted in Africa. A systematic literature review was conducted to better understand the landscape of tobacco control efforts in Africa. Methods A literature search of tobacco research conducted in all African countries from 1996 to 2016 was performed in PubMed, Embase, and African Index Medicus. Published abstracts meeting the inclusion criteria of focusing on nicotine or tobacco product(s and having been conducted in one or more African countries were selected for full coding and analysis. The authors coded on study characteristics such as type of research, tobacco product, and country. Three coders double-coded 5% of the articles reviewed to ensure agreement. Results This review found 645 relevant articles, in French and English, representing 52 African countries. South Africa was the focus of the greatest proportion of these published tobacco control research articles (23%, followed by Nigeria (17%, Egypt (13%, and Tunisia (12%. Reporting the prevalence of tobacco use was the focus of 51% of these articles. Other areas of research included the potential determinants of tobacco use (28%; knowledge, attitudes, and beliefs about tobacco products or policies (26%; and biological consequences of tobacco use (25%. Most studies (63% discussed cigarettes, and 15% studied smokeless tobacco. Youth-targeted studies comprised 25% of all research in Africa. Publications per year increased between 1996 and 2015, quadrupling in number by 2015. Conclusions A comprehensive review of the literature provides a baseline understanding of the tobacco control landscape and the increased attention countries are showing to tobacco and tobacco control. This research may inform opportunities for further research and for strengthening networks and thereby the

Implementation and research priorities for FCTC Articles 13 and 16: tobacco advertising, promotion, and sponsorship and sales to and by minors.

Science.gov (United States)

Nagler, Rebekah H; Viswanath, Kasisomayajula

2013-04-01

Article 13 of the Framework Convention on Tobacco Control (FCTC) calls for a comprehensive ban on tobacco advertising, promotion, and sponsorship (TAPS), and Article 16 calls for prohibition of tobacco sales to and by minors. Although these mandates are based on sound science, many countries have found provision implementation to be rife with challenges. This paper reviews the history of tobacco marketing and minor access restrictions in high-, middle-, and low-income countries, identifying past challenges and successes. We consider current challenges to FCTC implementation, how these barriers can be addressed, and what research is necessary to support such efforts. Specifically, we identify implementation and research priorities for FCTC Articles 13 and 16. Although a solid evidence base underpins the FCTC's call for TAPS bans and minor access restrictions, we know substantially less about how best to implement these restrictions. Drawing on the regulatory experiences of high-, middle-, and low-income countries, we discern several implementation and research priorities, which are organized into 4 categories: policy enactment and enforcement, human capital expertise, the effects of FCTC marketing and youth access policies, and knowledge exchange and transfer among signatories. Future research should provide detailed case studies on implementation successes and failures, as well as insights into how knowledge of successful restrictions can be translated into tobacco control policy and practice and shared among different stakeholders. Tobacco marketing surveillance, sales-to-minors compliance checks, enforcement and evaluation of restriction policies, and capacity building and knowledge transfer are likely to prove central to effective implementation.

Implementation and Research Priorities for FCTC Articles 13 and 16: Tobacco Advertising, Promotion, and Sponsorship and Sales to and by Minors

Science.gov (United States)

2013-01-01

Introduction: Article 13 of the Framework Convention on Tobacco Control (FCTC) calls for a comprehensive ban on tobacco advertising, promotion, and sponsorship (TAPS), and Article 16 calls for prohibition of tobacco sales to and by minors. Although these mandates are based on sound science, many countries have found provision implementation to be rife with challenges. Objective: This paper reviews the history of tobacco marketing and minor access restrictions in high-, middle-, and low-income countries, identifying past challenges and successes. We consider current challenges to FCTC implementation, how these barriers can be addressed, and what research is necessary to support such efforts. Specifically, we identify implementation and research priorities for FCTC Articles 13 and 16. Discussion: Although a solid evidence base underpins the FCTC’s call for TAPS bans and minor access restrictions, we know substantially less about how best to implement these restrictions. Drawing on the regulatory experiences of high-, middle-, and low-income countries, we discern several implementation and research priorities, which are organized into 4 categories: policy enactment and enforcement, human capital expertise, the effects of FCTC marketing and youth access policies, and knowledge exchange and transfer among signatories. Future research should provide detailed case studies on implementation successes and failures, as well as insights into how knowledge of successful restrictions can be translated into tobacco control policy and practice and shared among different stakeholders. Conclusion: Tobacco marketing surveillance, sales-to-minors compliance checks, enforcement and evaluation of restriction policies, and capacity building and knowledge transfer are likely to prove central to effective implementation. PMID:23291641

Tobacco control policy in France: from war to compromise and collaboration

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Alain Braillon

2012-09-01

Full Text Available BACKGROUND: Absence of an effective tobacco control policy costs lives and tobacco prevention is policy-sensitive. We describe the historical record of tobacco control in France. METHODS: Public policies and main decisions (laws, regulations, health plans for tobacco control were considered from 1950 to 2010. Data for cigarette sales and relative price of cigarettes were obtained from official databases. Sales are expressed in number of cigarettes. The relative price of cigarettes is the nominal price divided by the Consumer Price Index. RESULTS: The first step Veil Law (1976 blunted the steady increase in cigarette sales observed since World War II. The second period began with the Evin Law (1991. This law banned tobacco advertising and withdrew tobacco from the Consumer Price Index allowing for marked and repeated increases in taxes. Sales decreased over the next 6 years, from 97.1 billion to 83.0 billion in 1997 but then remained steady for 5 years (83.5 billion in 2001. The first Cancer Plan (2003 imposed three tax increases in a year (39% increase in price. Cigarette sales decreased to 54.9 billion in 2004. This period ended in 2004 when a moratorium on tobacco taxes was announced. The policies which have been implemented since President Sarkozy was elected in 2007 were flawed and protected the interests of the tobacco industry: prevalence of smoking is now increasing, mainly among the younger generation. Since 1991, the cigarette market has nearly halved but the decline has been a stop-and-go erratic process. The two 5-year periods (1997-2002 and 2005 -2010 during which consumption leveled off seem to demonstrate that government-driven health policies could have been influenced by commercial interests. CONCLUSION: Tobacco control efforts, especially tobacco tax increases, need to be sustained and shielded from the influence of the tobacco industry.

Current challenges in tobacco control.

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Slama, K

2004-10-01

Tobacco is the world's biggest preventable killer, but the circumstances of its history, the power and influence of its commerce and the nature of addiction make it a very difficult public health issue. Determinants of smoking are both individual and environmental. Genetics and environment influence to varying degrees all of the steps in a smoker's career. Persistence of use, degree of addiction to nicotine and difficulty in stopping are influenced by inherited traits and nicotine susceptibility, whereas the social environment and the individual's cognitions are the key factors in starting smoking and successfully stopping smoking. The tools available to tobacco control include influencing the social and cultural norms concerning tobacco; legislative and regulatory measures to protect the population and to limit tobacco industry marketing tactics, now encapsulated in the Framework Convention on Tobacco Control; and programmes to enhance the chance of not starting and successfully stopping. Strategies for tobacco control must work at both societal and individual levels, and directions are being taken that include genetic, pharmacological, behavioural, socio-cultural and international approaches.

Using tobacco-industry marketing research to design more effective tobacco-control campaigns.

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Ling, Pamela M; Glantz, Stanton A

2002-06-12

To improve tobacco-control efforts by applying tobacco-industry marketing research and strategies to clinical and public health smoking interventions, we analyzed previously secret tobacco-industry marketing documents. In contrast to public health, the tobacco industry divides markets and defines targets according to consumer attitudes, aspirations, activities, and lifestyles. Tobacco marketing targets smokers of all ages; young adults are particularly important. During the 1980s, cost affected increasing numbers of young and older smokers. During the 1990s, eroding social acceptability of smoking emerged as a major threat, largely from increasing awareness of the dangers of secondhand smoke among nonsmokers and smokers. Physicians and public health professionals should use tobacco-industry psychographic approaches to design more relevant tobacco-control interventions. Efforts to counter tobacco marketing campaigns should include people of all ages, particularly young adults, rather than concentrating on teens and young children. Many young smokers are cost sensitive. Tobacco-control messages emphasizing the dangers of secondhand smoke to smokers and nonsmokers undermine the social acceptability of smoking.

Strong tobacco control program requirements and secure funding are not enough: lessons from Florida.

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Kennedy, Allison; Sullivan, Sarah; Hendlin, Yogi; Barnes, Richard; Glantz, Stanton

2012-05-01

Florida's Tobacco Pilot Program (TPP; 1998-2003), with its edgy Truth media campaign, achieved unprecedented youth smoking reductions and became a model for tobacco control programming. In 2006, 3 years after the TPP was defunded, public health groups restored funding for tobacco control programming by convincing Florida voters to amend their constitution. Despite the new program's strong legal structure, Governor Charlie Crist's Department of Health implemented a low-impact program. Although they secured the program's strong structure and funding, Florida's nongovernmental public health organizations did not mobilize to demand a high-impact program. Implementation of Florida's Amendment 4 demonstrates that a strong programmatic structure and secure funding are insufficient to ensure a successful public health program, without external pressure from nongovernmental groups.

International law, national policies and youth smoking: an examination of the Framework Convention on Tobacco Control

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G Emmanuel Guindon

2018-03-01

Full Text Available Background The Framework Convention on Tobacco Control (FCTC addresses a wide range of issues including protection from exposure to secondhand smoke and advertising, promotion and sponsorship. The FCTC represents a minimum set of tobacco control policies, although the treaty explicitly encourages countries to go above and beyond these measures. Despite its lack of mandatory provisions. FCTC ratification and its timing may be good proxy for a country's commitment to tobacco control. Our first objective is to assess the impact of the FCTC on global youth tobacco use. Our second objective is to explore two areas that are amenable to policy change: secondhand smoke and advertising. Methods We used pooled repeated-cross-sectional data from youth surveys conducted between 1999 and 2015 in more than 150 low- and middle-income countries and multilevel analyses to account for the nesting of students in schools and schools in countries. First, we examined the association between three outcome variables (smoking susceptibility, defined as the absence of a firm decision not to smoke, current smoking defined as 30-day smoking prevalence and a five-point scale of smoking uptake and various indicators of the FCTC implementation. Second, we examined the association between exposure to secondhand smoke and advertising and indicators of the FCTC implementation. Results We found considerable heterogeneity in the association between different measures of youth smoking and indicators of the FCTC implementation. On the whole, we found clearer associations between exposure to secondhand smoke and advertising and indicators of the FCTC implementation. Conclusions A number of studies have examined changes in the implementation of tobacco control measures since the ratification of the FCTC but few studies have examined the effect of the FCTC on tobacco use; fewer still have used pre- and post-FCTC data. More research that use such data is needed.

Impact of Point-of-Sale Tobacco Display Bans in Thailand: Findings from the International Tobacco Control (ITC) Southeast Asia Survey.

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Li, Lin; Borland, Ron; Yong, Hua-Hie; Sirirassamee, Buppha; Hamann, Stephen; Omar, Maizurah; Quah, Anne C K

2015-08-13

In September 2005 Thailand became the first Asian country to implement a complete ban on the display of cigarettes and other tobacco products at point-of-sale (POS). This paper examined the impact of the POS tobacco display ban in Thailand, with Malaysia (which did not impose bans) serving as a comparison. The data came from the International Tobacco Control Southeast Asia Survey (2005-2011), a prospective cohort survey designed to evaluate the psychosocial and behavioral impacts of tobacco control policies. Main measures included smokers' reported awareness of tobacco displays and advertising at POS. At the first post-ban survey wave over 90% of smokers in Thailand were aware of the display ban policy and supported it, and about three quarters thought the ban was effective. Noticing tobacco displays in stores was lowest (16.9%) at the first post-ban survey wave, but increased at later survey waves; however, the levels were consistently lower than those in Malaysia. Similarly, exposure to POS tobacco advertising was lower in Thailand. The display ban has reduced exposure to tobacco marketing at POS. The trend toward increased noticing is likely at least in part due to some increase in violations of the display bans and/or strategies to circumvent them.

Impact of Point-of-Sale Tobacco Display Bans in Thailand: Findings from the International Tobacco Control (ITC Southeast Asia Survey

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Lin Li

2015-08-01

Full Text Available In September 2005 Thailand became the first Asian country to implement a complete ban on the display of cigarettes and other tobacco products at point-of-sale (POS. This paper examined the impact of the POS tobacco display ban in Thailand, with Malaysia (which did not impose bans serving as a comparison. The data came from the International Tobacco Control Southeast Asia Survey (2005–2011, a prospective cohort survey designed to evaluate the psychosocial and behavioral impacts of tobacco control policies. Main measures included smokers’ reported awareness of tobacco displays and advertising at POS. At the first post-ban survey wave over 90% of smokers in Thailand were aware of the display ban policy and supported it, and about three quarters thought the ban was effective. Noticing tobacco displays in stores was lowest (16.9% at the first post-ban survey wave, but increased at later survey waves; however, the levels were consistently lower than those in Malaysia. Similarly, exposure to POS tobacco advertising was lower in Thailand. The display ban has reduced exposure to tobacco marketing at POS. The trend toward increased noticing is likely at least in part due to some increase in violations of the display bans and/or strategies to circumvent them.

Can Tobacco Control Be Transformative? Reducing Gender Inequity and Tobacco Use among Vulnerable Populations

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Greaves, Lorraine

2014-01-01

Tobacco use and exposure is unequally distributed across populations and countries and among women and men. These trends and patterns reflect and cause gender and economic inequities along with negative health impacts. Despite a commitment to gender analysis in the preamble to Framework Convention on Tobacco Control there is much yet to be done to fully understand how gender operates in tobacco control. Policies, program and research in tobacco control need to not only integrate gender, but rather operationalize gender with the goal of transforming gender and social inequities in the course of tobacco control initiatives. Gender transformative tobacco control goes beyond gender sensitive efforts and challenges policy and program developers to apply gender theory in designing their initiatives, with the goal of changing negative gender and social norms and improving social, economic, health and social indicators along with tobacco reduction. This paper outlines what is needed to progress tobacco control in enhancing the status of gendered and vulnerable groups, with a view to reducing gender and social inequities due to tobacco use and exposure. PMID:24402065

Implementation of tobacco cessation brief intervention in complementary and alternative medicine practice: qualitative evaluation.

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Eaves, Emery R; Howerter, Amy; Nichter, Mark; Floden, Lysbeth; Gordon, Judith S; Ritenbaugh, Cheryl; Muramoto, Myra L

2017-06-23

This article presents findings from qualitative interviews conducted as part of a research study that trained Acupuncture, Massage, and Chiropractic practitioners' in Arizona, US, to implement evidence-based tobacco cessation brief interventions (BI) in their routine practice. The qualitative phase of the overall study aimed to assess: the impact of tailored training in evidence-based tobacco cessation BI on complementary and alternative medicine (CAM) practitioners' knowledge and willingness to implement BIs in their routine practice; and their patients' responses to cessation intervention in CAM context. To evaluate the implementation of skills learned from a tailored training program, we conducted semi-structured qualitative interviews with 54 CAM practitioners in Southern Arizona and 38 of their patients. Interview questions focused on reactions to the implementation of tobacco cessation BIs in CAM practice. After participating in a tailored BI training, CAM practitioners reported increased confidence, knowledge, and motivation to address tobacco in their routine practice. Patients were open to being approached by CAM practitioners about tobacco use and viewed BIs as an expected part of wellness care. Tailored training motivated CAM practitioners in this study to implement evidence-based tobacco cessation BIs in their routine practice. Results suggest that CAM practitioners can be a valuable point of contact and should be included in tobacco cessation efforts.

Results of the Global Youth Tobacco Survey and implementation of the WHO Framework Convention on Tobacco Control in the WHO Eastern Mediterranean Region (EMR) countries.

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Usmanova, Gulnoza; Mokdad, Ali H

2013-12-01

We used Global Youth Tobacco Survey (GYTS) data collected over time to monitor articles of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in WHO Eastern Mediterranean Region (EMR). The GYTS is a school-based survey, conducted in 23 countries in WHO EMR countries from 1999-2008. The prevalence of current smokeless tobacco use was high compared to cigarette use in all countries. In general, the following changes were observed between baseline and repeated surveys: in five countries fewer youth supported a ban on smoking in public places. In four countries more youth saw actors smoking on TV and were exposed to second-hand smoke (SHS) outside of home. Fewer youth were offered free cigarettes in ten countries; in eight countries youth saw less advertisement on TV; in seven countries youth had fewer items with a tobacco logo, discussed more reasons for smoking and dangers of smoking, and were less exposed to SHS at home; in six countries youth saw less advertisement at sports events. The GYTS data can be used for monitoring, evaluation of national tobacco control plans and defining future directions for tobacco control. Copyright © 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Tobacco control and the World Trade Organization: mapping member states' positions after the framework convention on tobacco control.

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Eckhardt, Jappe; Holden, Chris; Callard, Cynthia D

2016-11-01

To note the frequency of discussions and disputes about tobacco control measures at the World Trade Organization (WTO) before and after the coming into force of the Framework Convention on Tobacco Control (FCTC). To review trends or patterns in the positions taken by members of the WTO with respect to tobacco control measures. To discuss possible explanations for these observed trends/patterns. We gathered data on tobacco-related disputes in the WTO since its establishment in 1995 and its forerunner, the General Agreement on Tariffs and Trade (GATT), prior-FCTC and post-FCTC. We also looked at debates on tobacco control measures within the WTO more broadly. To this end, we classified and coded the positions of WTO member states during discussions on tobacco control and the FCTC, from 1995 until 2013, within the Technical Barriers to Trade (TBT) Committee and the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Council. There is a growing interest within the WTO for tobacco-related issues and opposition to tobacco control measures is moving away from high-income countries towards low(er) income countries. The growing prominence of tobacco issues in the WTO can be attributed at least in part to the fact that during the past decade tobacco firms have been marginalised from the domestic policy-making process in many countries, which has forced them to look for other ways and forums to influence decision-making. Furthermore, the finding that almost all recent opposition within the WTO to stronger tobacco regulations came from developing countries is consistent with a relative shift of transnational tobacco companies' lobbying efforts from developed to developing countries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Environmental health organisations against tobacco.

LENUS (Irish Health Repository)

Mulcahy, Maurice

2009-04-01

Implementing the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) relies heavily on enforcement. Little is known of the way different enforcement agencies operate, prioritise or network. A questionnaire was sent to representatives of the International Federation of Environmental Health (IFEH) in 36 countries. Tobacco control was given low priority. Almost two thirds did not have any tobacco control policy. A third reported their organisation had worked with other agencies on tobacco control. Obstacles to addressing tobacco control included a lack of resources (61%) and absence of a coherent strategy (39%).

Tobacco Industry Political Activity and Tobacco Control Policy Making in Washington: 1996-2000

OpenAIRE

Nixon, Meredith L. BA; Glantz, Stanton A. Ph.D.

2001-01-01

• After making substantial progress on tobacco control in the mid-1990s, the tobacco industry has stifled tobacco control activities in Washington through a mixture of campaign contributions and legal challenges. • Political campaign contributions have remained steadily high throughout the 1990s. Philip Morris, RJ Reynolds, the Tobacco Institute, Lorillard, Brown & Williamson, and the Smokeless Tobacco Council contributed $362,298 to campaigns in 1996 through 2000 election cycles: $1...

Adult tobacco use levels after intensive tobacco control measures: New York City, 2002-2003.

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Frieden, Thomas R; Mostashari, Farzad; Kerker, Bonnie D; Miller, Nancy; Hajat, Anjum; Frankel, Martin

2005-06-01

We sought to determine the impact of comprehensive tobacco control measures in New York City. In 2002, New York City implemented a tobacco control strategy of (1) increased cigarette excise taxes; (2) legal action that made virtually all work-places, including bars and restaurants, smoke free; (3) increased cessation services, including a large-scale free nicotine-patch program; (4) education; and (5) evaluation. The health department also began annual surveys on a broad array of health measures, including smoking. From 2002 to 2003, smoking prevalence among New York City adults decreased by 11% (from 21.6% to 19.2%, approximately 140000 fewer smokers). Smoking declined among all age groups, race/ethnicities, and education levels; in both genders; among both US-born and foreign-born persons; and in all 5 boroughs. Increased taxation appeared to account for the largest proportion of the decrease; however, between 2002 and 2003 the proportion of cigarettes purchased outside New York City doubled, reducing the effective price increase by a third. Concerted local action can sharply reduce smoking prevalence. However, further progress will require national action, particularly to increase cigarette taxes, reduce cigarette tax evasion, expand education and cessation services, and limit tobacco marketing.

The heterogeneous impact of a successful tobacco control campaign: a case study of Mauritius.

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Ross, Hana; Moussa, Leelmanee; Harris, Tom; Ajodhea, Rajive

2018-01-01

Mauritius has one of the highest smoking prevalences in Africa, contributing to its high burden of non-communicable diseases. Mauritius implemented a series of tobacco control measures from 2009 to 2012, including tobacco tax increases. There is evidence that these policies reduced tobacco consumption, but it is not clear what impact they had across different socioeconomic groups. The impact of tobacco control measures on different income groups was analysed by contrasting household tobacco expenditures reported in 2006-2007 and 2012 household expenditure surveys. We employed the seemingly unrelated regression model to assess the impact of tobacco use on other household expenditures and calculated Gini coefficients to assess tobacco expenditure inequality. From 2006 to 2012, excise taxes and retail cigarette prices increased by 40.6% and 15.3% in real terms, respectively. These increases were accompanied by numerous non-price tobacco control measures. The share of tobacco-consuming households declined from 35.7% to 29.3%, with the largest relative drop among low-income households. The Gini coefficient of household tobacco expenditures increased by 10.4% due to decreased spending by low-income households. Low-income households demonstrated the largest fall in their tobacco budget shares, and the impact of tobacco consumption on poverty decreased by 26.2%. Households that continued purchasing tobacco reduced their expenditures on transportation, communication, health, and education. These results suggest that tobacco control policies, including sizeable tax increases, were progressive in their impact. We conclude that tobacco use increases poverty and inequality, but stronger tobacco control policies can mitigate the impact of tobacco use on impoverishment. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The millennium development goals and tobacco control.

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Collishaw, Neil E

2010-03-01

The eight Millennium Development Goals were proposed by the UN Secretary-General in 2001. They are goals with measurable targets to be achieved by 2015 or earlier. The Goals were distilled from the 2000 United Nations Millennium Declaration, a sweeping statement of development values, principles, objectives and proposed actions. The Framework Convention on Tobacco Control (FCTC) is a demonstrable translation of some of the ideas in the Millennium Declaration into reality. With 165(i) Parties, the FCTC does more than just improve global tobacco control: * The FCTC contributes to achievement of many of the Millennium Development Goals, and benefits from success in implementation of the Goals in other sectors. * The treaty itself is a demonstration of strengthened international and national rule of law, central tenets of the Millennium Declaration. * The FCTC expands international law into the health sector and provides better balance of international law among economic, environmental, social and health sectors. The Millennium Declaration calls for a more equitable distribution of the benefits of globalization, and the FCTC delivers this result. * The FCTC provides a model for addressing other unsolved global problems through greater use of international law. Alcohol control and dietary improvements including greater control of empty calories in manufactured foods are examples of problems that may benefit from greater governance by international law. Were that to come to pass, those new treaties would also improve implementation of the Millennium Declaration and the Millennium Development Goals.

Promoting tobacco control law enforcement in China through applications of “Government Information Disclosure” and media advocacy

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Zhenyu Wang

2018-03-01

Effective implementation of smoke-free policies is important to create public health benefits and enhance the tobacco control movement. The civil society should make full use of existing policies or mechanisms such as “Government Information Disclosure” to monitor and promote tobacco control work.

Permissiveness toward tobacco sponsorship undermines tobacco control support in Africa.

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Ayo-Yusuf, Olalekan A; Olutola, Bukola G; Agaku, Israel T

2016-06-01

School personnel, who are respected members of the community, may exert significant influence on policy adoption. This study assessed the impact of school personnel's permissiveness toward tobacco industry sponsorship activities on their support for complete bans on tobacco advertisements, comprehensive smoke-free laws and increased tobacco prices. Representative data were obtained from the Global School Personnel Survey for 29 African countries (n = 17 929). Adjusted prevalence ratios (aPR) were calculated using multi-variable Poisson regression models to assess the impact of permissiveness toward tobacco sponsorship activities on support for tobacco control policies (p industry should be allowed to sponsor school events were significantly less likely to support complete bans on tobacco advertisements [aPR = 0.89; 95% confidence interval (CI) 0.84-0.95] and comprehensive smoke-free laws (aPR = 0.95; 95% CI 0.92-0.98). In contrast, support for complete tobacco advertisement bans was more likely among those who believed that the tobacco industry encourages youths to smoke (aPR = 1.27; 95% CI 1.17-1.37), and among those who taught about health sometimes (aPR = 1.06; 95% CI 1.01-1.11) or a lot (aPR = 1.05; 95% CI 1.01-1.10) compared with those who did not teach about health at all. These findings underscore the need to educate school personnel on tobacco industry's strategies to undermine tobacco control policies. This may help to build school personnel support for laws intended to reduce youth susceptibility, experimentation and established use of tobacco products. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Mentoring Cambodian and Lao health professionals in tobacco control leadership and research skills.

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Ferry, L Hyder; Job, J; Knutsen, S; Montgomery, S; Petersen, F; Rudatsikira, E; Singh, P

2006-06-01

The aim of the programme was to ultimately affect public health practice and policy in the Kingdom of Cambodia and Lao People's Democratic Republic (Lao PDR) by training key health professionals to conduct tobacco control research. Encouraged by the World Health Organization's Framework Convention on Tobacco Control, a global partnership formed to build effective leadership to develop and guide national tobacco control agendas. The partners were the Ministries of Health (Cambodia and Lao PDR), non-government organisations (Adventist Development and Relief Agency in Cambodia and Laos) and an academic institution (Loma Linda University, Loma Linda, California, USA). 16 health professionals, 10 from Cambodia and 6 from Lao PDR, were selected by local advisory committees to enter a two-year, intensive tobacco research graduate certificate and research training programme. We developed a "Global Tobacco Control Methods" (GTCM) 28 unit certificate programme that was offered in five sessions from September 2003 to September 2005 at the National Institute of Public Health, Phnom Penh, Cambodia. As part of their coursework, the 16 trainees actively participated in the development and implementation of two research projects. In the first project, "Healthy Doc Healthy Patient" (HDHP), trainees adapted an existing, self-administered questionnaire designed to assess health practices and beliefs of medical students in Cambodia and Lao PDR. The second project involved the design of a national prevalence of tobacco use and health beliefs study in Cambodia using a multi-stage, cluster sample method. Trainees were sponsored to attend and present at international tobacco control conferences to enhance their awareness of the tobacco epidemic. As of September 2005, 14 trainees (8 from Cambodia and 6 from Lao PDR) completed the courses in the GTCM certificate programme. The HDHP study sampled four medical school classes (years 3, 4, 5 and 6) in both Cambodia (n = 330, 71.1% response rate

Women and tobacco: a call for including gender in tobacco control research, policy and practice.

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Amos, Amanda; Greaves, Lorraine; Nichter, Mimi; Bloch, Michele

2012-03-01

Female smoking is predicted to double between 2005 and 2025. There have been numerous calls for action on women's tobacco use over the past two decades. In the present work, evidence about female tobacco use, progress, challenges and ways forward for developing gendered tobacco control is reviewed. Literature on girls, women and tobacco was reviewed to identify trends and determinants of tobacco use and exposure, the application of gender analysis, tobacco marketing, the impact of tobacco control on girls and women and ways to address these issues particularly in low-income and middle-income countries. Global female tobacco use is increasingly complex, involving diverse products and factors including tobacco marketing, globalisation and changes in women's status. In high-income countries female smoking is declining but is increasingly concentrated among disadvantaged women. In low-income and middle-income countries the pattern is more complex; in several regions the gap between girls' and boys' smoking is narrow. Gendered analyses and approaches to tobacco control are uncommon, especially in low-income and middle-income countries. Tobacco control has remained largely gender blind, with little recognition of the importance of understanding the context and challenges of girl's and women's smoking and secondhand smoke exposure. There has been little integration of gender considerations in research, policy and programmes. The present work makes a case for gender and diversity analyses in tobacco control to reflect and identify intersecting factors affecting women's tobacco use. This will help animate the WHO Framework Convention on Tobacco Control's concern for gender specificity and women's leadership, and reduce the impact of tobacco on women.

[Monitoring strategy for control of tobacco in Mexico: advertising, promotion and sponsorship, packaging and labeling].

Science.gov (United States)

Rodríguez-Bolaños, Rosibel; Reynales-Shigematsu, Luz Myriam; Ibañez-Hernández, Norma A; Santos-Luna, René; Valdés-Salgado, Raydel; Avila-Tang, Erika; Stillman, Frances

2010-01-01

To describe strategies used in the publicity, marketing, and sale, of tobacco products in 12 cities in Mexico. Tobacco products points of sale (POS) were identified within a 500 m radius of Global Youth Tobacco Survey (2005-2006) schools. We used observational surveys and an online Geographic Information System (GIS). In the 257 schools visited, we found, on average, 8.3 stores and 5 street vendors around each of them. Forty-four percent of the stores had interior tobacco publicity, 8.3% had tobacco products at children's eye level, 6.5% had some promotion, 33.6% had a no selling to minors sign, and 44.4% of stores and 58.8% of street vendors sold single cigarettes. Tobacco products are largely publicized and marketed around schools. There is no compliance of tobacco control legislation in regards to selling to minors and single cigarettes. It is necessary to implement a surveillance system to monitor strategies for tobacco control and the tobacco industry.

Evaluation of Smokers' Attitudes about Tobacco Control Program and Obstacles to the Implementation of this Program in Tehran

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Liley Mahmudi

2018-04-01

Full Text Available This study aimed to assess the status of cigarette marketing in Tehran and the attitude of smokers toward smoking Behavior and tobacco control programs in smokers of Tehran. This cross-sectional study was conducted on 608 volunteer smokers in Tehran City. Using a stratified cluster random sampling method, the study population involved smokers who used at least one cigarette per day. The data collection tool was an anonymous self-administered questionnaire including basic information and questions related to participants' attitude toward smoking habits (Cronbach's alpha; 78.19%.. (72.9% of the participants started smoking at the age of 10 to 19 years and 72.2% used foreign cigarettes. Each person spends a daily average of 30690 riyals for cigarettes. Being tempted (28.0%, feeling euphoria (27.8% and getting nervous (25.5% were the most common reasons of restarting cigarette smoking after cessation. A majority of the participants believed that smoking in public places was a violation of the rights of others and smoking should be avoided in such places. 61 Iranian and foreign cigarette brands available in the market that some foreign cigarettes were smuggled. Most smokers start smoking as teenagers, then smoking prevention programs should focus on adolescents as the most vulnerable age group. Raising the retail price of tobacco products through increasing taxes can reduce consumption particularly among first starters and youth. increasing taxes and prices of tobacco products may be effective when simultaneous effective measures are implemented to eliminate all kinds of illicit trade in all forms of tobacco products.

Tobacco industry strategies for influencing European Community tobacco advertising legislation.

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Neuman, Mark; Bitton, Asaf; Glantz, Stanton

2002-04-13

Restrictions on tobacco company advertising and sponsorship are effective parts of tobacco control programmes worldwide. Through Council Directive 98/43/EC, the European Community (EC) sought to end all tobacco advertising and sponsorship in EC member states by 2006. Initially proposed in 1989, the directive was adopted in 1998, and was annulled by the European Court of Justice in 2000 following a protracted lobbying campaign against the directive by a number of interested organisations including European tobacco companies. A new advertising directive was proposed in May, 2001. We reviewed online collections of tobacco industry documents from US tobacco companies made public under the US Master Settlement Agreement of 1998. Documents reviewed dated from 1978 to 1994 and came from Philip Morris, R J Reynolds, and Brown and Williamson (British American Tobacco) collections. We also obtained approximately 15,000 pages of paper records related to British American Tobacco from its documents' depository in Guildford, UK. This information was supplemented with information in the published literature and consultations with European tobacco control experts. The tobacco industry lobbied against Directive 98/43/EC at the level of EC member state governments as well as on a pan-European level. The industry sought to prevent passage of the directive within the EC legislature, to substitute industry-authored proposals in place of the original directive, and if necessary to use litigation to prevent implementation of the directive after its passage. The tobacco industry sought to delay, and eventually defeat, the EC directive on tobacco advertising and sponsorship by seeking to enlist the aid of figures at the highest levels of European politics while at times attempting to conceal the industry's role. An understanding of these proposed strategies can help European health advocates to pass and implement effective future tobacco control legislation.

Awareness and implementation of tobacco dependence treatment guidelines in Arizona: Healthcare Systems Survey 2000

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Menke J Michael

2008-12-01

Full Text Available Abstract Background This paper presents findings from the Tobacco Control in Arizona Healthcare Systems Survey, conducted in 2000. The purpose of the survey was to assess the status of Arizona healthcare systems' awareness and implementation of tobacco cessation and prevention measures. Methods The 20-item survey was developed by The University of Arizona HealthCare Partnership in collaboration with the Arizona Department of Health Services Bureau of Tobacco Education and Prevention. It was mailed to representatives of Arizona's 40 healthcare systems, including commercial and Medicare managed care organizations, "managed Medicaid" organizations, Veterans Affairs Health Care Systems, and Indian Health Service Medical Centers. Thirty-three healthcare systems (83% completed the survey. Results The majority of healthcare systems reported awareness of at least one tobacco cessation and prevention clinical practice guideline, but only one third reported full guideline implementation. While a majority covered some form of behavioral therapy, less than half reported covering tobacco treatment medications. "Managed Medicaid" organizations administered through the Arizona Health Care Cost Containment System were significantly less likely to offer coverage for behavioral therapy and less likely to cover pharmacotherapy than were their non-Medicaid counterparts in managed care, Veterans Affairs Health Care Systems and Indian Health Service Medical Centers. Conclusion Arizona healthcare system coverage for tobacco cessation in the year 2000 was comparable to national survey findings of the same year. The findings that only 10% of "Managed Medicaid" organizations covered tobacco treatment medication and were significantly less likely to cover behavioral therapy were important given the nearly double smoking prevalence among Medicaid patients. Throughout the years of the program, the strategic plan of the Arizona Department of Health Services Bureau of Tobacco

Effect of tobacco control policies on perinatal and child health: a systematic review and meta-analysis

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Faber, T. (Timor); Kumar, A. (Arun); J.P. Mackenbach (Johan); C. Millett (Christopher); Basu, S. (Sanjay); A. Sheikh (Aziz); J.V. Been (Jasper V.)

2017-01-01

textabstractBackground Tobacco smoking and smoke exposure during pregnancy and childhood cause considerable childhood morbidity and mortality. We did a systematic review and meta-analysis to investigate whether implementation of WHO's recommended tobacco control policies (MPOWER) was of benefit to

Predictors of women's attitudes toward world health organization framework convention on tobacco control policies in urban China.

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Abdullah, Abu Saleh; Yang, Tingzhong; Beard, Jennifer

2010-05-01

In 2005 China ratified the WHO Framework Convention on Tobacco Control (FCTC) and committed to implement tobacco control legislation and policies. Wide variation in smoking prevalence between men and women in China and the high exposure of women to secondhand smoke suggest that each component of the FCTC should be analyzed from a gender perspective. This study describes women's attitudes toward and predictors of support for four key FCTC measures in China. Cross-sectional data were collected from 1,408 women in two urban cities on demographics, smoking behavior, and attitudes toward key tobacco control measures. Seventy percent of the study women (n = 1,408) were exposed to secondhand smoke at home, work, or other public places. Support for the four FCTC measures of interest was as follows: 92.5% supported banning smoking in public places, 79.2% supported increasing the cigarette tax, 92% supported stronger health warnings on cigarette packages, and 87.1% favored banning tobacco advertising. The predictors for supporting each of these measures included socioeconomic, attitudinal, and behavioral factors. Urban Chinese women appear to support implementation of key WHO FCTC measures. Predictors of women's attitudes toward the key FCTC measures varied. The formulation process resulting from the tobacco control policy should consider these women-specific predictors in order to facilitate successful implementation of FCTC.

A framework to prevent and control tobacco among adolescents and children: introducing the IMPACT model.

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Arora, Monika; Mathur, Manu Raj; Singh, Neha

2013-03-01

The objective of this paper is to provide a comprehensive evidence based model aimed at addressing multi-level risk factors influencing tobacco use among children and adolescents with multi-level policy and programmatic approaches in India. Evidences around effectiveness of policy and program interventions from developed and developing countries were reviewed using Pubmed, Scopus, Google Scholar and Ovid databases. This evidence was then categorized under three broad approaches: Policy level approaches (increased taxation on tobacco products, smoke-free laws in public places and work places, effective health warnings, prohibiting tobacco advertising, promotions and sponsorships, and restricting access to minors); Community level approaches (school health programs, mass media campaigns, community based interventions, promoting tobacco free norms) and Individual level approaches (promoting cessation in various settings). This review of literature around determinants and interventions was organized into developing the IMPACT framework. The paper further presents a comparative analysis of tobacco control interventions in India vis a vis the proposed approaches. Mixed results were found for prevention and control efforts targeting youth. However, this article suggests a number of intervention strategies that have shown to be effective. Implementing these interventions in a coordinated way will provide potential synergies across interventions. Pediatricians have prominent role in advocating and implementing the IMPACT framework in countries aiming to prevent and control tobacco use among adolescents and children.

To assess control measures for tobacco consumption in Zambia between 2014 and 2017. What are the gaps?

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Davies Kalunga

2018-03-01

Full Text Available Background Cigarette smoking is a leading cause of global morbidity and mortality, in developing countries interest in smoking prevalence has been growing since 1999. Many factors are known to influence smoking prevalence and trends in prevalence, from individual level factors such as education level, to country-level factors such as national economic development and implementation of tobacco control policies, therefore there is need to assess the control measures for tobacco smoking in Zambia between 2014 and 2017and determine the gaps in policy implementation in tobacco consumption in Zambia. Methods This was a retrospective study using policy documents from central statistical office. Results The following gaps were identified in which there was no legislation: concerning Institutions and mechanisms to provide for a funding mechanism, Public education requiring mass public education campaigns to change public attitudes regarding tobacco and tobacco control, Advertising, promotion and sponsorship as a comprehensive ban involves a ban on all forms of direct and indirect advertisements, promotion and sponsorship, Price and tax measures as an effective means of reducing tobacco consumption, especially among young people. Monitoring- No known data or no recent data or data that are not both recent and representative (WHO report on the global tobacco epidemic, 2017. Conclusions The absence of legislation in these areas of institutions and mechanisms, public education, advertising, promotion and sponsorship and the price and tax measures have far reaching consequences in tobacco control in Zambia.

Anti-tobacco control industry strategies in Turkey.

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Keklik, Seda; Gultekin-Karakas, Derya

2018-02-26

Transnational tobacco companies (TTCs) penetrated the Turkish cigarette market due to trade and investment liberalization in the post-1980 period and eventually secured full control. Despite tobacco control policies put in place in reaction to accelerating consumption, TTCs reinforced their market power through a variety of strategies. This paper explores industry strategies that counteract tobacco control policies in Turkey. The study employs both qualitative and quantitative analyses to explore industry strategies in Turkey. Besides the content analyses of industry and market reports, descriptive analyses were conducted for the sub-periods of 1999-2015. The analyses focus on the market strategies of product innovation, advertisement-promotion, cost management and pricing. Rising sales of low tar, ultra-low tar, slim, super-slim and flavoured cigarettes indicate that product innovation served to sustain consumption. Besides, the tobacco industry, using its strong distribution channels, the Internet, and CSR projects, were found to have promoted smoking indirectly. The industry also rationalized manufacturing facilities and reduced the cost of tobacco, making Turkey a cigarette-manufacturing base. Tobacco manufacturers, moreover, offered cigarettes in different price segments and adjusted net prices both up and down according to price categories and market conditions. In response to the successful effect of shifts in price margins, the market share of mid-priced cigarettes expanded while those within the economy category maintained the highest market share. As a result of pricing strategies, net sales revenues increased. Aside from official cigarette sales, the upward trends in the registered and unregistered sales of cigarette substitutes indicate that the demand-side tobacco control efforts remain inadequate. The Turkish case reveals that the resilience of the tobacco industry vis-à-vis mainstream tobacco control efforts necessitates a new policy perspective

Approaches to tobacco control: the evidence base.

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Aquilino, M Lober; Lowe, J B

2004-02-01

Tobacco production, distribution, and use are international issues with significant health and economic implications. This paper provides an overview of the effective approaches to tobacco control including decreasing demand for tobacco products through taxation, consumer education, research, bans on advertising and promotion, warning labels, and restrictions on public smoking. The effectiveness of reducing the supply of tobacco products through prohibition, restrictions on youth access, crop substitution, trade restrictions, and control of smuggling, will also be discussed. Decreasing smoking, particularly among young people, by preventing or delaying initiation, preventing regular use, and increasing cessation through behavioural approaches for all ages is reviewed. Cessation methods including pharmacological approaches, 'quitlines', Internet programmes, and the targeting of specific populations are discussed. Internet availability of tobacco products and sustainability of current efforts are presented as continuing challenges to tobacco control.

Social, economic and legal dimensions of tobacco and its control in South-East Asia region.

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Kyaing, Nyo Nyo; Islam, Md Ashadul; Sinha, Dhirendra N; Rinchen, Sonam

2011-01-01

This paper examines the social, cultural, economic and legal dimensions of tobacco control in the South-East Asia Region in a holistic view through the review of findings from various studies on prevalence, tobacco economics, poverty alleviation, women and tobacco and tobacco control laws and regulations. Methods were Literature review of peer reviewed publications, country reports, WHO publications, and reports of national and international meetings on tobacco and findings from national level surveys and studies. Tobacco use has been a social and cultural part of the people of South-East Asia Region. Survey findings show that 30% to 60% of men and 1.8% to 15.6% of women in the Region use one or the other forms of tobacco products. The complex nature of tobacco use with both smoking and smokeless forms is a major challenge for implementing tobacco control measures. Prevalence of tobacco use is high among the poor and the illiterate. It is higher among males than females but studies show a rising trend among girls and women due to intensive marketing of tobacco products by the tobacco industry. Tobacco users spend a huge percent of their income on tobacco which deprives them and their families of proper nutrition, good education and health care. Some studies of the Region show that cost of treatment of diseases attributable to tobacco use was more than double the revenue that governments received from tobacco taxation. Another challenge the Region faces is the application of uniform tax to all forms of tobacco, which will reduce not only the availability of tobacco products in the market but also control people switching over to cheaper tobacco products. Ten out of eleven countries are Parties to the WHO Framework Convention on Tobacco Control and nine countries have tobacco control legislation. Enforcement of control measures is weak, particularly in areas such as smoke-free environments, advertisement at the point of sale and sale of tobacco to minors. Socio

Tobacco control and cessation in Romania – a situation analysis

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Antigona Trofor

2016-03-01

Full Text Available Romanian expertise in tobacco control and cessation is relatively young, as it has effectively started in the early ‘90’s. Ever since, smoking prevalence in the general population has decreased from 36.1% (48% B/25%F in 2000 to 26.7% (37.4% B/16.7% F in 2012, but it is still high and needs further efforts from the Romanian tobacco control community. Romania has ratified FCTC in May 2003 and has signed it in June 2004. A recent achievement we are all proud of consists of the new law to ban smoking in public places, applied from March 2016, a much stronger law than the past one. However, the future challenges will be to implement and ensure respect of this new law, to avoid its future amendments which already arise at the horizon, but also to introduce new regulation about taxation, illegal cigarettes traffic and e-cigarettes brands. A good point is the national Stop Smoking program that is still running since 2007 in over 50 Romanian smoking cessation centers to almost fully reimburse costs of pharmacotherapy and counselling. The constant preoccupation for education and expertise development inside the Romanian Society of Pulmonologists, in particular through its Tobaccology section established in 2007 is another plus of the Romanian tobacco control society, as well as its numerous alliances with other national and international professionals. This was fructified in various networks that have contributed to producing national smoking cessation guidelines, to creating many partnerships in tobacco control projects and in the newly successful anti-tobacco legislation.

Use of four major tobacco control interventions in New Zealand: a review.

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Wilson, Nick; Thomson, George; Edwards, Richard

2008-06-20

To identify the extent to which four major population-level tobacco control interventions were used in New Zealand from January 2000 to June 2007. We selected the four population-based tobacco control interventions with the strongest evidence base. For each intervention, we undertook literature searches to identify the extent of their use in New Zealand during the study period and made comparisons with the other 29 OECD countries. Increasing the unit price of tobacco: New Zealand has high tobacco prices, but the policy on tax has several limitations relative to best practice within OECD countries. In particular, the high price appears to be shifting many smokers from factory-made cigarettes to loose tobacco, rather than stimulating quitting. Controls on marketing: While New Zealand compares favourably with most other OECD countries for tobacco marketing controls, some jurisdictions have made more progress in specific areas (e.g. eliminating point-of-sale product displays and removing misleading descriptors on packaging). Mass media campaigns: The country routinely invests in these campaigns, but the budget is only around $1.20 per capita per year. Some design aspects of the campaigns are progressive, but comparisons with other countries indicate potential for improvements (e.g. learning from counter-industry campaigns in the USA). Smokefree environments regulations: New Zealand was one of the first OECD countries to implement comprehensive smokefree workplaces legislation (including restaurants and bars) and it still compares well. But gaps remain when compared to some other OECD jurisdictions (e.g. no smokefree car laws). There is still substantial scope for New Zealand to catch up to OECD leaders in these key tobacco control areas. In particular, there needs to be higher tax levels for loose tobacco (relative to factory-made cigarettes) and the elimination of residual marketing. There are also important gaps in exploiting synergies between interventions in this

Addressing the Social Determinants of Health to Reduce Tobacco-Related Disparities.

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Garrett, Bridgette E; Dube, Shanta R; Babb, Stephen; McAfee, Tim

2015-08-01

Comprehensive tobacco prevention and control efforts that include implementing smoke-free air laws, increasing tobacco prices, conducting hard-hitting mass media campaigns, and making evidence-based cessation treatments available are effective in reducing tobacco use in the general population. However, if these interventions are not implemented in an equitable manner, certain population groups may be left out causing or exacerbating disparities in tobacco use. Disparities in tobacco use have, in part, stemmed from inequities in the way tobacco control policies and programs have been adopted and implemented to reach and impact the most vulnerable segments of the population that have the highest rates of smokings (e.g., those with lower education and incomes). Education and income are the 2 main social determinants of health that negatively impact health. However, there are other social determinants of health that must be considered for tobacco control policies to be effective in reducing tobacco-related disparities. This article will provide an overview of how tobacco control policies and programs can address key social determinants of health in order to achieve equity and eliminate disparities in tobacco prevention and control. Tobacco control policy interventions can be effective in addressing the social determinants of health in tobacco prevention and control to achieve equity and eliminate tobacco-related disparities when they are implemented consistently and equitably across all population groups. Taking a social determinants of health approach in tobacco prevention and control will be necessary to achieve equity and eliminate tobacco-related disparities. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Tobacco Use Management System: Analyzing Tobacco Control From a Systems Perspective

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Young, David; Coghill, Ken; Zhang, Jian Ying

2010-01-01

We use systems thinking to develop a strategic framework for analyzing the tobacco problem and we suggest solutions. Humans are vulnerable to nicotine addiction, and the most marketable form of nicotine delivery is the most harmful. A tobacco use management system has evolved out of governments’ attempts to regulate tobacco marketing and use and to support services that provide information about tobacco's harms and discourage its use. Our analysis identified 5 systemic problems that constrain progress toward the elimination of tobacco-related harm. We argue that this goal would be more readily achieved if the regulatory subsystem had dynamic power to regulate tobacco products and the tobacco industry as well as a responsive process for resourcing tobacco use control activities. PMID:20466970

How compliant are tobacco vendors to india's tobacco control legislation on Ban of advertisments at point of sale? A three jurisdictions review.

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Goel, Sonu; Kumar, Ravinder; Lal, Pranay; Tripathi, Jp; Singh, Rana J; Rathinam, Arul; Christian, Anant

2014-01-01

Section 5 of India's tobacco control legislation "Cigarettes and Other Tobacco Products Act (COTPA), 2003"comprehensively prohibits all kinds of tobacco advertisement, promotion and sponsorship (TAPS), but permits advertisments at the point-of-sale (POS) under certain conditions. This provision has been exploited by the tobacco companies to promote their products. To measure compliance with the provisions of Section 5 of Indian tobacco control legislation (COTPA, 2003) at point of sale. A cross-sectional survey using an observation checklist was conducted in 1860 POS across three jurisdictions (Chennai city, District Vadodara and District Mohali) in India. The most common mode of advertisement of tobacco products was product showcasing (51.1%), followed by dangles (49.6%), stickers (33.8%) and boards (27.1%). More than one fourth of POS were found violating legal provisions for displaying advertisement boards in one or other forms (oversized, extended to full body lenth of POS, displayed brandname/ packshot and promotional messages). Advertisement boards (16.3%) without health warnings were also found and wherever found, more than 90% health warning were not as per the specification in respect to size, font and background color. Point of sale advertising is aggressively used by the tobacco industry to promote their products. There is an urgent need of effective implementation of a comprehensive ban on tobacco product advertisement, promotion and sponsorship at point of sale.

Tobacco taxation: the importance of earmarking the revenue to health care and tobacco control.

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Vardavas, Constantine I; Filippidis, Filippos T; Agaku, Israel; Mytaras, Vasileios; Bertic, Monique; Connolly, Gregory N; Tountas, Yannis; Behrakis, Panagiotis

2012-01-01

Increases in tobacco taxation are acknowledged to be one of the most effective tobacco control interventions. This study aimed at determining the mediating role of socioeconomical status (SES) and the earmarking of revenue to healthcare and tobacco control, in influencing population support for the adoption of a 2 Euro tobacco tax increase in Greece, amid the challenging economic environment and current austerity measures. Data was collected from two national household surveys, the "Hellas Health III" survey, conducted in October 2010 and the "Hellas Tobacco survey" conducted in September 2012. Data was analyzed from 694 and 1066 respondents aged 18 years or more, respectively. Logistic regression models were fitted to measure the adjusted relationship between socio-economic factors for the former, and support for increased taxation on tobacco products for the latter. In 2012 amidst the Greek financial crisis, population support for a flat two euro tax increase reached 72.1%, if earmarked for health care and tobacco control, a percentage high both among non-smokers (76%) and smokers (64%) alike. On the contrary, when not earmarked, only 43.6% of the population was in support of the equivalent increase. Women were more likely to change their mind and support a flat two-euro increase if the revenue was earmarked for health care and tobacco control (aOR = 1.70; 95% C.I: 1.22-2.38, p = 0.002). Furthermore, support for an increase in tobacco taxation was not associated with SES and income. Despite dire austerity measures in Greece, support for an increase in tobacco taxation was high among both smokers and non-smokers, however, only when specifically earmarked towards health care and tobacco control. This should be taken into account not only in Greece, but within all countries facing social and economic reform.

Implementation of the Tobacco-Free Campus Policy on College Campuses: Evidence From a Survey of College Students in Beijing.

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Gong, Min; Liang, Zhu-Yuan; Zhang, Yang-Yang; Shadel, William G; Zhou, Lei; Xiao, Jiaying

2016-11-01

China issued a nationwide "Tobacco-Free Campus" Policy (TFCP) in January 2014, but it is unclear how well it was implemented across China's 2138 college campuses. We conducted an Internet survey of Beijing college students to evaluate the implementation of the TFCP in Beijing. An Internet survey of 711 students from 37 colleges in Beijing was conducted in May 2015. Respondents reported on secondhand smoking (SHS) exposure on campus, knowledge on and actions taken against SHS, and tobacco marketing exposure on campus. Almost 90% of respondents were exposed to SHS on campus at least once in the past month. Approximately 37% of nonsmokers and 61% of smokers reported seeing a teacher smoking, and the majority of both smokers and nonsmokers reported seeing a classmate smoking in campus buildings. The likelihood and location of SHS exposure depend on the participant's demographics and own smoking behavior. Nonsmokers were more likely to be aware of the health risk of SHS than smokers. Although most participants were aware of the harms, only 13% and 9% tried to stop their last SHS exposure indoors and outdoors, respectively. Forty-seven students from 14 colleges noticed tobacco marketing activities on campus. The TFCP on Chinese college campuses was only partially enforced, particularly with regard to SHS. On January 29, 2014, the Chinese Ministry of Education issued the TFCP. A major barrier to effective tobacco control in China is the difficulty in implementing policies issued by the central government. At this point, it is unclear whether the TFCP was successfully implemented on China's college campuses. Major tobacco use monitoring efforts do not include college students. The present research describes the current tobacco control environment on Beijing's college campuses 15 months after the TFCP took effect. To our knowledge, this is the first paper in the English literature on tobacco environment and exposure (rather than a prevalence survey) of college students in

Linking Global Youth Tobacco Survey (GYTS) data to the WHO Framework Convention on Tobacco Control (FCTC): the case for the Seychelles.

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Viswanathan, Bharathi; Warren, Charles W; Jones, Nathan R; Asma, Samira; Bovet, Pascal

2008-09-01

Tobacco control has been recognized as a main public health concern in Seychelles for the past two decades. Tobacco advertising, sponsoring and promotion has been banned for years, tobacco products are submitted to high taxes, high-profile awareness programs are organized regularly, and several other control measures have been implemented. The Republic of Seychelles was the first country to ratify the WHO Framework Convention on Tobacco Control (FCTC) in the African region. Three population-based surveys have been conducted in adults in Seychelles and results showed a substantial decrease in the prevalence of smoking among adults between 1989 and 2004. A first survey in adolescents was conducted in Seychelles in 2002 (the Global Youth Tobacco Survey, GYTS) in a representative sample of 1321 girls and boys aged 13-15 years. The results show that approximately half of students had tried smoking and a quarter of both boys and girls had smoked at least one cigarette during the past 30 days. Although "current smoking" is defined differently in adolescents (>or=1 cigarette during the past 30 days) and in adults (>or=1 cigarette per day), which precludes direct comparison, the high smoking prevalence in youth in Seychelles likely predicts an increasing prevalence of tobacco use in the next adult generation, particularly in women. GYTS 2002 also provides important data on a wide range of specific individual and societal factors influencing tobacco use. Hence, GYTS can be a powerful tool for monitoring the situation of tobacco use in adolescents, for highlighting the need for new policy and programs, and for evaluating the impact of current and future programs.

Exposure to tobacco marketing and support for tobacco control policies.

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Hammond, David; Costello, Mary-Jean; Fong, Geoffrey T; Topham, Jennifer

2006-01-01

To examine the salience of tobacco marketing on postsecondary campuses and student support for tobacco control policies. Face-to-face surveys were conducted with 1690 students at 3 universities in southwestern Ontario. Virtually all (97%) students reported noticing tobacco marketing in the past year, and 35% reported noticing marketing on campus. There was strong support for smoke-free restrictions on campus, including restaurants and bars (82%), and for prohibitions on campus marketing. The presence of campus policies was associated with reduced exposure to marketing and increased policy support. There is strong support among students to remove tobacco marketing from campus and to introduce comprehensive smoke-free restrictions.

New Zealand tobacco retailers' attitudes to selling tobacco, point-of-sale display bans and other tobacco control measures: a qualitative analysis.

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Jaine, Richard; Russell, Marie; Edwards, Richard; Thomson, George

2014-06-20

We aimed to explore New Zealand tobacco retailers' views on selling tobacco, the forthcoming 2012 point of sale display ban and two other potential tobacco control interventions in the retail setting: compulsory sales of nicotine replacement therapy and licensing of tobacco retailers. We carried out in-depth interviews with 18 retailers from a variety of store types where tobacco was sold. Stores were selected from a range of locations with varying levels of deprivation. We used thematic analysis to analyse the data. All but four of the retailers were ambivalent about selling tobacco, would rather not sell it, or fell back on a business imperative for justification. Only one retailer was explicitly unconcerned about selling tobacco products. Most participants had few or no concerns about the removal of point-of-sale displays. Issues which were raised were mainly practical and logistical issues with the removal of displays. Only three thought sales would definitely be reduced. The majority of the retailers were not opposed to a possible requirement that nicotine replacement therapy products be made available wherever tobacco products are sold. Ten supported a licensing or registration scheme for tobacco retailers, and only three were opposed. We found widespread ambivalence about selling tobacco. There was considerable support for the licensing of tobacco retailers and other potential tobacco control measures. The retailers' attitudes about potential financial costs and security issues from a tobacco display ban were at odds with the tobacco industry predictions and the views of retailers' organisations. Some retailers appear to be potential allies for tobacco control. This is in contrast to retailer organisations, which may be out of step with many of their members in their strong opposition to retail tobacco control interventions.

The role of tobacco-specific media exposure, knowledge, and smoking status on selected attitudes toward tobacco control.

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Blake, Kelly D; Viswanath, K; Blendon, Robert J; Vallone, Donna

2010-02-01

In August 2007, the President's Cancer Panel urged the leadership of the nation to "summon the political will to address the public health crisis caused by tobacco use" (President's Cancer Panel, N, 2007, Promoting healthy lifestyles: Policy, program, and personal recommendations for reducing cancer risk. http://deainfo.nci.nih.gov/advisory/pcp/pcp07rpt/pcp07rpt.pdf). While some research has examined predictors of public support for tobacco control measures, little research has examined modifiable factors that may influence public attitudes toward tobacco control. We used the American Legacy Foundation's 2003 American Smoking and Health Survey 2 to examine the contribution of smoking status, knowledge of the negative effects of tobacco, and tobacco-specific media exposure (antitobacco messages, news coverage of tobacco issues, and protobacco advertising) on U.S. adults' attitudes toward tobacco control. In addition, we assessed whether smoking status moderates the relationship between tobacco-specific media exposure and policy attitudes. Weighted multivariable logistic regression models were employed. Results suggest that knowledge of the negative effects of tobacco and smoking status are associated with attitudes toward tobacco control and that exposure to tobacco-specific information in the media plays a role only in some instances. We found no evidence of effect modification by smoking status on the impact of exposure to tobacco-specific media on attitudes toward tobacco control. Understanding the impact of readily modifiable factors that shape policy attitudes is essential if we are to target outreach and education in a way that is likely to sway public support for tobacco control.

Military exceptionalism or tobacco exceptionalism: How civilian health leaders' beliefs may impede military tobacco control efforts

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Smith, EA; Malone, RE

2013-01-01

Smoking impairs the readiness and performance of military personnel, yet congressional opposition has thwarted military tobacco control initiatives. Involvement of civilian organizations might alter this political dynamic. We interviewed 13 leaders of national civilian public health and tobacco control organizations to explore their perspectives on military tobacco control, inductively analyzing data for themes. Leaders believed that military tobacco use was problematic but lacked specific kn...

Evaluation of Tobacco Control Policies in Bangladesh | CRDI ...

International Development Research Centre (IDRC) Digital Library (Canada)

Evaluation of Tobacco Control Policies in Bangladesh. Bangladesh introduced its first comprehensive tobacco control act in 2005, in an attempt to address the country's high prevalence of tobacco use. ... Institution. University of Dhaka. Pays d' institution. Bangladesh. Site internet. http://www.univdhaka.edu ...

Enhanced Tobacco Control Initiative at Johns Hopkins Health System: Employee Fairness Perception.

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Durrani, Shabnum; Lucik, Meg; Safeer, Richard

2018-02-01

Organizations often fail to establish a clear awareness of what employees consider fair when implementing changes to employee benefits in the workplace. In 2016, the Johns Hopkins Health System (JHHS) enhanced their tobacco control efforts. In addition to enhanced smoking cessation benefits, employees were offered an increased reduction in their insurance premiums if they were nonsmokers. To qualify for the reduction, employees participated in testing rather than relying on self-reporting as had been done in the past. The shift to testing prompted a concern by some senior management at JHHS who did not want employees to feel they were not trusted. As the program unfolded at JHHS, the four-component model of procedural justice was applied to provide a framework for reviewing the implementation of the new voluntary tobacco testing at JHHS from a fairness lens. The purpose of this article is to illustrate the application of the four-component procedural model of justice to the tobacco testing process at JHHS. As approximately 75% of employees participated in the program, the experience at JHHS can be instructive to other employers who are looking to implement changes in their workplaces and how to minimize unintended consequences with their employees.

Selected aspects of tobacco control in Croatia.

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Loubeau, Patricia R

2009-03-01

This paper seeks to outline the challenges of tobacco consumption control in the transitional economy of Croatia. It focuses on issues of taxation, high unemployment, and smuggling while attempting to meet European Union (EU) accession requirements for tobacco control legislation that reduces smoking consumption. The issue of tobacco control is not a simple one and requires a multi-pronged approach. While Croatia has made good progress in adopting legislation, it needs to strengthen its efforts both in terms of enforcement and increased taxation of cigarettes.

Local Nordic tobacco interests collaborated with multinational companies to maintain a united front and undermine tobacco control policies.

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Hiilamo, Heikki; Glantz, Stanton A

2013-03-01

To analyse how local tobacco companies in the Nordic countries, individually and through National Manufacturers' Associations, cooperated with British American Tobacco and Philip Morris in denying the health hazards of smoking and undermining tobacco control. Analysis of tobacco control policies in the Nordic countries and tobacco industry documents. Nordic countries were early adopters of tobacco control policies. The multinational tobacco companies recognised this fact and mobilised to oppose these policies, in part because of fear that they would set unfavourable precedents. Since at least 1972, the Nordic tobacco companies were well informed about and willing to participate in the multinational companies activities to obscure the health dangers of smoking and secondhand smoke and to oppose tobacco control policies. Cooperation between multinational companies, Nordic national manufacturer associations and local companies ensured a united front on smoking and health issues in the Nordic area that was consistent with the positions that the multinational companies were taking. This cooperation delayed smoke-free laws and undermined other tobacco control measures. Local tobacco companies worked with multinational companies to undermine tobacco control in distant and small Nordic markets because of concern that pioneering policies initiated in Nordic countries would spread to bigger market areas. Claims by the local Nordic companies that they were not actively involved with the multinationals are not supported by the facts. These results also demonstrate that the industry appreciates the global importance of both positive and negative public health precedents in tobacco control.

Tobacco industry manipulation of tobacco excise and tobacco advertising policies in the Czech Republic: an analysis of tobacco industry documents.

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Risako Shirane

Full Text Available The Czech Republic has one of the poorest tobacco control records in Europe. This paper examines transnational tobacco companies' (TTCs' efforts to influence policy there, paying particular attention to excise policies, as high taxes are one of the most effective means of reducing tobacco consumption, and tax structures are an important aspect of TTC competitiveness.TTC documents dating from 1989 to 2004/5 were retrieved from the Legacy Tobacco Documents Library website, analysed using a socio-historical approach, and triangulated with key informant interviews and secondary data. The documents demonstrate significant industry influence over tobacco control policy. Philip Morris (PM ignored, overturned, and weakened various attempts to restrict tobacco advertising, promoting voluntary approaches as an alternative to binding legislation. PM and British American Tobacco (BAT lobbied separately on tobacco tax structures, each seeking to implement the structure that benefitted its own brand portfolio over that of its competitors, and enjoying success in turn. On excise levels, the different companies took a far more collaborative approach, seeking to keep tobacco taxes low and specifically to prevent any large tax increases. Collective lobbying, using a variety of arguments, was successful in delaying the tax increases required via European Union accession. Contrary to industry arguments, data show that cigarettes became more affordable post-accession and that TTCs have taken advantage of low excise duties by raising prices. Interview data suggest that TTCs enjoy high-level political support and continue to actively attempt to influence policy.There is clear evidence of past and ongoing TTC influence over tobacco advertising and excise policy. We conclude that this helps explain the country's weak tobacco control record. The findings suggest there is significant scope for tobacco tax increases in the Czech Republic and that large (rather than small

Tobacco industry manipulation of tobacco excise and tobacco advertising policies in the Czech Republic: an analysis of tobacco industry documents.

Science.gov (United States)

Shirane, Risako; Smith, Katherine; Ross, Hana; Silver, Karin E; Williams, Simon; Gilmore, Anna

2012-01-01

The Czech Republic has one of the poorest tobacco control records in Europe. This paper examines transnational tobacco companies' (TTCs') efforts to influence policy there, paying particular attention to excise policies, as high taxes are one of the most effective means of reducing tobacco consumption, and tax structures are an important aspect of TTC competitiveness. TTC documents dating from 1989 to 2004/5 were retrieved from the Legacy Tobacco Documents Library website, analysed using a socio-historical approach, and triangulated with key informant interviews and secondary data. The documents demonstrate significant industry influence over tobacco control policy. Philip Morris (PM) ignored, overturned, and weakened various attempts to restrict tobacco advertising, promoting voluntary approaches as an alternative to binding legislation. PM and British American Tobacco (BAT) lobbied separately on tobacco tax structures, each seeking to implement the structure that benefitted its own brand portfolio over that of its competitors, and enjoying success in turn. On excise levels, the different companies took a far more collaborative approach, seeking to keep tobacco taxes low and specifically to prevent any large tax increases. Collective lobbying, using a variety of arguments, was successful in delaying the tax increases required via European Union accession. Contrary to industry arguments, data show that cigarettes became more affordable post-accession and that TTCs have taken advantage of low excise duties by raising prices. Interview data suggest that TTCs enjoy high-level political support and continue to actively attempt to influence policy. There is clear evidence of past and ongoing TTC influence over tobacco advertising and excise policy. We conclude that this helps explain the country's weak tobacco control record. The findings suggest there is significant scope for tobacco tax increases in the Czech Republic and that large (rather than small, incremental

TPPA and tobacco control: threats to APEC countries.

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Sy, Deborah K; Stumberg, Robert K

2014-11-01

Twelve-member countries of the Asia Pacific Economic Cooperation (APEC) are negotiating the Trans-Pacific Partnership Agreement (TPPA), a free trade agreement to facilitate international trade and investment. As reported by multiple sources, the TPPA would grant the same trade benefits and legal protections to tobacco products, services and investments that it would provide to other sectors. Malaysia proposed excluding tobacco control measures from the scope of all TPPA chapters while the US proposed only to establish a consultation process in tobacco-related disputes and to declare that tobacco control measures serve a health objective within the scope of the general exceptions. The article analyses selected TPPA trade and investment rules and shows how they strengthen the ability of tobacco companies or a country to challenge the most progressive tobacco control measures. In the absence of a complete TPPA text, the analysis is based on specific leaked chapters, legal analysis from observers in the negotiations, existing free trade agreements among the TPPA parties and positions of the tobacco industry and its allies. Five TPPA chapters pose the most significant threats to tobacco control measures: Investment, Regulatory Coherence, Services, Intellectual Property and Technical Barriers to Trade. Trade negotiators should expand safeguards to ensure that the TPPA does no harm. The most effective would be to exclude (carve out) tobacco control measures from the scope of all TPPA chapters, as Malaysia has proposed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Local Nordic tobacco interests collaborated with multinational companies to maintain a united front and undermine tobacco control policies

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Hiilamo, Heikki; Glantz, Stanton A

2012-01-01

Objective To analyse how local tobacco companies in the Nordic countries, individually and through National Manufacturers’ Associations, cooperated with British American Tobacco and Philip Morris in denying the health hazards of smoking and undermining tobacco control. Methods Analysis of tobacco control policies in the Nordic countries and tobacco industry documents. Results Nordic countries were early adopters of tobacco control policies. The multinational tobacco companies recognised this fact and mobilised to oppose these policies, in part because of fear that they would set unfavourable precedents. Since at least 1972, the Nordic tobacco companies were well informed about and willing to participate in the multinational companies activities to obscure the health dangers of smoking and secondhand smoke and to oppose tobacco control policies. Cooperation between multinational companies, Nordic national manufacturer associations and local companies ensured a united front on smoking and health issues in the Nordic area that was consistent with the positions that the multinational companies were taking. This cooperation delayed smoke-free laws and undermined other tobacco control measures. Conclusions Local tobacco companies worked with multinational companies to undermine tobacco control in distant and small Nordic markets because of concern that pioneering policies initiated in Nordic countries would spread to bigger market areas. Claims by the local Nordic companies that they were not actively involved with the multinationals are not supported by the facts. These results also demonstrate that the industry appreciates the global importance of both positive and negative public health precedents in tobacco control. PMID:22199013

From Tobacco to Obesity Prevention Policies: A Framework for Implementing Community-Driven Policy Change.

Science.gov (United States)

Walter, Lauren; Dumke, Kelly; Oliva, Ariana; Caesar, Emily; Phillips, Zoë; Lehman, Nathan; Aragon, Linda; Simon, Paul; Kuo, Tony

2018-04-01

Efforts to reverse the obesity epidemic require policy, systems, and environmental (PSE) change strategies. Despite the availability of evidence-based and other promising PSE interventions, limited evidence exists on the "how-to" of transitioning them into practice. For the past 13 years, the Los Angeles County Department of Public Health has been building capacity among community residents and other stakeholders to create effective community coalitions and to implement well-designed policy strategy campaigns using an evidence-based approach to policy change, the policy adoption model (PAM). Implementing a phase-based approach to policy change, the PAM was initially used to support the passage of over 140 tobacco control and prevention policies in Los Angeles County. Following these successes, Los Angeles County Department of Public Health applied the PAM to obesity prevention, operationalizing the policy process by training community residents and other stakeholders on the use of the model. The PAM has shown to be helpful in promoting PSE change in tobacco control and obesity prevention, suggesting a local-level model potentially applicable to other fields of public health seeking sustainable, community-driven policy change.

[A return on investment tool in tobacco control: what do stakeholders think?].

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Muñoz, Celia; Trapero-Bertran, Marta; Cheung, Kei Long; Evers, Silvia; Hiligsmann, Mickaël; de Vries, Hein; López-Nicolás, Ángel

2016-01-01

The European EQUIPT study will co-create a return on investment tool in several countries, aiming to provide decision makers with information and justification on the returns that can be generated by investing in tobacco control. This study aimed to identify the needs of potential users in Spain in order to provide information on the transferability of the tool. Telephone interviews with stakeholders were conducted including questions about the implementation of the tool, intended use and tobacco control interventions. Implementing the tool could provide added value to the information used in decision-making to advocate for cost-effective policies. The main drawback would be the training and time needed to learn how the tool works and for internal calculations. Knowledge and ideas from potential users collected in this study could inform the EQUIPT Tool adaptation. Thus, stakeholders could have an instrument that assists them on making healthcare decisions. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Cost-effectiveness analysis of population-based tobacco control strategies in the prevention of cardiovascular diseases in Tanzania.

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Frida Ngalesoni

Full Text Available Tobacco consumption contributes significantly to the global burden of disease. The prevalence of smoking is estimated to be increasing in many low-income countries, including Tanzania, especially among women and youth. Even so, the implementation of tobacco control measures has been discouraging in the country. Efforts to foster investment in tobacco control are hindered by lack of evidence on what works and at what cost.We aim to estimate the cost and cost-effectiveness of population-based tobacco control strategies in the prevention of cardiovascular diseases (CVD in Tanzania.A cost-effectiveness analysis was performed using an Excel-based Markov model, from a governmental perspective. We employed an ingredient approach and step-down methodologies in the costing exercise following a government perspective. Epidemiological data and efficacy inputs were derived from the literature. We used disability-adjusted life years (DALYs averted as the outcome measure. A probabilistic sensitivity analysis was carried out with Ersatz to incorporate uncertainties in the model parameters.Our model results showed that all five tobacco control strategies were very cost-effective since they fell below the ceiling ratio of one GDP per capita suggested by the WHO. Increase in tobacco taxes was the most cost-effective strategy, while a workplace smoking ban was the least cost-effective option, with a cost-effectiveness ratio of US$5 and US$267, respectively.Even though all five interventions are deemed very cost-effective in the prevention of CVD in Tanzania, more research on budget impact analysis is required to further assess the government's ability to implement these interventions.

Whither tobacco product regulation?

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McNeill, Ann; Hammond, David; Gartner, Coral

2012-03-01

Despite decades of industry innovation and regulatory efforts, the harmfulness of conventional cigarettes has not changed. There are several pitfalls in this area, including the long time lag before health impacts of product regulatory changes become apparent, the danger of consumers deriving false reassurance of lesser harm in the interim period, the lack of relevant expertise and the lack of an internationally agreed and evidence-based strategic approach. Articles 9 and 10 of the Framework Convention on Tobacco Control provide the potential for such a global strategy, and knowledge and research has increased significantly over recent years. However, there are huge opportunity costs in implementing product disclosure and regulatory strategies: most national regulators have very limited human and financial resources, which should be focused on other evidence-based tobacco control interventions. We believe therefore that it is now time to abandon the notion of safe or safer cigarettes while moving consumers towards cleaner nicotine products as soon as possible. In parallel to this, we recommend a number of other strategies be implemented including: reducing the appeal of all tobacco products, forbidding new tobacco products or brand variants being marketed without evidence of reduced harm, appeal or addictiveness, and developing a tobacco industry resourced, but industry independent, Framework Convention on Tobacco Control global repository to assist national regulators in understanding and regulating the products on their markets.

Public health aspects of tobacco control revisited

NARCIS (Netherlands)

Gallagher, Jennifer E.; Alajbeg, Ivan; Buechler, Silvia; Carrassi, Antonio; Hovius, Marjolijn; Jacobs, Annelies; Jenner, Maryan; Kinnunen, Taru; Ulbricht, Sabina; Zoitopoulos, Liana

The tobacco epidemic presents a major public health challenge, globally, and within Europe. The aim of the Public Health Work Stream at the 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals was to review the public health aspects of tobacco control and make

EUREST PLUS - European Regulatory Science on Tobacco: Policy implementation to reduce lung diseases - Proposal (Horizon2020

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Constantine Vardavas

2016-03-01

Full Text Available EUREST-PLUS, a thirteen –partner EU joint proposal, coordinated by ENSP (Coordinator: Constantine Vardavas, aims to monitor and evaluate the impact of the TPD at an EU level. The specific objectives of the proposal are: 1. To evaluate the psychosocial and behavioural impact of TPD implementation and FCTC implementation, through the creation of a longitudinal cohort of adult smokers in 6 EU MS (Germany, Greece, Hungary, Poland, Romania, Spain in a pre- vs. post- study design. 2. To assess support for TPD implementation through secondary dataset analyses of the 2015 Special Eurobarometer on Tobacco Survey (SETS, and through trend analyses on the merged datasets of the 2009, 2012 and2015 SETS datasets. 3. To document changes in e-cigarette product parameters (technical design, labelling, packaging and chemical composition following implementation of Article 20 of the TPD. 4. To enhance innovative joint research collaborations, through the pooling and comparisons across both other EU countries of the International Tobacco Control (ITC Project, and other non-EU countries.

Application of the Consolidated Framework for Implementation Research to assess factors that may influence implementation of tobacco use treatment guidelines in the Viet Nam public health care delivery system.

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VanDevanter, Nancy; Kumar, Pritika; Nguyen, Nam; Nguyen, Linh; Nguyen, Trang; Stillman, Frances; Weiner, Bryan; Shelley, Donna

2017-02-28

Services to treat tobacco dependence are not readily available to smokers in low-middle income countries (LMICs) where smoking prevalence remains high. We are conducting a cluster randomized controlled trial comparing the effectiveness of two strategies for implementing tobacco use treatment guidelines in 26 community health centers (CHCs) in Viet Nam. Guided by the Consolidated Framework for Implementation Research (CFIR), prior to implementing the trial, we conducted formative research to (1) identify factors that may influence guideline implementation and (2) inform further modifications to the intervention that may be necessary to translate a model of care delivery from a high-income country (HIC) to the local context of a LMIC. We conducted semi-structured qualitative interviews with CHC medical directors, health care providers, and village health workers (VHWs) in eight CHCs (n = 40). Interviews were transcribed verbatim and translated into English. Two qualitative researchers used both deductive (CFIR theory driven) and inductive (open coding) approaches to analysis developed codes and themes relevant to the aims of this study. The interviews explored four out of five CFIR domains (i.e., intervention characteristics, outer setting, inner setting, and individual characteristics) that were relevant to the analysis. Potential facilitators of the intervention included the relative advantage of the intervention compared with current practice (intervention characteristics), awareness of the burden of tobacco use in the population (outer setting), tension for change due to a lack of training and need for skill building and leadership engagement (inner setting), and a strong sense of collective efficacy to provide tobacco cessation services (individual characteristics). Potential barriers included the perception that the intervention was more complex (intervention characteristic) and not necessarily compatible (inner setting) with current workflows and staffing

Tobacco smoking: How far do the legislative control measures address the problem?

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Jiloha, Ram C.

2012-01-01

India ratified the WHO's Framework Convention on Tobacco Control in February 2004 and enacted legislation called, “Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act 2003” which specifically called for an end to direct and indirect form of tobacco advertisements. Under its Section 7, the Act also stipulates depiction of pictorial health warnings on all tobacco products. Since the enactment of the legislation, the tobacco companies are prohibited from any kind of advertisement. However, studies show that the instances of showing smoking in movies have increased significantly to 89% after the implementation of the Act. The brand placement has been also increased nearly three folds. Association of tobacco with glamour and style has also been established. Seventy-five percent of movies have showed the lead character smoking tobacco. The instances of females consuming tobacco in movies have also increased, pointing toward a specific market expansion strategy by tobacco companies using movies as a vehicle. General public does not feel that banning tobacco scenes in the movie will affect their decision to watch movies or the quality of movies. It was found that favorable images through mass media created a considerable influence on youngsters and increased their receptivity to tobacco smoking. Pictorial warning on tobacco products is yet to start. Tobacco industry's opposition to tobacco health warnings is understandable as it will adversely affect their business. However, policymakers should not evade their responsibility to mandate strong health warnings on all tobacco product packs. Legal action against offenders, investigation of the relationship and financial irregularities between film-makers and tobacco industry, and recall of the movies showing tobacco brand are the important measures recommended. PMID:22556442

Results from an evaluation of tobacco control policies at the 2010 Shanghai World Expo.

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Li, Xiang; Zheng, PinPin; Fu, Hua; Berg, Carla; Kegler, Michelle

2013-09-01

Large-scale international events such as World Expos and Olympic Games have the potential to strengthen smoke-free norms globally. The Shanghai 2010 World Expo was one of the first large-scale events to implement and evaluate the adoption of strict tobacco control policies. To evaluate implementation of tobacco control policies at the 2010 World Expo in Shanghai, China. This mixed methods evaluation was conducted from July to October 2010. Observations were conducted in all 155 pavilions and outdoor queuing areas, all 45 souvenir shops, a random sample of restaurants (51 of 119) and selected outdoor non-smoking areas in all sections of the Expo. In addition, intercept surveys were completed with 3022 visitors over a 4-month period. All pavilions and souvenir shops were smoke-free. Restaurants were smoke-free, with only 0.1% of customers observed smoking. Smoking was more common in outdoor non-smoking areas, but still relatively rare overall with only 4.5% of visitors observed smoking. Tobacco products were not sold or marketed in any public settings except for three pavilions that had special exemptions from the policy. Overall, 80.3% of visitors were aware of the smoke-free policy at the World Expo, 92.5% of visitors supported the policy and 97.1% of visitors were satisfied with the smoke-free environment. Tobacco control policies at the World Expo sites were generally well-enforced and accepted although compliance was not 100%, particularly in outdoor non-smoking areas.

Assessing implementation difficulties in tobacco use prevention and cessation counselling among dental providers

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Murtomaa Heikki

2011-05-01

Full Text Available Abstract Background Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. Methods A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73 and dental hygienists (n = 22 in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%. We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Results Internal consistency values for theoretical domains varied from 0.50 ('emotion' to 0.71 ('environmental context and resources'. The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4 and was identified as a potential implementation difficulty. The domain emotion

Assessing implementation difficulties in tobacco use prevention and cessation counselling among dental providers.

Science.gov (United States)

Amemori, Masamitsu; Michie, Susan; Korhonen, Tellervo; Murtomaa, Heikki; Kinnunen, Taru H

2011-05-26

Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC) counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73) and dental hygienists (n = 22) in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%). We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Internal consistency values for theoretical domains varied from 0.50 ('emotion') to 0.71 ('environmental context and resources'). The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4) and was identified as a potential implementation difficulty. The domain emotion provided the highest mean score (60%; 95% CI, 55

Political economy of tobacco control policy on public health in Japan.

Science.gov (United States)

Desapriya, E B R; Iwase, Nobutada; Shimizu, Shinji

2003-02-01

Tobacco use, particularly smoking, remains the number one cause of preventable disease and mortality in Japan. This review of the tobacco control policy and public health is the first to offer a composite review of the subject within Japan. This review attempts to evaluate the most important aspects of the current political economy of the tobacco control policy, and concludes that more effective control policies must be employed to minimize the impact of smoking on the public's health in Japan. Further the article attempts to place the approaches in the larger context of tobacco control, providing a vision for the future of tobacco prevention and control based on current knowledge. Tobacco use will remain the leading cause of preventable illness and death in Japan, until tobacco prevention and control efforts are commensurate with the harm caused by tobacco. Taken together, the results of various studies have clearly shown that control measures can influence tobacco smoking patterns, and in turn, the rate of tobacco-related problems. Government tobacco taxes have not kept pace with inflation for years. Availability of tobacco is virtually unlimited with easy access and the prices being very low due to the strong currency of Japan. Thus Japan must be one of the most tobacco accessible countries. It is important to ensure that people are not conditioned to smoke tobacco by an unduly favourable economic and commercial environment. For that reason, prevention advocates have called for substantial regulation of tobacco products and appeal for both tobacco tax increases and tobacco taxes to be indexed to inflation. In this review, present tobacco related public health policies in Japan are discussed with implication for prevention of tobacco related problems. Continued research in this area will be necessary to determine the most effective policies of reducing tobacco related problems in Japan.

Effect of nation-wide tobacco control policies on smoking cessation in high and low educated groups in 18 European countries

DEFF Research Database (Denmark)

Schaap, Maartje M; Kunst, Anton E; Leinsalu, Mall

2008-01-01

BACKGROUND: Recently a scale was introduced to quantify the implementation of tobacco control policies at country level. Our study used this scale to examine the potential impact of these policies on quit ratios in European countries. Special attention was given to smoking cessation among lower......-smokers divided by total ever-smokers. In regression analyses we explored the correlation between national quit ratios and the national score on the Tobacco Control Scale. RESULTS: Quit ratios were especially high (>45%) in Sweden, England, Netherlands, Belgium and France, and relatively low (... quit ratios than countries with less developed tobacco control policies. High and low educated smokers benefit about equally from the nation-wide tobacco control policies....

Point of sale tobacco advertisements in India.

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Chaudhry, S; Chaudhry, S; Chaudhry, K

2007-01-01

The effect of any legislation depends on its implementation. Limited studies indicate that tobacco companies may tend to use such provision for surrogate advertising. The point of sale advertisement provision has been placed in the Indian Tobacco Control legislation. The study was undertaken to assess the Indian scenario in this regard. To assess if there are any violations related to provision of point of tobacco sale advertisements under India's comprehensive tobacco Control legislation in different parts of India. Boards over various shops showing advertisements of tobacco products were observed in the cities of Delhi, Mumbai, Kolkata, Trivandrum and Jaipur, between September 2005 and March 2006. The point of sale advertisements mushroomed after the implementation of 2004 tobacco control legislation. Tobacco advertisement boards fully satisfying the point of sale provision were practically non-existent. The most common violation of point of sale advertisements was the larger size of the board but with tobacco advertisement equal to the size indicated in the legislation and remaining area often showing a picture. Invariably two boards were placed together to provide the impression of a large single repetitive advertisement. More than two boards was not common. Tobacco advertisement boards were also observed on closed shops/ warehouses, shops not selling tobacco products and on several adjacent shops. The purpose of the point of sale advertisements seems to be surrogate advertisement of tobacco products, mainly cigarettes.

Mexico SimSmoke: how changes in tobacco control policies would impact smoking prevalence and smoking attributable deaths in Mexico.

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Fleischer, Nancy L; Thrasher, James F; Reynales-Shigematsu, Luz Myriam; Cummings, K Michael; Meza, Rafael; Zhang, Yian; Levy, David T

2017-07-01

We examined the effect of tobacco control policies in Mexico on smoking prevalence and smoking-related deaths using the Mexico SimSmoke model. The model is based on the previously developed SimSmoke simulation model of tobacco control policy, and uses population size, smoking rates and tobacco control policy data for Mexico. It assesses, individually, and in combination, the effect of six tobacco control policies on smoking prevalence and smoking-related deaths. Policies included: cigarette excise taxes, smoke-free laws, anti-smoking public education campaigns, marketing restrictions, access to tobacco cessation treatments and enforcement against tobacco sales youth. The model estimates that, if Mexico were to adopt strong tobacco control policies compared to current policy levels, smoking prevalence could be reduced by 30% in the next decade and by 50% by 2053; an additional 470,000 smoking-related premature deaths could be averted over the next 40 years. The greatest impact on smoking and smoking-related deaths would be achieved by raising excise taxes on cigarettes from 55% to at least 70% of the retail price, followed by strong youth access enforcement and access to cessation treatments. Implementing tobacco control policies in Mexico could reduce smoking prevalence by 50%, and prevent 470,000 smoking-related deaths by 2053.

Implementing tobacco use treatment guidelines in public health dental clinics in New York City.

Science.gov (United States)

Shelley, Donna; Anno, Jaime; Tseng, Tuo-Yen; Calip, Greg; Wedeles, John; Lloyd, Madeleine; Wolff, Mark S

2011-04-01

In this study we evaluated the effect of a multicomponent intervention to implement the Public Health Service (PHS) guideline Treating Tobacco Use and Dependence in six randomly selected dental clinics in New York University's College of Dentistry. The main outcome measure-provider adherence to tobacco use treatment guidelines-was assessed by auditing a random selection of patient charts pre (698) and post (641) intervention. The intervention components included a chart reminder and referral system, free nicotine replacement therapy (NRT), and provider training and feedback. The results showed that rates of screening for tobacco use did not change between pre and post test chart audits. However, providers were significantly more likely to offer advice (28.4 percent pre, 49 percent post), assess readiness to quit (17.8 percent pre, 29.9 percent post), and offer assistance (6.5 percent pre and 15.6 percent post) in the post test period. Increases in NRT distribution were associated with booster training sessions but declined in the time periods between those trainings. Research is needed to further define sustainable strategies for implementing tobacco use treatment in dental clinics. The results of this study suggest the feasibility and effectiveness of using a tailored multicomponent approach to implement tobacco use treatment guidelines in dental clinics.

International trade agreements challenge tobacco and alcohol control policies.

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Zeigler, Donald W

2006-11-01

This report reviews aspects of trade agreements that challenge tobacco and alcohol control policies. Trade agreements reduce barriers, increase competition, lower prices and promote consumption. Conversely, tobacco and alcohol control measures seek to reduce access and consumption, raise prices and restrict advertising and promotion in order to reduce health and social problems. However, under current and pending international agreements, negotiated by trade experts without public health input, governments and corporations may challenge these protections as constraints on trade. Advocates must recognise the inherent conflicts between free trade and public health and work to exclude alcohol and tobacco from trade agreements. The Framework Convention on Tobacco Control has potential to protect tobacco policies and serve as a model for alcohol control.

Implementation strategies to promote community-engaged efforts to counter tobacco marketing at the point of sale.

Science.gov (United States)

Leeman, Jennifer; Myers, Allison; Grant, Jennifer C; Wangen, Mary; Queen, Tara L

2017-09-01

The US tobacco industry spends $8.2 billion annually on marketing at the point of sale (POS), a practice known to increase tobacco use. Evidence-based policy interventions (EBPIs) are available to reduce exposure to POS marketing, and nationwide, states are funding community-based tobacco control partnerships to promote local enactment of these EBPIs. Little is known, however, about what implementation strategies best support community partnerships' success enacting EBPI. Guided by Kingdon's theory of policy change, Counter Tools provides tools, training, and other implementation strategies to support community partnerships' performance of five core policy change processes: document local problem, formulate policy solutions, engage partners, raise awareness of problems and solutions, and persuade decision makers to enact new policy. We assessed Counter Tools' impact at 1 year on (1) partnership coordinators' self-efficacy, (2) partnerships' performance of core policy change processes, (3) community progress toward EBPI enactment, and (4) salient contextual factors. Counter Tools provided implementation strategies to 30 partnerships. Data on self-efficacy were collected using a pre-post survey. Structured interviews assessed performance of core policy change processes. Data also were collected on progress toward EBPI enactment and contextual factors. Analysis included descriptive and bivariate statistics and content analysis. Following 1-year exposure to implementation strategies, coordinators' self-efficacy increased significantly. Partnerships completed the greatest proportion of activities within the "engage partners" and "document local problem" core processes. Communities made only limited progress toward policy enactment. Findings can inform delivery of implementation strategies and tests of their effects on community-level efforts to enact EBPIs.

The vector of the tobacco epidemic: tobacco industry practices in low and middle-income countries.

Science.gov (United States)

Lee, Sungkyu; Ling, Pamela M; Glantz, Stanton A

2012-03-01

To understand transnational tobacco companies' (TTCs) practices in low and middle-income countries which serve to block tobacco-control policies and promote tobacco use. Systematic review of published research on tobacco industry activities to promote tobacco use and oppose tobacco-control policies in low and middle-income countries. TTCs' strategies used in low and middle-income countries followed four main themes-economic activity; marketing/promotion; political activity; and deceptive/manipulative activity. Economic activity, including foreign investment and smuggling, was used to enter new markets. Political activities included lobbying, offering voluntary self-regulatory codes, and mounting corporate social responsibility campaigns. Deceptive activities included manipulation of science and use of third-party allies to oppose smoke-free policies, delay other tobacco-control policies, and maintain support of policymakers and the public for a pro-tobacco industry policy environment. TTCs used tactics for marketing, advertising, and promoting their brands that were tailored to specific market environments. These activities included direct and indirect tactis, targeting particular populations, and introducing new tobacco products designed to limit marketing restrictions and taxes, maintain the social acceptability of tobacco use, and counter tobacco-control efforts. TTCs have used similar strategies in high-income countries as these being described in low and middle-income countries. As required by FCTC Article 5.3, to counter tobacco industry pressures and to implement effective tobacco-control policies, governments and health professionals in low and middle-income countries should fully understand TTCs practices and counter them.

Tobacco Industry Manipulation of Tobacco Excise and Tobacco Advertising Policies in the Czech Republic: An Analysis of Tobacco Industry Documents

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Shirane, Risako; Smith, Katherine; Ross, Hana; Silver, Karin E.; Williams, Simon; Gilmore, Anna

2012-01-01

Background The Czech Republic has one of the poorest tobacco control records in Europe. This paper examines transnational tobacco companies' (TTCs') efforts to influence policy there, paying particular attention to excise policies, as high taxes are one of the most effective means of reducing tobacco consumption, and tax structures are an important aspect of TTC competitiveness. Methods and Findings TTC documents dating from 1989 to 2004/5 were retrieved from the Legacy Tobacco Documents Library website, analysed using a socio-historical approach, and triangulated with key informant interviews and secondary data. The documents demonstrate significant industry influence over tobacco control policy. Philip Morris (PM) ignored, overturned, and weakened various attempts to restrict tobacco advertising, promoting voluntary approaches as an alternative to binding legislation. PM and British American Tobacco (BAT) lobbied separately on tobacco tax structures, each seeking to implement the structure that benefitted its own brand portfolio over that of its competitors, and enjoying success in turn. On excise levels, the different companies took a far more collaborative approach, seeking to keep tobacco taxes low and specifically to prevent any large tax increases. Collective lobbying, using a variety of arguments, was successful in delaying the tax increases required via European Union accession. Contrary to industry arguments, data show that cigarettes became more affordable post-accession and that TTCs have taken advantage of low excise duties by raising prices. Interview data suggest that TTCs enjoy high-level political support and continue to actively attempt to influence policy. Conclusion There is clear evidence of past and ongoing TTC influence over tobacco advertising and excise policy. We conclude that this helps explain the country's weak tobacco control record. The findings suggest there is significant scope for tobacco tax increases in the Czech Republic and

The Tobacco Industry and Children's Rights.

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van der Eijk, Yvette; Bialous, Stella A; Glantz, Stanton

2018-05-01

The manufacture, use, and marketing of tobacco present a serious threat to children's right to health. This makes the Convention on the Rights of the Child a potentially powerful tobacco-control tool and the United Nations Children's Fund (UNICEF), which oversees the convention's implementation, a potential leader in tobacco control. UNICEF actively supported tobacco control initiatives in the late 1990s, but since the early 2000s UNICEF's role in tobacco control has been minimal. Using the Truth Tobacco Industry Documents library, an online collection of previously secret tobacco industry documents, we sought to uncover information on the tobacco industry's ties with UNICEF. We found that from 1997 to 2000, when UNICEF was actively promoting tobacco control to support children's rights, the tobacco industry saw children's rights and UNICEF as potentially powerful threats to business that needed to be closely monitored and neutralized. The industry then positioned itself as a partner with UNICEF on youth smoking prevention initiatives as a way to avoid meaningful tobacco control measures that could save children's lives. After UNICEF's corporate engagement guidelines were loosened in 2003, tobacco companies successfully engaged with UNICEF directly and via front groups, including the Eliminating Child Labour in Tobacco Growing Foundation. This was part of an overall tobacco industry strategy to improve its corporate image, infiltrate the United Nations, and weaken global tobacco-control efforts. As part of its mission to protect children's rights, UNICEF should end all partnerships with the tobacco industry and its front groups. Copyright © 2018 by the American Academy of Pediatrics.

Critical realism: a practical ontology to explain the complexities of smoking and tobacco control in different resource settings.

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Oladele, Dunsi; Clark, Alexander M; Richter, Solina; Laing, Lory

2013-04-03

This paper presents critical realism (CR) as an innovative system for research in tobacco prevention and control. CR argues that underlying mechanisms are considered and explored to ensure effective implementation of any program/policy or intervention. Any intervention or program/policy that is transposed from one country to another or one setting to another is complex. The research was undertaken and analyzed through a critical ethnography lens using CR as a philosophical underpinning. The study relied upon the following components: original fieldwork in Nigeria including participant observation of smokers, in-depth interviews and focus groups with smokers, and in-depth interviews with health professionals working in the area of tobacco control in Nigeria. Findings from this small ethnographic study in Nigeria, suggest that Critical Realism holds promise for addressing underlying mechanism that links complex influences on smoking. This paper argues that understanding the underlying mechanisms associated with smoking in different societies will enable a platform for effective implementation of tobacco control policies that work in various settings.

Tobacco Control Research, Dissemination and Networking in ...

International Development Research Centre (IDRC) Digital Library (Canada)

Tobacco Control Research, Dissemination and Networking in Lebanon. The Tobacco ... IDRC “unpacks women's empowerment” at McGill University Conference ... New funding opportunity for gender equality and climate change. IDRC is ...

The Economics of Tobacco Control in Low and Middle-Income ...

International Development Research Centre (IDRC) Digital Library (Canada)

Economics, TOBACCO CONTROL, TOBACCO ... disease and productivity loss burdens);; Economic impact of tobacco control policies and programs ... International Water Resources Association, in close collaboration with IDRC, is holding a ...

Earned print media in advancing tobacco control in Himachal Pradesh, India: a descriptive study.

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Sharma, Renu; Shewade, Hemant Deepak; Gopalan, Balasubramaniam; Badrel, Ramesh Kumar; Rana, Jugdeep Singh

2017-01-01

The Union-Bloomberg Initiative tobacco control projects were implemented in Himachal Pradesh (a hilly state in North India) from 2007 to 2014. The project focused on the establishment of an administrative framework; increasing the capacity of stakeholders; enforcement of legislation; coalition and networking with multiple stakeholders; awareness generation with focus on earned media and monitoring and evaluation with policy-focussed research. This study aimed to systematically analyse all earned print news items related to the projects. In this cross-sectional descriptive study, quantitative content analysis of earned print news items was carried out using predetermined codes related to areas of tobacco control policies. We also carried out a cost description of the hypothetical value of this earned media. The area of the news item in cm 2 was multiplied by the average rate of space for the paid news item in that particular newspaper. There were 6348 news items: the numbers steadily increased with time. Focus on Monitoring tobacco use, Protecting people from tobacco smoke, Offering help to quit, Warning about dangers of tobacco, Enforcing a ban on tobacco advertising and promotion, Raising tax on tobacco products was seen in 24, 17, 9, 23, 22 and 3% of news items, respectively. Press releases were highest at 44% and report by correspondents at 24%. Further, 55, 23 and 21% news items focused on smoking, smokeless and both forms of tobacco use, respectively. Sixty-six per cent and 34% news items, respectively, were focused on youth and women. The news items had a hypothetical value of US$1503 628.3, which was three times more than the funds spent on all project activities. In the absence of funding for paid media, the project strategically used earned media to promote tobacco control policies in the state.

Tobacco packaging and mass media campaigns: research needs for Articles 11 and 12 of the WHO Framework Convention on Tobacco Control.

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Hammond, David; Wakefield, Melanie; Durkin, Sarah; Brennan, Emily

2013-04-01

Communicating the health risks of smoking remains a primary objective of tobacco-control policy. Articles 11 and 12 of the World Health Organization's Framework Convention on Tobacco Control establish standards for two important forms of communication: packaging regulations (Article 11), and mass media campaigns (Article 12). A narrative review approach was used to identify existing evidence in the areas of package labeling regulations (including health warnings, constituent and emission messages, and prohibitions on misleading information) and communication activities (including mass media campaigns and news media coverage). When available, recent reviews of the literature were used, updated with more recent high-quality studies from published literature. Implementation of Articles 11 and 12 share several important research priorities: (a) identify existing consumer information needs and gaps, (b) research on the message source to identify effective types of content for health warnings and media campaigns, (c) research on how messages are processed and the extent to which the content and form of messages need to be tailored to different cultural and geographic groups, as well as subgroups within countries, and (d) research to identify the most cost-effective mix and best practices for sustaining health communications over time. A unifying theme of effective health communication through tobacco packaging and mass media campaigns is the need to provide salient, timely, and engaging reminders of the consequences of tobacco use in ways that motivate and support tobacco users trying to quit and make tobacco use less appealing for those at risk of taking it up.

Strategies for tobacco control in India: a systematic review.

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Ailsa J McKay

Full Text Available Tobacco control needs in India are large and complex. Evaluation of outcomes to date has been limited.To review the extent of tobacco control measures, and the outcomes of associated trialled interventions, in India.Information was identified via database searches, journal hand-searches, reference and citation searching, and contact with experts. Studies of any population resident in India were included. Studies where outcomes were not yet available, not directly related to tobacco use, or not specific to India, were excluded. Pre-tested proformas were used for data extraction and quality assessment. Studies with reliability concerns were excluded from some aspects of analysis. The Framework Convention on Tobacco Control (FCTC was use as a framework for synthesis. Heterogeneity limited meta-analysis options. Synthesis was therefore predominantly narrative.Additional to the Global Tobacco Surveillance System data, 80 studies were identified, 45 without reliability concerns. Most related to education (FCTC Article 12 and tobacco-use cessation (Article 14. They indicated widespread understanding of tobacco-related harm, but less knowledge about specific consequences of use. Healthcare professionals reported low confidence in cessation assistance, in keeping with low levels of training. Training for schoolteachers also appeared suboptimal. Educational and cessation assistance interventions demonstrated positive impact on tobacco use. Studies relating to smoke-free policies (Article 8, tobacco advertisements and availability (Articles 13 and 16 indicated increasingly widespread smoke-free policies, but persistence of high levels of SHS exposure, tobacco promotions and availability-including to minors. Data relating to taxation/pricing and packaging (Articles 6 and 11 were limited. We did not identify any studies of product regulation, alternative employment strategies, or illicit trade (Articles 9, 10, 15 and 17.Tobacco-use outcomes could be improved

How effective has tobacco tax increase been in the Gambia? A case study of tobacco control

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Nargis, Nigar; Manneh, Yahya; Krubally, Bakary; Jobe, Baboucarr; Ouma, Ahmed E Ogwell; Tcha-Kondor, Noureiny; Blecher, Evan H

2016-01-01

Objectives The objective of the present study was to evaluate how effective tobacco tax increase has been in increasing price of tobacco products and reducing tobacco consumption in the Gambia. In addition, it tests the hypothesis that tobacco tax revenue grows while tobacco consumption decreases as a result of tax and price increase. Setting The study is designed at the macroeconomic level to examine the import of tobacco products and revenue collected from tobacco taxation in a low-income setting. Participants The participants of this study are the government officials employed in the Ministry of Finance and Economic Affairs (MoFEA), the Gambia and the Gambia Revenue Authority, who are in charge of planning and implementing the tobacco tax policy in the Gambia. Interventions The study includes 2 consecutive interventions in tobacco tax policy in the Gambia. The first intervention was moving the tax base for the uniform specific excise tax on cigarettes from weight to pack of cigarettes in 2013. The second intervention involved increasing the excise and the environmental tax on tobacco products in 2014. Primary and secondary outcome measures The primary outcome measures were the cost, insurance and freight value and the price of tobacco products. The secondary outcome measures included the import of tobacco products and tobacco tax revenue. Results In 2013–2014, the Gambia MoFEA raised the specific excise rate, which increased price, reduced consumption and generated significantly more government revenue from tobacco products. This is a clear evidence of the win-win outcome of raising tobacco tax. In addition, the Gambia has set the example of harmonising tax rates between tobacco products that reduces the substitution between tobacco products. Conclusions The Gambia presents the best practice in tobacco taxation. There is need for documenting more country-specific evidence on the win-win outcome of raising tobacco tax. PMID:27566626

How Tobacco Control Measures and Smuggling Influence Demand ...

International Development Research Centre (IDRC) Digital Library (Canada)

How Tobacco Control Measures and Smuggling Influence Demand in Panama. Panama's tobacco epidemic demonstrates ... Their goal: establish a new threshold for increasing the luxury tax on tobacco products, including cigarettes, based on the monthly evolution of cigarette sales. The researchers will survey brands in ...

Association between tobacco industry denormalization beliefs, tobacco control community discontent and smokers' level of nicotine dependence.

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Kushnir, Vladyslav; Selby, Peter; Cunningham, John A

2013-07-01

Tobacco industry denormalization (TID) informs the public about the tobacco industry's role in the tobacco epidemic and is an important component of a comprehensive tobacco control strategy. Although TID beliefs have been noted in adult smokers and associated with intent to quit, research has not evaluated whether they are affected by smokers' level of nicotine dependence. The present article sought to concurrently examine how attitudes towards the tobacco industry and tobacco control groups may differ among smokers of varying levels of nicotine dependence. In addition, it evaluated how these attitudes and beliefs may be associated with smokers' intentions to reduce or quit smoking. A random digit dialing telephone survey was conducted of 889 Canadian current daily smokers, 18 years and older. Attitudes towards the tobacco industry were mixed among the entire cohort and differences in beliefs towards the tobacco industry were not found among smokers of varying levels of nicotine dependence. However, smokers that held strong TID beliefs were 5 times more intent to quit smoking than those without such beliefs. Compared to smokers with low level of nicotine dependence, heavy smokers were more likely to report strong overall displeasure with the tobacco control community (OR=1.98, 95% CI=1.23-3.19, p=0.005), however there were no differences with regards to future intent to quit. The absence of strong negative sentiment toward the tobacco industry among smokers as a whole suggests that more targeted anti-industry messages are needed, raising greater awareness of tobacco industry practices within smokers and non-smokers alike. As heavier smokers' discontent with the tobacco control community highlights increasing social disapproval and pressure to quit smoking, future educational and media strategies used for smoking cessation purposes may benefit from emphasizing more of the positive attributes associated with quitting smoking, as opposed to the negative features of

A tobacco-free world: a call to action to phase out the sale of tobacco products by 2040.

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Beaglehole, Robert; Bonita, Ruth; Yach, Derek; Mackay, Judith; Reddy, K Srinath

2015-03-14

The time has come for the world to acknowledge the unacceptability of the damage being done by the tobacco industry and work towards a world essentially free from the sale (legal and illegal) of tobacco products. A tobacco-free world by 2040, where less than 5% of the world's adult population use tobacco, is socially desirable, technically feasible, and could become politically practical. Three possible ways forward exist: so-called business-as-usual, with most countries steadily implementing the WHO Framework Convention on Tobacco Control (FCTC) provisions; accelerated implementation of the FCTC by all countries; and a so-called turbo-charged approach that complements FCTC actions with strengthened UN leadership, full engagement of all sectors, and increased investment in tobacco control. Only the turbo-charged approach will achieve a tobacco-free world by 2040 where tobacco is out of sight, out of mind, and out of fashion--yet not prohibited. The first and most urgent priority is the inclusion of an ambitious tobacco target in the post-2015 sustainable development health goal. The second priority is accelerated implementation of the FCTC policies in all countries, with full engagement from all sectors including the private sector--from workplaces to pharmacies--and with increased national and global investment. The third priority is an amendment of the FCTC to include an ambitious global tobacco reduction goal. The fourth priority is a UN high-level meeting on tobacco use to galvanise global action towards the 2040 tobacco-free world goal on the basis of new strategies, new resources, and new players. Decisive and strategic action on this bold vision will prevent hundreds of millions of unnecessary deaths during the remainder of this century and safeguard future generations from the ravages of tobacco use. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Effectiveness of Tobacco Marketing Regulations on Reducing Smokers’ Exposure to Advertising and Promotion: Findings from the International Tobacco Control (ITC Four Country Survey

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K. Michael Cummings

2011-01-01

Full Text Available Exposure to tobacco product marketing promotes the initiation, continuation, and reuptake of cigarette smoking and as a result the World Health Organization Framework Convention on Tobacco Control (WHO FCTC has called upon member Parties to enact comprehensive bans on tobacco advertising and promotion. This study examines the immediate and long term effectiveness of advertising restrictions enacted in different countries on exposure to different forms of product marketing, and examines differences in exposure across different socioeconomic status (SES groups. Nationally representative data from the United Kingdom, Canada, Australia, and the United States, collected from adult smokers between 2002 and 2008 using the International Tobacco Control Four Country Survey (ITC-4, were used in this study (N = 21,615. In light of the specific marketing regulation changes that occurred during the course of this study period, changes in awareness of tobacco marketing via various channels were assessed for each country, and for different SES groups within countries. Tobacco marketing regulations, once implemented, were associated with significant reductions in smokers’ reported awareness of pro-smoking cues, and the observed reductions were greatest immediately following the enactment of regulations. Changes in reported awareness were generally the same across different SES groups, although some exceptions were noted. While tobacco marketing regulations have been effective in reducing exposure to certain types of product marketing there still remain gaps, especially with regard to in-store marketing and price promotions.

The Effectiveness of Tobacco Marketing Regulations on Reducing Smokers’ Exposure to Advertising and Promotion: Findings from the International Tobacco Control (ITC) Four Country Survey

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Kasza, Karin A.; Hyland, Andrew J.; Brown, Abraham; Siahpush, Mohammad; Yong, Hua-Hie; McNeill, Ann D.; Li, Lin; Cummings, K. Michael

2011-01-01

Exposure to tobacco product marketing promotes the initiation, continuation, and reuptake of cigarette smoking and as a result the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) has called upon member Parties to enact comprehensive bans on tobacco advertising and promotion. This study examines the immediate and long term effectiveness of advertising restrictions enacted in different countries on exposure to different forms of product marketing, and examines differences in exposure across different socioeconomic status (SES) groups. Nationally representative data from the United Kingdom, Canada, Australia, and the United States, collected from adult smokers between 2002 and 2008 using the International Tobacco Control Four Country Survey (ITC-4), were used in this study (N = 21,615). In light of the specific marketing regulation changes that occurred during the course of this study period, changes in awareness of tobacco marketing via various channels were assessed for each country, and for different SES groups within countries. Tobacco marketing regulations, once implemented, were associated with significant reductions in smokers’ reported awareness of pro-smoking cues, and the observed reductions were greatest immediately following the enactment of regulations. Changes in reported awareness were generally the same across different SES groups, although some exceptions were noted. While tobacco marketing regulations have been effective in reducing exposure to certain types of product marketing there still remain gaps, especially with regard to in-store marketing and price promotions. PMID:21556189

The effectiveness of tobacco marketing regulations on reducing smokers' exposure to advertising and promotion: findings from the International Tobacco Control (ITC) Four Country Survey.

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Kasza, Karin A; Hyland, Andrew J; Brown, Abraham; Siahpush, Mohammad; Yong, Hua-Hie; McNeill, Ann D; Li, Lin; Cummings, K Michael

2011-02-01

Exposure to tobacco product marketing promotes the initiation, continuation, and reuptake of cigarette smoking and as a result the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) has called upon member Parties to enact comprehensive bans on tobacco advertising and promotion. This study examines the immediate and long term effectiveness of advertising restrictions enacted in different countries on exposure to different forms of product marketing, and examines differences in exposure across different socioeconomic status (SES) groups. Nationally representative data from the United Kingdom, Canada, Australia, and the United States, collected from adult smokers between 2002 and 2008 using the International Tobacco Control Four Country Survey (ITC-4), were used in this study (N = 21,615). In light of the specific marketing regulation changes that occurred during the course of this study period, changes in awareness of tobacco marketing via various channels were assessed for each country, and for different SES groups within countries. Tobacco marketing regulations, once implemented, were associated with significant reductions in smokers' reported awareness of pro-smoking cues, and the observed reductions were greatest immediately following the enactment of regulations. Changes in reported awareness were generally the same across different SES groups, although some exceptions were noted. While tobacco marketing regulations have been effective in reducing exposure to certain types of product marketing there still remain gaps, especially with regard to in-store marketing and price promotions.

Tobacco packaging design for reducing tobacco use.

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McNeill, Ann; Gravely, Shannon; Hitchman, Sara C; Bauld, Linda; Hammond, David; Hartmann-Boyce, Jamie

2017-04-27

Tobacco use is the largest single preventable cause of death and disease worldwide. Standardised tobacco packaging is an intervention intended to reduce the promotional appeal of packs and can be defined as packaging with a uniform colour (and in some cases shape and size) with no logos or branding, apart from health warnings and other government-mandated information, and the brand name in a prescribed uniform font, colour and size. Australia was the first country to implement standardised tobacco packaging between October and December 2012, France implemented standardised tobacco packaging on 1 January 2017 and several other countries are implementing, or intending to implement, standardised tobacco packaging. To assess the effect of standardised tobacco packaging on tobacco use uptake, cessation and reduction. We searched MEDLINE, Embase, PsycINFO and six other databases from 1980 to January 2016. We checked bibliographies and contacted study authors to identify additional peer-reviewed studies. Primary outcomes included changes in tobacco use prevalence incorporating tobacco use uptake, cessation, consumption and relapse prevention. Secondary outcomes covered intermediate outcomes that can be measured and are relevant to tobacco use uptake, cessation or reduction. We considered multiple study designs: randomised controlled trials, quasi-experimental and experimental studies, observational cross-sectional and cohort studies. The review focused on all populations and people of any age; to be included, studies had to be published in peer-reviewed journals. We examined studies that assessed the impact of changes in tobacco packaging such as colour, design, size and type of health warnings on the packs in relation to branded packaging. In experiments, the control condition was branded tobacco packaging but could include variations of standardised packaging. Screening and data extraction followed standard Cochrane methods. We used different 'Risk of bias' domains for

Retailer adherence to Family Smoking Prevention and Tobacco Control Act, North Carolina, 2011.

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Rose, Shyanika W; Myers, Allison E; D'Angelo, Heather; Ribisl, Kurt M

2013-04-04

The Family Smoking Prevention and Tobacco Control Act regulates the sales and marketing of tobacco products in the United States; poor adherence by tobacco retailers may reduce the effectiveness of the Act's provisions. The objectives of this study were 1) to assess whether and to which provisions retailers were adherent and 2) to examine differences in adherence by county, retailer neighborhood, and retailer characteristics. We conducted multivariate analysis of tobacco retailers' adherence to 12 point-of-sale provisions of the Tobacco Control Act in 3 North Carolina counties. We conducted observational audits of 324 retailers during 3 months in 2011 to assess adherence. We used logistic regression to assess associations between adherence to provisions and characteristics of each county, retailer neighborhood, and retailer. We found 15.7% of retailers did not adhere to at least 1 provision; 84.3% adhered to all provisions. The provisions most frequently violated were the ban on sales of cigarettes with modified-risk labels (eg, "light" cigarettes) (43 [13.3%] retailers nonadherent) and the ban on self-service for cigarettes and smokeless tobacco (6 [1.9%] retailers nonadherent). We found significant differences in rates of nonadherence by county and type of retailer. Pharmacies and drug stores were more than 3 times as likely as grocery stores to be nonadherent. Most tobacco retailers have implemented regulatory changes without enforcement by the US Food and Drug Administration. Monitoring rates of adherence by store type and locale (eg, county) may help retailers comply with point-of-sale provisions.

Global health governance and the commercial sector: a documentary analysis of tobacco company strategies to influence the WHO framework convention on tobacco control.

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Weishaar, Heide; Collin, Jeff; Smith, Katherine; Grüning, Thilo; Mandal, Sema; Gilmore, Anna

2012-01-01

In successfully negotiating the Framework Convention on Tobacco Control (FCTC), the World Health Organization (WHO) has led a significant innovation in global health governance, helping to transform international tobacco control. This article provides the first comprehensive review of the diverse campaign initiated by transnational tobacco corporations (TTCs) to try to undermine the proposed convention. The article is primarily based on an analysis of internal tobacco industry documents made public through litigation, triangulated with data from official documentation relating to the FCTC process and websites of relevant organisations. It is also informed by a comprehensive review of previous studies concerning tobacco industry efforts to influence the FCTC. The findings demonstrate that the industry's strategic response to the proposed WHO convention was two-fold. First, arguments and frames were developed to challenge the FCTC, including: claiming there would be damaging economic consequences; depicting tobacco control as an agenda promoted by high-income countries; alleging the treaty conflicted with trade agreements, "good governance," and national sovereignty; questioning WHO's mandate; claiming the FCTC would set a precedent for issues beyond tobacco; and presenting corporate social responsibility (CSR) as an alternative. Second, multiple tactics were employed to promote and increase the impact of these arguments, including: directly targeting FCTC delegations and relevant political actors, enlisting diverse allies (e.g., mass media outlets and scientists), and using stakeholder consultation to delay decisions and secure industry participation. TTCs' efforts to undermine the FCTC were comprehensive, demonstrating the global application of tactics that TTCs have previously been found to have employed nationally and further included arguments against the FCTC as a key initiative in global health governance. Awareness of these strategies can help guard against

Global health governance and the commercial sector: a documentary analysis of tobacco company strategies to influence the WHO framework convention on tobacco control.

Directory of Open Access Journals (Sweden)

Heide Weishaar

Full Text Available In successfully negotiating the Framework Convention on Tobacco Control (FCTC, the World Health Organization (WHO has led a significant innovation in global health governance, helping to transform international tobacco control. This article provides the first comprehensive review of the diverse campaign initiated by transnational tobacco corporations (TTCs to try to undermine the proposed convention.The article is primarily based on an analysis of internal tobacco industry documents made public through litigation, triangulated with data from official documentation relating to the FCTC process and websites of relevant organisations. It is also informed by a comprehensive review of previous studies concerning tobacco industry efforts to influence the FCTC. The findings demonstrate that the industry's strategic response to the proposed WHO convention was two-fold. First, arguments and frames were developed to challenge the FCTC, including: claiming there would be damaging economic consequences; depicting tobacco control as an agenda promoted by high-income countries; alleging the treaty conflicted with trade agreements, "good governance," and national sovereignty; questioning WHO's mandate; claiming the FCTC would set a precedent for issues beyond tobacco; and presenting corporate social responsibility (CSR as an alternative. Second, multiple tactics were employed to promote and increase the impact of these arguments, including: directly targeting FCTC delegations and relevant political actors, enlisting diverse allies (e.g., mass media outlets and scientists, and using stakeholder consultation to delay decisions and secure industry participation.TTCs' efforts to undermine the FCTC were comprehensive, demonstrating the global application of tactics that TTCs have previously been found to have employed nationally and further included arguments against the FCTC as a key initiative in global health governance. Awareness of these strategies can help

Tobacco use patterns, knowledge, attitudes towards tobacco and availability of tobacco control training among school personnel from a rural area in Poland.

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Kaleta, Dorota; Polańska, Kinga; Rzeźnicki, Adam; Stelmach, Włodzimierz; Wojtysiak, Piotr

2017-01-01

Tobacco-free school environment as well as non-smoking teachers and school personnel provide positive role models for children and young people. In Poland, smoking should be banned in colleges, schools, educational establishments and educational care facilities. However, for the existing law to be effective, awareness of all people in school curriculum and enforcement of the law are crucial. The aim of the study was to evaluate tobacco use patterns, knowledge and attitudes towards tobacco as well as availability of tobacco control training among school personnel in a rural area in Poland. Moreover, compliance with tobacco control policies and their enforcement were assessed. The study was carried out in Piotrkowski district between November 2014 and May 2015 in accordance with the Global School Personnel Survey (GSPS) methodology. Sixty schools participated in the survey (92% of the schools from the region) with involvement of 1044 teachers and 500 non-teaching staff (the response rate - 83.1%). The multivariate linear regression analyses were applied to study factors linked to the need for anti-tobacco training dedicated to the youth and teachers' knowledge as well as activities to educate the students about tobacco use and its prevention. About 24% of the school personnel were current and 9% were ex-smokers. Significantly more teachers than the non-teaching staff indicated that the schools had a policy prohibiting tobacco use among students. In addition, 6% of the study participants indicated everyday violations of the tobacco control policy by the school personnel. More than 80% of the teaching personnel indicated the need for training dedicated to the youth to prevent their tobacco use. In the multivariate linear regression model, longer duration of working experience predicted higher levels of knowledge and more activities performed to teach the youth about tobacco use and its prevention. The smokers comparing to the non-smokers perceived the need for anti

Implications and priorities of tobacco control in Belgium and Europe

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P. Bartsch

2008-12-01

Full Text Available The present article aims to define what tobacco control is both in Europe and around the world. The situation of tobacco control in Belgium will be compared to other European countries using the tobacco control scale (TCS. If countries demonstrating a high TCS score have lower tobacco smoking prevalence than countries with a low TCS, it is not known whether the decrease in smoking prevalence over several years is well correlated with the increase in TCS score in each country during the same period. Moreover the article will raise the question of how far research will continue control into controlling the use of tobacco. The remaining 20% of smokers in the best tobacco control scale countries who are still smoking are not similar to the 20% that are now ex-smokers. Indeed we are now facing the "hard core smokers", who show great resistance to policy measures and be considered as ill individuals requiring specialised care rather than individuals with bad habits. The future tobacco control scale should place more importance on the quality of care and the implication of European countries providing improved access to this form of care and validated forms of treatment of this chronic, difficult to treat disease.

CDC Best Practices for Comprehensive Tobacco Control Programs - 2007

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U.S. Department of Health & Human Services — Centers for Disease Control and Prevention (CDC). Best Practices for Comprehensive Tobacco Control Programs. Funding. CDC's Best Practices for Comprehensive Tobacco...

CDC Best Practices for Comprehensive Tobacco Control Programs - 2014

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U.S. Department of Health & Human Services — Centers for Disease Control and Prevention (CDC). Best Practices for Comprehensive Tobacco Control Programs. Funding. CDC's Best Practices for Comprehensive Tobacco...

The importance of peer effects, cigarette prices and tobacco control policies for youth smoking behavior.

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Powell, Lisa M; Tauras, John A; Ross, Hana

2005-09-01

This paper expands the youth cigarette demand literature by undertaking an examination of the determinants of smoking among high school students incorporating the importance of peer effects and allowing cigarette prices (taxes) and tobacco control policies to have a direct effect and an indirect effect (via the peer effect) on smoking behavior. To control for the potential endogeneity of our school-based peer measure we implement a two-stage generalized least squares estimator for a dichotomous dependent variable and implement a series of diagnostic tests. The key finding is that peer effects play a significant role in youth smoking decisions: moving a high-school student from a school where no children smoke to a school where one quarter of the youths smoke is found to increase the probability that the youth smokes by about 14.5 percentage points. The results suggest that there is a potential for social multiplier effects with respect to any exogenous change in cigarette taxes or tobacco control policies.

Tobacco industry interference: A review of three South East Asian countries.

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Assunta, Mary; Ritthiphakdee, Bungon; Soerojo, Widyastuti; Cho, May Myat; Jirathanapiwat, Worrawan

2017-09-01

The WHO Framework Convention on Tobacco Control (FCTC) Article 5.3 requires governments to protect tobacco control policies from the commercial interest of the tobacco industry (TI). TI interference is the biggest barrier to implementing comprehensive tobacco control measures. This paper reviews the extent of the TI's interference in tobacco control policy development in three countries, Thailand, Myanmar, and Indonesia, and the governments' efforts to protect these policies. The paper draws on incidents of TI interference reported in the 2016 Tobacco Industry Interference Index: ASEAN Report on Implementation of the WHO FCTC Article 5.3. Base data were obtained through a questionnaire on twenty most commonly reported incidents of interference from the FCTC Article 5.3 Guidelines recommendations. A scoring system was developed. All three countries faced varying levels of TI interference. Thailand, though known for its stringent tobacco control measures, still faced interference while Myanmar remains vulnerable. Indonesia faced the highest industry interference which may explain why it is lagging behind in tobacco control and remains a nonparty to the WHO FCTC. The TI gains access to government officials through offers of technical assistance and its corporate social responsibility activities. Transparency in dealing with the TI is needed in all three countries. Most governments have not set up disclosure procedures when dealing with the TI. Outside the Department/Ministry of Health, other departments remain unaware of Article 5.3, not utilizing its strength to regulate the TI. More concerted effort is needed to implement Article 5.3 to achieve greater success in tobacco control.

Gender equity and tobacco control: bringing masculinity into focus.

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Morrow, Martha; Barraclough, Simon

2010-03-01

Gender is a key but often overlooked--determinant of tobacco use, especially in Asia, where sex-linked differences in prevalence rates are very large. In this article we draw upon existing data to consider the implications of these patterns for gender equity and propose approaches to redress inequity through gender-sensitive tobacco control activities. International evidence demonstrates that, in many societies, risk behaviours (including tobacco use) are practised substantially more by men and boys, and are also viewed as expressions of masculine identity. While gender equity focuses almost exclusively on the relative disadvantage of girls and women that exists in most societies, disproportionate male use of tobacco has profound negative consequences for men (as users) and for women (nonusers). Surprisingly, health promotion and tobacco control literature rarely focus on the role of gender in health risks among boys and men. However, tobacco industry marketing has masterfully incorporated gender norms, and also other important cultural values, to ensure its symbols are context-specific. By addressing gender-specific risks within the local cultural context--as countries are enjoined to do within the Framework Convention's Guiding Principles--it may be possible to accelerate the impact of mechanisms such as tobacco pricing, restrictions on marketing, smoking bans and provision of accurate information. It is essential that we construct a new research-to-policy framework for gender-sensitive tobacco control. Successful control of tobacco can only be strengthened by bringing males, and the concept of gender as social construction, back into our research and discussion on health and gender equity.

Protecting children and families from tobacco and tobacco-related NCDs in the Western Pacific: good practice examples from Malaysia, Philippines and Singapore.

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David, A M; Mercado, S P; Klein, J D; Kaundan, M s/o K; Koong, H N; Garcia, E

2017-09-01

Non-communicable diseases (NCDs) are generally considered diseases of adulthood, but NCD risk factors like tobacco use often are taken up during childhood and adolescence, and second-hand smoke exposure affects child survival and development. At a regional meeting of the Asia Pacific Child and Family Health Alliance for Tobacco Control, members reviewed existing good practices of child-focused tobacco control approaches using health promotion strategies. These interventions were implemented nationally in Malaysia, the Philippines and Singapore. Three good practice national examples were identified that focused on creating supportive tobacco-free environments and upgrading cessation skills among paediatricians. These country examples highlight strategic areas to protect children and families from the harms of tobacco, as part of NCD prevention and control. Training paediatricians in brief cessation advice has enabled them to address tobacco-using parents. Fully enforcing smoke-free public areas has led to an increase in smoke-free homes. The Tobacco Free Generation is a tobacco control 'endgame' strategy that taps into a social movement to deglamorize tobacco use and empower youth born in and after year 2000 to reject tobacco and nicotine addiction. Tobacco control is pivotal in the fight against NCDs; health promotion strategies to protect children and youth from tobacco have a critical role to play in NCD prevention and control. Frontline health workers, including primary care paediatricians, need to step up and actively advocate for full implementation of the WHO Framework Convention on Tobacco Control, including tobacco tax increases and smoke-free areas, while monitoring patients and their parents for tobacco use and second-hand smoke exposure, preventing adolescent smoking uptake, and offering cessation support. A life-course approach incorporating child-focused efforts to prevent initiation of smoking and second-hand smoke exposure with measures promoting

Tobacco industry's ITGA fights FCTC implementation in the Uruguay negotiations.

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Assunta, Mary

2012-11-01

To illustrate how the tobacco industry' front group, the International Tobacco Growers Association (ITGA), mobilised tobacco farmers to influence the fourth session of the Conference of the Parties (COP4) negotiations and defeat the adoption of Framework Convention on Tobacco Control Articles 9 and 10 Guidelines and Articles 17 and 18 progress report. A review of COP4 documents on Articles 9, 10, 17 and 18 was triangulated with relevant information from tobacco industry reports, websites of British American Tobacco, Philip Morris International and ITGA, presentations by tobacco industry executives and internal industry documents from the Legacy Tobacco Documents Library website. Philip Morris International and British American Tobacco rejected Articles 9 and 10 draft Guidelines claiming that banning ingredients in cigarettes will render burley leaf less commercially viable making tobacco growers in many countries suffer economic consequences. They claimed the terms 'attractiveness' and 'palatability' are not appropriate regulatory standards. The ITGA launched a global campaign to mobilise farmers to reject the draft Guidelines at COP4 in Uruguay. Tobacco producers, Brazil, Philippines, Tanzania, Zambia, Malawi and Zimbabwe, sent large delegations to COP4 and participated actively in the negotiation on the draft Guidelines. Partial Guidelines on Articles 9 and 10 on product regulation and disclosure were adopted. COP4's work on Article 17 provides guidance on viable alternatives, but the ITGA is opposed to this and continues fight crop substitution. Despite ITGA's international campaign to thwart the Guidelines on Articles 9 and 10 and a strong representation from tobacco-growing countries at COP4, the outcome after intense negotiations was the adoption of Partial Guidelines and work on Articles 17 and 18 to proceed.

Self-control, future orientation, smoking, and the impact of Dutch tobacco control measures.

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Daly, Michael; Delaney, Liam; Baumeister, Roy F

2015-06-01

The pronounced discrepancy between smokers' intentions to quit and their smoking behavior has led researchers to suggest that many smokers are time inconsistent, have self-control problems, and may benefit from external efforts to constrain their consumption. This study aims to test whether self-control and future orientation predict smoking levels and to identify if these traits modify how cigarette consumption responds to the introduction of tobacco control measures. A sample of Dutch adults (N = 1585) completed a measure of self-control and the Consideration of Future Consequences Scale (CFCS) in 2001 and indicated their tobacco consumption each year from 2001 to 2007. In 2004, a workplace smoking ban and substantial tax increase on tobacco was introduced in the Netherlands. To identify the potential impact of these tobacco control measures we examined whether participants smoked or were heavy smokers (20 + cigarettes per day) each year from 2001 to 2007. Participants with high self-control and CFCS scores showed lower rates of smoking across the seven year period of the study. The 2004 smoking restrictions were linked with a subsequent decline in heavy smoking. This decline was moderated by self-control levels. Those with low self-control showed a large reduction in heavy smoking whereas those with high self-control did not. The effects were, however, temporary: many people with low self-control resumed heavy smoking 2-3 years after the introduction of the tobacco restrictions. The immediate costs which national tobacco control measures impose on smokers may assist smokers with poor self-control in reducing their cigarette consumption.

The Impact of Tobacco Control Policies on Smoking Among Socioeconomic Groups in Nine European Countries, 1990-2007.

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Hu, Yannan; van Lenthe, Frank J; Platt, Stephen; Bosdriesz, Jizzo R; Lahelma, Eero; Menvielle, Gwenn; Regidor, Enrique; Santana, Paula; de Gelder, Rianne; Mackenbach, Johan P

2017-11-07

It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries during the past two decades. This paper aims to investigate the impact of price and non-price related population-wide tobacco control policies on smoking by socioeconomic group in nine European countries between 1990 and 2007. Individual-level education, occupation and smoking status were obtained from nationally representative surveys. Country-level price-related tobacco control policies were measured by the relative price of cheapest cigarettes and of cigarettes in the most popular price category. Country-level non-price policies were measured by a summary score covering four policy domains: smoking bans or restrictions in public places and workplaces, bans on advertising and promotion, health warning labels, and cessation services. The associations between policies and smoking were explored using logistic regressions, stratified by education and occupation, and adjusted for age, Gross Domestic Product, period and country fixed effects. The price of popular cigarettes and non-price policies were negatively associated with smoking among men. The price of the cheapest cigarettes was negatively associated with smoking among women. While these favorable effects were generally in the same direction for all socioeconomic groups, they were larger and statistically significant in lower socioeconomic groups only. Tobacco control policies as implemented in nine European countries, have probably helped to reduce the prevalence of smoking in the total population, particularly in lower socioeconomic groups. Widening inequalities in smoking may be explained by other factors. Policies with larger effects on lower socioeconomic groups are needed to reverse this trend. Socioeconomic inequalities in smoking widened between the 1990s and the 2000s in Europe. During the same period, there were intensified tobacco control policies

Challenges for philanthropy and tobacco control in China (1986-2012).

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Redmon, Pamela; Chen, Lincoln C; Wood, Jacob L; Li, Shuyang; Koplan, Jeffrey P

2013-09-01

To identify the international philanthropies that have invested in tobacco control in China, describe their role and strategies in changing the social norms of tobacco use, and define the outcomes achieved. Information on the international philanthropic donor China projects, including activities and outcomes, was gathered from multiple sources including organisational websites, key informant interviews and emails with project officers, and published research papers and reports. Philanthropic donations to China's tobacco control efforts began in 1986. The donors provided funds to national, city, provincial government organisations, non-government organisations, universities, and healthcare organisations throughout China to establish a tobacco control workforce and effective programmes to reduce the burden of tobacco use. International engagement has been an important dimension of tobacco control in China. Recognising the large burden of illness and capitalising on proven effective control measures, philanthropic organisations understandably seized the opportunity to achieve major health gains. Much of the international philanthropic investment has been directed at public information, policy change and building the Chinese research knowledge base. Documenting research and evaluation findings will continue to be important to ensure that promising practices and lessons learned are identified and shared with the China tobacco control practitioners. The ultimate question is whether foreign philanthropy is making a difference in tobacco control and changing social norms in China? The answer is plainly and simply that we do not know; the evidence is not yet available.

Polytobacco Use and the "Customization Generation"-New Perspectives for Tobacco Control.

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Horn, Kimberly; Pearson, Jennifer L; Villanti, Andrea C

2016-12-01

In recent years, the United States observed a significant uptake in concurrent use of multiple tobacco products and alternative nicotine delivery devices among youth-a phenomenon identified as polytobacco use-making tobacco control efforts more complex for clinicians, policy makers, and scientists, alike.The present commentary stimulates new perspectives on tobacco control in the context of polytobacco use and a youth culture of customization. This culture-based value of today's youth may inform current patterns of tobacco use. More specifically, the authors hypothesize a concept of tobacco customization-the concurrent use of multiple tobacco products to create personalized tobacco experience matching lifestyle, culture, values, and addiction levels. With a range of experiences made possible through an ever-increasing menu of tobacco products, flavors, and novel devices, the current youth culture of customization may also translate to tobacco customization. Given the predominance of polytobacco use in youth-tobacco users, tobacco control initiatives must be challenged to new perspectives. Should we discover the viability of tobacco customization, tobacco use strategies that target cultural values, harness popular trends, and culture and provide customizable experiences may have a notable impact on tobacco use in this population.

Assessing tobacco marketing regulation implementation level in Georgia: evidence from Non Communicable Disease Risk Factors STEPS Survey Georgia 2016

Directory of Open Access Journals (Sweden)

Lela Sturua

2018-03-01

Full Text Available Background Tobacco use continues to be the leading cause of preventable deaths worldwide; the biggest burden of it falls on low- and middle-income countries and this trend is expected to widen further in case of inaction. The overall objective of the study is to describe and analyze the findings of the Noncommunicable Disease Risk Factors STEPS Survey Georgia 2016 related to tobacco marketing regulation. Methods The current study in Georgia was a population-based STEPS survey of randomly selected adults aged 18-69 within each sex and 10-year age-group. A multi-stage cluster sample design was used to produce representative data for that age range in Georgia. A total of 5554 adults participated in the current survey. We assessed level o tobacco marketing regulation implementation in Georgia. Results Study results reported high prevalence of tobacco use in Georgian population (31.1% (95 % CI: 29.0-33.1. Study findings showed that about half of the current smokers are exposed to anti-tobacco information on TV or radio 52.3% (95% CI: 48.9 - 55.7, whereas 35.5% (95% CI: 32.2 - 38.8 reported being exposed to cigarette marketing at points of sales of tobacco products and 4.7% (95% CI: 3.2-6.1 to any cigarette promotions. Health warnings on cigarette packs was reported to be noticed by 88.7% (95% CI: 85.8-91.6 of current smokers; only 33% (95% CI: 25.4 - 40.7 of them reported having thought about quitting because of these warnings. Conclusions The prevalence of smoking in Georgia is high compared to other countries of the European Region and it is very likely that smoking related NCDs burden will increase. Stricter tobacco control policies coupled with anti-tobacco media campaigns can address this problem. Improved health warnings on tobacco packages and total ban of tobacco advertisement, promotion and sponsorship should be implemented in order to overcome prevailed tobacco industry marketing strategies.

The passage and initial implementation of Oregon's Measure 44

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Goldman, L.; Glantz, S.

1999-01-01

OBJECTIVE—To prepare a history of the passage and early implementation of Ballot Measure 44, "An Act to Support the Oregon Health Plan", and tobacco control policymaking in Oregon. Measure 44 raised cigarette taxes in Oregon by US$0.30 per pack, and dedicated 10% of the revenues to tobacco control.
METHODS—Data were gathered from interviews with members of the Committee to Support the Oregon Health Plan, Measure 44's campaign committee, as well as with state and local officials, and tobacco control advocates. Additional information was obtained from public documents, internal memoranda, and news reports.
RESULTS—Although the tobacco industry outspent Measure 44's supporters 7 to 1, the initiative passed with 56% of the vote. Even before the election, tobacco control advocates were working to develop an implementation plan for the tobacco control programme. They mounted a successful lobbying campaign to see that the legislature did not divert tobacco control funds to other uses. They also stopped industry efforts to limit the scope of the programme. The one shortcoming of the tobacco control forces was not getting involved in planning the initiative early enough to influence the amount of money that was devoted to tobacco control. Although public health groups provided 37% of the money it cost to pass Measure 44, only 10% of revenues were devoted to tobacco control.
CONCLUSIONS—Proactive planning and aggressive implementation can secure passage of tobacco control initiatives and see that the associated implementing legislation follows good public health practice.


Keywords: advocacy; legislation; implementation; tobacco tax PMID:10599577

Projecting the effects of tobacco control policies in the USA through microsimulation: a study protocol

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Levy, David T; Jeon, Jihyoun; Clarke, John; Gilkeson, Scott; Hall, Tim; Holford, Theodore R; Meza, Rafael

2018-01-01

Introduction Smoking remains the leading cause of preventable death in the USA but can be reduced through policy interventions. Computational models of smoking can provide estimates of the projected impact of tobacco control policies and can be used to inform public health decision making. We outline a protocol for simulating the effects of tobacco policies on population health outcomes. Methods and analysis We extend the Smoking History Generator (SHG), a microsimulation model based on data from the National Health Interview Surveys, to evaluate the effects of tobacco control policies on projections of smoking prevalence and mortality in the USA. The SHG simulates individual life trajectories including smoking initiation, cessation and mortality. We illustrate the application of the SHG policy module for four types of tobacco control policies at the national and state levels: smoke-free air laws, cigarette taxes, increasing tobacco control programme expenditures and raising the minimum age of legal access to tobacco. Smoking initiation and cessation rates are modified by age, birth cohort, gender and years since policy implementation. Initiation and cessation rate modifiers are adjusted for differences across age groups and the level of existing policy coverage. Smoking prevalence, the number of population deaths avoided, and life-years gained are calculated for each policy scenario at the national and state levels. The model only considers direct individual benefits through reduced smoking and does not consider benefits through reduced exposure to secondhand smoke. Ethics and dissemination A web-based interface is being developed to integrate the results of the simulations into a format that allows the user to explore the projected effects of tobacco control policies in the USA. Usability testing is being conducted in which experts provide feedback on the interface. Development of this tool is under way, and a publicly accessible website is available at http

An Overview of a Regionalist Approach to Tobacco Control in Africa ...

African Journals Online (AJOL)

The tobacco control network has been finding ways to prevent a tobacco epidemic in developing countries through the adoption of tobacco control laws. However, their efforts are obstructed by the tobacco companies. Using transnationalism and transnational advocacy network theories, the study examines new strategies ...

The growth in newspaper coverage of tobacco control in China, 2000-2010.

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Gao, Junling; Chapman, Simon; Sun, Shaojing; Fu, Hua; Zheng, Pinpin

2012-03-07

Media coverage of tobacco-related issues can potentially shape individual beliefs, attitudes and behaviors about tobacco use. This study aims to describe news coverage of tobacco control related issues in Chinese newspapers from 2000 to 2010. All 1149 articles related to tobacco control were extracted from the Database of Chinese Important Newspapers and content analyzed for the period Jan 1, 2000 to Dec 31, 2010. The changing pattern of tobacco control topic, article type, viewpoint, and article origin, and their relationship were analysed. News coverage of tobacco control related issues increased significantly (p newspapers (χ2 = 24.09, p = 0.002) and article types (χ2 = 193.35, p newspapers had more coverage of the dangers of tobacco and on enforcing bans on tobacco-advertising. News stories centered around monitoring tobacco use and smoke free activity, while editorials focused on enforcing bans on tobacco-advertising, youth access and programs and campaigns. Letters to editors focused on the dangers of smoking, raising tax, and smoking cessation. More articles (50.4%) took an anti-tobacco position (compared with 10.5% which were pro-smoking), with the amount of negative coverage growing significantly across the decade. National articles tended to lean toward anti-tobacco, however, local articles tended mix of pro-tobacco and neutral/balance positions. Editorials seemed to be more anti-tobacco oriented, but letters to the editor tended to show a mix of anti-tobacco and pro-tobacco positions. Chinese newspapers are giving increasing attention to tobacco control, but coverage remains lower than in the USA and Australia. Health workers need to give higher priority to efforts to increase news coverage beyond the present concentration around World No Tobacco Day and to develop strategies for making tobacco control issues more newsworthy to both national and local news outlets.

[Harm reduction strategy in tobacco control].

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Gorini, Giuseppe

2011-01-01

.Thus, California Department of Health Services prohibits promotion of snus and medicinal nicotine as a harm reduction strategy. However, the US Federal Family Smoking Prevention and Tobacco Control Act, signed by President Obama in 2009, places tobacco products under FDA jurisdiction: FDA must define criteria for lowering carcinogens and toxicants in tobacco products, making more available medicinal nicotine, evaluating PREPs, creating a federal Tobacco Control Agency.Which approaches is Italy going to follow?

Effects of a worksite tobacco control intervention in India: the Mumbai worksite tobacco control study, a cluster-randomised trial.

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Sorensen, Glorian; Pednekar, Mangesh; Cordeira, Laura Shulman; Pawar, Pratibha; Nagler, Eve M; Stoddard, Anne M; Kim, Hae-Young; Gupta, Prakash C

2017-03-01

We assessed a worksite intervention designed to promote tobacco control among workers in the manufacturing sector in Greater Mumbai, India. We used a cluster-randomised design to test an integrated health promotion/health protection intervention, the Healthy, Safe, and Tobacco-free Worksites programme. Between July 2012 and July 2013, we recruited 20 worksites on a rolling basis and randomly assigned them to intervention or delayed-intervention control conditions. The follow-up survey was conducted between December 2013 and November 2014. The difference in 30-day quit rates between intervention and control conditions was statistically significant for production workers (OR=2.25, p=0.03), although not for the overall sample (OR=1.70; p=0.12). The intervention resulted in a doubling of the 6-month cessation rates among workers in the intervention worksites compared to those in the control, for production workers (OR=2.29; p=0.07) and for the overall sample (OR=1.81; p=0.13), but the difference did not reach statistical significance. These findings demonstrate the potential impact of a tobacco control intervention that combined tobacco control and health protection programming within Indian manufacturing worksites. NCT01841879. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[MPOWER--strategy for fighting the global tobacco epidemic].

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Kaleta, Dorota; Kozieł, Anna; Miśkiewicz, Paulina

2009-01-01

It is estimated that tobacco use may cause death of 5 million people in 2008, which is higher than the number of deaths attributed to tuberculosis (TB), HIV/AIDS and malaria taken together. By 2030, the number of deaths related to the tobacco epidemic could exceed annually even 8 million. Despite many difficulties, a growing number of countries undertake intensive actions aimed at tobacco control. The objective of this paper was to discuss the major objectives of the MPOWER Report issued by the World Health Organization (WHO). The MPOWER package consists a set of six key and most effective strategies for fighting the global tobacco epidemic: 1) Monitoring tobacco consumption and the effectiveness of preventive measures; 2) Protect people from tobacco smoke; 3) Offer help to quit tobacco use; 4) Warn about the dangers of tobacco; 5) Enforce bans on tobacco advertising, promotion and sponsorship; and 6) Raise taxes on tobacco. It is proven that these strategies implemented in the compatible way, effectively decreases tobacco use. In addition, MPOWER comprises epidemiological data, information on implemented tobacco control measures and their efficiency. MPOWER is the only one document of a somewhat strategic nature that is a source of information on the spread of tobacco epidemic, as well as of suggestions concerning specific actions for supporting the fight against this epidemic.

Social responsibility in tobacco production? Tobacco companies' use of green supply chains to obscure the real costs of tobacco farming.

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Otañez, Marty; Glantz, Stanton A

2011-11-01

Tobacco companies have come under increased criticism because of environmental and labour practices related to growing tobacco in developing countries. Analysis of tobacco industry documents, industry websites and interviews with tobacco farmers in Tanzania and tobacco farm workers, farm authorities, trade unionists, government officials and corporate executives from global tobacco leaf companies in Malawi. British American Tobacco and Philip Morris created supply chains in the 1990 s to improve production efficiency, control, access to markets and profits. In the 2000s, the companies used their supply chains in an attempt to legitimise their portrayals of tobacco farming as socially and environmentally friendly, rather than take meaningful steps to eliminate child labour and reduce deforestation in developing countries. The tobacco companies used nominal self-evaluation (not truly independent evaluators) and public relations to create the impression of social responsibility. The companies benefit from $1.2 billion in unpaid labour costs because of child labour and more than $64 million annually in costs that would have been made to avoid tobacco-related deforestation in the top 12 tobacco growing developing countries, far exceeding the money they spend nominally working to change these practices. The tobacco industry uses green supply chains to make tobacco farming in developing countries appear sustainable while continuing to purchase leaf produced with child labour and high rates of deforestation. Strategies to counter green supply chain schemes include securing implementing protocols for the WHO Framework Convention on Tobacco Control to regulate the companies' practices at the farm level.

Social Responsibility in Tobacco Production? Tobacco Companies Use of Green Supply Chains to Obscure the Real Costs of Tobacco Farming

Science.gov (United States)

Otañez, Marty

2011-01-01

Background Tobacco companies have come under increased criticism because of environmental and labor practices related to growing tobacco in developing countries. Methods Analysis of tobacco industry documents, industry web sites and interviews with tobacco farmers in Tanzania and tobacco farm workers, farm authorities, trade unionists, government officials and corporate executives from global tobacco leaf companies in Malawi. Results British American Tobacco and Philip Morris created supply chains in the 1990s to improve production efficiency, control, access to markets, and profits. In the 2000s, the companies used their supply chains in an attempt to legitimize their portrayals of tobacco farming as socially and environmentally friendly, rather than take meaningful steps to eliminate child labor and reduce deforestation in developing countries. The tobacco companies used nominal self-evaluation (not truly independent evaluators) and public relations to create the impression of social responsibility. The companies benefit from $1.2 billion in unpaid labor costs due to child labor and more than $64 million annually in costs that would have been made to avoid tobacco related deforestation in the top twelve tobacco growing developing countries, far exceeding the money they spend nominally working to change these practices. Conclusions The tobacco industry uses green supply chains to make tobacco farming in developing countries appear sustainable while continuing to purchase leaf produced with child labor and high rates of deforestation. Strategies to counter green supply chain schemes include securing implementing protocols for the WHO Framework Convention on Tobacco Control to regulate the companies’ practices at the farm level. PMID:21504915

The growth in newspaper coverage of tobacco control in China, 2000-2010

Directory of Open Access Journals (Sweden)

Gao Junling

2012-03-01

Full Text Available Abstract Background Media coverage of tobacco-related issues can potentially shape individual beliefs, attitudes and behaviors about tobacco use. This study aims to describe news coverage of tobacco control related issues in Chinese newspapers from 2000 to 2010. Methods All 1149 articles related to tobacco control were extracted from the Database of Chinese Important Newspapers and content analyzed for the period Jan 1, 2000 to Dec 31, 2010. The changing pattern of tobacco control topic, article type, viewpoint, and article origin, and their relationship were analysed. Results News coverage of tobacco control related issues increased significantly (p p χ2 = 24.09, p = 0.002 and article types (χ2 = 193.35, p Conclusion Chinese newspapers are giving increasing attention to tobacco control, but coverage remains lower than in the USA and Australia. Health workers need to give higher priority to efforts to increase news coverage beyond the present concentration around World No Tobacco Day and to develop strategies for making tobacco control issues more newsworthy to both national and local news outlets.

Effects of the 2003 advertising/promotion ban in the United Kingdom on awareness of tobacco marketing: findings from the International Tobacco Control (ITC) Four Country Survey

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Harris, F; MacKintosh, A M; Anderson, S; Hastings, G; Borland, R; Fong, G T; Hammond, D

2006-01-01

Background In February 2003, a comprehensive ban on tobacco promotion came into effect in the United Kingdom, which prohibited tobacco marketing through print and broadcast media, billboards, the internet, direct mail, product placement, promotions, free gifts, coupons and sponsorships. Objective To investigate the impact of the UK's comprehensive ban on tobacco promotion on adult smokers' awareness of tobacco marketing in the UK relative to Canada, the United States and Australia. Design A total of 6762 adult smokers participated in two waves of a random digit dialled telephone survey across the four countries. Wave 1 was conducted before the UK ban (October–December 2002) and Wave 2 was conducted after the UK ban (May–September 2003). Key measures Awareness of a range of forms of tobacco marketing. Results Levels of tobacco promotion awareness declined significantly among smokers in the UK after implementation of the advertising ban. Declines in awareness were greater in those channels regulated by the new law and change in awareness of tobacco promotions was much greater in the UK than the other three countries not affected by the ban. At least in the short term, there was no evidence that the law resulted in greater exposure to tobacco promotions in the few media channels not covered by the law. Notwithstanding the apparent success of the UK advertising ban and the controls in other countries, 9–22% of smokers in the four countries still reported noticing things that promoted smoking “often or very often” at Wave 2. Conclusions The UK policy to ban tobacco advertising and promotion has significantly reduced exposure to pro‐tobacco marketing influences. These findings support the effectiveness of comprehensive bans on advertising and promotion, as included in the Framework Convention on Tobacco Control. PMID:16754943

Effects of the 2003 advertising/promotion ban in the United Kingdom on awareness of tobacco marketing: findings from the International Tobacco Control (ITC) Four Country Survey.

Science.gov (United States)

Harris, F; MacKintosh, A M; Anderson, S; Hastings, G; Borland, R; Fong, G T; Hammond, D; Cummings, K M

2006-06-01

In February 2003, a comprehensive ban on tobacco promotion came into effect in the United Kingdom, which prohibited tobacco marketing through print and broadcast media, billboards, the internet, direct mail, product placement, promotions, free gifts, coupons and sponsorships. To investigate the impact of the UK's comprehensive ban on tobacco promotion on adult smokers' awareness of tobacco marketing in the UK relative to Canada, the United States and Australia. A total of 6762 adult smokers participated in two waves of a random digit dialled telephone survey across the four countries. Wave 1 was conducted before the UK ban (October-December 2002) and Wave 2 was conducted after the UK ban (May-September 2003). Awareness of a range of forms of tobacco marketing. Levels of tobacco promotion awareness declined significantly among smokers in the UK after implementation of the advertising ban. Declines in awareness were greater in those channels regulated by the new law and change in awareness of tobacco promotions was much greater in the UK than the other three countries not affected by the ban. At least in the short term, there was no evidence that the law resulted in greater exposure to tobacco promotions in the few media channels not covered by the law. Notwithstanding the apparent success of the UK advertising ban and the controls in other countries, 9-22% of smokers in the four countries still reported noticing things that promoted smoking "often or very often" at Wave 2. The UK policy to ban tobacco advertising and promotion has significantly reduced exposure to pro-tobacco marketing influences. These findings support the effectiveness of comprehensive bans on advertising and promotion, as included in the Framework Convention on Tobacco Control.

Awareness of pro-tobacco advertising and promotion and beliefs about tobacco use: findings from the Tobacco Control Policy (TCP) India Pilot Survey.

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Bansal-Travers, Maansi; Fong, Geoffrey T; Quah, Anne C K; Sansone, Genevieve; Pednekar, Mangesh S; Gupta, Prakash C; Sinha, Dhirendra N

2014-12-01

Tobacco companies are utilizing similar strategies to advertise and promote their products in developing countries as they have used successfully for over 50 years in developed countries. The present study describes how adult smokers, smokeless tobacco users, and non-users of tobacco from the Tobacco Control Project (TCP) India Pilot Survey, conducted in 2006, responded to questions regarding their perceptions and observations of pro-tobacco advertising and promotion and beliefs about tobacco use. Analyses found that 74% (n=562) of respondents reported seeing some form of pro-tobacco advertising in the last six months, with no differences observed between smokers (74%), smokeless tobacco users (74%), and nonsmokers (73%). More than half of respondents reported seeing pro-tobacco advertising on store windows or inside shops. Overall, this study found that a significant percentage of tobacco users and non-users in India report seeing some form of pro-tobacco advertising and promotion messages. Additional analyses found that smokers were more likely to perceive tobacco use as harmful to their health compared with smokeless tobacco users and non-users (padvertising and promotion of tobacco products in India. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Awareness of pro-tobacco advertising and promotion and beliefs about tobacco use: Findings from the Tobacco Control Policy (TCP) India Pilot Survey†

Science.gov (United States)

Bansal-Travers, Maansi; Fong, Geoffrey T.; Quah, Anne C.K.; Sansone, Genevieve; Pednekar, Mangesh S.; Gupta, Prakash C.; Sinha, Dhirendra N.

2014-01-01

Tobacco companies are utilizing similar strategies to advertise and promote their products in developing countries as they have used successfully for over 50 years in developed countries. The present study describes how adult smokers, smokeless tobacco users, and non-users of tobacco from the Tobacco Control Project (TCP) India Pilot Survey, conducted in 2006, responded to questions regarding their perceptions and observations of pro-tobacco advertising and promotion and beliefs about tobacco use. Analyses found that 74% (n=562) of respondents reported seeing some form of pro-tobacco advertising in the last six months, with no differences observed between smokers (74%), smokeless tobacco users (74%), and nonsmokers (73%). More than half of respondents reported seeing pro-tobacco advertising on store windows or inside shops. Overall, this study found that a significant percentage of tobacco users and non-users in India report seeing some form of pro-tobacco advertising and promotion messages. Additional analyses found that smokers were more likely to perceive tobacco use as harmful to their health compared with smokeless tobacco users and non-users (padvertising and promotion of tobacco products in India. PMID:25455648

Impact of the implementation of a smoke free law in Serbia on exposure to tobacco smoke in different settings.

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Kosic Bibic Nada

2017-05-01

Results indicate that the implementation of the Smoke Free Law in Serbia led to a decrease in exposure to tobacco smoke in all places where smoking is banned. Legislation should be improved to protect customers and workers from exposure to tobacco smoke in the hospitality sector. It is necessary to improve compliance with the law as 23% of the population is exposed to tobacco smoke at work despite the ban. High exposure to tobacco smoke in citizens’ homes calls for implementation of campaigns aimed at the general population.

Future Health and Economic Impact of Comprehensive Tobacco Control in DoD: A Microsimulation Approach.

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Yang, Wenya; Zou, Quan; Tan, Eleonora; Watkins, Lachlan; Beronja, Kaleigh; Hogan, Paul F; Elenberg, Kimberly

2018-01-01

Tobacco use is a major concern to the Military Health System of the Department of Defense (DoD). The 2011 DoD Health Related Behavior Survey reported that 24.5% of active duty personnel are current smokers, which is higher than the national estimate of 20.6% for the civilian population. Overall, it is estimated that tobacco use costs the DoD $1.6 billion a year through related medical care, increased hospitalization, and lost days of work, among others. This study evaluated future health outcomes of Tricare Prime beneficiaries aged 18-64 yr (N = 3.2 million, including active duty and retired military members and their dependents) and the potential economic impact of initiatives that DoD may take to further its effort to transform the military into a tobacco-free environment. Our analysis simulated the future smoking status, risk of developing 25 smoking-related diseases, and associated medical costs for each individual using a Markov Chain Monte Carlo microsimulation model. Data sources included Tricare administrative data, national data such as Centers for Disease Control and Prevention mortality data and National Cancer Institute's cancer registry data, as well as relative risks of diseases obtained from a literature review. We found that the prevalence of active smoking among the Tricare Prime population will decrease from about 24% in 2015 to 18% in 2020 under a status quo scenario. However, if a comprehensive tobacco control initiative that includes a 5% price increase, a tighter clean air policy, and an intensified media campaign were to be implemented between 2016 and 2020, the prevalence of smoking could further decrease to 16%. The near 2 percentage points reduction in smoking prevalence represents an additional 81,240 quitters and translates to a total lifetime medical cost savings (in 2016 present value) of $968 million, with 39% ($382 million) attributable to Tricare savings. A comprehensive tobacco control policy within the DoD could significantly

Linking Global Youth Tobacco Survey (GYTS) data to the WHO Framework Convention on Tobacco Control (FCTC): the case for the Philippines.

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Miguel-Baquilod, Marina; Fishburn, Burke; Warren, Charles W; Jones, Nathan R; Asma, Samira

2008-09-01

The purpose of this paper is to present data from the Global Youth Tobacco Survey (GYTS) conducted in the Philippines in 2000 and 2003 which can be used as baseline measures to monitor provisions of the 2003 Tobacco Regulatory Act and Articles of the WHO FCTC. The GYTS is a school-based survey which uses a two-stage sample design to produce representative, independent, cross-sectional estimates. In both 2000 and 2003, the GYTS was conducted in three geographic zones in the Philippines. The zones are then combined to produce a representative national estimate each year. Data in this report are limited to students aged 13-15 years. The findings in this study show that in the Philippines changes occurred between 2000 and 2003 in that: students were less likely to smoke cigarettes or use other tobacco products, less likely to be exposed to SHS in public places, more likely to support bans on smoking in public places, more likely to have learned in school and from the media about the health hazards of tobacco use, and less likely to have been offered "free" cigarettes by a tobacco company representative. The synergy between the Philippines' leadership in passing the Clean Air Act in 1999 and the Tobacco Regulatory Air in 2003, in ratifying the WHO FCTC in 2005, and in supporting the conduct of the GYTS offers the Philippines a unique opportunity to develop, implement and evaluate the youth component of their comprehensive tobacco control policy that can be most helpful to the country.

Tobacco Control in Transition: Public Support and Governmental Disarray in Arizona 1997-2007

OpenAIRE

Hendlin M.Sc., Yogi H.; Barnes, Richard L JD; Glantz, Stanton A. Ph.D.

2008-01-01

• Tobacco control in Arizona flourished from 1997-2007, thanks to public support at the ballot box and the hard work of Arizonan tobacco control activists. • Arizona's state-run Tobacco Education and Prevention Program (TEPP), created by Proposition 200 in 1994 from 23% of a 40 cent tobacco tax increase, provided a key component in Arizona tobacco control, spending between $15 and $36 million annually. • Tobacco control advocacy between 1997 and 2007 resulted in more than tr...

African media coverage of tobacco industry corporate social responsibility initiatives.

Science.gov (United States)

McDaniel, Patricia A; Cadman, Brie; Malone, Ruth E

2018-02-01

Guidelines for implementing the World Health Organization's Framework Convention on Tobacco Control (FCTC) recommend prohibiting tobacco industry corporate social responsibility (CSR) initiatives, but few African countries have done so. We examined African media coverage of tobacco industry CSR initiatives to understand whether and how such initiatives were presented to the public and policymakers. We searched two online media databases (Lexis Nexis and Access World News) for all news items published from 1998 to 2013, coding retrieved items through a collaborative, iterative process. We analysed the volume, type, provenance, slant and content of coverage, including the presence of tobacco control or tobacco interest themes. We found 288 news items; most were news stories published in print newspapers. The majority of news stories relied solely on tobacco industry representatives as news sources, and portrayed tobacco industry CSR positively. When public health voices and tobacco control themes were included, news items were less likely to have a positive slant. This suggests that there is a foundation on which to build media advocacy efforts. Drawing links between implementing the FCTC and prohibiting or curtailing tobacco industry CSR programmes may result in more public dialogue in the media about the negative impacts of tobacco company CSR initiatives.

One Hundred Years in the Making: The Global Tobacco Epidemic.

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Wipfli, Heather; Samet, Jonathan M

2016-01-01

Today's global tobacco epidemic may represent one of the first instances of the globalization of a noninfectious cause of disease. This article focuses on the first century of the global tobacco epidemic and its current status, reviewing the current and projected future of the global tobacco epidemic and the steps that are in progress to end it. In the United States and many countries of Western Europe, tobacco consumption peaked during the 1960s and 1970s and declined as tobacco control programs were initiated, motivated by the evidence indicting smoking as a leading cause of disease. Despite this policy advancement and the subsequent reductions in tobacco consumption, the global tobacco epidemic continued to grow exponentially in the later years of the twentieth century, as the multinational companies sought new markets to replace those shrinking in high-income countries. In response, between 2000 and 2004, the World Health Organization developed its first public health treaty, the Framework Convention on Tobacco Control, which entered into force in 2005. An accompanying package of interventions has been implemented. New approaches to tobacco control, including plain packaging and single representation of brands, have been implemented by Australia and Uruguay, respectively, but have been challenged by the tobacco industry.

[Lessons learned from tobacco control in Spain].

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Fernández, Esteve; Villalbí, Joan R; Córdoba, Rodrigo

2006-01-01

The growing involvement in Spain by civil society in the demand for tobacco control policies has been notable. The basis for the creation of the National Committee for Tobacco Prevention was established in 2004. At the end of that year, an intensive intervention was aimed at specifying, in law, the regulatory actions in the National Plan for Tobacco Prevention. This would facilitate a qualitative leap, taking advantage of the legal transposition of the European directive on advertising. With broad political consensus, the Law 28/2005 was established regarding sanitary measures for tobacco and the regulation of the sale, supply and consumption of tobacco products. The objective stated in this law is to prevent the initiation of tobacco consumption, especially among youth, guarantee the right of non-smokers to breathe air free from tobacco smoke and make quitting this habit easier for people who wish to do so. The main issues included are the prohibition of tobacco advertising and the limitation of tobacco consumption in common work areas and enclosed public spaces. The new law has replaced the previous rules in Spain, which were some of the most permissive in the European Union in terms of tobacco sales, advertising limitations and restrictions on smoking locations. It is clear that there is still much to be done. At this time, more social support needs to be generated in favor of the new regulations, and an important effort needs to be made to educate the public.

Mapping U.S. government tobacco control leadership: networked for success?

Science.gov (United States)

Leischow, Scott J; Luke, Douglas A; Mueller, Nancy; Harris, Jenine K; Ponder, Paris; Marcus, Stephen; Clark, Pamela I

2010-09-01

In order to better understand how tobacco control efforts are coordinated across agencies of the Department of Health and Human Services (DHHS), we assessed tobacco control-related communication between tobacco control leaders across DHHS. Cross-sectional surveys were collected from individuals representing 11 DHHS agencies, and social network analyses were used to assess linkages and map agencies' tobacco control communication. Individuals within the Office of the Secretary and Centers for Disease Control and Prevention (CDC) were most central to the network, and those of highest rank were most likely to be central to the network (F = 4.03, p = .024). The Centers for Medicare and Medicaid Services, Food and Drug Administration, Health Resources and Services Administration, and Substance Abuse and Mental Health Services Administration had no or almost no contact with other agencies. There was considerable between-agency contact variability, and the CDC was the most central agency. Tobacco control communication across DHHS agencies was present but extremely variable. This inconsistency may compromise the ability of the DHHS to address tobacco use, a critical public health problem, in a coordinated and efficient fashion. In light of the new leadership at DHHS, this analysis describes a systems approach that can be reimplemented as a means of understanding and improving communication and collaboration to improve public health.

The Economics of Tobacco Control Research Initiative | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

The Economics of Tobacco Control Research Initiative ... action on tobacco will cause economic harm to governments, businesses, farmers, and poor families. ... Sign up now for IDRC news and views sent directly to your inbox each month.

Global Health Governance and the Commercial Sector: A Documentary Analysis of Tobacco Company Strategies to Influence the WHO Framework Convention on Tobacco Control

Science.gov (United States)

Weishaar, Heide; Collin, Jeff; Smith, Katherine; Grüning, Thilo; Mandal, Sema; Gilmore, Anna

2012-01-01

Background In successfully negotiating the Framework Convention on Tobacco Control (FCTC), the World Health Organization (WHO) has led a significant innovation in global health governance, helping to transform international tobacco control. This article provides the first comprehensive review of the diverse campaign initiated by transnational tobacco corporations (TTCs) to try to undermine the proposed convention. Methods and Findings The article is primarily based on an analysis of internal tobacco industry documents made public through litigation, triangulated with data from official documentation relating to the FCTC process and websites of relevant organisations. It is also informed by a comprehensive review of previous studies concerning tobacco industry efforts to influence the FCTC. The findings demonstrate that the industry's strategic response to the proposed WHO convention was two-fold. First, arguments and frames were developed to challenge the FCTC, including: claiming there would be damaging economic consequences; depicting tobacco control as an agenda promoted by high-income countries; alleging the treaty conflicted with trade agreements, “good governance,” and national sovereignty; questioning WHO's mandate; claiming the FCTC would set a precedent for issues beyond tobacco; and presenting corporate social responsibility (CSR) as an alternative. Second, multiple tactics were employed to promote and increase the impact of these arguments, including: directly targeting FCTC delegations and relevant political actors, enlisting diverse allies (e.g., mass media outlets and scientists), and using stakeholder consultation to delay decisions and secure industry participation. Conclusions TTCs' efforts to undermine the FCTC were comprehensive, demonstrating the global application of tactics that TTCs have previously been found to have employed nationally and further included arguments against the FCTC as a key initiative in global health governance

Implementation of the Tobacco Tactics intervention versus usual care in Trinity Health community hospitals

Directory of Open Access Journals (Sweden)

Sonia A. Duffy

2016-11-01

Full Text Available Abstract Background Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM implementation framework, a National Institutes of Health-sponsored study compared the nurse-administered Tobacco Tactics intervention to usual care. A prior paper describes the effectiveness of the Tobacco Tactics intervention. This subsequent paper provides data describing the remaining constructs of the RE-AIM framework. Methods This pragmatic study used a mixed methods, quasi-experimental design in five Michigan community hospitals of which three received the nurse-administered Tobacco Tactics intervention and two received usual care. Nurses and patients were surveyed pre- and post-intervention. Measures included reach (patient participation rates, characteristics, and receipt of services, adoption (nurse participation rates and characteristics, implementation (pre-to post-training changes in nurses' attitudes, delivery of services, barriers to implementation, opinions about training, documentation of services, and numbers of volunteer follow-up phone calls, and maintenance (continuation of the intervention once the study ended. Results Reach: Patient participation rates were 71.5 %. Compared to no change in the control sites, there were significant pre- to post-intervention increases in self-reported receipt of print materials in the intervention hospitals (n = 1370, p < 0.001. Adoption: In the intervention hospitals, all targeted units and several non-targeted units participated; 76.0 % (n = 1028 of targeted nurses and 317 additional staff participated in the training, and 92.4 % were extremely or somewhat satisfied with the training. Implementation: Nurses in the intervention hospitals reported increases in providing advice to quit, counseling, medications, handouts, and DVD (all p < 0.05 and reported decreased barriers to implementing smoking cessation services (p < 0.001. Qualitative comments were very

Three Eras in Global Tobacco Control: How Global Governance Processes Influenced Online Tobacco Control Networking.

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Wipfli, Heather; Chu, Kar-Hai; Lancaster, Molly; Valente, Thomas

2016-01-01

Online networks can serve as a platform to diffuse policy innovations and enhance global health governance. This study focuses on how shifts in global health governance may influence related online networks. We compare social network metrics (average degree centrality [AVGD], density [D] and clustering coefficient [CC]) of Globalink, an online network of tobacco control advocates, across three eras in global tobacco control governance; pre-Framework Convention on Tobacco Control (FCTC) policy transfer (1992-1998), global regime formation through the FCTC negotiations (1999-2005), and philanthropic funding through the Bloomberg Initiative (2006-2012). Prior to 1999, Globalink was driven by a handful of high-income countries (AVGD=1.908 D=0.030, CC=0.215). The FCTC negotiations (1999-2005) corresponded with a rapid uptick in the number of countries represented within Globalink and new members were most often brought into the network through relationships with regional neighbors (AVGD=2.824, D=0.021, CC=0.253). Between 2006 and 2012, the centrality of the US in the network increases significantly (AVGD=3.414, D=0.023, CC=0.310). The findings suggest that global institutionalization through WHO, as with the FCTC, can lead to the rapid growth of decentralized online networks. Alternatively, private initiatives, such as the Bloomberg Initiative, can lead to clustering in which a single source of information gains increasing influence over an online network.

Challenges for philanthropy and tobacco control in China (1986–2012)

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Redmon, Pamela; Chen, Lincoln C; Wood, Jacob L; Li, Shuyang; Koplan, Jeffrey P

2013-01-01

Objective To identify the international philanthropies that have invested in tobacco control in China, describe their role and strategies in changing the social norms of tobacco use, and define the outcomes achieved. Methods Information on the international philanthropic donor China projects, including activities and outcomes, was gathered from multiple sources including organisational websites, key informant interviews and emails with project officers, and published research papers and reports. Results Philanthropic donations to China's tobacco control efforts began in 1986. The donors provided funds to national, city, provincial government organisations, non-government organisations, universities, and healthcare organisations throughout China to establish a tobacco control workforce and effective programmes to reduce the burden of tobacco use. Conclusions International engagement has been an important dimension of tobacco control in China. Recognising the large burden of illness and capitalising on proven effective control measures, philanthropic organisations understandably seized the opportunity to achieve major health gains. Much of the international philanthropic investment has been directed at public information, policy change and building the Chinese research knowledge base. Documenting research and evaluation findings will continue to be important to ensure that promising practices and lessons learned are identified and shared with the China tobacco control practitioners. The ultimate question is whether foreign philanthropy is making a difference in tobacco control and changing social norms in China? The answer is plainly and simply that we do not know; the evidence is not yet available. PMID:23708270

Leadership Perceptions of Endgame Strategies for Tobacco Control in California.

Science.gov (United States)

Smith, Elizabeth A; McDaniel, Patricia A; Malone, Ruth E

2018-03-27

To explore the perspectives of key stakeholders regarding advancement of the tobacco endgame in California. Interviews and focus groups exploring participants' knowledge of the tobacco endgame concept, their reactions to 4 endgame policy proposals (banning tobacco sales, registering smokers, retailer reduction, and permanently prohibiting tobacco sales to all those born after a certain year ["tobacco-free generation"]), and policy priorities and obstacles. Interviews with 11 California legislators/legislative staff members, 6 leaders of national tobacco control organizations, and 5 leaders of California-based organizations or California subsidiaries of national organizations. Focus groups (7) with professional and volunteer tobacco control advocates in Northern, Southern, and Central California. Advocates were more familiar with the endgame concept than legislators or legislative staff. All proposed endgame policies received both support and opposition, but smoker registration and banning tobacco sales were the least popular, regarded as too stigmatizing or too extreme. The tobacco-free generation and retailer-reduction policies received the most support. Both were regarded as politically feasible, given their focus on protecting youth or regulating retailers and their gradual approach. Concerns raised about all the proposals included the creation of black markets and the potential for disparate impacts on disadvantaged communities. Participants' willingness to support novel tobacco control proposals suggests that they understand the magnitude of the tobacco problem and have some appetite for innovation despite concerns about specific endgame policies. A preference for more gradual approaches suggests that taking incremental steps toward an endgame policy goal may be the most effective strategy.

Tobacco and the Malays: ethnicity, health and the political economy of tobacco in Malaysia.

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Barraclough, Simon; Morrow, Martha

2017-04-01

To identify the historical nexus between Malaysia's largest and politically dominant ethnic group and the political economy of tobacco, and to consider the implications of this connection for tobacco control. Primary and secondary documentary sources in both English and Malay were analysed to illuminate key events and decisions, and the discourse of industry and government. Sources included: speeches by Malaysian political and industry actors; tobacco industry reports, press releases and websites; government documents; World Health Organization (WHO) tobacco control literature; and press reports. Malays have the highest smoking prevalence among Malaysia's major ethnic groups. The tobacco industry has consistently been promoted as furthering Malay economic development. Malays play the major role in growing and curing. Government-owned Malay development trusts have been prominent investors in tobacco corporations, which have cultivated linkages with the Malay elite. The religious element of Malay ethnicity has also been significant. All Malays are Muslim, and the National Fatwa Council has declared smoking to be haram (forbidden); however, the Government has declined to implement this ruling. Exaggerated claims for the socio-economic benefits of tobacco production, government investment and close links between tobacco corporations and sections of the Malay elite have created a conflict of interest in public policy, limited the focus on tobacco as a health policy issue among Malays and retarded tobacco control policy. More recently, ratification of the WHO Framework Convention on Tobacco Control, regional free trade policies reducing the numbers of growers, concerns about smoking from an Islamic viewpoint, and anxieties about the effects of smoking upon youth have increasingly challenged the dominant discourse that tobacco furthers Malay interests. Nevertheless, the industry remains a formidable political and economic presence in Malaysia that is likely to continue to

Evaluation of Tobacco Control Policies in Bangladesh | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

The three-year evaluation is expected to shed light on such issues as the price ... the effects of tobacco control policies; and changes in the form of tobacco use. ... Minister Bibeau announces appointments of IDRC's President and new ...

Qualitative Research for Tobacco Control : A How-to Introductory ...

International Development Research Centre (IDRC) Digital Library (Canada)

Qualitative Research for Tobacco Control : A How-to Introductory Manual for Researchers and Development Practitioners. Couverture du livre Qualitative Research for Tobacco Control : A How-to Introductory Manual for. Auteur(s):. Alison Mathie et Anne Carnozzi. Maison(s) d'édition: CRDI. 15 janvier 2005. ISBN :.

Tobacco Control in Africa: People, Politics and Policies | CRDI ...

International Development Research Centre (IDRC) Digital Library (Canada)

15 oct. 2011 ... Tobacco use in Sub-Saharan Africa is growing rapidly as a result of strong economic growth and the aggressive marketing tactics of tobacco multinationals. Although the policy interventions are well understood, the political economy of tobacco control in Sub-Saharan Africa is not, and this volume is a timely ...

Implementation of effective cigarette health warning labels among low and middle income countries: state capacity, path-dependency and tobacco industry activity.

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Hiilamo, Heikki; Glantz, Stanton A

2015-01-01

We investigates the effects of ratifying the WHO Framework Convention of Tobacco Control (FTCT), state capacity, path-dependency and tobacco industry activity on the implementation of effective health warning labels (HWL) on cigarette packs among low and middle income countries (LMIC). Using logistic regression in separate analyses for FCTC Article 11 compliant HWLs and graphic HWLs (GHWL), we found that the odds of FCTC compliance increased by a factor of 1.31 for each year after FCTC entered into force in the country (p health regulations require investments in broader state capacity. As the theory of path-dependency predicts voluntary agreements have long lasting influence on the direction of tobacco control in a country. Adopting voluntary HWL policies reduced likelihood of having FCTC compliant HWLs decades later. The fact that voluntary agreements delayed effective tobacco regulations suggests that policymakers must be careful of accepting industry efforts for voluntary agreements in other areas of public health as well, such as alcohol and junk food. Copyright © 2014 Elsevier Ltd. All rights reserved.

Compliance with point-of-sale tobacco control policies and student tobacco use in Mumbai, India.

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Mistry, Ritesh; Pednekar, Mangesh S; McCarthy, William J; Resnicow, Ken; Pimple, Sharmila A; Hsieh, Hsing-Fang; Mishra, Gauravi A; Gupta, Prakash C

2018-05-09

We measured how student tobacco use and psychological risk factors (intention to use and perceived ease of access to tobacco products) were associated with tobacco vendor compliance with India's Cigarettes and Other Tobacco Products Act provisions regulating the point-of-sale (POS) environment. We conducted a population-based cross-sectional survey of high school students (n=1373) and tobacco vendors (n=436) in school-adjacent communities (n=26) in Mumbai, India. We used in-class self-administered questionnaires of high school students, face-to-face interviews with tobacco vendors and compliance checks of tobacco POS environments. Logistic regression models with adjustments for clustering were used to measure associations between student tobacco use, psychological risk factors and tobacco POS compliance. Compliance with POS laws was low overall and was associated with lower risk of student current tobacco use (OR 0.48, 95% CI 0.26 to 0.91) and current smokeless tobacco use (OR 0.40, 95% CI 0.21 to 0.77), when controlling for student-level and community-level tobacco use risk factors. Compliance was not associated with student intention to use tobacco (OR 0.50; 95% CI 0.21 to 1.18) and perceived ease of access to tobacco (OR 0.73; 95% CI 0.53 to 1.00). Improving vendor compliance with tobacco POS laws may reduce student tobacco use. Future studies should test strategies to improve compliance with tobacco POS laws, particularly in low-income and middle-income country settings like urban India. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Project Cerberus: tobacco industry strategy to create an alternative to the Framework Convention on Tobacco Control.

Science.gov (United States)

Mamudu, Hadii M; Hammond, Ross; Glantz, Stanton A

2008-09-01

Between 1999 and 2001, British American Tobacco, Philip Morris, and Japan Tobacco International executed Project Cerberus to develop a global voluntary regulatory regime as an alternative to the Framework Convention on Tobacco Control (FCTC). They aimed to develop a global voluntary regulatory code to be overseen by an independent audit body and to focus attention on youth smoking prevention. The International Tobacco Products Marketing Standards announced in September 2001, however, did not have the independent audit body. Although the companies did not stop the FCTC, they continue to promote the International Tobacco Products Marketing Standards youth smoking prevention as an alternative to the FCTC. Public health civil society groups should help policymakers and governments understand the importance of not working with the tobacco industry.

Relationship between tobacco control policies and the delivery of smoking cessation services in nonprofit HMOs.

Science.gov (United States)

Stevens, Victor J; Solberg, Leif I; Quinn, Virginia P; Rigotti, Nancy A; Hollis, Jack A; Smith, K Sabina; Zapka, Jane G; France, Eric; Vogt, Thomas; Gordon, Nancy; Fishman, Paul; Boyle, Raymond G

2005-01-01

This project examined tobacco policies and delivery of cessation services in nonprofit HMOs that collectively provide comprehensive medical care to more than 8 million members. Three annual surveys with health plan managers showed that all of these health plans had written tobacco control guidelines that became more comprehensive over the span of this study. We also surveyed a random sample of 4207 current smokers who had attended a primary care visit in the past year (399-528 at each of nine health plans). Of these smokers, 71% reported advice to quit, 56% were asked about their willingness to quit, 49% were provided some assistance in quitting (mostly self-help material or information about classes or counseling), and 9% were offered some kind of follow-up. Smokers receiving assistance in quitting reported higher satisfaction with their care. In general, health plans with the most comprehensive policies also showed higher rates of implementing tobacco treatment programs in primary care. Compared with tobacco control efforts of a decade or more ago, considerable progress has been made. However, there is still room for improvement in the proportion of smokers who receive the most effective forms of assistance in quitting.

Evaluation of Tobacco Control Law at Cafe’ and Restaurants

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Hilal Özcebe

2015-04-01

Full Text Available Objective: This study was conducted in order to evaluate ideas of some cafe and restaurants’ clients and workers about the tobacco control law three years after entering into force in a central district in Ankara in 2008. Methods: In the descriptive study;105 management, 113 worker and 386 client was visited, face to face interviews were done using two different questionnaire form and another form for managements’ evaluation. SPSS 15.0 statistical package program, Chi-square and t-tests were used. Administrative leave was taken. Results: Mean age of workers was 30.1±8.32 years; 82.3% were men, 54.0% smoker; with clients the values are 27.7±8.61 years; 53.6% women and 39.4% were smokers. There’s a difference between smokers and non- smokers’ ideas about the hazards; death due to second-hand smoking (p=0.024; p<0.01. 80.3% of smokers and 74.3% of non-smokers knew the law in restaurants serving alcoholic beverages. Acceptance of the idea of the law could help to quit smoking was significantly different between smoker/non smoker workers and smoker/non smoker clients (p=0.004;p<0.001. According to observations, 7.6% of the managements didn’t have law related plaque, 94.1% had smoking free areas, 57.1% had show window, 22.7% had smoking individuals and 12.6% had ashtray. Conclusion: Tobacco use is an individualistic reality but also a public health issue. Publicly acceptance of 45 law and implementations are needed besides individual perceptions. Implementations must be inspected and Smokers’ observance of the rules must be supplied in order to decrease tobacco use and related health complications.

Gaps in tobacco control research in accordance with WHO FCTC guidelines: a systematic literature review in Thailand

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Sarunya Benjakul

2018-03-01

Full Text Available Background Evidence-based policy is a term often applied in various field of public health including tobacco control policy. Strengthening evidence -based tobacco control policy development should also base on reliable evidence, in particular research approach. The coverage of tobacco control research under WHO FCTC guidelines is crucial issues. Methods A systematic literature review was conducted for identifying the gaps in tobacco control research. The search for relevant publications was done by the search engine. The key inclusion and exclusion criteria were defined, focusing on published original article conducting in Thai context, both English and Thai language in the past 5 years. The quality of articles was assessed. The text of articles was analyzed based on WHO FCTC articles, at totally 15 articles as well as the 2 nd National Strategic Plan for Tobacco Control 2015 - 2019. Results The initial search resulted in 1,048 abstracts. After applying the inclusion and exclusion criteria for two rounds, 176 original articles were selected for the review. In the article reviewed, the most of WHO FCTC articles applying into the research conceptual framework was article 20 (63.1% with the purpose of gain new knowledge on tobacco harms and effects on health and cross sectional survey design for surveillance tobacco use among various groups. The rest of articles were focused on research related WHO FCTC article 12 (31.0% and article 14 (19.3%. Three articles did not conducted as a research framework, articles 5.3, 9 - 10 and 19. However, those resulted were implemented in specific area, setting and target groups that's not applicable for scaling up. Conclusions The successful transformation of research results to effective tobacco control policy under WHO FCTC depends on various issuers, especially time-based for conducting the research that sufficient to prove the project outcome and appropriate budget for comprehensive research design, coverage

[Individual, community, regulatory, and systemic approaches to tobacco control interventions].

Science.gov (United States)

Gorini, Giuseppe

2011-01-01

During the 60s and the 70s strategies for decreasing initiation or quitting have been developed, in order to find those with high success rates. Unfortunately, interventions with an individual approach involved few smokers, so their impact in decreasing smoking prevalence was limited. The socio-ecological model offers a theoretical framework to community interventions for smoking cessation developed during the 80s, in which smoking was considered not only an individual, but also a social problem. In the 80s and the 90s smoking cessation community trials were developed, such as the Community Intervention Trial for Smoking Cessation (COMMIT). Afterwards, policy interventions (price policy; smoking bans in public places; advertising bans; bans of sales to minors) were developed, such as the American Stop Smoking Intervention Study for Cancer Prevention (ASSIST). California has been the first State all over the world to develop a comprehensive Tobacco Control Program in 1988, becoming the place for an ever-conducted natural experiment. All policy interventions in tobacco control have been finally grouped together in the World Health Organization - Framework Convention on Tobacco Control (WHO-FCTC), the first Public Health Treaty. Study designs have changed, according to the individual, community, or regulatory approaches: the classical randomized controlled trials (RCTs), in which the sampling unit is the individual, have been carried out for the evaluation of smoking cessation treatments, whereas cluster RCTs, in which the sampling unit is the community, have been conducted for evaluating community interventions, such as COMMIT. Finally, quasi-experimental studies (before/after study; prospective cohorts, both with a control group), in which the observational unit is a State, have been used for evaluating tobacco control policies, such as ASSIST and the International Tobacco Control Policy Evaluation Project. Although the successes of the last 20 years, tobacco

The Framework Convention on Tobacco Control: opportunities and issues El Convenio Marco para el Control del Tabaco: oportunidades y problemas

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Kenneth E Warner

2008-01-01

Full Text Available The Framework Convention on Tobacco Control (FCTC, a World Health Organization sponsored global tobacco control treaty, constitutes the first major international tool with the potential to significantly reduce the global pandemic of tobacco-produced disease and death. After providing background on the prevalence of cigarette smoking and smoking attributable mortality, both at present and projected for the future, the paper then describes the FCTC and discusses its development, the barriers it has confronted, and the opportunities it offers for improving global health. Successful implementation of the provisions in the treaty could avoid literally tens of millions of premature tobacco-produced deaths over the next few decades.El Convenio Marco para el Control del Tabaco (CMCT, un tratado para el control global del tabaco patrocinado por la Organización Mundial de la Salud, constituye la primera herramienta internacional importante con el potencial de reducir significativamente la pandemia mundial de enfermedades y decesos producidos por el tabaco. Este ensayo proporciona antecedentes sobre la prevalencia de consumo de cigarrillos y sobre mortalidad atribuible a dicho consumo, tanto al presente como con proyección a futuro. Después describe el CMCT, su desarrollo, las barreras que ha confrontado y las oportunidades que ofrece para mejorar la salud global. La implementación exitosa de las disposiciones del tratado podría evitar, literalmente, decenas de millones de muertes prematuras producidas por el tabaco en las próximas décadas.

Tobacco Taxes and Tobacco Control Policies in Brazil, Mexico, and ...

International Development Research Centre (IDRC) Digital Library (Canada)

However, research has yet to explore differences in cigarette smoking rates ... Meanwhile, existing studies on the impact of tobacco taxes are based on ... Associação de Controle do Tabagismo, Promoção da Saúde e dos Direitos Humanos.

Tobacco control policies and perinatal and child health: a systematic review and meta-analysis

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Timor Faber

2018-03-01

Full Text Available Background Tobacco smoking and smoke exposure during pregnancy and childhood cause considerable childhood morbidity and mortality. We aimed to determine whether implementation of the World Health Organization's recommended tobacco control policies (MPOWER were of benefit to perinatal and child health. Methods We searched 19 electronic databases, hand-searched references and citations, and consulted experts to identify (quasi-experimental studies assessing the association between implementation of MPOWER policies and child health. Our primary outcomes of interest were: perinatal mortality, preterm birth, hospital attendance for asthma exacerbations, and hospital attendance for respiratory tract infections (RTIs. Where possible and appropriate, we combined data from different studies in random-effects meta-analyses. Results We identified 41 eligible studies that assessed (combinations of MPOWER policies: smoke-free legislation (n=35, tobacco taxation (n=11, and smoking cessation services (n=3. Following implementation of smoke-free legislation, rates of preterm birth decreased by -3.77% (10 studies, 27,530,183 individuals; 95%CI -6.37 to -1.16, hospital attendance for asthma exacerbations decreased by -9.83% (five studies, 684,826 events; 95%CI -16.62 to -3.04, and hospital attendance for RTIs decreased by -3.45% (two studies, 1,681,020 events; 95%CI -4.64, -2.25 for all RTIs, and by -18.48% (three studies, 887,414 events; 95%CI -32.79 to -4.17 for lower RTIs. Associations appeared to be stronger when comprehensive smoke-free laws were implemented. Among two studies assessing the association between smoke-free legislation and perinatal mortality, one demonstrated significant reductions in stillbirth and neonatal mortality. Meta-analysis of studies on other MPOWER policies was not possible; all four studies on increasing tobacco taxation and one of two on offering disadvantaged pregnant women help to quit smoking that reported on our primary

Tobacco use patterns, knowledge, attitudes towards tobacco and availability of tobacco control training among school personnel from a rural area in Poland

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Dorota Kaleta

2017-01-01

In order to make it possible for the inhabitants of Piotrkowski district to work and learn in tobacco smoke free environment there is an urgent need for taking actions aiming at increasing effectiveness of enforcing applicable tobacco control regulations in educational units. The necessity for systematic training dedicated to the youth to prevent their tobacco use, including accurate preparation of teachers, also needs to be highlighted.

Protocol for the mixed-methods process and context evaluation of the TB & Tobacco randomised controlled trial in Bangladesh and Pakistan: a hybrid effectiveness–implementation study

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Nohavova, Iveta; Dogar, Omara; Kralikova, Eva; Pankova, Alexandra; Zvolska, Kamila; Huque, Rumana; Fatima, Razia; Noor, Maryam; Elsey, Helen; Sheikh, Aziz; Siddiqi, Kamran; Kotz, Daniel

2018-01-01

Introduction Tuberculosis (TB) remains a significant public health problem in South Asia. Tobacco use increases the risks of TB infection and TB progression. The TB& Tobacco placebo-controlled randomised trial aims to (1) assess the effectiveness of the tobacco cessation medication cytisine versus placebo when combined with behavioural support and (2) implement tobacco cessation medication and behavioural support as part of general TB care in Bangladesh and Pakistan. This paper summarises the process and context evaluation protocol embedded in the effectiveness–implementation hybrid design. Methods and analysis We are conducting a mixed-methods process and context evaluation informed by an intervention logic model that draws on the UK Medical Research Council’s Process Evaluation Guidance. Our approach includes quantitative and qualitative data collection on context, recruitment, reach, dose delivered, dose received and fidelity. Quantitative data include patient characteristics, reach of recruitment among eligible patients, routine trial data on dose delivered and dose received, and a COM-B (‘capability’, ‘opportunity’, ‘motivation’ and ‘behaviour’) questionnaire filled in by participating health workers. Qualitative data include semistructured interviews with TB health workers and patients, and with policy-makers at district and central levels in each country. Interviews will be analysed using the framework approach. The behavioural intervention delivery is audio recorded and assessed using a predefined fidelity coding index based on behavioural change technique taxonomy. Ethics and dissemination The study complies with the guidelines of the Declaration of Helsinki. Ethics approval for the study and process evaluation was granted by the University of Leeds (qualitative components), University of York (trial data and fidelity assessment), Bangladesh Medical Research Council and Bangladesh Drug Administration (trial data and qualitative

Characterizing tobacco control mass media campaigns in England.

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Langley, Tessa; Lewis, Sarah; McNeill, Ann; Gilmore, Anna; Szatkowski, Lisa; West, Robert; Sims, Michelle

2013-11-01

To characterize publically funded tobacco control campaigns in England between 2004 and 2010 and to explore if they were in line with recommendations from the literature in terms of their content and intensity. International evidence suggests that campaigns which warn of the negative consequences of smoking and feature testimonials from real-life smokers are most effective, and that four exposures per head per month are required to reduce smoking prevalence. Characterization of tobacco control advertisements using a theoretically based framework designed to describe advertisement themes, informational and emotional content and style. Study of the intensity of advertising and exposure to different types of advertisement using data on population-level exposure to advertisements shown during the study period. England. Television Ratings (TVRs), a standard measure of advertising exposure, were used to calculate exposure to each different campaign type. A total of 89% of advertising was for smoking cessation; half of this advertising warned of the negative consequences of smoking, while half contained how-to-quit messages. Acted scenes featured in 72% of advertising, while only 17% featured real-life testimonials. Only 39% of months had at least four exposures to tobacco control campaigns per head. A theory-driven approach enabled a systematic characterization of tobacco control advertisements in England. Between 2004 and 2010 only a small proportion of tobacco control advertisements utilized the most effective strategies-negative health effects messages and testimonials from real-life smokers. The intensity of campaigns was lower than international recommendations. © 2013 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of The Society for the Study of Addiction.

The tobacco industry's thwarting of marketing restrictions and health warnings in Lebanon.

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Nakkash, R; Lee, K

2009-08-01

This article outlines how the tobacco industry has undermined tobacco control efforts in Lebanon since the early 1970s. An analysis of online and on-site tobacco industry documents, reviews of newspapers, policy and other documents, and interviews with key policy makers were conducted. Findings reveal how the weakness of tobacco control legislation in Lebanon has been the product of an effective tobacco industry strategy to weaken the content and scope of regulation, and delay adoption and implementation. The tobacco industry has built and maintained strong alliances that were and are regularly mobilised to effectively oppose regulation. Despite ratification of the World Health Organization Framework Convention on Tobacco Control in 2005, Lebanon's tobacco control track remains weak. Public health professionals and the government should work hard to oppose such tobacco industry tactics.

State tobacco control expenditures and tax paid cigarette sales

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Tauras, John A.; Xu, Xin; Huang, Jidong; King, Brian; Lavinghouze, S. Rene; Sneegas, Karla S.; Chaloupka, Frank J.

2018-01-01

This research is the first nationally representative study to examine the relationship between actual state-level tobacco control spending in each of the 5 CDC’s Best Practices for Comprehensive Tobacco Control Program categories and cigarette sales. We employed several alternative two-way fixed-effects regression techniques to estimate the determinants of cigarette sales in the United States for the years 2008–2012. State spending on tobacco control was found to have a negative and significant impact on cigarette sales in all models that were estimated. Spending in the areas of cessation interventions, health communication interventions, and state and community interventions were found to have a negative impact on cigarette sales in all models that were estimated, whereas spending in the areas of surveillance and evaluation, and administration and management were found to have negative effects on cigarette sales in only some models. Our models predict that states that spend up to seven times their current levels could still see significant reductions in cigarette sales. The findings from this research could help inform further investments in state tobacco control programs. PMID:29652890

Tobacco Control in California 2003-2007: Missed Opportunities

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Hong, MPH, Mi-Kyung; Barnes,, Richard L JD; Glantz,, Stanton PhD

2007-01-01

While smoking prevalence in California continued its decline (reaching an historic low of 13.3% in 2006), this rate was slower than in earlier years, reflecting the fact that tobacco control efforts in California in the period 2003-2007 continued to drift, with no clear indications that California would regain its international leadership in tobacco control. Neither the Schwarzenegger Administration nor the California Legislature sought to divert the Proposition 99 funding allocation...

The ERS role on Tobacco Control Policy in Europe

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Christina Gratziou

2016-03-01

Full Text Available The European Respiratory Society is an international medical organisation that brings together physicians, healthcare professionals, scientists and other experts working in respiratory medicine. Its aim is to alleviate suffering from respiratory diseases and promote lung health globally through science, education and advocacy. ERS has since its founding in 1990 demonstrated strong commitment to tobacco control. Through scientific assemblies, education courses, various alliances and collaboration (Framework Convention Alliance, European Chronic Disease Alliance, World Health Organisation etc. As well as a Tobacco Control Committee (TCC dedicated to advocacy, ERS constantly strives to promote strong and evidence-based policies to reduce the burden of tobacco related diseases. One of the main outcome of the TCC is the creation of Smokehaz, a website aimed at providing policy-makers with scientific information on the Health hazards associated with smoking. Recently, ERS created the Latin-America Working Group which aims at strengthening tobacco control activities in Spain, Portugal and Latin-American countries.

Economics of tobacco control research initiative: Operating costs for ...

International Development Research Centre (IDRC) Digital Library (Canada)

Economics of tobacco control research initiative: Operating costs for capacity building ... (but misinformed) beliefs about the economic benefits of the tobacco industry ... Nutrition, health policy, and ethics in the age of public-private partnerships.

Perceptions of Tobacco Control Media Campaigns Among Smokers With Lower Socioeconomic Status.

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McCullough, Anna; Meernik, Clare; Baker, Hannah; Jarman, Kristen; Walsh, Barbara; Goldstein, Adam O

2017-11-01

People with low socioeconomic status (SES) in the United States have disparately high rates of smoking and experience disproportionately high burdens of smoking-related disease. Tobacco control media campaigns are a critical strategy for reducing tobacco use prevalence, but evidence is mixed about the optimal use of mass media to reach and promote tobacco use cessation among people with low SES. Improved understanding of the factors influencing how low-SES tobacco users evaluate tobacco control media campaigns may inform development of more effective messages and strategies. Focus groups with primarily low-SES smokers in Connecticut were conducted, finding that participants had seen many tobacco control television ads that used graphic imagery and testimonials, but participants voiced two main themes that limited ad effectiveness: (1) skepticism about the content of ads, the role of the tobacco industry and the government in sponsoring the ads, and the safety and efficacy of cessation supports; and (2) barriers to quitting such as stress, social contexts, and addiction that participants perceived as being underappreciated in the context of the ads. Tobacco control media campaigns targeting low-SES tobacco users may need additional messages, tools, or refinements to more optimally motivate this group to make quit attempts.

Are physicians aware of their role in tobacco control? A conference-based survey in Portugal.

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Ravara, Sofia B; Castelo-Branco, Miguel; Aguiar, Pedro; Calheiros, Jose M

2014-09-20

The crucial role of physicians in tobacco control (TC) is widely recognized. In 2008, Portugal implemented a non-comprehensive smoke-free policy (SFP). In 2009, a conference-survey was carried out to explore Portuguese physicians' engagement in tobacco control, by evaluating the following: 1) attendance at TC training and awareness of training needs; 2) participation in TC activities; 3) attitudes and beliefs regarding SFPs. Questionnaire-based cross-sectional study conducted during two major national medical conferences targeting GPs, hospitalists, and students/recent graduates. Descriptive analysis and logistic regression were performed. Response rate was 63.7% (605/950). Of the 605 participants, 58.3% were GPs, 32.4% hospitalists, 9.3% others; 62.6% were female; mean age was 39.0 ± 12.9 years. Smoking prevalence was 29.2% (95% CI: 23.3-35.1) in males; 15.8% (95% CI: 12.1-19.5) in females, p health, awareness of SFP benefits and TC law was limited, p outdoors bans in healthcare/schools settings and smoking restrictions in the home/car, p outdoors and private settings. The findings suggest that Portuguese physicians are not aware of their role in tobacco control. Poor engagement of physicians in TC may contribute to the current lack of comprehensive policies in Portugal and Europe and undermine social norm change. Medical and professional continuing education on tobacco control should be made top priorities.

Prevalence and Patterns of Tobacco Use in Bangladesh from 2009 to 2012: Evidence from International Tobacco Control (ITC) Study.

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Nargis, Nigar; Thompson, Mary E; Fong, Geoffrey T; Driezen, Pete; Hussain, A K M Ghulam; Ruthbah, Ummul H; Quah, Anne C K; Abdullah, Abu S

2015-01-01

Smoking and passive smoking are collectively the biggest preventable cause of death in Bangladesh, with major public health burden of morbidity, disability, mortality and community costs. The available studies of tobacco use in Bangladesh, however, do not necessarily employ nationally representative samples needed to monitor the problem at a national scale. This paper examines the prevalence and patterns of tobacco use among adults in Bangladesh and the changes over time using large nationally representative comparable surveys. Using data from two enumerations of the International Tobacco Control (ITC) Bangladesh Project conducted in 2009 and 2012, prevalence estimates are obtained for all tobacco products by socio-economic determinants and sample types of over 90,000 individuals drawn from over 30,000 households. Household level sample weights are used to obtain nationally representative prevalence estimates and standard errors. Statistical tests of difference in the estimates between two time periods are based on a logistic regression model that accounts for the complex sampling design. Using a multinomial logit model, the time trend in tobacco use status is identified to capture the effects of macro level determinants including changes in tobacco control policies. Between 2009 and 2012, overall tobacco use went down from 42.4% to 36.3%. The decline is more pronounced with respect to smokeless tobacco use than smoking. The prevalence of exclusive cigarette smoking went up from 7.2% to 10.6%; exclusive bidi smoking remained stable at around 2%; while smoking both cigarette and bidi went down from 4.6% to 1.8%; exclusive smokeless tobacco use went down from 20.2% to 16.9%; and both smokeless tobacco use and smoking went down from 8.4% to 5.1%. In general, the prevalence of tobacco use is higher among men, increases from younger to older age groups, and is higher among poorer people. Smoking prevalence is the highest among the slum population, followed by the tribal

Prevalence and Patterns of Tobacco Use in Bangladesh from 2009 to 2012: Evidence from International Tobacco Control (ITC Study.

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Nigar Nargis

Full Text Available Smoking and passive smoking are collectively the biggest preventable cause of death in Bangladesh, with major public health burden of morbidity, disability, mortality and community costs. The available studies of tobacco use in Bangladesh, however, do not necessarily employ nationally representative samples needed to monitor the problem at a national scale. This paper examines the prevalence and patterns of tobacco use among adults in Bangladesh and the changes over time using large nationally representative comparable surveys.Using data from two enumerations of the International Tobacco Control (ITC Bangladesh Project conducted in 2009 and 2012, prevalence estimates are obtained for all tobacco products by socio-economic determinants and sample types of over 90,000 individuals drawn from over 30,000 households. Household level sample weights are used to obtain nationally representative prevalence estimates and standard errors. Statistical tests of difference in the estimates between two time periods are based on a logistic regression model that accounts for the complex sampling design. Using a multinomial logit model, the time trend in tobacco use status is identified to capture the effects of macro level determinants including changes in tobacco control policies.Between 2009 and 2012, overall tobacco use went down from 42.4% to 36.3%. The decline is more pronounced with respect to smokeless tobacco use than smoking. The prevalence of exclusive cigarette smoking went up from 7.2% to 10.6%; exclusive bidi smoking remained stable at around 2%; while smoking both cigarette and bidi went down from 4.6% to 1.8%; exclusive smokeless tobacco use went down from 20.2% to 16.9%; and both smokeless tobacco use and smoking went down from 8.4% to 5.1%. In general, the prevalence of tobacco use is higher among men, increases from younger to older age groups, and is higher among poorer people. Smoking prevalence is the highest among the slum population

From Kazimierz to Athens - three decades of tobacco control advancement in Europe: time to tobacco-caused diseases endgame

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Witold Antoni Zatoński

2017-05-01

Full Text Available In the early 1990s the premature mortality of young and middle-aged adults in many countries of Central and Eastern Europe (CEE reached some of the highest levels in the world. It was not only twice higher than in the countries of Western Europe, but also above the rates of many developing countries, including China and India. The main cause underlying this health catastrophe in CEE were tobacco-caused diseases. In November 1990, almost precisely a year after the collapse of the Berlin Wall, a summit of tobacco control leaders took place in the town of Kazimierz in Poland. The aim of the meeting was to devise a strategy and plan of action that would allow to counteract the tobacco epidemic ravaging the post-communist states. The Kazimierz conference gathered leading tobacco control experts from across Europe and North America. Almost thirty years on from the Kazimierz Declaration, most of its health goals have been fully accomplished. The gap in smoking between young adults in CEE and Western Europe is almost closed, as evidenced by converging lung cancer morbidity and mortality rates. However, tobacco control in Europe is far from being finished business. There is an urgent need to formulate a new plan, akin to the Kazimierz Declaration in the early 1990s, that would allow tobacco control in Europe to take another leap forward. We need a Declaration of Athens that outlines the vision of civil society movement for tobacco end game, and the ENSP is best placed to launch such an initiative.

Are Tobacco Control Policies Effective in Reducing Young Adult Smoking?

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Farrelly, Matthew C.; Loomis, Brett R.; Kuiper, Nicole; Han, Beth; Gfroerer, Joseph; Caraballo, Ralph S.; Pechacek, Terry F.; Couzens, G. Lance

2015-01-01

Purpose We examined the influence of tobacco control program funding, smoke-free air laws, and cigarette prices on young adult smoking outcomes. Methods We use a natural experimental design approach that uses the variation in tobacco control policies across states and over time to understand their influence on tobacco outcomes. We combine individual outcome data with annual state-level policy data to conduct multivariable logistic regression models, controlling for an extensive set of sociodemographic factors. The participants are 18- to 25-year-olds from the 2002–2009 National Surveys on Drug Use and Health. The three main outcomes are past-year smoking initiation, and current and established smoking. A current smoker was one who had smoked on at least 1 day in the past 30 days. An established smoker was one who had smoked 1 or more cigarettes in the past 30 days and smoked at least 100 cigarettes in his or her lifetime. Results Higher levels of tobacco control program funding and greater smoke-free-air law coverage were both associated with declines in current and established smoking (p smoke-free air laws was associated with lower past year initiation with marginal significance (p = .058). Higher cigarette prices were not associated with smoking outcomes. Had smoke-free-air law coverage and cumulative tobacco control funding remained at 2002 levels, current and established smoking would have been 5%–7% higher in 2009. Conclusions Smoke-free air laws and state tobacco control programs are effective strategies for curbing young adult smoking. PMID:24268360

Nurses' use of qualitative research approaches to investigate tobacco use and control.

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Schultz, Annette S H; Bottorff, Joan L; McKeown, Stephanie Barclay

2009-01-01

Qualitative research methods are increasingly used by nurse scientists to explore a wide variety of topics relevant to practice and/or health policy issues. The purpose of this chapter is to review the contributions of nurse scientists to the field of tobacco control through the use of qualitative research methods. A systematic literature search strategy was used to identify 51 articles published between 1980 and 2008. The majority (84%) of reviewed articles were authored by North American nurse scientists. Cessation was the most commonly (85%) studied aspect of tobacco control. Six qualitative research approaches were used: qualitative descriptive (55%), narrative analysis (8%), phenomenology (6%), grounded theory (14%), ethnography (12%), and case study (6%). Qualitative descriptive methods were primarily one-off studies to address practical problems or issues encountered in practice, and often validated current understandings related to tobacco. Researchers who used other types of qualitative methods and who conducted qualitative studies as part of programs of research were more likely to make more substantive contributions to the evolving field of tobacco control. These contributions related to how smoking intertwines with personal and social identities, the influence of social context on tobacco use, and nurses' involvement in tobacco control (both of their own tobacco use and in assisting others). Nurse scientists interested in exploring tobacco-related issues are encouraged to consider the full range of qualitative research approaches. Qualitative research methods contribute to our understanding of tobacco use arising from nursing practice, health care and policy, along with the field of tobacco control in general.

Effectiveness of tax and price policies in tobacco control.

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Chaloupka, Frank J; Straif, Kurt; Leon, Maria E

2011-05-01

Over 20 experts on economics, epidemiology, public policy and tobacco control were asked by the International Agency for Research on Cancer (IARC) to evaluate the strength of the available evidence on the effects of tax and price policies to prevent and reduce tobacco use. Draft papers presenting and assessing the evidence on the following topics were developed by the experts in an 8-month period prior to the meeting: tobacco industry pricing strategies and tax related lobbying; tax, price and aggregate demand for tobacco; tax, price and adult tobacco use, use among young people and use among the poor; tax avoidance and tax evasion; and the economic and health impact of tobacco taxation. Subsequently, papers were peer reviewed, revised and resubmitted for final discussion at a 6-day meeting at IARC in Lyon, France, where a consensus evaluation of 18 concluding statements using the pre-established criteria of the IARC Cancer Prevention Handbooks took place. Studies published (or accepted for publication) in the openly available scientific literature were the main source of evidence for the review and evaluation; other types of publications were included when appropriate. In support of 12 of the 18 conclusions, the experts agreed that there was sufficient evidence of effectiveness of increased tobacco excise taxes and prices in reducing overall tobacco consumption and prevalence of tobacco use and improvement of public health, including by preventing initiation and uptake among young people, promoting cessation among current users and lowering consumption among those who continue to use. For the remaining six concluding statements the evidence was strong (four statements) or limited (two statements). The evidence presented and assessed in IARC Handbook volume 14 documents the effectiveness of tax and price policies in the control of tobacco use and improvement of public health.

Role of the Health Promotion Foundation in tobacco control and capacity building among healthcare professionals in Poland

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Kinga Janik-Koncewicz

2017-05-01

Full Text Available During the first summit of world tobacco control leaders in Central and Eastern Europe, held in 1990 in Kazimierz in Poland, the inadequate engagement of medical professionals in helping people to quit smoking was identified as one of the main problems of the region. The Health Promotion Foundation was established in 1992 to co-ordinate the anti-tobacco movement in Poland and to implement the resolutions of Kazimierz. The Foundation initiated actions to introduce anti-tobacco legislation in Poland passed by the Polish Parliament in 1995. It was one of the first legislative acts in the world to recommend tobacco dependence treatment. The Foundation also took active part in the preparation of the Framework Convention on Tobacco Control, and was one of the contributing authors of Article 14. The Foundation has also engaged in competence building among healthcare providers. It has trained thousands of Polish doctors and nurses using a core, nation-wide tool: the Consensus on Diagnosis and Treatment of Tobacco Dependence. Finally, the Foundation engaged in activities to increase cessation drug availability, e.g. by conducting research, disseminating knowledge on, and promoting cytisine. Since the 1990s millions of Poles quit smoking, also thanks to the Foundation’s comprehensive activities. Further work is now focused on developing effective ways to engage greater numbers of medical doctors in the treatment of tobacco dependence and building innovative technologies supporting them and people who want to quit smoking.

Attitudes and behavioral response toward key tobacco control measures from the FCTC among Chinese urban residents

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Li Fuzhong

2007-09-01

Full Text Available Abstract Background The Chinese National People's Congress ratified the WHO Framework Convention on Tobacco Control (FCTC on 27 August 2005, signaling China's commitment to implement tobacco control policies and legislation consistent with the treaty. This study was designed to examine attitudes towards four WHO FCTC measures among Chinese urban residents. Methods In a cross-sectional design study, survey data were collected from two Chinese urban cities involving a sample of 3,003 residents aged 15 years or older. Through a face-to-face interview, respondents were asked about attitudes toward four tobacco control measures developed by the WHO FCTC. Data on the four dependent measures were analyzed using multivariate logistic regression analyses. Using descriptive statistics, potential change in smoking behavior that smokers might make in response to increasing cigarette prices is also reported. Results 81.8% of the respondents in the study sample supported banning smoking in public places, 68.8% favored increasing the cigarette tax, 85.1% supported health warnings on cigarette packages, and 85.7% favored banning tobacco advertising. The likelihood to support these measures was associated with gender, educational level, and personal income. Smokers were less likely to support these measures than non-smokers, with decreased support expressed by daily smokers compared to occasional smokers, and heavy smokers compared to light smokers. The proportion of switching to cheaper cigarette brands, decreasing smoking, and quitting smoking altogether with increased cigarette prices were 29.1%, 30.90% and 40.0% for occasional smokers, respectively; and 30.8%, 32.7% and 36.5% for daily smokers, respectively. Conclusion Results from this study indicate strong public support in key WHO FCTC measures and that increases in cigarette price may reduce tobacco consumption among Chinese urban residents. Findings from this study have implications with respect to

Attitudes and behavioral response toward key tobacco control measures from the FCTC among Chinese urban residents.

Science.gov (United States)

Yang, Tingzhong; Wu, Yanwei; Abdullah, Abu Saleh M; Dai, Di; Li, Fuzhong; Wu, Junqing; Xiang, Haiqing

2007-09-18

The Chinese National People's Congress ratified the WHO Framework Convention on Tobacco Control (FCTC) on 27 August 2005, signaling China's commitment to implement tobacco control policies and legislation consistent with the treaty. This study was designed to examine attitudes towards four WHO FCTC measures among Chinese urban residents. In a cross-sectional design study, survey data were collected from two Chinese urban cities involving a sample of 3,003 residents aged 15 years or older. Through a face-to-face interview, respondents were asked about attitudes toward four tobacco control measures developed by the WHO FCTC. Data on the four dependent measures were analyzed using multivariate logistic regression analyses. Using descriptive statistics, potential change in smoking behavior that smokers might make in response to increasing cigarette prices is also reported. 81.8% of the respondents in the study sample supported banning smoking in public places, 68.8% favored increasing the cigarette tax, 85.1% supported health warnings on cigarette packages, and 85.7% favored banning tobacco advertising. The likelihood to support these measures was associated with gender, educational level, and personal income. Smokers were less likely to support these measures than non-smokers, with decreased support expressed by daily smokers compared to occasional smokers, and heavy smokers compared to light smokers. The proportion of switching to cheaper cigarette brands, decreasing smoking, and quitting smoking altogether with increased cigarette prices were 29.1%, 30.90% and 40.0% for occasional smokers, respectively; and 30.8%, 32.7% and 36.5% for daily smokers, respectively. Results from this study indicate strong public support in key WHO FCTC measures and that increases in cigarette price may reduce tobacco consumption among Chinese urban residents. Findings from this study have implications with respect to policymaking and legislation for tobacco control in China.

Effectiveness of tobacco control television advertising in changing tobacco use in England: a population-based cross-sectional study.

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Sims, Michelle; Salway, Ruth; Langley, Tessa; Lewis, Sarah; McNeill, Ann; Szatkowski, Lisa; Gilmore, Anna B

2014-06-01

To examine whether government-funded tobacco control television advertising shown in England between 2002 and 2010 reduced adult smoking prevalence and cigarette consumption. Analysis of monthly cross-sectional surveys using generalised additive models. England. More than 80 000 adults aged 18 years or over living in England and interviewed in the Opinions and Lifestyle Survey. Current smoking status, smokers' daily cigarette consumption, tobacco control gross rating points (GRPs-a measure of per capita advertising exposure combining reach and frequency), cigarette costliness, tobacco control activity, socio-demographic variables. After adjusting for other tobacco control policies, cigarette costliness and individual characteristics, we found that a 400-point increase in tobacco control GRPs per month, equivalent to all adults in the population seeing four advertisements per month (although actual individual-level exposure varies according to TV exposure), was associated with 3% lower odds of smoking 2 months later [odds ratio (OR) = 0.97, 95% confidence interval (CI) = 0.95, 0.999] and accounted for 13.5% of the decline in smoking prevalence seen over this period. In smokers, a 400-point increase in GRPs was associated with a 1.80% (95%CI = 0.47, 3.11) reduction in average cigarette consumption in the following month and accounted for 11.2% of the total decline in consumption over the period 2002-09. Government-funded tobacco control television advertising shown in England between 2002 and 2010 was associated with reductions in smoking prevalence and smokers' cigarette consumption. © 2014 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Development of an integrated tobacco endgame strategy.

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van der Eijk, Yvette

2015-07-01

In recent years, various tobacco 'endgame' strategies have been suggested as a means to phase out tobacco consumption. Using country examples, this paper discusses three potential strategies: replacing cigarettes with alternative products (harm reduction), denying tobacco sales to people born after a certain year (the tobacco-free generation proposal), and further implementing measures based on the WHO Framework Convention for Tobacco Control (FCTC) treaty. It is argued that all strategies have potential issues that could be avoided by combining them into an integrated, sequential endgame that, first, using measures recommended in the WHO FCTC, creates a climate that facilitates the phasing out of cigarettes; second, implements a generational phase out of cigarette sales; and third, simultaneously permits the regulated use of alternative nicotine products. Thus, integrating ideas from various endgame strategies will result in a more effective, resilient tobacco endgame policy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The perimetric boycott: a tool for tobacco control advocacy.

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Offen, N; Smith, E A; Malone, R E

2005-08-01

To propose criteria to help advocates: (1) determine when tobacco related boycotts may be useful; (2) select appropriate targets; and (3) predict and measure boycott success. Analysis of tobacco focused boycotts retrieved from internal tobacco industry documents websites and other scholarship on boycotts. Tobacco related boycotts may be characterised by boycott target and reason undertaken. Most boycotts targeted the industry itself and were called for political or economic reasons unrelated to tobacco disease, often resulting in settlements that gave the industry marketing and public relations advantages. Even a lengthy health focused boycott of tobacco industry food subsidiaries accomplished little, making demands the industry was unlikely to meet. In contrast, a perimetric boycott (targeting institutions at the perimeter of the core target) of an organisation that was taking tobacco money mobilised its constituency and convinced the organisation to end the practice. Direct boycotts of the industry have rarely advanced tobacco control. Perimetric boycotts of industry allies offer advocates a promising tool for further marginalising the industry. Successful boycotts include a focus on the public health consequences of tobacco use; an accessible point of pressure; a mutual interest between the target and the boycotters; realistic goals; and clear and measurable demands.

Involvement of Consumer Groups in Tobacco Control: Russia and Belarus Experience

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Dmitry Yanin

2017-05-01

5. Cooperation of consumer organizations from Russia (KONFOP and Belarus (Belarus Consumer Society, launched to promote best Tobacco Control practices, according to FCTC provisions, is a success story of involvement of consumer groups in Tobacco Control.

Global health governance and the commercial sector: a documentary analysis of tobacco company strategies to Influence the WHO framework convention on tobacco control

OpenAIRE

Weishaar, Heide; Collin, Jeff; Smith, Katherine; Grüning, Thilo; Mandal, Sema; Gilmore, Anna

2012-01-01

Editors' Summary Background Every year, about 5 million people die worldwide from tobacco-related causes and, if current trends continue, annual deaths from tobacco-related causes will increase to 10 million by 2030. In response to this global tobacco epidemic, the World Health Organization (WHO) has developed an international instrument for tobacco control called the Framework Convention on Tobacco Control (FCTC). Negotiations on the FCTC began in 1999, and the international treaty—the first...

Public policy for the control of tobacco-related disease.

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Bierer, M F; Rigotti, N A

1992-03-01

Public policies concerning tobacco shape the environment of the smoker and nonsmoker alike. These policies use diverse means to achieve the common goal of reducing tobacco use and its attendant health consequences. Educational interventions such as warning labels, school curricula, and public service announcements serve to inform the public about the hazards of tobacco smoke. These are countered by the pervasive marketing of tobacco products by the tobacco industry, despite a ban on tobacco advertising on radio and television. Further restrictions on tobacco advertising and promotion have been proposed and await action. Cigarette excise taxes and smoker-nonsmoker insurance premium differentials discourage smoking by making it more costly to purchase cigarettes. Conversely, health insurance reimbursement for smoking cessation programs could reduce the cost of giving up the habit and might encourage cessation. Restricting or banning smoking in public places and workplaces decreases a smoker's opportunities to smoke, further inhibiting this behavior. Reducing the availability of cigarettes to children and adolescents may help to prevent them from starting to smoke. The environment of the smoker is conditioned by this pastiche of influences. Physicians who become involved in tobacco-control issues have the opportunity to alter the environmental influences on their patients. This is likely to be synergistic with physicians' efforts inside the office to encourage individual smokers to quit. As a first step toward advocacy outside the office, physicians can help to create a smoke-free health-care facility in their own institution. Beyond that, advocacy groups or the voluntary health organizations (e.g., American Lung Association) provide avenues for physicians to take a stand on community issues relevant to tobacco control. Physicians who take these steps to alter the environment of smokers beyond the office are likely to magnify the effect of their work with individual

FCTC Implementation in Nigeria: Lessons for Low and Middle-Income Countries.

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Egbe, Catherine O; Bialous, Stella A; Glantz, Stanton

2018-04-06

Nigeria is a significant tobacco market and influential country in Africa. Nigeria ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2005. We reviewed Nigeria's tobacco control legislation since 2000 and compliance of the National Tobacco Control Act (NTCA) 2015 with the FCTC. We reviewed the National Tobacco Control Bills 2011 (proposed by legislature) and 2014 (proposed by Executive), the NTCA 2015, and media stories on tobacco control from 2008 to 2017. The NTCA, despite being more comprehensive than Nigeria's first Tobacco Smoking (Control) law of 1990, maintained provisions promoted by the tobacco industry. Examples include: allowing designated smoking areas in hospitality venues, higher educational institutions, and transportation venues; a loophole in the advertising restictions allowing communications with consenting adults; having the Manufacturers Association of Nigeria (MAN) (which includes tobacco companies) on the National Tobacco Control Committee charged with working with the Ministry of Health to implement the law. The industry is also directly involved with the Standards Organisation of Nigeria (SON) in preparing regulations on cigarette constituents and emissions. In an unprecedented step globally, the law requires that implementing regulations be approved by the National Assembly, giving the industry another opportunity to weaken this law further by lobbying the legislators to favour the industry. As of January 2018 the law was still not being enforced. The NTCA can be strengthened through implementation guidelines still being developed. The industry should be prevented from interfering with through MAN and SON, as required by FCTC Article 5.3. The tobacco industry works to block FCTC implementation even after a country ratifies the treaty. The Nigerian case illustrates that it is essential for health authorities to remain vigilant and ensure that the tobacco industry does not play a decision-making role in the process of tobacco

Building tobacco control research in Thailand: meeting the need for innovative change in Asia.

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Hamann, Stephen L; Mock, Jeremiah; Hense, Sibasis; Charoenca, Naowarut; Kungskulniti, Nipapun

2012-01-28

In low- and middle-income countries (LMICs) over the past two decades locally relevant tobacco control research has been scant. Experience shows that tobacco control measures should be based on sound research findings to ensure that measures are appropriate for local conditions and that they are likely to have an impact. Research should also be integrated within tobacco control measures to ensure ongoing learning and the production of knowledge. Thailand, a middle-income country, has a public health community with a record of successful tobacco control and a longstanding commitment to research. Thailand's comprehensive approach includes taxation; bans on tobacco advertising, sponsorship and promotion; smoke-free areas; graphic cigarette pack warnings; social marketing campaigns; cessation counseling; and an established tobacco control research program. The purpose of this study was to document and analyze the development of tobacco control research capacity in Thailand and the impact of research on Thai tobacco control measures. We used mixed methods including review of historical documentation and policy reports, qualitative interviews with key members of Thailand's tobacco control community, and an analysis of research productivity. In Thailand, tobacco control research has evolved through three phases: (1) discovery of the value of research in the policymaking arena, (2) development of a structure to support research capacity building through international collaborations supported by foreign funding agencies, and (3) delivery of locally relevant research made possible largely through substantial stable funding from a domestic health promotion foundation. Over two decades, Thai tobacco control advocates have constructed five steppingstones to success: (1) adapting foreign research to inform policymaking and lobbying for more support for domestic research; (2) attracting foreign funding agencies to support small-scale research and capacity building; (3

Building tobacco control research in Thailand: meeting the need for innovative change in Asia

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Hamann Stephen L

2012-01-01

Full Text Available Abstract Introduction In low- and middle-income countries (LMICs over the past two decades locally relevant tobacco control research has been scant. Experience shows that tobacco control measures should be based on sound research findings to ensure that measures are appropriate for local conditions and that they are likely to have an impact. Research should also be integrated within tobacco control measures to ensure ongoing learning and the production of knowledge. Thailand, a middle-income country, has a public health community with a record of successful tobacco control and a longstanding commitment to research. Thailand's comprehensive approach includes taxation; bans on tobacco advertising, sponsorship and promotion; smoke-free areas; graphic cigarette pack warnings; social marketing campaigns; cessation counseling; and an established tobacco control research program. The purpose of this study was to document and analyze the development of tobacco control research capacity in Thailand and the impact of research on Thai tobacco control measures. Method We used mixed methods including review of historical documentation and policy reports, qualitative interviews with key members of Thailand's tobacco control community, and an analysis of research productivity. Findings In Thailand, tobacco control research has evolved through three phases: (1 discovery of the value of research in the policymaking arena, (2 development of a structure to support research capacity building through international collaborations supported by foreign funding agencies, and (3 delivery of locally relevant research made possible largely through substantial stable funding from a domestic health promotion foundation. Over two decades, Thai tobacco control advocates have constructed five steppingstones to success: (1 adapting foreign research to inform policymaking and lobbying for more support for domestic research; (2 attracting foreign funding agencies to support small

Daring to dream: reactions to tobacco endgame ideas among policy-makers, media and public health practitioners

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Wilson Nick

2011-07-01

Full Text Available Abstract Background Tobacco control strategies have mainly targeted reducing demand. Supply-side focused measures, though less familiar, deserve consideration, particularly to achieve 'endgame' tobacco control aims (e.g. achieving close to zero smoking prevalence. We explored attitudes towards supply-side focused 'endgame' tobacco control approaches and how they can be best communicated with senior policymakers, journalists, and public health practitioners. Methods We identified five supply-side focused approaches which could potentially lead to the tobacco endgame: two structural models and three discrete actions. The structural models were: (i a Nicotine Authority to coordinate tobacco control activities and regulate the nicotine/tobacco market for public health aims; and (ii a Tobacco Supply Agency acting as a monopoly purchaser of tobacco products and controlling the tobacco supply for public health aims. The actions were: (a allocating progressively reducing tobacco product import quotas (the 'sinking lid' until importation and commercial sale of tobacco products ceased; (b making tobacco companies responsible for reducing smoking prevalence with stringent financial penalties if targets were missed; and (c new laws to facilitate litigation against tobacco companies. These approaches were presented as means to achieve a tobacco free New Zealand by 2020 to 19 senior policymakers, journalists, and public health physicians in two focus groups and eight interviews, and their reactions sought. Results The tobacco-free vision was widely supported. Participants engaged fully with the proposed tobacco control approaches, which were viewed as interesting or even intriguing. Most supported increasing the focus on supply-side measures. Views differed greatly about the desirability, feasibility and likely effectiveness of each approach. Participants identified a range of potential barriers to implementation and challenges to successfully advocating and

Generating news media interest in tobacco control; challenges in an advanced policy environment.

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MacKenzie, Ross; Chapman, Simon

2012-08-01

To determine the efficacy of using media releases for tobacco control advocacy in Australia's advanced policy environment. Between February and August 2010, news releases that summarised either newly published but unpublicized research findings, or local developments in tobacco control, were sent to NSW media outlets. Reports arising from the releases were tracked using commercial services Media Monitors and Factiva, as well as Google and Google News. Other tobacco control related news items during the same period were also tracked and recorded. Twenty-one news releases generated 93 news items across all news media, with a quarter of these related to a story of porcine haemoglobin in cigarette filters. By comparison, 'live' policy issues (especially plain packaging and a significant tobacco tax increase) covered in this period attracted 1,033 news stories in the Australian media. Press releases describing recently published, but underpublicized research were issued in weeks where no major competing tobacco control news occurred. Results of this project indicate that in environments with advanced tobacco policy, media opportunities related to tobacco control advocacy are limited, as many objectives have been achieved. The media can still play a key advocacy role in such environments, and advocates need to be particularly vigilant for opportunities that do arise. The paper also highlights the increasingly important role of internet-based media, including opportunities presented by social media for tobacco control.

Family Smoking Prevention And Tobacco Control Act: banning outdoor tobacco advertising near schools and playgrounds.

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Luke, Douglas A; Ribisl, Kurt M; Smith, Carson; Sorg, Amy A

2011-03-01

The tobacco industry has challenged new FDA rules restricting outdoor tobacco advertising near schools and playgrounds on First Amendment grounds, arguing that they would lead to a near complete ban on tobacco advertising in dense urban areas. To examine how the 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA) rules banning outdoor tobacco advertising near schools and playgrounds would affect tobacco retailers. GIS spatial analyses of two different states (Missouri, New York), along with more detailed analyses of two urban areas within those states (St. Louis, New York City), were conducted in 2010. The percentage of tobacco retailers falling within 350-, 500-, and 1000-foot buffer zones was then calculated. 22% of retailers in Missouri and 51% in New York fall within 1000-foot buffers around schools. In urban settings, more retailers are affected, 29% in St. Louis and 79% in New York City. Sensitivity analyses demonstrate that smaller buffers decrease the proportion of affected retailers. That is, 350-foot buffers affect only 6.7% of retailers in St. Louis and 29% in New York City. The effects of new outdoor tobacco advertising restrictions vary by location and population density. In Missouri and New York, outdoor tobacco advertising would still be permitted in many locations if such advertising was prohibited in a 1000-foot buffer zone around schools and playgrounds. Much smaller buffer zones of 350 feet may result in almost no reduction of outdoor advertising in many parts of the country. Copyright © 2011. Published by Elsevier Inc.

British American Tobacco on Facebook: undermining article 13 of the global World Health Organization Framework Convention on Tobacco Control

OpenAIRE

Freeman, Becky; Chapman, Simon

2010-01-01

Background The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) bans all forms of tobacco advertising, promotion and sponsorship. The comprehensiveness of this ban has yet to be tested by online social networking media such as Facebook. In this paper, the activities of employees of the transnational tobacco company, British American Tobacco, (BAT) on Facebook and the type of content associated with two globally popular BAT brands (Dunhill and Lucky Strike) are mapp...

Tobacco Control Policy Making in North Dakota: A Tradition of Activism

OpenAIRE

Welle, Jennifer R MPH; Ibrahim, Jennifer K. Ph.D.; Glantz, Stanton A. Ph.D.

2004-01-01

EXECUTIVE SUMMARY North Dakota has a long history of tobacco-related legislation dating back to the late 1800's, well before the formal organization of health advocates for tobacco control. Citizens of North Dakota recognized the negative health effects of tobacco smoke before most of the nation and made attempts to regulate the sale and use of tobacco products throughout the early 1900's. In 1913, the North Dakota legislature went as far as prohibiting the use of tobacco products in...

Conceptualizing threats to tobacco control from international economic agreements: the Brazilian experience.

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Drope, Jeffrey; McGrady, Benn; Bialous, Stella Aguinaga; Lencucha, Raphael; Silva, Vera Luiza da Costa E

2017-10-19

Using the results of dozens of interviews with key actors involved in tobacco control policymaking, we examine these actors' perceptions of threats to tobacco control policy efforts from international economic policies on trade and investment. We also evaluate, from a legal perspective, the genuine threats that exist or potential challenges that economic policies may pose to the Brazilian government's public health efforts. We find that most actors did not perceive these economic policies as a major threat to tobacco control. Objectively, we found that some threats do exist. For example, Brazil's attempt to ban most tobacco additives and flavorings continues to met resistance at the World Trade Organization.

Effects of a Tobacco-Free Work Site Policy on Employee Tobacco Attitudes and Behaviors, Travis County, Texas, 2010-2012.

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Seidel, Sarah E; Metzger, Kristi; Guerra, Andrea; Patton-Levine, Jessie; Singh, Sandeepkumar; Wilson, William T; Huang, Philip

2017-12-14

The adoption of tobacco-free policies in behavioral health settings is an important step in reducing staff tobacco use as well as the high rates of tobacco use among people with mental illness and behavioral disorders. Studies have demonstrated the importance of staff support when implementing tobacco-free workplace policies, but there is limited research examining tobacco use prevalence among staff and staff attitude before and after policy adoption. Integral Care, a local authority for behavioral health and developmental disabilities in Austin, Texas, and Austin Public Health embarked on a comprehensive planning process before implementing a 100% tobacco-free campus policy. The objectives were 1) assess staff tobacco use and attitudes toward a tobacco-free policy, 2) communicate policy to staff, 3) provide staff education and training, and 4) provide cessation resources. Integral Care and Austin Public Health conducted a web-based employee survey 6 months before and 6 and 12 months after implementation of the policy to measure tobacco use prevalence and attitudes among employees. Employees had significant improvements in tobacco use prevalence and attitudes toward the tobacco-free policy from pre-implementation to post-implementation. Tobacco use prevalence among staff decreased from 27.6% to 13.8%, and support for the policy increased from 60.6% to 80.3% at 12 months post-implementation. Adoption of 100% tobacco-free campus policies in behavioral health settings can result in significant reductions in staff tobacco use. Leadership should provide staff with education, training, and cessation support before adoption of tobacco-free work site policies to ensure success.

One unhealthy commodities industry? Understanding links across tobacco, alcohol and ultra-processed food manufacturers and their implications for tobacco control and the SDGS

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Jeff Collin

2018-03-01

Full Text Available Background FCTC Article 5.3 requires protection against tobacco industry interference in policy-making. By contrast, manufacturers of alcohol and ultra-processed food and drink products are often identified as potential partners in multi-sectoral health initiatives, including via the Sustainable Development Goals (SDGs. This divergence has been questioned given evidence of strategic similarities across sectors, to which this presentation adds an examination of structural links and their implications for health policy. This focuses on an analysis of 'interlocking directorates', via which directors of one organisation also occupy positions on different boards, widely as the principal indicator of network ties across corporations. Methods Using data from corporate websites, annual reports and business databases, we employ UCINET social network analysis software to examine interlocks in the top six transnational companies of each sector within and across tobacco, alcohol and food companies, with political elites, and with health and development agencies. Results We present findings via (i profiles of individual tobacco industry directors, highlighting strategically valuable links to other actors; (ii a quantitative comparison of interlocks across the three sectors, with no direct links between tobacco and food companies but with alcohol companies providing several bridges between them, and with food companies more extensively linked to political elites and health agencies; (iii a case study of the board of brewing giant SAB Miller at the time of its mega-merger with AB InBev to highlight the significance to tobacco control of wider interactions enabled by interlocks. Conclusions This account of linkages across tobacco, alcohol and ultra-processed food companies calls into question regulatory approaches that treat the tobacco industry as an exceptional case. Neglecting conflicts of interest with other unhealthy commodity producers is potentially

Can demand-side policies stop the tobacco industry's damage? Lessons from Turkey.

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Gultekin-Karakas, Derya

2015-01-01

Trade and investment liberalisation in the post-1980 period allowed the penetration of transnational tobacco companies into the Turkish market. State control over the market was gradually removed and tobacco farming, manufacturing, trade and consumption were reshaped in line with the needs of transnational tobacco companies. The resultant increase in product proliferation and aggressive marketing strategies led to a dramatic rise in cigarette consumption in the 1990s, making Turkey a market with one of the sharpest consumption increases in the world. While Turkey implemented demand-side tobacco control policies to reduce consumption after 1996, it continued to stimulate manufacturing and trade in a conflicting way. The Turkish case verifies that the liberalisation process facilitated by the state under the auspices of international institutions conflicts with tobacco control. Liberalisation paves the way for market expansions of transnational tobacco companies that resist tobacco control in their drive for profit. Current global tobacco control policies, with no interest in controlling manufacturing, have limited effect on consumption. The Turkish case indicates the necessity of establishing public control over tobacco manufacturing and trade from a public health perspective.

The tobacco endgame in Hong Kong: public support for a total ban on tobacco sales.

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Wang, Man Ping; Wang, Xin; Lam, Tai Hing; Viswanath, Kasisomayajula; Chan, Sophia S

2015-03-01

Tobacco endgame policies are increasingly advocated to end tobacco use. This study investigated public support for a total ban on tobacco sales, use and possession in Hong Kong. A telephone survey was conducted among 1537 randomly selected residents in 2012 to assess their support for a total ban on tobacco sales, usage and possession. Information on sociodemographic characteristics, smoking, and second hand smoke exposure were collected. Logistic regression was used to investigate factors associated with support for a total ban. Most of the never smokers (75.3%), ex-smokers (63.9%), and nearly half of current smokers (48.9%) backed some form of a total ban on tobacco. A total ban on tobacco sales was the most popular option among the three groups, with over half (64.8%) of all respondents supporting a ban within 10 years. Current smoking and higher educational attainment were associated with less support for a total ban on tobacco sales. Among current smokers, having quit intentions and attempts to quit were associated with support for a total ban. A total ban on tobacco sales was supported by most respondents. Ex-smokers and current smokers also voiced substantial support, although less than never smokers. A total ban on tobacco sales before 2022 should be the goal as it is supported by most of the respondents. Interim tobacco control measures, such as tax increases, expansion of smoking cessation services and plain packaging should be implemented to help current smokers quit and reduce smoking initiation before implementation of the ban. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Retailer opinions about and compliance with family smoking prevention and tobacco control act point of sale provisions: a survey of tobacco retailers.

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Rose, Shyanika W; Emery, Sherry L; Ennett, Susan; Reyes, Heathe Luz McNaughton; Scott, John C; Ribisl, Kurt M

2015-09-11

The objectives of this study were to document retailer opinions about tobacco control policy at the point of sale (POS) and link these opinions with store level compliance with sales and marketing provisions of the Tobacco Control Act. This study conducted interviews of 252 tobacco retailers in three counties in North Carolina and linked their opinions with in-person observational audit data of their stores' compliance with POS policies. We conducted analyses examining retailer factors associated with noncompliance using Generalized Estimating Equations (GEE) controlling for individual, store, neighborhood, and county factors. Over 90 % of retailers support minors' access provisions and a large minority (over 40 %) support graphic warnings and promotion bans. Low levels of support were found for a potential ban on menthol cigarettes (17 %). Store noncompliance with tobacco control policies was associated with both more reported retailer barriers to compliance and less support for POS policies. Awareness of and source of information about tobacco control regulations were not associated with compliance when accounting for neighborhood and county characteristics. Retailers expressed some support for a wide range of POS policies. Advocates and government agencies tasked with enforcement can work with retailers as stakeholders to enhance support, mitigate barriers, and promote compliance with tobacco control efforts at the point of sale.

The study protocol for a randomized controlled trial of a family-centred tobacco control program about environmental tobacco smoke (ETS to reduce respiratory illness in Indigenous infants

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Segan Catherine

2010-03-01

Full Text Available Abstract Background Acute respiratory illness (ARI is the most common cause of acute presentations and hospitalisations of young Indigenous children in Australia and New Zealand (NZ. Environmental tobacco smoke (ETS from household smoking is a significant and preventable contributor to childhood ARI. This paper describes the protocol for a study which aims to test the efficacy of a family-centred tobacco control program about ETS to improve the respiratory health of Indigenous infants in Australia and New Zealand. For the purpose of this paper 'Indigenous' refers to Australia's Aboriginal and Torres Strait Islander peoples when referring to Australian Indigenous populations. In New Zealand, the term 'Indigenous' refers to Māori. Methods/Design This study will be a parallel, randomized, controlled trial. Participants will be Indigenous women and their infants, half of whom will be randomly allocated to an 'intervention' group, who will receive the tobacco control program over three home visits in the first three months of the infant's life and half to a control group receiving 'usual care' (i.e. they will not receive the tobacco control program. Indigenous health workers will deliver the intervention, the goal of which is to reduce or eliminate infant exposure to ETS. Data collection will occur at baseline (shortly after birth and when the infant is four months and one year of age. The primary outcome is a doctor-diagnosed, documented case of respiratory illness in participating infants. Discussion Interventions aimed at reducing exposure of Indigenous children to ETS have the potential for significant benefits for Indigenous communities. There is currently a dearth of evidence for the effect of tobacco control interventions to reduce children's exposure to ETS among Indigenous populations. This study will provide high-quality evidence of the efficacy of a family-centred tobacco control program on ETS to reduce respiratory illness. Outcomes of

La función de la Oficina Nacional para el Control del Tabaco en México The role of the National Office for Tobacco Control in Mexico

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Justino Regalado-Pineda

2008-01-01

Full Text Available El tabaquismo, como la primera causa de muerte prevenible en el mundo, impone la implementación de políticas públicas acordes a la dimensión el problema. El Convenio Marco para el Control del Tabaco (CMCT de la Organización Mundial de la Salud establece una guía para este propósito. El solo hecho de haber firmado y ratificado el convenio no garantiza la consecución de los objetivos centrales, su éxito depende del compromiso y de las acciones implementadas por cada uno de los países que lo han adoptado. Es necesaria la construcción de las capacidades necesarias para el desarrollo de políticas sustentables de control del tabaco. La "capacidad nacional" consiste en el desarrollo de recursos humanos expertos y la creación de una estructura de ingeniería organizacional que le dé sustento a los programas sobre los que operará la implementación del tratado. La creación de la Oficina Nacional para el Control del Tabaco (ONCT permitirá fortalecer las acciones del Gobierno Federal encaminadas a la aplicación de políticas públicas de acuerdo con los lineamientos del CMCT de manera sustentable y permanente. En este ensayo se plantea la importancia de la ONCT para la implementación de políticas públicas para el control del tabaco, las funciones que desempeñará y los objetivos a mediano y largo plazo.Tobacco smoking as the first cause of preventable dead in the world requires the implementation of proper public policies. The WHO Framework Convention on Tobacco Control (FCTC sets the basis for this purpose at the national level. But the successful implementation of FCTC depends on a series of actions of every single member of the convention for the development of National Capacity. Building capacity implies the construction of human resources and organizational engineering or "institutional building" in order to enforce and guarantee the Plan of Action for the implementation of FCTC. The creation of the National Office for Tobacco

Availability of illicit tobacco in small retail outlets before and after the implementation of Australian plain packaging legislation.

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Scollo, Michelle; Bayly, Megan; Wakefield, Melanie

2015-03-01

We aimed to assess change in the availability of illicit tobacco in small mixed business retail outlets following the December 2012 introduction of plain packaging in Australia. 303 small retail outlets were visited in June and September 2012 (baseline months), and in December 2012 and February, April and July 2013. Fieldworkers requested a particular low-cost brand of cigarettes and then pressed the retailer for an 'even cheaper' brand. The cheapest pack of cigarettes offered was purchased and later examined to assess any divergence from prescribed Australian packaging regulations. The price paid was compared with tax liability and recommended retail price for the particular brand and pack size. In a sub-set of 179 stores, fieldworkers then asked the retailer about availability of unbranded (chop-chop) tobacco. Thirteen (2.2%) of 598 packs purchased pre-plain packaging were either non-compliant with Australian health warnings and/or suspiciously priced. Four packs (1.3%) of 297 met either or both criteria in the December implementation month, and five (0.6%) of 878 did so in the three collection months following implementation. Chop-chop was offered upon enquiry on 0.6% (n=2) of 338 occasions prior to implementation, 0.6% (n=1) of 170 occasions in the December 2012 implementation month, and 0.6% (n=3) of 514 occasions postimplementation. The likelihood of a 'positive' response (either an offer to sell or information about where unbranded tobacco may be purchased) did not differ across preimplementation, during-implementation and postimplementation waves. Overall, packs judged likely to be illicit were sold in response to requests for cheapest available packs on fewer than one percent of occasions. Offers to sell unbranded tobacco were rare. No change in availability of illicit tobacco was observed following implementation of plain packaging. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go

Tobacco industry efforts to erode tobacco advertising controls in Hungary.

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Szilágyi, T; Chapman, S

2004-12-01

To review strategies of transnational tobacco companies (TTCs) at creating a favourable advertising environment for their products in Hungary, with special regard to efforts resulting in the liberalisation of tobacco advertising in 1997. Analysis of internal tobacco industry documents relevant to Hungary available on the World Wide Web. Transcripts of speeches of members of the Parliament during the debate of the 1997 advertising act were also reviewed. The tobacco companies not only entered the Hungarian market by early participation in the privatisation of the former state tobacco monopoly, but also imported theirsophisticated marketing experiences. Evasion and violation of rules in force, creation of new partnerships, establishment and use of front groups, finding effective ways for influencing decision makers were all parts of a well orchestrated industry effort to avoid a strict marketing regulation for tobacco products.

Science for Tobacco Control Policies

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Constantine Vardavas

2016-03-01

Full Text Available The recent adoption of the Tobacco Products Directive is a unique opportunity to enhance the regulation of tobacco products in the European Union. In this presentation a brief overview of the development of an EU common reporting format for submission of data on ingredients contained in tobacco and related products will be presented, as an example of European tobacco regulatory science.

Estimating the Potential Impact of Tobacco Control Policies on Adverse Maternal and Child Health Outcomes in the United States Using the SimSmoke Tobacco Control Policy Simulation Model.

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Levy, David; Mohlman, Mary Katherine; Zhang, Yian

2016-05-01

Numerous studies document the causal relationship between prenatal smoking and adverse maternal and child health (MCH) outcomes. Studies also reveal the impact that tobacco control policies have on prenatal smoking. The purpose of this study is to estimate the effect of tobacco control policies on prenatal smoking prevalence and adverse MCH outcomes. The US SimSmoke simulation model was extended to consider adverse MCH outcomes. The model estimates prenatal smoking prevalence and, applying standard attribution methods, uses estimates of MCH prevalence and relative smoking risks to estimate smoking-attributable MCH outcomes over time. The model then estimates the effect of tobacco control policies on adverse birth outcomes averted. Different tobacco control policies have varying impacts on the number of smoking-attributable adverse MCH birth outcomes. Higher cigarette taxes and comprehensive marketing bans individually have the biggest impact with a 5% to 10% reduction across all outcomes for the period from 2015 to 2065. The policies with the lowest impact (2%-3% decrease) during this period are cessation treatment, health warnings, and complete smoke-free laws. Combinations of all policies with each tax level lead to 23% to 28% decreases across all outcomes. Our findings demonstrate the substantial impact of strong tobacco control policies for preventing adverse MCH outcomes, including long-term health implications for children exposed to low birth weight and preterm birth. These benefits are often overlooked in discussions of tobacco control. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Price and tax measures and illicit trade in the framework convention on tobacco control: what we know and what research is required.

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van Walbeek, Corne; Blecher, Evan; Gilmore, Anna; Ross, Hana

2013-04-01

Article 6 of the Framework Convention on Tobacco Control commits Parties to use tax and price policies to reduce tobacco use, whereas Article 15 commits Parties to implement measures to eliminate the illicit trade in tobacco products. This paper identifies research gaps/needs, especially in low- and middle-income countries, which, if adequately addressed, would help in implementing Articles 6 and 15. Based on a recent comprehensive review on the impact of tax and price on tobacco consumption and a summary of reviews and narratives about the illicit tobacco market, research gaps are identified. Countries have highly diverse research needs, depending on the stage of the tobacco epidemic, previous research and data availability, and making a ranking of research needs infeasible. Broad issues for further research are the following: (1) monitoring tobacco consumption, prices, and taxes, (2) assessing the effectiveness of the tax structure in generating revenue and reducing tobacco use, (3) strengthening the tax administration system in order to reduce tax evasion and tax avoidance, (4) improving our understanding of the political economy of tobacco tax policy, and (5) employing a multidisciplinary approach to assessing the magnitude of illicit tobacco trade. At a technical level, the case for increasing excise taxes to improve public health and increase government revenue is easily made, but the political and policy environment is often not supportive. In order to effectively impact policy, the required approach would typically make use of rigorous economic techniques, and be cognizant of the political economy of raising excise taxes.

Price and Tax Measures and Illicit Trade in the Framework Convention on Tobacco Control: What We Know and What Research Is Required

Science.gov (United States)

2013-01-01

Introduction: Article 6 of the Framework Convention on Tobacco Control commits Parties to use tax and price policies to reduce tobacco use, whereas Article 15 commits Parties to implement measures to eliminate the illicit trade in tobacco products. This paper identifies research gaps/needs, especially in low- and middle-income countries, which, if adequately addressed, would help in implementing Articles 6 and 15. Methods: Based on a recent comprehensive review on the impact of tax and price on tobacco consumption and a summary of reviews and narratives about the illicit tobacco market, research gaps are identified. Results: Countries have highly diverse research needs, depending on the stage of the tobacco epidemic, previous research and data availability, and making a ranking of research needs infeasible. Broad issues for further research are the following: (1) monitoring tobacco consumption, prices, and taxes, (2) assessing the effectiveness of the tax structure in generating revenue and reducing tobacco use, (3) strengthening the tax administration system in order to reduce tax evasion and tax avoidance, (4) improving our understanding of the political economy of tobacco tax policy, and (5) employing a multidisciplinary approach to assessing the magnitude of illicit tobacco trade. Conclusions: At a technical level, the case for increasing excise taxes to improve public health and increase government revenue is easily made, but the political and policy environment is often not supportive. In order to effectively impact policy, the required approach would typically make use of rigorous economic techniques, and be cognizant of the political economy of raising excise taxes. PMID:22987785

Application of Discrete-Choice Experiment Methods in Tobacco Control: A Systematic Review.

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Regmi, Kabindra; Kaphle, Dinesh; Timilsina, Sabina; Tuha, Nik Annie Afiqah

2018-03-01

Economic evidence relating to tobacco control is generally derived from the cost effectiveness of smoking-cessation programs or the economic impact of tobacco-induced disease, based on revealed-preference data. However, empirical estimates from stated-preference data on tobacco users' preferences, smoking behaviour and smoking cessation aids using analytical techniques such as discrete-choice experiments (DCEs) could be important for policy decision making in tobacco control. Our objective was to review the practice and utility of DCE methodology across nicotine- and tobacco-related issues, particularly smoking and smoking-cessation behaviour, anti-smoking policies and preferences for smoking-cessation aids. We searched the PubMed, MEDLINE and ECONLIT databases for full-text original research articles on tobacco-related issues published between January 2000 and April 2016 that used a DCE method. We summarised the evidence and methodological characteristics of DCEs according to Lancsar and Louviere, 2008. Our review of the 12 eligible studies showed that DCE methodology was used to elicit smoker preferences and to evaluate tobacco-control policies. The majority of the studies were published in the last 5 years. The areas of application were smoking cessation, smoking behaviour, electronic cigarette use, water-pipe smoking and tobacco packaging. Monetary attributes were the most influential attributes in all studies. The design of the DCEs varied. DCE studies of tobacco-related issues were methodologically consistent with guidelines proposed for conducting health-related DCEs.

Effect of nationwide tobacco control policies on smoking cessation in high and low educated groups in 18 European countries

NARCIS (Netherlands)

Schaap, M. M.; Kunst, A. E.; Leinsalu, M.; Regidor, E.; Ekholm, O.; Dzurova, D.; Helmert, U.; Klumbiene, J.; Santana, P.; Mackenbach, J. P.

2008-01-01

BACKGROUND: Recently a scale was introduced to quantify the implementation of tobacco control policies at country level. Our study used this scale to examine the potential impact of these policies on quit ratios in European countries. Special attention was given to smoking cessation among lower

Young peoples awareness and support for tobacco control legislation: A study among in-school youth in Lagos, Nigeria.

Science.gov (United States)

Odukoya, Oluwakemi Ololade; Chife, Jacob Obi; Odeyemi, Kofoworola A; Nwangwu, Genevieve I

2015-01-01

.1%) cigarettes. Few (13.7%) respondents did not support the law banning cigarette advertisement on mass forms of media. Similarly, 12.2% did not support the law allowing cigarette sponsorship and promotions by cigarette companies. Majority (83.7%) of the respondents agreed with the law banning the sale of cigarettes arouhd school premises while 66.2% supported the ban on sales of cigarettes in single sticks. Majority of the students (78.3%) agreed that health warnings should be placed on all cigarette packages while 62.5% agreed that the prices of cigarettes should be increased to discourage buyers. Up to 69.2% agreed that cigarette scenes should be prohibited in movies for kids. In general, majority (94.3%) of the respondents expressed a high level of support for tobacco related legislation. A bi-variate analysis showed students who received pocket money were found to have significantly higher levels of awareness compared with those who did not receive pocket money. (p=0.003). We also found that females were generally less supportive of tobacco control legislation compared to their male counterparts. School based education programs should be carried out to inform and educate students about existing tobacco.laws in Nigeria. Policy makers should leverage on the support of key stakeholders like young-people for-thd passage and effective implementation of tobacco control laws.

Deconstructing myths, building alliances: a networking model to enhance tobacco control in hospital mental health settings.

Science.gov (United States)

Ballbè, Montse; Gual, Antoni; Nieva, Gemma; Saltó, Esteve; Fernández, Esteve

2016-01-01

Life expectancy for people with severe mental disorders is up to 25 years less in comparison to the general population, mainly due to diseases caused or worsened by smoking. However, smoking is usually a neglected issue in mental healthcare settings. The aim of this article is to describe a strategy to improve tobacco control in the hospital mental healthcare services of Catalonia (Spain). To bridge this gap, the Catalan Network of Smoke-free Hospitals launched a nationwide bottom-up strategy in Catalonia in 2007. The strategy relied on the creation of a working group of key professionals from various hospitals -the early adopters- based on Rogers' theory of the Diffusion of Innovations. In 2016, the working group is composed of professionals from 17 hospitals (70.8% of all hospitals in the region with mental health inpatient units). Since 2007, tobacco control has improved in different areas such as increasing mental health professionals' awareness of smoking, training professionals on smoking cessation interventions and achieving good compliance with the national smoking ban. The working group has produced and disseminated various materials, including clinical practice and best practice guidelines, implemented smoking cessation programmes and organised seminars and training sessions on smoking cessation measures in patients with mental illnesses. The next challenge is to ensure effective follow-up for smoking cessation after discharge. While some areas of tobacco control within these services still require significant improvement, the aforementioned initiative promotes successful tobacco control in these settings. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Tobacco Control and Health Advocacy in the European Union: Understanding Effective Coalition-Building.

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Weishaar, Heide; Collin, Jeff; Amos, Amanda

2016-02-01

Coalitions of supporters of comprehensive tobacco control policy have been crucial in achieving policy success nationally and internationally, but the dynamics of such alliances are not well understood. Qualitative semi-structured, narrative interviews with 35 stakeholders involved in developing the European Council Recommendation on smoke-free environments. These were thematically analyzed to examine the dynamics of coalition-building, collaboration and leadership in the alliance of organizations which successfully called for the development of comprehensive European Union (EU) smoke-free policy. An alliance of tobacco control and public health advocacy organizations, scientific institutions, professional bodies, pharmaceutical companies, and other actors shared the goal of fighting the harms caused by second-hand smoke. Alliance members jointly called for comprehensive EU smoke-free policy and the protection of the political debates from tobacco industry interference. The alliance's success was enabled by a core group of national and European actors with long-standing experience in tobacco control, who facilitated consensus-building, mobilized allies and synchronized the actions of policy supporters. Representatives of Brussels-based organizations emerged as crucial strategic leaders. The insights gained and identification of key enablers of successful tobacco control advocacy highlight the strategic importance of investing into tobacco control at European level. Those interested in effective health policy can apply lessons learned from EU smoke-free policy to build effective alliances in tobacco control and other areas of public health. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

Awareness of tobacco advertising, perceived harms of smoking, and beliefs about tobacco control among a sample of Shanghainese in China.

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Zheng, PinPin; Qian, Haihong; Wang, Fan; Sun, Shaojing; Nehl, Eric J; Wong, Frank Y

2013-10-01

This study aims to examine beliefs among residents of Shanghai, China concerning tobacco advertising and control policies concurrent with new restrictions on tobacco use and advertising in the city. A total of 518 residents of Shanghai completed a telephone interview survey. We found that 51% of participants had seen or heard of the Zhonghua cigarette brand's 'Love China' tobacco ad campaign in the past 2 years, 59% believed that the campaign would influence people to buy this specific cigarette brand as a gift, and 30% believed that it would encourage smoking. More than 75% of respondents would support legislation banning tobacco advertising in all public places, and 88% would support legislation prohibiting smoking in all public places. Multivariate analyses indicated that those who were female, more than 50 years, have accepted college and above education, and perceived greater benefits to smoking cessation were more likely to support banning tobacco advertising and prohibiting smoking in public places. Non-smokers were more likely to support prohibiting smoking in public places. The findings suggest that although tobacco advertising is widely prevalent in Shanghai, it is disliked by the public. Respondents showed high levels of support for tobacco control policies.

Cost-effectiveness of a smokeless tobacco control mass media campaign in India.

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Murukutla, Nandita; Yan, Hongjin; Wang, Shuo; Negi, Nalin Singh; Kotov, Alexey; Mullin, Sandra; Goodchild, Mark

2017-08-10

Tobacco control mass media campaigns are cost-effective in reducing tobacco consumption in high-income countries, but similar evidence from low-income countries is limited. An evaluation of a 2009 smokeless tobacco control mass media campaign in India provided an opportunity to test its cost-effectiveness. Campaign evaluation data from a nationally representative household survey of 2898 smokeless tobacco users were compared with campaign costs in a standard cost-effectiveness methodology. Costs and effects of the Surgeon campaign were compared with the status quo to calculate the cost per campaign-attributable benefit, including quit attempts, permanent quits and tobacco-related deaths averted. Sensitivity analyses at varied CIs and tobacco-related mortality risk were conducted. The Surgeon campaign was found to be highly cost-effective. It successfully generated 17 259 148 additional quit attempts, 431 479 permanent quits and 120 814 deaths averted. The cost per benefit was US$0.06 per quit attempt, US$2.6 per permanent quit and US$9.2 per death averted. The campaign continued to be cost-effective in sensitivity analyses. This study suggests that tobacco control mass media campaigns can be cost-effective and economically justified in low-income and middle-income countries. It holds significant policy implications, calling for sustained investment in evidence-based mass media campaigns as part of a comprehensive tobacco control strategy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

African Tobacco Control Research Initiative Scoping Exercise ...

International Development Research Centre (IDRC) Digital Library (Canada)

The African Tobacco Control Research Initiative (ATCRI) was established in ... of taxation, advertising bans, smoke-free places and graphic health warnings. ... Special journal issue highlights IDRC-supported findings on women's paid work.

Harm reduction in U.S. tobacco control: Constructions in textual news media.

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Eversman, Michael H

2015-06-01

U.S. tobacco control has long emphasized abstinence, yet quitting smoking is hard and cessation rates low. Tobacco harm reduction alternatives espouse substituting cigarettes with safer nicotine and tobacco products. Policy shifts embracing tobacco harm reduction have increased media attention, yet it remains controversial. Discourse theory posits language as fluid, and socially constructed meaning as neither absolute nor neutral, elevating certain views over others while depicting "discursive struggle" between them. While an abstinence-based framework dominates tobacco policy, discourse theory suggests constructions of nicotine and tobacco use can change, for example by positioning tobacco harm reduction more favorably. Textual discourse analysis was used to explore constructions of tobacco harm reduction in 478 (308 original) U.S. textual news media articles spanning 1996-2014. Using keyword database sampling, retrieved articles were analyzed first as discrete recording units and then to identify emergent thematic content. Constructions of tobacco harm reduction shifted over this time, revealing tension among industry and policy interests through competing definitions of tobacco harm reduction, depictions of its underlying science, and accounts of regulatory matters including tobacco industry support for harm reduction and desired marketing and taxation legislation. Heightened salience surrounding tobacco harm reduction and electronic cigarettes suggests their greater acceptance in U.S. tobacco control. Various media depictions construct harm reduction as a temporary means to cessation, and conflict with other constructions of it that place no subjective value on continued "safer" tobacco/nicotine use. Constructions of science largely obscure claims of the veracity of tobacco harm reduction, with conflict surrounding appropriate public health benchmarks for tobacco policy and health risks of nicotine use. Taxation policies and e-cigarette pricing relative to

Tobacco Control at Community Colleges: Context and Opportunities

Directory of Open Access Journals (Sweden)

Scott McIntosh

2016-12-01

Opportunities for best practice strategies for tobacco control were identified for community colleges, and would require little additional infrastructure. Policy adherence and enforcement could be improved with awareness raising with students, faculty and staff. Cessation tools for students must be convenient, understandable, and accessible from multiple locations. Feasible approaches for future initiatives could include testing low cost technology such as quitlines, Web Assisted Tobacco Interventions (WATI and outside partnerships with community organizations and health agencies.

Coverage of tobacco control in Jordanian newspapers: implications for strengthening the role of news media.

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Bader, Rasha K; Shtaiwi, Aisha S; Shihab, Rawan A; Obeidat, Nour A; Hawari, Feras I

2017-07-16

News media play a critical role in tobacco control. To strengthen this role in Jordan, four newspapers were searched and 1 145 articles between 2011 and 2015 were coded for mention of MPOWER topics and for tone of coverage (neutral, pro-, or anti-tobacco control). Monthly counts, mention of tobacco control topics and the tones were examined. The monthly count of tobacco control-related news items showed an upward trend with an average monthly growth of 16%. Peaks in coverage were observed in synchrony with national tobacco control developments. 'Warn' was the topic most frequently mentioned (46%). 'Protect' was the only topic that showed a statistically significant upward trend over time. A pro-tobacco control tone was more prevalent than an antitobacco control or neutral tone. Thus, efforts are needed to enhance the newsworthiness of certain topics, boost influence on decision-makers and pre-empt industry interference.

National Cancer Institute's leadership role in promoting State and Community Tobacco Control research.

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Ginexi, Elizabeth M; Vollinger, Robert E

2016-10-01

The National Cancer Institute (NCI) has been at the vanguard of funding tobacco control research for decades with major efforts such as the Community Intervention Trial for Smoking Cessation (COMMIT) in 1988 and the American Stop Smoking Intervention Study (ASSIST) in 1991, followed by the Tobacco Research Initiative for State and Community Interventions in 1999. Most recently, in 2011, the NCI launched the State and Community Tobacco Control (SCTC) Research Initiative to address gaps in secondhand smoke policies, tax and pricing policies, mass media countermeasures, community and social norms and tobacco marketing. The initiative supported large scale research projects and time-sensitive ancillary pilot studies in response to expressed needs of state and community partners. This special issue of Tobacco Control showcases exciting findings from the SCTC. In this introductory article, we provide a brief account of NCI's historical commitment to promoting research to inform tobacco control policy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Socioeconomic inequalities in the impact of tobacco control policies on adolescent smoking

DEFF Research Database (Denmark)

Pförtner, Timo-Kolja; Hublet, Anne; Schnohr, Christina Warrer

2016-01-01

INTRODUCTION: There are concerns that tobacco control policies may be less effective in reducing smoking among disadvantaged socioeconomic groups and thus may contribute to inequalities in adolescent smoking. This study examines how the association between tobacco control policies and smoking of 15...... regression analyses were conducted to assess the association of weekly smoking with components of the Tobacco Control Scale (TCS), and to assess whether this association varied according to family affluence (FAS). Analyses were carried out per gender and adjusted for national wealth and general smoking rate...

Tobacco Use In California 1990-1991

OpenAIRE

University of California, San Diego; California Department of Health Services; Westat, Inc.; Los Angels County Department of Health Services

1991-01-01

Summary This report presents data from a survey of cigarette smoking behaviors and attitudes among Californians conducted between June, 1990 and July, 1991. The prevalence of current smoking among adults in California was 22.2%, with males (25.5%) smoking more than females (19.1%). This represents a sharp decline in smoking following the increase in the tobacco excise tax and implementation of a comprehensive tobacco control program by the State of California. The decline in preva...

The impact of televised tobacco control advertising content on campaign recall: Evidence from the International Tobacco Control (ITC) United Kingdom Survey

Science.gov (United States)

2014-01-01

Background Although there is some evidence to support an association between exposure to televised tobacco control campaigns and recall among youth, little research has been conducted among adults. In addition, no previous work has directly compared the impact of different types of emotive campaign content. The present study examined the impact of increased exposure to tobacco control advertising with different types of emotive content on rates and durations of self-reported recall. Methods Data on recall of televised campaigns from 1,968 adult smokers residing in England through four waves of the International Tobacco Control (ITC) United Kingdom Survey from 2005 to 2009 were merged with estimates of per capita exposure to government-run televised tobacco control advertising (measured in GRPs, or Gross Rating Points), which were categorised as either “positive” or “negative” according to their emotional content. Results Increased overall campaign exposure was found to significantly increase probability of recall. For every additional 1,000 GRPs of per capita exposure to negative emotive campaigns in the six months prior to survey, there was a 41% increase in likelihood of recall (OR = 1.41, 95% CI: 1.24–1.61), while positive campaigns had no significant effect. Increased exposure to negative campaigns in both the 1–3 months and 4–6 month periods before survey was positively associated with recall. Conclusions Increased per capita exposure to negative emotive campaigns had a greater effect on campaign recall than positive campaigns, and was positively associated with increased recall even when the exposure had occurred more than three months previously. PMID:24885426

Adolescent Tobacco Use in Urban Versus Rural Areas of the United States: The Influence of Tobacco Control Policy Environments.

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Pesko, Michael F; Robarts, Adam M T

2017-07-01

Adults and adolescents who reside in rural areas of the United States are traditionally more likely to be tobacco users. This urban-rural disparity remains largely unexplained and, more recently, it is unclear what impact the emergence of electronic cigarettes (e-cigarettes) has had on adolescent tobacco use in urban and rural areas. Our objective is to evaluate the influence of sociodemographics and tobacco control policy environments on adolescent tobacco use in urban versus rural areas, as well as to identify the effect of e-cigarettes on traditional patterns of urban-rural tobacco use. This study analyzes repeated cross-sectional data from the National Youth Tobacco Survey for the years 2011-2014. We estimate the associations between rural residence, cigarette taxes, tobacco advertisement exposure, and ease of access to tobacco with six tobacco use outcomes: current (past 30-day) use of cigarettes, e-cigarettes, cigars, smokeless tobacco, multiple tobacco products, and any tobacco. E-cigarette use among urban youths aged 11-17 years in the United States increased from .82% in 2011 to 8.62% in 2014 (p e-cigarettes. Our predictors account for approximately 40% of the difference in urban-rural cigarette use. Sociodemographics, cigarette taxes, and tobacco advertisement exposure are significant predictors of adolescent tobacco use in the United States but do not entirely explain urban-rural disparities. In addition, e-cigarettes appear to be rapidly changing traditional patterns of tobacco use, particularly in urban areas. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.