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.
Hefler, Marita; Freeman, Becky; Chapman, Simon
The tobacco industry's use of social media sites, such as Facebook, is an emerging area of research; however, this is the first study of the potential for social media to advance tobacco control. This paper presents three case studies of using social media for tobacco control advocacy, demonstrates how social media can facilitate direct and effective action, and provides tools and lessons learned for future campaigns.
Eversman, Michael H
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
Langley, Tessa; Lewis, Sarah; McNeill, Ann; Gilmore, Anna; Szatkowski, Lisa; West, Robert; Sims, Michelle
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.
Sharma, Renu; Shewade, Hemant Deepak; Gopalan, Balasubramaniam; Badrel, Ramesh Kumar; Rana, Jugdeep Singh
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.
Murukutla, Nandita; Yan, Hongjin; Wang, Shuo; Negi, Nalin Singh; Kotov, Alexey; Mullin, Sandra; Goodchild, Mark
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.
of tobacco control laws, and limited public awareness about the hazards of tobacco com- bine to create a growing health crisis. Currently, 70% of .... exposure to tobacco smoke in “workplaces, public transport, and indoor public places.” At the time, Guatemalan law prohibited smoking in schools and hospitals — but had only ...
Duke, Jennifer C; Hansen, Heather; Kim, Annice E; Curry, Laurel; Allen, Jane
Background The promotion of evidence-based cessation services through social media sites may increase their utilization by smokers. Data on social media adoption and use within tobacco control programs (TCPs) have not been reported. Objective This study examines TCP use of and activity levels on social media, the reach of TCP sites, and the level of engagement with the content on sites. Methods A cross-sectional descriptive study of state TCP social media sites and their content was conducted...
McDaniel, Patricia A; Lown, E Anne; Malone, Ruth E
Media coverage of tobacco industry corporate social responsibility (CSR) initiatives represents a competitive field where tobacco control advocates and the tobacco industry vie to shape public and policymaker understandings about tobacco control and the industry. Through a content analysis of 649 US news items, we examined US media coverage of tobacco industry CSR and identified characteristics of media items associated with positive coverage. Most coverage appeared in local newspapers, and CSR initiatives unrelated to tobacco, with non-controversial beneficiaries, were most commonly mentioned. Coverage was largely positive. Tobacco control advocates were infrequently cited as sources and rarely authored opinion pieces; however, when their voices were included, coverage was less likely to have a positive slant. Media items published in the South, home to several tobacco company headquarters, were more likely than those published in the West to have a positive slant. The absence of tobacco control advocates from media coverage represents a missed opportunity to influence opinion regarding the negative public health implications of tobacco industry CSR. Countering the media narrative of virtuous companies doing good deeds could be particularly beneficial in the South, where the burdens of tobacco-caused disease are greatest, and coverage of tobacco companies more positive.
Duke, Jennifer C; Hansen, Heather; Kim, Annice E; Curry, Laurel; Allen, Jane
The promotion of evidence-based cessation services through social media sites may increase their utilization by smokers. Data on social media adoption and use within tobacco control programs (TCPs) have not been reported. This study examines TCP use of and activity levels on social media, the reach of TCP sites, and the level of engagement with the content on sites. A cross-sectional descriptive study of state TCP social media sites and their content was conducted. In 2013, 60% (30/50) of TCPs were using social media. Approximately one-quarter (26%, 13/50) of all TCPs used 3 or more social media sites, 24% (12/50) used 2, and 10% (5/50) used 1 site. Overall, 60% (30/50) had a Facebook page, 36% (18/50) had a Twitter page, and 40% (20/50) had a YouTube channel. The reach of social media was different across each site and varied widely by state. Among TCPs with a Facebook page, 73% (22/30) had less than 100 likes per 100,000 adults in the state, and 13% (4/30) had more than 400 likes per 100,000 adults. Among TCPs with a Twitter page, 61% (11/18) had less than 10 followers per 100,000 adults, and just 1 state had more than 100 followers per 100,000 adults. Seven states (23%, 7/30) updated their social media sites daily. The most frequent social media activities focused on the dissemination of information rather than interaction with site users. Social media resources from a national cessation media campaign were promoted infrequently. The current reach of state TCP social media sites is low and most TCPs are not promoting existing cessation services or capitalizing on social media's interactive potential. TCPs should create an online environment that increases participation and 2-way communication with smokers to promote free cessation services.
Fallin, Amanda; Glantz, Stanton A
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
Bialous, Stella Aguinaga; Kaufman, Nancy; Sarna, Linda
To review and summarize tobacco control policies, their impact in curbing the tobacco epidemic, and to describe a role for nursing advocacy. Published articles and research studies. Comprehensive tobacco control policy is one of the most effective mechanisms to prevent tobacco-related cancers and other illnesses. The World Health Organization's Framework Convention on Tobacco Control, and the Master Settlement Agreement in the United States have provided new opportunities for tobacco control. Nursing participation in the policy process can expand and strengthen these policies' activities. Involvement in tobacco control should be integral to oncology nursing efforts to prevent cancer, promote health, and quality of life.
Chaloupka, Frank J; Yurekli, Ayda; Fong, Geoffrey T
Increases in tobacco taxes are widely regarded as a highly effective strategy for reducing tobacco use and its consequences. The voluminous literature on tobacco taxes is assessed, drawing heavily from seminal and recent publications reviewing the evidence on the impact of tobacco taxes on tobacco use and related outcomes, as well as that on tobacco tax administration. Well over 100 studies, including a growing number from low-income and middle-income countries, clearly demonstrate that tobacco excise taxes are a powerful tool for reducing tobacco use while at the same time providing a reliable source of government revenues. Significant increases in tobacco taxes that increase tobacco product prices encourage current tobacco users to stop using, prevent potential users from taking up tobacco use, and reduce consumption among those that continue to use, with the greatest impact on the young and the poor. Global experiences with tobacco taxation and tax administration have been used by WHO to develop a set of 'best practices' for maximising the effectiveness of tobacco taxation. Significant increases in tobacco taxes are a highly effective tobacco control strategy and lead to significant improvements in public health. The positive health impact is even greater when some of the revenues generated by tobacco tax increases are used to support tobacco control, health promotion and/or other health-related activities and programmes. In general, oppositional arguments that higher taxes will have harmful economic effects are false or overstated.
Wills, Thomas A; Gibbons, Frederick X; Sargent, James D; Gerrard, Meg; Lee, Hye-Ryeon; Dal Cin, Sonya
To investigate whether self-control moderates the effect of media influences on tobacco and alcohol use among youth and if so how this effect occurs. In Study 1, a regional sample of 10-year olds (N = 290) was interviewed in households; attention to tobacco/alcohol advertising was assessed. In Study 2, a national sample of youth ages 10-14 years (N = 6,522) was surveyed by telephone; exposure to tobacco/alcohol use in movies was assessed. Good self-control was measured in both studies. Willingness to use substances and affiliation with peer substance users (Study 1); involvement in smoking or drinking (Study 2). In Study 1, the effect of tobacco/alcohol advertising on predisposition for substance use was lower among persons scoring higher on good self-control. In Study 2, the effect of movie smoking/alcohol exposure on adolescent tobacco/alcohol use was lower, concurrently and prospectively, among persons scoring higher on good self-control. Moderation occurred primarily through reducing the effect of movie exposure on positive smoking/alcohol expectancies and the effect of expectancies on adolescent use; some evidence for moderation of social processes was also noted. Covariates in the analyses included demographics, sensation seeking, and IQ. Good self-control reduces the effect of adverse media influences on adolescent tobacco and alcohol use. Findings on the processes underlying this effect may be useful for media literacy and primary prevention programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
McDaniel, Patricia A; Cadman, Brie; Malone, Ruth E
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.
Hamill, Stephen; Turk, Tahir; Murukutla, Nandita; Ghamrawy, Mohamed; Mullin, Sandra
New media campaigns hold great potential to grow public awareness about the dangers of tobacco use and advance tobacco control policies, including in low-income and middle-income countries (LMICs), which have shared in a decade of explosive growth in mobile and internet penetration. With the majority of deaths from the tobacco epidemic occurring in LMICs, new media must be harnessed both as an advocacy tool to promote social mobilisation around tobacco issues and to build public support for MPOWER policies. This paper examines three consecutive new media advocacy campaigns that used communication channels such as mobile SMS, Facebook and online advertising to promote tobacco control policies. It includes some of the lessons learned, such as the pitfalls of relying on viral growth as a strategy for obtaining reach and campaign growth; the challenge of translating strategies from traditional media to new media; and the importance of incorporating marketing strategies such as paid advertising, community organising or public relations. It also identifies some of the many knowledge gaps and proposes future research directions. 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.
Tran, D T; Kosik, R O; Mandell, G A; Chen, Y A; Su, T P; Chiu, A W; Fan, A P
To investigate the use of tobacco in Vietnam. Review study. Data were collected through a review of tobacco-related literature in Vietnam. Grey literature and web content from agencies such as the World Health Organization and the US Centers for Disease Control and Prevention were consulted. Tobacco smoking is still common in Vietnam, although numerous policies have been issued and implemented over the last two decades. Based on the most recent data (2010), the prevalence of smoking among adults aged >15 years was 23.8%, with a higher percentage among males (47.4%) than females (1.4%). The prevalence of smoking among students aged 13-15 was 3.8% (2007), with a similar gender pattern. The prevalence of exposure to secondhand smoke is of concern, with 73.1% and 55.9% of adults reporting exposure to secondhand smoke at home and at work or other places, respectively. Of the adult respondents, 55.5% believed that smoking may cause lung cancer, stroke and heart disease. Most students (93.4%) and adults (91.6%) had seen anti-smoking media messages. Of the students, 56.4% had seen pro-cigarette advertisements on billboards, 36.9% had seen pro-cigarette advertisements in newspapers or magazines, and 8.2% had been offered free cigarettes by tobacco company representatives. The price of cigarettes decreased by approximately 5% between 1995 and 2006, whereas gross domestic product per capita increased by more than 150%. On average, smokers smoked 13.5 cigarettes per day, and spent US$86 on cigarettes per year. Despite such high levels of tobacco exposure in Vietnam, the total tax on cigarettes remains at 45% of the retail price. Furthermore, only 29.7% of smokers had been advised to quit by a healthcare provider in the past 12 months. Strong enforcement and evidence-based regulations which rounded on MPOWER are needed to help protect current smokers and non-smokers from the devastating effects of tobacco. Copyright © 2012 The Royal Society for Public Health. Published by
Niederdeppe, Jeff; Kellogg, Maxwell; Skurka, Christofer; Avery, Rosemary J
This study tests whether exposure to state antismoking media campaigns is associated with increased support for comprehensive bans on smoking indoors and cigarette advertising. We combine commercially available data on market-level state-sponsored antismoking advertisements with three waves of the Current Population Survey's Tobacco Use Supplement to test the relationship between market-level volume of state antismoking advertising exposure and support for tobacco control policy between 2001 and 2002. We use logistic regression to assess which message themes employed in the advertisements are associated with increased support for tobacco control policy. The overall market-level volume of exposure to state antismoking ads targeted to adults or the general population was associated with significant increases in support for comprehensive indoor smoking bans. These effects were driven by exposure to ads emphasising the health consequences of smoking to others, anti-industry appeals and irrationality/addiction appeals. Evidence of campaign impact on support for tobacco advertising bans was less clear and, when statistically significant, small in magnitude relative to the impact of the state economic and tobacco control policy environment. This study shows that that large-scale antismoking media campaigns can have a meaningful secondary impact on support for comprehensive indoor smoking bans. Future research should identify the conditions under which mass media campaigns primarily targeting smoking behaviour may influence public support for a variety of other tobacco control policies. © 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.
Full Text Available Portuguese introduced tobacco to India 400 years ago. Ever since, Indians have used tobacco in various forms. Sixty five per cent of all men and 33% of all women use tobacco in some form. Tobacco causes over 20 categories of fatal and disabling diseases including oral cancer. By 2020 it is predicted that tobacco will account for 13% of all deaths in India. A major step has to be taken to control what the World Health Organization, has labeled a ′smoking epidemic′ in developing countries. India′s anti-tobacco legislation, first passed in 1975, was largely limited to health warnings and proved to be insufficient. A new piece of national legislation, proposed in 2001, represents an advance including banning smoking in public places, advertising and forbidding sale of tobacco to minors. Preventing the use of tobacco in various forms as well as treating nicotine addiction is the major concern of dentists and physicians. The dental encounter probably constitutes a "teachable moment" when the patient is receptive to counseling about life- style issues. Both policy makers and health professionals must work together for achieving a smoke free society for our coming generations.
Turk, Tahir; Murukutla, Nandita; Gupta, Shefali; Kaur, Jagdish; Mullin, Sandra; Saradhi, Ranjana; Chaturvedi, Pankaj
The burden of tobacco-related morbidity and mortality in India is substantial, with smokeless tobacco being the predominant form of tobacco use. Use of smokeless tobacco (for example gutkha, paan, khaini, and pan masala) is linked to a host of socioeconomic and cultural factors including gender, regional differences, educational level, and income disparities. Given the scale of the problem, a national social marketing campaign was developed and implemented. The creative approach used testimonials from a surgeon and patients at Tata Memorial Hospital in Mumbai. The communication message approach was designed to reflect the realities of disfiguring, disabling, and fatal cancers caused by smokeless tobacco. Evaluation of the campaign identified significant differences across a range of campaign behavioral predictors by audience segments aware of the campaign versus those who were "campaign unaware". Significant findings were also identified regarding vulnerable groups by gender (female/male) and rural/urban disparities. Findings are discussed in relation to the powerful impact of using graphic, emotive, and testimonial imagery for tobacco control with socially disadvantaged groups.
Crankshaw, Erik C.; Beach, Robert H.; Austin, W. David; Altman, David G.; Jones, Alison Snow
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…
Hu, Teh-wei; Lee, Anita H
During the past decade, tobacco leaf production has shifted from high-income countries to developing countries, particularly those in Africa. Most African governments promote tobacco farming as a way to alleviate poverty. The economic benefit of tobacco farming has been used by the tobacco industry to block tobacco control policies. The tobacco industry is active in promoting the alleged positive aspects of tobacco farming and in 'protecting' farmers from what they portray as unfair tobacco control regulations that reduce demand. Tobacco farming has many negative consequences for the health and well-being of farmers, as well as for the environment and the long-term well-being of the countries concerned. We provide an overview of tobacco farming issues in Africa. Encompassing multi-dimensional issues of economic development, there is far more to it than tobacco control questions.
This paper makes obvious the role of mass media in supporting the effort of an organisation/group of citizens to achieve changes of a social nature (requires, first of all, changes of public policies) and its promotion at the level of decision-makers, as well as public opinion. The main purpose of this paper is to study the phenomenon of media advocacy, identify its social potential to project and evaluate media engagement in the national anti-tobacco campaign of 2007. The anti-tobacco campaign carried out in 2007 had as an aim the public awareness on changing the tobacco control policies in Moldova. Media advocacy activities have been focused towards improving journalists' knowledge in the field of tobacco control and encouraging them (through media products carried out) to influence the Parliament's members to ratify documents against smoking. the increase by two-three times and, for some media means even by ten times, of the number of anti-tobacco references (articles, radio and TV broadcastings) as compared to 2006. Media advocacy had a significant contribution to the unfolding of political and social events in this field (approval of FCTC; approval of a new Law on tobacco and tobacco products, stipulating "restrictions and afferent provisions to the consumption of tobacco products and the harmful effects on health").
McCool, Judith; Freeman, Becky; Tanielu, Helen
Tobacco use among young Pacific populations continues to undermine efforts to reduce the escalating rates of non-communicable disease in the region. Reducing tobacco use to less than 5 percent by 2025 is now a World Health Organisation (WHO) mandated target for the Pacific region. Yet, little is known about the drivers to uptake of tobacco use among young people in the Pacific. Family and peers are expected to be important in this process, but similarly, tobacco marketing may also play an important role. The tobacco industry has been highly adaptive to the changing media environment across the Pacific Islands. The aim of this study was to develop an understanding of the social cultural and media drivers to tobacco uptake and use among young Samoans to contribute to the design of effective tobacco control intervention. We examined high school students (aged 16 and 17 years) perceptions of tobacco use in their community, access and use of media channels and the extent to which they are cognizant of both pro and anti-tobacco imagery across a range of media. Data was collected through in-depth semi-structured interviews. A thematic analysis of the interview data identified common and divergent beliefs, attitudes and behaviours surrounding tobacco use and the influence of the media. Family is critically important for representing normative tobacco use in Samoa. The use of media, in particular digital media, was found to be conditioned by parental views on the use of media in the home. Media access remains highly regulated within more traditional households. Loyalty to traditional cultural practices (Fa'a Samoa) underpinned views on the limited influence of media on social norms around tobacco use. Parents were thought to have the greatest influence on youth smoking. Tobacco use was viewed as a personal, or family issue, and not a problem that was amendable to change at a societal level. In order to develop effective and culturally relevant tobacco control policies, the
Kaestle, Christine E; Chen, Yvonnes; Estabrooks, Paul A; Zoellner, Jamie; Bigby, Brandon
The purpose of this pilot study was to assess the impact of media literacy for tobacco prevention for youth delivered through a community site. A randomized pretest-posttest evaluation design with matched-contact treatment and control conditions. The pilot study was delivered through the YMCA in a lower-income suburban and rural area of Southwest Virginia, a region long tied, both economically and culturally, to the tobacco industry. Children ages 8 to 14 (76% white, 58% female) participated in the study (n = 38). The intervention was an antismoking media literacy program (five 1-hour lessons) compared with a matched-contact creative writing control program. General media literacy, three domains of tobacco-specific media literacy ("authors and audiences," "messages and meanings," and "representation and reality"), tobacco attitudes, and future expectations were assessed. Multiple regression modeling assessed the impact of the intervention, controlling for pretest measures, age, and sex. General media literacy and tobacco-specific "authors and audiences" media literacy improved significantly for treatment compared with control (p media literacy measures and for tobacco attitudes were not significant. Future expectations of smoking increased significantly for treatment participants ages 10 and younger (p media literacy are accompanied by an increase in future expectations to smoke for younger children.
Llaguno-Aguilar, Silvia Elena; Dorantes-Alonso, Ana Del Carmen; Thrasher, James F; Villalobos, Victor; Besley, John C
Estimate the frequency and manner in which mass media represent tobacco and tobacco control policies. 660 stories published in six Mexican newspapers during 2007 were content analyzed. The majority of the news stories were published in the last quarter of the year, due to discussion of pending local and federal legislation. The vast majority of the stories were in favor of tobacco control policies (49%) or neutral (41%). The most frequently occurring themes in the stories were: legislation (36%), tobacco smoke (28%), economy (24%), and packaging (17%). Actors mentioned were: governmental institutions (24%), legislators (21%), tobacco industry (18%), and national and international non-governmental organizations (7 and 8%, respectively). Advocacy efforts should take advantage of mass media, which appears generally neutral or in favor of tobacco control policies in Mexico.
Indeed, while international organizations and donors still shape much of the agenda and are helpful by providing resources and expertise, most of the significant agents of policy reform within countries–a major component of success in tobacco control–are endogenous to countries, not exogenous to them. The structure of ...
Full Text Available The last decade has seen unprecedented achievements in global tobacco control. These include the entry into force of the WHO Framework Convention on Tobacco Control (WHO FCTC and 179 states, as well as the European Union, becoming Parties to the Treaty,leading to an increased global cognizance of the negative health and economic impact of tobacco use. Governments around the world continue to adopt and implement effective tobacco control strategies and financial contributions from major philanthropies have increased the levels of financial support for tobacco control efforts in low- and middle-income countries. The UN high-level summit on Noncommunicable Diseases (NCDs in 2011 and the 2015 adoption of the Sustainable Development Goals (SDGs, in which NCDs and acceleration of implementation of WHO FCTC are included as specific targets, represent an increased global recognition of the need to address tobacco use prevalence as a key element of NCD interventions...
Freeman, Becky; Chapman, Simon
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...
Thomas N O Achia
Full Text Available Media utilization has been identified as an important determinant of tobacco use. We examined the association between self-reported tobacco use and frequency of mass media utilization by women and men in nine low-to middle-income sub-Saharan African countries.Data for the study came from Demographic and Health Surveys conducted in Burkina Faso, Ethiopia, Liberia, Lesotho, Malawi, Swaziland, Uganda, Zambia and Zimbabwe over the period 2006-2011. Each survey population was a cross-sectional sample of women aged 15-49 years and men aged 15-59 years, with information on tobacco use and media access being obtained by face-to-face interviews. An index of media utilization was constructed based on responses to questions on the frequency of reading newspapers, frequency of watching television and frequency of listening to the radio. Demographic and socioeconomic variables were considered as potentially confounding covariates. Logistic regression models with country and cluster specific random effects were estimated for the pooled data.The risk of cigarette smoking increased with greater utilization to mass media. The use of smokeless tobacco and tobacco use in general declined with greater utilization to mass media. The risk of tobacco use was 5% lower in women with high media utilization compared to those with low media utilization [Adjusted Odds Ratio (AOR = 0.95, 95% confidence interval (CI:0.82-1.00]. Men with a high media utilization were 21% less likely to use tobacco compared to those with low media utilization [AOR = 0.79, 95%CI = 0.73-0.85]. In the male sample, tobacco use also declined with the increased frequency of reading newspapers (or magazines, listening to radio and watching television.Mass media campaigns, conducted in the context of comprehensive tobacco control programmes, can reduce the prevalence of tobacco smoking in sub-Saharan Africa. The reach, intensity, duration and type of messages are important aspects of the campaigns but
Dec 14, 2010 ... In Canada people have come to recognize the harmful effects of tobacco on health. In many poorer countries, however, the globalization of the tobacco industry, the lack of tobacco control laws, and limited public awareness about the hazards of tobacco combine to create a growing health crisis. Currently ...
Chang, Fong-ching; Miao, Nae-fang; Lee, Ching-mei; Chen, Ping-hung; Chiu, Chiung-hui; Lee, Shu-ching
This study examined the relationship of media exposure and media literacy to alcohol and tobacco use among adolescents in Taiwan. A total of 2992 10th-grade students recruited from 26 high schools in Taipei, Taiwan, completed a questionnaire in 2010. The multivariable analysis results indicated that the students with higher alcohol and tobacco media exposure were more likely to use alcohol and tobacco and have intentions to drink and smoke, while students with higher media literacy were less likely to use alcohol and have intentions to drink and smoke. © The Author(s) 2014.
Equity: Understanding the value and impact of tobacco control policies on different social groups. Commercial influence: Understanding ... achievement of the global target to reduce NCDs by. 25% by 2025 and remains a priority for ... Government ministries, academic institutions, and non-governmental organizations are ...
communicable disease (NCD) burden in low- and middle-income countries. The Centre for Tobacco Control in Africa (CTCA), based at Makerere University in Uganda, serves as a regional centre, providing tools and evidence to support tobacco control ...
White, Victoria M; Durkin, Sarah J; Coomber, Kerri; Wakefield, Melanie A
To examine how the intensity and duration of tobacco control advertising relate to adolescent smoking prevalence. Australian students (aged 12-17 years) participating in a national survey conducted triennially between 1993 and 2008 (sample size range 12 314-16 611). The outcome measure was students' smoking in the previous 4 weeks collected through anonymous, self-completed surveys. For each student, monthly targeted rating points (TRPs, a measure of television advertising exposure) for tobacco control advertising was calculated for the 3 and 12 months prior to surveying. For each time period, cumulative TRPs exposure and exposure to three intensity levels (≥100 TRPs/month; ≥400 TRPs/month; ≥800 TRPs/month) over increasing durations (eg, 1 month, 2 months, etc) were calculated. Logistic regression examined associations between TRPs and adolescent smoking after controlling for demographic and policy variables. Past 3-month cumulative TRPs were found to have an inverse relationship with smoking prevalence. Low TRPs exposure in the past 12 months was positively associated with adolescent smoking prevalence. However, smoking prevalence reduced with cumulative exposure levels above 5800 cumulative TRPs. Additionally, exposure to ≥400 TRPs/month and ≥800 TRPs/month were associated with reduced likelihood of smoking, although the duration needed for this effect differed for the two intensity levels. When intensity was ≥400 TRPs/month, the odds of smoking only reduced with continuous exposure. When intensity was ≥800 TRPs/month, exposure at levels less than monthly was associated with reductions in smoking prevalence. Both antismoking advertising intensity and duration are important for ensuring reductions in adolescent smoking prevalence. 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.
At the World Health Assembly in May 2003 the. Member States of the World Health Organization. (WHO) have agreed on a groundbreaking public health treaty to control tobacco supply and consumption. The text of the WHO Framework. Convention on Tobacco Control (FCTC) covers tobacco taxation, smoking prevention ...
Murukutla, Nandita; Turk, Tahir; Prasad, C V S; Saradhi, Ranjana; Kaur, Jagdish; Gupta, Shefali; Mullin, Sandra; Ram, Faujdar; Gupta, Prakash C; Wakefield, Melanie
Smokeless tobacco consumption in India is a significant source of morbidity and mortality. In order to educate smokeless tobacco users about the health harms of smokeless tobacco and to denormalise tobacco usage and encourage quitting, a national television and radio mass media campaign targeted at smokeless tobacco users was aired for 6 weeks during November and December 2009. The campaign was evaluated with a nationally representative household survey of smokeless tobacco users (n = 2898). The effect of campaign awareness was assessed with logistic regression analysis. The campaign affected smokeless tobacco users as intended: 63% of smokeless-only users and 72% of dual users (ie, those who consumed both smoking and smokeless forms) recalled the campaign advertisement, primarily through television delivery. The vast majority (over 70%) of those aware of the campaign said that it made them stop and think, was relevant to their lives and provided new information. 75% of smokeless-only users and 77% of dual users said that it made them feel concerned about their habit. Campaign awareness was associated with better knowledge, more negative attitudes towards smokeless tobacco and greater cessation-oriented intentions and behaviours among smokeless tobacco users. Social marketing campaigns that utilise mass media are feasible and efficacious interventions for tobacco control in India. Implications for future mass media tobacco control programming in India are discussed.
Chen, Ii-Lun; Husten, Corinne G
Electronic cigarettes (e-cigarettes) have recently gained significant attention in the marketplace and in the media. However, limited information is available about the worldwide impact of e-cigarettes; most public health officials are calling for more data so they can more fully understand the potential risks and benefits of e-cigarettes in order to inform regulatory action. In the USA, e-cigarettes that are marketed as tobacco products are not currently regulated by the Food and Drug Administration (FDA). However, having a continuum of nicotine-containing products that cross jurisdictional lines within the FDA in the future would create the potential (and the need) for a comprehensive nicotine strategy at the FDA. As part of developing the most appropriate approach to e-cigarette regulation, FDA Center for Tobacco Products scientists have been reviewing the available literature to determine the state of e-cigarette knowledge and have identified research areas that could be addressed. This supplement provides a summary of the current knowledge and research gaps pertaining to e-cigarettes with regards to product design, chemistry and toxicology of e-liquid and aerosol constituents, human factor-based risk factors, abuse liability, clinical pharmacology and human health effects, paediatric issues, and environmental issues.
Sargent, J D; Gibson, J; Heatherton, T F
To examine the concurrent effects of exposure to movie smoking and tobacco marketing receptivity on adolescent smoking onset and progression. Cross-sectional study of 4524 northern New England adolescents aged 10-14 in 1999 with longitudinal follow-up of 2603 baseline never-smokers. Cross-sectional outcomes included ever tried smoking and higher level of lifetime smoking among 784 experimenters. The longitudinal outcome was onset of smoking among baseline never-smokers two years later. Movie smoking exposure was modelled as four population quartiles, tobacco marketing receptivity included two levels-having a favourite tobacco advert and wanting/owning tobacco promotional items. All analyses controlled for sociodemographics, other social influences, personality characteristics of the adolescent and parenting style. In the full cross-sectional sample, 17.5% had tried smoking; both exposure to movie smoking and receptivity to tobacco marketing were associated with having tried smoking. Among experimental smokers, the majority (64%) were receptive to tobacco marketing, which had a multivariate association with higher level of lifetime smoking (movie smoking did not). In the longitudinal study 9.5% of baseline never-smokers tried smoking at follow-up. Fewer never-smokers (18.5%) were receptive to tobacco marketing. Movie smoking had a multivariate association with trying smoking (receptivity to tobacco marketing did not). The results suggest separate roles for entertainment media and tobacco marketing on adolescent smoking. Both exposures deserve equal emphasis from a policy standpoint.
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.
Zhan, Qianyi; Zhang, Jiawei; Yu, Philip S; Emery, Sherry; Xie, Junyuan
Anti-tobacco mass media campaigns are designed to influence tobacco users. It has been proved that campaigns will produce users' changes in awareness, knowledge, and attitudes, and also produce meaningful behavior change of audience. Anti-smoking television advertising is the most important part in the campaign. Meanwhile, nowadays, successful online social networks are creating new media environment, however, little is known about the relation between social conversations and anti-tobacco campaigns. This paper aims to infer social influence of these campaigns, and the problem is formally referred to as the Social Influence inference of anti-Tobacco mass mEdia campaigns (Site) problem. To address the Site problem, a novel influence inference framework, TV advertising social influence estimation (Asie), is proposed based on our analysis of two real anti-tobacco campaigns. Asie divides audience attitudes toward TV ads into three distinct stages: 1) cognitive; 2) affective; and 3) conative. Audience online reactions at each of these three stages are depicted by Asie with specific probabilistic models based on the synergistic influences from both online social friends and offline TV ads. Extensive experiments demonstrate the effectiveness of Asie.
Gallagher, J.E.; Alajbeg, I.; Buchler, S.; Carrassi, A.; Hovius, M.; Jacobs, A.; Jenner, M.; Kinnunen, T.; Ulbricht, S.; Zoitopoulos, L.
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
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
Gendall, Philip; Hoek, Janet; Thomson, George; Edwards, Richard; Pene, Gina; Gifford, Heather; Pirikahu, Gill; McCool, Judith
Marketers have long recognized the power and importance of branding, which creates aspirational attributes that increase products' attractiveness. Although brand imagery has traditionally been communicated via mass media, packaging's importance in promoting desirable brand-attribute associations has increased. Knowledge of how groups prone to smoking experimentation interpret tobacco branding would inform the debate over plain packaging currently occurring in many countries. We conducted 12 group discussions and four in-depth interviews with 66 young adult smokers and nonsmokers of varying ethnicities from two larger New Zealand cities and one provincial city. Participants evaluated 10 familiar and unfamiliar tobacco brands using brand personality attributes and discussed the associations they had made. Participants ascribed very different images to different brands when exposed to the packaging alone, regardless of whether they had seen or heard of the brands before. Perceptual mapping of brands and image attributes highlighted how brand positions varied from older, more traditional, and male oriented to younger, feminine, and "cool." Our findings emphasize the continuing importance of tobacco branding as a promotion tool, even when communicated only by packaging. The ease with which packaging alone enabled young people to identify brand attributes and the desirable associations these connoted illustrate how tobacco packaging functions as advertising. The results support measures such as plain packaging of tobacco products to reduce exposure to these overt behavioral cues.
Levy, David T; Tam, Jamie; Kuo, Charlene; Fong, Geoffrey T; Chaloupka, Frank
The Tobacco Control Scorecard, published in 2004, presented estimates of the effectiveness of different policies on smoking rates. Since its publication, new evidence has emerged. We update the Scorecard to include recent studies of demand-reducing tobacco policies for high-income countries. We include cigarette taxes, smoke-free air laws, media campaigns, comprehensive tobacco control programs, marketing bans, health warnings, and cessation treatment policies. To update the 2004 Scorecard, a narrative review was conducted on reviews and studies published after 2000, with additional focus on 3 policies in which previous evidence was limited: tobacco control programs, graphic health warnings, and marketing bans. We consider evaluation studies that measured the effects of policies on smoking behaviors. Based on these findings, we derive estimates of short-term and long-term policy effect sizes. Cigarette taxes, smoke-free air laws, marketing restrictions, and comprehensive tobacco control programs are each found to play important roles in reducing smoking prevalence. Cessation treatment policies and graphic health warnings also reduce smoking and, when combined with policies that increase quit attempts, can improve quit success. The effect sizes are broadly consistent with those previously reported for the 2004 Scorecard but now reflect the larger evidence base evaluating the impact of health warnings and advertising restrictions.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
McLeod, K; Wakefield, M; Chapman, S; Smith, K Clegg; Durkin, S
This study aims to show how smokers were represented in smoking-related news articles, editorials, letters and columns in a major Australian newspaper over an 11-year period from January 1995 to December 2005. Qualitative content analysis was conducted on a sample of 618 articles to identify 21 representational categories (RCs) of the smoker. Articles were also examined for statements that lent organisational support to either tobacco control or the promotion of tobacco. The construction of the smoker as a "regulated citizen" due to being subjected to tobacco policy was the most prevalent RC, occurring in 43.4% of articles. Of the 13 most prevalent RCs, eight were constructions of the smoker that lent support to tobacco control outcomes, two were supportive of the promotion of tobacco, and three could be used by both parties. 30.6% of articles contained at least one statement from a tobacco control advocacy source, compared with only 13.6% of articles having a statement towards the promotion of tobacco. These results indicate that constructions of the smoker that support tobacco control have dominated smoking-related discourse in this Australian newspaper and that representations favouring a tobacco industry viewpoint appeared less often. However, the pro-tobacco representations of smokers in reports relating to legal issues highlight an area of media discourse in which tobacco control advocates should remain vigilant.
Aquilino, M Lober; Lowe, J B
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.
Malone, Ruth E; Grundy, Quinn; Bero, Lisa A
Objective To conduct a review of research examining the effects of tobacco industry denormalisation (TID) on smoking-related and attitude-related outcomes. Methods The authors searched Pubmed and Scopus databases for articles published through December 2010 (see figure 1). We included all peer-reviewed TID studies we could locate that measured smoking-related outcomes and attitudes toward the tobacco industry. Exclusion criteria included: non-English language, focus on tobacco use rather than TID, perceived ad efficacy as sole outcome, complex program interventions without a separately analysable TID component and non peer-reviewed literature. We analysed the literature qualitatively and summarised findings by outcome measured. Results After excluding articles not meeting the search criteria, the authors reviewed 60 studies examining TID and 9 smoking-related outcomes, including smoking prevalence, smoking initiation, intention to smoke and intention to quit. The authors also reviewed studies of attitudes towards the tobacco industry and its regulation. The majority of studies suggest that TID is effective in reducing smoking prevalence and initiation and increasing intentions to quit. Evidence is mixed for some other outcomes, but some of the divergent findings may be explained by study designs. Conclusions A robust body of evidence suggests that TID is an effective tobacco control intervention at the population level that has a clear exposure–response effect. TID may also contribute to other tobacco control outcomes not explored in this review (including efforts to ‘directly erode industry power’), and thus may enhance public support and political will for structural reforms to end the tobacco epidemic. PMID:22345240
Blake, Kelly D; Viswanath, K; Blendon, Robert J; Vallone, Donna
To assess the relative, independent contribution of reported tobacco-specific media exposure (pro-tobacco advertising, anti-tobacco advertising, and news coverage of tobacco issues) to US adults' support for policy efforts that aim to regulate the portrayal of smoking in movies. Using the American Legacy Foundation's 2003 American Smoking and Health Survey (ASHES-2), multivariable logistic regression was used to model the predicted probability that US adults support movie-specific tobacco control policies, by reported exposure to tobacco-specific media messages, controlling for smoking status, education, income, race/ethnicity, age, sex, knowledge of the negative effects of tobacco and state. Across most outcome variables under study, findings reveal that reported exposure to tobacco-specific media messages is associated with adult attitudes towards movie-specific policy measures. Most exposure to tobacco information in the media (with the exception of pro-tobacco advertising on the internet) contributes independently to the prediction of adult support for movie-specific policies. The direction of effect follows an expected pattern, with reported exposure to anti-tobacco advertising and news coverage of tobacco predicting supportive attitudes towards movie policies, and reported exposure to pro-tobacco advertising lessening support for some movie policies, though the medium of delivery makes a difference. Media campaigns to prevent tobacco use and exposure to secondhand smoke have had value beyond the intended impact of single-issue campaigns; exposure to anti-tobacco campaigns and public dialogue about the dangers of tobacco seem also to be associated with shaping perceptions of the social world related to norms about tobacco, and ideas about regulating the portrayal of smoking in movies.
MAMUDU, H. M.
Tobacco control civil society organisations mobilised to influence countries during the negotiation of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) between 1999 and 2003. Tobacco control civil society organisations and coalitions around the world embraced the idea of an international tobacco control treaty and came together as the Framework Convention Alliance (FCA), becoming an important non-state actor within the international system of tobacco control. Archival documents and interviews demonstrate that the FCA successfully used strategies including publication of a newsletter, shaming, symbolism and media advocacy to influence policy positions of countries during the FCTC negotiation. The FCA became influential in the negotiation process by mobilising tobacco control civil society organisations and resources with the help of the Internet and framing the tobacco control discussion around global public health. PMID:19333806
Erickson, A C; McKenna, J W; Romano, R M
A review of mass media response to the smoking issue over the past 25 years reveals that sustained involvement of the broadcast and print media has served significantly to heighten public awareness and reduce smoking rates in the total U.S. population. Public service advertising has been an integral part of the smoking control movement from its outset, but today's intensely competitive media environment has forced health promoters to look beyond public service announcements in the development of total communication programs. Media advocacy--using the media to sharpen public awareness and mold public policy to serve the public interest, a technique derived from political campaigns--is emerging as a powerful tool in the smoking control movement. Its emphasis is on changing the entire social context of tobacco use in America, rather than the smoking behavior of people. Because media advocates' success pivots on their access to the media, they must be able both to create news and to react quickly to breaking news and unexpected events. The opportunistic, risk-taking nature of media advocacy requires that most efforts be waged at the State and local levels. An increasing number of State health departments and other organizations are using paid advertising to improve the frequency and reach of nonsmoking messages. Research verifies that paid media campaigns increase the target audience's exposure to smoking control messages, but planning and making efficient media purchases require sophistication and, of course, the necessary funds. Irrefutable medical evidence linking smoking to disease and addiction, combined with the powerful social force of the nonsmokers' rights movement, offer hope that a smoke-free society is an achievable goal. Success,however, will only be realized if tobacco control activists make use of the full range of mass media technologies to sustain and nourish this momentum.
Corrao, M. A.; Guindon, G. E.; Cokkinides, V.; Sharma, N.
The tobacco control movement needs a global information system permitting routine monitoring of the tobacco trade, tobacco farming, the tobacco industry, the prevalence of tobacco use, associated mortality, and national resources for combating tobacco. The Tobacco Control Country Profiles database, a data collection initiative led by the American Cancer Society in collaboration with WHO and the Centers for Disease Control and Prevention, represents the first step in the development of such a ...
The influence of newspaper coverage and a media campaign on smokers' support for smoke-free bars and restaurants and on secondhand smoke harm awareness: findings from the International Tobacco Control (ITC) Netherlands Survey.
Nagelhout, Gera E; van den Putte, Bas; de Vries, Hein; Crone, Matty; Fong, Geoffrey T; Willemsen, Marc C
To assess the influence of newspaper coverage and a media campaign about Dutch smoke-free legislation on smokers' support for smoke-free bars and restaurants and on secondhand smoke (SHS) harm awareness. A content analysis was conducted of 1041 newspaper articles on the smoke-free legislation published in six Dutch newspapers from March 2008 to April 2009. Smokers who were regular readers of at least one of these newspapers (n = 677) were selected from the pre-ban and post-ban waves of the International Tobacco Control Netherlands Survey. Exposure to newspaper coverage and the implementation campaign was correlated with changes in smokers' support for smoke-free bars and restaurants and SHS harm awareness. Most newspaper coverage was found to be negative towards the smoking ban (57%) and focused on economic aspects (59%) rather than health aspects (22%). Exposure to this coverage had a small but significantly negative effect on support for smoke-free bars and restaurants (β = -0.09, p = 0.013). Among higher educated smokers, exposure to positive newspaper coverage had a more positive effect on support for smoke-free bars and restaurants. In addition, exposure to the implementation campaign had a small but significantly positive effect on SHS harm awareness (β = 0.11, p = 0.001). Media attention on smoke-free legislation can influence smokers' support for the legislation and SHS harm awareness. Tobacco control advocates should aim to establish positive media attention that puts forward the health arguments for the legislation.
Everett, Kevin D; Chadwick, Ginny; Cowan, Stanley R; Kinkade, Emily
Tobacco control policies reduce the health and economic burden caused by tobacco. With over half of the United States communities lacking adequate protective policies, an examination of policy adoption factors can provide insights to facilitate policy adoption. A case study approach examines the rate of adoption, prominent media frames, policy leaders' perceptions and coalition activities for smokefree and Tobacco 21 policies adopted in Missouri. Findings show compared to smokefree policy, Tobacco 21 requires a considerably shorter timeframe and fewer resources for adoption. Tobacco 21 coalitions target a small group of stakeholders compared to smokefree coalitions' emphasis on broad community engagement. Both policies are formally opposed, but elected officials perceive less political risk supporting Tobacco 21. As a new tobacco control policy tool, Tobacco 21 has relative advantage that should be considered by community health advocates.
Poston, Walker S. C.; Suminski, Richard R.; Hoffman, Kevin M.; Jitnarin, Nattinee; Hughey, Joseph; Lando, Harry A.; Winsby, Amelia; Haddock, Keith
Despite progress in policy changes, tobacco use rates are still high in the military. Little is known about the views of those who create and implement tobacco control policies within the Department of Defense. These individuals determine what policy initiatives will be developed, prioritized, and implemented. We conducted key informant interviews with 16 service-level policy leaders (PLs) and 36 installation-level tobacco control managers (TCMs). PLs and TCMs believed that line leadership view tobacco control as a low priority that has minimal impact on successful mission completion. They also identified cultural factors that perpetuate tobacco use, such as low cost and easy accessibility to tobacco, smoke breaks, and uneven or unknown enforcement of current tobacco policies. PMID:20968274
The sale of tobacco products is a profitable venture for retailers. Willingness to participate in tobacco control was high among the retailers. There is a need to raise awareness and co-opt tobacco retailers as change agents in tobacco control efforts.
Peelen, Myrthe J.; Sheikh, Aziz; Kok, Marjolein; Hajenius, Petra; Zimmermann, Luc J.; Kramer, Boris W.; Hukkelhoven, Chantal W.; Reiss, Irwin K.; Mol, Ben W.; Been, Jasper V.
We investigated whether changes in perinatal outcomes occurred following introduction of key tobacco control policies in the Netherlands: smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign (January-February 2004); and extension of the smoke-free law to the
M. Peelen (Myrthe); A. Sheikh (Aziz); M. Kok (Marjolein); P.J. Hajenius (Petra); L.J.I. Zimmermann (Luc); B.W. Kramer (Boris); C.W.P.M. Hukkelhoven (Chantal); I.K.M. Reiss (Irwin); B.W. Mol (Ben W.); J.V. Been (Jasper V.)
textabstractWe investigated whether changes in perinatal outcomes occurred following introduction of key tobacco control policies in the Netherlands: smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign (January-February 2004); and extension of the smoke-free law
Hébert, Emily T; Case, Kathleen R; Kelder, Steven H; Delk, Joanne; Perry, Cheryl L; Harrell, Melissa B
Little is known about the nature and extent of adolescents' exposure to tobacco- and e-cigarette-related communications on social media. In this study, we describe the prevalence and correlates of youth exposure and engagement with tobacco- and e-cigarette-related social media. Data are from the baseline survey of the Texas Adolescent Tobacco and Marketing Surveillance system, a cross-sectional sample of sixth, eighth, and 10th graders (n = 3907, N = 461,097). Weighted logistic regression models were used to examine associations between demographic characteristics, sensation seeking, tobacco use, and exposure and engagement with tobacco-related social media. Overall, 52.5% of students reported exposure to tobacco-related social media in the past month, whereas social media was higher among those who were susceptible to, had ever, or currently use both combustible tobacco and e-cigarettes (AOR = 2.10-3.46, p social media. Adolescents who are susceptible to or use e-cigarettes and/or combustible tobacco are exposed to and engage with tobacco-related social media more than their peers. Social media appears to be an important venue when targeting vulnerable youth in prevention campaigns. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Otañez, Martin G.; Mamudu, Hadii M.
Transnational tobacco manufacturing and tobacco leaf companies engage in numerous efforts to oppose global tobacco control. One of their strategies is to stress the economic importance of tobacco to the developing countries that grow it. We analyze tobacco industry documents and ethnographic data to show how tobacco companies used this argument in the case of Malawi, producing and disseminating reports promoting claims of losses of jobs and foreign earnings that would result from the impending passage of the Framework Convention on Tobacco Control (FCTC). In addition, they influenced the government of Malawi to introduce resolutions or make amendments to tobacco-related resolutions in meetings of United Nations organizations, succeeding in temporarily displacing health as the focus in tobacco control policymaking. However, these efforts did not substantially weaken the FCTC. PMID:19696392
Hatoun, Jonathan; Davis-Plourde, Kendra; Penti, Brian; Cabral, Howard; Kazis, Lewis
Exposure to environmental tobacco smoke increases pediatric asthma severity. Strict, state-level tobacco control reduces smoking. The Child Asthma Call-Back Survey (Child ACBS) is a nationally representative survey of the guardians of children with asthma. The American Lung Association's annual State of Tobacco Control report grades tobacco control laws in each state including a tax grade (cigarette excise tax relative to the national mean), and a smoke-free air grade (number of locations where smoking is prohibited). We joined Child ACBS data from 2006 to 2010 with corresponding state and year tobacco grades. In the primary analysis, we investigated the effect of state tax grades on a child's asthma severity by using a logistic regression model adjusting for year. A secondary analysis assessed the impact of smoke-free air grades on in-home smoking. Our analysis included 12 860 Child ACBS interviews from 35 states over 5 years, representing over 24 million individuals. We merged 112 unique State of Tobacco Control grades with patient data by state and year. A higher tax grade was associated with reduced severity (adjusted odds ratio = 1.40; P = .007, 95% confidence interval: 1.10-1.80). A better smoke-free air grade was not associated with decreased in-home smoking after adjusting for confounding by income and type of residence. A stronger tobacco tax is associated with reduced asthma severity. Further study is needed to determine the effect of smoke-free air laws on in-home environmental. This work supports ongoing efforts to strengthen tobacco control through federal and state regulations. Copyright © 2018 by the American Academy of Pediatrics.
Zawahir, Shukry; Omar, Maizurah; Awang, Rahmat; Yong, Hua-Hie; Borland, Ron; Sirirassamee, Buppha; Fong, Geoffrey T; Hammond, David
Finding ways to discourage adolescents from taking up smoking is important because those who begin smoking at an earlier age are more likely to become addicted and have greater difficulty in quitting. This article examined whether anti smoking messages and education could help to reduce smoking susceptibility among adolescents in two Southeast Asian countries and to explore the possible moderating effect of country and gender. Data came from Wave 1 of the International Tobacco Control Southeast Asia Project (ITC-SEA) survey conducted in Malaysia (n = 1,008) and Thailand (n = 1,000) where adolescents were asked about receiving antismoking advice from nurses or doctors, being taught at schools about the danger of smoking, noticing antismoking messages, knowledge of health effects of smoking, beliefs about the health risks of smoking, smoking susceptibility, and demographic information. Data were analyzed using chi-square tests and logistic regression models. Overall, significantly more Thai adolescents reported receiving advice from their nurses or doctors about the danger of smoking (p < .001), but no country difference was observed for reported antismoking education in schools and exposure to antismoking messages. Multivariate analyses revealed that only provision of antismoking education at schools was significantly associated with reduced susceptibility to smoking among female Malaysian adolescents (OR = 0.26). Higher knowledge of smoking harm and higher perceived health risk of smoking were associated with reduced smoking susceptibility among Thai female (OR = 0.52) and Malaysian male adolescents (OR = 0.63), respectively. Educating adolescents about the dangers of smoking in schools appears to be the most effective means of reducing adolescents' smoking susceptibility in both countries, although different prevention strategies may be necessary to ensure effectiveness for male and female adolescents.
Lesbian, gay, bisexual and transgender (LGBT) view it differently than non-LGBT: Exposure to tobacco-related couponing, e-cigarette advertisements, and anti-tobacco messages on social and traditional media.
Emory, Kristen; Buchting, Francisco O; Trinidad, Dennis R; Vera, Lisa; Emery, Sherry L
LGBT populations use tobacco at disparately higher rates nationwide, compared to national averages. The tobacco industry has a history targeting LGBT with marketing efforts, likely contributing to this disparity. This study explores whether exposure to tobacco content on traditional and social media is associated with tobacco use among LGBT and non-LGBT. This study reports results from LGBT (N=1,092) and non-LGBT (N=16,430) respondents to a 2013 nationally representative cross-sectional online survey of US adults (N=17,522). Frequency and weighted prevalence were estimated and adjusted logistic regression analyses were conducted. LGBT reported significantly higher rates of past 30-day tobacco media exposure compared to non-LGBT, this effect was strongest among LGBT who were smokers (pFacebook, etc.) than did non-LGBT (p<0.05). Non-LGBT reported more exposure from traditional media sources such as television, most notably anti-tobacco messages (p=0.0088). LGBT had higher odds of past 30-day use of cigarettes, e-cigarettes, and cigars compared to non-LGBT, adjusting for past 30-day media exposure and covariates (p≤0.0001). LGBT (particularly LGBT smokers) are more likely to be exposed to and interact with tobacco-related messages on new and social media than their non-LGBT counterparts. Higher levels of tobacco-media exposure were significantly associated with higher likelihood of tobacco use. This suggests tobacco control must work toward reaching LGBT across a variety of media platforms, particularly new and social media outlets.
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.
Crosbie, Eric; Sosa, Patricia; Glantz, Stanton A
Objective To analyze the passage of Costa Rica’s 2012 tobacco control law. Materials and methods Review of legislation, newspaper articles, and key informant interviews. Results Tobacco control advocates, in close collaboration with international health groups, recruited national, regional and international experts to testify in the Legislative Assembly, implemented grassroots advocacy campaigns, and generated media coverage to enact strong legislation in March 2012 consistent with the World Health Organization Framework Convention on Tobacco Control, despite tobacco industry lobbying efforts that for decades blocked effective tobacco control legislation. Conclusion Costa Rica’s experience illustrates how with resources, good strategic planning, aggressive tactics and perseverance tobacco control advocates can overcome tobacco industry opposition in the Legislative Assembly and Executive Branch. This determined approach has positioned Costa Rica to become a regional leader in tobacco control. PMID:26879509
Full Text Available Objective. To analyze the passage of Costa Rica’s 2012 tobacco control law. Materials and methods. Review of legislation, newspaper articles, and key informant interviews. Results. Tobacco control advocates, in close collaboration with international health groups, recruited national, regional and international experts to testify in the Legislative Assembly, implemented grassroots advocacy campaigns, and generated media coverage to enact strong legislation in March 2012 consistent with the World Health Organization Framework Convention on Tobacco Control, despite tobacco industry lobbying efforts that for decades blocked effective tobacco control legislation. Conclusion. Costa Rica’s experience illustrates how with resources, good strategic planning, ag- gressive tactics and perseverance tobacco control advocates can overcome tobacco industry opposition in the Legislative Assembly and Executive Branch. This determined approach has positioned Costa Rica to become a regional leader in tobacco control.
Full Text Available Objective. To analyze the passage of Costa Rica’s 2012 tobacco control law. Materials and methods. Review of legislation, newspaper articles, and key informant interviews. Results. Tobacco control advocates, in close collaboration with international health groups, recruited national, regional and international experts to testify in the Legislative Assembly, implemented grassroots advocacy campaigns, and generated media coverage to enact strong legislation in March 2012 consistent with the World Health Organization Framework Convention on Tobacco Control, despite tobacco industry lobbying efforts that for decades blocked effective tobacco control legislation. Conclusion. Costa Rica’s experience illustrates how with resources, good strategic planning, aggressive tactics and perseverance tobacco control advocates can overcome tobacco industry opposition in the Legislative Assembly and Executive Branch. This determined approach has positioned Costa Rica to become a regional leader in tobacco control.
Douglas, Erika L.; Land, Stephanie R.; Miller, Elizabeth; Fine, Michael J.
BACKGROUND Media literacy programs have shown potential for reduction of adolescent tobacco use. We aimed to determine if an anti-smoking media literacy curriculum improves students’ media literacy and affects factors related to adolescent smoking. METHODS We recruited 1170 9th grade students from 64 classrooms in 3 public urban high schools. Students were randomized by classroom to a media literacy curriculum versus a standard educational program. In an intent-to-treat analysis, we used multi-level modeling to determine if changes in study outcomes were associated with the curricular intervention, controlling for baseline student covariates and the clustering of students within classrooms. RESULTS Among participants, mean age was 14.5 years and 51% were male, with no significant differences in baseline characteristics between groups. Smoking media literacy changed more among intervention participants compared with control participants (0.24 vs. 0.08, p media literacy curriculum is more effective than a standard educational program in teaching media literacy and improving perceptions of the true prevalence of smoking among adolescents. PMID:25099425
Mochizuki-Kobayashi, Y; Samet, JM; Yamaguchi, N
Worldwide, tobacco use is a leading cause of preventable disease and premature death. For a century, large corporations have manufactured and sold cigarettes, a highly, addictive tobacco product. Today, over 1 billion people smoke. In recent decades, as smoking has declined in developed countries, the multinational tobacco companies have aggressively sought new markets in the developing countries. In Japan, tobacco smoking is one of the main avoidable causes of disease and death. The...
Lee, Youn Ok; Momin, Behnoosh; Hansen, Heather; Duke, Jennifer; Harms, Kristin; McCartney, Amanda; Neri, Antonio; Kahende, Jennifer; Zhang, Lei; Stewart, Sherri L
Digital media are often used to encourage smoking cessation by increasing quitline call volume through direct promotion to smokers or indirect promotion to smoker proxies. The documentation of a program's experiences utilizing digital media is necessary to develop both the knowledge base and a set of best practices. This case study highlights the use of digital media in a proxy-targeted campaign to promote the California Smokers' Helpline to health care professionals from October 2009 to September 2012. We describe the iterative development of the campaign's digital media activities and report campaign summaries of web metrics (website visits, webinar registrations, downloads of online materials, online orders for promotional materials) and media buy (gross impressions) tracking data. The campaign generated more than 2.7 million gross impressions from digital media sources over 3 years. Online orders for promotional materials increased almost 40% over the course of the campaign. A clearly defined campaign strategy ensured that there was a systematic approach in developing and implementing campaign activities and ensuring that lessons learned from previous years were incorporated. Discussion includes lessons learned and recommendations for future improvements reported by campaign staff to inform similar efforts using digital media.
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 ...
Tauras, John A; Chaloupka, Frank J; Quah, Anne Chiew Kin; Fong, Geoffrey T
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.
Tafawa, Adebola Odunlami; Viswanath, Kasisomayajula; Kawachi, Ichiro; Williams, David R
Mass media exposure is a strong determinant of tobacco use yet little is known about this relationship in African countries. We explored socio-demographic and socio-contextual correlates of tobacco consumption and associations between mass media exposure, gender and the use of any and various forms of tobacco among Nigerians. The study included 47,805 adults from the cross-sectional and nationally representative Nigeria demographic and health survey 2008. Weighted binary logistic models predicted any tobacco use whereas weighted multinomial logistic models predicted smoking and smokeless tobacco, all compared with no tobacco use. Approximately 4.2% of Nigerian adults used tobacco--2.7% smoked tobacco whereas 1.5% used smokeless tobacco. Tobacco use was more prevalent among men than women (12% vs. 0.6%; p value <0.0001). Gender modified the associations between tobacco use and radio exposure or TV exposure (p values ranged = 0.02-0.05). Among men, some radio exposure and high radio exposure were associated with increased odds of any tobacco use, compared with no radio exposure. Among men, infrequently reading newspapers/magazines and frequently reading newspapers/magazines were associated with higher odds of smokeless tobacco use, compared with not reading newspapers/magazines. Among women, infrequently reading newspapers/magazines was associated with reduced odds of smokeless tobacco use, compared with not reading newspaper/magazines. The relationships between mass media exposure and tobacco consumption differed by gender and were more pronounced among men. Research on radio programs may help to form policies that can address tobacco use among Nigerian men.
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.
.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?
Liang, Yunji; Zheng, Xiaolong; Zeng, Daniel Dajun; Zhou, Xingshe; Leischow, Scott James; Chung, Wingyan
The commercial potential of social media is utilized by tobacco manufacturers and vendors for tobacco promotion online. However, the prevalence and promotional strategies of pro-tobacco content in social media are still not widely understood. The goal of this study was to reveal what is presented by the tobacco industry, and how it promotes itself, on social media sites. The top 70 popular cigarette brands are divided into two groups according to their retail prices: group H (brands with high retail prices) and group L (brands with low retail prices). Three comprehensive searches were conducted on Facebook, Wikipedia, and YouTube respectively using the top 70 popular cigarette brands as keywords. We identified tobacco-related content including history and culture, product features, health warnings, home page of cigarette brands, and Web-based tobacco shops. Furthermore, we examined the promotional strategies utilized in social media. According to the data collected from March 3, 2014 to March 10, 2014, 43 of the 70 representative cigarette brands had created 238 Facebook fan pages, 46 cigarette brands were identified in Wikipedia, and there were over 120,000 pro-tobacco videos on YouTube, associated with 61 cigarette brands. The main content presented on the three social media websites differs significantly. Wikipedia focuses on history and culture (67%, 32/48; Psocial media. Sales promotion is more prevalent on YouTube than on the other two sites (64%, 39/61 vs 35%, 15/43; P=.004). Generally, the sale promotions of higher-cost brands in social media are more prevalent than those of lower-cost brands (55%, 16/29 vs 7%, 1/14; Psocial media allows more pro-tobacco information to be accessed by online users. This dilemma indicates that corresponding regulations should be established to prevent tobacco promotion in social media.
The Department for International Development (DFID), United Kingdom, is making a grant of up to £1 100 000 to IDRC to cover three years of Research for International Tobacco Control (RITC) programming between April 2005 and March 2008. The funding is intended to support activities outlined in RITC's program ...
... Democratic Republic of Congo, Ethiopia, Togo and Uganda). The specific objectives are to undertake baseline surveys, organize stakeholder meetings, identify obstacles to tobacco control, and identify opportunities for policy intervention, particularly in the form of taxation, advertising bans, smoke-free places and graphic ...
The Tobacco Control Research Group (TCRG), University of Beirut (AUB), is a multidisciplinary team of professionals from the health sciences, medicine, chemistry and engineering departments. The Group was established in 1999 with IDRC support and has since produced some remarkable research on waterpipe ...
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.
Pinkleton, Bruce E; Weintraub Austin, Erica; Cohen, Marilyn; Miller, Autumn; Fitzgerald, Erin
Researchers used a quasi-experiment (N = 723) conducted in the field and using both pretests and posttests to carry out a theory-based evaluation of the effectiveness of a media literacy curriculum implemented in Washington state. Results showed that reflective thinking concerning media message about tobacco increased for all media literacy participants, whether or not they had used tobacco previously. Changes in reflective thinking affected a range of decision-making indicators. Lesson participants who had not used tobacco demonstrated greater change at earlier stages of decision making in ways that suggested a greater understanding of the persuasive techniques used by tobacco manufacturers, on indicators such as perceived realism, desirability, and similarity. Lesson participants who had tried tobacco demonstrated greater change at later stages of decision making on indicators such as perceived peer norms for tobacco use, identification with tobacco-related portrayals, and expectancies for tobacco use. All participants also showed increases in their ability and motivations to resist smoking-related influences. Overall, the results suggest that media literacy has important and somewhat different effects on those who have and those who have not experimented with tobacco use. The results also show the importance of measuring cognitive and affective indicators of decision making that may change gradually as participants gain experience putting lessons learned into action.
Waduarachchige Don Aruna Shantha De Silva
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
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...
communicable disease (NCD) burden in low- and middle-income countries. The Centre for Tobacco Control in Africa (CTCA), based at Makerere University in Uganda, serves as a regional centre, providing tools and evidence to support tobacco control ...
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...
Primack, Brian A.; Douglas, Erika L.; Land, Stephanie R.; Miller, Elizabeth; Fine, Michael J.
Background: Media literacy programs have shown potential for reduction of adolescent tobacco use. We aimed to determine if an anti-smoking media literacy curriculum improves students' media literacy and affects factors related to adolescent smoking. Methods: We recruited 1170 9th-grade students from 64 classrooms in 3 public urban high…
Mar 8, 2018 ... IDRC's investments focus on addressing the economic rationale for tobacco control; research supported by the Centre enables countries to implement fiscal and policy measures to effectively control and reduce tobacco use. IDRC has supported international tobacco control research for more than 20 years ...
Full Text Available Objective: To describe, as of July 2011, the status of tobacco control legislation in Africa in three key areas of the Framework Convention on Tobacco Control (FCTC—(1 Protection from exposure to tobacco smoke, (2 Packaging and labelling of tobacco products, and (3 Tobacco advertising, promotion and sponsorship. Methods: Review and analysis of tobacco control legislation in Africa, media reports, journal articles, tobacco industry documents and data published in the 2011 WHO Report on the Global Tobacco Epidemic. Results: Modest progress in FCTC implementation in Africa with many countries having legislation or policies on the protection from exposure to tobacco smoke, however, only a handful of countries meet the standards of the FCTC Article 8 and its Guidelines particularly with regards to designated smoking areas. Little progress on packaging and labelling of tobacco products, with few countries having legislation meeting the minimum standards of the FCTC Article 11 and its Guidelines. Mauritius is the only African country with graphic or pictorial health warnings in place and has the largest warning labels in Africa. Slightly better progress in banning tobacco advertising, promotion and sponsorship has been shown by African countries, although the majority of legislation falls short of the standards of the FCTC Article 13 and its Guidelines. Despite their efforts, African countries’ FCTC implementation at national level has not matched the strong regional commitment demonstrated during the FCTC treaty negotiations. Conclusion: This study highlights the need for Africa to step up efforts to adopt and implement effective tobacco control legislation that is fully compliant with the FCTC. In order to achieve this, countries should prioritise resources for capacity building for drafting strong FCTC compliant legislation, research to inform policy and boost political will, and countering the tobacco industry which is a major obstacle to FCTC
To describe, as of July 2011, the status of tobacco control legislation in Africa in three key areas of the Framework Convention on Tobacco Control (FCTC)-(1) Protection from exposure to tobacco smoke, (2) Packaging and labelling of tobacco products, and (3) Tobacco advertising, promotion and sponsorship. Review and analysis of tobacco control legislation in Africa, media reports, journal articles, tobacco industry documents and data published in the 2011 WHO Report on the Global Tobacco Epidemic. Modest progress in FCTC implementation in Africa with many countries having legislation or policies on the protection from exposure to tobacco smoke, however, only a handful of countries meet the standards of the FCTC Article 8 and its Guidelines particularly with regards to designated smoking areas. Little progress on packaging and labelling of tobacco products, with few countries having legislation meeting the minimum standards of the FCTC Article 11 and its Guidelines. Mauritius is the only African country with graphic or pictorial health warnings in place and has the largest warning labels in Africa. Slightly better progress in banning tobacco advertising, promotion and sponsorship has been shown by African countries, although the majority of legislation falls short of the standards of the FCTC Article 13 and its Guidelines. Despite their efforts, African countries' FCTC implementation at national level has not matched the strong regional commitment demonstrated during the FCTC treaty negotiations. This study highlights the need for Africa to step up efforts to adopt and implement effective tobacco control legislation that is fully compliant with the FCTC. In order to achieve this, countries should prioritise resources for capacity building for drafting strong FCTC compliant legislation, research to inform policy and boost political will, and countering the tobacco industry which is a major obstacle to FCTC implementation in Africa.
Sargent, James D; Hanewinkel, Reiner
To examine differential effects of smoking in films and tobacco advertising on adolescent smoking. We hypothesize that movie smoking will have greater effects on smoking initiation, whereas tobacco advertising receptivity will primarily affect experimentation. Longitudinal observational study of adolescents. School-based surveys conducted in Schleswig-Holstein, Germany. A total of 4384 adolescents age 11-15 years at baseline and re-surveyed 1 year later; ever smoking prevalence was 38% at time 1. The main outcome variable combined two items assessing life-time and current smoking (alpha = 0.87). Baseline never smokers were analyzed separately from those who had tried smoking (ever smokers). Exposure to smoking in 398 internationally distributed US movies was modeled as a continuous variable, with 0 corresponding to the 5th percentile and 1 to the 95th percentile of exposure. Tobacco marketing receptivity consisted of naming a brand for a favorite tobacco advertisement. Ordinal logistic regressions controlled for socio-demographics, other social influences, personality characteristics of the adolescent and parenting style. Whereas 34% of ever smokers were receptive to tobacco marketing at time 1, only 6% of never smokers were. Among time 1 never smokers, exposure to movie smoking was a significantly stronger predictor of higher time 2 smoking level [adjusted proportional odds ratio = 2.76, 95% confidence interval (1.84, 4.15)] than was tobacco marketing receptivity (1.53 [1.07, 2.20]). Among time 1 ever smokers, both tobacco marketing receptivity and exposure to movie smoking predicted higher levels of time 2 smoking [2.17 (1.78, 2.63) and 1.62 (1.18, 2.23), respectively], and the two estimates were not significantly different. In this longitudinal study, exposure to movie smoking was a stronger predictor of smoking initiation than tobacco marketing receptivity, which was more common among ever smokers. The results suggest that entertainment media smoking should be
Amos, Amanda; Greaves, Lorraine; Nichter, Mimi; Bloch, Michele
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.
This podcast helps raise retailers awareness of the new federal tobacco regulations. Created: 6/22/2010 by The CDC Division of News and Electronic Media and the FDA Center for Tobacco Products. Date Released: 6/22/2010.
Depue, Jacob B; Southwell, Brian G; Betzner, Anne E; Walsh, Barbara M
Assessing the potential link between smoking behavior and exposure to mass media depictions of smoking on social networking Web sites. A representative longitudinal panel of 200 young adults in Connecticut. Telephone surveys were conducted by using computer assisted telephone interviewing technology and electronic dialing for random digit dialing and listed samples. Connecticut residents aged 18 to 24 years. To measure encoded exposure, respondents were asked whether or not they had smoked a cigarette in the past 30 days and about how often they had seen tobacco use on television, in movies, and in social media content. Respondents were also asked about cigarette use in the past 30 days, and a series of additional questions that have been shown to be predictive of tobacco use. Logistic regression was used to test for our main prediction that reported exposure to social media tobacco depictions at time 1 would influence time 2 smoking behavior. Encoded exposure to social media tobacco depictions (B = .47, p social media depictions of tobacco use predict future smoking tendency, over and above the influence of TV and movie depictions of smoking. This is the first known study to specifically assess the role of social media in informing tobacco behavior.
Promoting Implementation of Tobacco Control Laws and Policies in Nigeria. 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 ...
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 ...
Despite progress in implementing tobacco control policies, trade liberalization has significantly increased tobacco consumption among women and children in some Asian countries. It has also reduced advertising restrictions. This project will evaluate the threats to developing and implementing tobacco control policies as a ...
Freeman, Becky; Chapman, Simon
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 mapped. BAT employees on Facebook were identified and then the term 'British American Tobacco' was searched for in the Facebook search engine and results recorded, including titles, descriptions, names and the number of Facebook participants involved for each search result. To further detail any potential promotional activities, a search for two of BAT's global brands, 'Dunhill' and 'Lucky Strike', was conducted. Each of the 3 search terms generated more than 500 items across a variety of Facebook subsections. Some BAT employees are energetically promoting BAT and BAT brands on Facebook through joining and administrating groups, joining pages as fans and posting photographs of BAT events, products and promotional items. BAT employees undertaking these actions are from countries that have ratified the WHO FCTC, which requires signatories to ban all forms of tobacco advertising, including online and crossborder exposure from countries that are not enforcing advertising restrictions. The results of the present research could be used to test the comprehensiveness of the advertising ban by requesting that governments mandate the removal of this promotional material from Facebook.
Lidón-Moyano, Cristina; Sampedro-Vida, Marc; Matilla-Santander, Nuria; Martín-Sánchez, Juan Carlos; González-Marrón, Adrián; Bunch, Kailey; Martínez-Sánchez, Jose M
The objective of this work is to describe the acceptability of some tobacco products regulations and to explore their relation with tobacco control legislation levels in Europe. We used data on tobacco control activities in Europe in 2007, 2010 and 2013 measured by the Tobacco Control Scale (TCS) and data regarding attitudes about tobacco control regulations (i.e. adding picture health warnings on all packages of tobacco products or increasing taxes on tobacco products) from the Special Eurobarometer of 2009, 2012 and 2014 (n = 80,831). We calculated the prevalence ratio of favorable attitudes towards tobacco products restrictions in the reference year 2009 vs. the most current year (i.e. 2009 vs 2014), and the effect of previous TCS scores on the attitudes towards tobacco products regulations adjusted for sociodemographic variables. Strong support for the studied tobacco products regulations, which modestly increased over time, was observed. A positive relation was generally observed between TCS scores and support for the studied tobacco products regulations at both the ecological and individual level. A positive correlation was found between TCS scores and support for increasing taxes on tobacco products (r sp :0.29; 95%CI: 0.10, 0.48) at the ecological level, while at the individual level, the positive association was more remarkable in the case of support for adding large health warning labels to packaging. In conclusion, support for the studied tobacco products regulations were positively related with European tobacco control levels of implementation both at the ecological and individual level. Copyright © 2018 Elsevier Inc. All rights reserved.
Tiller, Kelly; Starnes, Jane H.; Feleke, Shiferaw T.
The “Family Smoking Prevention and Tobacco Control Act” was signed into law on June 22, 2009. The bill grants the Federal Food and Drug Administration (FDA) an authority to regulate the manufacturing and marketing of tobacco products. Tobacco leaf is not subject to the regulation. As a result, it is not apparent what it does mean to tobacco growers. However, since the demand for tobacco is in large part determined by the demand for cigarettes, a change in demand for cigarettes due to the FDA ...
Oct 15, 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 ...
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
Nunez-Smith, Marcella; Wolf, Elizabeth; Huang, Helen Mikiko; Chen, Peggy G.; Lee, Lana; Emanuel, Ezekiel J.; Gross, Cary P.
The authors systematically reviewed 42 quantitative studies on the relationship between media exposure and tobacco, illicit drug, and alcohol use among children and adolescents. Overall, 83% of studies reported that media was associated with increased risk of smoking initiation, use of illicit drugs, and alcohol consumption. Of 30 studies…
Poorolajal, Jalal; Mohammadi, Younes; Mahmoodi, Azam
This study assessed the status of cigarette marketing in Iran as well as the attitude of smokers toward smoking and the policies and tobacco control programs in the country. This cross-sectional study was conducted on 3480 volunteer smokers in six provinces, using a stratified cluster random sampling method. The study population consisted of smokers who used at least one cigarette per day. The data collection tool was an anonymous self-administered questionnaire including basic information and 20 five-choice questions related to participants' attitude toward smoking habits (Cronbach's alpha; 79.73%.). The majority (66.9%) of participants started smoking at the age of 10 to 19 years and 61.1% used foreign cigarettes. Of 160 marketed brands, 38 (23.8%) were domestic and 122 (76.2%) were foreign, including 63 (39.3%) imported and 59 (36.9%) smuggled brands. Being tempted (25.0%), getting nervous (24.1%), and seeking euphoria (24.1%) were the most common reasons for restarting cigarette smoking after cessation. The majority of participants believed that smoking in public places was a violation of the rights of others and smoking should be avoided in such places. 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. However, 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.
Meanwhile, existing studies on the impact of tobacco taxes are based on average "price elasticity of demand," a measure that shows how overall demand for ... IDRC is investing in local solutions to address climate change-related challenges in India, including heat stress, water management, and climate-related migration.
Tobacco use in many Latin American countries is high among boys, girls, men, and women. However, research has yet to explore differences in cigarette smoking rates between lower- and higher-income groups in middle-income countries such as Brazil, Mexico, and Uruguay. Meanwhile, existing studies on the impact of ...
Branstetter, Steven A; Lengerich, Eugene; Dignan, Mark; Muscat, Joshua
A critical component of the US Food and Drug Administration's new authority to regulate tobacco products is understanding communications and marketing of tobacco products and their perceived risks in different geographic, age, race, ethnic and socioeconomic groups. Such information might be particularly useful in subgroups of the population or geographic areas that experience high tobacco use and suffer a disproportionate burden from tobacco-related diseases. For certain populations, there may be additional cultural factors unique to the geographical region which may promote smoking behavior. The purpose of the present study was to examine the perceptions of tobacco-related media messages among a sample of rural Appalachian natives, a population with smoking rates higher than the national average and who are disproportionately affected by tobacco-related and other cancers. A series of four focus group sessions were conducted in a north-central area of Pennsylvania, in one of 52 counties in Pennsylvania designated as within the Appalachian region. Participants were recruited via direct mail letters, advertisements in a local newspaper, and recruiting flyers posted at the local library. The focus groups were moderated by trained professional staff from The Pennsylvania State University's Center for Survey Research (CSR). Focus group sessions sought to examine perceptions of tobacco-related media in an Appalachian region of Pennsylvania. The sessions were audiotaped and transcribed, and the data was analyzed using qualitative approaches. Participants reported that pro-tobacco ads and favorable messages were received through the internet, direct mail, convenience stores, billboards, movies, and other sources. Anti-tobacco messages were identified primarily from television and magazines. In general, participants concluded that quitting was a matter of choice and was not influenced by pro- or anti-tobacco media. These results indicate that both pro- and anti-tobacco
Nakkash, R T; Torossian, L; El Hajj, T; Khalil, J; Afifi, R A
Progress in tobacco control policy making has occurred worldwide through advocacy campaigns involving multiple players- civil society groups, activists, academics, media and policymakers. The Framework Convention on Tobacco Control (FCTC)-the first ever global health treaty-outlines evidence-based tobacco control policies. Lebanon ratified the FCTC in 2005, but until 2011, tobacco control policies remained rudimentary and not evidence-based. Beginning in 2009, a concerted advocacy campaign was undertaken by a variety of stakeholders with the aim of accelerating the process of adopting a strong tobacco control policy. The campaign was successful, and Law 174 passed the Lebanese Parliament in August 2011. In this article, we analyse the policy making process that led to the adoption of Law 174 using Kingdon's model. The analysis relies on primary and secondary data sources including historical records of key governmental decisions, documentation of the activities of the concerted advocacy campaign and in-depth interviews with key stakeholders. We describe the opening of a window of opportunity as a result of the alignment of the problem, policy and politics streams. Furthermore, findings revealed that despite the challenge of persistent tobacco industry interference and established power relations between the industry, its allies and policymakers; policy entrepreneurs succeeded in supporting the alignment of the streams, and influencing the passage of the law. Kingdon's multiple stream approach was useful in explaining how tobacco control became an emerging policy issue at the front of the policy agenda in Lebanon.
Harris, F; MacKintosh, A M; Anderson, S; Hastings, G; Borland, R; Fong, G T; Hammond, D; Cummings, K M
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.
Mons, U; Pötschke-Langer, M
Structural measures of tobacco prevention are effective and cost-efficient measures to reduce tobacco consumption and the related health and economic consequences. However, Germany has been very reluctant in implementing tobacco control laws for several decades. Only recently has Germany increased its efforts in tobacco control, which has resulted in a decrease of tobacco consumption and in a decrease of smoking rates, especially in youths. This paper summarizes the evidence-based measures of tobacco prevention as well as the progress of recent German tobacco control policies. Finally, the barriers of further effective tobacco control policies are discussed and illustrated with examples. For decades, politics gave in to pressure and influence of lobbyists of the strong tobacco industry, which deceived the public and politics for their economic interests and in order to establish a high social acceptance of smoking. In addition, there is the phenomenon of "denialism", which means the convinced denial of scientific findings regarding smoking and smoking prevention in opponents of tobacco control, who are not directly affiliated with the tobacco industry.
Donaldson, Elisabeth A; Hoffman, Allison C; Zandberg, Izabella; Blake, Kelly D
Addiction beliefs about tobacco use are associated with intentions to use and use of tobacco products. Exposure to information about tobacco products in media sources may affect addiction beliefs. To examine the relationship between media exposure and tobacco product addiction beliefs. A nationally representative sample of US adults (n=3738) from the 2015 National Cancer Institute's Health Information National Trends Survey was used to examine addiction beliefs about cigarettes, cigars, smokeless tobacco, electronic cigarettes, hookah/waterpipe tobacco, and roll-your-own cigarettes. We used logistic regression to examine the relationship between media exposure and addiction beliefs. We defined media exposure by hours exposed, as well as exposure to tobacco use health effects information through media sources including social media. We categorized media sources by whether respondents actively or passively engaged with the source. A majority (60.6% to 87.3%) of respondents believed that cigarettes, cigars, roll-your-own cigarettes and smokeless tobacco are addictive. Less than half of respondents believed that electronic cigarettes or hookah/waterpipes are addictive (45.2% and 49.8%, respectively). Respondents exposed to messages about tobacco use health effects on active media channels (e.g., social media) had greater odds of believing that smokeless tobacco (adjusted odds ratio [AOR]=1.48), hookah/waterpipe (AOR=1.69), and roll-your-own cigarettes (AOR=1.61) are addictive. Respondents exposed to tobacco use health effects messages on passive media channels (e.g., television), had greater odds of believing that cigarettes (AOR=2.76) and electronic cigarettes (AOR=2.12) are addictive. US adult exposure to information about the health effects of tobacco use was associated with addiction beliefs about tobacco products. Published by Elsevier Ltd.
Collishaw, Neil E
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.
Ling, Pamela M; Glantz, Stanton A
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.
Robertson, Lindsay; Marsh, Louise; Hoek, Janet; McGee, Rob
Higher tobacco retailer density promotes smoking by making cigarettes more accessible and available, and by increasing environmental cues to smoke. We aimed to examine tobacco control experts' views on policies that could reduce tobacco retail availability. Telephone interviews with 25 individuals drawn from academia, non-governmental organisations, Māori and Pacific health, smoking cessation services, district health boards and other public health-related organisations. We used a semi-structured interview guide to explore the perceived importance of reducing tobacco retail supply, views on different policy options and barriers to policy adoption. Qualitative content analysis was conducted using transcripts as the data source. Participants believed tobacco retailer licensing was an important short-term step towards the 2025 goal. In the long-term, participants envisaged tobacco only being available at a small number of specialised outlets, either pharmacies or adult-only stores. To achieve that long-term scenario, participants suggested a sinking-lid policy on licences or a zoning approach could be adopted to gradually reduce outlet density. Policies banning sales at certain types of outlet were not considered feasible. There is tension between the tobacco retail reduction policies seen as more likely to be politically acceptable, and the need to make substantial changes to the tobacco retail environment by 2025. Future research could investigate possible legal mechanisms for requiring existing tobacco retailers to transition out of selling tobacco.
Erguder, Toker; Cakir, Banu; Aslan, Dilek; Warren, Charles W; Jones, Nathan R; Asma, Samira
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
COHEN, J.; SARABIA, V.; ASHLEY, M. J.
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. PMID:11740029
Cohen, J E; Sarabia, V; Ashley, M J
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.
Bier, Melinda C; Zwarun, Lara; Fehrmann Warren, Victoria
The impact of any prevention intervention depends on its ability to influence health risks and behavior change and the extent to which the target audience has access to and participates in the program. In this article, the authors make the case that media literacy-based tobacco prevention education can be integrated into the middle school curriculum in a way that delivers on both counts. They describe Missouri's successful development and dissemination of the Youth Empowerment in Action! Tobacco Education, Advocacy, and Media curriculum to schools serving populations that are most vulnerable to tobacco-related health disparities. They make three recommendations to support health program developers' efforts to motivate and prepare teachers to implement and sustain universal tobacco prevention education in areas of highest need.
Nargis, N; Hussain, A K M G; Fong, G T
Smokeless tobacco use occupies a significant portion of overall tobacco consumption in Bangladesh. Yet very little is known about the effectiveness of tax and price policy in controlling the use of smokeless tobacco use in the country. The paper examines the price distribution of various smoked (cigarette, bidi) and smokeless tobacco products (zarda, gul) using the univariate Epanechnikov kernel density function. It estimates the own and cross price elasticity of demand for the most widely used smokeless tobacco product zarda using two-step regression analysis. The analysis is based on data from the ITC Bangladesh Wave 3 Survey which is a nationally representative cohort survey of tobacco users and nonusers conducted in in Bangladesh during 2011-12. The price elasticity of lower price brands of zarda is estimated at -0.64 and of higher priced brands at -0.39, and the cross price elasticity of zarda with respect to cigarette price at 0.35. The tax increase on smokeless tobacco needs to be greater than the tax increase on smoked tobacco to bridge the wide price differential between the two types of products that currently encourages downward substitution from smoked to smokeless tobacco and discourages quitting behavior. This paper argues that increasing tax on smokeless tobacco simultaneously with the tax increase on smoked tobacco can have significant negative impact on the prevalence of smokeless tobacco use in Bangladesh. Finally, a specific excise system replacing the existing ad valorem excise tax can substantially contribute to the revenue collection performance from smokeless tobacco products.
Smith, Elizabeth A; McDaniel, Patricia A; Malone, Ruth E
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.
Elmore, Kristen C; Scull, Tracy M; Kupersmidt, Janis B
Adolescents' media environment offers information about who uses substances and what happens as a result-how youth interpret these messages likely determines their impact on normative beliefs about alcohol and tobacco use. The Message Interpretation Processing (MIP) theory predicts that substance use norms are influenced by cognitions associated with the interpretation of media messages. This cross-sectional study examined whether high school adolescents' (n = 817, 48 % female, 64 % white) media-related cognitions (i.e., similarity, realism, desirability, identification) were related to their perceptions of substance use norms. Results revealed that adolescents' media-related cognitions explained a significant amount of variance in perceived social approval for and estimated prevalence of peer alcohol and tobacco use, above and beyond previous use and demographic covariates. Compared to prevalence norms, social approval norms were more closely related to adolescents' media-related cognitions. Results suggest that critical thinking about media messages can inhibit normative perceptions that are likely to increase adolescents' interest in alcohol and tobacco use.
Jayawardhana, Jayani; Bradford, W. David; Jones, Walter; Nietert, Paul J.; Silvestri, Gerard
We investigate whether the distributions to the states from the Tobacco Master Settlement Agreement (MSA) in 1998 is associated with stronger tobacco control efforts. We use state level data from 50 states and the District of Columbia from four time periods post MSA (1999, 2002, 2004, and 2006) for the analysis. Using fixed effect regression models, we estimate the relationship between MSA disbursements and a new aggregate measure of strength of state tobacco control known as the Strength of Tobacco Control (SoTC) Index. Results show an increase of $1 in the annual per capita MSA disbursement to a state is associated with a decrease of −0.316 in the SoTC mean value, indicating higher MSA payments were associated with weaker tobacco control measures within states. In order to achieve the initial objectives of the MSA payments, policy makers should focus on utilizing MSA payments strictly on tobacco control activities across states. PMID:25506827
Otañez, Marty G; Mamudu, Hadii; Glantz, Stanton A
To examine the influence of US-based tobacco leaf-buying companies, Universal Corporation and Alliance One International, on Malawi's economy and trade policy in 2000-6. Analyses of ethnographic data and tobacco industry documents. Universal Corporation and Alliance One International, through their subsidiary companies Limbe Leaf and Alliance One, respectively, in Malawi, control policy-making advisory groups and operate a tobacco cartel to influence Malawi's economic and trade sectors. Limbe Leaf's corporate secretary and lawyer is a member of several policy-making committees that advise the Malawi government on tobacco-related trade policy. The corporate representative's presence prevents other committee members from taking positions against the tobacco industry and ensures government policy that advances industry interests to obtain low-cost tobacco. The World Bank and Malawi's Anti-corruption Bureau report allegations of collusion between Limbe Leaf and Alliance One over prices at tobacco markets. Allegations of collusion between Limbe Leaf and Alliance One prompted Malawi President Bingu Mutharika in 2006 to warn the companies to end non-competitive practices or leave the country, but there was no meaningful follow-up action. Findings from interviews with small-scale tobacco traders in Malawi suggest that Universal and Alliance One International purchase smuggled raw tobacco from the neighbouring countries, Zambia and Mozambique, undermining growers' efforts to benefit from tobacco farming in Malawi. These actions restrict competition, depress tobacco prices for Malawi's farmers and contribute to poverty in Malawi, while keeping the country dependent on tobacco growing.
Full Text Available The Tobacco Control Economics Project is a project that seeks to gather evidence on tobacco use and economics in southern Africa. It is a project of the University of Cape Town with support from the DataFirst repository based at the University of Cape Town. Its aim is to gather data that already exists, sometimes in digital form, frequently in offline records or in some cases paper records, and bring them together as an open resource. The project faces challenges of data gathering as well as permissions. Frequently data is or should be “available” in some form but control over the data is relinquished only unreluctantly. In many cases the legal standing of data is unclear. Many of the challenges relating to the bringing together of the data involve ascertaining what the legal standing of a dataset is or gaining permissions for its re-use. DataFirst is a longstanding data sharing infrastructure with professional and experienced data management staff. Challenges of ensuring continued funding and maintenance are similar to those of data infrastructures globally. The infrastructure meets international standards and provides leadership to other services and platforms in this space.
Wackowski, Olivia A; Manderski, Michelle T Bover; Lewis, M Jane; Delnevo, Cristine D
Little research exists on the impact of risk information comparing smokeless tobacco (SLT) use, particularly snus, to cigarette smoking. This study explored this topic using a communication channel where smokers may be exposed to such information-the news media. We randomly assigned 1008 current smokers to read one of three constructed news stories or to a control group (no article). The "favorable" story framed snus as a "safer" smoking alternative while the "cautious" story described snus risks. The "mixed" version described potential risks and harm-reduction benefits. Participants completed a post-article survey with snus risk and harm perception and use intention measures. Article condition was significantly associated with perceived harm of daily snus use relative to smoking (1 = a lot less harmful - 5 = a lot more harmful; p media when communicating about tobacco risks.
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.
Luke, Douglas A; Ribisl, Kurt M; Smith, Carson; Sorg, Amy A
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.
Full Text Available Abstract Background While Italy has implemented some tobacco control policies over the last few decades, which resulted in a decreased smoking prevalence, there is still considerable scope to strengthen tobacco control policies consistent with the World Health Organization (WHO policy guidelines. The present study aims to evaluate the effect of past and project the effect of future tobacco control policies on smoking prevalence and associated premature mortality in Italy. Methods To assess, individually and in combination, the effect of seven types of policies, we used the SimSmoke simulation model of tobacco control policy. The model uses population, smoking rates and tobacco control policy data for Italy. Results Significant reductions of smoking prevalence and premature mortality can be achieved through tobacco price increases, high intensity media campaigns, comprehensive cessation treatment program, strong health warnings, stricter smoke-free air regulations and advertising bans, and youth access laws. With a comprehensive approach, the smoking prevalence can be decreased by as much as 12% soon after the policies are in place, increasing to a 30% reduction in the next twenty years and a 34% reduction by 30 years in 2040. Without effective tobacco control policies, a total of almost 300 thousand lives will be prematurely lost due to smoking by the year 2040. Conclusion Besides presenting the benefits of a comprehensive tobacco control strategy, the model helps identify information gaps in surveillance and evaluation schemes that will promote the effectiveness of future tobacco control policy in Italy.
Sinha, Dhirendra Narain; Gupta, Prakash C; Reddy, K Srinath; Prasad, Vinayak M; Rahman, Khalilur; Warren, Charles W; Jones, Nathan R; Asma, Samira
India made 2 important policy statements regarding tobacco control in the past decade. First, the India Tobacco Control Act (ITCA) was signed into law in 2003 with the goal to reduce tobacco consumption and protect citizens from exposure to secondhand smoke (SHS). Second, in 2005, India ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). During this same period, India conducted the Global Youth Tobacco Survey (GYTS) in 2003 and 2006 in an effort to track tobacco use among adolescents. The GYTS is a school-based survey of students aged 13-15 years. Representative national estimates for India in 2003 and 2006 were used in this study. In 2006, 3.8% of students currently smoked cigarettes and 11.9% currently used other tobacco products. These rates were not significantly different than those observed in 2003. Over the same period, exposure to SHS at home and in public places significantly decreased, whereas exposure to pro-tobacco ads on billboards and the ability to purchase cigarettes in a store did not change significantly. The ITCA and the WHO FCTC have had mixed impacts on the tobacco control effort for adolescents in India. The positive impacts have been the reduction in exposure to SHS, both at home and in public places. The negative impacts are seen with the lack of change in pro-tobacco advertising and ability to purchase cigarettes in stores. The Government of India needs to consider new and stronger provisions of the ITCA and include strong enforcement measures.
Mihaltan Florin Dumitru
Full Text Available In our presentation we are evaluating the progress of the tobacco control in Romania looking form the point of view on NGO in the last 26 years. We are signalling the progressive steps towards policy and an advocacy from our perspective and the consequences of our success. The final result is reflected in the new law starting in force on March 17th, 2016, a real advance in our fight. We are identifying in the same time the new challenging problems after launching the new law. Probably the biggest gain of our fight is the extensive partnership with all the factors, our efforts to bring together in a big family as the coalition “Romania Respira” politicians, advocates, judges, economists, young’s and also the new way found to encourage all: mass media, politicians, journalists, public to support us.
Novotny, T E; Carlin, D
On 28 February 2005, the Framework Convention on Tobacco Control came into force as a result of at least 40 countries becoming State Parties through ratification of this first ever health treaty sponsored by the World Health Organization. This article discusses the bioethical, trade, and legal aspects of global tobacco control. Special emphasis is given to globalisation of tobacco use and the challenges it poses to sovereign nations. It also advocates a bioethical basis in the pursuit of global solutions to expanding tobacco use.
This grant will allow the Southeast Asia Tobacco Control Alliance (SEATCA) to coordinate a research program in support of the successful implementation (in the case of Cambodia) and ratification (in the case of Lao PDR) of the World Health Organization's Framework Convention on Tobacco Control (WHO FCTC).
Fiscal policy - the use of government spending and revenue generation powers - is a powerful tool available to governments in the struggle to control the tobacco epidemic. Examples of fiscal policy ... Trade and investment agreements : barriers to national public health and tobacco control measures. Studies. Innovative ...
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 :.
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.
Jackson-Morris, Angela; Latif, Ehsan
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/.
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
Eckhardt, Jappe; Holden, Chris; Callard, Cynthia D
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/.
Margaret B. Nolan
Full Text Available The number of global tobacco-related deaths is projected to increase from about 6 million to 8 million annually by 2030, with more than 80% of these occurring in low- and middle-income countries (LMICs. The World Health Organization Framework Convention on Tobacco Control (FCTC came into force in 2005 and Article 14 relates specifically to the treatment of tobacco dependence. However, LMICs, in particular, face several barriers to implementing tobacco dependence treatment. This paper is a descriptive evaluation of a novel grant funding mechanism that was initiated in 2014 to address these barriers. Global Bridges. Healthcare Alliance for Tobacco Dependence Treatment aims to create and mobilize a global network of healthcare professionals and organizations dedicated to advancing evidence-based tobacco dependence treatment and advocating for effective tobacco control policy. A 2014 request for proposals (RFP focused on these goals, particularly in LMICs, where funding for this work had been previously unavailable. 19 grants were awarded by Global Bridges to organizations in low- and middle-income countries across all six WHO regions. Virtually all focused on developing a tobacco dependence treatment curriculum for healthcare providers, while also influencing the political environment for Article 14 implementation. As a direct result of these projects, close to 9,000 healthcare providers have been trained in tobacco dependence treatment and an estimated 150,000 patients have been offered treatment. Because most of these projects are designed with a “train-the-trainer” component, two years of grant funding has been a tremendous catalyst for accelerating change in tobacco dependence treatment practices throughout the world. In order to foster such exponential growth and continue to maintain the impact of these projects, ongoing financial, educational, and professional commitments are required.
Ginexi, Elizabeth M; Vollinger, Robert E
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/.
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.
Schillo, Barbara A; Mowery, Andrea; Greenseid, Lija O; Luxenberg, Michael G; Zieffler, Andrew; Christenson, Matthew; Boyle, Raymond G
This observational study assessed the relation between mass media campaigns and service volume for a statewide tobacco cessation quitline and stand-alone web-based cessation program. Multivariate regression analysis was used to identify how weekly calls to a cessation quitline and weekly registrations to a web-based cessation program are related to levels of broadcast media, media campaigns, and media types, controlling for the impact of external and earned media events. There was a positive relation between weekly broadcast targeted rating points and the number of weekly calls to a cessation quitline and the number of weekly registrations to a web-based cessation program. Additionally, print secondhand smoke ads and online cessation ads were positively related to weekly quitline calls. Television and radio cessation ads and radio smoke-free law ads were positively related to web program registration levels. There was a positive relation between the number of web registrations and the number of calls to the cessation quitline, with increases in registrations to the web in 1 week corresponding to increases in calls to the quitline in the subsequent week. Web program registration levels were more highly influenced by earned media and other external events than were quitline call volumes. Overall, broadcast advertising had a greater impact on registrations for the web program than calls to the quitline. Furthermore, registrations for the web program influenced calls to the quitline. These two findings suggest the evolving roles of web-based cessation programs and Internet-use practices should be considered when creating cessation programs and media campaigns to promote them. Additionally, because different types of media and campaigns were positively associated with calls to the quitline and web registrations, developing mass media campaigns that offer a variety of messages and communicate through different types of media to motivate tobacco users to seek services
Schillo Barbara A
Full Text Available Abstract Background This observational study assessed the relation between mass media campaigns and service volume for a statewide tobacco cessation quitline and stand-alone web-based cessation program. Methods Multivariate regression analysis was used to identify how weekly calls to a cessation quitline and weekly registrations to a web-based cessation program are related to levels of broadcast media, media campaigns, and media types, controlling for the impact of external and earned media events. Results There was a positive relation between weekly broadcast targeted rating points and the number of weekly calls to a cessation quitline and the number of weekly registrations to a web-based cessation program. Additionally, print secondhand smoke ads and online cessation ads were positively related to weekly quitline calls. Television and radio cessation ads and radio smoke-free law ads were positively related to web program registration levels. There was a positive relation between the number of web registrations and the number of calls to the cessation quitline, with increases in registrations to the web in 1 week corresponding to increases in calls to the quitline in the subsequent week. Web program registration levels were more highly influenced by earned media and other external events than were quitline call volumes. Conclusion Overall, broadcast advertising had a greater impact on registrations for the web program than calls to the quitline. Furthermore, registrations for the web program influenced calls to the quitline. These two findings suggest the evolving roles of web-based cessation programs and Internet-use practices should be considered when creating cessation programs and media campaigns to promote them. Additionally, because different types of media and campaigns were positively associated with calls to the quitline and web registrations, developing mass media campaigns that offer a variety of messages and communicate through
Zeigler, Donald W
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.
Panda, Bhuputra; Rout, Anita; Pati, Sanghamitra; Chauhan, Abhimanyu Singh; Tripathy, Asima; Shrivastava, Radhika; Bassi, Abhinav
Tobacco use is a leading cause of deaths and disabilities in India, killing about 1.2 lakh people in 2010. About 29% of adults use tobacco on a daily basis and an additional 5% use it occasionally. In Odisha, non-smoking forms are more prevalent than smoking forms. The habit has very high opportunity cost as it reduces the capacity to seek better nutrition, medical care and education. In line with the WHO Framework Convention on Tobacco Control (FCTC), the Cigarettes and Other Tobacco Products Act (COTPA) is a powerful Indian national law on tobacco control. The Government of Odisha has shown its commitment towards enforcement and compliance of COTPA provisions. In order to gauge the perceptions and practices related to tobacco control efforts and level of enforcement of COTPA in the State, this cross-sectional study was carried out in seven selected districts. A semi-structured interview schedule was developed, translated into Odiya and field-tested for data collection. It mainly contained questions related to knowledge on provisions of section 4-7 of COTPA 2003, perception about smoking, chewing tobacco and practices with respect to compliance of selected provisions of the Act. 1414 samples were interviewed. The highest percentage of respondents was from the government departments. 70% of the illiterates consumed tobacco as compared to 34% post graduates. 52.1% of the respondents were aware of Indian tobacco control laws, while 80.8% had knowledge about the provision of the law prohibiting smoking in public places. However, 36.6% of the respondents reported that they had 'very often' ' seen tobacco products being sold 'to a minor', while 31.2% had seen tobacco products being sold 'by a minor'. In addition, 24.8% had 'very often' seen tobacco products being sold within a radius of 100 yards of educational institutions.
Hiilamo, Heikki; Glantz, Stanton A
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.
Arora, Monika; Mathur, Manu Raj; Singh, Neha
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.
Shaffer, E R; Brenner, J E; Houston, T P
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.
The initiative funds innovative fiscal policy research supporting tobacco control in low and middle-income countries (LMICs). Aimed at preventing tobacco-related diseases and promoting public health, this is a five-year partnership between IDRC and the world's leading independent cancer charity dedicated to saving lives ...
May 26, 2017 ... In South Africa, research provided the government with the foundation to increase taxes, ban all tobacco advertising and industry sponsorships, and prohibit smoking in public places. South Africa's winning tobacco control strategy. Across Asia, Africa, and Latin America, researchers are using sophisticated ...
15 oct. 2011 ... 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 ... the African Tobacco Situational Analyses, a recent major public health initiative sponsored by the Canada's International Development Research Centre.
Asma, Samira; Song, Yang; Cohen, Joanna; Eriksen, Michael; Pechacek, Terry; Cohen, Nicole; Iskander, John
During the 20th century, use of tobacco products contributed to the deaths of 100 million persons worldwide. In 2011, approximately 6 million additional deaths were linked to tobacco use, the world's leading underlying cause of death, responsible for more deaths each year than human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis, and malaria combined. One third to one half of lifetime users die from tobacco products, and smokers die an average of 14 years earlier than nonsmokers. Manufactured cigarettes account for 96% of all tobacco sales worldwide. From 1880 to 2009, annual global consumption of cigarettes increased from an estimated 10 billion cigarettes to approximately 5.9 trillion cigarettes, with five countries accounting for 58% of the total consumption: China (38%), Russia (7%), the United States (5%), Indonesia (4%), and Japan (4%). Among the estimated 1 billion smokers worldwide, men outnumber women by four to one. In 14 countries, at least 50% of men smoke, whereas in more than half of these same countries, fewer than 10% of women smoke. If current trends persist, an estimated 500 million persons alive today will die from use of tobacco products. By 2030, tobacco use will result in the deaths of approximately 8 million persons worldwide each year. Yet, every death from tobacco products is preventable.
Dresler, Carolyn; Lando, Harry; Schneider, Nick; Sehgal, Hitakshi
The Framework Convention for Tobacco Control (FCTC) is currently the most potent tool for implementation of tobacco control laws across the globe. The FCTC is derivative from previously constructed international human rights conventions. These previous conventions have enforcement mechanisms, unlike the FCTC. However, the FCTC relies on state parties to report periodically on its implementation rather than on a continuous monitoring system. The Human Rights and Tobacco Control Network proposes that abiding by the principles of human rights delineated by international treaties, citizens across the globe can demand effective action for tobacco control. This paper explains the link between fundamental human rights and the right to tobacco control. Mechanisms are described to link the FCTC and its principles with human rights-based monitoring reports, which are provided to oversight committees for the other human rights conventions. The initial work of the Human Rights and Tobacco Control Network is summarised and considers the future directions for the human rights-based approach to tobacco control.
Offen, N; Smith, E A; Malone, R E
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.
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 mapped. Methods BAT employees on Facebook were identified and then the term ‘British American Tobacco’ was searched for in the Facebook search engine and results recorded, including titles, descriptions, names and the number of Facebook participants involved for each search result. To further detail any potential promotional activities, a search for two of BAT's global brands, ‘Dunhill’ and ‘Lucky Strike’, was conducted. Results Each of the 3 search terms generated more than 500 items across a variety of Facebook subsections. Discussion Some BAT employees are energetically promoting BAT and BAT brands on Facebook through joining and administrating groups, joining pages as fans and posting photographs of BAT events, products and promotional items. BAT employees undertaking these actions are from countries that have ratified the WHO FCTC, which requires signatories to ban all forms of tobacco advertising, including online and crossborder exposure from countries that are not enforcing advertising restrictions. The results of the present research could be used to test the comprehensiveness of the advertising ban by requesting that governments mandate the removal of this promotional material from Facebook. PMID:20395406
... Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces when people burn ... as smuggling, illicit manufacturing and counterfeiting. The tobacco industry and others often argue that high tobacco product ...
Bansal-Travers, Maansi; Fong, Geoffrey T.; Quah, Anne C.K.; Sansone, Genevieve; Pednekar, Mangesh S.; Gupta, Prakash C.; Sinha, Dhirendra N.
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
Bansal-Travers, Maansi; Fong, Geoffrey T; Quah, Anne C K; Sansone, Genevieve; Pednekar, Mangesh S; Gupta, Prakash C; Sinha, Dhirendra N
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.
Kennedy, Allison; Sullivan, Sarah; Hendlin, Yogi; Barnes, Richard; Glantz, Stanton
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.
Nagelhout, Gera E; Crone, Matty R; van den Putte, Bas; Willemsen, Marc C; Fong, Geoffrey T; de Vries, Hein
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 survey was performed before the implementation of the interventions and the 2009 and 2010 surveys were performed after the implementation. No significant age and educational differences in successful smoking cessation were found after the implementation of the three tobacco control interventions, although smokers aged 15-39 years were more likely to attempt to quit. Of the three population-level tobacco control interventions that were implemented simultaneously in the Netherlands, only the smoke-free legislation seemed to have increased quit attempts. The price increase of cigarettes may have been only effective in stimulating smoking cessation among younger smokers. Larger tax increases, stronger smoke-free legislation and media campaigns about the dangers of (second-hand) smoking are needed in the Netherlands.
Jaine, Richard; Russell, Marie; Edwards, Richard; Thomson, George
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.
Sy, Deborah K; Stumberg, Robert K
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.
-free by presidential decree. However, policies governing other aspects of tobacco control, such as taxation measures, have yet to be put in place. And, although the country has good research capacity, research projects are often carried out in ...
Chaloupka, Frank J; Straif, Kurt; Leon, Maria E
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.
Wagoner, Kimberly G.; Sutfin, Erin L.; Song, Eunyoung Y.; King, Jessica L.; Egan, Kathleen L.; Reboussin, Beth; Debinski, Beata; Spangler, John; Wolfson, Mark
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…
Morrow, Martha; Barraclough, Simon
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.
Crosbie, Eric; Sosa, Patricia; Glantz, Stanton A
To analyse the process of implementing and enforcing smoke-free environments, tobacco advertising, tobacco taxes and health warning labels from Costa Rica's 2012 tobacco control law. Review of tobacco control legislation, newspaper articles and interviewing key informants. Despite overcoming decades of tobacco industry dominance to win enactment of a strong tobacco control law in March 2012 consistent with WHO's Framework Convention on Tobacco Control, the tobacco industry and their allies lobbied executive branch authorities for exemptions in smoke-free environments to create public confusion, and continued to report in the media that increasing cigarette taxes led to a rise in illicit trade. In response, tobacco control advocates, with technical support from international health groups, helped strengthen tobacco advertising regulations by prohibiting advertising at the point-of-sale (POS) and banning corporate social responsibility campaigns. The Health Ministry used increased tobacco taxes earmarked for tobacco control to help effectively promote and enforce the law, resulting in high compliance for smoke-free environments, advertising restrictions and health warning label (HWL) regulations. Despite this success, government trade concerns allowed, as of December 2015, POS tobacco advertising, and delayed the release of HWL regulations for 15 months. The implementation phase continues to be a site of intensive tobacco industry political activity in low and middle-income countries. International support and earmarked tobacco taxes provide important technical and financial assistance to implement tobacco control policies, but more legal expertise is needed to overcome government trade concerns and avoid unnecessary delays in implementation. 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/.
Keklik, Seda; Gultekin-Karakas, Derya
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
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.
... the immediate and longer term. Following a baseline assessment, stakeholder meeting and mapping exercise, the Zambian team has chosen as priorities enforcement of the existing smoke-free law in Lusaka and tobacco cessation in four health districts of Lusaka. This grant will allow the team to work toward these goals.
Wakefield, Melanie A; Coomber, Kerri; Durkin, Sarah J; Scollo, Michelle; Bayly, Megan; Spittal, Matthew J; Simpson, Julie A; Hill, David
To determine the impact of tobacco control policies and mass media campaigns on smoking prevalence in Australian adults. Data for calculating the average monthly prevalence of smoking between January 2001 and June 2011 were obtained via structured interviews of randomly sampled adults aged 18 years or older from Australia's five largest capital cities (monthly mean number of adults interviewed: 2375). The influence on smoking prevalence was estimated for increased tobacco taxes; strengthened smoke-free laws; increased monthly population exposure to televised tobacco control mass media campaigns and pharmaceutical company advertising for nicotine replacement therapy (NRT), using gross ratings points; monthly sales of NRT, bupropion and varenicline; and introduction of graphic health warnings on cigarette packs. Autoregressive integrated moving average (ARIMA) models were used to examine the influence of these interventions on smoking prevalence. The mean smoking prevalence for the study period was 19.9% (standard deviation: 2.0%), with a drop from 23.6% (in January 2001) to 17.3% (in June 2011). The best-fitting model showed that stronger smoke-free laws, tobacco price increases and greater exposure to mass media campaigns independently explained 76% of the decrease in smoking prevalence from February 2002 to June 2011. Increased tobacco taxation, more comprehensive smoke-free laws and increased investment in mass media campaigns played a substantial role in reducing smoking prevalence among Australian adults between 2001 and 2011.
Kuipers, Mirte A G; Monshouwer, Karin; van Laar, Margriet; Kunst, Anton E
The strength of national tobacco control varies by country, but it is unclear how this relates to smoking in adolescents of high and low SES. This study examined the association between tobacco control policies and adolescent smoking and investigated the differences in this association between adolescents of high and low SES. Data of 90,351 adolescents aged 15-16 years from 13 European countries were obtained from the 2003, 2007, and 2011 European Survey Project on Alcohol and other Drugs databases. Logistic regression analyses were performed in 2014 with a random intercept at the country level and with daily smoking as the outcome. The Tobacco Control Scale was the score for national tobacco control policy. SES was based on parental education. In all studied countries, except Portugal, adolescent smoking prevalence rates were highest among low-SES respondents. Stronger tobacco control policies were associated with lower smoking rates in all three survey waves (2003, OR=0.75, 95% CI=0.55, 1.01; 2007, OR=0.84, 95% CI=0.73, 0.98; 2011, OR=0.85, 95% CI=0.74, 0.98). The association was consistently stronger in high-SES than in low-SES individuals, but the difference was not statistically significant. Countries with stronger tobacco control policies tend to have lower smoking rates. We are unable to demonstrate significant socioeconomic inequalities in the effect of tobacco control policies on adolescent smoking. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Abraham, Amanda J; Bagwell-Adams, Grace; Jayawardhana, Jayani
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.
Douglas, Malinda R; Carter, Sara Sally R; Wilson, Andrew P; Chan, Andie
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
Silvia Elena Llaguno-Aguilar
Full Text Available Se estima la frecuencia y la forma en que los medios de comunicación presentan el tema de tabaco y las políticas públicas para su control. Se recopilaron y analizaron 660 notas sobre tabaco publicadas en 2007 en seis diarios mexicanos. Se observó un gran incremento de notas en el último semestre del año, debido a la discusión de la legislación local y federal. La mayoría de las notas fue a favor del control de tabaco (49% o neutra al respecto (41%. Los temas más presentes fueron: legislación (36%, el humo de tabaco (28%, economía (24% y empaquetado (17%. Los actores mencionados fueron: instituciones gubernamentales (24%, legisladores (21%, tabacaleras (18%, y organizaciones no gubernamentales nacionales (7% e internacionales (8%. Se debe aprovechar la disposición de los medios de comunicación, generalmente a favor, o con una postura neutra, para reallizar actividades de abogacía de las políticas públicas para el control del tabaco.Estimate the frequency and manner in which mass media represent tobacco and tobacco control policies. 660 stories published in six Mexican newspapers during 2007 were content analyzed. The majority of the news stories were published in the last quarter of the year, due to discussion of pending local and federal legislation. The vast majority of the stories were in favor of tobacco control policies (49% or neutral (41%. The most frequently occurring themes in the stories were: legislation (36%, tobacco smoke (28%, economy (24%, and packaging (17%. Actors mentioned were: governmental institutions (24%, legislators (21%, tobacco industry (18%, and national and international non-governmental organizations (7 and 8%, respectively. Advocacy efforts should take advantage of mass media, which appears generally neutral or in favor of tobacco control policies in Mexico.
Tanski, S E; Prokhorov, A V; Klein, J D
Youth around the world take up smoking and use tobacco products at high rates. Young people may not grasp the long-term consequences of tobacco use, although tobacco consumption and exposure has been shown to have significant negative health effects. Youth use a variety of tobacco products that are smoked, chewed, or sniffed, including machine-manufactured cigarettes, cigars, bidis, kreteks, sticks, and snuff. Prevention efforts have focused on countering those aspects that are believed to contribute to smoking uptake, such as tobacco industry advertising and promotion, and access to tobacco. There are many aspects of tobacco promotion through the media that have been more difficult to control, however, such as product placement within popular cinema movies. Once a youth has taken up tobacco, he or she is more likely than an adult to become addicted and should be offered treatment for tobacco cessation. Although there is not yet sufficient evidence to prove efficacy, the same treatments are suggested for youth as are recommended for adults, including nicotine replacement products. Given the severity of the tobacco epidemic worldwide and the devastating health effects on an individual and population basis, there are currently many efforts to curtail the tobacco problem, including the World Health Organization (WHO) sponsored Framework Convention on Tobacco Control. It is through comprehensive and collaborative efforts such as this that the global hazard of tobacco is most likely to be overcome.
Barnsley, Kathryn; Walters, E. Haydn; Wood-Baker, Richard
Tasmania led in several areas of tobacco control legislation reform in the period 1997 to 2010. Despite this, Tasmania lagged in other crucial areas, particularly the allocation of resources for community education, mass media campaigns and cessation programmes. Key impediments were crony capitalism; the conservative ideology of "white…
Green, Melanie C; Clark, Jenna L
A growing body of research suggests that smoking portrayals in movies influence adolescent tobacco use. However, the mechanism for this influence remains unclear. The aim of this paper is to provide an overview of research on narrative transportation theory, particularly as applied to movies and smoking. We propose that this theory can provide a valuable framework for guiding research on the role of entertainment media in smoking and other addictive behaviors. We review empirical work on transportation theory and highlight the psychological mechanisms underlying transportation effects. 'Transportation into narrative worlds' refers to cognitive, emotional and imagery engagement into a narrative (including movies and entertainment media). We link this work with research on the effects of movie smoking. Research suggests that individuals who are more highly transported into narratives show greater attitude, belief and behavior change. Transportation effects work through reducing counterarguing, creating connections (identification and liking) with characters and increasing perceptions of realism and emotional involvement. We propose several future directions and research challenges for applying a transportation framework to the issue of entertainment media effects on smoking and tobacco disparities. Understanding factors contributing to transportation may provide a more nuanced view of who will be affected by movie smoking, and understanding the psychological processes underlying narrative persuasion may guide intervention efforts. Narrative transportation theory suggests that individuals' cognitive, emotional and imagery immersion in a narrative is a key mechanism of attitude, belief and behavior change. This theory provides a potentially generative and psychologically grounded framework for increasing knowledge about the boundary conditions and processes underlying the effects of entertainment media on tobacco use. © 2012 The Authors, Addiction © 2012 Society for
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 ...
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
Weishaar, Heide; Collin, Jeff; Smith, Katherine; Grüning, Thilo; Mandal, Sema; Gilmore, Anna
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
T. A. Don
Full Text Available An important aim during smokeless tobacco product (snus storage is keeping its quantitative and qualitative properties. Another significant factor is its biological safety due to its oral way of consumption. The main factors affecting quality during storage are: temperature, relative humidity, air composition, ventilation rate, surrounding products and package. Snus consumption is growing, but till present it was slightly spread in Russia and as a result little studied, thus studying process of its storage is an actual question. The aims of the research were: studying terms and methods of storage that provide constant product’s quality. Samples with different composition were taken for carrying research. Quality evaluation was carried according to standard for tobacco branch methods and to new methods developed in the laboratory of technologies for manufacturing tobacco products. Products were stored at lowered and room temperatures. It is discovered that snus with herbs added can be stored at room temperature and humidity not more than three months. Snus with coffee added can be stored not more than four months without changing its taste. Adding honey to this product slightly decreases its score by sensory evaluation, but remains it possible for consumption. Sensory testing score after storage at lowered temperature has remained unchanged. Optimal terms of storage were found. For room temperature they are: temperature 17-25 °C, relative air humidity 65 – 75 %, for lowered temperature – 5 °C and relative air humidity 50 -60 %. It was discovered that composition of snus and environmental parameters affect its storage duration.
Full Text Available Objective. To use evidence from the GYTS to inform tobacco-control policy in Suriname. Materials and methods. The GYTS was conducted in 2000, 2004, and 2009 among secondary school students (13-15 years in a two-stage cluster sample design. Results. A total of 2744 students participated. From 2000 to 2009, results showed an increased prevalence of “current use of cigarettes” and “other tobacco products” in females (31% and 98%. Additionally, students reported a decreased, but still high, exposure to second-hand smoke at home (56.6-46.6% and in public places (67.8-53.3% and to pro-tobacco advertising (newspapers and magazines: 76.3-54.0%; billboards: 77.4-52.6%. Less than half of all respondents were taught about the dangers of smoking in school. Discussion. National smoking prevalence coincides with regional trends. The results of the GYTS provided evidence for the comprehensive tobacco control legislation, passed in 2013. Future GYTS can further monitor its implementation and progress made in achieving WHO FCTC goals.
Trochim, W M K; Stillman, F A; Clark, P I; Schmitt, C L
To construct a conceptual model of tobacco industry tactics to undermine tobacco control programmes for the purposes of: (1) developing measures to evaluate industry tactics, (2) improving tobacco control planning, and (3) supplementing current or future frameworks used to classify and analyse tobacco industry documents. Web based concept mapping was conducted, including expert brainstorming, sorting, and rating of statements describing industry tactics. Statistical analyses used multidimensional scaling and cluster analysis. Interpretation of the resulting maps was accomplished by an expert panel during a face-to-face meeting. 34 experts, selected because of their previous encounters with industry resistance or because of their research into industry tactics, took part in some or all phases of the project. Maps with eight non-overlapping clusters in two dimensional space were developed, with importance ratings of the statements and clusters. Cluster and quadrant labels were agreed upon by the experts. The conceptual maps summarise the tactics used by the industry and their relationships to each other, and suggest a possible hierarchy for measures that can be used in statistical modelling of industry tactics and for review of industry documents. Finally, the maps enable hypothesis of a likely progression of industry reactions as public health programmes become more successful, and therefore more threatening to industry profits.
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Hawkins, Summer Sherburne; Bach, Nicoline; Baum, Christopher F
While increasing cigarette taxes has been a major policy driver to decrease smoking, taxes on other tobacco products have received less attention. Our aims were to evaluate the impact of chewing tobacco/cigar taxes, cigarette taxes, and smoke-free legislation on adolescent male and female use of smokeless tobacco and cigars. We analyzed data on 499,381 adolescents age 14-18 years from 36 US states in the Youth Risk Behavior Surveys (1999-2013) linked to state-level tobacco control policies. We conducted difference-in-differences regression models to assess whether changes in taxes and the enactment of smoke-free legislation were associated with smokeless tobacco use and, separately, cigar use. Models were stratified by adolescent sex. We found that chewing tobacco taxes had no effect on smokeless tobacco use and cigar taxes had no effect on cigar use. In contrast, among males a 10% increase in cigarette taxes was associated with a 1.0 percentage point increase (0.0010, 95% CI 0.0003-0.0017) in smokeless tobacco use. A 10% increase in cigarette taxes was also associated with a 1.5 percentage point increase (0.0015, 95% CI 0.0006-0.0024) in cigar use among males and a 0.7 percentage point increase (0.0007, 95% CI 0.0001-0.0013) in cigar use among females. There was some evidence that smoke-free legislation was associated with an 1.1 percentage point increase (0.0105, 95% CI 0.0015-0.0194) in smokeless tobacco use among males only, but no effect of smoke-free legislation on cigar use for males or females. Higher state cigarette taxes are associated with adolescents' use of cheaper, alternative tobacco products such as smokeless tobacco and cigars. Reducing tobacco use will require comprehensive tobacco control policies that are applied equally to and inclusive of all tobacco products.
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.
Panader-Torres, Adriana; Agudelo-Cely, Nancy Aurora; Bolívar-Suárez, Yolima; Cárdenas-Cárdenas, Luz Mery
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.
Farrelly, Matthew C.; Loomis, Brett R.; Kuiper, Nicole; Han, Beth; Gfroerer, Joseph; Caraballo, Ralph S.; Pechacek, Terry F.; Couzens, G. Lance
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
Terry-McElrath, Yvonne M.; Emery, Sherry; Wakefield, Melanie A.; O’Malley, Patrick M.; Szczypka, Glen; Johnston, Lloyd D.
Objective Young adults in the U.S. have one of the highest smoking prevalence rates of any age group, and young adulthood is a critical time period of targeting by the tobacco industry. We examined relationships between potential exposure to tobacco-related media campaigns from a variety of sponsors and 2-year smoking change measures among a longitudinal sample of U.S. adults aged 20-30 from 2001-2008. Methods Self-report data were collected from a longitudinal sample of 13,076 U.S. young adults from age 20-30. These data were merged with tobacco-related advertising exposure data from Nielsen Media Research. Two-year measures of change in smoking were regressed on advertising exposures. Results Two-year smoking uptake was unrelated to advertising exposure. The odds of quitting among all smokers and reduction among daily smokers in the two years between the prior and current survey were positively related to anti-tobacco advertising, especially potential exposure levels of 104-155 ads over the past 24 months. Tobacco company advertising (including corporate image and anti-smoking) and pharmaceutical industry advertising were unrelated to quitting or reduction. Conclusions Continued support for sustained, public health-based, well-funded anti-tobacco media campaigns may help reduce tobacco use among young adults. PMID:21972061
Strekalova, Yulia A; Damiani, Rachel E
Understanding the appropriate medium to communicate health promotion messages is vital for improving personal and societal health. As increasingly more people utilize social media for health information, public health practitioners use these platforms to engage an existing audience in health promotion messages. In this study, the relational framing theory was used as a lens for studying how message framing may influence social media audience engagement. Specifically, we assessed how posts from Tobacco Free Florida's Facebook page were framed as either dominant-submissive or affiliate-disaffiliate to an implied audience of either smokers, nonsmokers, active quitters, or a mixed audience, and the extent to which a direct call for engagement, in terms of a request to comment, like, or share the post, was used for audience engagement. A three-way interaction for the level of engagement through comments was significant, F(3217) = 7.11, p implied audience choice played a role in audience engagement with smoking cessation posts on social media. Implied audiences of Tobacco Free Florida's posts included smokers, those who are trying to quit, and nonsmokers as health promotion can be targeted at the individual's health, social support infrastructure, or the well-being of the society, and implications for strategic message design and audience targeting are discussed.
Laura Bastos Carvalho
Full Text Available This paper aims at verifying if the measures adopted in Brazil for tobacco control are paternalistic and if they, in any way, restrict individual liberties. Firstly, some of the theories on paternalism and their relation to liberty will be analyzed, focusing on the Libertarian Paternalism doctrine. Then, measures for tobacco control adopted in other countries and in Brazil will be discussed. Finally, each measure adopted in Brazil will be thoroughly analyzed, in order to verify if it restricts liberty and if there are less restrictive measures available. The conclusion is that the measures adopted in Brazil, even though they are predominantly paternalistic, do not necessarily restrict individual liberties.
Sorensen, G; Stoddard, A M; Youngstrom, R; Emmons, K; Barbeau, E; Khorasanizadeh, F; Levenstein, C
OBJECTIVES: This report describes local unions' positions on tobacco control initiatives and factors related to these positions. METHODS: A national random sample of local union leaders was surveyed by telephone. RESULTS: Forty-eight percent of local unions supported worksite smoking bans or restrictions, and only 8% opposed both a ban and a restriction. CONCLUSIONS: Support for tobacco control initiatives among local unions was higher than might be expected on the basis of previous evidence. Engaging unions in smoking policy formation is likely to contribute to the larger public health goal of reducing smoking and exposure to second-hand smoke among workers. PMID:10754979
Kyaing, Nyo Nyo; Islam, Md Ashadul; Sinha, Dhirendra N; Rinchen, Sonam
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
Malone, Ruth E
Tobacco 'endgame' discourse has emerged in recognition of the nature of the global public health emergency created by tobacco use and tobacco promotion. This discourse is a promising development, but translating it into action requires developing some consensus, at least by countries or regions. It also requires negotiating some of the recurring tensions within the tobacco control movement, contributing to risks for the movement as visionaries clash with pragmatists. This paper outlines one combination of approaches that might hold promise for the US situation. Every significant achievement in tobacco control was preceded by many influential people saying it couldn't be done, wouldn't work, or would create new problems. The risks of not envisioning an endpoint for the tobacco epidemic are far greater than the risks of attempting any endgame solutions and failing.
Assunta, M; Chapman, S
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.
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
Warner, Kenneth E
Despite their lethality, cigarettes are subject to little regulation that directly restricts their contents or their legality. This may change in the near future with the Framework Convention on Tobacco Control (FCTC), the world's first global health treaty, now in force, as well as developments in a few individual countries. Cigarettes are subject to a substantial number of country-specific regulations regarding their conditions of sale: their price (mostly through taxation), the places where they can be consumed (clean indoor air laws), who can smoke them (prohibitions on their use by or sales to minors), how they can be advertised or promoted (if at all), and how they must be packaged (minimum pack sizes, warning labels, plain packaging). Such policies constitute the core of successful tobacco control. The FCTC has been ratified by 180 countries representing 90% of the world's population. The FCTC requires compliance with numerous provisions relating to the kinds of regulations noted above. The treaty also mandates explicit attention to direct product regulation. Several countries have such authority, at least in limited forms. In the US, for example, the Food and Drug Administration (FDA) now has the legal authority to regulate tobacco products, including their contents. The possibility exists that, in the foreseeable future, a country will mandate product standards that will substantially reduce the appeal of cigarettes and other combusted tobacco products, which are by far the leading sources of the death and disease associated with tobacco.
Lisa M. Wilson
Full Text Available Background. Policymakers need estimates of the impact of tobacco control (TC policies to set priorities and targets for reducing tobacco use. We systematically reviewed the independent effects of TC policies on smoking behavior. Methods. We searched MEDLINE (through January 2012 and EMBASE and other databases through February 2009, looking for studies published after 1989 in any language that assessed the effects of each TC intervention on smoking prevalence, initiation, cessation, or price participation elasticity. Paired reviewers extracted data from studies that isolated the impact of a single TC intervention. Findings. We included 84 studies. The strength of evidence quantifying the independent effect on smoking prevalence was high for increasing tobacco prices and moderate for smoking bans in public places and antitobacco mass media campaigns. Limited direct evidence was available to quantify the effects of health warning labels and bans on advertising and sponsorship. Studies were too heterogeneous to pool effect estimates. Interpretations. We found evidence of an independent effect for several TC policies on smoking prevalence. However, we could not derive precise estimates of the effects across different settings because of variability in the characteristics of the intervention, level of policy enforcement, and underlying tobacco control environment.
Wilson, Lisa M.; Avila Tang, Erika; Chander, Geetanjali; Hutton, Heidi E.; Odelola, Olaide A.; Elf, Jessica L.; Heckman-Stoddard, Brandy M.; Bass, Eric B.; Little, Emily A.; Haberl, Elisabeth B.; Apelberg, Benjamin J.
Background. Policymakers need estimates of the impact of tobacco control (TC) policies to set priorities and targets for reducing tobacco use. We systematically reviewed the independent effects of TC policies on smoking behavior. Methods. We searched MEDLINE (through January 2012) and EMBASE and other databases through February 2009, looking for studies published after 1989 in any language that assessed the effects of each TC intervention on smoking prevalence, initiation, cessation, or price participation elasticity. Paired reviewers extracted data from studies that isolated the impact of a single TC intervention. Findings. We included 84 studies. The strength of evidence quantifying the independent effect on smoking prevalence was high for increasing tobacco prices and moderate for smoking bans in public places and antitobacco mass media campaigns. Limited direct evidence was available to quantify the effects of health warning labels and bans on advertising and sponsorship. Studies were too heterogeneous to pool effect estimates. Interpretations. We found evidence of an independent effect for several TC policies on smoking prevalence. However, we could not derive precise estimates of the effects across different settings because of variability in the characteristics of the intervention, level of policy enforcement, and underlying tobacco control environment. PMID:22719777
Stella Regina Martins
Full Text Available ABSTRACT Objective: To determine the level of agreement with effective tobacco control measures recommended by the World Health Organization and to assess the attitudes toward, knowledge of, and beliefs regarding smoking among third-year medical students at University of São Paulo School of Medicine, located in the city of São Paulo, Brazil. Methods: Between 2008 and 2012, all third-year medical students were invited to complete a self-administered questionnaire based on the Global Health Professionals Student Survey and its additional modules. Results: The study sample comprised 556 students. The level of agreement with the World Health Organization recommendations was high, except for the components “received smoking cessation training” and “raising taxes is effective to reduce the prevalence of smoking”. Most of the students reported that they agree with banning tobacco product sales to minors (95%, believe that physicians are role models to their patients (84%, and believe that they should advise their patients to quit cigarette smoking (96% and using other tobacco products (94%. Regarding smoking cessation methods, most of the students were found to know more about nicotine replacement therapy than about non-nicotine therapies (93% vs. 53%. Only 37% of the respondents were aware of the importance of educational antismoking materials, and only 31% reported that they believe in the effectiveness of encouraging their patients, during medical visits. In our sample, the prevalence of current cigarette smoking was 5.23%; however, 43.82% of the respondents reported having experimented with water-pipe tobacco smoking. Conclusions: Our results revealed the need to emphasize to third-year medical students the importance of raising the prices of and taxes on tobacco products. We also need to make students aware of the dangers of experimenting with tobacco products other than cigarettes, particularly water-pipe tobacco smoking.
Miguel-Baquilod, Marina; Fishburn, Burke; Warren, Charles W; Jones, Nathan R; Asma, Samira
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.
Sorensen, Glorian; Pednekar, Mangesh; Cordeira, Laura Shulman; Pawar, Pratibha; Nagler, Eve M; Stoddard, Anne M; Kim, Hae-Young; Gupta, Prakash C
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/.
While there is much research on tobacco control worldwide, there is little that is specific to the Brazilian context. This project will attempt to address the problem by pilot testing a training workshop for Brazilian researchers and government officials on gender methodologies, approaches and protocols as they pertain to ...
While qualitative research has much to offer the field of tobacco control, it is often neglected in favour of quantitative research. Sometimes this is due to lack of experience in qualitative research; in other cases, it is because policymakers and program planners do not always know how to make maximum use of qualitative ...
This grant will allow the Southeast Asia Tobacco Control Alliance (SEATCA) to coordinate a research program in support of the successful implementation (in the ... Research Group (TCRG), University of Beirut (AUB), is a multidisciplinary team of professionals from the health sciences, medicine, chemistry and engineering ...
imitation brand tobacco products in Panama City. Finally, the team will interview owners and employees of public service establishments (such as bars, restaurants, casinos, and hotels). The researchers will ask these stake- holders to describe their views on how smoke-free space control measures impact their customer ...
This grant will allow researchers to undertake a three-year survey of smoking in a nationally representative sample of 2 500 households. The survey will apply the analytic framework and methods used in the International Tobacco Control Policy Evaluation Project coordinated by the University of Waterloo (Canada) and ...
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 controlling tobacco consumption. The
Higashi, Hideki; Khuong, Tuan A; Ngo, Anh D; Hill, Peter S
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
Ngo Anh D
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
Sarna, Linda; Bialous, Stella Aguinaga; Chan, Sophia S C; Hollen, Patricia; O'Connell, Kathleen A
This report from members of the Health Behavior Expert Panel of the American Academy of Nursing (AAN) provides an overview of nurse-led scholarship in tobacco control. We reviewed published reviews of nurse-led studies in the field. The synthesis includes theory development, methodological approaches, studies focused on prevention of tobacco use, nursing interventions for tobacco dependence including studies with selected populations, investigations to reduce secondhand smoke, and studies of health care systems and policy. Gaps in the literature provided direction for stimulating nursing science, accelerating adoption of evidence-based recommendations in practice, expanding nursing education, and increasing nursing visibility and influence in health care policy efforts. The AAN is positioned to maximize nursing leadership in this effort. Copyright © 2013 Elsevier Inc. All rights reserved.
Danishevski, Kirill; Gilmore, Anna; McKee, Martin
Background Since the political transition in 1991, Russia has been targeted intensively by the transnational tobacco industry. Already high smoking rates among men have increased further; traditionally low rates among women have more than doubled. The tobacco companies have so far faced little opposition as they shape the discourse on smoking in Russia. This paper asks what ordinary Russians really think about possible actions to reduce smoking. Methods A representative sample of the Russian population (1600 respondents) was interviewed face-to-face in November 2007. Results Only 14% of respondents considered tobacco control in Russia adequate, while 37% felt that nothing was being done at all. There was support for prices keeping pace with or even exceeding inflation. Over 70% of all respondents favoured a ban on sales from street kiosks, while 56% believed that existing health warnings (currently 4% of front and back of packs) were inadequate. The current policy of designating a few tables in bars and restaurants as non-smoking was supported by less than 10% of respondents, while almost a third supported a total ban, with 44% supporting provision of equal space for smokers and non-smokers. Older age, non-smoking status and living a smaller town all emerged as significantly associated with the propensity to support of antismoking measures. The tobacco companies were generally viewed as behaving like most other companies in Russia, with three-quarters believing that they definitely or maybe bribe politicians. Knowledge of impact of smoking on health was limited with significant underestimation of dangers and addictive qualities of tobacco. A third believed that light cigarettes are safer than normal. Conclusion The majority of the Russian population would support considerable strengthening of tobacco control policies but there is also a need for effective public education campaigns. PMID:18653793
Danishevski, K; Gilmore, A; McKee, M
Since the political transition in 1991, Russia has been targeted intensively by the transnational tobacco industry. Already high smoking rates among men have increased further; traditionally low rates among women have more than doubled. The tobacco companies have so far faced little opposition as they shape the discourse on smoking in Russia. This paper asks what ordinary Russians really think about possible actions to reduce smoking. A representative sample of the Russian population (1600 respondents) was interviewed face to face in November 2007. Only 14% of respondents considered tobacco control in Russia adequate, while 37% thought that nothing was being done at all. There was support for prices keeping pace with or even exceeding inflation. Over 70% of all respondents favoured a ban on sales from street kiosks, while 56% believed that existing health warnings (currently 4% of front and back of packs) were inadequate. The current policy of designating a few tables in bars and restaurants as non-smoking was supported by less than 10% of respondents, while almost a third supported a total ban, with 44% supporting provision of equal space for smokers and non-smokers. Older age, non-smoking status and living in a smaller town all emerged as significantly associated with the propensity to support antismoking measures. The tobacco companies were generally viewed as behaving like most other companies in Russia, with three-quarters of respondents believing that these companies definitely or maybe bribe politicians. Knowledge of impact of smoking on health was limited with significant underestimation of dangers and addictive qualities of tobacco. A third believed that light cigarettes are safer than normal cigarettes. The majority of the Russian population would support considerable strengthening of tobacco control policies but there is also a need for effective public education campaigns.
Chatterjee, Nilesh; Patil, Deepak; Kadam, Rajashree; Fernandes, Genevie
India has 274 million tobacco users and a tobacco use prevalence of 38% in rural areas. Tobacco consumption causes 1 million deaths and costs the health system nearly US$23 billion annually. Tobacco control policies exist but lack proper implementation. In this article, we review the Tobacco-free Village (TfV) program conducted in Maharashtra state in India and describe its process to help villages in rural India achieve "tobacco-free" status (i.e., the sale and use of tobacco are prohibited by law). We reviewed program documents and conducted 22 qualitative interviews with program staff and village-level stakeholders. From 2008 to 2014, Salaam Mumbai Foundation implemented the TfV program in 60 villages in Maharashtra state. The program used a number of strategies to help villages become tobacco free, including collaborating with a community-based organization, leveraging existing health workers, conducting a situation analysis, training health workers, engaging stakeholders, developing TfV assessment criteria, mobilizing the community, conducting health education, imposing sanctions, and offering incentives. By 2014, 4 villages had achieved tobacco-free status according to 11 assessment criteria. Successful villages demonstrated strong local leader involvement, ownership of the program, and commitment to the cause by residents. The TfV program faced barriers including poor motivation of health workers, difficulty in changing social norms of tobacco use, and refusal of local vendors to stop tobacco sales due to financial losses. This low-cost, community-driven program holds promise for helping public health practitioners and governments implement and achieve the goals of tobacco control policies, especially in resource-scarce settings. © Chatterjee et al.
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.
Kamran Habib Awan
Conclusion: Application and implementation of measures outline in the MPOWER package, formulation and enforcement of sturdy laws on tobacco control, and development of infrastructure and trained workforce are fundamental to manage and reinforce tobacco control measures in the GCC region.
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
Welle, Jennifer R MPH; Ibrahim, Jennifer K. Ph.D.; Glantz, Stanton A. Ph.D.
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...
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.
Movsisyan, Narine K; Connolly, Gregory N
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.
Movsisyan, Narine K; Connolly, Gregory N
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
Hecht, Stephen S
This paper was written in response to a request from the U.S. National Cancer Institute. The goal is to discuss some research directions related to establishing tobacco product standards under the Family Smoking Prevention and Tobacco Control Act, which empowers the U.S. Food and Drug Administration to regulate tobacco products. Potential research related to tobacco product ingredients, nicotine, and harmful or potentially harmful constituents of tobacco products is discussed. Ingredients, which are additives, require less attention than nicotine and harmful or potentially harmful constituents. With respect to nicotine, the threshold level in tobacco products below which dependent users will be able to freely stop using the product if they choose to do so is a very important question. Harmful and potentially harmful constituents include various toxicants and carcinogens. An updated list of 72 carcinogens in cigarette smoke is presented. A crucial question is the appropriate levels of toxicants and carcinogens in tobacco products. The use of carcinogen and toxicant biomarkers to determine these levels is discussed. The need to establish regulatory standards for added ingredients, nicotine, and other tobacco and tobacco smoke constituents leads to many interesting and potentially highly significant research questions, which urgently need to be addressed.
Cruz, Natália Ferreira; Mantovani, Vanessa Monteiro; Maciel, Sérgio Von Poser; Boaz, Solange Klockner; Knorst, Marli Maria; Echer, Isabel Cristina
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 Tobac...
White, Ashley H; Brown-Johnson, Gati G; Martinez, Sydney A; Paulson, Sjonna; Beebe, Laura A
Public education campaigns in tobacco control play an important role in changing tobacco-related knowledge, attitudes and behaviors. The Oklahoma Tobacco Stops with Me campaign has been effective in changing attitudes overall and across subpopulations towards secondhand smoke risks. Investigate campaign impact on secondhand smoke policy and risk attitudes. Serial cross-sectional data analyzed with univariate and multivariable models. Random-digit dialing surveys conducted in 2007 and 2015 PARTICIPANTS: Oklahomans 18-65 years old Main Outcomes and Measures: (1) Support for smokefree bars; (2) risk assessment of secondhand smoke (very harmful, causes heart disease, causes sudden infant death); and 3) likelihood of protecting yourself from secondhand smoke. With Tobacco Stops with Me exposure, from 2007 to 2015, Oklahomans demonstrated significant increases in: (1) supporting smokefree bars (23.7% to 55%); (2) reporting beliefs that SHS causes heart disease (58.5% to 72.6%), is very harmful (63.8% to 70.6%) and causes sudden infant death (24% to 34%); and 3) reporting they are very likely to ask someone not to smoke nearby (45% to 52%). Controlling for demographics, smokers and males showed reduced attitude change. In uncontrolled comparisons, high-school graduates faired better than non-diploma individuals, who lacked significant attitude changes. Tobacco Stops with Me achieved its mission to more closely align public perception of SHS with well-documented secondhand smoke risks. Efforts to target women were particularly successful. Smokers may be resistant to messaging; closing taglines that reinstate individual choice may help to reduce resistance/reactance (e.g., adding Oklahoma Helpline contact information).
Allen, Jane Appleyard; Duke, Jennifer C; Davis, Kevin C; Kim, Annice E; Nonnemaker, James M; Farrelly, Matthew C
This review synthesizes the published literature on using mass media campaigns to reduce youth tobacco use, with particular focus on effects within population subgroups and the relative effectiveness of campaign characteristics. A search of PubMed and PsycINFO conducted in March of 2014 yielded 397 studies with 34 suitable for inclusion. Included were quantitative studies that evaluate an antitobacco media campaign intended to influence youth cognitions or behavior or explore the relative effectiveness of campaign characteristics among youth. An automated search and assessment of suitability for inclusion was done. Study outcomes were compared and synthesized. Antitobacco media campaigns can be effective across racial/ethnic populations, although the size of the campaign effect may differ by race/ethnicity. Evidence is insufficient to determine whether campaign outcomes differ by socioeconomic status (SES) and population density. Youth are more likely to recall and think about advertising that includes personal testimonials; a surprising narrative; and intense images, sound, and editing. Evidence in support of using a health consequences message theme is mixed; an industry manipulation theme may be effective in combination with a health consequences message. Research is insufficient to determine whether advertising with a secondhand smoke or social norms theme influences youth tobacco use. Our recommendation is to develop antitobacco campaigns designed to reach all at-risk youth, which can be effective across racial/ethnic populations. Research priorities include assessing campaign influence among lower SES and rural youth, disentangling the effects of message characteristics, and assessing the degree to which this body of evidence may have changed as a result of changes in youth culture and communication technology.
Erika B Fulmer
Full Text Available Youth are exposed to many types of protobacco influences, including smoking in movies, which has been shown to cause initiation. This study investigates associations between different channels of protobacco media and susceptibility to smoking cigarettes, cigarette experimentation, and current tobacco use among US middle and high school students.By using data from the 2012 National Youth Tobacco Survey, structural equation modeling was performed in 2013. The analyses examined exposure to tobacco use in different channels of protobacco media on smoking susceptibility, experimentation, and current tobacco use, accounting for perceived peer tobacco use.In 2012, 27.9% of respondents were never-smokers who reported being susceptible to trying cigarette smoking. Cigarette experimentation increased from 6.3% in 6th grade to 37.1% in 12th grade. Likewise, current tobacco use increased from 5.2% in 6th grade to 33.2% in 12th grade. Structural equation modeling supported a model in which current tobacco use is associated with exposure to static advertising through perception of peer use, and by exposure to tobacco use depicted on TV and in movies, both directly and through perception of peer use. Exposure to static advertising appears to directly increase smoking susceptibility but indirectly (through increased perceptions of peer use to increase cigarette experimentation. Models that explicitly incorporate peer use as a mediator can better discern the direct and indirect effects of exposure to static advertising on youth tobacco use initiation.These findings underscore the importance of reducing youth exposure to smoking in TV, movies, and static advertising.
Elmore, Kristen; Scull, Tracy M.; Kupersmidt, Janis B.
Adolescents’ media environment offers information about who uses substances and what happens as a result—how youth interpret these messages likely determines their impact on normative beliefs about alcohol and tobacco use. The Message Interpretation Processing (MIP) theory predicts that substance use norms are influenced by cognitions associated with the interpretation of media messages. This cross-sectional study examined whether high school adolescents’ (n=817, 48% female, 64% white) media-related cognitions (i.e., similarity, realism, desirability, identification) were related to their perceptions of substance use norms. Results revealed that adolescents’ media-related cognitions explained a significant amount of variance in perceived social approval for and estimated prevalence of peer alcohol and tobacco use, above and beyond previous use and demographic covariates. Compared to prevalence norms, social approval norms were more closely related to adolescents’ media-related cognitions. Results suggest that critical thinking about media messages can inhibit normative perceptions that are likely to increase adolescents’ interest in alcohol and tobacco use. PMID:27837371
Moon, Sung Seek; Rao, Uma
In this article, we present the effects of three hypothesized protective factors: social activities, school-related activities, and anti-substance use media messages on adolescent tobacco and alcohol use. Data were drawn from the “Monitoring the Future” (MTF) research project, which was conducted by the Institute for Social Research at the University of Michigan. The sample included 2,551 twelfth-grade students. The results of the structural equation model showed that exposure to media anti-d...
Husain, Muhammad Jami; English, Lorna McLeod; Ramanandraibe, Nivo
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.
Ribisl, Kurt M
This paper is part of a collection that identifies research priorities that will help guide the efforts of the U.S. Food and Drug Administration (FDA) as it regulates tobacco products. This paper examines the major provisions related to tobacco product advertising, marketing, sales, and distribution included in Public Law 111-31, the "Family Smoking Prevention and Tobacco Control Act". This paper covers 5 areas related to (a) marketing regulations (e.g., ban on color and imagery in ads, ban on nontobacco gifts with purchase); (b) granting FDA authority over the sale, distribution, accessibility, advertising, and promotion of tobacco and lifting state preemption over advertising; (c) remote tobacco sales (mail order and Internet); (d) prevention of illicit and cross-border trade; and (e) noncompliant export products. Each of the 5 sections of this paper provides a description and brief history of regulation, what is known about this regulatory strategy, and research opportunities.
The influence of newspaper coverage and a media campaign on smokers' support for smoke-free bars and restaurants and on secondhand smoke harm awareness: findings from the International Tobacco Control (ITC) Netherlands Survey
Nagelhout, G.E.; van den Putte, B.; de Vries, H.; Crone, M.; Fong, G.T.; Willemsen, M.C.
Objective: To assess the influence of newspaper coverage and a media campaign about Dutch smoke-free legislation on smokers' support for smoke-free bars and restaurants and on secondhand smoke (SHS) harm awareness. Design and main outcome measures: A content analysis was conducted of 1041 newspaper
... for State Tobacco Control Programs Basic Information Health Effects Cancer Heart Disease and Stroke Chronic Obstructive Pulmonary Disease (COPD) Smoking During Pregnancy Secondhand Smoke Smokeless Products Electronic Cigarettes Youth Tobacco Prevention Tobacco ...
Lewis, M Jane; Ling, Pamela M
Background As limitations on traditional marketing tactics and scrutiny by tobacco control have increased, the tobacco industry has benefited from direct mail marketing which transmits marketing messages directly to carefully targeted consumers utilising extensive custom consumer databases. However, research in these areas has been limited. This is the first study to examine the development, purposes and extent of direct mail and customer databases. Methods We examined direct mail and database marketing by RJ Reynolds and Philip Morris utilising internal tobacco industry documents from the Legacy Tobacco Document Library employing standard document research techniques. Results Direct mail marketing utilising industry databases began in the 1970s and grew from the need for a promotional strategy to deal with declining smoking rates, growing numbers of products and a cluttered media landscape. Both RJ Reynolds and Philip Morris started with existing commercial consumer mailing lists, but subsequently decided to build their own databases of smokers’ names, addresses, brand preferences, purchase patterns, interests and activities. By the mid-1990s both RJ Reynolds and Philip Morris databases contained at least 30 million smokers’ names each. These companies valued direct mail/database marketing’s flexibility, efficiency and unique ability to deliver specific messages to particular groups as well as direct mail’s limited visibility to tobacco control, public health and regulators. Conclusions Database marketing is an important and increasingly sophisticated tobacco marketing strategy. Additional research is needed on the prevalence of receipt and exposure to direct mail items and their influence on receivers’ perceptions and smoking behaviours. PMID:26243810
Lewis, M Jane; Ling, Pamela M
As limitations on traditional marketing tactics and scrutiny by tobacco control have increased, the tobacco industry has benefited from direct mail marketing which transmits marketing messages directly to carefully targeted consumers utilising extensive custom consumer databases. However, research in these areas has been limited. This is the first study to examine the development, purposes and extent of direct mail and customer databases. We examined direct mail and database marketing by RJ Reynolds and Philip Morris utilising internal tobacco industry documents from the Legacy Tobacco Document Library employing standard document research techniques. Direct mail marketing utilising industry databases began in the 1970s and grew from the need for a promotional strategy to deal with declining smoking rates, growing numbers of products and a cluttered media landscape. Both RJ Reynolds and Philip Morris started with existing commercial consumer mailing lists, but subsequently decided to build their own databases of smokers' names, addresses, brand preferences, purchase patterns, interests and activities. By the mid-1990s both RJ Reynolds and Philip Morris databases contained at least 30 million smokers' names each. These companies valued direct mail/database marketing's flexibility, efficiency and unique ability to deliver specific messages to particular groups as well as direct mail's limited visibility to tobacco control, public health and regulators. Database marketing is an important and increasingly sophisticated tobacco marketing strategy. Additional research is needed on the prevalence of receipt and exposure to direct mail items and their influence on receivers' perceptions and smoking behaviours. 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/
Qualitative analysis of attitudes toward tobacco control policy is a key for in-depth understanding why people oppose or are in favor of tobacco control policy and its results can help in effective enforcement of the new tobacco control law in Poland.
Brewer, Hannah J.; Kulik, Keri S.; Klingaman, Linda; Deutschlander, Sharon; Black, Christine
Background: Tobacco use leads to more deaths each year than any other single factor. This research examined teenagers' perceptions of anti-tobacco messages to determine which campaigns and educational approaches were most effective in preventing tobacco use among youth. Methods: Students from five rural high schools in western Pennsylvania were…
Yorifuji, Takashi; Tanihara, Shinichi; Takao, Soshi; Kawachi, Ichiro
The slow progress of tobacco control policy in Japan reflects the tension among the interests of the Finance Ministry (which remains the majority shareholder of Japan Tobacco, Inc), the Health Ministry, tobacco growers and consumers. We sought to examine regional disparities in compliance with national tobacco control legislation (the 2003 Health Promotion Law). Specifically, we sought to examine whether prefecture-level compliance with legislation was correlated with decreases in smoking prevalence, and decreases in lung cancer mortality rates. We also examined whether prefectural involvement in growing tobacco was associated with lower compliance with the law. From 2001 to 2007, higher prefectural compliance with tobacco control laws was associated with decreased prevalence of smoking. Decreased tobacco consumption was in turn associated with declining lung cancer mortality. Prefectures involved in growing tobacco exhibited lower levels of compliance with national tobacco control laws. The same prefectures also exhibited the worst improvement in smoking prevalence. This study in Japan suggests that tobacco control policies are being unevenly implemented across prefectures, and that measures to counteract the influence of local tobacco culture are required to reduce the disparities in regional tobacco control outcomes in that country.
Kozlowski, Lynn T
Even though interest in reducing or eliminating tobacco-caused diseases is a common goal in tobacco control, many experts hold different views on addiction as a target of intervention. Some consider tobacco-caused addiction as a tobacco-caused disease to be eliminated alongside the other diseases. Some consider tobacco-caused addiction as a much lower priority disease to be eliminated, and a subset of this group is prepared to employ addiction to tobacco (nicotine) as a tool to reduce other t...
Wagoner, Kimberly G; Sutfin, Erin L; Song, Eunyoung Y; King, Jessica L; Egan, Kathleen L; Reboussin, Beth; Debinski, Beata; Spangler, John; Wolfson, Mark
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.
Kan, Ming-yue; Lau, Maggie
Asia's tobacco control movement was strengthened owing to the need to fulfill the Framework Convention on Tobacco Control (FCTC). The present study aims to assess the compliance rates of tobacco retailers to the law forbidding the sales of tobacco to minors in Hong Kong before and after the growth of the tobacco control movement brought by the enactment of the newly amended tobacco control law with effect from 2007. The legislation was enacted to fulfill the FCTC. Two waves of territory-wide compliance checks conducted in 2006 and 2008 were compared. The compliance check was conducted using Standard Protocol. The overall compliance rate was still low though it increased from 18.9% in 2006 to 27.0% in 2008. The compliance rate of convenience stores and newspaper stands improved whereas the rate for restaurants, grocery stores and petrol stations worsened. Less tobacco retailing outlets displayed a specified warning sign required in 2008 (33.7%) comparing to 2006 (41.4%). The indoor smoking ban of the FCTC unintentionally changed the cigarette retailing landscape and finally improved the compliance rate. The case study also demonstrated that the Asia region still has much room for improvement in fulfilling the FCTC in term of effective implementation and enforcement. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.
Bosdriesz, Jizzo R; Willemsen, Marc C; Stronks, Karien; Kunst, Anton E
Higher Tobacco Control Scale (TCS) scores, in the early 2000s were associated with higher smoking cessation rates across Europe, both among lower and higher educated people. We aimed to assess if this association held in recent years. Repeated cross-sectional Eurobarometer surveys were used, in 27 European countries from 2006 to 2012 (study sample=73,617 adults). We used multilevel regression to model associations between the TCS (ranging from 0 to 100, quantifying: tobacco price, smoke-free laws, mass-media campaigns, advertising bans, warning labels, and cessation support) and both smoking cessation and cigarettes smoked per day. We modelled associations according to respondents' education and occupation, with adjustment for age, sex, and survey-wave. We found no association between the TCS and smoking cessation for lower or middle educated respondents, but we did find an association for higher educated respondents (OR: 1.13, 95%CI: 1.08 to 1.19). For smoking intensity, we observed no associations with the TCS for lower educated respondents (beta: 0.04, 95%CI: -0.33 to 0.41) but we did observe significant associations for middle (beta: -0.25, 95%CI: -0.47 to -0.03) and higher educated respondents (beta: -0.27, 95%CI: -0.55 to -0.01). Associations were observed for both manual and non-manual classes, but not for those not working for pay. Of the TCS domains, none were associated with smoking cessation for lower educated respondents, but five were for higher educated respondents. Associations between tobacco control policies and smoking cessation were found mostly among higher socioeconomic groups. This underlines the need for specific tobacco control policies that explicitly focus on reaching low socio-economic groups. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Abstract Background Cigarette smoking takes a staggering toll on human health and attracts considerable public health attention, yet real solutions seem distant. The 2004 Family Smoking Prevention and Tobacco Control Act (US Senate bill S2461 would have given the US Food and Drug Administration limited authority to regulate cigarettes to "protect the public health." However, such legislation is unlikely to substantially reduce smoking or related deaths. Discussion The past 500 years of tobacco control efforts demonstrate that nicotine prohibition is a practical impossibility for numerous reasons, state revenue being one of the most ominous. The FDA already has regulatory authority over pharmaceutical grade nicotine products, and requires pharmacists to dispense the most addictive of these only with prescriptions. Meanwhile, every corner store can sell far more addictive and dangerous cigarettes to any adult. The FDA could immediately increase competition between cigarettes and clean nicotine products by approving available nicotine products for over-the-counter sales to adults. Similarly permissive regulation of cigarettes and addictive nicotine products will reduce tobacco use and improve smokers' health, but increase nicotine use in the population. Fortunately, restricted youth access and accurate labeling of nicotine's absolute risks will dissuade many non-smokers from experimenting with it, while accurate depiction of its risks relative to cigarette smoking will encourage many smokers to switch. The FDA could take a series of small steps that might ultimately replace a large proportion of cigarette smoking with equally addictive nicotine products, without risking serious public health setbacks. Vaccine, methadone, and injury prevention policies establish relevant public health precedents. Summary Cigarettes, or an equally addictive alternative, will be a permanent and common product in most societies. Regulations restricting only the safest
Moon, Sung Seek; Rao, Uma
In this article, we present the effects of three hypothesized protective factors: social activities, school-related activities, and anti-substance use media messages on adolescent tobacco and alcohol use. Data were drawn from the "Monitoring the Future" (MTF) research project, which was conducted by the Institute for Social Research at the University of Michigan. The sample included 2,551 twelfth-grade students. The results of the structural equation model showed that exposure to media anti-drug messages had an indirect negative effect on tobacco and alcohol use through school-related activity and social activity. The results suggest that comprehensive ecological interventions encompassing media, family, and school can increase on the preventive effects of adolescent's substance use.
Tabuchi, Takahiro; Iso, Hiroyasu; Brunner, Eric
Previous systematic reviews of population-level tobacco control interventions and their effects on smoking inequality by socioeconomic factors concluded that tobacco taxation reduce smoking inequality by income (although this is not consistent for other socioeconomic factors, such as education). Inconsistent results have been reported for socioeconomic differences, especially for other tobacco control measures, such as smoke-free policies and anti-tobacco media campaigns. To understand smoking inequality itself and to develop strategies to reduce smoking inequality, knowledge of the underlying principles or mechanisms of the inequality over a long time-course may be important. For example, the inverse equity hypothesis recognizes that inequality may evolve in stages. New population-based interventions are initially primarily accessed by the affluent and well-educated, so there is an initial increase in socioeconomic inequality (early stage). These inequalities narrow when the deprived population can access the intervention after the affluent have gained maximum benefit (late stage). Following this hypothesis, all tobacco control measures may have the potential to reduce smoking inequality, if they continue for a long term, covering and reaching all socioeconomic subgroups. Re-evaluation of the impact of the interventions on smoking inequality using a long time-course perspective may lead to a favorable next step in equity effectiveness. Tackling socioeconomic inequality in smoking may be a key public health target for the reduction of inequality in health.
Gilmore, Anna B
Background This paper builds on tobacco document research by analysing contemporary materials to explore how the global tobacco market has changed, how transnational tobacco companies (TTCs) are responding and identify the implications for tobacco control. Methods Analysis of a variety of materials including tobacco company annual reports, investor relations materials, financial analyst reports, market research reports and data. Findings Once China, where TTCs have little market share, is excluded, global cigarette volumes are already declining. Nevertheless, industry profits continue to increase. This pattern is explained by TTCs’ pricing power - their ability to increase prices faster than volumes fall; a consequence of market failure. Pricing power is now fundamental to the TTCs’ long-term future. Consequently, and in light of growing regulations, the TTCs’ business model is changing. Product innovation is now a key marketing technique used to drive consumers to buy more expensive (ie profitable) premium cigarettes. Contrary to established wisdom, high tobacco excise rates, particularly where increases in excise are gradual, can benefit TTCs by enabling price (profit) increases to be disguised. Large intermittent tax increases likely have a greater public health benefit. TTC investments in smokeless appear designed to eliminate competition between smokeless and cigarettes, thereby increasing TTCs’ pricing power while enabling them to harness the rhetoric of harm reduction. Conclusions Monitoring TTCs can inform effective policy development. The TTC’s value maximising approach suggests that a ban on product innovation and more informed tobacco excise policies are needed. PMID:22345234
Lindson, Nicola; Richards-Doran, Dan; Heath, Laura; Hartmann-Boyce, Jamie
The Cochrane Tobacco Addiction Group (TAG) conducts systematic reviews of the evidence for tobacco cessation and prevention interventions. In 2016 TAG conducted a priority-setting, stakeholder engagement project to identify where further research is needed in the areas of tobacco control and smoking cessation. The project comprised two surveys and a workshop. A range of stakeholders participated, including members of the public (smokers and ex-smokers), clinicians, researchers, research funders, health-care commissioners and public health organizations. The first survey phase identified unanswered research questions in the field of tobacco control. The second phase asked participants to rank these, with overall rankings calculated by combining scores across participants. The workshop allowed attendees to discuss prioritization of topics and questions in more depth. Workshop discussions were transcribed and analysed thematically, and a final voting activity at the close of the workshop allowed participants to choose topics to prioritize and to de-prioritize. A total of 304 stakeholders (researchers, health professionals, smokers and ex-smokers, guideline developers, research funders and policymakers, representing 28 countries) identified 183 unanswered research questions. These were categorized into 15 research categories. A total of 175 participants prioritized categories and questions in the second survey phase, with 'electronic cigarettes'; 'addressing inequalities'; and 'mental health and other substance abuse' prioritized as the top three categories. Forty-three stakeholders attended the workshop and discussed reasons for and against category prioritization. Prioritized research categories largely mirrored those in the survey stage, although 'treatment delivery' also emerged as a key category. Five cross-cutting themes emerged: efficacy; relative efficacy; cost effectiveness; addressing inequalities; and different types of evidence. There are many unanswered
Clayforth, Cassandra; Pettigrew, Simone; Mooney, Katie; Lansdorp-Vogelaar, Iris; Rosenberg, Michael; Slevin, Terry
To assess the relative cost-effectiveness of various non-television advertising media in encouraging 25-39 year-old male smokers to respond to a cessation-related call to action. Information about how new electronic media compare in effectiveness is important to inform the implementation of future tobacco control media campaigns. Two testimonial advertisements featuring members of the target group were developed for radio, press and online media. Multiple waves of media activity were scheduled over a period of seven weeks, including an initial integrated period that included all three media and subsequent single media phases that were interspersed with a week of no media activity. The resulting Quit website hits, Quitline telephone calls, and registrations to online and telephone counselling services were compared to advertising costs to determine the relative cost-effectiveness of each media in isolation and the integrated approach. The online-only campaign phase was substantially more cost-effective than the other phases, including the integrated approach. This finding is contrary to the current assumption that the use of a consistent message across multiple media simultaneously is the most cost-effective way of reaching and affecting target audiences. Online advertising may be a highly cost-effective channel for low-budget tobacco control media campaigns. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.
Odukoya, Oluwakemi Ololade; Chife, Jacob Obi; Odeyemi, Kofoworola A; Nwangwu, Genevieve I
.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.
Karimi, K J; Ayah, R; Olewe, T
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 (peducation were less likely to have a workplace policy (ppost-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/
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
Cavalcante, Tânia Maria; Pinho, Mariana Coutinho Marques de; Perez, Cristina de Abreu; Teixeira, Ana Paula Leal; Mendes, Felipe Lacerda; Vargas, Rosa Rulff; Carvalho, Alexandre Octávio Ribeiro de; Rangel, Erica Cavalcanti; Almeida, Liz Maria de
Since 2005, Brazil has been a Party of the World Health Organization Framework Convention on Tobacco Control, an international treaty whose measures are the foundation of the National Tobacco-Control Policy (NTCP), of Brazil. The results evidence a significant decrease in the prevalence of smokers and in tobacco-related morbidity and mortality. These results, however, could have been even better if there wasn't the interference of the tobacco supply chain (TSC), controlled by transnational corporations, which has become more intense over the last 10 years. These companies made Brazil not only a repository for tobacco, but also for economic and political power capable of threatening NTCP achievements. This Essay recounts the development of NTCP and the tobacco supply chain modus operandi to hamper it, and discusses how the strengthening of policies to promote alternative crops for tobacco could shield NTCP from such interference.
Myers, Allison E; Southwell, Brian G; Ribisl, Kurt M; Moreland-Russell, Sarah; Lytle, Leslie A
Tobacco control policies affecting the point of sale (POS) are an emerging intervention, yet POS-related news media content has not been studied. We describe news coverage of POS tobacco control efforts and assess relationships between article characteristics, including policy domains, frames, sources, localisation and evidence present, and slant towards tobacco control efforts. High circulation state (n=268) and national (n=5) newspapers comprised the sampling frame. We retrieved 917 relevant POS-focused articles in newspapers from 1 January 2007 to 31 December 2014. 5 raters screened and coded articles, 10% of articles were double coded, and mean inter-rater reliability (IRR) was 0.74. POS coverage emphasised tobacco retailer licensing (49.1% of articles) and the most common frame present was regulation (71.3%). Government officials (52.3%), followed by tobacco retailers (39.6%), were the most frequent sources. Half of articles (51.3%) had a mixed, neutral or antitobacco control slant. Articles presenting a health frame, a greater number of protobacco control sources, and statistical evidence were significantly more likely to also have a protobacco control slant. Articles presenting a political/rights or regulation frame, a greater number of antitobacco control sources, or government, tobacco industry, tobacco retailers, or tobacco users as sources were significantly less likely to also have a protobacco control slant. Stories that feature procontrol sources, research evidence and a health frame also tend to support tobacco control objectives. Future research should investigate how to use data, stories and localisation to encourage a protobacco control slant, and should test relationships between content characteristics and policy progression. 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/.
Mirra, Antonio Pedro; Carvalho, Adriana Pereira de
In the tobacco control program, educational, socioeconomic, ecological and legislative actions should be planned. Legislative actions should include the federal, state and municipal spheres, have a primarily preventive purpose and federal reach. Survey of bills presented in both legislative houses at federal level, House of Representatives and Senate (which together form the National Congress) and the resulting laws. In the period from 1965 to 2015, 254 bills were filed with the House of Representatives and, from 1971 to 2015, 68 others were presented to the Senate. In the House of Representatives, of the 254 bills, 68.9% were archived/rejected/returned, 14.9% did not have a result, 12.2% are currently being processed/analyzed by commissions, 2.0% refer to the inclusion of amendments/law annexes, 1.2% were transformed into legal norm/proposition of origin and 0.8% were transformed into laws. In the Senate, of the 68 bills, 19.1% were filed, 33.8% did not have a result, 4.4% were currently being processed, and 42.7% referred to changes in the law. Anti--tobacco actions were more prevalent in the periods 1979-1984 by the AMB, 1985-2007 by MS/INCA, and in 2008-2015 by the ACT. Tobacco control legislation has progressed constantly, with the provocation of legislators from both Houses triggered by the MS/INCA and civil entities committed to smoking control, such as a number of non-governmental organizations (especially the AMB and the ACT).
Antonio Pedro Mirra
Full Text Available Summary Introduction: In the tobacco control program, educational, socioeconomic, ecological and legislative actions should be planned. Legislative actions should include the federal, state and municipal spheres, have a primarily preventive purpose and federal reach. Objective: Survey of bills presented in both legislative houses at federal level, House of Representatives and Senate (which together form the National Congress and the resulting laws. Method: In the period from 1965 to 2015, 254 bills were filed with the House of Representatives and, from 1971 to 2015, 68 others were presented to the Senate. Results: In the House of Representatives, of the 254 bills, 68.9% were archived/rejected/returned, 14.9% did not have a result, 12.2% are currently being processed/analyzed by commissions, 2.0% refer to the inclusion of amendments/law annexes, 1.2% were transformed into legal norm/proposition of origin and 0.8% were transformed into laws. In the Senate, of the 68 bills, 19.1% were filed, 33.8% did not have a result, 4.4% were currently being processed, and 42.7% referred to changes in the law. Anti--tobacco actions were more prevalent in the periods 1979-1984 by the AMB, 1985-2007 by MS/INCA, and in 2008-2015 by the ACT. Conclusion: Tobacco control legislation has progressed constantly, with the provocation of legislators from both Houses triggered by the MS/INCA and civil entities committed to smoking control, such as a number of non-governmental organizations (especially the AMB and the ACT.
Blouin, Chantal; Dubé, Laurette
To date the global health diplomacy agenda has focused primarily on infectious diseases. Policymakers have not dedicated the same level of attention to chronic diseases, despite their rising contribution to the global burden of disease. Negotiation of the Framework convention on tobacco control provides an apt example from global health diplomacy to tackle diet-related chronic diseases. What lessons can be learned from this experience for preventing obesity? This article looks at why a global policy response is necessary, at the actors and interests involved in the negotiations, and at the forum for diplomacy.
Nagelhout, Gera E.; Crone, Matty R.; van den Putte, Bas; Willemsen, Marc C.; Fong, Geoffrey T.; de Vries, Hein
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…
Li, Lin; Borland, Ron; Fong, Geoffrey T; Thrasher, James F; Hammond, David; Cummings, Kenneth M
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 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.
Deeming Tobacco Products To Be Subject to the Federal Food, Drug, and Cosmetic Act, as Amended by the Family Smoking Prevention and Tobacco Control Act; Restrictions on the Sale and Distribution of Tobacco Products and Required Warning Statements for Tobacco Products. Final rule.
The Food and Drug Administration (FDA) is issuing this final rule to deem products meeting the statutory definition of "tobacco product,'' except accessories of the newly deemed tobacco products, to be subject to the Federal Food, Drug, and Cosmetic Act (the FD&C Act), as amended by the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act). The Tobacco Control Act provides FDA authority to regulate cigarettes, cigarette tobacco, roll-your-own tobacco, smokeless tobacco, and any other tobacco products that the Agency by regulation deems to be subject to the law. With this final rule, FDA is extending the Agency's "tobacco product'' authorities in the FD&C Act to all other categories of products that meet the statutory definition of "tobacco product" in the FD&C Act, except accessories of such newly deemed tobacco products. This final rule also prohibits the sale of "covered tobacco products" to individuals under the age of 18 and requires the display of health warnings on cigarette tobacco, roll-your own tobacco, and covered tobacco product packages and in advertisements. FDA is taking this action to reduce the death and disease from tobacco products. In accordance with the Tobacco Control Act, we consider and intend the extension of our authorities over tobacco products and the various requirements and prohibitions established by this rule to be severable.
). Point-of-sale advertising refers to the display of promotional materials where tobacco products are sold. View moreTobacco Industry Marketing Practices at Point-of-Sale (Argentina and Guatemala) ...
higher than the rate of inflation) on tobacco products, legislation requiring graphic warnings on tobacco products (messages to be proposed, pretested and monitored over time by the team) and smoke-free spectator viewing areas at venues ...
higher than the rate of inflation) on tobacco products, legislation requiring graphic warnings on tobacco products (messages to be proposed, pretested and monitored over time by the team) and smoke-free spectator viewing areas at venues ...
Partos, Timea R; Gilmore, Anna B; Hitchman, Sara C; Hiscock, Rosemary; Branston, J Robert; McNeill, Ann
Raising tobacco prices is the most effective population-level intervention for reducing smoking, but this is undermined by the availability of cheap tobacco. This study monitors trends in cheap tobacco use among adult smokers in the UK between 2002-2014 via changes in product type, purchase source, and prices paid. Weighted data from 10 waves of the International Tobacco Control policy evaluation study were used. This is a longitudinal cohort study of adult smokers with replenishment; 6169 participants provided 15812 responses. Analyses contrasted 1) product type: roll-your-own (RYO) tobacco, factory made packs (FM-P), and cartons (FM-C); 2) purchase source: UK store-based sources (e.g. supermarkets, convenience stores) with non-UK/ non-store sources representing tax avoidance/ evasion (e.g. outside the UK, duty free, informal sellers); and 3) prices paid (inflation-adjusted to 2014 values). Generalised Estimating Equations tested linear changes over time. 1) RYO use increased significantly over time as FM decreased. 2) UK store-based sources constituted approximately 80% of purchases over time, with no significant increases in tax avoidance/ evasion. 3) Median RYO prices were less than half that of FM, with FM-C cheaper than FM-P. Non-UK/ non-store sources were cheapest. Price increases of all three product types from UK store-based sources from 2002 - 2014 were statistically significant, but not substantial. Wide (and increasing for FM-P) price ranges meant each product type could be purchased in 2014 at prices below their 2002 medians from UK store-based sources. Options exist driving UK smokers to minimise their tobacco expenditure; smokers do so largely by purchasing cheap tobacco products from UK stores. The effectiveness of price increases as a deterrent to smoking is being undermined by the availability of cheap tobacco such as roll-your-own tobacco and cartons of packs of factory-made cigarettes. Wide price ranges allowed smokers in 2014 to easily obtain
The Family Smoking Prevention and Tobacco Control Act, enacted on June 22, 2009, gives FDA jurisdiction to regulate tobacco products “as appropriate for the protection of the public health.” This is a major change to a regulatory scheme for tobacco that has historically excluded FDA. Among other things, the Act gives FDA authority to restrict the sale and marketing of tobacco products and to require changes in the design and characteristics of tobacco products. Many aspects of the Act are ...
Sims, Michelle; Salway, Ruth; Langley, Tessa; Lewis, Sarah; McNeill, Ann; Szatkowski, Lisa; Gilmore, Anna B
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.
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.
Drope, Jeffrey; McGrady, Benn; Bialous, Stella Aguinaga; Lencucha, Raphael; Silva, Vera Luiza da Costa E
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.
Laurence William Gill
Full Text Available According to World Health Organisation figures, 30% of all cancer deaths, 20% of all coronary heart diseases and strokes and 80% of all chronic obstructive pulmonary disease are caused by cigarette smoking. Environmental Tobacco Smoke (ETS exposure has also been shown to be associated with disease and premature death in non-smokers. In response to this environmental health issue, several countries have brought about a smoking ban policy in public places and in the workplace. Countries such as the U.S., France, Italy, Ireland, Malta, the Netherlands, Sweden, Scotland, Spain, and England have all introduced policies aimed at reducing the population exposure to ETS. Several investigations have monitored the effectiveness of these smoking ban policies in terms of ETS concentrations, human health and smoking prevalence, while others have also investigated a number of alternatives to smoking ban policy measures. This paper reviews the state of the art in research, carried out in the field of ETS, smoking bans and Tobacco Control to date and highlights the need for future research in the area.
According to World Health Organisation figures, 30% of all cancer deaths, 20% of all coronary heart diseases and strokes and 80% of all chronic obstructive pulmonary disease are caused by cigarette smoking. Environmental Tobacco Smoke (ETS) exposure has also been shown to be associated with disease and premature death in non-smokers. In response to this environmental health issue, several countries have brought about a smoking ban policy in public places and in the workplace. Countries such as the U.S., France, Italy, Ireland, Malta, the Netherlands, Sweden, Scotland, Spain, and England have all introduced policies aimed at reducing the population exposure to ETS. Several investigations have monitored the effectiveness of these smoking ban policies in terms of ETS concentrations, human health and smoking prevalence, while others have also investigated a number of alternatives to smoking ban policy measures. This paper reviews the state of the art in research, carried out in the field of ETS, smoking bans and Tobacco Control to date and highlights the need for future research in the area.
Lando-King, Elizabeth A; Malone, Ruth E; Haddock, Christopher K; Poston, Walker S Carlos; Lando, Harry A; Jahnke, Sara A; Hawk, Nita; Smith, Elizabeth A
Although the United States Air Force (USAF) has been a leader in efforts to reduce tobacco use among service members, tobacco continues to be a problem and initiatives to decrease tobacco use further require buy-in from leadership. We explored line leaderships' perspectives on tobacco. A diverse group of 10 senior commissioned and 10 non-commissioned personnel were interviewed. Respondents reported substantial changes in the culture of tobacco use during their years of service, from near ubiquity to restricted use areas. They also perceived mixed messages coming from the USAF, including simultaneous discouragement of and accommodations for tobacco use, and variability in policies and enforcement. Many respondents indicated that allowing tobacco use creates conflict and undermines military discipline and suggested that a tobacco-free policy would be the best way to eliminate these contradictions. Although there has been substantial movement away from a culture of tobacco in the USAF, current policies and variable enforcement of these policies create unnecessary contradictions. Establishing a tobacco-free service would resolve these issues in addition to improving the health of service members and veterans.
The Family Smoking Prevention and Tobacco Control Act (the "Act"), enacted in June 2009, gave the U.S. Food and Drug Administration authority to regulate tobacco products. The current paper reviews the provisions for packaging and labeling, including the existing evidence and research priorities. Narrative review using electronic literature search of published and unpublished sources in 3 primary areas: health warnings, constituent labeling, and prohibitions on the promotional elements of packaging. The Act requires 9 pictorial health warnings covering half of cigarette packages and 4 text warnings covering 30% of smokeless tobacco packages. The Act also prohibits potentially misleading information on packaging, including the terms "light" and "mild," and provides a mandate to require disclosure of chemical constituents on packages. Many of the specific regulatory provisions are based on the extent to which they promote "greater public understanding of the risks of tobacco." As a result, research on consumer perceptions has the potential to shape the design and renewal of health warnings and to determine what, if any, information on product constituents should appear on packages. Research on consumer perceptions of existing and novel tobacco products will also be critical to help identify potentially misleading information that should be restricted under the Act. Packaging and labeling regulations required under the Act will bring the United States in line with international standards. There is an immediate need for research to evaluate these measures to guide future regulatory action.
Levy, David; Fergus, Cristin; Rudov, Lindsey; McCormick-Ricket, Iben; Carton, Thomas
Despite the presence of tobacco control policies, Louisiana continues to experience a high smoking burden and elevated smoking-attributable deaths. The SimSmoke model provides projections of these health outcomes in the face of existing and expanded (simulated) tobacco control polices. The SimSmoke model utilizes population data, smoking rates, and various tobacco control policy measures from Louisiana to predict smoking prevalence and smoking-attributable deaths. The model begins in 1993 and estimates are projected through 2054. The model is validated against existing Louisiana smoking prevalence data. The most powerful individual policy measure for reducing smoking prevalence is cigarette excise tax. However, a comprehensive cessation treatment policy is predicted to save the most lives. A combination of tobacco control policies provides the greatest reduction in smoking prevalence and smoking-attributable deaths. The existing Louisiana excise tax ranks as one of the lowest in the country and the legislature is against further increases. Alternative policy measures aimed at lowering prevalence and attributable deaths are: cessation treatments, comprehensive smoke-free policies, and limiting youth access. These three policies have a substantial effect on smoking prevalence and attributable deaths and are likely to encounter more favor in the Louisiana legislature than increasing the state excise tax.
Liang, Yunji; Zheng, Xiaolong; Zeng, Daniel Dajun; Zhou, Xingshe; Leischow, Scott James; Chung, Wingyan
Social media is becoming a new battlefield for tobacco "wars". Evaluating the current situation is very crucial for the advocacy of tobacco control in the age of social media. To reveal the impact of tobacco-related user-generated content, this paper characterizes user interaction and social influence utilizing social network analysis and information theoretic approaches. Our empirical studies demonstrate that the exploding pro-tobacco content has long-lasting effects with more active users and broader influence, and reveal the shortage of social media resources in global tobacco control. It is found that the user interaction in the pro-tobacco group is more active, and user-generated content for tobacco promotion is more successful in obtaining user attention. Furthermore, we construct three tobacco-related social networks and investigate the topological patterns of these tobacco-related social networks. We find that the size of the pro-tobacco network overwhelms the others, which suggests a huge number of users are exposed to the pro-tobacco content. These results indicate that the gap between tobacco promotion and tobacco control is widening and tobacco control may be losing ground to tobacco promotion in social media.
Pförtner, Timo-Kolja; Hublet, Anne; Schnohr, Christina Warrer
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 ...
Bosdriesz, Jizzo R.; Willemsen, Marc C.; Stronks, Karien; Kunst, Anton E.
There has been much variation between European countries in the development of tobacco control policy. Not much is known about the factors that shape this variation. This study aimed to assess the role of political factors in tobacco control policy development. We used data from 11 European
Background. The South African (SA) government has implemented comprehensive tobacco control measures in line with the requirements of the Framework Convention on Tobacco Control. The effect of these measures on smoking prevalence and smoking-related attitudes, particularly among young people, is largely ...
The Call for concept notes on the Economics of Tobacco Control in Low and Middle-income Countries (LMICs) offers up to CA$1 million over a maximum of four years to support evidence-based research on the economic rationale for the adoption of tobacco-control policies across LMICs in four regions: Asia, Latin America ...
Kilgore, Elizabeth A; Mandel-Ricci, Jenna; Johns, Michael; Coady, Micaela H; Perl, Sarah B; Goodman, Andrew; Kansagra, Susan M
In 2002, New York City implemented a comprehensive tobacco control plan that discouraged smoking through excise taxes and smoke-free air laws and facilitated quitting through population-wide cessation services and hard-hitting media campaigns. Following the implementation of these activities through a well-funded and politically supported program, the adult smoking rate declined by 28% from 2002 to 2012, and the youth smoking rate declined by 52% from 2001 to 2011. These improvements indicate that local jurisdictions can have a significant positive effect on tobacco control.
Redmon, Pamela; Chen, Lincoln C; Wood, Jacob L; Li, Shuyang; Koplan, Jeffrey P
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
Redmon, Pamela; Chen, Lincoln C; Wood, Jacob L; Li, Shuyang; Koplan, Jeffrey P
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.
Martins, Stella Regina; Paceli, Renato Batista; Bussacos, Marco Antônio; Fernandes, Frederico Leon Arrabal; Prado, Gustavo Faibischew; Lombardi, Elisa Maria Siqueira; Terra-Filho, Mário; Santos, Ubiratan Paula
To determine the level of agreement with effective tobacco control measures recommended by the World Health Organization and to assess the attitudes toward, knowledge of, and beliefs regarding smoking among third-year medical students at University of São Paulo School of Medicine, located in the city of São Paulo, Brazil. Between 2008 and 2012, all third-year medical students were invited to complete a self-administered questionnaire based on the Global Health Professionals Student Survey and its additional modules. The study sample comprised 556 students. The level of agreement with the World Health Organization recommendations was high, except for the components "received smoking cessation training" and "raising taxes is effective to reduce the prevalence of smoking". Most of the students reported that they agree with banning tobacco product sales to minors (95%), believe that physicians are role models to their patients (84%), and believe that they should advise their patients to quit cigarette smoking (96%) and using other tobacco products (94%). Regarding smoking cessation methods, most of the students were found to know more about nicotine replacement therapy than about non-nicotine therapies (93% vs. 53%). Only 37% of the respondents were aware of the importance of educational antismoking materials, and only 31% reported that they believe in the effectiveness of encouraging their patients, during medical visits. In our sample, the prevalence of current cigarette smoking was 5.23%; however, 43.82% of the respondents reported having experimented with water-pipe tobacco smoking. Our results revealed the need to emphasize to third-year medical students the importance of raising the prices of and taxes on tobacco products. We also need to make students aware of the dangers of experimenting with tobacco products other than cigarettes, particularly water-pipe tobacco smoking. Determinar o grau de concordância com medidas eficazes de controle do tabaco
Keshavarz, Hooman; Jafari, Ahmad; Khami, Mohammad Reza; Virtanen, Jorma Ilmari
Conclusive evidence exists about associations between several life-threatening diseases and passive smoking. The objective of our study was to investigate the prevalence of passive smoking among Iranian dental students, to assess their attitudes towards tobacco control programs, and to explore the association between these two and tobacco use. In eight randomly selected dental schools, all fourth-year students were surveyed by means of a self-administered anonymous questionnaire in December 2010. The Global Health Professions Student Survey (GHPSS) questionnaire served as the data collection instrument. Exposure to environmental tobacco smoke (ETS) was assessed during the previous week. Chi-square test, logistic regression, and linear regression served for statistical analyses. The response rate was 84% (325 students, 66% female). Exposure to ETS was reported by 74% of the participants. Men were significantly more exposed to ETS at home, and in other places than were women. Most of the students agreed on queried tobacco control policies. The lowest agreement (72%) was for banning smoking in coffee shops and teahouses. A logistic regression model showed that adjusted for gender, passive smoking at home is significantly associated with current tobacco use. A linear regression model suggested that the total score of attitudes is significantly associated with passive smoking at home, passive smoking in other places, tobacco use experience, and current tobacco use. The study reports high exposure to ETS among dental students, and its association with current tobacco use and attitudes towards tobacco control.
Objective: To outline a novel strategy for controlling the tobacco market. Arguments: More comprehensive controls over the tobacco market are essential and long overdue. Effective controls need to encourage the development of less harmful products; control commercial communication to ensure that potential harms are highlighted relative to any benefits; and provide mechanisms to move consumers away from tobacco use, or at least towards less harmful alternatives. Achieving this by regulating the existing industry is one strategy. This paper puts the case for an alternative: to have marketing controlled by an agency (called here the Tobacco Products Agency, or TPA) which tendered to manufacturers for product and which distributed to retailers in ways that reduce incentives to bend or break the law. The TPA would be backed by legislation that made tobacco a controlled substance with possession sale and use only allowed as permitted by the regulations, which in reality would be only as provided by the TPA. Conclusions: The overall effect of such a model, which we call a "regulated market model", would be to eliminate most of the incentives and remaining opportunities for commercial promotion of tobacco and to create incentives to encourage the development of less harmful tobacco products. Such a model preserves the competition inherent in a free market, but directs it towards the challenge of reducing the harm from tobacco use. PMID:14660771
Hu, Teh-Wei; Lee, Anita H; Mao, Zhengzhong
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.
To outline a novel strategy for controlling the tobacco market. More comprehensive controls over the tobacco market are essential and long overdue. Effective controls need to encourage the development of less harmful products; control commercial communication to ensure that potential harms are highlighted relative to any benefits; and provide mechanisms to move consumers away from tobacco use, or at least towards less harmful alternatives. Achieving this by regulating the existing industry is one strategy. This paper puts the case for an alternative: to have marketing controlled by an agency (called here the Tobacco Products Agency, or TPA) which tendered to manufacturers for product and which distributed to retailers in ways that reduce incentives to bend or break the law. The TPA would be backed by legislation that made tobacco a controlled substance with possession sale and use only allowed as permitted by the regulations, which in reality would be only as provided by the TPA. The overall effect of such a model, which we call a "regulated market model", would be to eliminate most of the incentives and remaining opportunities for commercial promotion of tobacco and to create incentives to encourage the development of less harmful tobacco products. Such a model preserves the competition inherent in a free market, but directs it towards the challenge of reducing the harm from tobacco use.
Tobacco use globally and in. South Africa. Tobacco continues to be the leading cause of death and disease worldwide. Globally, the prevalence of smoking among adults decreased between 1980 and 2012 from 41% to 31% for men and from 11% to 6% for women, yet the number of smokers increased to nearly 1 billion ...
Jul 15, 2011 ... The higher taxes forced the tobacco industry to change its pricing strategy. Rather than absorb all or part of the tax to keep cigarette prices relatively steady — and thereby keep tobacco consumption as high as possible — the industry chose to maintain its profit margins by passing the tax on to consumers ...
Siddiqi, Kamran; Scammell, Katy; Huque, Rumana; Khan, Amina; Baral, Sushil; Ali, Shehzad; Watt, Ian
Most South Asian countries are signatories to the WHO Framework Convention for Tobacco Control (FCTC). However, there is little information on the extent to which FCTC standards are effectively implemented for controlling smokeless tobacco (SLT)-used by over 250 million people in the region. We assessed the feasibility of a novel approach based on interviewing the key actors of SLT supply chain and analyzing its findings using standards set by FCTC. Using a snowball-sampling technique, we interviewed point-of-sale vendors, wholesale retailers, manufacturers, raw-tobacco retailers, and farmers involved in the supply chain of SLT in Bangladesh, Nepal, and Pakistan. Using a structured-questionnaire, participants were asked about their customer profiles; product types; marketing practices; suppliers; profit margins, awareness and adherence to legislation. We recruited 72% (130/180) of all supply chain actors approached. Findings indicate several loopholes in the existing taxation, regulatory, and inspection systems. A significant proportion of smuggled and counterfeit SLT products are available in the market. Most SLT products are sold without recommended warnings, information on their ingredients, and manufacturers' details. There appear to be no restrictions on sale of SLT products to minors. On the other hand, there are also several incentives built-in the supply chain that makes tobacco farming, SLT manufacturing, and its sale a profitable business. Our novel approach to study SLT control was successful in identifying and interviewing actors involved in its supply chain. The analysis using FCTC could provide valuable information to policy makers and enable them to effectively regulate SLT products. © 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: firstname.lastname@example.org.
Terry-McElrath, Yvonne M; Emery, Sherry; Wakefield, Melanie A; O'Malley, Patrick M; Szczypka, Glen; Johnston, Lloyd D
Young adults in the USA have one of the highest smoking prevalence rates of any age group, and young adulthood is a critical time period of targeting by the tobacco industry. The authors examined relationships between potential exposure to tobacco-related media campaigns from a variety of sponsors and 2-year smoking change measures among a longitudinal sample of US adults aged 20-30 years from 2001 to 2008. Self-report data were collected from a longitudinal sample of 12,931 US young adults from age 20 to 30. These data were merged with tobacco-related advertising exposure data from Nielsen Media Research. Two-year measures of change in smoking were regressed on advertising exposures. Two-year smoking uptake was unrelated to advertising exposure. The odds of quitting among all smokers and reduction among daily smokers in the 2 years between the prior and current survey were positively related to anti-tobacco advertising, especially potential exposure levels of 104-155 ads over the past 24 months. Tobacco company advertising (including corporate image and anti-smoking) and pharmaceutical industry advertising were unrelated to quitting or reduction. Continued support for sustained, public health-based well-funded anti-tobacco media campaigns may help reduce tobacco use among young adults.
Rodríguez-Bolaños, Rosibel; Reynales-Shigematsu, Luz Myriam; Ibañez-Hernández, Norma A; Santos-Luna, René; Valdés-Salgado, Raydel; Avila-Tang, Erika; Stillman, Frances
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.
Phelps-Tschang, Jane S.; Miller, Elizabeth; Rice, Kristen; Primack, Brian A.
Facilitator-led smoking media literacy (SML) programs have improved media literacy and reduced intention to smoke. However, these programs face limitations including high costs and barriers to standardization. We examined the efficacy of a Web-based media literacy program in improving smoking media literacy skills among adolescents. Sixty-six 9th…
Hamann Stephen L
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
Adebiyi, Akindele O; Oluwafemi, Akinbode
Tobacco industry's undermining of tobacco control goes on unabated in sub-Saharan African countries, especially in Kenya, Nigeria, and Uganda. The Framework Convention on Tobacco Control (FCTC) contains provisions aimed at curbing these activities. However, the level to which FCTC is implemented and the strength of each country's tobacco control law will determine its usefulness in this regard. We determined the implementation status and strength of tobacco control laws in Kenya, Nigeria, and Uganda. The World Health Organization and Campaign for Tobacco-Free Kids websites were queried for secondary data related to tobacco control. Sources and data were disambiguated and reported as tables. Composite scores for implementation were computed based on the number of indicators of the articles of the FCTC reported on by each country. Strength of tobacco control law (SoTCL) was computed based on the total number of domains of the laws meeting a defined acceptable standard. Total obtainable score for implementation and SoTCL were 148 and 38, respectively. On the FCTC, Kenya, Nigeria, and Uganda achieved 75, 61.5, and 46.6% implementation, respectively. SoTCL was weakest in the smoke-free domain for Kenya, tobacco advertisement promotion and sponsorship domain for Nigeria, and packaging and labeling domain for Uganda. SoTCL scores were 18 (47.4%), 20 (52.6%), and 34 (89.5%) for Nigeria, Kenya, and Uganda, respectively. Kenya, Nigeria, and Uganda will need to strengthen their tobacco control laws through appropriate amendment as well as regulatory mechanisms that guarantee alignment with FCTC and the implementation thereof.
The Global Adult Tobacco Survey (GATS), conducted in 2011 by the Indonesian National Institute of Health Research and Development and the U.S. Center for Disease Control and Prevention, showed that more than 67% of men and almost 40% of boys aged 13-15 use tobacco.
Fulmer, Erika; Rogers, Todd; Glasgow, LaShawn; Brown, Susan; Kuiper, Nicole
The outcome indicator framework helps tobacco prevention and control programs (TCPs) plan and implement theory-driven evaluations of their efforts to reduce and prevent tobacco use. Tobacco use is the single-most preventable cause of morbidity and mortality in the United States. The implementation of public health best practices by comprehensive state TCPs has been shown to prevent the initiation of tobacco use, reduce tobacco use prevalence, and decrease tobacco-related health care expenditures. Achieving and sustaining program goals require TCPs to evaluate the effectiveness and impact of their programs. To guide evaluation efforts by TCPs, the Centers for Disease Control and Prevention's Office on Smoking and Health developed an outcome indicator framework that includes a high-level logic model and evidence-based outcome indicators for each tobacco prevention and control goal area. In this article, we describe how TCPs and other community organizations can use the outcome indicator framework in their evaluation efforts. We also discuss how the framework is used at the national level to unify tobacco prevention and control efforts across varying state contexts, identify promising practices, and expand the public health evidence base.
Gansky, Stuart A; Ryan, Jennifer L; Ellison, James A; Isong, Umo; Miller, Arthur J; Walsh, Margaret M
To determine the tobacco-related knowledge, attitudes, and practice behaviors among US pediatric dentists. A survey was conducted in 1998 among a national, random sample of 1500 American Academy of Pediatric Dentistry members. Chi-square tests and logistic regression with odds ratios (ORs) and 95% confidence intervals assessed factors related to pediatric dentists' tobacco control behaviors. Response was 65% for the survey. Only 12% of respondents had prior tobacco prevention/cessation training. Of those untrained, 70% were willing to be trained. Less than two-thirds correctly answered any of four tobacco-related knowledge items. Over one-half agreed pediatric dentists should engage in tobacco control behaviors, but identified patient resistance as a barrier. About 24% of respondents reported always/often asking their adolescent patients about tobacco use; 73% reported always/often advising known tobacco users to quit; and 37% of respondents always/often assisting with stopping tobacco use. Feeling prepared to perform tobacco control behaviors (ORs = 1.9-2.8), a more positive attitude score (4 points) from 11 tobacco-related items (ORs = 1.5-1.8), and a higher statewide tobacco use prevalence significantly predicted performance of tobacco control behaviors. Findings suggest thatraining programs on tobacco use and dependence treatment in the pediatric dental setting may be needed to promote tobacco control behaviors for adolescent patients.
Usmanova, Gulnoza; Mokdad, Ali H
We used data from the Global Youth Tobacco Survey (GYTS) to monitor articles of the World Health Organization Framework Convention on Tobacco Control in Former Soviet Union (FSU) countries. The GYTS is a school-based survey, which uses a two-stage sample design to produce representative, independent, cross-sectional estimates. The GYTS was conducted in 10 out of 12 FSU countries from 1999 to 2008. The prevalence of ever smoking and current smoking, smoking initiation, and exposure to second-hand smoking decreased over time. Overall, willingness to stop smoking, supporting smoking bans, and receiving information about the dangers of smoking increased over time. Overall, our study shows that FSU countries had positive changes in tobacco-use prevalence and perception among youth over time. Our findings should be used as baseline measures for future tobacco-control interventions aimed at reducing tobacco use among youth. Moreover, our results call for the enforcement of restricting advertising for tobacco products.
Prem K Mony
Full Text Available Background: Tobacco use is a major cause of avoidable mortality. Postgraduate doctors in training are an important group of physicians likely to influence patients′ tobacco use/cessation. Objective: To assess preparedness for tobacco control among clinical postgraduate residents of a medical college in southern India. Materials and Methods: A cross-sectional study was undertaken among all clinical postgraduate residents enrolled in St. John′s Medical College, Bangalore, to assess knowledge, attitude, and practice regarding tobacco cessation in their patients. A self-administered, anonymous questionnaire was used. Simple descriptive analysis was undertaken. Results: The overall response rate was 66% (76/116. Mean (S.D. knowledge score on tobacco use prevalence and disease burden was 6.2 (2.0 out of 10. About 25% of them were not aware of nicotine replacement therapy as a treatment option for tobacco cessation. Nearly two thirds of them expected their patients to ask for assistance with quitting and nearly half were sceptical about patients′ ability to quit. While 80% of them enquired routinely about tobacco use in their patients, only 50% offered advice on quitting and less than a third assessed readiness to quit or offered assistance with quitting in their patients. Conclusion: Our study revealed suboptimal levels of knowledge and tobacco cessation practice among postgraduate residents. Attitudes toward tobacco cessation by their patients was however generally positive and there was substantial interest in further training in tobacco control. Reorienting postgraduate medical education to include tobacco control interventions would enable future physicians to be better equipped to deal with nicotine addiction.
Full Text Available Introduction. Waterpipe tobacco smoking prevalence is increasing worldwide despite its documented health effects. A general belief that it is less harmful than cigarettes may be fuelled by the lack of media campaigns highlighting its health effects. We aimed to create and assess the impact of a social media campaign about dangers of waterpipe smoking. Methods. The “ShishAware” campaign included three social media (Facebook, Twitter, and YouTube and a website. Nine months after launch we collected data to assess use of, and reaction to, our media accounts. Results. Requiring limited maintenance resources, Facebook attracted campaign supporters but YouTube attracted opposers. Twitter enabled the most organisation-based contact but Facebook was the most interactive medium. Facebook users were more likely to “like” weekday than weekend statuses and more likely to comment on “shisha fact” than “current affairs” statuses. Follower subscription increased as our posting rate increased. Our YouTube video gained 19,428 views (from all world continents and 218 comments (86% from pro-waterpipe smokers. Conclusions. Social media campaigns can be created and maintained relatively easily. They are innovative and have the potential for wide and rapid diffusion, especially towards target audiences. There is a need for more rigorous evaluation of their effects, particularly among the youth.
Rennen, Els; Nagelhout, Gera E; van den Putte, Bas; Janssen, Eva; Mons, Ute; Guignard, Romain; Beck, François; de Vries, Hein; Thrasher, James F; Willemsen, Marc C
This study examined whether awareness of tobacco control policies was associated with social unacceptability of smoking and whether social unacceptability had an effect on smoking cessation in three European countries. Representative samples (n = 3865) of adult smokers in France, the Netherlands and Germany were used from two survey waves of the longitudinal International Tobacco Control Europe Surveys. Associations were examined of aspects of social unacceptability of smoking (i.e. feeling uncomfortable, important people disapproval and societal disapproval) with tobacco policy awareness (i.e. awareness of warning labels, anti-tobacco information and smoking restrictions at work) and smoking cessation. Only the positive association of awareness of anti-tobacco information with feeling uncomfortable about smoking was significant in each of the three countries. Important people disapproval predicted whether smokers attempted to quit, although this did not reach significance in the French and German samples in multivariate analyses. Our findings suggest that anti-tobacco information campaigns about the dangers of second-hand smoke in France and about smoking cessation in the Netherlands and Germany might have reduced the social acceptability of smoking in these countries. However, campaigns that influence the perceived disapproval of smoking by important people may be needed to ultimately increase attempts to quit smoking.
Armendares, Pedro Enrique; Reynales Shigematsu, Luz Miriam
Various studies and analyses show that an increase in tobacco prices through taxation is one of the most efficient tools in the application of integral policies in the fight against tobacco. Increases in taxes contribute to cessation, to reductions in consumption and in the number of deaths among addicts and to decrease the number of people who start to smoke. However, many governments hesitate to apply high taxes to tobacco for fear of possible negative economic results including loss of jobs and a decrease in fiscal revenue as a consequence of smuggling. Both literature and empirical experience indicate that these negative consequences do not occur or have been overestimated, often due to arguments promoted by the tobacco industry itself. Increases in tobacco taxes result in greater fiscal income, even in the presence of smuggling, which can be confronted without eroding tobacco control policies. Numerous countries, including Mexico, still have a wide margin for increasing tobacco taxes, and thereby to take advantage of an exceptional opportunity that benefits both the population's health and the public treasury. To do so, governments must stand up to the powerful tobacco industry, which is aware of the efficiency of taxes to combat tobacco use and therefore resorts to intense ad campaigns, political lobbying and negotiation of voluntary agreements for "self-regulation" in order to avoid stricter legislative or fiscal measures.
Full Text Available Tobacco use is inextricably linked to a number of health risks both in the general and HIV-infected populations. There is, however, a dearth of research on effective tobacco control programs among people living with HIV, and especially among adolescents, young adults and pregnant women, groups with heightened or increased vulnerability secondary to tobacco use. Adolescents and young adults constitute a growing population of persons living with HIV infection. Early and continued tobacco use in this population living with a disease characterized by premature onset multimorbidity and chronic inflammation is of concern. Additionally, there is an increased acuity for tobacco control among HIV-infected pregnant women to reduce pregnancy morbidity and improve fetal outcome. This review will provide an important summary of current knowledge of tobacco use among HIV-infected adolescents, young adults and pregnant women. The effects of tobacco use in these specific populations will be presented and the current state of tobacco control within these populations, assessed.
Sims, M; Langley, T; Lewis, S; Richardson, S; Szatkowski, L; McNeill, A; Gilmore, A B
To examine the effects of tobacco control television advertisements with positive and negative emotional content on adult smoking prevalence and cigarette consumption. Analysis of monthly cross-sectional surveys using generalised additive models. England. 60 000 adults aged 18 years or over living in England and interviewed in the Opinions and Lifestyle Survey from 2004 to 2010. Current smoking status, daily cigarette consumption, tobacco control gross rating points (GRPs-a measure of per capita advertising exposure), cigarette costliness, concurrent tobacco control policies, sociodemographic variables. After adjusting for cigarette costliness, other tobacco control policies and individual characteristics, we found that a 400-point increase in positive emotive GRPs was associated with 7% lower odds of smoking (odds ratio (OR) 0.93, 95% CI 0.87 to 0.98) 1 month later and a similar increase in negative emotive GRPs was significantly associated with 4% lower odds of smoking (OR 0.96, 95% CI 0.92 to 0.999) 2 months later. An increase in negative emotive GRPs from 0 to 400 was also associated with a significant 3.3% (95% CI 1.1 to 5.6) decrease in average cigarette consumption. There was no evidence that the association between positive emotive GRPs and the outcomes differed depending on the intensity of negative emotive GRPs (and vice versa). This is the first study to explore the effects of campaigns with different types of emotive content on adult smoking prevalence and consumption. It suggests that both types of campaign (positive and negative) are effective in reducing smoking prevalence, whereas consumption among smokers was only affected by campaigns evoking negative emotions. 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/
Regueira, Gabriela; Suárez-Lugo, Nery; Jakimczuk, Silvia
In the Latin America region, the tobacco epidemic among women is a fact. This is related to the change in social and economic status among women and the efforts of the tobacco industry to capture their market share. The FCTC has the potential to be an important treaty for women if its articles include a gender perspective. Women's rights treaties, also represent an important tool to stop the epidemic. Women's participation is key in this process.
York, Nancy L; Pritsos, Chris A; Gutierrez, Antonio P
The purpose of this study was to identify Nevada legislators' views on comprehensive smoke-free (SF) policy development. The Nevada Clean Indoor Air Act (NCIAA) is a weak law that prohibits smoking in most indoor public places, excluding stand-alone bars and casino gaming areas. Nevada's state senators and assembly members were contacted to participate in the study. A literature review guided modifications of an instrument previously used to measure county-level officials' policy views in Kentucky. Descriptive statistics were conducted for selected variables, while independent t tests and one-way analysis of variance were used to examine differences between various groups. 23 of 63 legislators participated. Even though the majority of officials recognized smoking as a health hazard and nicotine as addictive, there was not overwhelming support for strengthening the NCIAA, raising cigarette excise taxes or providing cessation benefits to citizens. Officials believed that the NCIAA was having a negative economic impact on smaller gaming businesses, but not on the casino industry. Democrats were more likely than Republicans to agree that raising the excise tax by $1 is important for needed state revenues. 63% of legislators believed that they would be persuaded to strengthen the NCIAA regardless of its financial impact on small businesses, if their constituents supported such a move. No other state relies on gaming revenues as much as Nevada. Given that legislators are strongly influenced by their constituents' views, policy advocates need to establish grassroots support for strengthening the current NCIAA and also tobacco control laws in general.
C M Singh
Full Text Available Tobacco use is among the leading causes of preventable premature death and disease all over the world. As per World Health Organization (WHO estimates, at present, its use kills more than 5 million people each year worldwide and most of these deaths occur in low and middle-income countries. If immediate steps are not taken to tackle the problem gap in deaths between low and middle-income countries and high-income countries is expected to widen further over the next several decades. It is estimated that if current trends of tobacco use persist, it will take a toll of more than 8 million lives worldwide every year by 2030, out of these 80% premature deaths are expected to occur in low and middle-income countries. By the end of this century, tobacco may kill a billion people or more unless urgent action is taken.1 Deaths attributed to tobacco use are increasing in India and account for about one sixth of the world’s tobacco-related deaths. Estimations on tobacco-related deaths revealed the fact that smoking was expected to kill nearly one million Indians by the early 2010.2
Tat, John; Nguy, Mike; Tong, Eric K; Cheng, Aaron J; Chung, Lois Y; Sadler, Georgia Robins
The Asian Grocery Store-Based Cancer Education Program (the Program) is a proven strategy for promoting early breast cancer detection among Asian American women. The authors sought to test whether the same public health model can become an effective strategy for increasing the Asian community's awareness of the California Smokers' Helpline (the Helpline) and thereby, potentially decreasing this community's use of tobacco products. The new module, mainly staffed by four well-trained, volunteer undergraduates, explained the risks of first- and second-hand tobacco exposure and how to access the Helpline's services. A brochure, provided in English, Chinese, Korean, and Vietnamese (the Helpline's available Asian languages), was used to guide the bicultural, bilingual students' tobacco-related discussions with shoppers. The students' repeated presence at the nine partnering Asian grocery stores served as reminders of the Helpline's availability. In its first year of operation, the student trainers reached 1,052 men and 1,419 women with tobacco cessation messages. Equally important, the participating grocery stores' managers did not object to students telling their customers to quit using the tobacco products sold in their stores. The results suggest that the Program's tobacco cessation module is a viable, community-specific, public health strategy. It is also a strategy with the potential for applications to reduce other health threats.
Plotnikova, Evgeniya; Hill, Sarah E; Collin, Jeff
The increasingly inequitable impacts of tobacco use highlight the importance of ensuring developing countries' ongoing participation in global tobacco control. The WHO Framework Convention on Tobacco Control (FCTC) has been widely regarded as reflecting the high engagement and effective influence of developing countries. We examined participation in FCTC governance based on records from the first four meetings of the Conference of the Parties (COP), comparing representation and delegate diversity across income levels and WHO regions. While attendance at the COP sessions is high, there are substantial disparities in the relative representation of different income levels and regions, with lower middle and low income countries contributing only 18% and 10% of total meeting delegates, respectively. In regional terms, Europe provided the single largest share of delegates at all except the Durban (2008) meeting. Thirty-nine percent of low income countries and 27% of those from Africa were only ever represented by a single person delegation compared with 10% for high income countries and 11% for Europe. Rotation of the COP meeting location outside of Europe is associated with better representation of other regions and a stronger presence of delegates from national ministries of health and focal points for tobacco control. Developing countries face particular barriers to participating in the COP process, and their engagement in global tobacco control is likely to diminish in the absence of specific measures to support their effective participation.
Maslennikova, Galina Ya; Oganov, Rafael G; Boytsov, Sergey A; Ross, Hana; Huang, An-Tsun; Near, Aimee; Kotov, Alexey; Berezhnova, Irina; Levy, David T
Russia has high smoking rates and weak tobacco control policies. A simulation model is used to examine the effect of tobacco control policies on past and future smoking prevalence and premature mortality in Russia. The Russia model was developed using the SimSmoke tobacco control model previously developed for the USA and other nations. The model inputs population size, birth, death and smoking rates specific to Russia. It assesses, individually and in combination, the effect of seven types of policies consistent with the WHO Framework Convention on Tobacco Control (FCTC): taxes, smoke-free air, mass media campaign, advertising bans, warning labels, cessation treatment and youth access policies. Outcomes are smoking prevalence and the number of smoking-attributable deaths by age and gender from 2009 to 2055. Increasing cigarette taxes to 70% of retail price, stronger smoke-free air laws, a high-intensity media campaign and comprehensive treatment policies are each potent policies to reduce smoking prevalence and smoking-attributable premature deaths in Russia. With the stronger set of policies, the model estimates that, relative to the status quo trend, smoking prevalence can be reduced by as much as 30% by 2020, with a 50% reduction projected by 2055. This translates into 2 684 994 male and 1 011 985 female premature deaths averted from 2015-2055. SimSmoke results highlight the relative contribution of policies to reducing the tobacco health burden in Russia. Significant inroads to reducing smoking prevalence and premature mortality can be achieved through strengthening tobacco control policies in line with FCTC recommendations. 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.
Mitchell, Andrew; Sheargold, Elizabeth
Since the adoption of the WHO's WHO Framework Convention on Tobacco Control, governments have been pursuing progressively stronger and more wide-reaching tobacco control measures. In response, tobacco companies are frequently using international trade and investment agreements as tools to challenge domestic tobacco control measures. Several significant new trade and investment agreements that some fear may provide new legal avenues to the tobacco industry to challenge health measures are currently under negotiation, including the Trans-Pacific Partnership (a 12 party agreement of Asia-Pacific regional countries) and the Transatlantic Trade and Investment Partnership (an agreement between the USA and the European Union). This commentary examines different options for treaty provisions that the parties could employ in these agreements to minimise legal risks relating to tobacco control measures. It recommends that parties take a comprehensive approach, combining provisions that minimise the potential costs of litigation with provisions that increase the likelihood of a state successfully defending tobacco control measures in such litigation. 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.
Hipple, Bethany; Lando, Harry; Klein, Jonathan; Winickoff, Jonathan
Worldwide, the burden of suffering to children caused by tobacco does not just originate from exposure to tobacco smoke or smoking, but includes exposure to tobacco-friendly media, poverty associated with money spent on tobacco, increased incidence of tobacco-related fires, and the harms related to child labor in tobacco cultivation. Despite global efforts through human rights acts, the Framework Convention on Tobacco Control, and the MPOWER report, tobacco use continues to accelerate in most countries. While the efforts that have been taken, such as smoking bans in public, are worthy actions, not enough is being done to protect children and teens. More can be done at the policy level, by individuals, and by health care providers. Copyright © 2011 Mosby, Inc. All rights reserved.
Dai, Hongying; Hao, Jianqiang
Under the 2009 Family Smoking Prevention and Tobacco Control Act , the Food and Drug Administration (FDA) has been routinely inspecting tobacco retailers' compliance with under-age sales laws. We seek to identify factors associated with Retail Violation Rate for sale to minors (RVRm). We collected the tobacco retailer inspection data for 2015 from the FDA compliance check database. RVRm was calculated at the census tract level and overlaid with tobacco regulations and youth smoking prevalence at the state level. Multi-level spatial analysis was performed to examine the impacts of tobacco jurisdiction variations, youth smoking rates and neighbourhood social characteristics on RVRm. A total of 136 816 compliance checks involving minors conducted by the FDA in 2015 were analysed. A higher RVRm was associated with higher youth smoking prevalence (aRR=1.04, pTobacco regulations show significant relationships with RVRm. For every one dollar increase in cigarette tax per pack, the likelihood of retail violations was reduced by 2% (aRR=0.98, p=0.03). For every 10% increase in tobacco prevention spending towards Centers for Disease Control recommended funding targets, the likelihood of retail violations was reduced by 1% (aRR=0.99, p=0.01). RVRm increased in states that enacted stronger smoke-free air policies (aRR=1.08, ptobacco regulations and neighbourhood social characteristics with tobacco retailers' compliance with under-age sales laws. This study provides evidence to support stronger tobacco regulations and control policies in reducing youth access to tobacco products. © 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.
Angela M. Jackson-Morris
Full Text Available The MPOWER policy package enables countries to implement effective, evidence-based strategies to address the threat posed to their population by tobacco. All countries have challenges to overcome when implementing tobacco control policy. Some are generic such as tobacco industry efforts to undermine and circumvent legislation; others are specific to national or local context. Various factors influence how successfully challenges are addressed, including the legal-political framework for enforcement, public and administrative attitudes towards the law, and whether policy implementation measures are undertaken. This paper examines District Tobacco Control Taskforces, a flexible policy mechanism developed in Bangladesh to support the implementation of the Smoking and Tobacco Products Usage (Control Act 2005 and its 2013 Amendment. At the time of this study published research and/or data was not available and understanding about these structures, their role, contribution, limitations and potential, was limited. We consider Taskforce characteristics and suggest that the “package” comprises a distinctive tobacco control implementation model. Qualitative data is presented from interviews with key informants in ten districts with activated taskforces (n = 70 to provide insight from the perspectives of taskforce members and non-members. In all ten districts taskforces were seen as a crucial tool for tobacco control implementation. Where taskforces were perceived to be functioning well, current positive impacts were perceived, including reduced smoking in public places and tobacco advertising, and increased public awareness and political profile. In districts with less well established taskforces, interviewees believed in their taskforce’s ‘potential’ to deliver similar benefits once their functioning was improved. Recommendations to improve functioning and enhance impact were made. The distinctive taskforce concept and lessons from their
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
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.
Drope, Jeffrey; Chavez, Jenina Joy
For more than two decades, public health scholars and proponents have demonstrated concern about the negative effects of trade liberalisation on tobacco control policies. However, there is little theoretically-guided, empirical research across time and space that evaluates this relationship. Accordingly, we use one major region that has experienced rapid and significant recent liberalisation, Southeast Asia, and examine key tobacco control-relevant outcomes between 1999 and 2012. While we find a modest increase in regional trade in tobacco products in some countries, the effects on tobacco affordability and consumption are very mixed with no clear link to liberalisation. We argue that widespread penetration of the region by transnational tobacco firms is likely mitigating the effects of trade liberalisation. Notably, tobacco control policies have also generally improved across the region, part of which is likely the result of successful regional and global efforts by civil society, governments and intergovernmental organisations. The results suggest that scholars and public health proponents should move the focus away from narrow economic aspects of liberalisation toward specific issues that are more likely to affect tobacco control, such as intellectual property rights protections and investor-state dispute settlement. 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.
Shafer, Paul R; Davis, Kevin C; Patel, Deesha; Rodes, Robert; Beistle, Diane
In 2012, the US Centers for Disease Control and Prevention (CDC) launched Tips From Former Smokers (Tips), the first federally funded national tobacco education campaign. In 2013, a follow-up Tips campaign aired on national cable television networks, radio, and other channels, with supporting digital advertising to drive traffic to the Tips campaign website. The objective of this study was to use geographic and temporal variability in 2013 Tips campaign television media doses and ad tagging to evaluate changes in traffic to the campaign website in response to specific doses of campaign media. Linear regression models were used to estimate the dose-response relationship between weekly market-level television gross rating points (GRPs) and weekly Web traffic to the Tips campaign website. This relationship was measured using unique visitors, total visits, and page views as outcomes. Ad GRP effects were estimated separately for ads tagged with the Tips campaign website URL and 1-800-QUIT-NOW. In the average media market, an increase of 100 television GRPs per week for ads tagged with the Tips campaign website URL was associated with an increase of 650 unique visitors (Padvertising efforts on consumers' use of campaign-specific websites.
Levy, David T; Huang, An-Tsun; Currie, Laura M; Clancy, Luke
This article compares the predicted impact of tobacco tax increases alone and as part of a comprehensive tobacco control strategy on smoking prevalence and smoking-attributable deaths (SADs) across 15 European countries. Country-specific population, smoking prevalence and policy data with modified parameter values have been applied to the previously validated SimSmoke model for 10 high-income and 5 middle-income European nations. The impact of past and potential future policies is modelled. Models generally validated well across the 15 countries, and showed the impact of past policies. Without stronger future policies, 44 million lives would be lost due to smoking across the 15 study countries between 2011 and 2040, but effective policies could avert 7.7 million of those premature deaths. Results suggest that past policies have been effective in reducing smoking rates, but there is also a strong potential for future policies consistent with the Framework Convention on Tobacco Control. When specific taxes are increased to 70% of retail price, strong smoke-free air laws, youth access laws and marketing restrictions are enforced, stronger health warnings are implemented, and cessation treatment and media campaigns are supported, smoking prevalence and SADs will fall substantially in European countries. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.
The goals of tobacco control endgame strategies are specified in terms of the desired levels of tobacco use and/or tobacco related health consequences. Yet the strategies being considered may have other consequences beyond tobacco use prevalence, forms and related harms. Most of the proposed strategies threaten to create large black markets with potential attendant harms: corruption, high illegal earnings, violence and/or organised crime. Western societies of course have considerable experience with these problems in the context of prohibition of drugs such as cannabis, cocaine, heroin and methamphetamine. These experiences suggest that low prevalence has been achieved only by tough enforcement with damaging unintended consequences. Tobacco prohibition (total or partial) may not present the same trade-off but there is little basis for making a projection of the scale, form and harms of the attendant black markets. Nonetheless, these harms should not be ignored in analyses of the endgame proposals.
Lam, T S; Tse, L A; Yu, I T; Griffiths, S
To investigate the prevalence of active smoking and environmental tobacco smoke (ETS) exposure among medical students in Hong Kong, and their attitudes and beliefs towards tobacco control. A cross-sectional survey with a self-administrated questionnaire. All medical students from a university in Hong Kong were invited to participate in this survey and completed structured questionnaires. Descriptive data analyses were performed. In total, 313 medical students participated in this study (response rate 44.7%). Only 7.2% [95% confidence interval (CI) 4.3-10.1] reported having ever smoked and 0.7% (95% CI 0-1.6%) were current smokers. ETS exposure at home was reported by 19.3% (95% CI 14.9-23.8) of students, but the proportion of ETS exposure in public places was much higher (61.6%, 95% CI 56.2-67.1%). More than 85% of students had positive attitudes towards tobacco control, but 30.8% (95% CI 25.6-36.0) disagreed with banning smoking in disco/bars/pubs. Although the majority (93.1%, 95% CI 90.3-96.0) of students thought that health professionals should receive specific training for counselling on smoking cessation, only 38.0% (95% CI 32.5-43.5) reported having received any formal training in this area. This study suggests that a specific professional training programme, including counselling on smoking cessation and actions on legislation and tobacco tax policy, should be built into the undergraduate medical curriculum.
Springvloet, L.; Willemsen, M. C.; Mons, U.; van den Putte, B.; Kunst, A. E.; Guignard, R.; Hummel, K.; Allwright, S.; Siahpush, M.; de Vries, H.; Nagelhout, G. E.
This study examined educational differences in associations of noticing anti-tobacco information with smoking-related attitudes and quit intentions among adult smokers. Longitudinal data (N = 7571) from two waves of six countries of the International Tobacco Control (ITC) Europe Surveys were included. Generalized estimating equation analyses and…
The Framework Convention on Tobacco Control has been effective as of February 2005. This is an epoch making event for the world tobacco control. However, in Japan, almost nothing has been changed due to the intrusion of the tobacco industry and Ministry of Finance. In article 8, the Government still cannot pass a law to protect Japanese people from passive smoking. In article 11, Ministry of Finance is still permitting an old package. In article 13, no restriction is possible except a self-imposed control. Japan Society for Tobacco Control has made a passive smoking prevention bill and presented a petition to the Minister of Health, Labor and Welfare with related 4 bills. Cooperation, money and champion are the three most important issues that we have to pursue.
Lee, Chung-Yol MD, MPH; Glantz, Stanton A. Ph.D.
Cigarette consumption among people 15 years or older peaked in Switzerland in the early 1970’s with 3,700 cigarettes per capita and per year, followed by a decline to 2,800 cigarettes per capita and per year in 1994. After a decline of the proportion of smokers from 37% in 1980 to 31% in 1992, this proportion has increased again to 33% in 1997. Women, particularly the young, and children and adolescents, have shown a continued increase in smoking prevalence, despite the focus of tobacco preve...
Minh, Hoang Van; Ngan, Tran Thu; Mai, Vu Quynh; My, Nguyen Thi Tuyet; Chung, Le Hong; Kien, Vu Duy; Anh, Tran Tuan; Ngoc, Nguyen Bao; Giap, Vu Van; Cuong, Nguyen Manh; Manh, Pham Duc; Giang, Kim Bao
In Vietnam, the WHO Framework Convention on Tobacco Control (WHO FCTC) took effect in March 2005 while MPOWER has been implemented since 2008. This paper describes the progress and challenges of implementation of the MPOWER package in Vietnam. We can report that, in term of monitoring, Vietnam is very active in the Global Tobacco Surveillance System, completing two rounds of the Global Adult Tobacco Survey (GATS) and three rounds of the Global Youth Tobacco Survey (GYTS). To protect people from tobacco smoke, Vietnam has issued and enforced a law requiring comprehensive smoking bans at workplaces and public places since 2013. Tobacco advertising and promotion are also prohibited with the exception of points of sale displays of tobacco products. Violations come in the form of promotion girls, corporate social responsibility activities from tobacco manufacturers and packages displayed by retail vendors. Vietnam is one of the 77 countries that require pictorial health warnings to be printed on cigarette packages to warn about the danger of tobacco and the warnings have been implemented effectively. Cigarette tax is 70% of factory price which is equal to less than 45% of retail price and much lower than the recommendation of WHO. However, Vietnam is one of the very few countries that require manufacturers and importers to make "compulsory contributions" at 1-2% of the factory price of cigarettes sold in Vietnam for the establishment of a Tobacco Control Fund (TCF). The TCF is being operated well. In 2015, 67 units of 63 provinces/cities, 22 ministries and political-social organizations and 6 hospitals received funding from TCF to implement a wide range of tobacco control activities. Cessation services have been starting with a a toll-free quit-line but need to be further strengthened. In conclusion, Vietnam has constantly put efforts into the tobacco control field with high commitment from the government, scientists and activists. Though several remarkable achievements
Allison M. Schmidt
Full Text Available Tobacco use, the leading cause of preventable death in the U.S., can be reduced through state-level tobacco prevention and cessation programs. In the absence of research about how to communicate the need for these programs to policymakers, this qualitative study aimed to understand the motivations and priorities of policymakers in North Carolina, a state that enacted a strong tobacco control program from 2003–2011, but drastically reduced funding in recent years. Six former legislators (three Democrats, three Republicans and three lobbyists for health organizations were interviewed about their attitudes towards tobacco use, support of state-funded programs, and reactions to two policy briefs. Five themes emerged: (1 high awareness of tobacco-related health concerns but limited awareness of program impacts and funding, (2 the primacy of economic concerns in making policy decisions, (3 ideological differences in views of the state’s role in tobacco control, (4 the impact of lobbyist and constituent in-person appeals, and (5 the utility of concise, contextualized data. These findings suggest that building relationships with policymakers to communicate ongoing program outcomes, emphasizing economic data, and developing a constituent advocacy group would be valuable to encourage continued support of state tobacco control programs.
Assunta, Mary; Dorotheo, E Ulysses
To measure the implementation of WHO Framework Convention on Tobacco Control (FCTC) Article 5.3 at country level using a new Tobacco Industry Interference Index and to report initial results using this index in seven Southeast Asian countries. Score sheet based on WHO FCTC Article 5.3 Guidelines sent to correspondents in seven Southeast Asian countries, using a scoring system designed with the help of tobacco control experts and validated through focused group discussions. The seven countries ranked from the lowest level of interference to the highest are Brunei, Thailand, Lao PDR, Cambodia, Philippines, Malaysia and Indonesia. Countries that face high levels of unnecessary interaction with the tobacco industry also face high levels of tobacco industry influence in policy development. Most governments do not allow any tobacco industry representatives on their delegation to sessions of the Conference of the Parties or its subsidiary bodies nor accept their sponsorship for delegates, but most governments still accept or endorse offers of assistance from the tobacco industry in implementing tobacco control policies. Most governments also receive tobacco industry contributions (monetary or in kind) or endorse industry corporate social responsibility activities. Governments do not have a procedure for disclosing interactions with the tobacco industry, but Lao PDR, Philippines and Thailand have instituted measures to prevent or reduce industry interference. This Tobacco Industry Interference Index, based on the WHO FCTC Article 5.3 Guidelines, is a useful advocacy tool for identifying both progress and gaps in national efforts at implementing WHO FCTC Article 5.3. 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/
Assunta, Mary; Dorotheo, E Ulysses
Objective To measure the implementation of WHO Framework Convention on Tobacco Control (FCTC) Article 5.3 at country level using a new Tobacco Industry Interference Index and to report initial results using this index in seven Southeast Asian countries. Methods Score sheet based on WHO FCTC Article 5.3 Guidelines sent to correspondents in seven Southeast Asian countries, using a scoring system designed with the help of tobacco control experts and validated through focused group discussions. Results The seven countries ranked from the lowest level of interference to the highest are Brunei, Thailand, Lao PDR, Cambodia, Philippines, Malaysia and Indonesia. Countries that face high levels of unnecessary interaction with the tobacco industry also face high levels of tobacco industry influence in policy development. Most governments do not allow any tobacco industry representatives on their delegation to sessions of the Conference of the Parties or its subsidiary bodies nor accept their sponsorship for delegates, but most governments still accept or endorse offers of assistance from the tobacco industry in implementing tobacco control policies. Most governments also receive tobacco industry contributions (monetary or in kind) or endorse industry corporate social responsibility activities. Governments do not have a procedure for disclosing interactions with the tobacco industry, but Lao PDR, Philippines and Thailand have instituted measures to prevent or reduce industry interference. Conclusions This Tobacco Industry Interference Index, based on the WHO FCTC Article 5.3 Guidelines, is a useful advocacy tool for identifying both progress and gaps in national efforts at implementing WHO FCTC Article 5.3. PMID:25908597
Teaching tobacco dependence treatment and counseling skills during medical school: rationale and design of the Medical Students helping patients Quit tobacco (MSQuit) group randomized controlled trial.
Hayes, Rashelle B; Geller, Alan; Churchill, Linda; Jolicoeur, Denise; Murray, David M; Shoben, Abigail; David, Sean P; Adams, Michael; Okuyemi, Kola; Fauver, Randy; Gross, Robin; Leone, Frank; Xiao, Rui; Waugh, Jonathan; Crawford, Sybil; Ockene, Judith K
Physician-delivered tobacco treatment using the 5As is clinically recommended, yet its use has been limited. Lack of adequate training and confidence to provide tobacco treatment is cited as leading reasons for limited 5A use. Tobacco dependence treatment training while in medical school is recommended, but is minimally provided. The MSQuit trial (Medical Students helping patients Quit tobacco) aims to determine if a multi-modal and theoretically-guided tobacco educational intervention will improve tobacco dependence treatment skills (i.e. 5As) among medical students. 10 U.S. medical schools were pair-matched and randomized in a group-randomized controlled trial to evaluate whether a multi-modal educational (MME) intervention compared to traditional education (TE) will improve observed tobacco treatment skills. MME is primarily composed of TE approaches (i.e. didactics) plus a 1st year web-based course and preceptor-facilitated training during a 3rd year clerkship rotation. The primary outcome measure is an objective score on an Objective Structured Clinical Examination (OSCE) tobacco-counseling smoking case among 3rd year medical students from schools who implemented the MME or TE. MSQuit is the first randomized to evaluate whether a tobacco treatment educational intervention implemented during medical school will improve medical students' tobacco treatment skills. We hypothesize that the MME intervention will better prepare students in tobacco dependence treatment as measured by the OSCE. If a comprehensive tobacco treatment educational learning approach is effective, while also feasible and acceptable to implement, then medical schools may substantially influence skill development and use of the 5As among future physicians. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.
Hawkins, Summer Sherburne; Bach, Nicoline; Baum, Christopher F
Our aims were to examine the impact of cigarette taxes and smoke-free legislation on current adolescent smoking and smoking frequency overall as well as test whether there were differential policy effects by age. Using data on 717,543 adolescents from 43 states in the 1999-2013 Youth Risk Behavior Surveys, we used difference-in-differences regression models to evaluate the impact of tobacco control policies on current adolescent smoking (yes/no) and, separately, smoking frequency (defined as 0, 1-5, 6-29, 30+ days per month). We tested an interaction between age and cigarette taxes and, separately, smoke-free legislation. From 1999 to 2013, adolescent smoking decreased from 35.3% to 13.9% and 41 of 43 states increased their cigarette tax in real terms by an average of 257%. By the end of the study period, 29 of 43 states had 100% smoke-free restaurant legislation. Although we found no overall effect of cigarette taxes on current smoking, there was a significant interaction by age. Among 14- and 15-year olds, every $1.00 cigarette tax increase was associated with a 2.2 and 1.6 percentage point reduction in smoking, respectively. The enactment of 100% smoke-free restaurant legislation was associated with an overall reduction in adolescent smoking by 1.1 percentage points and there were no differences by age. Cigarette taxes and smoke-free legislation were also associated with decreased smoking frequency. The youngest adolescents are the most price sensitive, and cigarette taxes continue to be a successful approach to reduce adolescent smoking. Smoke-free legislation may also be an effective strategy to reduce smoking among all adolescents. Copyright © 2016 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Bump, Jesse B; Reich, Michael R
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.
Takanori Adachi; Yoichi Hizen
Are anti-establishment mass media really useful in preventing politicians from behaving dishonestly? This paper proposes a voting model for analyzing how differences in the direction of media bias affect politicians' behavior. In particular, the probability of corruption by an incumbent is higher (than that in the case of no media bias) if and only if the mass media have some degree of "anti-incumbent" bias (i.e., information favorable to the incumbent is converted into unfavorable news about...
Husten, Corinne G; Deyton, Lawrence R
The USA has a rich history of public health efforts to reduce morbidity and mortality from tobacco use. Comprehensive tobacco-prevention programmes, when robustly implemented, reduce the prevalence of youth and adult smoking, decrease cigarette consumption, accelerate declines in tobacco-related deaths, and diminish health-care costs from tobacco-related diseases. Effective public health interventions include raising the price of tobacco products, smoke-free policies, counter-marketing campaigns, advertising restrictions, augmenting access to treatment for tobacco use through insurance coverage and telephone help lines, and comprehensive approaches to prevent children and adolescents from accessing tobacco products. The US Food and Drug Administration (FDA) has six major areas of regulatory authority: regulation of tobacco products; regulation of the advertising, marketing, and promotion of tobacco products; regulation of the distribution and sales of tobacco products; enforcement of the provisions of the Tobacco Control Act and tobacco regulations; regulatory science to support FDA authorities and activities; and public education about the harms of tobacco products and to support FDA regulatory actions. With passing of the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act) in June, 2009, important new regulatory approaches were added to the tobacco prevention and control arsenal. Copyright © 2013 Elsevier Ltd. All rights reserved.
Lyons, Ailsa; McNeill, Ann; Britton, John
Smoking in films is a common and well documented cause of youth smoking experimentation and uptake and hence a significant health hazard. The extent of exposure of young people to tobacco imagery in television programming has to date been far less investigated. We have therefore measured the extent to which tobacco content occurs in prime time UK television, and estimated exposure of UK youth. The occurrence of tobacco, categorised as actual tobacco use, implied tobacco use, tobacco paraphernalia, other reference to tobacco, tobacco brand appearances or any of these, occurring in all prime time broadcasting on the five most popularly viewed UK television stations during 3 separate weeks in 2010 were measured by 1-minute interval coding. Youth exposure to tobacco content in the UK was estimated using media viewing figures. Actual tobacco use, predominantly cigarette smoking, occurred in 73 of 613 (12%) programmes, particularly in feature films and reality TV. Brand appearances were rare, occurring in only 18 programmes, of which 12 were news or other factual genres, and 6 were episodes of the same British soap opera. Tobacco occurred with similar frequency before as after 21:00, the UK watershed for programmes suitable for youth. The estimated number of incidences of exposure of the audience aged less than 18 years for any tobacco, actual tobacco use and tobacco branding were 59 million, 16 million and 3 million, respectively on average per week. Television programming is a source of significant exposure of youth to tobacco imagery, before and after the watershed. Tobacco branding is particularly common in Coronation Street, a soap opera popular among youth audiences. More stringent controls on tobacco in prime time television therefore have the potential to reduce the uptake of youth smoking in the UK.
Lyons, Ailsa; McNeill, Ann; Britton, John
Background Smoking in films is a common and well documented cause of youth smoking experimentation and uptake and hence a significant health hazard. The extent of exposure of young people to tobacco imagery in television programming has to date been far less investigated. We have therefore measured the extent to which tobacco content occurs in prime time UK television, and estimated exposure of UK youth. Methods The occurrence of tobacco, categorised as actual tobacco use, implied tobacco use, tobacco paraphernalia, other reference to tobacco, tobacco brand appearances or any of these, occurring in all prime time broadcasting on the five most popularly viewed UK television stations during 3 separate weeks in 2010 were measured by 1-minute interval coding. Youth exposure to tobacco content in the UK was estimated using media viewing figures. Findings Actual tobacco use, predominantly cigarette smoking, occurred in 73 of 613 (12%) programmes, particularly in feature films and reality TV. Brand appearances were rare, occurring in only 18 programmes, of which 12 were news or other factual genres, and 6 were episodes of the same British soap opera. Tobacco occurred with similar frequency before as after 21:00, the UK watershed for programmes suitable for youth. The estimated number of incidences of exposure of the audience aged less than 18 years for any tobacco, actual tobacco use and tobacco branding were 59 million, 16 million and 3 million, respectively on average per week. Conclusions Television programming is a source of significant exposure of youth to tobacco imagery, before and after the watershed. Tobacco branding is particularly common in Coronation Street, a soap opera popular among youth audiences. More stringent controls on tobacco in prime time television therefore have the potential to reduce the uptake of youth smoking in the UK. PMID:23479113
Feirman, Shari P; Donaldson, Elisabeth; Glasser, Allison M; Pearson, Jennifer L; Niaura, Ray; Rose, Shyanika W; Abrams, David B; Villanti, Andrea C
The US Food and Drug Administration has expressed interest in using mathematical models to evaluate potential tobacco policies. The goal of this systematic review was to synthesize data from tobacco control studies that employ mathematical models. We searched five electronic databases on July 1, 2013 to identify published studies that used a mathematical model to project a tobacco-related outcome and developed a data extraction form based on the ISPOR-SMDM Modeling Good Research Practices. We developed an organizational framework to categorize these studies and identify models employed across multiple papers. We synthesized results qualitatively, providing a descriptive synthesis of included studies. The 263 studies in this review were heterogeneous with regard to their methodologies and aims. We used the organizational framework to categorize each study according to its objective and map the objective to a model outcome. We identified two types of study objectives (trend and policy/intervention) and three types of model outcomes (change in tobacco use behavior, change in tobacco-related morbidity or mortality, and economic impact). Eighteen models were used across 118 studies. This paper extends conventional systematic review methods to characterize a body of literature on mathematical modeling in tobacco control. The findings of this synthesis can inform the development of new models and the improvement of existing models, strengthening the ability of researchers to accurately project future tobacco-related trends and evaluate potential tobacco control policies and interventions. These findings can also help decision-makers to identify and become oriented with models relevant to their work. © 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: email@example.com.
Full Text Available Background: Tobacco smoking continues to be a major preventable cause of death and disease and therefore tobacco control research is extremely important. However, research in this area is often hampered by a lack in funding and there is a need for scientometric techniques to display research efforts. Methods: The present study combines classical bibliometric tools with novel scientometric and visualizing techniques in order to analyse and categorise research in the field of tobacco control. Results: All studies related to tobacco control and listed in the ISI database since 1900 were identified by the use of defined search terms.Using bibliometric approaches, a continuous increase in qualitative markers such as collaboration numbers or citations were found for tobacco control research. The combination with density equalizing mapping revealed a distinct global pattern of research productivity and citation activity. Radar chart techniques were used to visualize bi- and multilateral research cooperation and institutional cooperation. Conclusions: The present study supplies a first scientometricapproach that visualises research activity in the field of tobacco control. It provides data that can be used for funding policy and the identification of research clusters.
Maina, William K; Kitonyo, Rachael; Ogwell, Ahmed E O
To assess the level of public support for tobacco control policies and to discuss how these findings could be used to influence the legislative process in the passing of tobacco control law in the country. A cross-sectional study conducted in Kenya between March and May 2007 on a random sample of 2021 (991 men and 1030 women) respondents aged 18 years and above. Interviews were done using a structured questionnaire by a research consultancy firm with long-standing experience in public polling. The majority of respondents supported tobacco control policies as proposed by WHO Framework Convention on Tobacco Control. For example, 95% of the respondents supported smoking restrictions in all enclosed public places and workplaces, 94% supported visible health warnings on tobacco product packages, 83% supported a ban on advertisements of cigarettes and tobacco products and 69% supported a ban on sponsorship of events by tobacco companies. However, 60% perceived that there was very little commitment by legislators to tobacco control. There was overwhelming public support for tobacco control policies and a general view that government was not doing enough in implementing policies to protect the public from tobacco harm. This public opinion poll was used as an advocacy tool to generate support among legislators for national tobacco control law.
... Safety Obesity Prescription Drug Overdoses Teen Pregnancy Tobacco Digital Media Tools About Vital Signs Subscribe to RSS ... of tobacco use E nforce bans on tobacco advertising R aise taxes on tobacco Establish comprehensive tobacco ...
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.
Goel, Sonu; Kumar, Ravinder; Lal, Pranay; Tripathi, Jp; Singh, Rana J; Rathinam, Arul; Christian, Anant
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.
Li, Lin; Borland, Ron; Yong, Hua-Hie; Sirirassamee, Buppha; Hamann, Stephen; Omar, Maizurah; Quah, Anne C K
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.
They will incorporate preliminary results from the Global Adult Tobacco Survey, led by the Ministry of Health and the Instituto Conmemorativo Gorgas de Estudios de la Salud in 2012. This data will be integrated into a more structured analysis of demand, with time ranges and cross-sectional data. It will allow researchers to ...
Jul 22, 2011 ... The challenge is to communicate the dangers of tobacco in ways that mesh with the priorities of countries dealing with a multitude of economic and ... One of them is the whole question of why people smoke — whether it helps them cope with stress or regulate their emotional states — a puzzle that's key to ...
Through this initiative, Cancer Research UK and IDRC aim to address the development challenges posed by tobacco use in LMICs. ... Nutrition, health policy, and ethics in the age of public-private partnerships. How are public health actors working with the food and drinks industry to prevent diet-related disease? A new ...
Jul 15, 2011 ... This work provided a further policy foundation for the Minister of Health, who in 1998 announced legislation to ban all tobacco advertising and industry sponsorships, prohibit smoking in public places, prevent the sale of cigarettes to people under 16 years of age, and ban the distribution of free cigarettes as ...
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
Rennen, E.; Nagelhout, G.E.; van den Putte, B.; Janssen, E.; Mons, U.; Guignard, R.; Beck, F.; de Vries, H.; Thrasher, J.F.; Willemsen, M.C.
This study examined whether awareness of tobacco control policies was associated with social unacceptability of smoking and whether social unacceptability had an effect on smoking cessation in three European countries. Representative samples (n = 3865) of adult smokers in France, the Netherlands and
Roberts, Bayard; Stickley, Andrew; Gilmore, Anna B; Danishevski, Kirill; Kizilova, Kseniya; Bryden, Anna; Rotman, David; Haerpfer, Christian; McKee, Martin
To describe levels of knowledge on the harmful effects of tobacco and public support for tobacco control measures in nine countries of the former Soviet Union and to examine the characteristics associated with this knowledge and support. Standardised, cross-sectional nationally representative surveys conducted in 2010/2011 with 18 000 men and women aged 18 years and older in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Respondents were asked a range of questions on their knowledge of the health effects of tobacco and their support for a variety of tobacco control measures. Descriptive analysis was conducted on levels of knowledge and support, along with multivariate logistic regression analysis of characteristics associated with overall knowledge and support scores. Large gaps exist in public understanding of the negative health effects of tobacco use, particularly in Azerbaijan, Kazakhstan, Kyrgyzstan and Moldova. There are also extremely high levels of misunderstanding about the potential effects of 'light' cigarettes. However, there is popular support for tobacco control measures. Over three quarters of the respondents felt that their governments could be more effective in pursuing tobacco control. Higher levels of education, social capital (membership of an organisation) and being a former or never-smoker were associated with higher knowledge on the health effects of tobacco and/or being more supportive of tobacco control measures. Increasing public awareness of tobacco's health effects is essential for informed decision-making by individuals and for further increasing public support for tobacco control measures.
Tee, G H; Hairi, N N; Hairi, F
Physicians should play a leading role in combatting smoking; information on attitudes of future physicians towards tobacco control measures in a middle-income developing country is limited. Of 310 future physicians surveyed in a medical school in Malaysia, 50% disagreed that it was a doctor's duty to advise smokers to stop smoking; 76.8% agreed that physicians should not smoke before advising others not to smoke; and 75% agreed to the ideas of restricting the sale of cigarettes to minors, making all public places smoke-free and banning advertising of tobacco-related merchandise. Future physicians had positive attitudes towards tobacco regulations but had not grasped their responsibilities in tobacco control measures.
Full Text Available Through analysis of the nature and character of media practice, the paper shows that the media are basic political instrument of manipulative social control of the democratic order. Control of social reality as a fundamental social role of the media stems from the manipulative power of the media that is based in the strategies of production and control of the symbolic potential of the society. Through the production and control of the symbolic potential of the society, the media transform symbolic power in social action or absence of social action through homogenization and activate individuals and social groups in public opinion or their dispersion and breaking off in the public. Development of manipulation, control, oppression, domination and hegemony, the media becomes a product of instrumentalist mind which contributing 'colonization of the lifeworld' and the development of modern society which on a rational way becoming totalitarian.
Schmidt, Allison M.; Kowitt, Sarah D.; Myers, Allison E.; Goldstein, Adam O.
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...
Full Text Available Tobacco use is the most important preventable risk factor for premature death. The World Health Organization (WHO Framework Convention on Tobacco Control (FCTC, the first international public health treaty, came into force in 2005. This paper reviews the present status of tobacco control policies in Korea according to the WHO FCTC recommendations. In Korea, cigarette use is high among adult males (48.2% in 2010, and cigarette prices are the lowest among the Organization for Economic Cooperation and Development countries with no tax increases since 2004. Smoke-free policies have shown incremental progress since 1995, but smoking is still permitted in many indoor public places. More than 30% of non-smoking adults and adolescents are exposed to second-hand smoke. Public education on the harmful effects of tobacco is currently insufficient and the current policies have not been adequately evaluated. There is no comprehensive ban on tobacco advertising, promotion, or sponsorship in Korea. Cigarette packages have text health warnings on only 30% of the main packaging area, and misleading terms such as "mild" and "light" are permitted. There are nationwide smoking cessation clinics and a Quitline service, but cessation services are not covered by public insurance schemes and there are no national treatment guidelines. The sale of tobacco to minors is prohibited by law, but is poorly enforced. The socioeconomic inequality of smoking prevalence has widened, although the government considers inequality reduction to be a national goal. The tobacco control policies in Korea have faltered recently and priority should be given to the development of comprehensive tobacco control policies.
Springvloet, L; Willemsen, M C; Mons, U; van den Putte, B; Kunst, A E; Guignard, R; Hummel, K; Allwright, S; Siahpush, M; de Vries, H; Nagelhout, G E
This study examined educational differences in associations of noticing anti-tobacco information with smoking-related attitudes and quit intentions among adult smokers. Longitudinal data (N = 7571) from two waves of six countries of the International Tobacco Control (ITC) Europe Surveys were included. Generalized estimating equation analyses and multiple linear and logistic regression analyses were conducted. Higher educated smokers noticed anti-tobacco information slightly more often than lower educated smokers (F(2) = 25.78, P educational differences were found in the association of noticing anti-tobacco information with smoking-related attitudes but associations with quit intentions were found only among low (OR = 1.12, P = 0.001) and high educated respondents (OR = 1.11, P educated respondents (OR = 1.02, P = 0.43). Noticing anti-tobacco information may positively influence quit intentions and possibly smoking-related attitudes. Lower educated smokers were as likely to be influenced by anti-tobacco information as higher educated smokers but noticed anti-tobacco information less often; increasing reach of anti-tobacco information may increase impact in this group. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: firstname.lastname@example.org.
Morrow, Martha; Barraclough, Simon
In the World Health Organization's Western Pacific Region, being born male is the single greatest risk marker for tobacco use. While the literature demonstrates that risks associated with tobacco use may vary according to sex, gender refers to the socially determined roles and responsibilities of men and women, who initiate, continue and quit using tobacco for complex and often different reasons. Cigarette advertising frequently appeals to gender roles. Yet tobacco control policy tends to be gender-blind. Using a broad gender-sensitivity framework, this contradiction is explored in four Western Pacific countries. Part I of the study discusses issues surrounding gender and tobacco, and analyses developments in Malaysia and the Philippines. Part II deals with Singapore and Vietnam. In all four countries, gender was salient for the initiation and maintenance of smoking, and in Malaysia and the Philippines was highly significant in cigarette promotion. Yet, with a few exceptions, gender was largely unrecognized in control policy. Suggestions for overcoming this weakness in order to enhance tobacco control are made in Part II.
Mutlu, Erdem İlker; Seydioğulları, Mustafa; Aslan, Dilek
The Framework Convention on Tobacco Control is a multilateral international agreement which has been generated to protect the health of nationals and nations against the hazards/risks of tobacco and its products. All high contracting parties to the Convention undertake the international responsibility to fulfill all the requirements of the Convention’s articles in national legal systems. The Framework Convention on Tobacco Control has a considerable place among other international conventions on health. Within the self-executing desing/system of the Convention, a vital regulation focuses on banning the advertisement, promotion, and sponsorship of tobacco products. Because they are one of the various components of tobacco advertisement, promotion, and sponsorship, taste panels should be assessed within the content of the Convention. Thus, banning taste panel activities is an important step in tobacco control and it is one of the basic areas where medical and law sciences should collaborate. In this article, a comprehensive frame has been drawn to the issue and recommendations have been developed for the future. PMID:29404102
Morrow, Martha; Barraclough, Simon
In the World Health Organization's Western Pacific Region, being born male is the single greatest risk marker for tobacco use. While the literature demonstrates that risks associated with tobacco use may vary according to sex, gender refers to the socially determined roles and responsibilities of men and women, who initiate, continue and quit using tobacco for complex and often different reasons. Cigarette advertising frequently appeals to gender roles. Yet tobacco control policy tends to be gender-blind. Using a broad, gender-sensitivity framework, this contradiction is explored in four Western Pacific countries. Part I of the study presented the rationale, methodology and design of the study, discussed issues surrounding gender and tobacco, and analysed developments in Malaysia and the Philippines (see the previous issue of this journal). Part II deals with Singapore and Vietnam. In all four countries gender was salient for the initiation and maintenance of smoking. Yet, with a few exceptions, gender was largely unrecognized in control policy. Suggestions for overcoming this weakness in order to enhance tobacco control are made.
Huang, Song-Lih; Lin, I-Feng; Chen, Chuan-Yu; Tsai, Tzu-I
To assess the impact of a set of comprehensive tobacco control policies implemented in Taiwan in 2009, including extensive smoke-free policy, advertisement ban, pictorial warning and price increase, on adolescent smoking prevalence. Five waves of cross-sectional surveys. Taiwan, 2004-11. Nationally representative sample of junior high schools aged 13-15 years, in a biennial survey, total sample size 101,100. Core questionnaire of the Global Youth Tobacco Survey, including ever smoking, 30-day smoking and number of cigarettes smoked. The magnitude of prevalence change before and after the 2009 policy implementation was quantified by adjusted odds ratios estimated by piecewise logistic regression models. The 30-day smoking prevalence demonstrated an upward trend [odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.02-1.10] between 2004 and 2008. Significant decline in 30-day smoking prevalence after the 2009 law implementation was observed (OR = 0.84, 95% CI = 0.71-0.99). Those living in non-city areas demonstrated a greater magnitude of change. In addition to changes in prevalence, we observed some delay in the age starting smoking, reduction in smokers who smoke fewer than one cigarette per day, and decrease in smokers who did not buy cigarettes. The decline in smoking prevalence was contributed primarily by the reduction in experimenters. The comprehensive tobacco control programme introduced in Taiwan in 2009 was associated with a reduction in adolescent smoking, particularly among those in earlier stages of smoking and those who resided in non-city areas. © 2013 Society for the Study of Addiction.
Stillman, Frances A; Schmitt, Carol L; Rosas, Scott R
Collaborations between cancer prevention and tobacco control programs can leverage scarce resources to address noncommunicable diseases globally, but barriers to cooperation and actual collaboration are substantial. To foster collaboration between cancer prevention and tobacco control programs, the Global Health Partnership conducted research to identify similarities and differences in how the 2 programs viewed program success. Using concept mapping, cancer prevention and tobacco control experts generated statements describing the components of a successful cancer prevention or tobacco control program and 33 participants sorted and rated the final 99 statements. Multidimensional scaling analysis with a 2-dimensional solution was used to identify an 8-cluster conceptual map of program success. We calculated Pearson correlation coefficients for all 99 statements to compare the item-level ratings of both groups and used t tests to compare the mean importance of ratings assigned to each cluster. Eight major clusters of success were identified: 1) advocacy and persuasion, 2) building sustainability, 3) partnerships, 4) readiness and support, 5) program management fundamentals, 6) monitoring and evaluation, 7) utilization of evidence, and 8) implementation. We found no significant difference between the maps created by the 2 groups and only 1 mean difference for the importance ratings for 1 of the clusters: cancer prevention experts rated partnerships as more important to program success than did tobacco control experts. Our findings are consistent with those of research documenting the necessary components of successful programs and the similarities between cancer prevention and tobacco control. Both programs value the same strategies to address a common risk factor: tobacco use. Identifying common ground between these 2 research and practice communities can benefit future collaborations at the local, state, tribal, national, and international levels, and inform the
Full Text Available We simulated tobacco control and pharmacological strategies for preventing cardiovascular deaths in India, the country that is expected to experience more cardiovascular deaths than any other over the next decade.A microsimulation model was developed to quantify the differential effects of various tobacco control measures and pharmacological therapies on myocardial infarction and stroke deaths stratified by age, gender, and urban/rural status for 2013 to 2022. The model incorporated population-representative data from India on multiple risk factors that affect myocardial infarction and stroke mortality, including hypertension, hyperlipidemia, diabetes, coronary heart disease, and cerebrovascular disease. We also included data from India on cigarette smoking, bidi smoking, chewing tobacco, and secondhand smoke. According to the model's results, smoke-free legislation and tobacco taxation would likely be the most effective strategy among a menu of tobacco control strategies (including, as well, brief cessation advice by health care providers, mass media campaigns, and an advertising ban for reducing myocardial infarction and stroke deaths over the next decade, while cessation advice would be expected to be the least effective strategy at the population level. In combination, these tobacco control interventions could avert 25% of myocardial infarctions and strokes (95% CI: 17%-34% if the effects of the interventions are additive. These effects are substantially larger than would be achieved through aspirin, antihypertensive, and statin therapy under most scenarios, because of limited treatment access and adherence; nevertheless, the impacts of tobacco control policies and pharmacological interventions appear to be markedly synergistic, averting up to one-third of deaths from myocardial infarction and stroke among 20- to 79-y-olds over the next 10 y. Pharmacological therapies could also be considerably more potent with further health system
Basu, Sanjay; Glantz, Stanton; Bitton, Asaf; Millett, Christopher
We simulated tobacco control and pharmacological strategies for preventing cardiovascular deaths in India, the country that is expected to experience more cardiovascular deaths than any other over the next decade. A microsimulation model was developed to quantify the differential effects of various tobacco control measures and pharmacological therapies on myocardial infarction and stroke deaths stratified by age, gender, and urban/rural status for 2013 to 2022. The model incorporated population-representative data from India on multiple risk factors that affect myocardial infarction and stroke mortality, including hypertension, hyperlipidemia, diabetes, coronary heart disease, and cerebrovascular disease. We also included data from India on cigarette smoking, bidi smoking, chewing tobacco, and secondhand smoke. According to the model's results, smoke-free legislation and tobacco taxation would likely be the most effective strategy among a menu of tobacco control strategies (including, as well, brief cessation advice by health care providers, mass media campaigns, and an advertising ban) for reducing myocardial infarction and stroke deaths over the next decade, while cessation advice would be expected to be the least effective strategy at the population level. In combination, these tobacco control interventions could avert 25% of myocardial infarctions and strokes (95% CI: 17%-34%) if the effects of the interventions are additive. These effects are substantially larger than would be achieved through aspirin, antihypertensive, and statin therapy under most scenarios, because of limited treatment access and adherence; nevertheless, the impacts of tobacco control policies and pharmacological interventions appear to be markedly synergistic, averting up to one-third of deaths from myocardial infarction and stroke among 20- to 79-y-olds over the next 10 y. Pharmacological therapies could also be considerably more potent with further health system improvements. Smoke
Rose, Shyanika W; Emery, Sherry L; Ennett, Susan; Reyes, Heathe Luz McNaughton; Scott, John C; Ribisl, Kurt M
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.
Bosdriesz, Jizzo R; Willemsen, Marc C; Stronks, Karien; Kunst, Anton E
There has been much variation between European countries in the development of tobacco control policy. Not much is known about the factors that shape this variation. This study aimed to assess the role of political factors in tobacco control policy development. We used data from 11 European countries from 1996 to 2010. Multilevel regression modelling was used to investigate associations between the Tobacco Control Scale (TCS) and indicators of left-wing government and government effectiveness (policy formulation, implementation and enforcement), with control for confounders. An association was found between left-wing government and TCS over the period 1996-2003, but not over the whole period. The association between government effectiveness and TCS was significant and negative over the whole period, but positive between 2001 and 2005. Residual analysis showed that TCS scores from 2002 onwards were higher than expected based on the political factors. Associations varied among the five subscales of the TCS. The results suggest that, on the whole, national political factors have had only a minor influence on the large variations in tobacco control policy development in Europe over the last 15 years. However, there are indications that left-wing governments were important for early adoption of tobacco control policy, and high government effectiveness was important in the phase of adopting innovative policies. However, since 2002, with the advent of international treaties, the influence of national politics has diminished. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Full Text Available There is now 50-years of experience in the United States litigating against the tobacco industry. As the base of evidence regarding health effects has evolved and new legal strategies have emerged, successive waves of litigation have occurred. The many failures by the first and second waves were followed by some notable successes in the third. Litigation by flight attendants and the states led to substantial settlements and some beneficial consequences for tobacco control. One of the most significant consequences of state litigation was access to the industry's documents, gained through the Minnesota settlement. These documents further empowered the tobacco control movement and strengthened the basis for legal action. The continuing litigation in the United States remains a threat to the industry, in spite of the mixed outcomes of recent cases.Existe en los Estados Unidos una experiencia 50 años de litigios contra la industria del tabaco. La base de evidencia recopilada en relación con los efectos de la salud ha respaldado una nueva estrategia legal, lo que a su vez ha desencadenado sucesivas oleadas de conflicto. Los errores de la primera y segunda oleada fueron relevados por algunos éxitos notables en la tercera. Asimismo, los pleitos con asistentes de vuelos y con los estados condujeron al establecimiento substancial de algunos beneficios para controlar el consumo de tabaco. Uno de los resultados más significativos de litigio estatal ganado en el estado de Minnesota fue el acceso a los documentos de la industria. Estos documentos fomentaron el movimiento del control del tabaco y consolidaron la base para su demanda legal. Así, el continuo pleito en los Estados Unidos sigue siendo una amenaza para la industria tabacalera, a pesar de los resultados contradictorios de casos recientes.
Levy, David T; Jeon, Jihyoun; Clarke, John; Gilkeson, Scott; Hall, Tim; Holford, Theodore R; Meza, Rafael
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
Crosbie, Eric; Sosa, Particia; Glantz, Stanton A
Describe the process of enacting and defending strong tobacco packaging and labelling regulations in Uruguay amid Philip Morris International's (PMI) legal threats and challenges. Triangulated government legislation, news sources and interviews with policy-makers and health advocates in Uruguay. In 2008 and 2009, the Uruguayan government enacted at the time the world's largest pictorial health warning labels (80% of front and back of package) and prohibited different packaging or presentations for cigarettes sold under a given brand. PMI threatened to sue Uruguay in international courts if these policies were implemented. The Vazquez administration maintained the regulations, but a week prior to President Vazquez's successor, President Mujica, took office on 1 March 2010 PMI announced its intention to file an investment arbitration dispute against Uruguay in the International Centre for the Settlement of Investment Disputes. Initially, the Mujica administration announced it would weaken the regulations to avoid litigation. In response, local public health groups in Uruguay enlisted former President Vazquez and international health groups and served as brokers to develop a collaboration with the Mujica administration to defend the regulations. This united front between the Uruguayan government and the transnational tobacco control network paid off when Uruguay defeated PMI's investment dispute in July 2016. To replicate Uruguay's success, other countries need to recognise that strong political support, an actively engaged local civil society and financial and technical support are important factors in overcoming tobacco industry's legal threats to defend strong public health regulations. © 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.
Kasza, Karin A; Hyland, Andrew J; Brown, Abraham; Siahpush, Mohammad; Yong, Hua-Hie; McNeill, Ann D; Li, Lin; Cummings, K Michael
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.
Kasza, Karin A.; Hyland, Andrew J.; Brown, Abraham; Siahpush, Mohammad; Yong, Hua-Hie; McNeill, Ann D.; Li, Lin; Cummings, K. Michael
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
K. Michael Cummings
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.
Full Text Available Introduction: India is the second largest consumer of tobacco in the world, and varieties of both smoked and smokeless tobacco products are widely available. The national program for tobacco control is run like a vertical stand-alone program. There is a lack of understanding of existing opportunities and barriers within the health programs that influence the integration of tobacco control messages into them. The present formative research identifies such opportunities and barriers. Methods: We conducted a multi-step, mixed methodological study of primary care personnel and policy-makers in two Indian states of Andhra Pradesh and Gujarat. The primary purpose of our study was to investigate health worker and policy-maker perceptions on the integration of tobacco control intervention. We systematically collected data in three steps: In Step I, we conducted in-depth interviews (IDIs and focus group discussions with primary care health personnel, Step II consists of a quantitative survey among health care providers (n = 1457 to test knowledge, attitudes and practices in tobacco control and Step III we conducted 75 IDIs with program heads and policy-makers to evaluate the relative congruence of their views on integration of the tobacco control program. Results: Majority of the health care providers recognized tobacco use as a major health problem. There was a general consensus for the need of training for effective dissemination of information from health care providers to patients. Almost 92% of the respondents opined that integration of tobacco control with other health programs will be highly effective to downscale the tobacco epidemic. Conclusions: Our findings suggest the need for integration of tobacco control program into existing health programs. Integration of tobacco control strategies into the health care system within primary and secondary care will be more effective and counseling for tobacco cessation should be available for population
Foster, Caroline; Thrasher, Jim; Kim, Sei-Hill; Rose, India; Besley, John; Navarro, Ashley
Citing agenda-building theory, this article examines the influence of three key factors on the news media's coverage of the process of placing tobacco and tobacco products under regulation of the U.S. Food and Drug Administration between 1993 and 2009. We analyzed data from a content analysis of 570 news articles from The New York Times and Washington Post and found that the media published significantly more FDA regulation articles during the Clinton administration than during the Bush administration. Our analysis links that imbalance of media coverage to the influence of the president of the United States (Clinton and Bush, during the duration of this study), journalistic routines and real world events. We compared the Clinton and Bush era news coverage on article prominence, article topics, and reasons to support/oppose FDA regulation and found significant differences, which we suggest led to the imbalance of news articles in the two administrations.
Gardner, Benjamin; West, Robert
Increasing the price of cigarettes reduces consumption, with a global price elasticity of approximately -0.4. In the UK where the cost of cigarettes is already relatively high, there is an issue surrounding public acceptance of further price rises ahead of the inflation rate. Previous research suggests that price increases may be supported where funds are dedicated to tobacco control. This study assessed public support in England for such a policy. A cross-sectional household survey was conducted in England between August 2008 and January 2009. A representative sample of 8736 respondents aged 16+, of whom 1900 (22%) were cigarette smokers at the time of the survey, was recruited. The primary outcome measure was support for a 20p (4%) price increase on a pack of cigarettes with proceeds going to fund tobacco control activities. 6216 participants (71%), including half (47%) of current cigarette smokers, indicated that they would support a 20p price increase if funds were dedicated to tobacco control activities. Levels of support among smokers were similar across the social gradient and gender. Younger smokers were more likely to support the increase. Smokers who smoked 0-10 cigarettes per day were more supportive of the increase than heavier smokers. There is broad public support for raising the cost of cigarettes with funds being used for tobacco control activities. The absence of a social gradient among smokers concurs with other research showing that more disadvantaged smokers are as engaged with tobacco control objectives as more affluent smokers.
Loomis, Brett R.; Han, Beth; Gfroerer, Joe; Kuiper, Nicole; Couzens, G. Lance; Dube, Shanta; Caraballo, Ralph S.
Objectives. We examined the influence of tobacco control policies (tobacco control program expenditures, smoke-free air laws, youth access law compliance, and cigarette prices) on youth smoking outcomes (smoking susceptibility, past-year initiation, current smoking, and established smoking). Methods. We combined data from the 2002 to 2008 National Surveys on Drug Use and Health with state and municipality population data from the US Census Bureau to assess the associations between state tobacco control policy variables and youth smoking outcomes, focusing on youths aged 12 to 17 years. We also examined the influence of policy variables on youth access when these variables were held at 2002 levels. Results. Per capita funding for state tobacco control programs was negatively associated with all 4 smoking outcomes. Smoke-free air laws were negatively associated with all outcomes except past-year initiation, and cigarette prices were associated only with current smoking. We found no association between these outcomes and retailer compliance with youth access laws. Conclusions. Smoke-free air laws and state tobacco control programs are effective strategies for curbing youth smoking. PMID:23327252
Carroll, Allison J; Labarthe, Darwin R; Huffman, Mark D; Hitsman, Brian
The purpose of this review is to emphasize the role of tobacco prevention and control in cardiovascular health (CVH) promotion and cardiovascular disease (CVD) prevention, including the importance of these endpoints for measuring the full impact of tobacco-related policies, programs, and practices. In this review, we describe an overview of tobacco control interventions that have led to substantial declines in tobacco use and the relationship between these declines with CVH and CVD. We review interventions that have had success in high-income countries (HICs) as well as those that are gaining traction in low- and middle-income countries (LMICs). We emphasize the challenges to comprehensive tobacco prevention and control strategies faced by LMICs, and highlight the special role of cardiovascular health professionals in achieving CVH promotion and CVD prevention endpoints through tobacco control. Tobacco prevention and control strategies have a strong scientific basis, yet a distinct gap remains between this evidence and implementation of tobacco control policies, particularly in LMICs. Health professionals can contribute to tobacco control efforts, especially through patient-level clinical interventions, when supported by a health care system and government that recognize and support tobacco control as a critical strategy for CVH promotion and CVD prevention. Understanding, supporting, and applying current and evolving policies, programs, and practices in tobacco prevention and control is the province of all health professionals, especially those concerned with CVH promotion and CVD prevention. A new tobacco control roadmap from the World Heart Federation provides a strong impetus to the needed interdisciplinary collaboration. Copyright © 2016 Elsevier Inc. All rights reserved.
Mao, Zhengzhong; Shi, Jian; Chen, Wendong
Objectives To identify key economic issues involved in raising the tobacco tax and to recommend possible options for tobacco tax reform in China. Methods Estimated price elasticities of the demand for cigarettes, prevalence data and epidemiology are used to estimate the impact of a tobacco tax increase on cigarette consumption, government tax revenue, lives saved, employment and revenue loss in the cigarette industry and tobacco farming. Results The recent Chinese tax adjustment, if passed along to the retail price, would reduce the number of smokers by 630 000 saving 210 000 lives, at a price elasticity of −0.15. A tax increase of 1 RMB (or US$0.13) per pack of cigarettes would increase the Chinese government's tax revenue by 129 billion RMB (US 17.2 billion), decrease consumption by 3.0 billion packs of cigarettes, reduce the number of smokers by 3.42 million and save 1.14 million lives. Conclusion The empirical economic analysis and tax simulation results clearly indicate that increasing the tobacco tax in China is the most cost-effective instrument for tobacco control. PMID:20008158
Cavallo, David N; Chou, Wen-Ying Sylvia; McQueen, Amy; Ramirez, Amelie; Riley, William T
Social media are now used by a majority of American internet users. Social media platforms encourage participants to share information with their online social connections and exchange user-generated content. Significant numbers of people are already using social media to share health-related information. As such, social media provide an opportunity for "user-generated" cancer control and prevention interventions that employ users' behavior, knowledge, and existing social networks for the creation and dissemination of interventions. These interventions also enable novel data collection techniques and research designs that will allow investigators to examine real-time behavioral responses to interventions. Emerging social media-based interventions for modifying cancer-related behaviors have been applied to such domains as tobacco use, diet, physical activity, and sexual practices, and several examples are discussed for illustration purposes. Despite some promising early findings, challenges including inadequate user engagement, privacy concerns, and lack of internet access among some groups need to be addressed in future research. Recommendations for advancing the field include stronger partnerships with commercial technology companies, utilization of rapid and adaptive designs to identify successful strategies for user engagement, rigorous and iterative efficacy testing of these strategies, and inclusive methods for intervention dissemination. ©2014 American Association for Cancer Research.
Guindon, G. Emmanuel; Driezen, Pete; Chaloupka, Frank J.; Fong, Geoffrey T.
Background Decades of research have produced overwhelming evidence that tobacco taxes reduce tobacco use and increase government tax revenue. The magnitude and effectiveness of taxes at reducing tobacco use provide an incentive for tobacco users, manufacturers and others, most notably criminal networks, to devise ways to avoid or evade tobacco taxes. Consequently, tobacco tax avoidance and tax evasion can reduce the public health and fiscal benefit of tobacco taxes. Objectives First, this study aims to document, using data from the International Tobacco Control Policy Evaluation Project (ITC), levels and trends in cigarette users’ tax avoidance and tax evasion behaviour in a sample of sixteen low-, middle- and high-income countries. Second, this study explores factors associated with cigarette tax avoidance and evasion. Methods We use data from ITC surveys conducted in 16 countries to estimate the extent and the type of cigarette tax avoidance/evasion between countries and across time. We use self-reported information about the source of a smoker’s last purchase of cigarettes or self-reported packaging information, or similar information gathered by the interviewers during face-to-face interviews to measure tax avoidance/evasion behaviours. We use generalized estimating equations (GEE) to explore individual-level factors that may affect the likelihood of cigarette tax avoidance or evasion in Canada, United States, United Kingdom and France. Findings We find prevalence estimates of cigarette tax avoidance/evasion vary substantially between countries and across time. In Canada, France and the United Kingdom, more than 10% of smokers report last purchasing cigarettes from low or untaxed sources while in Malaysia, some prevalence estimates suggest substantial cigarette tax avoidance/evasion. We also find important associations between household income and education and the likelihood to engage in tax avoidance/evasion. These associations, however, vary both in
Guindon, G Emmanuel; Driezen, Pete; Chaloupka, Frank J; Fong, Geoffrey T
Decades of research have produced overwhelming evidence that tobacco taxes reduce tobacco use and increase government tax revenue. The magnitude and effectiveness of taxes in reducing tobacco use provide an incentive for tobacco users, manufacturers and others, most notably criminal networks, to devise ways to avoid or evade tobacco taxes. Consequently, tobacco tax avoidance and tax evasion can reduce the public health and fiscal benefit of tobacco taxes. First, this study aims to document, using data from the International Tobacco Control Policy Evaluation Project (ITC), levels and trends in cigarette users' tax avoidance and tax evasion behaviour in a sample of 16 low-, middle- and high-income countries. Second, this study explores factors associated with cigarette tax avoidance and evasion. We used data from ITC surveys conducted in 16 countries to estimate the extent and type of cigarette tax avoidance/evasion between countries and across time. We used self-reported information about the source of a smoker's last purchase of cigarettes or self-reported packaging information, or similar information gathered by the interviewers during face-to-face interviews to measure tax avoidance/evasion behaviours. We used generalised estimating equations to explore individual-level factors that may affect the likelihood of cigarette tax avoidance or evasion in Canada, the USA, the UK and France. We found prevalence estimates of cigarette tax avoidance/evasion vary substantially between countries and across time. In Canada, France and the UK, more than 10% of smokers reported last purchasing cigarettes from low or untaxed sources, while in Malaysia some prevalence estimates suggested substantial cigarette tax avoidance/evasion. We also found important associations between household income and education and the likelihood to engage in tax avoidance/evasion. These associations, however, varied both in direction and magnitude across countries.
Various forms of smokeless tobacco (mainly snuff and chewing tobacco) cause an immediate increase in heart rate and blood pressure, but regular users of smokeless tobacco do not have permanent changes of heart rate or blood pressure when not exposed to tobacco. Cardiac output during workload and maximal working capacity are unaffected. Users of smokeless tobacco usually do not have the biochemical stigmata that regular smokers have. Thus, the scientific literature suggests that they are similar to non-tobacco users in terms of levels of hemoglobin/hematocrit, leukocytes, antioxidant vitamins, fibrinogen, components of the fibrinolytic system, C-reactive protein, and thromboxane A2 production. Two studies have found that snuff users, as opposed to smokers, do not have increased intima-media thickness or atherosclerotic lesions when investigated by ultrasound. Results on the risk for myocardial infarction have provided conflicting evidence, 2 case-control studies showing the same risks as in non-tobacco users and one cohort study showing an increased risk for cardiovascular death. In all, the use of smokeless tobacco (with snuff being the most studied variant) involves a much lower risk for adverse cardiovascular effects than smoking does. Whether or not the apparent risk reduction is a useful strategy to help inveterate smokers to quit is a matter of debate, as are the public health effects of a high prevalence of snuff use in some populations. Copyright 2003, Elsevier Science (USA). All rights reserved.
Konfino, Jonatan; Ferrante, Daniel; Mejia, Raul; Coxson, Pamela; Moran, Andrew; Goldman, Lee; Pérez-Stable, Eliseo J
Argentina's congress passed a tobacco control law that would enforce 100% smoke-free environments for the entire country, strong and pictorial health warnings on tobacco products and a comprehensive advertising ban. However, the Executive Branch continues to review the law and it has not been fully implemented. Our objective was to project the potential impact of full implementation of this tobacco control legislation on cardiovascular disease. The Coronary Heart Disease (CHD) Policy Model was used to project future cardiovascular events. Data sources for the model included vital statistics, morbidity and mortality data, and tobacco use estimates from the National Risk Factor Survey. Estimated effectiveness of interventions was based on a literature review. Results were expressed as life-years, myocardial infarctions and strokes saved in an 8-year-period between 2012 and 2020. In addition we projected the incremental effectiveness on the same outcomes of a tobacco price increase not included in the law. In the period 2012-2020, 7500 CHD deaths, 16 900 myocardial infarctions and 4300 strokes could be avoided with the full implementation and enforcement of this law. Annual per cent reduction would be 3% for CHD deaths, 3% for myocardial infarctions and 1% for stroke. If a tobacco price increase is implemented the projected avoided CHD deaths, myocardial infarctions and strokes would be 15 500, 34 600 and 11 900, respectively. Implementation of the tobacco control law would produce significant public health benefits in Argentina. Strong advocacy is needed at national and international levels to get this law implemented throughout Argentina.
Hublet, Anne; Schmid, Holger; Clays, Els
AIMS: To investigate the associations between well-known, cost-effective tobacco control policies at country level and smoking prevalence among 15-year-old adolescents. DESIGN: Multi-level modelling based on the 2005-06 Health Behaviour in School-aged Children Study, a cross-national study...... at individual level, and with country-level variables from the Tobacco Control Scale and published country-level databases. SETTING: Twenty-nine European countries. PARTICIPANTS: A total of 25 599 boys and 26 509 girls. MAIN OUTCOME MEASURES: Self-reported regular smoking defined as at least weekly smoking...... vending machines) = -0.372, P = 0.06]. CONCLUSIONS: For boys, some of the currently recommended tobacco control policies may help to reduce smoking prevalence. However, the model is less suitable for girls, indicating gender differences in the potential efficacy of smoking policies. Future research should...
Chamberlain, Catherine; Perlen, Susan; Brennan, Sue; Rychetnik, Lucie; Thomas, David; Maddox, Raglan; Alam, Noore; Banks, Emily; Wilson, Andrew; Eades, Sandra
Tobacco smoking is a leading cause of disease and premature mortality among Aboriginal and Torres Strait Islander (Indigenous) Australians. While the daily smoking prevalence among Indigenous Australians has declined significantly from 49% in 2001, it remains about three times higher than that of non-Indigenous Australians (39 and 14%, respectively, for age ≥15 years in 2014-15). This overview of systematic reviews aimed to synthesise evidence about reducing tobacco consumption among Indigenous peoples using a comprehensive framework for Indigenous tobacco control in Australia comprised of the National Tobacco Strategy (NTS) and National Aboriginal and Torres Strait Islander Health Plan (NATSIHP) principles and priorities. MEDLINE, EMBASE, systematic review and Indigenous health databases were searched (2000 to Jan 2016) for reviews examining the effects of tobacco control interventions among Indigenous peoples. Two reviewers independently screened reviews, extracted data, and assessed review quality using Assessing the Methodological Quality of Systematic Reviews. Data were synthesised narratively by framework domain. Reporting followed the PRISMA statement. Twenty-one reviews of varying quality were included. There was generally limited Indigenous-specific evidence of effective interventions for reducing smoking; however, many reviewers recommended multifaceted interventions which incorporate Indigenous leadership, partnership and engagement and cultural tailoring. Under the NTS priority areas, reviewers reported evidence for brief smoking cessation interventions and pharmacological support, mass media campaigns (on knowledge and attitudes) and reducing affordability and regulation of tobacco sales. Aspects of intervention implementation related to the NATSIHP domains were less well described and evidence was limited; however, reviewers suggested that cultural tailoring, holistic approaches and building workforce capacity were important strategies to address
Schmitt, Carol L; Lee, Youn Ok; Curry, Laurel E; Farrelly, Matthew C; Rogers, Todd
To identify unmet research needs of state and community tobacco control practitioners pertaining to electronic nicotine delivery systems (ENDS or e-cigarettes) that would inform policy and practice efforts at the state and community levels, and to describe ENDS-related research and dissemination activities of the National Cancer Institute-funded State and Community Tobacco Control Research Initiative. To determine specific research gaps relevant to state and community tobacco control practice, we analysed survey data collected from tobacco control programmes (TCPs) in all 50 U.S. states and the District of Columbia (N=51). Survey items covered a range of ENDS issues: direct harm to users, harm of secondhand vapour, cessation, flavours, constituents and youth access. There is no ENDS topic on which a majority of state TCP managers feel very informed. They feel least informed about harms of secondhand vapour while also reporting that this information is among the most important for their programme. A majority (N=31) of respondents indicated needs for research on the implications of ENDS products for existing policies. TCP managers report that ENDS research is highly important for practice and need research-based information to inform decision making around the inclusion of ENDS in existing tobacco control policies. For optimal relevance to state and community TCPs, research on ENDS should prioritise study of the health effects of ENDS use and secondhand exposure to ENDS vapour in the context of existing tobacco control policies. 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 range of tobacco control activities should be viewed as essential parts of a complex multi-component puzzle. Intervention strategies designed to address tobacco control should be comprehensive and include both primary and secondary prevention activities and be multi-faceted and capable of bringing about change at both the individual and broader social and cultural levels. In this paper I argue for a mutually inclusive framework in which the various components contribute in important and different ways. I examine the prevalence of smoking and identify the high risk groups, then I examine the range of available strategies and present the evidence for their success. I discuss the primary prevention approaches such as warning labels, taxes, price increases, workplace bans, education in schools, mass media and self-help materials, as well as brief interventions and treatment strategies which are conducted at the worksite, general practice and specialized cessation clinics. The areas for future research are delineated for increased resource allocation and include: the best ways to disseminate brief interventions to smokers, methods to motivate smokers; training of health professionals to deliver brief interventions; enhancing quitting and access to existing treatment resources among specific disadvantaged minority groups, e.g. migrants, unemployed youth, the effect on smoking prevalence of warning labels on cigarette packets and price rises on cigarettes.
Pisinger, Charlotta; Robinson, Kirstine Magtengaard; Jørgensen, Torben
Smoking remains the single preventable factor with the highest impact on morbidity and mortality in Denmark. The aims of this study were to assess the quality of municipal tobacco control (TC) in the 29 municipalities of the Capital Region of Denmark, and to compare the quality of the TC and the ......Smoking remains the single preventable factor with the highest impact on morbidity and mortality in Denmark. The aims of this study were to assess the quality of municipal tobacco control (TC) in the 29 municipalities of the Capital Region of Denmark, and to compare the quality of the TC...
... before parliamentary committees, given hundreds of media interviews in Canada and the United States, published numerous tobacco-related articles, and initiated private prosecutions for violations of tobacco control laws. Cunningham now works in Ottawa as a senior policy analyst for the Canadian Cancer Society.
Rose, Shyanika W; Myers, Allison E; D'Angelo, Heather; Ribisl, Kurt M
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.
Wang, Fan; Zheng, Pinpin; Yang, Dongyun; Freeman, Becky; Fu, Hua; Chapman, Simon
Although China ratified the WHO Framework Convention on Tobacco Control [FCTC] in 2005, the partial ban on tobacco advertising does not cover the internet. Weibo is one of the most important social media channels in China, using a format similar to its global counterpart, Twitter. The Weibo homepage is a platform to present products, brands and corporate culture. There is great potential for the tobacco industry to exploit Weibo to promote products. Seven tobacco industry Weibo accounts that each had more than 5000 fans were selected to examine the content of Weibos established by tobacco companies or their advertising agents. Of the 12073 posts found on the seven accounts, 92.3% (11143) could be classified into six main themes: traditional culture, popular culture, social and business affairs, advertisement, public relations and tobacco culture. Posts under the theme of popular culture accounted for about half of total posts (49%), followed by 'advertisement' and 'tobacco culture' (both at 12%), 'traditional culture' and 'public relations' (both at 11%), and finally 'social and business affairs' (5%). 33% of posts included the words 'cigarette' or 'smoking' and 53% of posts included the tobacco brand name, indicating that tobacco companies carefully construct the topic and content of posts. Weibo is an important new online marketing tool for the Chinese tobacco industry. Tobacco industry use of Weibo to promote brands and normalize smoking subverts China's ratification of the WHO FCTC. Policy to control tobacco promotion needs reforming to address this widespread circumvention of China's tobacco advertising ban.
Smith, Katherine Clegg; Bone, Lee; Clay, Eric A; Owings, Kerry; Thames, Sean; Stillman, Frances
Young adults are generally overlooked in tobacco control initiatives, even though they are critical to sustained success. African American young adults who are not in higher education or working are particularly vulnerable to harmful tobacco use, given high smoking rates and limited access to cessation services. Guided by community-based participatory research (CBPR) principles, we sought to identify program and community-level strategies to reduce tobacco use among African American young adults in Baltimore. We describe the challenges and opportunities for integrating effective tobacco control into community-based education and job training programs for unemployed young adults. As part of a longstanding community-research partnership in Baltimore, we conducted fourteen semistructured key informant interviews with leaders from city government and education and job training programs for young adults. The research design, data collection, analysis, and dissemination all included dialogue between and active contribution by both research and community partners. Interview data were structured into opportunities (mindset for change and desire for bonds with a trusted adult), challenges (culture of fatalism, tobacco as a stress reliever, and culture of tobacco use among young adults), and possible tobacco control solutions (tobacco education designed with and for program staff and participants and integration of tobacco issues into holistic program goals and policies). The emergent themes enhance our understanding of how tobacco is situated in the lives of unemployed young adults and the potential for building sustainable, community-based public health solutions.
Vijayaraghavan, Maya; Olsen, Pamela; Weeks, John; McKelvey, Karma; Ponath, Claudia; Kushel, Margot
To examine attitudes toward tobacco control policies among older African American homeless-experienced smokers. A qualitative study. Oakland, California. Twenty-two African American older homeless-experienced smokers who were part of a longitudinal study on health and health-related outcomes (Health Outcomes of People Experiencing Homelessness in Older Middle Age Study). We conducted in-depth, semistructured interviews with each participant to explore beliefs and attitudes toward tobacco use and cessation, barriers to smoking cessation, and attitudes toward current tobacco control strategies including raising cigarette prices, smoke-free policies, and graphic warning labels. We used a grounded theory approach to analyze the transcripts. Community social norms supportive of cigarette smoking and co-use of tobacco with other illicit substances were strong motivators of initiation and maintenance of tobacco use. Self-reported barriers to cessation included nicotine dependence, the experience of being homeless, fatalistic attitudes toward smoking cessation, substance use, and exposure to tobacco industry marketing. While participants were cognizant of current tobacco control policies and interventions for cessation, they felt that they were not specific enough for African Americans experiencing homelessness. Participants expressed strong support for strategies that de-normalized tobacco use and advertised the harmful effects of tobacco. Older African American homeless-experienced smokers face significant barriers to smoking cessation. Interventions that advertise the harmful effects of tobacco may be effective in stimulating smoking cessation among this population.
Driezen, Pete; Abdullah, Abu S.; Nargis, Nigar; Hussain, A. K. M. Ghulam; Fong, Geoffrey T.; Thompson, Mary E.; Quah, Anne C. K.; Xu, Steve
This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011–2012) of the International Tobacco Control (ITC) Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a) cigarette smoking and (b) smokeless tobacco use and (c) whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco’s harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO’s Framework Convention on Tobacco Control. PMID:27571090
Muñoz Martínez, Hepzibah; Pederson, Ann
The article examines how civil society organisations in Argentina used the United Nations Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) to frame the country's failure to enact strong national tobacco control legislation as a violation of women's rights in the late 2000s. We analyze this case study through the politics of scale, namely the social processes that produce, reproduce, and contest the boundaries of policies and socio-economic relations. This approach understands how multiple scales overlap and connect to obstruct or enhance the right to health in Latin America. In Argentina, the global organisation of tobacco companies, the reach of international financial institutions and the national dynamics of economic austerity and export-orientation promoted the local production and use of tobacco (leaf and cigarettes) and reproduced health inequalities in the country throughout the 1990s and the early 2000s. Yet, the visible legacy of local and national human rights struggles in the adoption of international human rights treaties into Argentina's national constitution allowed the tobacco control movement to link the scale of women's bodies to the right to health through the use of CEDAW to change national legislation, tackling the social determinants of the tobacco epidemic.
Hasan, Agus; Foss, Bjarne; Sagatun, Svein Ivar
The flow of fluids through porous media can be described by the Boussinesq’s equation with mixed boundary conditions; a Neumann’s boundary condition and a nonlinear boundary condition. The nonlinear boundary condition provides a means to control the fluid flow through porous media. In this paper...
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
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
Pragati B Hebbar
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
Troelstra, Sigrid A.; Bosdriesz, Jizzo R.; de Boer, Michiel R.; Kunst, Anton E.
Background The impact of tobacco control policies on measures of smoking cessation behaviour has often been studied, yet there is little information on their precise magnitude and duration. This study aims to measure the magnitude and timing of the impact of Dutch tobacco control policies on the
Troelstra, Sigrid A; Bosdriesz, Jizzo R; de Boer, Michiel R; Kunst, Anton E
BACKGROUND: The impact of tobacco control policies on measures of smoking cessation behaviour has often been studied, yet there is little information on their precise magnitude and duration. This study aims to measure the magnitude and timing of the impact of Dutch tobacco control policies on the
Stoof, Cathelijne; Kettridge, Nicholas; Gray, Alan; Ascoli, Davide; Fernandes, Paulo; Marrs, Rob; Allen, Katherine; Doerr, Stephan; Clay, Gareth; McMorrow, Julia; Vandvik, Vidgis; Davies, Matt
A golden rule in science communication is to be in charge - particularly when communicating sensitive topics. When our recent review on the use of fire and UK peatlands (Davies et al. 2016a) was accidentally released into the public domain prior to publication, we were certainly not in charge. The international fire ecology literature recognises that there are many potential benefits from the controlled use of fire, yet this tool is frequently viewed negatively in the UK. This may be at least partly due to its association with (creating habitat for) grouse hunting. In Davies et al. (2016a) we highlighted this controversy. We countered recent publications that portrayed controlled fires as having predominantly negative impacts on the environment (including water quality), often based on studies of potentially severe wildfires. We furthermore explored both the benefits and negative consequence of controlled burns. As fire is a highly political and emotional topic in the UK, we planned a press release upon publication of our paper to take the lead in the communication. The accidental release however prevented us from doing so, and came about inadvertently through one of us following the new rules of publication for University staff within the UK, designed to satisfy the Research Excellence Framework guidelines, i.e. that the accepted version of all papers should be entered immediately on acceptance into institutional repositories. To avoid similar issues, we suggest that all authors of commentary papers, especially if controversial, should endure that embargo terms are enforced in repository depositions strictly to prevent this happening. Ironically, our paper that called for informed, unbiased debate was used out of context by groups aligned with different wider environmental, social and political agendas. Our scientific credibility was consequently questioned in a blog by a prominent Guardian journalist, who disagreed with us on the focus of our review (fire effects
Jenson, Desmond; Lester, Joelle; Berman, Micah L
Among other key objectives, the 2009 Family Smoking Prevention and Tobacco Control Act was designed to end an era of constant product manipulation by the tobacco industry that had led to more addictive and attractive products. The law requires new tobacco products to undergo premarket review by the US Food and Drug Administration (FDA) before they can be sold. To assess FDA's implementation of its premarket review authorities, we reviewed FDA actions on new product applications, publicly available data on industry applications to market new products, and related FDA guidance documents and public statements. We conclude that FDA has not implemented the premarket review process in a manner that prioritises the protection of public health. In particular, FDA has (1) prioritised the review of premarket applications that allow for the introduction of new tobacco products over the review of potentially non-compliant products that are already on the market; (2) misallocated resources by accommodating the industry's repeated submissions of deficient premarket applications and (3) weakened the premarket review process by allowing the tobacco industry to market new and modified products that have not completed the required review process. 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/
Andrei Konstantinovich Demin
Full Text Available Russia ratified WHO FCTC on 3 June 2008. On December 22, 2008 Federal law "Technical regulations on tobacco products" was adopted, probably normalizing activities of tobacco companies in view of risks posed by the Convention. Annual production capacity exceeds 700 billion cigarettes. According to GATS the highest prevalence of tobacco use in 2009 was in Russia, 39.1% of adults (43.9 million used tobacco, smoking prevalence of 60.2% among men and 21.7% among women. In 2015, the Ministry of Health reported a 17% decline in the number of smokers since the adoption of tobacco control legislation in 2013. The law introduced comprehensive smoke free policies, picture warnings, banned point of sales materials (POSM, alas standards and order of cessation care have not been approved yet. Taxes are low and are regulated within Eurasian Economic Union agreements with a risk of remaining low. Article 5.3 implementation and signing of Protocol on Illicit Trade are among priorities.
Lowe, John; Aquilino, Mary; Abramsohn, Erin
Objectives: Comprehensive training in the area of tobacco control and prevention has not been available to public health students receiving professional degrees. This study describes findings of a project designed to develop and evaluate an integrated approach to the education of Masters of Public Health (MPH) students at the University of Iowa…
Lai, T.; Habicht, J.; Reinap, M.; Chisholm, D.; Baltussen, R.M.P.M.
OBJECTIVE: To assess the population-level costs, effects and cost-effectiveness of different alcohol and tobacco control strategies in Estonia. DESIGN: A WHO cost-effectiveness modelling framework was used to estimate the total costs and effects of interventions. Costs were assessed in Estonian
Full Text Available 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.
...." -David J. Hess, Rensselaer Polytechnic Institute "At the cutting edge of comparative health policy studies in a globalizing world, Reid's book will set the pace for years to come." Reid Globalizing Globalizing Tobacco Control -Adele E. Clarke, University of California, San Francisco A tangible aspect of living, working, and traveling in the...
Bosdriesz, Jizzo R.; Willemsen, Marc C.; Stronks, Karien; Kunst, Anton E.
Higher Tobacco Control Scale (TCS) scores, in the early 2000s were associated with higher smoking cessation rates across Europe, both among lower and higher educated people. We aimed to assess if this association held in recent years. Repeated cross-sectional Eurobarometer surveys were used, in 27
Full Text Available Since its start in 2002, the ITC Project has been conducting evaluation studies of tobacco control policies via prospective cohort surveys of tobacco users in 28 countries, including 9 EU countries. This presentation will focus on the design of the ITC Project and how it differs from and complements existing evidence-gathering systems (monitoring and surveillance systems in measuring and understanding the impact of FCTC policies. The presentation will also describe the ITC Project's most recent initiatives: (1 the EUREST-PLUS study focusing on measuring the impact of the Tobacco Products Directive, and (2 a large-scale international cohort study of e-cigarettes starting in the United States, Canada, England, and Australia.
Misra, Gaurav; Such Aparicio, Jose Miguel
Social media sites are key mediators of online communication. Yet the privacy controls for these sites are not fully socially aware, even when privacy management is known to be fundamental to successful social relationships.
Poston, Walker S C; Haddock, Christopher K; Jahnke, Sara A; Jitnarin, Nattinee
Little is known about veterans service organizations (VSOs) and their perspectives on veterans smoking or military tobacco control. Veterans have high smoking rates and many started smoking in the military, where a culture promoting use exists. A qualitative content analysis of VSO Web sites was conducted to classify health topics and identify tobacco-related information. Web sites were coded by trained raters from January to June of 2011. Data were entered, cleaned, and analyzed from July 2011 to January 2012. Twenty-four active VSO Web sites meeting inclusion criteria were rated independently. A comprehensive form was used to code 15 veteran-relevant health topics across multiple content areas/domains within the Web sites. Raters achieved 94.5% interrater agreement over nearly 5000 data points. Health content was coded as present or not within multiple VSO Web site areas/domains. The frequency of coverage by each VSO Web site and the number of VSO Web sites that mentioned a health topic in different Web site areas/domains were tabulated. A total of 277 health topics were addressed, with the top five being insurance/Tricare/Veterans Administration issues (28.2%), posttraumatic stress disorder (PTSD; 15.5%), disability/amputation/wounds (13.4%), Agent Orange (10.5%), and traumatic brain injury (9.0%). Tobacco was mentioned four times (1.4%) across all 24 VSO Web sites, and smoking cessation was never addressed. VSO Web sites provide little information on tobacco-related topics and none offered information about smoking cessation. Given the high rates of tobacco use among veterans and active-duty service members, and the interaction between smoking and PTSD symptoms and treatment outcomes, VSOs should consider making tobacco control and smoking cessation higher-priority health issues on their Web sites.
While the 'low-tar' scheme has been widely recognised as a misleading tactic used by the tobacco industry to deceive the public about the true risks of cigarette smoking, a similar campaign using the slogan of 'less harmful, low tar' was launched by the Chinese tobacco industry, that is, State Tobacco Monopoly Administration/China National Tobacco Corporation and began to gain traction during the last decade. Despite the fact that no sufficient research evidence supports the claims made by the industry that these cigarettes are safer, the Chinese tobacco industry has continued to promote them using various health claims. As a result, the production and sales of 'less harmful, low-tar' cigarettes have increased dramatically since 2000. Recently, a tobacco industry senior researcher, whose main research area is 'less harmful, low-tar' cigarettes, was elected as an Academician to the prestigious Chinese Academy of Engineering for his contribution to developing 'less harmful, low-tar' cigarettes. The tobacco researcher's election caused an outcry from the tobacco control community and the general public in China. This paper discusses the Chinese tobacco industry's 'less harmful, low-tar' initiatives and calls for the Chinese government to stop the execution of this deceptive strategy for tobacco marketing.
Fleischer, Nancy L; Thrasher, James F; Reynales-Shigematsu, Luz Myriam; Cummings, K Michael; Meza, Rafael; Zhang, Yian; Levy, David T
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.
Kupersmidt, Janis B; Scull, Tracy M; Benson, Jessica W
The Media Ready Program was designed as a middle school, media literacy education, preventive intervention program to improve adolescents' media literacy skills and reduce their intention to use alcohol or tobacco products. In a short-term efficacy trial, schools in North Carolina were randomly assigned to conditions (Media Ready: n = 214; control: n = 198). Boys in the Media Ready group reported significantly less intention to use alcohol in the future than did boys in the control group. Also, students in the Media Ready group who had used tobacco in the past reported significantly less intention to use tobacco in the future than did students in the control group who had previously used tobacco. Multilevel multiple mediation analyses suggest that the set of logical analysis Message Interpretation Processing variables mediated the program's effect on students' intentions to use alcohol or tobacco in the future.
Dresler, Carolyn; Wei, Mei; Heck, Julia E; Allwright, Shane; Haglund, Margaretha; Sanchez, Sara; Kralikova, Eva; Stücker, Isabelle; Tamang, Elizabeth; Gritz, Ellen R; Hashibe, Mia
Tobacco-related cancers and, in particular, lung cancer still represents a substantial public health epidemic across Europe as a result of high rates of smoking prevalence. Countries in Europe have proposed and implemented tobacco control policies to reduce smoking prevalence, with some countries being more progressive than others. The aim of this study was to examine factors that influenced women's attitudes across five European countries relative to comprehensive smokefree laws in their countries. A cross-sectional landline telephone survey on attitudes towards tobacco control laws was conducted in five European countries: France, Ireland, Italy, the Czech Republic, and Sweden. Attitudinal scores were determined for each respondent relative to questions about smokefree laws. Logistic regression models were used to obtain odds ratios with 95% confidence intervals. A total of 5000 women were interviewed (1000 women from each country). The majority of women, regardless of smoking history, objected to smoking in public buses, enclosed shopping centers, hospitals, and other indoor work places. More women who had quit smoking believed that new tobacco control laws would prompt cessation - as compared with women who still smoked. In general, there is very high support for national smokefree laws that cover bars, restaurants, and public transport systems. As such laws are implemented, attitudes do change, as demonstrated by the differences between countries such as Ireland and the Czech Republic. Implementing comprehensive smokefree laws will gain high approval and will be associated with prompting people to quit.
Goetz, Marc; Hirsche, Jörg; Bauerfeind, Martin Andreas; González, María-Cruz; Hyun, Tae Kyung; Eom, Seung Hee; Chriqui, Dominique; Engelke, Thomas; Großkinsky, Dominik K.; Roitsch, Thomas
Pollination in flowering plants is initiated by germination of pollen grains on stigmas followed by fast growth of pollen tubes representing highly energy-consuming processes. The symplastic isolation of pollen grains and tubes requires import of Suc available in the apoplast. We show that the functional coupling of Suc cleavage by invertases and uptake of the released hexoses by monosaccharide transporters are critical for pollination in tobacco (Nicotiana tabacum). Transcript profiling, in situ hybridization, and immunolocalization of extracellular invertases and two monosaccharide transporters in vitro and in vivo support the functional coupling in supplying carbohydrates for pollen germination and tube growth evidenced by spatiotemporally coordinated expression. Detection of vacuolar invertases in maternal tissues by these approaches revealed metabolic cross talk between male and female tissues and supported the requirement for carbohydrate supply in transmitting tissue during pollination. Tissue-specific expression of an invertase inhibitor and addition of the chemical invertase inhibitor miglitol strongly reduced extracellular invertase activity and impaired pollen germination. Measurements of (competitive) uptake of labeled sugars identified two import pathways for exogenously available Suc into the germinating pollen operating in parallel: direct Suc uptake and via the hexoses after cleavage by extracellular invertase. Reduction of extracellular invertase activity in pollen decreases Suc uptake and severely compromises pollen germination. We further demonstrate that Glc as sole carbon source is sufficient for pollen germination, whereas Suc is supporting tube growth, revealing an important regulatory role of both the invertase substrate and products contributing to a potential metabolic and signaling-based multilayer regulation of pollination by carbohydrates. PMID:27923989
Goetz, Marc; Guivarćh, Anne; Hirsche, Jörg; Bauerfeind, Martin Andreas; González, María-Cruz; Hyun, Tae Kyung; Eom, Seung Hee; Chriqui, Dominique; Engelke, Thomas; Großkinsky, Dominik K; Roitsch, Thomas
Pollination in flowering plants is initiated by germination of pollen grains on stigmas followed by fast growth of pollen tubes representing highly energy-consuming processes. The symplastic isolation of pollen grains and tubes requires import of Suc available in the apoplast. We show that the functional coupling of Suc cleavage by invertases and uptake of the released hexoses by monosaccharide transporters are critical for pollination in tobacco (Nicotiana tabacum). Transcript profiling, in situ hybridization, and immunolocalization of extracellular invertases and two monosaccharide transporters in vitro and in vivo support the functional coupling in supplying carbohydrates for pollen germination and tube growth evidenced by spatiotemporally coordinated expression. Detection of vacuolar invertases in maternal tissues by these approaches revealed metabolic cross talk between male and female tissues and supported the requirement for carbohydrate supply in transmitting tissue during pollination. Tissue-specific expression of an invertase inhibitor and addition of the chemical invertase inhibitor miglitol strongly reduced extracellular invertase activity and impaired pollen germination. Measurements of (competitive) uptake of labeled sugars identified two import pathways for exogenously available Suc into the germinating pollen operating in parallel: direct Suc uptake and via the hexoses after cleavage by extracellular invertase. Reduction of extracellular invertase activity in pollen decreases Suc uptake and severely compromises pollen germination. We further demonstrate that Glc as sole carbon source is sufficient for pollen germination, whereas Suc is supporting tube growth, revealing an important regulatory role of both the invertase substrate and products contributing to a potential metabolic and signaling-based multilayer regulation of pollination by carbohydrates. © 2017 American Society of Plant Biologists. All Rights Reserved.
Fryer, Craig S; Seaman, Elizabeth L; Clark, Rachael S; Plano Clark, Vicki L
Tobacco use among young people is a complex and serious global dilemma that demands innovative and diverse research approaches. The purpose of this methodological review was to examine the current use of mixed methods research in tobacco control with youth and young adult populations and to develop practical recommendations for tobacco control researchers interested in this methodology. Using PubMed, we searched five peer-reviewed journals that publish tobacco control empirical literature for the use of mixed methods research to study young populations, age 12-25 years. Our team analyzed the features of each article in terms of tobacco control topic, population, youth engagement strategies, and several essential elements of mixed methods research. We identified 23 mixed methods studies published by authors from five different countries reported between 2004 and 2015. These 23 articles examined various topics that included tobacco use behavior, tobacco marketing and branding, and cessation among youth and young adults. The most common mixed methods approach was variations of the concurrent design in which the qualitative and quantitative strands were administered at the same time and given equal priority. This review documented several innovative applications of mixed methods research as well as challenges in the reporting of the complex research designs. The use of mixed methods research in tobacco control has great potential for advancing the understanding of complex behavioral and sociocultural issues for all groups, especially youth and young adults.
Craig S Fryer
Full Text Available Tobacco use among young people is a complex and serious global dilemma that demands innovative and diverse research approaches. The purpose of this methodological review was to examine the current use of mixed methods research in tobacco control with youth and young adult populations and to develop practical recommendations for tobacco control researchers interested in this methodology.Using PubMed, we searched five peer-reviewed journals that publish tobacco control empirical literature for the use of mixed methods research to study young populations, age 12-25 years. Our team analyzed the features of each article in terms of tobacco control topic, population, youth engagement strategies, and several essential elements of mixed methods research.We identified 23 mixed methods studies published by authors from five different countries reported between 2004 and 2015. These 23 articles examined various topics that included tobacco use behavior, tobacco marketing and branding, and cessation among youth and young adults. The most common mixed methods approach was variations of the concurrent design in which the qualitative and quantitative strands were administered at the same time and given equal priority. This review documented several innovative applications of mixed methods research as well as challenges in the reporting of the complex research designs.The use of mixed methods research in tobacco control has great potential for advancing the understanding of complex behavioral and sociocultural issues for all groups, especially youth and young adults.
Gneiting, Uwe; Schmitz, Hans Peter
Smoking and drinking constitute two risk factors contributing to the rising burden of non-communicable diseases in low- and middle-income countries. Both issues have gained increased international attention, but tobacco control has made more sustained progress in terms of international and domestic policy commitments, resources dedicated to reducing harm, and reduction of tobacco use in many high-income countries. The research presented here offers insights into why risk factors with comparable levels of harm experience different trajectories of global attention. The analysis focuses particular attention on the role of dedicated global health networks composed of individuals and organizations producing research and engaging in advocacy on a given health problem. Variation in issue characteristics and the policy environment shape the opportunities and challenges of global health networks focused on reducing the burden of disease. What sets the tobacco case apart was the ability of tobacco control advocates to create and maintain a consensus on policy solutions, expand their reach in low- and middle-income countries and combine evidence-based research with advocacy reaching beyond the public health-centered focus of the core network. In contrast, a similar network in the alcohol case struggled with expanding its reach and has yet to overcome divisions based on competing problem definitions and solutions to alcohol harm. The tobacco control network evolved from a group of dedicated individuals to a global coalition of membership-based organizations, whereas the alcohol control network remains at the stage of a collection of dedicated and like-minded individuals. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2016; all rights reserved.
Kinnison, M.L.; Powe, N.R.; Steinberg, E.P.
The authors review 100 randomized controlled trials (RCTs) that examine the safety or efficacy of new low-osmolality contrast media (LOM) and focus on the 43 RCTs judged to be of the highest quality. These RCTs showed no consistent differences in nephrotoxicity between high- and low-osmolality contrast media. Certain cardiovascular parameters were altered less with low-osmolality agents during intracardiac injection, but the clinical significance of these differences in unclear. Heat and pain sensations occurred less often with low-osmolality contrast media. No differences were noted in the incidence of nausea, vomiting, urticaria, or bronchospasm. Even with numerous RCTs comparing these media, physicians still must make economically significant choices about contrast media without sufficient data about their relative safety
Forsyth, Susan R; Malone, Ruth E
Tobacco content has been identified in popular video games played by adolescents. To date, there are no established instruments for categorizing tobacco content. We describe development and demonstrate the use of an instrument to categorize types of tobacco content. Interviews were conducted with 61 participants: 20 adolescents (mean age 17.7), and 41 adults (mean age 23.9), who discussed favorite games and recalled tobacco content. All games mentioned were examined for tobacco content by watching movies of game play on YouTube, examining individual game Wiki sites, and reviewing content descriptors provided by the Entertainment Software Rating Board (ESRB), Common Sense Media and the Internet Movie Database (IMDb). A typology of tobacco content was created and correlated with gamer recall of tobacco content. Participants together mentioned 366 games, of which 152 were unique. Tobacco content was verified in 39.5% (60/152) of games. Six categories of content were identified, including "no tobacco content." Of games containing tobacco, 88% (53/60) contained at least two categories of content. Games with more categories were associated with greater gamer recall of tobacco content. Tobacco content is present in video games and consciously recalled by players, with higher accuracy of recall associated with games featuring multiple types of tobacco content and more engaging, player-active content. Playing video games is now a daily part of most adolescents' lives. Tobacco content is present in many popular games. Currently there are no published instruments to assist in categorizing tobacco content in video games. This study describes a systematic approach to categorizing tobacco content in video games and demonstrates that games featuring more categories of tobacco content are associated with more accurate gamer recall of the presence of tobacco content when compared with games with fewer categories of content. Understanding the extent of such content will be essential
Feliu, Ariadna; Filippidis, Filippos T; Joossens, Luk; Fong, Geoffrey T; Vardavas, Constantine I; Baena, Antoni; Castellano, Yolanda; Martínez, Cristina; Fernández, Esteve
Tobacco use is still highly prevalent in Europe, despite the tobacco control efforts made by the governments. The development of tobacco control policies varies substantially across countries. The Tobacco Control Scale (TCS) was introduced to quantify the implementation of tobacco control policies across European countries OBJECTIVE: To assess the midterm association of tobacco control policies on smoking prevalence and quit ratios among 27 European Union (EU) Member States (EU27). Ecological study. We used the TCS in EU27 in 2007 and the prevalence of tobacco and quit ratios data from the Eurobarometer survey (2006 (n=27 585) and 2014 (n=26 793)). We analysed the relationship between the TCS scores and smoking prevalence and quit ratios and their relative changes (between 2006 and 2014) by means of scatter plots and multiple linear regression models. In EU27, countries with higher scores in the TCS, which indicates higher tobacco control efforts, have lower prevalence of smokers, higher quit ratios and higher relative decreases in their prevalence rates of smokers over the last decade. The correlation between TCS scores and smoking prevalence (r sp =-0.444; P=0.02) and between the relative changes in smoking prevalence (r sp =-0.415; P=0.03) was negative. A positive correlation was observed between TCS scores and quit ratios (r sp =0.373; P=0.06). The percentage of smoking prevalence explained by all TCS components was 28.9%. EU27 should continue implementing comprehensive tobacco control policies as they are key for reducing the prevalence of smoking and an increase tobacco cessation rates in their population. © 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.
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
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.
Mitchell, Rebecca J; Weisman, Susan R; Jones, Resa M; Erickson, Darin
Examine unionized workers' knowledge and attitudes about workplace tobacco use, their exposure to secondhand smoke, and the role of labor unions in addressing smoking and cessation coverage policies. Random-digit dial telephone survey. Unionized workers in Minnesota (N = 508). Knowledge and attitudes about workplace tobacco use and tobacco control policy making. Multiple logistic regression. The majority of respondents viewed secondhand smoke exposure as an important workplace health and safety issue, a health risk to nonsmokers, and a driver of increased health care costs, but smokers were less likely than nonsmokers to agree. Only 7% of respondents supported their unions taking the lead in tobacco control policy making. A large majority of those surveyed rated smoking cessation programs as an important benefit for which their labor unions could bargain; however, smokers and those whose workplaces allowed smoking were less likely than their counterparts to agree. Most unionized workers were aware of the health effects of exposure to secondhand smoke and supported union bargaining for restrictions on workplace smoking and cessation programs, although few workers supported their unions taking the lead in initiating worksite smoking policies. Results suggest that campaigns to promote smoke-free worksites should be tailored to unionized workers, and further collaborations with labor unions to promote policy change are needed.
Faber, T. (Timor); Kumar, A. (Arun); J.P. Mackenbach (Johan); C. Millett (Christopher); Basu, S. (Sanjay); A. Sheikh (Aziz); J.V. Been (Jasper V.)
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
Kenneth E Warner
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.
Roeseler, April; Feighery, Ellen C; Cruz, Tess Boley
Tobacco marketing influences tobacco use initiation, maintenance of use, and it undermines comprehensive tobacco control programmes. Policies to ban the impact of tobacco marketing are most likely to be more effective if they are comprehensive, as partial bans shift marketing to non-banned forms of media. A comprehensive approach to reducing tobacco marketing includes documentation through monitoring, media and policy interventions and aggressive enforcement of existing laws. This paper summarises California tobacco industry monitoring of events and retail outlets, and findings about exposure to and beliefs about tobacco industry marketing among youths and adults conducted during the period 2000 through 2008. There was no overall change in the average number of cigarette materials per store, and an increase in the percentage of stores with advertisements promoting price discounts for cigarettes. Stores with cigarette advertisements near candy displays declined from 12.5% (95% CI 9.8% to 15.2%) to 1% (95% CI 0.2% to 1.9%) of stores, and advertisements at or below the eye-level of children declined from 78.6% (95% CI 75.2% to 82.0%) to 31% (95% CI 27.1% to 34.9%) of stores. Overall, the number of public events with tobacco sponsorship declined from 77.3% to 48.1%. This trend was consistent with a significant decline noted among high school students and adults who reported seeing tobacco advertisements at events or attending a tobacco company-sponsored event. Tobacco industry monitoring, media, policy and enforcement interventions may have contributed to observed changes in tobacco marketing and to declines in reported exposure to tobacco marketing.
Faced with a difficult business environment in the United States and the falling demand for cigarettes in industrialized countries, multinational tobacco companies have been competing fiercely to expand their sales in developing countries. Because of the worldwide threat posed by smoking to health and the emphasis being placed by international tobacco companies on marketing in developing countries, an international regulatory strategy, such as the WHO proposed Framework Convention on Tobacco Control, is needed. This review describes from a public health perspective the possible scope and key considerations of protocols that should be included in the convention. The key international areas that should be considered in tobacco control are: prices, smuggling; tax-free tobacco products; advertising and sponsorship; the Internet; testing methods; package design and labelling; agriculture; and information sharing. PMID:10994267
Allen, Jane A; Davis, K C; Kamyab, K; Farrelly, M C
This study explores whether exposure to advertisements that focus on the negative effects of tobacco industry advertising and promotion at the point of sale (anti-POS advertising) influence: (i) attitude toward POS advertising; (ii) perceived impact of POS advertising on youth smoking; and (iii) support for a ban on tobacco promotion at the POS among adult non-smokers in New York. Data are from a split-sample, experimental study, using an online media tracking survey with embedded TV, radio and print advertising. Exposure to anti-POS advertising was associated with higher odds of holding a negative attitude toward POS advertising (OR 2.43, P advertisements on youth smoking. Findings suggest the possibility that a mass media campaign could be used to influence public attitude toward POS advertising and support for a ban on tobacco promotion at the POS. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: email@example.com.
This book explores the use of media by American birth control movement since the early twentieth century, as they built support for fertility control and the availability of contraception. Though these public efforts in advertising and education were undertaken initially by leading advocates,
Kupersmidt, Janis B; Scull, Tracy M; Austin, Erica Weintraub
Media Detective is a 10-lesson elementary school substance use prevention program developed on the basis of the message interpretation processing model designed to increase children's critical thinking skills about media messages and reduce intent to use tobacco and alcohol products. The purpose of this study was to conduct a short-term, randomized, controlled trial to evaluate the effectiveness of Media Detective for achieving these goals. Elementary schools were randomly assigned to conditions to either receive the Media Detective program (n=344) or serve in a waiting list control group (n=335). Boys in the Media Detective group reported significantly less interest in alcohol-branded merchandise than boys in the control group. Also, students who were in the Media Detective group and had used alcohol or tobacco in the past reported significantly less intention to use and more self-efficacy to refuse substances than students who were in the control group and had previously used alcohol or tobacco. This evaluation provides evidence that Media Detective can be effective for substance use prevention in elementary school-aged children. Notably, media-related cognitions about alcohol and tobacco products are malleable and relevant to the development and maintenance of substance use behaviors during late childhood. The findings from this study suggest that media literacy-based interventions may serve as both a universal and a targeted prevention program that has potential for assisting elementary school children in making healthier, more informed decisions about use of alcohol and tobacco products.
NINING NURUL AZIZAH
Full Text Available Fluorescent pseudomonass isolated from local plants-rishosphere in temanggung controlled lincat disease of tobacco. This report describe phenotypic charactheristics of the bacteria in order to be used as a base for the development of the bacteria as a biological control agent of lincat disease. Phenotypic charactheristics of six isolates of fluorescent Pseudomonass which controlled lincat disease in the field were determined in the laboratory of Plant Bacteriology, Faculty of Agriculture, Gadjah Mada University. Plant pathogenicity tests were conducted by hypersensitive reaction into tobacco leaf and inoculation to tobacco plants. Antagonism test between fluorescent Pseudomonass and other candidate of biological control agents were also conducted. The results indicated that the bacteria were rod shape, Gram negative, positive reaction in catalase and oxidase tests. Nitrate reduce to nitrite, arginine was hydrolysed, fluorescent pigment were produced on King’s B medium, levan formation positive and all bacteria denitrifiy. The bacteria used urea, tween 80 and amylum were not hydrolised, poly--hydroxybutyrate was not accumulated in the cells. Negative reactions were observed for lysine decarboxylation, indol production, VP/MR reaction, and gelatn liquefation. Some compounds could be used as solely carbon sources. All isolates grew on the medium containing 2% NaCl. The best pH for growth was 6-7 and all isolates grew at 20-41C. Negative result were obtained for hypersensitive reaction and pathogenicity tests.
Muñoz, Celia; Trapero-Bertran, Marta; Cheung, Kei Long; Evers, Silvia; Hiligsmann, Mickaël; de Vries, Hein; López-Nicolás, Ángel
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.
Al-Qadasi, F A; Shah, S A; Ghazi, H F
This study aimed to assess the risk factors for gastric cancer in Yemen. A hospital-based case-control study of 70 cases and 140 controls was carried out in Sana'a city between May and October 2014. A structured questionnaire was used to collect information through direct interview. Living in rural areas, tobacco chewing and drinking untreated water were significant risk factors for gastric cancer. Frequent consumption of chicken, cheese, milk, starchy vegetables, cucumber, carrots, leeks, sweet pepper, fruit drinks, legumes and olive oil were associated significantly with decreased risk of gastric cancer. Multiple logistic regression analysis showed that chewing tobacco and frequent consumption of white bread were associated with increased risk of gastric cancer, whereas frequent consumption of chicken, cooked potatoes and fruit drinks had an inverse association. Risk of gastric cancer can be prevented by health education and increasing community awareness.
Sorensen, G; Youngstrom, R; Maclachlan, C; Gibson, S J; Emmons, K; Johnston, D; Levenstein, C
Although worksite smoking restrictions have become increasingly common in recent years, organized labor has generally not been involved in the adoption of these policies; some evidence suggests that unions often oppose the adoption of worksite smoking policies. To contribute to an understanding of labor's role in tobacco control policies, this paper reports the results of a review of 85 arbitration cases and 5 cases of unfair labor practices charges published between 1986 and 1994. In most of the cases reviewed, management unilaterally imposed a new smoking policy, which the union then grieved. Union opposition to the policy generally focused on the process by which the policy was adopted, rather than the content of the policy; the concern was that management had breached its duty to bargain with the union regarding the adoption of the policy. These results underline the importance of joint labor-management actions on worksite tobacco control policies.
Fu Steven S
Full Text Available Abstract Background Most smokers do not receive comprehensive, evidence-based treatment for tobacco use that includes intensive behavioral counseling along with pharmacotherapy. Further, the use of proven, tobacco treatments is lower among minorities than among Whites. The primary objectives of this study are to: (1 Assess the effect of a proactive care intervention (PRO on population-level smoking abstinence rates (i.e., abstinence among all smokers including those who use and do not utilize treatment and on utilization of tobacco treatment compared to reactive/usual care (UC among a diverse population of smokers, (2 Compare the effect of PRO on population-level smoking abstinence rates and utilization of tobacco treatments between African American and White smokers, and (3 Determine the cost-effectiveness of the proactive care intervention. Methods/Design This prospective randomized controlled trial identifies a population-based sample of current smokers from the Department of Veterans Affairs (VA electronic medical record health factor dataset. The proactive care intervention combines: (1 proactive outreach and (2 offer of choice of smoking cessation services (telephone or face-to-face. Proactive outreach includes mailed invitation materials followed by an outreach call that encourages smokers to seek treatment with choice of services. Proactive care participants who choose telephone care receive VA telephone counseling and access to pharmacotherapy. Proactive care participants who choose face-to-face care are referred to their VA facility's smoking cessation clinic. Usual care participants have access to standard smoking cessation services from their VA facility (e.g., pharmacotherapy, smoking cessation clinic and from their state telephone quitline. Baseline data is collected from VA administrative databases and participant surveys. Outcomes from both groups are collected 12 months post-randomization from participant surveys and from VA
Hizlinda, Tohid; Noriah, Mohd Ishak; Noor Azimah, Muhammad; Farah Naaz, Momtaz Ahmad; Anis Ezdiana, Abdul Aziz; Khairani, Omar
Background: The prevalence of teenage smoking has decreased over the past decade following the implementation of the national tobacco control programme. However, the effect of the programme on smoking cessation in teenagers has not been determined. Methods: Twenty-eight participants (12 teenagers, 8 teachers, and 8 doctors) were interviewed using 5 in-depth interviews and 3 group discussions. Social cognitive theory (SCT) was applied as the theoretical framework. Semi-structured interview protocols were used, and thematic analysis and analytic generalisation utilising SCT were performed. Results: The current national tobacco control programme was found to be ineffective in promoting smoking cessation among teenagers. The participants attributed the ineffective campaign to the followings: inadequacy of message content, lack of exposure to the programme, and poor presentation and execution. In addition, the participants perceived the developed tobacco control policies to be a failure based on poor law enforcement, failure of retailers to comply with the law, social availability of cigarettes to teenagers, and easy availability of cheap, smuggled cigarettes. This study highlighted that the programme-related problems (environmental factors) were not the only factors contributing to its perceived ineffectiveness. The cunning behaviour of the teenagers (personal factor) and poor self-efficacy to overcome nicotine addiction (behavioural factor) were also found to hinder cessation. Conclusion: Tobacco control programmes should include strategies beyond educating teenagers about smoking and restricting their access to cigarettes. Strategies to manage the cunning behaviour of teenagers and strategies to improve their self-efficacy should also be implemented. These comprehensive programmes should have a foundation in SCT, as this theory demonstrates the complex interactions among the environmental, personal, and behavioural factors that influence teenage smoking. PMID
Ballbè, Montse; Gual, Antoni; Nieva, Gemma; Saltó, Esteve; Fernández, Esteve
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.
McCreadie, Robin G
Specialised services should be developed to help people with schizophrenia and associated substance misuse. The extent of the problem therefore needs to be known. To determine the use of drugs, alcohol and tobacco by people with schizophrenia drawn from rural, suburban and urban settings, and to compare use by general population control subjects. People with schizophrenia (n=316) and general population controls of similar gender distribution, age and postcode area of residence (n=250) were identified in rural, urban and suburban areas of Scotland. Use of drugs and alcohol was assessed by the Schedules for Clinical Assessment in Neuropsychiatry, and use of tobacco by a questionnaire. More patients than controls reported problem use of drugs in the past year (22 (7%) v. 5 (2%)) and at some time before then (50 (20%) v. 15 (6%)) and problem use of alcohol in the past year (42 (17%) v. 25 (10%)) but not at some time previously (99 (40%) v. 84 (34%)). More patients were current smokers (162 (65%) v. 99 (40%)). Problem use of drugs and alcohol by people with schizophrenia is greater than in the general population, but absolute numbers are small. Tobacco use is the greatest problem.
Jiang, Guohong; Li, Wei; Zheng, Wenlong; Xu, Zhongliang; Wang, Dezheng; Pan, Yi; Shen, Chengfeng; Yang, Yi; Wang, Zhuo; Ma, Jie; Xue, Xiaodan; Shen, Wenda
To evaluate the integrated effects of tobacco control programs through comparing the pre- and post-implementation of the Tianjin Tobacco Control Act (Act), in 4 successive years. Case-related data on myocardial infarction was collected by Tianjin Surveillance System, New Case Registry. Both the representative sample size of indoor working places and public places for observation and PM2.5 monitored were selected through the calculation of Survey System, while the representative sample size of people involved in the survey for interview was under the Door to Door and Intercept. Through comparing the pre- and post-implementation programs on Act, the posting of "No Smoking Sign" had become much more visible in hospitals, schools, governmental buildings and the waiting areas of public transportation. People smoked much less in the main public places, excepting for hotels and public bath rooms (P infarction presented at the hospitals were declining annually, among the indoor workers. Act showed a positive effect in decreasing the number of smokers in public places thus protecting people from the negative effects on SHS. Message on health effect and social benefits on tobacco control should be disseminated to facilitate the comprehensive implementation of the Act.
Agaku, Israel T; Odani, Satomi; Sturgis, Stephanie; Harless, Charles; Glover-Kudon, Rebecca
Smokeless tobacco has been actively promoted by tobacco companies using endorsements by major sport figures, and research indicates that tobacco advertising can lead to youth initiation of tobacco use (1,2). Television and radio advertisements for cigarettes and smokeless tobacco have been prohibited since 1969,* and the 1998 Master Settlement Agreement(†) further prohibited tobacco companies from targeting youths with tobacco product advertisements in specified areas. In 2010, the Food and Drug Administration (FDA), under authority of the 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA), prohibited tobacco-brand sponsorship (i.e., sponsorship of sports and entertainment events or other social or cultural events using the tobacco brand name or anything identifiable with any brand of cigarettes or smokeless tobacco).(§) However, corporate-name tobacco sponsorship (i.e., sponsorship using the name of the corporation that manufactures regulated tobacco products) is still permitted under certain conditions.(¶) To monitor tobacco advertising and promotional activities in sports in the United States, CDC analyzed trends in sports-related marketing expenditures for cigarettes and smokeless tobacco during 1992-2013 using data from the Federal Trade Commission (FTC). During 1992-2013, sports-related marketing expenditures, adjusted by the consumer price index to constant 2013 dollars, decreased significantly for both cigarettes (from $136 million in 1992 to $0 in 2013) and smokeless tobacco (from $34.8 million in 1992 to $2.1 million in 2013). During 2010-2013, after the prohibition of tobacco-brand sponsorship in sports under the FSPTCA, cigarette manufacturers reported no spending (i.e., $0) on sports-related advertising and promotional activities; in contrast, smokeless tobacco manufacturers reported expenditures of $16.3 million on advertising and promoting smokeless tobacco in sports during 2010-2013. These findings indicate that despite prohibitions
Congress passed the Family Smoking Prevention and Tobacco Control Act in 2009 with the aim of reducing tobacco-related illnesses and deaths by curbing tobacco's appeal to and use by children and adolescents. Legislators considered provisions of the FSPTCA restricting tobacco advertising and labeling key to realizing the law's intended health benefits. But a lawsuit now before the U.S. Court of Appeals for the Sixth Circuit challenges the tobacco marketing restrictions as impermissible restraints on tobacco companies' commercial speech rights under the First Amendment. This article analyzes the constitutionality of each FSPTCA tobacco advertising and labeling restriction in light of U.S. Supreme Court decisions defining the extent of First Amendment protection for commercial speech, prior efforts to restrict tobacco marketing, and the outcomes of legal challenges to some of the prior marketing restrictions. Several of the FSPTCA tobacco advertising and labeling restrictions were drafted with insufficient accommodations for tobacco companies' First Amendment right to convey and consumers' First Amendment right to receive truthful information about lawful tobacco products and are therefore unconstitutional as currently written.
This project will support the collection of baseline data against which to measure future changes in smoking patters and amount of tobacco consumed. ... Chinese Center for Disease Control and Prevention ... Impact of multinational tobacco companies' penetration on tobacco consumption in China : final technical report ...
Full Text Available Tras su aprobación por 171 Estados Miembros de la Organización Mundial de la Salud (OMS el 1 de marzo de 2003, un tratado que marca un hito en la historia de la salud pública y que se encamina a controlar el abastecimiento y el consumo de tabaco será presentado ante la Asamblea Mundial de la Salud (AMS, que contemplará su adopción en la reunión que tendrá inicio el 19 de mayo de 2003 en Ginebra, Suiza. La AMS es la máxima autoridad decisoria de la OMS y su principal cometido es determinar las políticas de dicha Organización. El tratado propuesto, que se conoce por Convenio Marco para el Control del Tabaco (CMCT, abarca asuntos tales como la gravación del tabaco; la prevención y el tratamiento del hábito de fumar; el comercio ilícito, la publicidad, el patrocinio y la promoción de los producto del tabaco, y la rotulación de los paquetes y cajetillas. Si la Asamblea Mundial de la Salud adopta el CMCT, el tratado se abrirá a la firma de los Estados Miembros de la OMS. Después de que sea ratificado por 40 países, el tratado entrará en vigor en los países que lo hayan aprobado. Aunque desde 1970 ha habido casi 20 resoluciones de la Asamblea Mundial de la Salud encaminadas a apoyar iniciativas para el control del tabaco, la diferencia entre dichas resoluciones y el presente tratado radica en que el cumplimiento de las provisiones de este último tendrá fuerza jurídica para las distintas partes cuando el convenio entre en vigor. Los únicos tres países que se opusieron abiertamente al proyecto de texto aprobado el 1 de marzo de 2003 fueron Alemania, Cuba y Estados Unidos de América. Funcionarios del Gobierno estadounidense han señalado que tratarán de lograr que se enmiende la redacción del texto del tratado en la Asamblea Mundial de la Salud en mayo.
Full Text Available Tras su aprobación por 171 Estados Miembros de la Organización Mundial de la Salud (OMS el 1 de marzo de 2003, un tratado que marca un hito en la historia de la salud pública y que se encamina a controlar el abastecimiento y el consumo de tabaco será presentado ante la Asamblea Mundial de la Salud (AMS, que contemplará su adopción en la reunión que tendrá inicio el 19 de mayo de 2003 en Ginebra, Suiza. La AMS es la máxima autoridad decisoria de la OMS y su principal cometido es determinar las políticas de dicha Organización. El tratado propuesto, que se conoce por Convenio Marco para el Control del Tabaco (CMCT, abarca asuntos tales como la gravación del tabaco; la prevención y el tratamiento del hábito de fumar; el comercio ilícito, la publicidad, el patrocinio y la promoción de los producto del tabaco, y la rotulación de los paquetes y cajetillas. Si la Asamblea Mundial de la Salud adopta el CMCT, el tratado se abrirá a la firma de los Estados Miembros de la OMS. Después de que sea ratificado por 40 países, el tratado entrará en vigor en los países que lo hayan aprobado. Aunque desde 1970 ha habido casi 20 resoluciones de la Asamblea Mundial de la Salud encaminadas a apoyar iniciativas para el control del tabaco, la diferencia entre dichas resoluciones y el presente tratado radica en que el cumplimiento de las provisiones de este último tendrá fuerza jurídica para las distintas partes cuando el convenio entre en vigor. Los únicos tres países que se opusieron abiertamente al proyecto de texto aprobado el 1 de marzo de 2003 fueron Alemania, Cuba y Estados Unidos de América. Funcionarios del Gobierno estadounidense han señalado que tratarán de lograr que se enmiende la redacción del texto del tratado en la Asamblea Mundial de la Salud en mayo.
Harris, Jeffrey E; Balsa, Ana Inés; Triunfo, Patricia
We analyzed a nationwide registry of all pregnancies in Uruguay during 2007-2013 to assess the impact of three types of tobacco control policies: (1) provider-level interventions aimed at the treatment of nicotine dependence, (2) national-level increases in cigarette taxes, and (3) national-level non-price regulation of cigarette packaging and marketing. We estimated models of smoking cessation during pregnancy at the individual, provider and national levels. The rate of smoking cessation during pregnancy increased from 15.4% in 2007 to 42.7% in 2013. National-level non-price policies had the largest estimated impact on cessation. The price response of the tobacco industry attenuated the effects of tax increases. While provider-level interventions had a significant effect, they were adopted by relatively few health centers. Quitting during pregnancy increased birth weight by an estimated 188 g. Tobacco control measures had no effect on the birth weight of newborns of non-smoking women. Copyright © 2015 Elsevier B.V. All rights reserved.
Apollonio, D E; Malone, R E
To describe the tobacco industry's relationships with and influence on homeless and mentally ill smokers and organisations providing services to them. Analysis of internal tobacco industry documents and journal articles. The tobacco industry has marketed cigarettes to the homeless and seriously mentally ill, part of its "downscale" market, and has developed relationships with homeless shelters and advocacy groups, gaining positive media coverage and political support. Tobacco control advocates and public health organisations should consider how to target programmes to homeless and seriously mentally ill individuals. Education of service providers about tobacco industry efforts to cultivate this market may help in reducing smoking in these populations.
Barrientos-Gutiérrez, Tonatiuh; Barrientos-Gutiérrez, Inti; Reynales-Shigematsu, Luz Myriam; Thrasher, James F; Lazcano-Ponce, Eduardo
Exposure to tobacco advertisement is associated with smoking initiation among the youth, its elimination is a key objective to effectively curb the tobacco epidemic. Historically, the tobacco industry has pioneered the use of new communication technologies to keep and expand their market. Nowadays, Internet and video games have transcended the entertainment sphere, becoming significant media for massive communication and providing new opportunities for advertisement. The present essay reviews the existing literature on tobacco presence in the Internet and video games to define research and policy tasks required to develop effective means for tobacco advertisement regulation and control.
Full Text Available En España ha sido visible la creciente implicación de la sociedad civil en la demanda de políticas de control del tabaquismo. Las bases para la creación del Comité Nacional para la Prevención del Tabaquismo (CNPT fueron asentadas en 2004. A finales de ese año la intensa actuación para concretar las acciones reguladoras del incipiente Plan Nacional para la Prevención del Tabaquismo culminó en una ley que permitió un salto cualitativo, aprovechando la trasposición legal de la directiva europea de publicidad: la Ley 28/2005, que, en un clima de amplio consenso político y mediático, dispone medidas sanitarias frente al tabaquismo y regula la venta, el suministro, el consumo y la publicidad de los productos del tabaco. El objetivo declarado por esta ley es evitar el inicio del consumo de tabaco particularmente entre los jóvenes, garantizar el derecho de los no fumadores a respirar aire sin humo del tabaco y hacer más fácil el abandono de este hábito a las personas que lo deseen. Sus temas principales son la prohibición de la publicidad del tabaco y la limitación de su consumo en centros de trabajo y espacios públicos cerrados. La nueva ley ha substituido a la normativa previa en España, que era una de las más permisivas de la Unión Europea en temas como la venta de tabaco, limitación de la publicidad y restricciones de lugares de consumo. No obstante, está claro que aún queda mucho por hacer. En este momento hace falta generar apoyo social a la nueva regulación y hacer un esfuerzo importante de sensibilización y educación del público.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 regulartory actions in the National Plan for Tobacco Prevention. This would facilitate a
The study examined the influence of media enlightenment programmes on control and prevention of cerebrospinal meningitis among people of Ilorin metropolis, Kwara State, Nigeria. The study population comprised all the people within Ilorin metropolis, Kwara state. A descriptive research design of survey method was ...
Teo, Koon K; Ounpuu, Stephanie; Hawken, Steven; Pandey, M R; Valentin, Vicent; Hunt, David; Diaz, Rafael; Rashed, Wafa; Freeman, Rosario; Jiang, Lixin; Zhang, Xiaofei; Yusuf, Salim
Tobacco use is one of the major avoidable causes of cardiovascular diseases. We aimed to assess the risks associated with tobacco use (both smoking and non-smoking) and second hand tobacco smoke (SHS) worldwide. We did a standardised case-control study of acute myocardial infarction (AMI) with 27,089 participants in 52 countries (12,461 cases, 14,637 controls). We assessed relation between risk of AMI and current or former smoking, type of tobacco, amount smoked, effect of smokeless tobacco, and exposure to SHS. We controlled for confounders such as differences in lifestyles between smokers and non-smokers. Current smoking was associated with a greater risk of non-fatal AMI (odds ratio [OR] 2.95, 95% CI 2.77-3.14, ptobacco alone was associated with OR 2.23 (1.41-3.52), and smokers who also chewed tobacco had the highest increase in risk (4.09, 2.98-5.61). SHS was associated with a graded increase in risk related to exposure; OR was 1.24 (1.17-1.32) in individuals who were least exposed (1-7 h per week) and 1.62 (1.45-1.81) in people who were most exposed (>21 h per week). Young male current smokers had the highest population attributable risk (58.3%; 95% CI 55.0-61.6) and older women the lowest (6.2%, 4.1-9.2). Population attributable risk for exposure to SHS for more than 1 h per week in never smokers was 15.4% (12.1-19.3). Tobacco use is one of the most important causes of AMI globally, especially in men. All forms of tobacco use, including different types of smoking and chewing tobacco and inhalation of SHS, should be discouraged to prevent cardiovascular diseases.
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.
Kuipers, Mirte A. G.; Nagelhout, Gera E.; Willemsen, Marc C.; Kunst, Anton E.
In 2003, the Netherlands introduced tobacco control policies, including bans on tobacco sales to minors, advertising and sponsoring and tobacco sales in government institutions. We examined the extent to which these policies were associated with a change in educational inequalities in adolescent
Sreenivas P. Veeranki
Approximately 19% (30.7% males; 10.2% females of adolescents currently smoke cigarettes, and 7% (8.5% males and 5.8% females currently use non-cigarette tobacco products. Regardless of sex, peer smoking behavior was significantly associated with increased tobacco use among adolescents. In addition, exposures to tobacco industry promotions, secondhand smoke (SHS and anti-smoking media messages were associated with tobacco use. The strong gender gap in the use of non-cigarette tobacco products, and the role of peer smoking and industry promotions in adolescent females’ tobacco use should be of major advocacy and policy concern. A comprehensive tobacco control program integrating parental and peer education, creating social norms, and ban on promotions is necessary to reduce adolescents’ tobacco use.
Li, Na; Najafian-Razavi, Maryam; Gillet, Denis
Due to the huge exposure of personal information in social media, a challenge now is to design effective privacy mechanisms that protect against unauthorized access to social data. In this paper, a trust model for social media is first presented. Based on the trust model, a trust-aware privacy control protocol is proposed, that exploits the underlying inter-entity trust information. The objective is to design a fine-grained privacy scheme that ensures a user’s online information is disclosed ...
Durrani, Shabnum; Lucik, Meg; Safeer, Richard
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.
Provides two lesson plans for classroom use. Focuses on media influence on the use of alcohol and tobacco and on regulatory laws and their effect on drug use. Identifies connections that can be made to textbooks and magazine articles, as well as suggestions for opening, developing, and concluding each lesson. (DK)
Escobedo, P; Cruz, TB; Tsai, K-Y; Allem, J-P; Soto, DW; Kirkpatrick, MG; Pattarroyo, M; Unger, JB
Limited information exists about strategies and methods used on brand marketing websites to transmit pro-tobacco messages to tobacco users and potential users. This study compared age verification methods, themes, interactive activities and links to social media across tobacco brand websites.This study examined 12 tobacco brand websites representing four tobacco product categories: cigarettes, cigar/cigarillos, smokeless tobacco, and e-cigarettes. Website content was analyzed by tobacco produ...
Park, Elyse R; Ostroff, Jamie S; Perez, Giselle K; Hyland, Kelly A; Rigotti, Nancy A; Borderud, Sarah; Regan, Susan; Muzikansky, Alona; Friedman, Emily R; Levy, Douglas E; Holland, Susan; Eusebio, Justin; Peterson, Lisa; Rabin, Julia; Miller-Sobel, Jacob; Gonzalez, Irina; Malloy, Laura; O'Brien, Maureen; de León-Sanchez, Suhana; Whitlock, C Will
Despite the well-established risks of persistent smoking, 10-30% of cancer patients continue to smoke after diagnosis. Evidence-based tobacco treatment has yet to be integrated into routine oncology care. This paper describes the protocol, manualized treatment, evaluation plan, and overall study design of comparing the effectiveness and cost of two treatments across two major cancer centers. A two-arm, two-site randomized controlled comparative effectiveness trial is testing the hypothesis that an Intensive Treatment (IT) intervention is more effective than a Standard Treatment (ST) intervention in helping recently diagnosed cancer patients quit smoking. Both interventions include 4 weekly counseling sessions and FDA-approved smoking cessation medication advice. The IT includes an additional 4 biweekly and 3 monthly booster sessions as well as dispensal of the recommended FDA-approved smoking cessation medication at no cost. The trial is enrolling patients with suspected or newly diagnosed cancer who have smoked a cigarette in the past 30days. Participants are randomly assigned to receive the ST or IT condition. Tobacco cessation outcomes are assessed at 3 and 6months. The primary study outcome is 7-day point prevalence biochemically-validated tobacco abstinence. Secondary study outcomes include the incremental cost-effectiveness of the IT vs. ST. This trial will answer key questions about delivering tobacco treatment interventions to newly diagnosed cancer patients. If found to be efficacious and cost-effective, this treatment will serve as a model to be integrated into oncology care settings nation-wide, as we strive to improve treatment outcomes and quality of life for cancer patients. Copyright © 2016. Published by Elsevier Inc.
El-Toukhy, Sherine; Choi, Kelvin; Hitchman, Sara C; Bansal-Travers, Maansi; Thrasher, James F; Yong, Hua-Hie; O'Connor, Richard J; Shang, Ce
BACKGROUND: Ecological models emphasise multilevel influences on health behaviours. While studies show that exposure to price promotions is associated with smoking behaviour and its antecedents, less is known about whether these associations differ by macro-level factors such as national price promotion policies.METHODS: Current and former smokers (N=4698) from the International Tobacco Control Policy Evaluation Project four-country cohort were included in weighted multivariate logistic regre...
Teixeira, Luiz Antônio da Silva; Paiva, Carlos Henrique Assunção; Ferreira, Vanessa Nolasco
This study analyses the development of a tobacco-control agenda in Brazil following the country's participation in the World Health Organization Framework Convention on Tobacco Control (WHO-FCTC). This process started with the diplomatic negotiations for the participation of Brazil in the treaty, in 2003, and its ratification by the National Congress, in 2005, and was marked by substantial controversies between public health players, who are accountable for tobacco-control actions, and the high echelon of Brazilian diplomacy, emissaries of the tobacco industry, representatives of small tobacco farmers from the Southern region of the country, congress representatives, senators and ministers. The study is based on the contributions of John W. Kingdon on the development of an agenda for the formulation of public policies. It took into account secondary references, legislative and institutional sources from the 1995 to 2005 period. It concluded that the association of tobacco-related healthcare actions by technically skilled officials, the involvement of the high echelon of the Ministry of Foreign Affairs (policy flow), the initiative for the establishment of the WHO-FCTC (problem flow), and the existence of a favorable environment in both, executive and legislative (political flow), opened a window of opportunity for WHO-FCTC ratification and its inclusion in the government decision agenda.
Hafez, N; Ling, P M
To describe Philip Morris' global market research and international promotional strategies targeting young adults. Analysis of previously secret tobacco industry documents. Philip Morris pursued standardised market research and strategic marketing plans in different regions throughout the world using research on young adults with three principle foci: lifestyle/psychographic research, brand studies, and advertising/communication effectiveness. Philip Morris identified core similarities in the lifestyles and needs of young consumers worldwide, such as independence, hedonism, freedom, and comfort. In the early 1990s Philip Morris adopted standardised global marketing efforts, creating a central advertising production bank and guidelines for brand images and promotions, but allowing regional managers to create regionally appropriate individual advertisements. Values and lifestyles play a central role in the global marketing of tobacco to young adults. Worldwide counter marketing initiatives, coupled with strong, coherent global marketing policies such as the Framework Convention on Tobacco Control, are needed to break associations between young adult values and tobacco brands. As globalisation promotes the homogenisation of values and lifestyles, tobacco control messages that resonate with young adults in one part of the world may appeal to young adults in other countries. Successful tobacco control messages that appeal to young people, such as industry denormalisation, may be expanded globally with appropriate tailoring to appeal to regional values.
Ahrens, David; Jones, Nathan; Pfister, Kyle; Remington, Patrick L
Although public and media attention has focused on the federal role in the regulation of tobacco products, state government remains an important arena for changing tobacco control policies. Lobbying state officials by public health and the tobacco industry is a commonly used mechanism to influence public policy. Major bills of the 2007-2008 and 2009-2010 Wisconsin legislative sessions related to tobacco use regulation were analyzed by the hours engaged in lobbying and the estimated expenditures by supporters and opponents of tobacco control legislation in reports submitted to the Government Accountability Board. In the 2007-2008 legislative session, anti-tobacco control organizations reported lobbying expenditures of more than $2 million (2627 hours) while opposing bills to raise tobacco excise taxes and enact smoke-free legislation; pro-tobacco control organizations reported lobbying expenditures of $623,000 (3997 hours) while supporting these bills. In the first 6 months of the 2009 session, anti-tobacco control groups spent $1.25 million (1472 hours) and pro-tobacco control groups spent $172,000 (1727 hours). In the 2007-2008 legislative session, the proposal to increase the tobacco tax by $1 per pack was passed. However, the smoke-free indoor air bill was defeated. Anti-tobacco control organizations outspent pro-tobacco control organizations by a margin of over 3:1. In 2009 anti-tobacco control groups outspent health groups by a ratio of 7:1. Legislation for smoke-free workplaces and an increase in the cigarette tax was enacted. However, funding for tobacco prevention and treatment programs was substantially reduced.
Carter, Owen B J; Donovan, Robert; Jalleh, Geoffrey
The authors' objective was to conduct a trial of viral e-mail marketing as a distribution method for tobacco control advertisements. University students (n = 200) in the state of Western Australia were randomly allocated to receive 1 of 2 e-mails with hyperlinks to tobacco control advertisements ("Toilet" and "Rubbish") emphasizing the disgusting nature of smoking. Recipients followed a hyperlink to a Web page playing Toilet or Rubbish on endless loop. Viewers were encouraged to forward the e-mail to their friends and invited to complete an online survey about the advertisement. Unique downloads for each advertisement were identified by internet provider (IP) location and tallied by date and geographical location to assess subsequent dissemination beyond the initial 200 students. There were 826 unique viewings of the advertisements averaging 26.9 viewings per day for the first fortnight, followed by a lower average of 4.1 hits per day for the next 3.5 months. IP addresses identified hits from 3 other Australian states and 7 other countries. Online surveys were completed by 103 respondents (12.5% of total hits) but included few smokers (n = 9). Significantly more respondents rated Toilet as "funny" compared with Rubbish (40% vs. 11%; p < .05), likely explaining why the former accounted for significantly more viewings than the latter (487 vs. 339; p < .001). There was a greater than fourfold return in dissemination for each initial e-mail sent but daily hits rapidly deteriorated over time. Entertainment appears to facilitate viral e-mails being forwarded onwards but only exceptionally compelling tobacco control materials are ever likely to become self-perpetuating.
Turk, Tahir; Chaturvedi, Pankaj; Murukutla, Nandita; Mallik, Vaishakhi; Sinha, Praveen; Mullin, Sandra
The evidence on the efficacy of tobacco control messages in low and middle-income country (LMIC) settings is limited but growing. Low message salience and disengagement, in the face of tobacco control messages, are possible barriers to self-efficacy and cessation-related behaviours of tobacco users. Although adaptations of existing pretested graphic and emotional appeals have been found to impact on behaviours, more personalised, culturally relevant and compelling appeals may more fully engage message receivers to elicit optimal behavioural responses. The objective of these case studies is to use lessons learnt from high-income country tobacco control communication programmes, and adapt practical approaches to provide cost-effective, culturally nuanced,