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Tobacco Control
Journal Prestige (SJR): 2.752  Citation Impact (citeScore): 3 Number of Followers: 16  Hybrid journal (It can contain Open Access articles)ISSN (Print) 0964-4563 - ISSN (Online) 1468-3318 Published by BMJ Publishing Group  [62 journals]
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- Off-White: decentring Whiteness in tobacco science
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Authors: Lee, J. P; Maddox, R, Kennedy, M, Nahvi, S, Guy, M. C.
Pages: 537 - 539
Abstract: ‘Vulnerable’ is sometimes used to refer to specific groups of people who use tobacco products. In bioethics, ‘vulnerable’ denotes a need for protection.1 2 In tobacco science, however, the precise nature of vulnerability is commonly undefined. Tobacco programmes may seek to engage ‘vulnerable’ people in programmes that ‘develop capacities’ or ‘build strengths’, implying that people who smoke are deficient in qualities that make other people invulnerable to smoking and the tobacco industry. ‘Vulnerable’ may also simply code for ‘not White’ or ‘off-White’. Some minoritised populations indeed experience specific vulnerabilities (eg, Black people globally, from overpolicing and brutality). The sources of their vulnerabilities are not intrinsic but rather extrinsic: systems of oppression that disenfranchise and de-invest in minoritised groups and further institutionalise bias, racism and discrimination.3 The academic discourse of vulnerability in tobacco science often reflects and perpetuates racialised logic, which can, in turn,...
Keywords: Open access
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tc-2023-057998
Issue No: Vol. 32, No. 5 (2023)
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- Worldwide news and comment
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Authors: Evans-Reeves, K; Canty, R, Perera, M. N.
Pages: 540 - 545
Abstract: All articles written by Karen Evans-Reeves, Ruth Canty, Manuja Niranshi Perera unless otherwise attributed. Ideas and items for News Analysis should be sent to k.a.evans-reeves@bath.ac.uk GlobalChanging the business climate to protect the earth’s climate United Nations bodies already offer the necessary tools to remove industry obstacles from the path of a liveable climate and improved public health. The global community must use them. For decades, the vehicle industry produced vehicle fuel with lead additives. The decision by carmakers and refiners to use lead helped vehicles achieve greater power and was patented by its producers. It also poisoned human beings. This was not a surprise. As early as the Roman era there were suspicions that lead damaged human health, and — more immediately — workers at the plants producing tetraethyl lead in the 1920s were reporting extreme medical maladies. Some died. Yet, science is always playing...
Keywords: TC News analysis
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tc-2023-058297
Issue No: Vol. 32, No. 5 (2023)
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- Nicotine replacement therapy 'gift cards for hospital inpatients who
smoke: a prospective before-and-after controlled pilot evaluation-
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Authors: Mullen, K. A; Walker, K. L, Noble, S, Pritchard, G, Garg, A, Martin, N, Pipe, A. L, Reid, R. D.
Pages: 546 - 552
Abstract: IntroductionA common barrier identified by individuals trying to quit smoking is the cost of cessation pharmacotherapies. The purpose of this evaluation was to: (1) Assess the feasibility of offering nicotine replacement therapy (NRT) ‘gift cards’ to hospitalised smokers for use posthospitalisation; and, (2) Estimate the effect of providing NRT gift cards on 6-month smoking abstinence.MethodsA prospective, quasi-experimental, before-and-after controlled cohort design with random sampling was used to compare patients who had received the Ottawa Model for Smoking Cessation (OMSC) intervention (‘control’) with patients who received the OMSC plus a $C300 Quit Card (‘QCI’), which they could use to purchase any brand or form of NRT from any Canadian pharmacy.Results750 Quit Cards were distributed to the three participating hospitals of which 707 (94.3%) were distributed to patients. Of the cards received by patients, 532 (75.2%) were used to purchase NRT. A total of 272 participants completed evaluation surveys (148 control; 124 QCI).Point prevalence abstinence rates adjusted for misreporting among survey responders were 15.3% higher in the QCI group, compared with controls (44.4% vs 29.1%; OR 1.95, 1.18–3.21; p=0.009). Satisfaction was high among participants in both groups, and among staff delivering the QCI. QCI participants rated the intervention as high in terms of motivation, ease of use and helpfulness.ConclusionsThe NRT gift card appears to be a feasible and effective smoking cessation tool that removes a primary barrier to the use of evidence-based smoking cessation pharmacotherapies, while motivating both patients and health providers.
Keywords: Open access
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056947
Issue No: Vol. 32, No. 5 (2023)
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- Development of the UNC Perceived Message Effectiveness Scale for Youth
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Authors: Noar, S. M; Gottfredson, N, Vereen, R. N, Kurtzman, R, Sheldon, J. M, Adams, E, Hall, M. G, Brewer, N. T.
Pages: 553 - 558
Abstract: PurposeTobacco prevention media campaigns are an important tool to address youth tobacco use. We developed a theory-based perceived message effectiveness (PME) Scale to use when vetting messages for campaigns.MethodsParticipants were a national sample of N=623 US adolescents (ages 13–17 years) recruited from a national probability-based panel. In an online experiment, we randomised adolescents to view tobacco prevention ads. All participants viewed an ad on smoking or vaping from the US Food and Drug Administration’s The Real Cost campaign and a control video, in a random order. After ad exposure, we assessed PME using nine candidate items and constructs for convergent and criterion validity analyses. We used confirmatory factor analysis and examined information curves to select the scale items.ResultsA brief PME scale with three items (α=0.95) worked equally well for demographically diverse adolescents with different patterns of tobacco use. The Real Cost ads generated higher PME scores than the control videos for both vaping and smoking (convergent validity; p
Keywords: Open access
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056929
Issue No: Vol. 32, No. 5 (2023)
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- Classifying European cigarette consumption trajectories from 1970 to 2015
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Authors: Poirier, M. J; Lin, G, Watson, L. K, Hoffman, S. J.
Pages: 559 - 566
Abstract: ObjectivesTo systematically code and classify longitudinal cigarette consumption trajectories in European countries since 1970.DesignBlinded duplicate qualitative coding of periods of year-over-year relative increase, plateau, and decrease of national per capita cigarette consumption and categorisation of historical cigarette consumption trajectories based on longitudinal patterns emerging from the data.Setting41 countries or former countries in the European region for which data are available between 1970 and 2015.ResultsRegional trends in longitudinal consumption patterns identify stable or decreasing consumption throughout Northern, Western and Southern European countries, while Eastern and Southeastern European countries experienced much greater instability. The 11 emergent classes of historical cigarette consumption trajectories were also regionally clustered, including a distinctive inverted U or sine wave pattern repeatedly emerging from former Soviet and Southeastern European countries.ConclusionsThe open-access data produced by this study can be used to conduct comparative international evaluations of tobacco control policies by separating impacts likely attributable to gradual long-term trends from those more likely attributable to acute short-term events. The complex, regionally clustered historical trajectories of cigarette consumption in Europe suggest that the enduring normative frame of a gently sloping downward curve in cigarette consumption can offer a false sense of security among policymakers and can distract from plausible causal mechanisms among researchers. These multilevel and multisectoral causal mechanisms point to the need for a greater understanding of the political economy of regional and global determinants of cigarette consumption.
Keywords: Open access
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056627
Issue No: Vol. 32, No. 5 (2023)
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- Shifts in preference for Natural American Spirit and associated belief
that ones own cigarette brand might be less harmful than other brands:
results from Waves 1-4 of the Population Assessment of Tobacco and Health
(PATH) Study (2013-2018)-
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Authors: Pearson, J; Ganz, O, Ohman-Strickland, P, Wackowski, O. A.
Pages: 567 - 574
Abstract: IntroductionPeople believe that cigarettes using ‘organic,’ ‘additive-free’ or similar descriptors are less harmful than other cigarettes. Natural American Spirit (NAS) is the most popular US cigarette brand using these descriptors. This cohort study describes changes in US smokers’ odds of preferring NAS and changes in NAS smokers’ odds of believing their brand might be less harmful than other brands.MethodsData come from four waves (2013–2018) of the Population Assessment of Tobacco and Health (PATH) Study. Generalised estimating equations produced population-averaged estimates of relationships between (1) NAS brand preference and wave and (2) belief that one’s own brand might be less harmful than other brands, wave and NAS brand preference. Models tested interactions by age group and sexual minority status.ResultsThe odds that smokers preferred NAS increased by 60% in W4 relative to W1. Disproportionate preference by younger adult and sexual minority smokers was observed. The odds that NAS smokers believed their own brand might be less harmful decreased by 50% between W1 and W4, but this perception was still 16 times higher for NAS compared with non-NAS smokers. Given the increasing preference for NAS, there was no significant change in the absolute number of NAS smokers who believed their own brand might be less harmful (W1: 562 122 (95% CI 435 190 to 689 055) vs W4: 580 378 (95% CI 441 069 to 719 689)).ConclusionsBoth brand popularity and concentration of brand-related harm perceptions are important for understanding population impact of changes in cigarette marketing.
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056985
Issue No: Vol. 32, No. 5 (2023)
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- Follow the money: a closer look at US tobacco industry marketing
expenditures-
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Authors: Levy, D. T; Liber, A. C, Cadham, C, Sanchez-Romero, L. M, Hyland, A, Cummings, M, Douglas, C, Meza, R, Henriksen, L.
Pages: 575 - 582
Abstract: IntroductionWhile much of the concern with tobacco industry marketing has focused on direct media advertising, a less explored form of marketing strategy is to discount prices. Price discounting is important because it keeps the purchase price low and can undermine the impact of tax increases.MethodsWe examine annual US marketing expenditures from 1975 to 2019 by the largest cigarette and smokeless tobacco companies as reported to the Federal Trade Commission. We consider three categories: direct advertising, promotional allowances and price discounting. In addition to considering trends in these expenditures, we examine how price discounting expenditures relate to changes in product prices and excise taxes.ResultsUS direct advertising expenditures for cigarettes fell from 80% of total industry marketing expenditures in 1975 to less than 3% in 2019, while falling from 39% in 1985 to 6% in 2019 for smokeless tobacco. Price discounting expenditures for cigarettes became prominent after the Master Settlement Agreement and related tax increases in 2002. By 2019, 87% of cigarette marketing expenditures were for price discounts and 7% for promotional allowances. Smokeless marketing expenditures were similar: 72% for price promotions and 13% for promotional allowances. Price discounting increased with prices and taxes until reaching their currently high levels.ConclusionsBetween 1975 and 2019, direct advertising dramatically fell while price discounting and promotional expenditures increased. Local, state and federal policies are needed that apply non-tax mechanisms to increase tobacco prices and restrict industry contracts to offset industry marketing strategies. Further study is needed to better understand industry decisions about marketing expenditures.
Keywords: Open access
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056971
Issue No: Vol. 32, No. 5 (2023)
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- Naturally leading: a content analysis of terms, themes and word
associations in Natural American Spirit advertising, 2000-2020-
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Authors: Gratale, S. K; Ganz, O, Wackowski, O. A, Lewis, M. J.
Pages: 583 - 588
Abstract: BackgroundNatural American Spirit (NAS) is a cigarette brand distinguished by supposed ‘natural’, ‘additive-free’ characteristics, marketing of which is tied to misperceptions of reduced harm. In 2017, NAS’s manufacturer agreed (with the Food and Drug Administration) to remove ‘natural’/‘additive-free’ from US marketing. Prior research has explored NAS marketing immediately post-agreement. This study sought to identify prominent post-agreement terms and themes and analyse how they had been used in pre-agreement ads.MethodsWe conducted a content analysis of NAS ads from 2000 to 2020 (N=176), documenting prominent pre-agreement and post-agreement terms/themes and examining how they are used in NAS ads. We coded for descriptors, themes, imagery and promotions, and extended prior research by analysing how leading post-agreement terms were used in conjunction and thematically associated with ‘additive-free’ and ‘natural’ before the agreement.ResultsResults indicated ‘tobacco and water’ and ‘Real. Simple. Different.’ increased post-agreement, as did environmental imagery. ‘Organic’ was prominent pre-agreement and post-agreement. The descriptors used most often in post-agreement ads almost always appeared in conjunction with (and were thematically linked to) ‘natural’ and ‘additive-free’ in pre-agreement ads.ConclusionsIn the years since the agreement, NAS ads have heavily relied on still-allowable descriptors that may invite reduced risk misperceptions. Notably, these descriptors were consistently used alongside the banned terminology before the agreement and presented as if affiliated conceptually, possibly prompting similar connotations. Findings indicate a continuing need for research into NAS advertising effects and a potential role for additional regulatory action.
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056938
Issue No: Vol. 32, No. 5 (2023)
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- Identifying best modelling practices for tobacco control policy
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Authors: Huang, V; Head, A, Hyseni, L, O'Flaherty, M, Buchan, I, Capewell, S, Kypridemos, C.
Pages: 589 - 598
Abstract: BackgroundPolicy simulation models (PSMs) have been used extensively to shape health policies before real-world implementation and evaluate post-implementation impact. This systematic review aimed to examine best practices, identify common pitfalls in tobacco control PSMs and propose a modelling quality assessment framework.MethodsWe searched five databases to identify eligible publications from July 2013 to August 2019. We additionally included papers from Feirman et al for studies before July 2013. Tobacco control PSMs that project tobacco use and tobacco-related outcomes from smoking policies were included. We extracted model inputs, structure and outputs data for models used in two or more included papers. Using our proposed quality assessment framework, we scored these models on population representativeness, policy effectiveness evidence, simulated smoking histories, included smoking-related diseases, exposure-outcome lag time, transparency, sensitivity analysis, validation and equity.FindingsWe found 146 eligible papers and 25 distinct models. Most models used population data from public or administrative registries, and all performed sensitivity analysis. However, smoking behaviour was commonly modelled into crude categories of smoking status. Eight models only presented overall changes in mortality rather than explicitly considering smoking-related diseases. Only four models reported impacts on health inequalities, and none offered the source code. Overall, the higher scored models achieved higher citation rates.ConclusionsWhile fragments of good practices were widespread across the reviewed PSMs, only a few included a ‘critical mass’ of the good practices specified in our quality assessment framework. This framework might, therefore, potentially serve as a benchmark and support sharing of good modelling practices.
Keywords: Open access
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056825
Issue No: Vol. 32, No. 5 (2023)
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- Differential impact of the Canadian point-of-sale tobacco display bans on
quit attempts and smoking cessation outcomes by sex, income and education:
longitudinal findings from the ITC Canada Survey-
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Authors: Usidame, B; Xie, Y, Thrasher, J. F, Lozano, P, Elliott, M. R, Fong, G. T, Fleischer, N. L.
Pages: 599 - 606
Abstract: SignificanceThis study examines the differential effects of Canadian point-of-sale (POS) tobacco display bans across provinces on quit attempts and smoking cessation, by sex, education and income.MethodsWe analysed survey data from five waves (waves 4–8) of the International Tobacco Control Canada Survey, a population-based, longitudinal survey, where provinces implemented display bans between 2004 and 2010. Primary outcomes were quit attempts and successful cessation. We used generalised estimating equation Poisson regression models to estimate associations between living in a province with or without a POS ban (with a 24-month threshold) and smoking outcomes. We tested whether these associations varied by sex, education and income by including interaction terms.ResultsAcross survey waves, the percentage of participants in provinces with POS bans established for more than 24 months increased from 5.0% to 95.8%. There was no association between POS bans and quit attempts for provinces with bans in place for 0–24 months or more than 24 months, respectively (adjusted relative risk (aRR)=0.99, 95% CI: 0.89 to 1.10; 1.03, 95% CI: 0.88 to 1.20). However, we found a differential impact of POS bans on quit attempts by sex, whereby bans were more effective for women than men for bans of 0–24 months. Participants living in a province with a POS ban for at least 24 months had a higher chance of successful cessation (aRR=1.49; 95% CI: 1.08 to 2.05) compared with those in a province without a ban. We found no differences in the association between POS bans and quit attempts or cessation by education or income, and no differences by sex for cessation.ConclusionPOS bans are associated with increased smoking cessation overall and more quit attempts among women than men.
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056805
Issue No: Vol. 32, No. 5 (2023)
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- Spatial analysis of tobacco outlet density on secondhand smoke exposure
and asthma health among children in Baltimore City-
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Authors: Kaviany, P; Senter, J. P, Collaco, J. M, Corrigan, A. E, Brigham, E, Wood, M, Woo, H, Liu, C, Koehl, R, Galiatsatos, P, Koehler, K, Hansel, N, McCormack, M.
Pages: 607 - 613
Abstract: RationaleTobacco outlets are concentrated in low-income neighbourhoods; higher tobacco outlet density is associated with increased smoking prevalence. Secondhand smoke (SHS) exposure has significant detrimental effects on childhood asthma. We hypothesised there was an association between higher tobacco outlet density, indoor air pollution and worse childhood asthma.MethodsBaseline data from a home intervention study of 139 children (8–17 years) with asthma in Baltimore City included residential air nicotine monitoring, paired with serum cotinine and asthma control assessment. Participant addresses and tobacco outlets were geocoded and mapped. Multivariable regression modelling was used to describe the relationships between tobacco outlet density, SHS exposure and asthma control.ResultsWithin a 500 m radius of each participant home, there were on average six tobacco outlets. Each additional tobacco outlet in a 500 m radius was associated with a 12% increase in air nicotine (p
Keywords: Editor's choice
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056878
Issue No: Vol. 32, No. 5 (2023)
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- Uncovering the advertising and promotional strategies of tobacco companies
in Cambodia: recall of below-the-line marketing among young male smokers-
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Authors: Stubbs, T; White, V. M, Kong, M, Toumbourou, J. W.
Pages: 614 - 619
Abstract: IntroductionTobacco companies have used below-the-line marketing in novel ways to promote their brands to youth in low/middle-income countries in Southeast Asia. This study explores how young male smokers in Cambodia experience below-the-line marketing strategies.MethodsConvenience sampling was used to recruit 147 young male smokers (18–24 years) in Cambodia in early 2020. Local research assistants conducted mixed-methods interviews with participants in Khmer or English. Participants recalled exposure to below-the-line marketing strategies and provided in-depth descriptions about their experiences with individual sales promotions. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using thematic analysis.Results54% of participants recalled exposure to at least one below-the-line marketing strategy, including point-of-sale promotions (32.7%), individual sales promotions (27.9%) and online advertising (14.3%). Participants described individual sales promotions in public settings, and recalled that promoters were mostly female, attractive and targeted young males. Tactics used to encourage young people to accept promotional offers included free cigarettes and sample packets, swapping current cigarettes for new brands and collecting consumer details after interviewing. The brands and product features of cigarettes being promoted were readily described by participants.ConclusionThis study provides evidence that illegal below-the-line marketing is still occurring in Cambodia, and increased monitoring and enforcement of advertising restrictions is needed.
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-057063
Issue No: Vol. 32, No. 5 (2023)
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- Ex ante evaluation of the impact of tobacco control policy measures aimed
at the point of sale in the Netherlands-
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Authors: van Deelen, T. R. D; Kunst, A. E, van den Putte, B, Veldhuizen, E. M, Kuipers, M. A. G.
Pages: 620 - 626
Abstract: IntroductionThe Netherlands aims to implement stricter tobacco control policies targeting the retail environment. This paper is an ex ante policy evaluation of the potential impact of the current tobacco display and advertising ban as well as future tobacco sales bans on tobacco outlet visibility and availability.MethodsBetween September 2019 and June 2020, all potential tobacco retailers in four Dutch cities (Amsterdam, Eindhoven, Haarlem and Zwolle) were visited and mapped using Global Positioning System. For each retailer selling tobacco, we completed a checklist on the visibility of tobacco products and advertising. Expected reductions in tobacco outlet visibility and availability were calculated per policy measure in absolute numbers (percentage or percentage point decrease) as well as density and proximity.ResultsOut of 870 tobacco outlets, 690 were identified with visible tobacco products/advertising. The display ban in supermarkets and small outlets (respectively) is expected to decrease the number (–15; –42 percentage points), outlet density per 10 000 capita (–0.9; –2.6) and proximity in metres (+27 m; +400 m) of outlets with visible products/advertising. The upcoming bans on vending machines and sales in supermarkets are expected to decrease the number (–12%; –31%), density (–0.7; –1.9) and proximity (+12 m; +68 m) of tobacco outlets. Further changes in the number, density and proximity (respectively) of tobacco outlets may be achieved with future sales bans in petrol stations (–7%; –0.4; +60 m) and particularly with a ban on sales in small outlets (–43%; –2.7; +970 m).ConclusionA display ban and a sales ban in small outlets will contribute most to reducing tobacco outlet visibility and availability, assuming that no market shift towards other tobacco outlets will take place.
Keywords: Open access
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-057205
Issue No: Vol. 32, No. 5 (2023)
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- Flavours and flavourings in waterpipe products: a comparison between
tobacco, herbal molasses and steam stones-
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Authors: Bakker-'t Hart, I. M. E; Bakker, F, Pennings, J. L. A, Weibolt, N, Eising, S, Talhout, R.
Pages: 627 - 634
Abstract: ObjectivesFlavoured products are especially appealing to youth and contribute to the onset of waterpipe smoking and continued use of waterpipe tobacco. The goal of database and chemical analysis was to provide a clear overview of commonly used flavours and flavourings in tobacco and related waterpipe products, that is, herbal molasses and steam stones.MethodsIn 2019, 249 waterpipe tobacco products were registered in the European Common Entry Gate by manufacturers to be marketed in The Netherlands. Flavour categories were assigned to the registered products based on their brand names and product descriptions. Nicotine and eleven 1111 flavourings were identified and quantified in waterpipe tobacco (n=8), herbal molasses (n=7) and steam stones (n=4) by extraction and gas chromatography–mass spectrometry (GC–MS) analysis.ResultsFlavour categories could be assigned to 237 of 249 registered waterpipe tobacco products. Eight flavour main categories and 48 unique subcategories were identified and presented in a flavour wheel. All registered waterpipe tobacco products were flavoured, and the majority (78%) was fruit flavoured. Herbal molasses contained similar median flavouring levels, and steam stones contained lower median levels compared with waterpipe tobacco. Flavourings in waterpipe products were almost exclusively fruity and sweet, often in combination with menthol/mint flavourings.ConclusionsThis study is the first to present a waterpipe tobacco flavour wheel, providing a quick overview of waterpipe tobacco flavours and thereby aiding communication among experts around the globe. GC–MS analysis revealed that the most prevalent flavourings are present in similar levels in herbal and tobacco waterpipe products. Banning flavourings in all waterpipe products would be a good strategy to reduce waterpipe smoking among youth.
Keywords: Open access
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056955
Issue No: Vol. 32, No. 5 (2023)
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- Tobacco company agreements with tobacco retailers for price discounts and
prime placement of products and advertising: a scoping review-
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Authors: Reimold, A. E; Lee, J. G. L, Ribisl, K. M.
Pages: 635 - 644
Abstract: ObjectiveThe objectives of this scoping review are to examine existing research on the often-secretive contracts between tobacco manufacturers and retailers, to identify contract requirements and incentives, and to assess the impact of contracts on the sales and marketing of tobacco products in the retail setting.Data sourcesThe systematic search was conducted in PubMed/MEDLINE, Web of Science, Scopus, ProQuest Political Science Database, Business Source Premier, ProQuest Agricultural & Environmental Science Collection, and Global Health through December 2020.Study selectionWe included studies that collected and analysed empirical data related to tobacco contracts, tobacco manufacturers, and tobacco retailers. Two reviewers independently screened all 2786 studies, excluding 2694 titles and abstracts and 65 full texts resulting in 27 (0.97%) included studies.Data extractionStudy characteristics, contract prevalence, contract requirements and incentives, and the influence of contracts on the retail environment were extracted from each study.Data synthesisWe created an evidence table and conducted a narrative review of included studies.ConclusionsContracts are prevalent around the world and handsomely incentivise tobacco retailers in exchange for substantial manufacturer control of tobacco product availability, placement, pricing and promotion in the retail setting. Contracts allow tobacco companies to promote their products and undermine tobacco control efforts in the retail setting through discounted prices, promotions and highly visible placement of marketing materials and products. Policy recommendations include banning tobacco manufacturer contracts and retailer incentives along with more transparent reporting of contract incentives given to retailers.
Keywords: Open access
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-057026
Issue No: Vol. 32, No. 5 (2023)
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- Spinning a global web: tactics used by Big Tobacco to attract children at
tobacco points-of-sale-
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Authors: Brown, J. L; Rosen, D, Carmona, M. G, Parra, N, Hurley, M, Cohen, J. E.
Pages: 645 - 651
Abstract: Most of the published literature on cigarette advertising and promotion at points-of-sale is on research conducted in high-income countries. We report findings from monitoring cigarette advertising and promotion at points-of-sale near schools and playgrounds in 42 countries, the majority low-income and middle-income. Four strategies were detected across most of these countries: (1) display of cigarettes near snacks, sweets and sugary drinks, (2) placement of cigarette advertisements near the eye-level of children, (3) advertisements and display of flavoured cigarettes and (4) sale of single sticks of cigarettes. These advertising and promotional tactics target children and youth and demonstrate that multinational tobacco companies use similar strategies to promote cigarettes at points-of-sale. The widespread violations of existing laws and regulations, the exploitation of regulatory loopholes and lack of existing tobacco control policies that apply to points-of-sale call for adoption and enactment of provisions recommended by the WHO Framework Convention on Tobacco Control such as comprehensive bans on tobacco advertisement, promotion and sponsorship, bans on sale of single cigarette sticks and regulation of flavours. These strategies will help to protect children and youth from exposure to tobacco advertising.
Keywords: Open access
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-057095
Issue No: Vol. 32, No. 5 (2023)
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- Cigarette smoking and misperceived norms among adults in rural Uganda: a
population-based study-
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Authors: Perkins, J. M; Kakuhikire, B, Baguma, C, Evans, C. Q, Rasmussen, J. D, Satinsky, E. N, Kyokunda, V, Juliet, M, Ninsiima, I, Bangsberg, D. R, Tsai, A. C.
Pages: 652 - 656
Abstract: BackgroundLittle is known about perceived norms about cigarette smoking in Uganda or the extent to which perceptions drive personal cigarette smoking behaviour.MethodsWe conducted a cross-sectional study in 2016–2018 that targeted all adults who resided within eight villages in Rwampara District, southwestern Uganda. Personal cigarette smoking frequency was elicited by self-report. We also asked participants what they believed to be the cigarette smoking frequency of most other adult men and women in their villages (i.e., perceived norms). Frequent cigarette smoking was defined as 4+ times/week. We compared perceived norms to cigarette smoking frequency reports aggregated at the village level. We used multivariable Poisson regression to estimate the association between perceived norms and personal cigarette smoking behaviour.ResultsAmong 1626 participants (91% response rate), 92 of 719 men (13%) and 6 of 907 women (0.7%) reported frequent smoking. However, 1030 (63%) incorrectly believed most men in their villages smoked cigarettes frequently. Additionally, 116 (7%) incorrectly believed that most women in their villages smoked cigarettes frequently. These misperceptions were pervasive across social strata. Men who misperceived frequent cigarette smoking as the norm among other men in their villages were more likely to smoke frequently themselves (adjusted relative risk=1.49; 95% CI, 1.13 to 1.97).ConclusionsMost adults overestimated cigarette smoking frequency among village peers. Men who incorrectly believed that frequent smoking was the norm were more likely to engage in frequent smoking themselves. Applying a ‘social norms approach’ intervention by promoting existing healthy norms may prevent smoking initiation or motivate reductions in smoking among men in rural Uganda.
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056470
Issue No: Vol. 32, No. 5 (2023)
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- Transitions to smokeless tobacco use among adult cigarette smokers in the
Population Assessment of Tobacco and Health (PATH) Study, Waves 3-5
(2015-2019)-
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Authors: Jackson, R. A; Ren, C, Coleman, B, Day, H. R, Chang, C. M, Kofie, J, Rivers, D, Kanel, M, Ambrose, B. K.
Pages: 657 - 660
Abstract: ObjectiveExamine patterns of dual use of cigarettes and smokeless tobacco and complete switching over time among adult current cigarette smokers using data from the Population Assessment of Tobacco and Health Study Wave 3 (2015–2016), Wave 4 (2016–2018) and Wave 5 (2018–2019).MethodsWe examined four tobacco use states among 6834 exclusive smokers and 372 dual users at Wave 3 with two waves of follow-up data: exclusive cigarette use, exclusive smokeless tobacco use, dual use and use of neither product.ResultsAmong exclusive smokers at Wave 3, only 1.6% (95% CI: 1.3% to 2.1%) transitioned to dual use at Wave 4, and 0.1% (95% CI: 0.07% to 0.2%) switched to exclusive smokeless tobacco use. Among exclusive smokers who switched to dual use, 53.1% (95% CI: 40.9% to 64.9%) returned to exclusive cigarette smoking, 34.3% (95% CI: 23.8% to 46.6%) maintained dual use and 12.6% (95% CI: 7.0% to 21.7%) did not smoke cigarettes after an additional wave of follow-up. Dual users at Wave 3 were likely to maintain their dual use status at Wave 4, 51.2% (95% CI: 46.1% to 56.3%) and Wave 5, 47.9% (95% CI: 40.1% to 55.8%).ConclusionsVery few cigarette smokers transition to smokeless tobacco use, and among those who do, dual use is more common than exclusive smokeless tobacco use. Further, the majority of exclusive cigarette smokers who transition to dual use at Wave 4 continue smoking cigarettes at Wave 5, either as dual users or as exclusive smokers.
Keywords: Open access
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056907
Issue No: Vol. 32, No. 5 (2023)
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- Monitoring compliance with Senegals tobacco products packaging and
labelling requirements 6 months after implementation of the law-
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Authors: Sagna, M. B; Rosemeyer, M. C, Ba, O, Diouf, F, Walter, K, Camara Bityeki, B, Carmona, M. G, Sebrie, E. M.
Pages: 661 - 663
Abstract: IntroductionAs of December 2021, 22 countries and one jurisdiction in WHO African Region (AFRO) have adopted pictorial health warning labels on tobacco packaging, but only 13 have implemented them. In 2014, Senegal enacted a comprehensive tobacco control law, which requires strong provisions on tobacco packaging and labelling. The objective of this study was to assess the level of compliance with these provisions in Senegal 6 months after implementation.MethodsData collection took place in Senegal’s capital city of Dakar across 12 districts in February 2018, following the Tobacco Pack Surveillance System Field Protocol developed by the Institute for Global Tobacco Control at Johns Hopkins Bloomberg School of Public Health. Unique tobacco packs were purchased from a total of 48 tobacco vendors, and compliance with new packaging and labelling provisions was assessed.ResultsIn total, seven unique cigarette packs were confirmed to be legally available for sale in Dakar, Senegal. All packs complied with all health warning provisions (type, size, location, language and quitline information) as well as bans on quantitative emissions yields. However, no pack complied with the descriptive constituents and emissions statement required on the lateral side, and four of the seven packs violated the ban on misleading brand descriptors.ConclusionsAFRO countries have made substantial progress in adopting comprehensive tobacco control laws that bring them closer into alignment with the Framework Convention on Tobacco Control. This study found areas of effective implementation of FCTC recommended packaging and labelling requirements, as well as areas in need of stronger enforcement.
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056973
Issue No: Vol. 32, No. 5 (2023)
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- Legislative provisions for standardised tobacco packaging and changes in
public support in 27 European countries-
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Authors: KC, S; Filippidis, F. T, Laverty, A. A.
Pages: 664 - 666
Abstract: BackgroundGlobal adoption of standardised packaging requirements for tobacco products is a victory for public health, but their proliferation and impacts rely partly on public support. How this is related to legislation remains underassessed. This study explored change over time in public support for standardised packaging in countries with varying degrees of legislative provisions.MethodsWe used data from 27 European countries, collected from 2017 (n=28, 300) and 2020 (n=27, 901) waves of the Eurobarometer survey, to assess self-reported support for standardised packaging regulations among both smokers and non-smokers. Countries were grouped into three categories of policy adoption (policy implemented; policy legislated; no legislation) and changes in support were assessed using multilevel Poisson regression models.ResultsIn 2020, public support for standardised packaging was 71% (95% CI 68% to 74%) in countries that implemented standardised packaging legislation, 57% (55% to 60%) in countries that had legislated but not yet implemented legislation and 41% (40%to 42%) in countries with no legislation. Compared with 2017, this represented a relative change of +8% (1% to 15%), +12% (5% to 21%) and –5% (95% CI –2% to –8%), respectively, in the three country categories. Among smokers, there was no indication of change in support across the three groups. Among non-smokers, support increased in countries with existing legislation (adjusted prevalence ratio [aPR]=1.14, 95% CI 1.06 to 1.23) and decreased in countries with no legislation (aPR=0.93, 0.90 to 0.97).ConclusionsPublic support for standardised packaging regulations increased in countries implementing and legislating for these measures, particularly among non-smokers. An overall increase in support provides reassurance for policymakers defending policy action on tobacco packaging, as well as for those seeking to implement standardised packaging in their own countries.
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-057068
Issue No: Vol. 32, No. 5 (2023)
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- Promoting convergence and closing gaps using affordability-based minimum
taxes: an illustration using the European Union Tobacco Tax Directive-
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Authors: Branston, J. R; Lopez-Nicolas, A.
Pages: 667 - 671
Abstract: BackgroundThe rules governing tobacco taxation in the European Union (EU) are currently under revision. Earlier research has proposed reforms aimed at stimulating price convergence across countries by linking national minimum taxes to a measure of average prices across the EU. This paper proposes that revised tax rules include an affordability criterion whereby minimum taxes are required to be no less than a common prespecified fraction of domestic average disposable income.MethodsLongitudinal data on prices and taxes on factory-made cigarettes and roll-your-own tobacco in 24 EU member states and the UK between 2011 and 2019 are used to estimate econometric models for their weighted average prices as a function of taxes. Two scenarios are simulated with the models’ estimates: a baseline scenario for the actual tax stance pertaining to 2020 and a reform scenario implementing an additional affordability criterion.ResultsThe affordability criterion would significantly increase the price of both tobacco products, particularly in richer countries with relatively low tobacco prices that are often not affected by the increases in nominal minima mandated by the EU rules. There would also be some price convergence between the two tobacco products, both on average and in the majority of countries.ConclusionsSuch results show an affordability criterion could be a potentially fruitful complement to the tax reforms proposed in earlier research.
Keywords: Open access
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-056960
Issue No: Vol. 32, No. 5 (2023)
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- Widening sexual orientation inequities in smoking among older adults in
the USA, 2015-2019-
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Authors: Yang, J; Lee, J. G. L.
Pages: 673 - 674
Abstract: A recent editorial in Tobacco Control noted the neglect of older adults in the field of tobacco control, arguing that we must do better.1 This research letter seeks to answer that call and amplify its message by assessing what is missed in health equity research when older adults are ignored in another area of inequity: differences in smoking by sexual orientation.2 3 Older lesbian, gay and bisexual (LGB) adults often have been rendered invisible in popular culture with detrimental effects.4 While evidence clearly shows LGB adults overall have higher risk of smoking than their heterosexual counterparts,2 research and interventions for addressing LGB smoking inequities, with some exceptions,5 neglect older adults.6 This letter examines trends in inequities in smoking between LGB and heterosexual older adults. Methods We used pooled data from the 2015–2019 National Survey...
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-057037
Issue No: Vol. 32, No. 5 (2023)
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- Beware big tobacco bearing gifts: tobacco industry corporate social
responsibility activities in Greece-
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Authors: Taravira, N. A; Laurence, L, Filippidis, F. T.
Pages: 675 - 676
Abstract: The WHO recommends that parties of the Framework Convention on Tobacco Control (FCTC) should "denormalize and, to the extent possible, regulate activities described as ‘socially responsible’ by the tobacco industry, including but not limited to activities described as ‘Corporate Social Responsibility’ (CSR)".1 2 However, governments continue to accept and endorse CSR activities led by tobacco companies, a trend that has intensified during the COVID-19 pandemic.3 This report highlights recent CSR activities by Papastratos, the Greek subsidiary of Philip Morris International (PMI).4 During the pandemic, Papastratos has been involved in various activities described by the company as CSR, which have given the company a platform to promote its activities and speak directly to the Greek government. The company’s largest initiative focused on supporting small retail businesses.5 To this direction, Papastratos has committed 10 million euros and collaborated with technology companies to...
PubDate: 2023-08-17T00:45:27-07:00
DOI: 10.1136/tobaccocontrol-2021-057143
Issue No: Vol. 32, No. 5 (2023)
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