Cigarette excise tax structure and cigarette prices: evidence from the global adult tobacco survey and the U.S. National Adult Tobacco Survey.

PubMed

Chaloupka, Frank J; Kostova, Deliana; Shang, Ce

2014-01-01

The importance of tobacco tax structure in determining the relative prices of different tobacco products and brands has become increasingly recognized. The structuring of tobacco tax across products and brands within a country can impact the variability of prices within a country, shaping consumption and influencing tobacco users' incentives to switch down to cheaper alternatives in response to tax and price increases. Brand-specific data on the average prices paid for the top 5 cigarette brands in 13 countries were obtained from the Global Adult Tobacco Survey, and for the United States, data were obtained from the National Adult Tobacco Survey. The variability of cigarette prices paid across brands was analyzed in the context of each country's tobacco tax structure. Countries with simpler cigarette tax structures, particularly those that emphasize specific taxes and do not involve tier-based taxes, exhibit less variability in the prices smokers pay for cigarettes across brands. Increases in cigarette taxes in countries with simpler tax structures will be more effective in reducing cigarette smoking and its health and economic consequences than comparable tax increases in countries where tax structures are more complicated and there are greater opportunities for switching to cheaper brands in order to avoid a tax increase.

Menthol Cigarette Smoking among Lesbian, Gay, Bisexual, and Transgender Adults

PubMed Central

Fallin, Amanda; Goodin, Amie J.; King, Brian A.

2015-01-01

Background Menthol can mask the harshness and taste of tobacco, making menthol cigarettes easier to use and increasing their appeal among vulnerable populations. The tobacco industry has targeted youth, women, and racial minorities with menthol cigarettes, and these groups smoke menthol cigarettes at higher rates. The tobacco industry has also targeted the lesbian, gay, bisexual, and transgender (LGBT) communities with tobacco product marketing. Purpose To assess current menthol cigarette smoking by sexual orientation among a nationally representative sample of U.S. adults. Methods Data were obtained from the 2009–2010 National Adult Tobacco Survey, a national landline and cellular telephone survey of non-institutionalized U.S. adults aged ≥18 years, to compare current menthol cigarette smoking between LGBT (n=2,431) and heterosexual/straight (n=110,841) adults. Data were analyzed during January–April 2014 using descriptive statistics and logistic regression adjusted for sex, age, race, and educational attainment. Results Among all current cigarette smokers, 29.6% reported usually smoking menthol cigarettes in the past 30 days. Menthol use was significantly higher among LGBT smokers, with 36.3% reporting that the cigarettes they usually smoked were menthol compared to 29.3% of heterosexual/straight smokers (p<0.05); this difference was particularly prominent among LGBT females (42.9%) compared to heterosexual/straight women (32.4%) (p<0.05). Following adjustment, LGBT smokers had greater odds of usually smoking menthol cigarettes than heterosexual/straight smokers (OR=1.31, 95% CI=1.09, 1.57). Conclusions These findings suggest that efforts to reduce menthol cigarette use may have the potential to reduce tobacco use and tobacco-related disease and death among LGBT adults. PMID:25245795

Smoking Cessation Awareness and Utilization Among Lesbian, Gay, Bisexual, and Transgender Adults: An Analysis of the 2009–2010 National Adult Tobacco Survey

PubMed Central

Lee, Youn Ok; Bennett, Keisa; Goodin, Amie

2016-01-01

Introduction: Each year, there are more than 480 000 deaths in the United States attributed to smoking. Lesbian, gay, bisexual and transgender (LGBT) adults are a vulnerable population that smokes at higher rates than heterosexuals. Methods: We used data collected from the National Adult Tobacco Survey 2009–2010, a large, nationally representative study using a randomized, national sample of US landline and cellular telephone listings, (N = 118 590). We compared LGBT adults to their heterosexual counterparts with regard to exposure to advertisements promoting smoking cessation, and awareness and use of tobacco treatment services, including quitlines, smoking cessation classes, health professional counseling, nicotine replacement therapy, and medications. Results: Fewer GBT men, compared to heterosexual men, were aware of the quitline. However, LGBT individuals have similar exposure to tobacco cessation advertising, as well as similar awareness of and use of evidence based cessation methods as compared to heterosexual peers. Conclusions: The similarly of awareness and use of cessation support indicates a need for LGBT-specific efforts to reduce smoking disparities. Potential interventions would include: improving awareness of, access to and acceptability of current cessation methods for LGBT patients, developing tailored cessation interventions, and denormalizing smoking in LGBT community spaces. PMID:26014455

Waterpipe Tobacco Smoking in the United States: Findings from the National Adult Tobacco Survey

PubMed Central

Salloum, Ramzi G.; Thrasher, James F.; Kates, Frederick R.; Maziak, Wasim

2014-01-01

Objective To report prevalence and correlates of waterpipe tobacco smoking (WTS) use among U.S. adults. Methods Data were from the 2009–2010 National Adult Tobacco Survey, a nationally representative sample of U.S. adults. Estimates of WTS ever and current use were reported overall, and by sex, age, race/ethnicity, educational attainment, annual household income, sexual orientation, and cigarette smoking status. State-level prevalence rates of WTS ever were reported using choropleth thematic maps for the overall population and by sex. Results The national prevalence of WTS ever was 9.8% and 1.5% for current use. WTS ever was more prevalent among those who are male (13.4%), 18–24 years old (28.4%) compared to older adults, non-Hispanic White (9.8%) compared to non-Hispanic Black, with some college education (12.4%) compared to no high school diploma, and reporting sexual minority status (21.1%) compared to heterosexuals. States with highest prevalence included DC(17.3%), NV(15.8%), and CA(15.5%). Conclusion WTS is now common among young adults in the US and high in regions where cigarette smoking prevalence is lowest and smoke-free policies have a longer history. To reduce its use, WTS should be included in smoke-free regulations and state and federal regulators should consider policy development in other areas, including taxes, labeling, and distribution. PMID:25535678

Transgender Use of Cigarettes, Cigars, and E-Cigarettes in a National Study.

PubMed

Buchting, Francisco O; Emory, Kristen T; Scout; Kim, Yoonsang; Fagan, Pebbles; Vera, Lisa E; Emery, Sherry

2017-07-01

Tobacco use among transgender adults continues to be an area of research with few reported findings. The limited literature indicates higher cigarette use among transgender adults, compared with the general population. This national study is the first to report on cigarettes, cigars, and e-cigarettes by examining differences in transgender tobacco use independent of sexual orientation. Data were collected in 2013 using a nationally cross-sectional online survey of U.S. adults (cisgender, n=17,164; transgender, n=168) and analyzed in 2015. Past 30-day tobacco use point estimates and adjusted logistic regression while controlling for false discovery rate were reported for transgender and cisgender respondents. Transgender adults reported higher past 30-day use of any cigarette/cigar/e-cigarette product (39.7% vs 25.1%) and current use of cigarettes (35.5% vs 20.7%), cigars (26.8% vs 9.3%), and e-cigarettes (21.3% vs 5.0%) compared with cisgender adults (all p-values ≤0.003). Transgender respondents had significantly higher odds of past 30-day tobacco product use for any cigarette/cigar/e-cigarette product (OR=1.97, 95% CI=1.25, 3.1), e-cigarettes (OR=5.15, 95% CI=3.36, 7.88), cigars (OR=3.56, 95% CI=2.27, 5.59), and cigarettes (OR=2.10, 95% CI=1.35, 3.28) versus cisgender respondents (all p-values ≤0.0035). Transgender adults are at higher risk for tobacco use than cisgender adults and risk of specific product use varies by gender. This is the first U.S. national study to assess differences in use of various tobacco products using questions that specifically ask for gender identity separately from sexual orientation. This study provides data that can inform targeted interventions to promote transgender health. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Cross-country comparison of waterpipe use: nationally representative data from 13 low and middle-income countries from the Global Adult Tobacco Survey (GATS).

PubMed

Morton, Jeremy; Song, Yang; Fouad, Heba; Awa, Fatimah El; Abou El Naga, Randa; Zhao, Luhua; Palipudi, Krishna; Asma, Samira

2014-09-01

Evidence shows that smoking tobacco using a waterpipe is significantly associated with diseases. Despite this, waterpipe use seems to be increasing worldwide, though nationally representative data are not widely available. The Global Adult Tobacco Survey (GATS) provides an opportunity to measure various indicators of waterpipe use from nationally representative surveys. Data were obtained for adults 15 years of age or older from 13 countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Russia, Thailand, Turkey, Ukraine, Uruguay and Vietnam) who completed GATS from 2008-2010. The GATS questionnaire collected data on current waterpipe use, including daily/less than daily prevalence and number of sessions per day/week. An optional waterpipe module measured former use, age of initiation, and level of consumption during a session. GATS was successful in producing nationally representative data on waterpipe use from 13 countries, many of which for the first time. The prevalence of waterpipe use among men was highest in Vietnam (13.0%) and Egypt (6.2%); among women, waterpipe use was highest in Russia (3.2%) and Ukraine (1.1%). While over 90% of adults in Ukraine thought smoking tobacco causes serious illness, only 31.4% thought smoking tobacco using a waterpipe causes serious illness. GATS data provide the ability to analyse waterpipe use within a country and across countries. Monitoring of waterpipe use at a national level will better enable countries to target tobacco control interventions such as education campaigns about the negative health effects of waterpipe use. 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.

Point-of-sale cigarette purchase patterns among U.S. adult smokers-National Adult Tobacco Survey, 2012-2014.

PubMed

Kruger, Judy; Jama, Amal; Lee, Joseph G L; Kennedy, Sara; Banks, Asha; Sharapova, Saida; Agaku, Israel

2017-08-01

Tobacco products are ubiquitous in most U.S. retail environments. Given that data on preferred point-of-sale purchase locations among U.S. adult tobacco users are limited, an enhanced understanding of tobacco purchase locations can help inform tobacco control policy, planning, and practice. We investigated prevalence and sociodemographic characteristics associated with cigarette purchase location among U.S. adult smokers. Pooled data came from the 2012-2013 (N=60,192) and 2013-2014 (N=75,233) National Adult Tobacco Surveys. Current cigarette smokers (n=18,005) aged ≥18 were asked if they purchased cigarettes within the previous 30days (n=15,182) and, if so, where they last purchased cigarettes. In 2016, logistic regression adjusted for sex, age, race/ethnicity, education level and annual household income was used to assess characteristics associated with purchase location. Among current smokers, 90.2% reported purchasing cigarettes in the past 30days. The most common purchase locations were convenience stores/gas stations (69.1%), tobacco discount stores (9.9%), drug stores (5.0%), supermarkets (4.9%), and liquor stores (3.6%). The odds of purchasing cigarettes at convenience stores/gas stations were higher among men (adjusted odds ratio (AOR)=1.4; 95% confidence interval (CI)=1.2-1.5) than women; and among adults aged 18-24 (AOR=3.1; 95% CI=2.4-3.9), 25-44 (AOR=3.1; 95% CI=2.7-3.7), and 45-64years (AOR=1.8 95% CI=1.6-2.1) than adults aged ≥65years. Over two-thirds of U.S. smokers last purchased cigarettes from convenience stores/gas stations. Understanding the relationship between purchase location and smoker characteristics may inform tobacco control strategies in the retail environment. Published by Elsevier Inc.

Tobacco Use and Sexual Orientation in a National Cross-sectional Study: Age, Race/Ethnicity, and Sexual Identity-Attraction Differences.

PubMed

McCabe, Sean Esteban; Matthews, Alicia K; Lee, Joseph G L; Veliz, Phil; Hughes, Tonda L; Boyd, Carol J

2018-04-09

The purpose of this study is to determine the past-year prevalence estimates of any nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder based on sexual identity among U.S. adults, and to examine potential variations in these estimates by age, race/ethnicity, and sexual identity-attraction concordance/discordance. The 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions collected data via in-person interviews with a cross-sectional nationally representative sample of non-institutionalized adults (response rate=60.1%) and analyses for the present study were conducted in 2017. Any past-year nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder were most prevalent among sexual minority-identified adults compared with heterosexual-identified adults, with notable variations based on sex, age, race/ethnicity, and sexual identity-attraction discordance. Elevated rates of any nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder among sexual minorities were most prevalent among younger lesbian women and gay men, and all age groups of bisexual men and women. The odds of any nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder were significantly greater among sexual identity-attraction discordant women and significantly lower among sexual identity-attraction discordant men. These findings provide valuable new information about sexual minority subgroups, such as self-identified bisexual older adults and sexual identity-attraction discordant women, that appear to be at higher risk for adverse smoking-related health consequences as a result of their elevated rates of cigarette smoking. Additional attention is warranted to examine these high-risk subpopulations prospectively and, if the results are replicated with larger samples, this information can be used to target smoking-cessation and lung cancer screening efforts. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Tobacco harm perceptions and use among sexual and gender minorities: findings from a national sample of young adults in the United States.

PubMed

Ganz, Ollie; Johnson, Amanda L; Cohn, Amy M; Rath, Jessica; Horn, Kimberly; Vallone, Donna; Villanti, Andrea C

2018-06-01

In the United States, the prevalence of tobacco use among sexual and gender minorities (SGM) is higher compared to their non-SGM counterparts. Tobacco harm perceptions have gone largely unexamined as a potential mechanism supporting disproportionate tobacco use among this population. The purpose of this study was to examine differences between SGM and non-SGM young adults in harm perceptions of various tobacco products and tobacco use behavior and whether low tobacco-related harm perceptions moderate the relationship between identifying as a SGM and tobacco use behavior. This study used data from Wave 10 of the Truth Initiative Young Adult Cohort Study, a sample of U.S. young adults (ages 18-34). Data were collected from September to October 2016 and the study sample included 3089 individuals. Demographics, past 30-day use of cigarettes, little cigars/cigarillos/bidis and electronic cigarettes were assessed. Absolute and relative harm perceptions of these products were also examined. Identifying as a SGM and low tobacco harm perceptions were found to be positively associated with past 30-day tobacco use. There was no interaction between SGM status and harm perceptions on past 30-day tobacco use CONCLUSIONS: Findings confirm that SGM young adults continue to disproportionately use tobacco products, compared to non-SGM young adults. More research is needed to understand moderators of the relationship between SGM status and tobacco use in young adults. Copyright © 2018 Elsevier Ltd. All rights reserved.

Tobacco Product Use Among Adults - United States, 2013-2014.

PubMed

Hu, S Sean; Neff, Linda; Agaku, Israel T; Cox, Shanna; Day, Hannah R; Holder-Hayes, Enver; King, Brian A

2016-07-15

While significant declines in cigarette smoking have occurred among U.S. adults during the past 5 decades, the use of emerging tobacco products* has increased in recent years (1-3). To estimate tobacco use among U.S. adults aged ≥18 years, CDC and the Food and Drug Administration (FDA) analyzed data from the 2013-2014 National Adult Tobacco Survey (NATS). During 2013-2014, 21.3% of U.S. adults used a tobacco product every day or some days, and 25.5% of U.S. adults used a tobacco product every day, some days, or rarely. Despite progress in reducing cigarette smoking, during 2013-2014, cigarettes remained the most commonly used tobacco product among adults. Young adults aged 18-24 years reported the highest prevalence of use of emerging tobacco products, including water pipes/hookahs and electronic cigarettes (e-cigarettes). Furthermore, racial/ethnic and sociodemographic differences in the use of any tobacco product were observed, with higher use reported among males; non-Hispanic whites, non-Hispanic blacks, and non-Hispanics of other races(†); persons aged <45 years; persons living in the Midwest or South; persons with a General Educational Development (GED) certificate; persons who were single/never married/not living with a partner or divorced/separated/widowed; persons with annual household income <$20,000; and persons who were lesbian, gay, or bisexual (LGB). Population-level interventions that focus on all forms of tobacco product use, including tobacco price increases, high-impact anti-tobacco mass media campaigns, comprehensive smoke-free laws, and enhanced access to help quitting tobacco use, in conjunction with FDA regulation of tobacco products, are critical to reducing tobacco-related diseases and deaths in the United States.(§).

Media exposure and tobacco product addiction beliefs: Findings from the 2015 Health Information National Trends Survey (HINTS-FDA 2015).

PubMed

Donaldson, Elisabeth A; Hoffman, Allison C; Zandberg, Izabella; Blake, Kelly D

2017-09-01

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.

Flavoured non-cigarette tobacco product use among US adults: 2013-2014.

PubMed

Bonhomme, Michèle G; Holder-Hayes, Enver; Ambrose, Bridget K; Tworek, Cindy; Feirman, Shari P; King, Brian A; Apelberg, Benjamin J

2016-11-01

Limited data exist on flavoured non-cigarette tobacco product (NCTP) use among US adults. Data from the 2013 to 2014 National Adult Tobacco Survey (N=75 233), a landline and cellular telephone survey of US adults aged ≥18, were assessed to estimate past 30-day NCTP use, flavoured NCTP use and flavour types using bivariate analyses. During 2013-2014, 14.4% of US adults were past 30-day NCTP users. Nationally, an estimated 10.2 million e-cigarette users (68.2%), 6.1 million hookah users (82.3%), 4.1 million cigar smokers (36.2%) and 4.0 million smokeless tobacco users (50.6%) used flavoured products in the past 30 days. The most prevalent flavours reported were menthol/mint (76.9%) for smokeless tobacco; fruit (74.0%) for hookah; fruit (52.4%), candy/chocolate/other sweet flavours (22.0%) and alcohol (14.5%) for cigars/cigarillos/filtered little cigars; fruit (44.9%), menthol/mint (43.9%) and candy/chocolate/other sweet flavours (25.7%) for e-cigarettes and fruit (56.6%), candy/chocolate/other sweet flavours (26.5%) and menthol/mint (24.8%) for pipes. Except for hookah and pipes, past 30-day flavoured product use was highest among 18-24-year olds. By cigarette smoking, never smoking e-cigarette users (84.8%) were more likely to report flavoured e-cigarette use, followed by recent former smokers (78.1%), long-term former smokers (70.4%) and current smokers (63.2%). Flavoured NCTP use is prominent among US adult tobacco users, particularly among e-cigarette, hookah and cigar users. Flavoured product use, especially fruit and sweet-flavoured products, was higher among younger adults. It is important for tobacco prevention and control strategies to address all forms of tobacco use, including flavoured tobacco products. 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/.

Flavoured non-cigarette tobacco product use among US adults: 2013–2014

PubMed Central

Bonhomme, Michèle G; Holder-Hayes, Enver; Ambrose, Bridget K; Tworek, Cindy; Feirman, Shari P; King, Brian A; Apelberg, Benjamin J

2017-01-01

Introduction Limited data exist on flavoured non-cigarette tobacco product (NCTP) use among US adults. Methods Data from the 2013 to 2014 National Adult Tobacco Survey (N=75 233), a landline and cellular telephone survey of US adults aged ≥18, were assessed to estimate past 30-day NCTP use, flavoured NCTP use and flavour types using bivariate analyses. Results During 2013–2014, 14.4% of US adults were past 30-day NCTP users. Nationally, an estimated 10.2 million e-cigarette users (68.2%), 6.1 million hookah users (82.3%), 4.1 million cigar smokers (36.2%) and 4.0 million smokeless tobacco users (50.6%) used flavoured products in the past 30 days. The most prevalent flavours reported were menthol/mint (76.9%) for smokeless tobacco; fruit (74.0%) for hookah; fruit (52.4%), candy/chocolate/other sweet flavours (22.0%) and alcohol (14.5%) for cigars/cigarillos/filtered little cigars; fruit (44.9%), menthol/mint (43.9%) and candy/chocolate/other sweet flavours (25.7%) for e-cigarettes and fruit (56.6%), candy/chocolate/other sweet flavours (26.5%) and menthol/mint (24.8%) for pipes. Except for hookah and pipes, past 30-day flavoured product use was highest among 18–24-year olds. By cigarette smoking, never smoking e-cigarette users (84.8%) were more likely to report flavoured e-cigarette use, followed by recent former smokers (78.1%), long-term former smokers (70.4%) and current smokers (63.2%). Conclusions Flavoured NCTP use is prominent among US adult tobacco users, particularly among e-cigarette, hookah and cigar users. Flavoured product use, especially fruit and sweet-flavoured products, was higher among younger adults. It is important for tobacco prevention and control strategies to address all forms of tobacco use, including flavoured tobacco products. PMID:27794065

The Next Generation of Users: Prevalence and Longitudinal Patterns of Tobacco Use Among US Young Adults

PubMed Central

Williams, Valerie; Rath, Jessica; Villanti, Andrea C.; Vallone, Donna

2014-01-01

Objectives. We monitored the prevalence and patterns of use of the array of tobacco products available to young adults, who are at risk for initiation and progression to established tobacco use. Methods. We used data from waves 1 to 3 of GfK’s KnowledgePanel (2011–2012), a nationally representative cohort of young adults aged 18 to 34 years (n = 2144). We examined prevalence and patterns of tobacco product use over time, associated demographics, and state-level tobacco policy. We used multivariable logistic regression to determine predictors of initiation of cigarettes as well as noncombustible and other combustible products. Results. The prevalence of ever tobacco use rose from 57.28% at wave 1 to 67.43% at wave 3. Use of multiple products was the most common pattern (66.39% of tobacco users by wave 3). Predictors of initiation differed by product type and included age, race/ethnicity, policy, and use of other tobacco products. Conclusions. Tobacco use is high among young adults and many are using multiple products. Efforts to implement policy and educate young adults about the risks associated with new and emerging products are critical to prevent increased initiation of tobacco use. PMID:24922152

Advertising of tobacco products at point of sale: who are more exposed in Brazil?

PubMed

Ferreira-Gomes, Adriana Bacelar; Moura, Lenildo de; Araújo-Andrade, Silvânia Suely de; Lacerda-Mendes, Felipe; Perez, Cristina A; Abaakouk, Zohra

2017-01-01

To describe the adult population perception of cigarette advertising at point of sale, according their tobacco-use status and socio-demographic characteristics such as sex, age, race/color, region, household location and schooling. A multivariable analysis was carried out using data from the Global Adult Tobacco Survey in 2008 and the National Health Survey in 2013. Both surveys showed that among nonsmokers: women, young adults and those who had over 10 years of schooling had more frequently noticed advertising of cigarettes at point of sale. It was also observed that among the population with fewer years of schooling these proportions increased significantly. A measure that completely bans tobacco advertising would be more effective to protect the vulnerable groups from tobacco consumption.

Tobacco and Marijuana Initiation Among African American and White Young Adults

PubMed Central

Kennedy, Sara M.; Patel, Roshni P.; Cheh, Paul; Hsia, Jason; Rolle, Italia V.

2016-01-01

Introduction African American youth use marijuana at similar rates and tobacco at lower rates compared with white youth; however, in adulthood, tobacco use is similar. Tobacco and marijuana use are closely associated; differing initiation patterns may contribute to observed racial differences in tobacco prevalence by age. Therefore, it is important to assess tobacco and marijuana initiation patterns by race. Methods Data were obtained from 56,555 adults aged 18–25 who completed the 2005–2012 National Survey on Drug Use and Health. The analysis was restricted to those who reported ever use of marijuana and combustible tobacco (cigarettes and/or cigars). Three mutually exclusive categories of initiation patterns were evaluated: use of marijuana before tobacco; marijuana and tobacco at the same age; and tobacco before marijuana. Multivariable regression models were used to assess changes over time and compare these outcomes by race while controlling for sociodemographics, risk perceptions, and current substance use. Results In 2005, 26.6% of African American and 14.3% of white young adults used marijuana before tobacco, compared with 41.5% of African American and 24.0% of white young adults in 2012 (P < .001). Overall, African American young adults had greater odds of using marijuana before tobacco (AOR = 1.79; 95% CI: 1.67, 1.91) compared with whites. Conclusion African American young adults were more likely than whites to use marijuana before tobacco and both groups were increasingly likely to use marijuana before tobacco over time. A greater understanding of how marijuana initiation interacts with tobacco initiation could inform more effective tobacco and marijuana use prevention efforts. Implications Among ever users of combustible tobacco and marijuana, greater proportions of African American young adults used marijuana before tobacco or at the same age than their white counterparts. Moreover, both African Americans and whites were more likely to use marijuana before tobacco in 2012 compared with 2005. Tobacco control policy may benefit from a broader understanding of the patterns of initiation to tobacco and marijuana use. Some public health interventions aimed at preventing and reducing combustible tobacco use among African American young adults may be strengthened by considering marijuana use. PMID:26391577

Characteristics of Hookah Tobacco Smoking Sessions and Correlates of Use Frequency Among US Adults: Findings From Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study.

PubMed

Robinson, Joelle N; Wang, Baoguang; Jackson, Kia J; Donaldson, Elisabeth A; Ryant, Chase A

2018-05-03

Hookah tobacco smoking has increased in the United States. However, information on hookah use frequency and other characteristics of hookah use is limited. Investigators analyzed data from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative, longitudinal cohort study of US youth and adults. Our analysis draws on baseline data from adult (ages ≥18 years) ever (N = 10 624) and past year (n = 3947) hookah users. Bivariate and regression analyses were conducted to identify associations between demographics, use characteristics, and hookah use frequency. Overall, 16.4% of adults reported ever smoking tobacco from a hookah. Of those, 31.9% reported smoking hookah within the past year. Among 3947 past-year hookah tobacco smokers, 10.7% were daily/weekly users, 13.7% were monthly users, 42.1% smoked every couple of months, and 33.5% smoked about once a year. Among daily/weekly hookah users, 66% were young adults (ages 18-24 years). When comparing daily/weekly hookah users to those who smoked every couple of months, more frequent hookah use was associated with younger age, male gender, a greater number of times the hookah is refilled during a session, fewer people sharing, and hookah ownership. Although there were few demographic differences between daily/weekly users and less frequent hookah tobacco smokers, some notable differences in use behaviors exist among use frequency groups. Unlike other tobacco products, hookah is often smoked communally, over an extended time period. A detailed understanding of hookah user characteristics and experiences could inform hookah-specific measures, messaging, and regulations. To our knowledge, this is one of the first studies to characterize hookah use frequency, session length, and other hookah use experiences using a nationally representative sample of US adult hookah smokers. Understanding characteristics of hookah tobacco smokers, their use experiences, and patterns of hookah use frequency would be useful in assessing risks for hookah tobacco dependence at the population level. Additionally, identifying variation in use behaviors of hookah tobacco smokers could be used to inform the development of strategies to reduce and prevent hookah tobacco use, such as tobacco regulations or public education efforts, particularly among young adults.

Tobacco Use Among Working Adults - United States, 2014-2016.

PubMed

Syamlal, Girija; King, Brian A; Mazurek, Jacek M

2017-10-27

Cigarette smoking has declined considerably among U.S. adults over several decades (1); however, increases have occurred in the use of noncigarette tobacco products in recent years, and the use of multiple tobacco products has become common among current users of noncigarette tobacco products (2,3). Differences in tobacco use have also been observed across population subgroups, including among working adults (2,4). CDC analyzed National Health Interview Survey (NHIS) data for 2014-2016 to describe the most recent prevalence estimates of current (every day or some days) tobacco product use among working U.S. adults by industry and occupation. Among working adults, 22.1% (32.7 million) currently used any form of tobacco; 15.4% used cigarettes, 5.8% used other combustible tobacco (cigars, pipes, water pipes or hookahs, very small cigars, and bidis), 3.0% used smokeless tobacco, and 3.6% used electronic cigarettes (e-cigarettes); 4.6% (6.9 million) reported current use of two or more tobacco products. By industry, any tobacco use ranged from 11.0% among education services to 34.3% among construction workers; current use of two or more tobacco products was highest among construction workers (7.1%). By occupation, any tobacco use ranged from 9.3% among life, physical, and social science workers to 37.2% among installation, maintenance, and repair workers; current use of two or more tobacco products was highest among installation, maintenance, and repair workers (10.1%). Proven interventions to prevent and reduce tobacco product use, including current use of multiple products, among working adults are important (5,6). Workplace tobacco-control interventions have been especially effective in reducing cigarette smoking prevalence (7).

National and State-Specific Attitudes toward Smoke-Free Parks among U.S. Adults

PubMed Central

Kruger, Judy; Jama, Amal; Kegler, Michelle; Marynak, Kristy; King, Brian

2016-01-01

Outdoor places, such as parks, remain a source of secondhand smoke (SHS) exposure. We assessed attitudes toward smoke-free parks among U.S. adults. Data came from the 2009–2010 National Adult Tobacco Survey, a landline and cellular telephone survey of noninstitutionalized adults aged ≥18 in the 50 U.S. states and D.C. Descriptive statistics and logistic regression were used to assess the prevalence and sociodemographic correlates of attitudes toward smoke-free parks, overall and by current tobacco use. Overall, 38.5% of adults reported favorable attitudes toward complete smoke-free parks; prevalence ranged from 29.2% in Kentucky to 48.2% in Maine. Prevalence of favorable attitudes toward smoke-free parks was higher among nonusers of tobacco (44.6%) and noncombustible-only users (30.0%) than any combustible users (21.3%). The adjusted odds of having a favorable attitude were higher among: women; Hispanics and Black non-Hispanics, American Indian and Alaska Native non-Hispanics, and other non-Hispanics; those with an unspecified sexual orientation; and those with children aged ≤17 in the household, relative to each characteristics respective referent group. Odds were lower among: any combustible tobacco and noncombustible-only tobacco users; adults aged 45–64; and those with some college or an undergraduate degree. Opportunities exist to educate the public about the benefits of smoke-free outdoor environments. PMID:27589779

National and State-Specific Attitudes toward Smoke-Free Parks among U.S. Adults.

PubMed

Kruger, Judy; Jama, Amal; Kegler, Michelle; Marynak, Kristy; King, Brian

2016-08-31

Outdoor places, such as parks, remain a source of secondhand smoke (SHS) exposure. We assessed attitudes toward smoke-free parks among U.S. adults. Data came from the 2009-2010 National Adult Tobacco Survey, a landline and cellular telephone survey of noninstitutionalized adults aged ≥18 in the 50 U.S. states and D.C. Descriptive statistics and logistic regression were used to assess the prevalence and sociodemographic correlates of attitudes toward smoke-free parks, overall and by current tobacco use. Overall, 38.5% of adults reported favorable attitudes toward complete smoke-free parks; prevalence ranged from 29.2% in Kentucky to 48.2% in Maine. Prevalence of favorable attitudes toward smoke-free parks was higher among nonusers of tobacco (44.6%) and noncombustible-only users (30.0%) than any combustible users (21.3%). The adjusted odds of having a favorable attitude were higher among: women; Hispanics and Black non-Hispanics, American Indian and Alaska Native non-Hispanics, and other non-Hispanics; those with an unspecified sexual orientation; and those with children aged ≤17 in the household, relative to each characteristics respective referent group. Odds were lower among: any combustible tobacco and noncombustible-only tobacco users; adults aged 45-64; and those with some college or an undergraduate degree. Opportunities exist to educate the public about the benefits of smoke-free outdoor environments.

Co-occurrence of tobacco product use, substance use, and mental health problems among adults: Findings from Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) Study.

PubMed

Conway, Kevin P; Green, Victoria R; Kasza, Karin A; Silveira, Marushka L; Borek, Nicolette; Kimmel, Heather L; Sargent, James D; Stanton, Cassandra; Lambert, Elizabeth; Hilmi, Nahla; Reissig, Chad J; Jackson, Kia J; Tanski, Susanne E; Maklan, David; Hyland, Andrew J; Compton, Wilson M

2017-08-01

Although non-cigarette tobacco product use is increasing among U.S. adults, their associations with substance use and mental health problems are unclear. This study examined co-occurrence of tobacco use, substance use, and mental health problems, and its moderation by gender, among 32,202U.S. adults from Wave 1 (2013-2014) of the nationally representative longitudinal Population Assessment of Tobacco and Health (PATH) Study. Participants self-reported current cigarette, e-cigarette, traditional cigar, cigarillo, filtered cigar, hookah, smokeless tobacco and other tobacco product use; past year alcohol, marijuana, and other drug use; and past year substance use, internalizing and externalizing problems. Compared to non-current tobacco users, current users were more likely to report alcohol or drug use (adjusted odds ratio (AOR)=2.6; 95% confidence interval (CI): 2.3, 2.9), with the strongest associations observed for cigarillo and hookah users. Across all tobacco product groups, users were more likely to report internalizing (AOR=1.9; 95% CI: 1.7, 2.1), externalizing (AOR=1.6; 95% CI: 1.5, 1.8), and substance use (AOR=3.4; 95% CI: 2.9, 4.1) problems than non-users. Gender moderated many of these associations and, of these, all non-cigarette tobacco product associations were stronger among females. This nationally representative study of U.S. adults is the first to comprehensively document tobacco use, substance use, and mental health comorbidities across the range of currently available tobacco products, while also demonstrating that female tobacco users are at increased risk for substance use and mental health problems. These findings may point to gender differences in vulnerability and suggest that interventions incorporate gender-specific approaches. Copyright © 2017 Elsevier B.V. All rights reserved.

Tobacco Retail Outlet Density and Young Adult Tobacco Initiation

PubMed Central

Pearson, Jennifer L.; Anesetti-Rothermel, Andrew; Xiao, Haijun; Kirchner, Thomas R.; Vallone, Donna

2016-01-01

Background: A growing body of evidence indicates that the density of tobacco retail outlets around the home residence may influence tobacco use among youth and adults. The purpose of this study was to examine the impact of neighborhood tobacco retail outlet density on young adult initiation of different tobacco product types. Methods: Cross-sectional data from a 2013 nationally representative sample of young adults aged 18–34 was examined in relation to a 2012 geocoded listing of all outlets likely to sell tobacco in the United States. Separate multivariable logistic regression analyses examined associations between neighborhood outlet density and past 6 months first use of cigarettes, non-cigarette combustible products, and noncombustible products among adults aged 18–24 and 25–34. Results: Outlet density was significantly associated with recent initiation of cigarettes and other combustibles, but this impact varied for younger and older groups. Increased density was significantly associated with a higher likelihood of initiating cigarette use among adults aged 25–34 (OR = 3.75, 95% CI = 1.18, 11.90), and of initiating non-cigarette combustible use among 18–24 year olds (OR = 3.16, 95% CI = 1.03, 9.74). There was no impact of outlet density on recent noncombustible product initiation among either group. Conclusion: This study is the first to examine the impact of tobacco outlet density on young adult initiation of cigarettes and other tobacco products. Findings demonstrate that residential neighborhood outlet density is associated with recent initiation of combustible products and this effect varies by product type and age. The tobacco outlet environment may be a critical factor in promoting young adult tobacco use initiation. PMID:25666816

Tobacco industry control of menthol in cigarettes and targeting of adolescents and young adults.

PubMed

Kreslake, Jennifer M; Wayne, Geoffrey Ferris; Alpert, Hillel R; Koh, Howard K; Connolly, Gregory N

2008-09-01

We examined whether tobacco manufacturers manipulate the menthol content of cigarettes in an effort to target adolescents and young adults. We analyzed data from tobacco industry documents describing menthol product development, results of laboratory testing of US menthol brands, market research reports, and the 2006 National Survey on Drug Use and Health. The tobacco industry attracted new smokers by promoting cigarettes with lower menthol content, which were popular with adolescents and young adults, and provided cigarettes with higher menthol content to long-term smokers. Menthol cigarette sales remained stable from 2000 to 2005 in the United States, despite a 22% decline in overall packs sold. Tobacco companies manipulate the sensory characteristics of cigarettes, including menthol content, thereby facilitating smoking initiation and nicotine dependence. Menthol brands that have used this strategy have been the most successful in attracting youth and young adult smokers and have grown in popularity.

Young adult smoking behavior: a national survey.

PubMed

Ling, Pamela M; Neilands, Torsten B; Glantz, Stanton A

2009-05-01

Young adults have the highest smoking rate of any age group in the U.S., and new strategies to decrease young adult smoking are needed. The objective of the current study was to identify psychographic and demographic factors associated with current smoking and quitting behaviors among young adults. Attitudes, social groups, and self-descriptors, including supporting action against the tobacco industry, advertising receptivity, depression, alcohol use, and other factors associated with smoking were tested for associations with smoking behaviors in a 2005 cross-sectional survey of 1528 young adults (aged 18-25 years) from a web-enabled panel. Analyses were conducted in 2007. Being older was associated with current smoking, whereas having some higher education and being African American or Hispanic were negatively associated with smoking. Supporting action against the tobacco industry was negatively associated with smoking (AOR=0.34 [95% CI=0.22, 0.52]). Perceived usefulness of smoking, exposure to smokers, increased perceived smoking prevalence, receptivity to tobacco advertising, binge drinking, and exposure to tobacco advertising in bars and clubs were associated with smoking. Supporting action against the tobacco industry was associated with intentions to quit smoking (AOR=4.43 [95% CI=2.18, 8.60]). Young adults are vulnerable to tobacco-industry advertising. Media campaigns that denormalize the tobacco industry and appeal to young adults appear to be a powerful intervention to decrease young adult smoking.

Tobacco and Marijuana Initiation Among African American and White Young Adults.

PubMed

Kennedy, Sara M; Patel, Roshni P; Cheh, Paul; Hsia, Jason; Rolle, Italia V

2016-04-01

African American youth use marijuana at similar rates and tobacco at lower rates compared with white youth; however, in adulthood, tobacco use is similar. Tobacco and marijuana use are closely associated; differing initiation patterns may contribute to observed racial differences in tobacco prevalence by age. Therefore, it is important to assess tobacco and marijuana initiation patterns by race. Data were obtained from 56,555 adults aged 18-25 who completed the 2005-2012 National Survey on Drug Use and Health. The analysis was restricted to those who reported ever use of marijuana and combustible tobacco (cigarettes and/or cigars). Three mutually exclusive categories of initiation patterns were evaluated: use of marijuana before tobacco; marijuana and tobacco at the same age; and tobacco before marijuana. Multivariable regression models were used to assess changes over time and compare these outcomes by race while controlling for sociodemographics, risk perceptions, and current substance use. In 2005, 26.6% of African American and 14.3% of white young adults used marijuana before tobacco, compared with 41.5% of African American and 24.0% of white young adults in 2012 (P < .001). Overall, African American young adults had greater odds of using marijuana before tobacco (AOR = 1.79; 95% CI: 1.67, 1.91) compared with whites. African American young adults were more likely than whites to use marijuana before tobacco and both groups were increasingly likely to use marijuana before tobacco over time. A greater understanding of how marijuana initiation interacts with tobacco initiation could inform more effective tobacco and marijuana use prevention efforts. Among ever users of combustible tobacco and marijuana, greater proportions of African American young adults used marijuana before tobacco or at the same age than their white counterparts. Moreover, both African Americans and whites were more likely to use marijuana before tobacco in 2012 compared with 2005. Tobacco control policy may benefit from a broader understanding of the patterns of initiation to tobacco and marijuana use. Some public health interventions aimed at preventing and reducing combustible tobacco use among African American young adults may be strengthened by considering marijuana use. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Prevalence of tobacco smoking in Vietnam: findings from the Global Adult Tobacco Survey 2015.

PubMed

Van Minh, Hoang; Giang, Kim Bao; Ngoc, Nguyen Bao; Hai, Phan Thi; Huyen, Doan Thi Thu; Khue, Luong Ngoc; Lam, Nguyen Tuan; Nga, Pham Thi Quynh; Quan, Nguyen The; Xuyen, Nguyen Thi

2017-02-01

We report the prevalence of tobacco smoking among adult populations in Vietnam, 2015. The Vietnam GATS 2015 was a nationally representative survey. 9513 households were selected using two-stage random systematic sampling method. Handheld computers were used for capturing data. Data collection was carried-out by National Statistics Office of Vietnam in 2015. Weight was used in all estimates. The Vietnam GATS 2015 found that the prevalence of smoking in Vietnam was 22.5% overall, 45.3% among men, and 1.1% among women. The overall 2015-2010 reduction in prevalence of any tobacco product was 5.3%. However, the reduction was not statistically significant. The significant reduction in prevalence of tobacco smoking was found for any type of cigarette (-8.4%), and especially for hand-rolled cigarettes (-38.3%). The use of cigarettes significantly decreased in urban areas (-14.7%). The reduction in the prevalence of tobacco smoking in Vietnam during the last 5 years (2010-2015) has not been as high as expected, especially in rural areas. Further efforts are needed to continue to reduce the harms caused by tobacco smoking.

Trends in tobacco smoke exposure and blood lead levels among youths and adults in the United States: the National Health and Nutrition Examination Survey, 1999-2008.

PubMed

Richter, Patricia A; Bishop, Ellen E; Wang, Jiantong; Kaufmann, Rachel

2013-12-19

Tobacco smoke is a source of exposure to thousands of toxic chemicals including lead, a chemical of longstanding public health concern. We assessed trends in blood lead levels in youths and adults with cotinine-verified tobacco smoke exposure by using 10 years of data from the National Health and Nutrition Examination Survey. Geometric mean levels of blood lead are presented for increasing levels of tobacco smoke exposure. Regression models for lead included age, race/ethnicity, poverty, survey year, sex, age of home, birth country, and, for adults, alcohol consumption. Lead levels were evaluated for smokers and nonsmokers on the basis of age of residence and occupation. Positive trend tests indicate that a linear relationship exists between smoke exposure and blood lead levels in youths and adults and that secondhand smoke exposure contributes to blood lead levels above the level caused by smoking. Youths with secondhand smoke exposure had blood lead levels suggestive of the potential for adverse cognitive outcomes. Despite remediation efforts in housing and the environment and declining smoking rates and secondhand smoke exposure in the United States, tobacco smoke continues to be a substantial source of exposure to lead in vulnerable populations and the population in general.

Hands-on Workshops Aim to Strengthen Tobacco Control Efforts in Indonesia

Cancer.gov

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.

[Tobacco consumption, mortality and fiscal policy in Mexico].

PubMed

Guerrero-López, Carlos Manuel; Muños-Hernández, José Alberto; Sáenz de Miera-Juárez, Belén; Reynales-Shigematsu, Luz Myriam

2013-01-01

To analyze tobacco consumption in the last 12 years, its impact on chronic diseases mortality and the potential benefits of fiscal policy in Mexico. Through the analysis of national health surveys (ENSA, ENSANUT), records of mortality and economic surveys between 2000 and 2012, smoking prevalence, chronic diseases mortality and consumption were estimated. In 2012, 9.2% and 19% of Mexican youths and adults were current smokers. Between 2000 and 2012, smoking prevalence did not change. However, the average consumption among adolescents and adults declined whilst the special tobacco tax has being increased. Mortality attributable to tobacco consumption for four diseases was estimated in 60 000 in 2010. Tobacco consumption remains the leading cause of preventable death. Increasing taxes on tobacco products could deter the tobacco epidemic and consequently chronic diseases mortality in Mexico.

Flavored tobacco product use among U.S. young adults.

PubMed

Villanti, Andrea C; Richardson, Amanda; Vallone, Donna M; Rath, Jessica M

2013-04-01

Passage of the U.S. Family Smoking Prevention and Tobacco Control Act in 2009 led to a ban on the sale of flavored cigarettes, largely because of studies showing targeting of these products to youth and young adults. There are no current restrictions on the marketing or sale of noncigarette or new nontraditional smokeless tobacco products (such as snus and dissolvable products), which are available in more than 45 flavors. To determine the prevalence of flavored tobacco use, dual use of flavored and menthol tobacco products, and sociodemographic predictors of flavored tobacco product use in young adults aged 18-34 years (N=4196). The current study utilizes data from Legacy's Young Adult Cohort Study, a nationally representative sample collected in January 2012. Data were analyzed using Stata IC 11.0 in June 2012. Overall, 18.5% of tobacco users report using flavored products, and dual use of menthol and flavored product use ranged from 1% (nicotine products) to 72% (chewing tobacco). In a multivariable model controlling for menthol use, younger adults were more likely to use flavored tobacco products (OR=1.89, 95% CI=1.14, 3.11), and those with a high school education had decreased use of flavored products (OR=0.56; 95% CI=0.32, 0.97). Differences in use may be due to the continued targeted advertising of flavored products to young adults and minorities. Those most likely to use flavored products are also those most at risk of developing established tobacco-use patterns that persist through their lifetime. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Health-care Provider Screening and Advice for Smoking Cessation Among Smokers With and Without COPD: 2009-2010 National Adult Tobacco Survey.

PubMed

Schauer, Gillian L; Wheaton, Anne G; Malarcher, Ann M; Croft, Janet B

2016-03-01

Cigarette smoking is the predominant cause of COPD. Quitting can prevent development of and complications from COPD. The gold standard in clinician delivery of smoking cessation treatments is the 5As (ask, advise, assess, assist, arrange). This study assessed prevalence and correlates of self-reported receipt of the 5A strategies among adult smokers with and without COPD. Data were analyzed from 20,021 adult past-year cigarette smokers in the 2009-2010 National Adult Tobacco Survey, a nationally representative telephone survey of US adults 18 years of age and older. Past-year receipt of the 5As was self-reported by participants who saw a clinician in the past year. Logistic regression was used to estimate the likelihood of receipt of each of the 5As by COPD status, adjusted for sociodemographic and smoking characteristics. Among smokers, those with COPD were more likely than those without COPD to report being asked about tobacco use (95.4% vs 85.8%), advised to quit (87.5% vs 59.4%), assessed for readiness to quit (63.8% vs 37.9%), offered any assistance to quit (58.6% vs 34.0%), and offered follow-up (14.9% vs 5.2%). In adjusted logistic regression models, those with COPD were significantly more likely than those without COPD to receive each of the 5As. Health professionals should continue to prioritize tobacco cessation counseling and treatment to smokers with COPD. Increased system-level changes and insurance coverage for cessation treatments could be used to improve the delivery of brief tobacco cessation counseling to all smokers, regardless of COPD status. Copyright © 2016 American College of Chest Physicians. All rights reserved.

The association between alcohol, marijuana use, and new and emerging tobacco products in a young adult population.

PubMed

Cohn, Amy; Villanti, Andrea; Richardson, Amanda; Rath, Jessica M; Williams, Valerie; Stanton, Cassandra; Mermelstein, Robin

2015-09-01

Young adults have the highest rates of alcohol, tobacco, and other drug use relative to any other age group. Few studies have examined the co-occurrence of substance use with new and emerging tobacco products in this vulnerable group, or the underlying personality factors that may explain these associations. To address this gap, this study examined the association of current alcohol and marijuana use with the use of cigarettes and emerging tobacco products in a nationally representative sample of young adults. Data were drawn from 18 to 24year olds in Wave 4 (January 2013; n=1609) of the Legacy Young Adult Cohort, a nationally-representative sample of men and women. Never, ever (lifetime), and past 30-day use of little cigars/cigarillos (LCCs), hookah, e-cigarettes, and cigarettes were assessed separately in current (everyday or some days) alcohol and marijuana users. Using weighted estimates, multivariable multinomial logistic regression models showed that current alcohol and marijuana use were associated with lifetime and past 30-day use of cigarettes, LCCs, e-cigarettes, and hookah, with different magnitudes of association found across each product. Post-hoc exploratory analyses showed that sensation-seeking traits moderated the relationship of alcohol (but not marijuana) use to current use of select tobacco products. Marijuana and alcohol use may enhance risk for emerging tobacco products use in young adulthood. Prevention and intervention programs may need to target poly-use of alcohol, marijuana, and tobacco rather than focusing on a single risk behavior during these critical years. Copyright © 2015 Elsevier Ltd. All rights reserved.

Tobacco use in older adults in Ghana: sociodemographic characteristics, health risks and subjective wellbeing.

PubMed

Yawson, Alfred E; Baddoo, Akosua; Hagan-Seneadza, Nana Ayegua; Calys-Tagoe, Benedict; Hewlett, Sandra; Dako-Gyeke, Phyllis; Mensah, George; Minicuci, Nadia; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul; Biritwum, Richard

2013-10-20

Tobacco use over the life-course threatens to increase disease burden in older adulthood, including lower income countries like Ghana. This paper describes demographic, socioeconomic, health risks and life satisfaction indices related to tobacco use among older adults in Ghana. This work was based on the World Health Organization's multi-country Study on global AGEing and adult health (SAGE), conducted in six countries including Ghana. Wave one of SAGE in Ghana was conducted in 2007-2008 as collaboration between WHO and the University of Ghana Medical School through the Department of Community Health. A nationally representative sample of 4305 older adults aged 50 years and above were interviewed. Associations between tobacco consumption and sociodemographic, socioeconomic, health risk and life satisfaction were evaluated using chi-square and odds ratio (OR). Logistic regression analyses, adjusted for age, sex and other variables, were conducted to determine predictors of tobacco consumption in older persons. Overall prevalence of current daily smokers among older adults in Ghana was 7.6%. Tobacco use (i.e. ever used tobacco) was associated with older males, (AOR = 1.10, CI 1.05-1.15), older adults residing in rural locations (AOR = 1.37, CI 1.083-1.724), and older adults who used alcohol (AOR = 1.13, CI 0.230-2.418). Tobacco use was also associated (although not statistically significant per p-values) with increased self-reporting of angina, arthritis, asthma, chronic lung disease, depression, diabetes, hypertension, and stroke. Older adults who used tobacco and with increased health risks, tended to be without health insurance (AOR = 1.41, CI 1.111-1.787). Satisfaction with life and daily living was much lower for those who use tobacco. Regional differences existed in tobacco use; the three northern regions (Upper East, Northern and Upper West) had higher proportions of tobacco use among older adults in the country. Quitting tobacco use was higher in the 70+ years age group, in women, among urban residents and in those with at least secondary education. Quitting tobacco use also increased with increasing income levels. Tobacco use among older adults in Ghana was associated with older men living in rural locations, chronic ill-health and reduced life satisfaction. A high proportion of older adults have stopped using tobacco, demonstrating the possibilities for effective public health interventions. Health risk reduction strategies through targeted anti-smoking health campaigns, improvement in access to health and social protection (such as health insurance) will reduce health risks among older persons who use tobacco.

Associations of depressive and anxiety disorders with periodontal disease prevalence in young adults: analysis of 1999-2004 National Health and Nutrition Examination Survey (NHANES) data.

PubMed

Khambaty, Tasneem; Stewart, Jesse C

2013-06-01

Depression and anxiety have been linked to periodontal disease, an emerging risk factor for chronic diseases. However, this literature is mixed, and few studies have concurrently evaluated depression and anxiety. We simultaneously examined the associations of depressive and anxiety disorders with periodontal disease prevalence and explored tobacco use as a mediator. Participants were 1,979 young adults from the National Health and Nutrition Examination Survey 1999-2004 who underwent a diagnostic interview and a dental examination. Adults with panic disorder had a threefold higher odds of having periodontal disease than those without this disorder (OR = 3.07, 95 % CI 1.17-8.02). This relationship was partially mediated by tobacco use and remained after adjustment for major depressive disorder and generalized anxiety disorder, which were not related to periodontal disease. Young adults with panic disorder may have greater odds of having periodontal disease, in part, due to increased tobacco use.

US adult tobacco users' absolute harm perceptions of traditional and alternative tobacco products, information-seeking behaviors, and (mis)beliefs about chemicals in tobacco products.

PubMed

Bernat, Jennifer K; Ferrer, Rebecca A; Margolis, Katherine A; Blake, Kelly D

2017-08-01

Harm perceptions about tobacco products may influence initiation, continued use, and cessation efforts. We assessed associations between adult traditional tobacco product use and absolute harm perceptions of traditional and alternative tobacco products. We also described the topics individuals looked for during their last search for information, their beliefs about chemicals in cigarettes/cigarette smoke, and how both relate to harm perceptions. We ran multivariable models with jackknife replicate weights to analyze data from the 2015 administration of the National Cancer Institute's Health Information National Trends Survey (N=3376). Compared to never users, individuals reported lower perceived levels of harm for products they use. Among current tobacco users, ethnicity, thinking about chemicals in tobacco, and information-seeking were all factors associated with tobacco product harm perceptions. In the full sample, some respondents reported searching for information about health effects and cessation and held misperceptions about the source of chemicals in tobacco. This study fills a gap in the literature by assessing the absolute harm perceptions of a variety of traditional and alternative tobacco products. Harm perceptions vary among tobacco products, and the relationship among tobacco use, information seeking, thoughts about chemicals in tobacco products, and harm perceptions is complex. Data suggest that some individuals search for information about health effects and cessation and hold misperceptions about chemicals in tobacco products. Future inquiry could seek to understand the mechanisms that contribute to forming harm perceptions and beliefs about chemicals in tobacco products. Published by Elsevier Ltd.

Prevalence and Determinants of Tobacco Use in India: Evidence from Recent Global Adult Tobacco Survey Data

PubMed Central

Singh, Akansha; Ladusingh, Laishram

2014-01-01

Background Tobacco use in India is characterized by a high prevalence of smoking and smokeless tobacco use, with dual use also contributing a noticeable proportion. In the context of such a high burden of tobacco use, this study examines the regional variations, and socioeconomic, demographic and other correlates of smoking, smokeless tobacco and dual use of tobacco in India. Methods and Findings We analyzed a cross sectional, nationally representative sample of individuals from the Global Adult Tobacco Survey in India (2009–10), which covered 69,296 individuals aged 15 years and above. The current tobacco use in three forms, namely, smoking only, smokeless tobacco use only, and both smoking and smokeless tobacco use were considered as outcomes in this study. Descriptive statistics, cross tabulations and multinomial logistic regression analysis were adopted as analytical tools. Smokeless tobacco use was the major form of tobacco use in India followed by smoking and dual tobacco use. Tobacco use was higher among males, the less educated, the poor, and the rural population in India. Respondents lacking knowledge of health hazards of tobacco had higher prevalence of tobacco use in each form. The prevalence of different forms of tobacco use varies significantly by states. The prevalence of tobacco use increases concomitantly with age among females. Middle-aged adult males had higher prevalence of tobacco use. Age, education and region were found to be significant determinants of all forms of tobacco use. Adults from the poor household had significantly higher risk of consuming smokeless tobacco. Lack of awareness about the selected hazards of tobacco significantly affects tobacco use. Conclusions There is an urgent need to curb the use of tobacco among the sub-groups of population with higher prevalence. Tobacco control policies in India should adopt a targeted, population-based approach to control and reduce tobacco consumption in the country. PMID:25474196

The Process of Cessation Among Current Tobacco Smokers: A Cross-Sectional Data Analysis From 21 Countries, Global Adult Tobacco Survey, 2009-2013.

PubMed

Mbulo, Lazarous; Palipudi, Krishna M; Nelson-Blutcher, Glenda; Murty, Komanduri S; Asma, Samira

2015-09-17

We analyzed data from the Global Adult Tobacco Survey (GATS) from 21 countries to categorize smokers by stages of cessation and highlight interventions that could be tailored to each stage. GATS is a nationally representative household survey that measures tobacco use and other key indicators by using a standardized protocol. The distribution of smokers into precontemplation, contemplation, and preparation stages varied by country. Using the stages of change model, each country can design and implement effective interventions suitable to its cultural, social, and economic situations to help smokers advance successfully through the stages of cessation.

Exposure to environmental tobacco smoke among South Korean adults: a cross-sectional study of the 2005 Korea National Health and Nutrition Examination Survey.

PubMed

Lee, Bo-Eun; Ha, Eun-Hee

2011-04-03

Studies have identified that environmental tobacco smoke exposure is associated with sociodemographic factors such as age, sex, and socioeconomic status, but few studies have been conducted in South Korea. In this study, the authors investigated the extent of environmental tobacco smoke exposure and factors related in a nationally representative sample of Korean adults. The data of 7,801 adults aged 19 years and over collected during the 2005 Korea National Health and Nutrition Examination Survey were analyzed. Information on smoking habits and exposure to environmental tobacco smoke was obtained by self-reports using a standardized questionnaire. Risks of environmental tobacco smoke exposure conferred by sociodemographic variables and behavioral risk factors were evaluated using logistic regression methods. Overall, 36.1% of nonsmokers (defined as those not currently smoking) and 50.1% of current smokers were found to be exposed to environmental tobacco smoke either at work or at home. Among the nonsmokers, women were more likely to be exposed to environmental tobacco smoke at home (OR = 5.22, 95%CI, 4.08-6.67). Furthermore, an inverse relationship was found between education level and the risk of environmental tobacco smoke exposure at home (OR = 1.73, 95%CI, 1.38-2.17 for those with a high school education; OR = 2.30, 95%CI, 1.68-3.16 for those with a middle school education; and OR = 2.58, 95%CI, 1.85-3.59 for those with less than an elementary school education vs. those with a college education or more). In addition, those with office, sales service, or manual labor jobs were found to be at significantly higher risk of environmental tobacco smoke exposure at work than those with professional, administrative, or managerial jobs. Also, the risk of environmental tobacco smoke exposure in the workplace was significantly higher for alcohol drinkers than non-drinkers (OR = 1.23, 95%CI, 1.07-1.47). After adjusting for age, sex and education, it was found that those exposed to environmental tobacco smoke at home were more likely to have been admitted to hospital during the previous year (OR 1.29, 95%CI, 1.002-1.66). In this study of Korean adults, exposure to environmental tobacco smoke at home or work was found to be affected by sex, age, marital status, educational level, and type of occupation. Accordingly, these factors should be given appropriate consideration by those developing policies or interventions designed to control exposure to environmental tobacco smoke.

State-Specific Prevalence of Tobacco Product Use Among Adults - United States, 2014-2015.

PubMed

Odani, Satomi; Armour, Brian S; Graffunder, Corinne M; Willis, Gordon; Hartman, Anne M; Agaku, Israel T

2018-01-26

Despite recent declines in cigarette smoking prevalence, the tobacco product landscape has shifted to include emerging tobacco products* (1,2). Previous research has documented adult use of smokeless tobacco and cigarettes by state (3); however, state-specific data on other tobacco products are limited. To assess tobacco product use in the 50 U.S. states and the District of Columbia (DC), CDC and the National Cancer Institute analyzed self-reported use of six tobacco product types: cigarettes, cigars, regular pipes, water pipes, electronic cigarettes (e-cigarettes), and smokeless tobacco products among adults aged ≥18 years using data from the 2014-2015 Tobacco Use Supplement to the Current Population Survey (TUS-CPS). Prevalence of ever-use of any tobacco product ranged from 27.0% (Utah) to 55.4% (Wyoming). Current (every day or some days) use of any tobacco product ranged from 10.2% (California) to 27.7% (Wyoming). Cigarettes were the most common currently used tobacco product in all states and DC. Among current cigarette smokers, the proportion who currently used one or more other tobacco products ranged from 11.5% (Delaware) to 32.3% (Oregon). Differences in tobacco product use across states underscore the importance of implementing proven population-level strategies to reduce tobacco use and expanding these strategies to cover all forms of tobacco marketed in the United States. Such strategies could include comprehensive smoke-free policies, tobacco product price increases, anti-tobacco mass media campaigns, and barrier-free access to clinical smoking cessation resources (1,4).

Tobacco Use among Minnesota Adults, 2014.

PubMed

Boyle, Raymond G; Amato, Michael S; Rode, Peter; Kinney, Ann M; St Claire, Ann W; Taylor, Kristie

2015-09-01

The changing landscape of tobacco including the introduction of new products such as smokeless tobaccos and electronic delivery devices has highlighted the need for continued surveillance of tobacco use. Minnesota has conducted an in-depth surveillance of adult tobacco use since 1999. For the fifth in the series, conducted in 2014, 9304 telephone interviews were completed. The 2014 prevalence of cigarette smoking (14.4%) continues a downward trend that remains lower than the national smoking prevalence (17.3%). Among all Minnesota adults, use prevalence of other tobacco products was as follows: e-cigarettes 5.9%, all smokeless tobaccos 3.6%, cigars 3.0%, water pipe 1.4%, and regular pipe 0.7%. Among individuals who have never smoked cigarettes, smokeless tobacco was the most common product used (2.0%), nearly twice the prevalence of e-cigarette use (1.2%). Former smokers were equally likely to use smokeless tobacco (4.9%) or e-cigarettes (4.8%). Among smokers, 27.3% reported current use of e-cigarettes. In the past 15 years, cigarette smoking prevalence in Minnesota has dropped by an average of 0.51 percentage points annually, and prevalence could drop to less than 5% by 2034.

Tobacco Product Use Among Sexual Minority Adults

PubMed Central

Johnson, Sarah E.; Holder-Hayes, Enver; Tessman, Greta K.; King, Brian A.; Alexander, Tesfa; Zhao, Xiaoquan

2016-01-01

Introduction A growing body of evidence reveals higher rates of tobacco use among sexual minority populations relative to non-minority (“straight”) populations. This study seeks to more fully characterize this disparity by examining tobacco use by distinct sexual identities and gender to better understand patterns of: (1) cigarette smoking and smoking history; and (2) use of other tobacco products including cigars, pipes, hookah, e-cigarettes, and smokeless tobacco. Methods Data from the 2012–2013 National Adult Tobacco Survey, a random-digit dialed landline and cellular telephone survey of U.S. adults aged ≥18 years, were analyzed in 2014. A sexual minority category was created by combining gay, lesbian, and bisexual responses, along with those who selected an option for other non-heterosexual identities. Results Smoking prevalence was higher among sexual minority adults (27.4%) than straight adults (17.3%). Cigarette smoking was particularly high among bisexual women (36.0%). Sexual minority women started smoking and transitioned to daily smoking earlier than their straight peers. Use of other tobacco products was higher among sexual minority women: prevalence of e-cigarette (12.4%), hookah (10.3%), and cigar use (7.2%) was more than triple that of their straight female peers (3.4%, 2.5%, and 1.3%, respectively). Likewise, prevalence of sexual minority men’s e-cigarette (7.9%) and hookah (12.8%) use exceeded that of straight men (4.7% and 4.5%, respectively). Conclusions Tobacco use is significantly higher among sexual minority than straight adults, particularly among sexual minority women. These findings underscore the importance of tobacco control efforts designed to reach sexual minorities and highlight the heterogeneity of tobacco use within this population. PMID:26526162

Use of electronic nicotine delivery systems and other tobacco products among USA adults, 2014: results from a national survey.

PubMed

Weaver, Scott R; Majeed, Ban A; Pechacek, Terry F; Nyman, Amy L; Gregory, Kyle R; Eriksen, Michael P

2016-03-01

This study assessed the awareness and use of traditional and novel tobacco products and dual use of cigarettes with electronic nicotine delivery systems (ENDS) among USA adults. Data were obtained from the 2014 Tobacco Products and Risk Perceptions Survey of a probability sample of 5717 USA adults conducted June-November, 2014. Use of ENDS varied by demography and by cigarette and other tobacco use. Adults aged 25-34, non-heterosexual adults, and those reporting poorer health reported higher rates of current ENDS use. Current cigarette smokers had much greater odds of ENDS ever use than never smokers, with one-half of all cigarette smokers having used ENDS and 20.7 % currently using them. However, 22.0 % of current ENDS users were former cigarette smokers, and 10.0 % were never cigarette smokers. Patterns of ENDS use are evolving rapidly and merit continued surveillance. Nearly 10 % of adult ENDS usage is among never smokers. The public health challenge is how to enhance the potential that ENDS can replace combusted tobacco products without expanding nicotine use among youth, long-term ex-smokers, and other vulnerable populations.

Prevalence of waterpipe tobacco smoking among population aged 15 years or older, Vietnam, 2010.

PubMed

Xuan, Le Thi Thanh; Van Minh, Hoang; Giang, Kim Bao; Nga, Pham Thi Quynh; Hai, Phan Thi; Minh, Nguyen Thac; Hsia, Jason

2013-04-18

The prevalence of waterpipe tobacco smoking is increasing globally and is associated with adverse outcomes requiring tobacco control interventions. We estimated the prevalence of waterpipe tobacco use among adult populations in Vietnam in 2010 and examined its association with sociodemographic factors. We used data from the Global Adult Tobacco Survey (GATS) conducted in Vietnam in 2010. GATS surveyed a national representative sample of adults aged 15 years or older from 11,142 households by using a 2-phase sampling design analogous to a 3-stage stratified cluster sampling. Descriptive statistical analyses and multivariate logistic regression modeling were conducted. A total of 6.4% of Vietnamese aged 15 years or older (representing about 4.1 million adult waterpipe smokers) reported current waterpipe tobacco smoking. The prevalence of waterpipe tobacco smoking was significantly higher among men than women (13% vs 0.1%). Area of residence (rural or urban), age group, asset-based wealth quintile, and geographic region of residence were significantly associated with waterpipe tobacco smoking among men. The significant correlates of current waterpipe tobacco smoking among men were lower education levels, being middle-aged (45-54 years), lower asset-based wealth levels, living in rural areas, not living in the South East and the Mekong River Delta geographic regions, and the belief that smoking does not causes diseases. Rural dwellers who are poor should be targeted in tobacco control programs. Further studies are needed that examine perceptions of the adverse health effects and the cultural factors of waterpipe tobacco smoking.

Prevalence and correlates of alcohol and tobacco use among pregnant women in the United States: Evidence from the NSDUH 2005-2014.

PubMed

Oh, Sehun; Reingle Gonzalez, Jennifer M; Salas-Wright, Christopher P; Vaughn, Michael G; DiNitto, Diana M

2017-04-01

Alcohol and tobacco use during pregnancy are among the strongest and most preventable risk factors for adverse neonatal health outcomes, but few developmentally sensitive, population-based studies of this phenomenon have been conducted. To address this gap, the present study examined the prevalence and correlates of alcohol and tobacco use among pregnant adolescents (aged 12-17) and adults (aged 18-44) in the United States. Data were derived from the population-based National Survey of Drug Use and Health (80,498 adolescent and 152,043 adult women) between 2005 and 2014. Findings show disconcerting levels of past-month use among pregnant women with 11.5% of adolescent and 8.7% of adult women using alcohol, and 23.0% of adolescent and 14.9% of adult women using tobacco. Compared to their non-pregnant counterparts, pregnant adolescents were less likely to report past 30-day alcohol use (AOR=0.52, 95% CI=0.36-0.76), but more likely to report past 30-day tobacco use (AOR=2.20, 95% CI=1.53-3.18). Compared to their non-pregnant adult counterparts, pregnant adults were less likely to report using alcohol (AOR=0.06, 95% CI=0.05-0.07) and tobacco (AOR=0.47, 95% CI=0.43-0.52). Compared to pregnant abstainers, pregnant women reporting alcohol/tobacco use were more likely to have had a major depressive episode in the past 12months, report criminal justice system involvement, and endorse comorbid alcohol/tobacco use. Given alcohol and tobacco's deleterious consequences during pregnancy, increased attention to reducing use is critical. Findings suggest that tobacco use is especially problematic for both adolescents and adults and is strongly linked with depression and criminal justice involvement, especially among adults. Copyright © 2017 Elsevier Inc. All rights reserved.

Cigarette Smoking, Desire to Quit, and Tobacco-Related Counseling Among Patients at Adult Health Centers

PubMed Central

Lebrun-Harris, Lydie A.; Fiore, Michael C.; Tomoyasu, Naomi; Ngo-Metzger, Quyen

2015-01-01

Objectives. We determined cigarette smoking prevalence, desire to quit, and tobacco-related counseling among a national sample of patients at health centers. Methods. Data came from the 2009 Health Center Patient Survey and the 2009 National Health Interview Survey. The analytic sample included 3949 adult patients at health centers and 27 731 US adults. Results. Thirty-one percent of health center patients were current smokers, compared with 21% of US adults in general. Among currently smoking health center patients, 83% desired to quit and 68% received tobacco counseling. In multivariable models, patients had higher adjusted odds of wanting to quit if they had indications of severe mental illness (adjusted odds ratio [AOR] = 3.26; 95% confidence interval [CI] = 1.19, 8.97) and lower odds if they had health insurance (AOR = 0.43; 95% CI = 0.22, 0.86). Patients had higher odds of receiving counseling if they had 2 or more chronic conditions (AOR = 2.05; 95% CI = 1.11, 3.78) and lower odds if they were Hispanic (AOR = 0.57; 95% CI = 0.34, 0.96). Conclusions. Cigarette smoking prevalence is substantially higher among patients at health centers than US adults in general. However, most smokers at health centers desire to quit. Continued efforts are warranted to reduce tobacco use in this vulnerable group. PMID:24625147

Cigarette Smoking, Desire to Quit, and Tobacco-Related Counseling Among Patients at Adult Health Centers.

PubMed

Lebrun-Harris, Lydie A; Fiore, Michael C; Tomoyasu, Naomi; Ngo-Metzger, Quyen

2015-01-01

Objectives. We determined cigarette smoking prevalence, desire to quit, and tobacco-related counseling among a national sample of patients at health centers. Methods. Data came from the 2009 Health Center Patient Survey and the 2009 National Health Interview Survey. The analytic sample included 3949 adult patients at health centers and 27 731 US adults. Results. Thirty-one percent of health center patients were current smokers, compared with 21% of US adults in general. Among currently smoking health center patients, 83% desired to quit and 68% received tobacco counseling. In multivariable models, patients had higher adjusted odds of wanting to quit if they had indications of severe mental illness (adjusted odds ratio [AOR] = 3.26; 95% confidence interval [CI] = 1.19, 8.97) and lower odds if they had health insurance (AOR = 0.43; 95% CI = 0.22, 0.86). Patients had higher odds of receiving counseling if they had 2 or more chronic conditions (AOR = 2.05; 95% CI = 1.11, 3.78) and lower odds if they were Hispanic (AOR = 0.57; 95% CI = 0.34, 0.96). Conclusions. Cigarette smoking prevalence is substantially higher among patients at health centers than US adults in general. However, most smokers at health centers desire to quit. Continued efforts are warranted to reduce tobacco use in this vulnerable group.

The Process of Cessation Among Current Tobacco Smokers: A Cross-Sectional Data Analysis From 21 Countries, Global Adult Tobacco Survey, 2009–2013

PubMed Central

Palipudi, Krishna M.; Nelson-Blutcher, Glenda; Murty, Komanduri S.; Asma, Samira

2015-01-01

We analyzed data from the Global Adult Tobacco Survey (GATS) from 21 countries to categorize smokers by stages of cessation and highlight interventions that could be tailored to each stage. GATS is a nationally representative household survey that measures tobacco use and other key indicators by using a standardized protocol. The distribution of smokers into precontemplation, contemplation, and preparation stages varied by country. Using the stages of change model, each country can design and implement effective interventions suitable to its cultural, social, and economic situations to help smokers advance successfully through the stages of cessation. PMID:26378897

Prevalence of tobacco use among adults in Egypt, 2009.

PubMed

Fouad, Heba; Awa, Fatimah El; Naga, Randa Abou El; Emam, Awatef Hussien; Labib, Sahar; Palipudi, Krishna Mohan; Andes, Linda J; Asma, Samira; Talley, Brandon

2016-06-01

We assessed the differences in overall use of tobacco and in the use of various tobacco products, by sex and by frequency of use across various demographic groups. We used data from the Global Adult Tobacco Survey (GATS), conducted in 2009 in Egypt. The data consist of answers to GATS by 20,924 respondents from a nationally representative, multistage probability sample of adults aged 15 years or older from all regions of Egypt. Current tobacco use was defined as current smoking or use of smokeless tobacco products, either daily or occasionally. We analyzed the differences in current cigarette, shisha, and smokeless tobacco use by sex and frequency of use (daily or occasional); and by demographic characteristics that included age, region, education level and employment status. Overall, 19.7% of the Egyptian population currently use some form of tobacco. Men (38.1% [95% confidence interval (CI) 36.8-39.4]) are much more likely than women (0.6% [95% CI 0.4-0.9]) to use tobacco. Almost 96% of men who use tobacco, do so daily. Men are more likely to use manufactured cigarettes (31.8% [95% CI 30.6-33.1]) than shisha (6.2% [95% CI 5.6-6.9]) or smokeless tobacco (4.1% [95% CI 3.4-4.8]). Few women use tobacco (cigarettes (0.2%), shisha (0.3%) and smokeless tobacco (0.3%)); however, all women who currently smoke shisha, do so daily. Lower educational status, being between ages 25-64 and being employed predicted a higher use of tobacco. Egypt has implemented several initiatives to reduce tobacco use. The World Health Organization (WHO) MPOWER technical package, which aims to reverse the tobacco epidemic, is implemented at various levels throughout the country. Our findings show that there is significant variation in the prevalence of tobacco use and types of tobacco used by adult men and women in Egypt. GATS data can be used to better understand comparative patterns of tobacco use by adults, which in turn can be used to develop interventions. © The Author(s) 2013.

[Global Adult Tobacco Survey in Poland--the aim and current experiences].

PubMed

Kaleta, Dorota; Kozieł, Anna; Miśkiewicz, Paulina

2009-01-01

Poland is one of the countries, where smoking is widely spread and smoking-induced diseases have become a significant health and socio-economic issue. Since 1999, the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC), in cooperation with partner organizations have been working on the implementation of the global control system known as the Global Tobacco Surveillance System (GTSS). This system expands the opportunities of individual countries in the area of designing, implementing and evaluating comprehensive anti-tobacco programs. The Global Adult Tobacco Survey (GATS) has been incorporated into the GTSS system in 2007. The aim of the work is to explain and promote the objectives of GATS and the process of its implementation in Poland based on current experiences of the WHO Country Office for Poland. GATS concentrates on monitoring of tobacco use by adults (aged over 15 years). It is a representative, national survey of households, standardized on a global scale. GATS is supported by Bloomberg Philanthropies as a part of the Bloomberg Global Initiative to Reduce Tobacco Use. Two executive agencies, the M. Skłodowska-Curie Institute of Oncology, Warsaw and the Warsaw Medical University, have been assigned to implement the Global Adult Tobacco Survey in Poland. The prepatory works for pre-testing and further stages of the survey implementation are currently under the final phase. Data gathered by GATS will enable us to learn more about the use of tobacco by the adult population in Poland. They will also indicate the most effective methods of the tobacco control in our country.

Independent and Interactive Effects of Smoking Bans and Tobacco Taxes on a Cohort of US Young Adults.

PubMed

Vuolo, Mike; Kelly, Brian C; Kadowaki, Joy

2016-02-01

We examined the mutual effects of smoking bans and taxes on smoking among a longitudinal cohort of young adults. We combined a repository of US tobacco policies at the state and local level with the nationally representative geocoded National Longitudinal Survey of Youth 1997 (2004-2011) from ages 19 to 31 years and Census data, to examine the impact of tobacco policies on any current and daily pack smoking. The analytic sample amounts to 19,668 observations among 4341 individuals within 487 cities. For current smoking, we found significant effects for comprehensive smoking bans, but not excise taxes. We also found an interaction effect, with bans being most effective in locales with no or low taxes. For daily pack smoking, we found significant effects for taxes, but limited support for bans. Social smoking among young adults is primarily inhibited by smoking bans, but excise taxes only deter such smoking in the absence of a ban. Heavy smokers are primarily deterred by taxes. Although both policies have an impact on young adult smoking behaviors, their dual presence does not intensify each policy's efficacy.

Mass media exposure, social stratification, and tobacco consumption among Nigerian adults.

PubMed

Tafawa, Adebola Odunlami; Viswanath, Kasisomayajula; Kawachi, Ichiro; Williams, David R

2012-03-01

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.

Quantifying the effect of changes in state-level adult smoking rates on youth smoking.

PubMed

Farrelly, Matthew C; Arnold, Kristin Y; Juster, Harlan R; Allen, Jane A

2014-01-01

Quantify the degree to which changes in state-level adult smoking prevalence subsequently influence youth smoking prevalence. Analysis of data from the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) collected from 1995 to 2006 and the National Youth Tobacco Survey (NYTS) collected from 1999 to 2006. Adults 25 years or older who completed the TUS-CPS and youth in middle and high school who completed the NYTS. Current smoking among middle and high school students as a function of the change in state-level adult smoking, controlling for individual-level sociodemographic characteristics and state-level tobacco control policy variables. Among middle school students, declines in state-level adult smoking rates are associated with lower odds of current smoking (P < .05), and each doubling of the decline in adult smoking rates is associated with a 6.0% decrease in youth smoking. Among high school students, declines in state-level adult smoking rates are not associated with current smoking. Higher cigarette prices were associated with lower odds of smoking among middle and high school students. Greater population coverage by smoke-free air laws and greater funding for tobacco control programs were associated with lower odds of current smoking among high school students but not middle school students. Compliance with youth access laws was not associated with middle or high school smoking. By quantifying the effect of changes in state-level adult smoking rates on youth smoking, this study enhances the precision with which the tobacco control community can assess the return on investment for adult-focused tobacco control programs.

Prevalence of Waterpipe Tobacco Smoking Among Population Aged 15 Years or Older, Vietnam, 2010

PubMed Central

Van Minh, Hoang; Giang, Kim Bao; Nga, Pham Thi Quynh; Hai, Phan Thi; Minh, Nguyen Thac; Hsia, Jason

2013-01-01

Introduction The prevalence of waterpipe tobacco smoking is increasing globally and is associated with adverse outcomes requiring tobacco control interventions. We estimated the prevalence of waterpipe tobacco use among adult populations in Vietnam in 2010 and examined its association with sociodemographic factors. Methods We used data from the Global Adult Tobacco Survey (GATS) conducted in Vietnam in 2010. GATS surveyed a national representative sample of adults aged 15 years or older from 11,142 households by using a 2-phase sampling design analogous to a 3-stage stratified cluster sampling. Descriptive statistical analyses and multivariate logistic regression modeling were conducted. Results A total of 6.4% of Vietnamese aged 15 years or older (representing about 4.1 million adult waterpipe smokers) reported current waterpipe tobacco smoking. The prevalence of waterpipe tobacco smoking was significantly higher among men than women (13% vs 0.1%). Area of residence (rural or urban), age group, asset-based wealth quintile, and geographic region of residence were significantly associated with waterpipe tobacco smoking among men. The significant correlates of current waterpipe tobacco smoking among men were lower education levels, being middle-aged (45–54 years), lower asset-based wealth levels, living in rural areas, not living in the South East and the Mekong River Delta geographic regions, and the belief that smoking does not causes diseases. Conclusion Rural dwellers who are poor should be targeted in tobacco control programs. Further studies are needed that examine perceptions of the adverse health effects and the cultural factors of waterpipe tobacco smoking. PMID:23597395

Differences in Tobacco Product Use Among Past Month Adult Marijuana Users and Nonusers: Findings From the 2003-2012 National Survey on Drug Use and Health.

PubMed

Schauer, Gillian L; Berg, Carla J; Kegler, Michelle C; Donovan, Dennis M; Windle, Michael

2016-03-01

This study assessed differences in individual tobacco product use between past month marijuana users and nonusers, and trends in overall tobacco use and use of specific tobacco products among marijuana users. Data were obtained from 378 459 adults participating in the 2003-2012 National Survey on Drug Use and Health, a cross-sectional, household interview survey conducted annually. Data from the most recent 2 years (2011-2012) were used to assess differences in the prevalence of various tobacco products by past month marijuana status. Data from all years were used to assess historical trends in overall tobacco use, and use of cigarettes, cigars, and blunts among marijuana users; trend significance was assessed using orthogonal polynomials. From 2011-2012, the prevalence of any past month tobacco use among the 9727 past month marijuana users was 68.6% excluding blunts, and 78.3% including blunts (vs. 25.3% for nonusers, P < .0001); 77.3% of past month marijuana users reported past month combusted tobacco use (vs. 23.4% of non-MJ users, P < .0001). By product, 60.1% of past month marijuana users reported past month cigarette use, 42.0% reported past month blunt use, and 20.6% reported past month cigar use. Overall, adjusted trends in past month cigarette use decreased, while trends in past month blunt use increased; cigar use did not change. Tobacco use is highly prevalent among adult marijuana users and represents an important potential comorbidity of marijuana use. In light of increasing policies legalizing marijuana, it is critical to monitor changes in overall and specific tobacco product use. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Adult smokers in Colombia: Who isn’t giving it up

PubMed Central

Storr, Carla L.; Cheng, Hui; Posada-Villa, Jose; Aguilar-Gaxiola, Sergio; Anthony, James C.

2008-01-01

Without ongoing surveillance systems to assess tobacco product demand and exposure levels, many low and middle income countries monitor smoking via periodic cross-sectional surveys. In this article, we seek to update estimates for the prevalence of adult smoking in Colombia and contribute additional information useful for tobacco control initiatives. Data are from the 2003 Colombian National Study of Mental Health (NSMH). A national probability sample of 4,426 adults (age 18-65) was assessed via a computer-assisted interview. An estimated 49% of the adult population had smoked at least once in their lifetimes; one in three adults (31%) had smoked regularly. Nearly half of regular smokers had been able to quit (44%; 95% CI= 40-48). Several personal and smoking related characteristics were associated with failing to quit: being a younger age, employed as compared to being a homemaker, and a history of daily use. Quitters and non-quitters were equivalent with respect to sex, educational status, and age of smoking onset. In conclusion, our findings describe the characteristics of regular smokers in Colombia and identify subgroups of non-quitters that may help guide tobacco control activities. PMID:18006241

Dependence symptoms and cessation intentions among US adult daily cigarette, cigar, and e-cigarette users, 2012-2013.

PubMed

Rostron, Brian L; Schroeder, Megan J; Ambrose, Bridget K

2016-08-18

Cigar and e-cigarette use is becoming increasingly common among US tobacco users and the Food and Drug Administration recently asserted regulatory jurisdiction over these products, among others, in May 2016. Research on tobacco dependence among users of these products is limited, however. We therefore examined several symptoms of dependence and cessation intentions among adult cigarette, cigar, and/or e-cigarette users in a nationally representative sample. We used nationally representative data from more than 60,000 participants in the US National Adult Tobacco Survey (NATS) from 2012 to 2013 to analyze dependence symptoms and cessation intentions for users of cigarettes, cigars, and/or e-cigarettes but not other tobacco products. Among daily tobacco users, dual cigarette and cigar users on average smoked more cigarettes per day (17.3, 95 % CI = 16.1, 18.6 vs. 15.8, 95 % CI = 15.4, 16.2), had shorter times to first tobacco use after waking (21.4 min, 95 % CI = 16.6, 24.9 vs. 25.9 min, 95 % CI = 25.3, 26.5), and were more likely to report withdrawal and craving symptoms than exclusive cigarette smokers. Dual cigarette and e-cigarette users were more likely than exclusive cigarette smokers to report withdrawal and craving symptoms and cessation intentions. Exclusive cigar and e-cigarette users were less likely to report withdrawal and craving symptoms than users of other products, but even so, more than a third of exclusive cigar (38.8 %, 95 % CI = 27.4 %, 51.6 %) and e-cigarette (46.1 %, 95 % CI = 35.1 %, 57.4 %) users reported experiencing a strong craving for a tobacco product in the past 30 days. Dual cigarette and cigar users show evidence of greater dependence symptoms and dual cigarette and e-cigarette users show evidence of greater dependence symptoms and cessation intentions compared with exclusive cigarette smokers. A sizeable number of users of all of the tobacco products report dependence symptoms such as craving for tobacco.

Electronic data collection and management system for global adult tobacco survey.

PubMed

Pujari, Sameer J; Palipudi, Krishna M; Morton, Jeremy; Levinsohn, Jay; Litavecz, Steve; Green, Michael

2012-01-01

Portable handheld computers and electronic data management systems have been used for national surveys in many high-income countries, however their use in developing countries has been challenging due to varying geographical, economic, climatic, political and cultural environments. In order to monitor and measure global adult tobacco use, the World Health Organization and the US Centers for Disease Control and Prevention initiated the Global Adult Tobacco Survey, a nationally representative household survey of adults, 15 years of age or older, using a standard core questionnaire, sample design, and data collection and management procedures. The Survey has been conducted in 14 low- and middle-income countries, using an electronic data collection and management system. This paper describes implementation of the electronic data collection system and associated findings. The Survey was based on a comprehensive data management protocol, to enable standardized, globally comparable high quality data collection and management. It included adaptation to specific country needs, selection of appropriate handheld hardware devices, use of open source software, and building country capacity and provide technical support. In its first phase, the Global Adult Tobacco Survey was successfully conducted between 2008 and 2010, using an electronic data collection and management system for interviews in 302,800 households in 14 countries. More than 2,644 handheld computers were fielded and over 2,634 fieldworkers, supervisors and monitors were trained to use them. Questionnaires were developed and programmed in 38 languages and scripts. The global hardware failure rate was < 1% and data loss was almost 0%. Electronic data collection and management systems can be used effectively for conducting nationally representative surveys, particularly in low- and middle-income countries, irrespective of geographical, climatic, political and cultural environments, and capacity-building at the country level is an important vehicle for Health System Strengthening.

Contraband tobacco on post-secondary campuses in Ontario, Canada: analysis of discarded cigarette butts

PubMed Central

2013-01-01

Background No studies to date have assessed young adults’ use of First Nations/Native tobacco, a common form of contraband tobacco in Canada. This study examined the proportion of First Nations/Native cigarette butts discarded on post-secondary campuses in the province of Ontario, and potential differences between colleges and universities and across geographical regions. Methods In 2009, discarded cigarette butts were collected from high-traffic smoking locations at 12 universities and 13 colleges purposively selected to represent a variety of institutions from all 7 health service regions across Ontario. Cigarette butts were identified as First Nations/Native tobacco if they were: known First Nations/Native brands; had names not matching domestic and international legally-manufactured cigarettes; had no visible branding or logos. Results Of 36,355 butts collected, 14% (95% CI = 9.75–19.04) were First Nations/Native. Use of this tobacco was apparent on all campuses, accounting for as little as 2% to as much as 39% of cigarette consumption at a particular school. Proportions of First Nations/Native butts were not significantly higher on colleges (M = 17%) than universities (M = 12%), but were significantly higher in the North region. Conclusions The presence of cheap First Nations/Native (contraband) tobacco on post-secondary campuses suggests the need for regulation and public education strategies aimed to reduce its use. Strategies should account for regional variations, and convey messages that resonate with young adults. Care must be taken to present fair messages about First Nations/Native tobacco, and avoid positioning regulated tobacco as a healthier option than contraband. PMID:23577796

Youth tobacco use in the United States--problem, progress, goals, and potential solutions.

PubMed

Glynn, T J; Greenwald, P; Mills, S M; Manley, M W

1993-07-01

Efforts to control tobacco use and tobacco-related morbidity and mortality in the United States continue to be generally successful. In the quarter century since the publication of the first Surgeon General's Report on Tobacco and Health, adult smoking rates in the United States have been reduced by nearly 34%. Controlling tobacco use among our nation's youth, however, has not been as successful. Although there was considerable success in reducing adolescent tobacco use in the late 1970s and early 1980s, tobacco use among youth has remained essentially stable for the past decade. The health and economic burden of tobacco use, current knowledge about youth tobacco use, and youth-related national tobacco reduction goals for the Year 2000 are reviewed. Analysis of the research of the past two decades clearly indicates that there is no "magic bullet" in existence or in sight for the reduction of tobacco use, either among youth or among adults. This does not mean that opportunities for significant advances through, for example, pharmacological therapies or the broad application of media or policy strategies should not continue to be explored, but that for the moment no single approach appears to work best. Rather, a comprehensive approach that applies multiple prevention and cessation strategies simultaneously appears to be most effective in tobacco use control. Among youth, the combination of tobacco control strategies that may work best includes those that involve the family, primary care physicians, and other health professionals such as nurses and dentists; programs that are carried out in schools and/or through the media; and societal approaches such as access and advertising restrictions and increased taxes.

Promoting tobacco through the international language of dance music: British American Tobacco and the Ministry of Sound.

PubMed

Stanton, Caitlin R; Chu, Alexandria; Collin, Jeff; Glantz, Stanton A

2011-02-01

Tobacco companies target young adults through marketing strategies that use bars and nightclubs to promote smoking. As restrictions increasingly limit promotions, music marketing has become an important vehicle for tobacco companies to shape brand image, generate brand recognition and promote tobacco. Analysis of previously secret tobacco industry documents from British American Tobacco, available at http://legacy.library.ucsf.edu. In 1995, British American Tobacco (BAT) initiated a partnership with London's Ministry of Sound (MOS) nightclub to promote Lucky Strike cigarettes to establish relevance and credibility among young adults in the UK. In 1997, BAT extended their MOS partnership to China and Taiwan to promote State Express 555. BAT sought to transfer values associated with the MOS lifestyle brand to its cigarettes. The BAT/MOS partnership illustrates the broad appeal of international brands across different regions of the world. Transnational tobacco companies like BAT are not only striving to stay contemporary with young adults through culturally relevant activities such as those provided by MOS but they are also looking to export their strategies to regions across the world. Partnerships like this BAT/MOS one skirt marketing restrictions recommended by the World Health Organization's Framework Convention on Tobacco Control. The global scope and success of the MOS program emphasizes the challenge for national regulations to restrict such promotions.

Promoting tobacco through the international language of dance music: British American Tobacco and the Ministry of Sound

PubMed Central

Stanton, Caitlin R.; Chu, Alexandria; Collin, Jeff

2011-01-01

Background: Tobacco companies target young adults through marketing strategies that use bars and nightclubs to promote smoking. As restrictions increasingly limit promotions, music marketing has become an important vehicle for tobacco companies to shape brand image, generate brand recognition and promote tobacco. Methods: Analysis of previously secret tobacco industry documents from British American Tobacco, available at http://legacy.library.ucsf.edu. Results: In 1995, British American Tobacco (BAT) initiated a partnership with London’s Ministry of Sound (MOS) nightclub to promote Lucky Strike cigarettes to establish relevance and credibility among young adults in the UK. In 1997, BAT extended their MOS partnership to China and Taiwan to promote State Express 555. BAT sought to transfer values associated with the MOS lifestyle brand to its cigarettes. The BAT/MOS partnership illustrates the broad appeal of international brands across different regions of the world. Conclusion: Transnational tobacco companies like BAT are not only striving to stay contemporary with young adults through culturally relevant activities such as those provided by MOS but they are also looking to export their strategies to regions across the world. Partnerships like this BAT/MOS one skirt marketing restrictions recommended by the World Health Organization’s Framework Convention on Tobacco Control. The global scope and success of the MOS program emphasizes the challenge for national regulations to restrict such promotions. PMID:20159772

Decrease in smoking prevalence--Minnesota, 1999-2010.

PubMed

2011-02-11

Following the landmark 1998 settlement of the lawsuit, State of Minnesota versus Philip Morris, Inc., et al., Minnesota implemented a series of tobacco control efforts to limit the harm caused by tobacco use. In 2001, quitline services for tobacco users without health insurance coverage for cessation services were introduced and statewide mass media campaigns publicizing them were initiated. In 2005, Minnesota imposed a $0.75 per pack tax on cigarettes, followed in 2009 by a $0.62 per pack increase in federal excise tax, contributing in large part to a more than $2 increase in the average price of cigarettes. In 2007, a comprehensive, statewide smoke-free law was passed. Using surveillance data from the Minnesota Adult Tobacco Survey (MATS) and cigarette pack sales data, this report examines the effects of these tobacco-related public health efforts. Compared with a 15% decline in national adult smoking prevalence since 1999, adult smoking prevalence in Minnesota decreased 27.1%, from 22.1% in 1999 to 16.1% in 2010. During the same period, per capita cigarette sales in Minnesota decreased 40%. In addition, in 2010 compared with 1999, a higher percentage of adults reported that smoking was restricted in their homes (87.2% versus 64.5%), and adults were less likely to report exposure to secondhand smoke (45.6% versus 67.2%). In the past decade, Minnesota has benefited from sustained tobacco control. Future progress in decreasing adult smoking and reducing exposure to secondhand smoke will depend on a concerted effort across the public health community to keep tobacco control a priority.

Identifying "social smoking" U.S. young adults using an empirically-driven approach.

PubMed

Villanti, Andrea C; Johnson, Amanda L; Rath, Jessica M; Williams, Valerie; Vallone, Donna M; Abrams, David B; Hedeker, Donald; Mermelstein, Robin J

2017-07-01

The phenomenon of "social smoking" emerged in the past decade as an important area of research, largely due to its high prevalence in young adults. The purpose of this study was to identify classes of young adult ever smokers based on measures of social and contextual influences on tobacco use. Latent class models were developed using social smoking measures, and not the frequency or quantity of tobacco use. Data come from a national sample of young adult ever smokers aged 18-24 (Truth Initiative Young Adult Cohort Study, N=1564). The optimal models identified three latent classes: Class 1 - nonsmokers (52%); Class 2 - social smokers (18%); and Class 3 - smokers (30%). Nearly 60% of the "social smoker" class self-identified as a social smoker, 30% as an ex-smoker/tried smoking, and 12% as a non-smoker. The "social smoker" class was most likely to report using tobacco mainly or only with others. Past 30-day cigarette use was highest in the "smoker" class. Hookah use was highest in the "social smoker" class. Other tobacco and e-cigarette use was similar in the "social smoker" and "smoker" classes. Past 30-day tobacco and e-cigarette use was present for all products in the "non-smoker" class. Young adult social smokers emerge empirically as a sizable, distinct class from other smokers, even without accounting for tobacco use frequency or intensity. The prevalence of hookah use in "social smokers" indicates a group for which the social aspect of tobacco use could drive experimentation and progression to regular use. Copyright © 2017 Elsevier Ltd. All rights reserved.

An assessment of the effectiveness of tobacco control measures on behavior changes related to tobacco use among adolescents and young adults in a district in Sri Lanka.

PubMed

De Silva, W D; Sinha, D N; Kahandawaliyanag, A

2012-01-01

Sri Lanka became a signatory to the WHO Frame Work Convention on Tobacco Control in September 2003, and this was ratified in November 2003. With a view to reduce the use of tobacco in Sri Lanka, the National Authority on Tobacco and Alcohol Act (NATA) No. 27 of 2006 was implemented. To assess the behavior changes related to tobacco use among adolescents and young adults following exposure to tobacco control measures were implemented by NATA. A case-control study was conducted on 42 adolescent (aged 13-19 years) and 156 young adult (aged 20-39 years) men living in Anuradhapura Divisional Secretary area in Sri Lanka. Cases (current quitters) and controls (current smokers) were compared to ascertain the outcome following the exposure to tobacco control measures. A self-administered questionnaire and focus group discussions were used to ascertain the exposure status in cases and controls. Confounding was controlled by stratification and randomization. Univariate analysis was performed by Backward Stepwise (Likelihood Ratio) method. Among 198 respondents, 66 (27.3% adolescents and 72.7% young adults) were quitters, while 132 smokers (18.2% adolescents and 81.8% young adults) were current smokers. Exposure to the anti-smoking media messages revealed that TV was the strongest media that motivated smokers to quit smoking. Majority (66%) of cases and control were not exposed to tobacco promotion advertisements, while 47% of the cases and 50% of the control had never seen tobacco advertisements during community events. All cases (66) as well as 89% (118) of the control had not noticed competitions or prizes sponsored by tobacco industry during last year ( P = 0.13). Tobacco control measures implemented by NATA had a favorable influence on behavior change related to smoking among quitters and current smokers.

Multiple tobacco product use among US adolescents and young adults

PubMed Central

Soneji, Samir; Sargent, James; Tanski, Susanne

2016-01-01

Objective To assess the extent to which multiple tobacco product use among adolescents and young adults falls outside current Food and Drug Administration (FDA) regulatory authority. Methods We conducted a web-based survey of 1596 16–26-year-olds to assess use of 11 types of tobacco products. We ascertained current (past 30 days) tobacco product use among 927 respondents who ever used tobacco. Combustible tobacco products included cigarettes, cigars (little filtered, cigarillos, premium) and hookah; non-combustible tobacco products included chew, dip, dissolvables, e-cigarettes, snuff and snus. We then fitted an ordinal logistic regression model to assess demographic and behavioural associations with higher levels of current tobacco product use (single, dual and multiple product use). Results Among 448 current tobacco users, 54% were single product users, 25% dual users and 21% multiple users. The largest single use category was cigarettes (49%), followed by hookah (23%), little filtered cigars (17%) and e-cigarettes (5%). Most dual and multiple product users smoked cigarettes, along with little filtered cigars, hookah and e-cigarettes. Forty-six per cent of current single, 84% of dual and 85% of multiple tobacco product users consumed a tobacco product outside FDA regulatory authority. In multivariable analysis, the adjusted risk of multiple tobacco use was higher for males, first use of a non-combustible tobacco product, high sensation seeking respondents and declined for each additional year of age that tobacco initiation was delayed. Conclusions Nearly half of current adolescent and young adult tobacco users in this study engaged in dual and multiple tobacco product use; the majority of them used products that fall outside current FDA regulatory authority. This study supports FDA deeming of these products and their incorporation into the national media campaign to address youth tobacco use. PMID:25361744

Health Benefits and Cost-Effectiveness of Brief Clinician Tobacco Counseling for Youth and Adults.

PubMed

Maciosek, Michael V; LaFrance, Amy B; Dehmer, Steven P; McGree, Dana A; Xu, Zack; Flottemesch, Thomas J; Solberg, Leif I

2017-01-01

To help clinicians and care systems determine the priority for tobacco counseling in busy clinic schedules, we assessed the lifetime health and economic value of annually counseling youth to discourage smoking initiation and of annually counseling adults to encourage cessation. We conducted a microsimulation analysis to estimate the health impact and cost effectiveness of both types of tobacco counseling in a US birth cohort of 4,000,000. The model used for the analysis was constructed from nationally representative data sets and structured literature reviews. Compared with no tobacco counseling, the model predicts that annual counseling for youth would reduce the average prevalence of smoking cigarettes during adult years by 2.0 percentage points, whereas annual counseling for adults will reduce prevalence by 3.8 percentage points. Youth counseling would prevent 42,686 smoking-attributable fatalities and increase quality-adjusted life years (QALYs) by 756,601 over the lifetime of the cohort. Adult counseling would prevent 69,901 smoking-attributable fatalities and increase QALYs by 1,044,392. Youth and adult counseling would yield net savings of $225 and $580 per person, respectively. If annual tobacco counseling was provided to the cohort during both youth and adult years, then adult smoking prevalence would be 5.5 percentage points lower compared with no counseling, and there would be 105,917 fewer smoking-attributable fatalities over their lifetimes. Only one-third of the potential health and economic benefits of counseling are being realized at current counseling rates. Brief tobacco counseling provides substantial health benefits while producing cost savings. Both youth and adult intervention are high-priority uses of limited clinician time. © 2017 Annals of Family Medicine, Inc.

Health Benefits and Cost-Effectiveness of Brief Clinician Tobacco Counseling for Youth and Adults

PubMed Central

Maciosek, Michael V.; LaFrance, Amy B.; Dehmer, Steven P.; McGree, Dana A.; Xu, Zack; Flottemesch, Thomas J.; Solberg, Leif I.

2017-01-01

PURPOSE To help clinicians and care systems determine the priority for tobacco counseling in busy clinic schedules, we assessed the lifetime health and economic value of annually counseling youth to discourage smoking initiation and of annually counseling adults to encourage cessation. METHODS We conducted a microsimulation analysis to estimate the health impact and cost effectiveness of both types of tobacco counseling in a US birth cohort of 4,000,000. The model used for the analysis was constructed from nationally representative data sets and structured literature reviews. RESULTS Compared with no tobacco counseling, the model predicts that annual counseling for youth would reduce the average prevalence of smoking cigarettes during adult years by 2.0 percentage points, whereas annual counseling for adults will reduce prevalence by 3.8 percentage points. Youth counseling would prevent 42,686 smoking-attributable fatalities and increase quality-adjusted life years (QALYs) by 756,601 over the lifetime of the cohort. Adult counseling would prevent 69,901 smoking-attributable fatalities and increase QALYs by 1,044,392. Youth and adult counseling would yield net savings of $225 and $580 per person, respectively. If annual tobacco counseling was provided to the cohort during both youth and adult years, then adult smoking prevalence would be 5.5 percentage points lower compared with no counseling, and there would be 105,917 fewer smoking-attributable fatalities over their lifetimes. Only one-third of the potential health and economic benefits of counseling are being realized at current counseling rates. CONCLUSIONS Brief tobacco counseling provides substantial health benefits while producing cost savings. Both youth and adult intervention are high-priority uses of limited clinician time. PMID:28376459

Sexual orientation discrimination and tobacco use disparities in the United States.

PubMed

McCabe, Sean Esteban; Hughes, Tonda L; Matthews, Alicia K; Lee, Joseph G L; West, Brady T; Boyd, Carol J; Arslanian-Engoren, Cynthia

2017-12-30

Differences in tobacco/nicotine use by sexual orientation are well documented. Development of interventions requires attention to the etiology of these differences. This study examined associations among sexual orientation discrimination, cigarette smoking, any tobacco/nicotine use, and DSM-5 tobacco use disorder (TUD) in the U.S. We used data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions based on in-person interviews with a nationally representative sample of non-institutionalized U.S. adults. Approximately 8.3% of the population reported same-sex sexual attraction, 3.1% reported at least one same-sex sexual partner in the past-year, and 2.8% self-identified as lesbian, gay or bisexual. Sexual attraction, sexual behavior, and sexual identity were significantly associated with cigarette smoking, any tobacco/nicotine use, and DSM-5 TUD. Risk of all tobacco/nicotine outcomes was most pronounced for bisexual adults across all three sexual orientation dimensions. Approximately half of sexual minorities who identified as lesbian or gay and one-fourth of those who identified as bisexual reported past-year sexual orientation discrimination. Sexual minorities who experienced high levels of past-year sexual orientation discrimination had significantly greater probability of past-year cigarette smoking, any tobacco/nicotine use, and TUD relative to sexual minorities who experienced lower levels of sexual orientation discrimination or no discrimination. Sexual minorities, especially bisexual adults, are at heightened risk of cigarette smoking, any tobacco/nicotine use, and DSM-5 TUD across all three major sexual orientation dimensions. Tobacco prevention and cessation efforts should target bisexual adults and consider the role sexual orientation discrimination plays in cigarette smoking and treatment of TUD. Differences in tobacco/nicotine use by sexual orientation are well documented, but little is known about differences across all three sexual orientation dimensions (attraction, behavior, and identity) or the origins of these differences. This study is the first to show that differences in tobacco/nicotine use across the three sexual orientation dimensions for respondents who were exclusively heterosexually-oriented were minimal, but varied more substantially among sexual minority women and men across the three sexual orientation dimensions. Sexual minorities who experienced high levels of past-year sexual orientation discrimination had significantly greater probability of cigarette smoking, any tobacco/nicotine use and DSM-5 tobacco use disorder. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Potential Consequences of E-Cigarette Use: Is Youth Health Going Up in Smoke

DTIC Science & Technology

2016-10-01

composed of adolescents and young adults. Using data from the National Youth Tobacco Survey (NYTS), we examine trends over time in the use of traditional...among NYTS respondents participating in the 2011-2014 survey waves. By comparing the accuracy of these predictions across e-cigarette users and...This study draws on existing literature and publicly available data from the National Youth Tobacco Survey (NYTS) to address three fundamental

Patterns of combustible tobacco use in U.S. young adults and potential response to graphic cigarette health warning labels.

PubMed

Villanti, Andrea C; Pearson, Jennifer L; Cantrell, Jennifer; Vallone, Donna M; Rath, Jessica M

2015-03-01

In the evolving landscape of tobacco use, it remains unclear how tobacco control efforts should be designed and promoted for maximum impact. The current study links the identification of latent classes of young adult combustible tobacco users with anticipated responses to graphic health warning labels (HWLs). Data were collected in January 2012 using an online address-based panel as part of the Legacy Young Adult Cohort Study, and analyses were conducted in 2013. Latent class analyses identified five groups of tobacco users in a national sample of 4,236 young adults aged 18-34years: (1) little cigar/cigarillo/bidi (LCC) and hookah users (4%); (2) nonusers, open to smoking (3%); (3) daily smokers who self-identify as "smokers" (11%); (4) nondaily, light smokers who self-identify as "social or occasional smokers" (9%); and (5) nonusers closed to smoking (73%). Of the nonusers closed to smoking, 23% may be better characterized as at risk for tobacco initiation. Results indicate differences in the potential effectiveness of HWLs across classes. Compared to the daily "smokers," LCC and hookah users (RRR=2.35) and nonusers closed to smoking (RRR=2.33) were more than twice as likely to report that new graphic HWLs would make them think about not smoking. This study supports the potential of graphic HWLs to prevent young nonusers from using tobacco products. It suggests that the extension of prominent HWLs to other tobacco products, including LCCs and hookah tobacco, may also serve a prevention function. Copyright © 2014 Elsevier Ltd. All rights reserved.

Results from the Albanian Adult Tobacco Survey.

PubMed

Ross, Hana; Zaloshnja, Eduard; Levy, David T; Tole, Dhimiter

2008-12-01

Tobacco use prevalence in Europe is characterized by large disparities, with Western nations reporting smoking rates generally below 25%, while Eastern nations have smoking rates usually above 30%. Albania provides a distressing case study for Eastern Europe in which the exposure to the West after the fall of the communist regime dramatically increased the availability of Western-type cigarettes, while adoption of counterbalancing tobacco control measures lagged far behind. Results based on the representative Albanian Adult Tobacco Survey (AATS) conducted in 2007 suggest that smoking is a major problem, with a 64% smoking prevalence among Albanian men. It is becoming an increasingly greater concern among women, whose smoking prevalence more than doubled since 1990, reaching 19% in 2007. Young women living in urban areas are particularly susceptible to tobacco use; about one-third of them reported that they smoke. About 85% of current smokers smoke daily and with very high intensity, which further increases their risk of dying of smoking-attributable diseases. Smoking and secondhand exposure kill about 3,800 Albanians per year, about one-fifth of all deaths in the country. In addition, tobacco use imposes opportunity costs on Albanian households, which spent $358.6 million on cigarettes in 2007, or about 6% of the gross domestic product (GDP). To reduce the health and economic burden caused by tobacco use, the Albanian government should implement and enforce evidence-based tobacco control policies such increasing cigarette taxes; promoting cessation, particularly via the health care system; and enacting stricter clean indoor air laws.

Independent and Interactive Effects of Smoking Bans and Tobacco Taxes on a Cohort of US Young Adults

PubMed Central

Kelly, Brian C.; Kadowaki, Joy

2016-01-01

Objectives. We examined the mutual effects of smoking bans and taxes on smoking among a longitudinal cohort of young adults. Methods. We combined a repository of US tobacco policies at the state and local level with the nationally representative geocoded National Longitudinal Survey of Youth 1997 (2004–2011) from ages 19 to 31 years and Census data, to examine the impact of tobacco policies on any current and daily pack smoking. The analytic sample amounts to 19 668 observations among 4341 individuals within 487 cities. Results. For current smoking, we found significant effects for comprehensive smoking bans, but not excise taxes. We also found an interaction effect, with bans being most effective in locales with no or low taxes. For daily pack smoking, we found significant effects for taxes, but limited support for bans. Conclusions. Social smoking among young adults is primarily inhibited by smoking bans, but excise taxes only deter such smoking in the absence of a ban. Heavy smokers are primarily deterred by taxes. Although both policies have an impact on young adult smoking behaviors, their dual presence does not intensify each policy’s efficacy. PMID:26691133

Alternative Tobacco Product Use and Smoking Cessation: A National Study

PubMed Central

Popova, Lucy

2013-01-01

Objectives. We investigated the frequency of alternative tobacco product use (loose leaf, moist snuff, snus, dissolvables, electronic cigarettes [e-cigarettes]) among smokers and the association with quit attempts and intentions. Methods. A nationally representative probability-based cross-sectional survey of 1836 current or recently former adult smokers was completed in November 2011. Multivariate logistic regressions evaluated associations between alternative tobacco product use and smoking cessation behaviors. Results. Of the smokers, 38% had tried an alternative tobacco product, most frequently e-cigarettes. Alternative tobacco product use was associated with having made a quit attempt, and those intending to quit were significantly more likely to have tried and to currently use the products than were smokers with no intentions to quit. Use was not associated with successful quit attempts. Interest in future use of alternative tobacco products was low, except for e-cigarettes. Conclusions. Alternative tobacco products are attractive to smokers who want to quit smoking, but these data did not indicate that alternative tobacco products promote cessation. Unsubstantiated overt and implied claims that alternative tobacco products aid smoking cessation should be prohibited. PMID:23488521

Tracking MPOWER in 14 countries: results from the Global Adult Tobacco Survey, 2008-2010.

PubMed

Song, Yang; Zhao, Luhua; Palipudi, Krishna Mohan; Asma, Samira; Morton, Jeremy; Talley, Brandon; Hsia, Jason; Ramanandraibe, Nivo; Caixeta, Roberta; Fouad, Heba; Khoury, Rula; Sinha, Dhirendra; Rarick, James; Bettcher, Douglas; Peruga, Armando; Deland, Katherine; D'Espaignet, Edouard Tursan

2016-06-01

The World Health Organization (WHO) MPOWER is a technical package of six tobacco control measures that assist countries in meeting their obligations of the WHO Framework Convention Tobacco Control and are proven to reduce tobacco use. The Global Adult Tobacco Survey (GATS) systematically monitors adult tobacco use and tracks key tobacco control indicators. GATS is a nationally representative household survey of adults aged 15 and older, using a standard and consistent protocol across countries; it includes information on the six WHO MPOWER measures. GATS Phase I was conducted from 2008-2010 in 14 high-burden low- and middle-income countries. We selected one key indicator from each of the six MPOWER measures and compared results across 14 countries. Current tobacco use prevalence rates ranged from 16.1% in Mexico to 43.3% in Bangladesh. We found that the highest rate of exposure to secondhand smoke in the workplace was in China (63.3%). We found the highest 'smoking quit attempt' rates in the past 12 months among cigarette smokers in Viet Nam (55.3%) and the lowest rate was in the Russian Federation (32.1%). In five of the 14 countries, more than one-half of current smokers in those 5 countries said they thought of quitting because of health warning labels on cigarette packages. The Philippines (74.3%) and the Russian Federation (68.0%) had the highest percentages of respondents noticing any cigarette advertising, promotion and sponsorship. Manufactured cigarette affordability ranged from 0.6% in Russia to 8.0% in India. Monitoring tobacco use and tobacco control policy achievements is crucial to managing and implementing measures to reverse the epidemic. GATS provides internationally-comparable data that systematically monitors and tracks the progress of the other five MPOWER measures. © The Author(s) 2013.

Polytobacco Use of Cigarettes, Cigars, Chewing Tobacco, and Snuff Among US Adults

PubMed Central

Wang, Yingning; Yao, Tingting; Lightwood, James; Max, Wendy

2016-01-01

Abstract Introduction: Tobacco use prevalence has been commonly estimated on a product by product basis and the extent of polytobacco use among current users of each tobacco product is not well understood. This study aimed to examine the prevalence, trends, and correlates of polytobacco use among current users of cigarettes, cigars, chewing tobacco, and snuff in US adults aged ≥18. Methods: We used pooled data from the 1998, 2000, 2005, and 2010 Cancer Control Supplements of the National Health Interview Survey ( N = 123 399 adults). Multivariate logistic regression models were estimated to determine significant factors associated with polytobacco use. Results: In 2010, the prevalence of polytobacco use was 8.6% among current cigarette smokers, 50.3% among current cigar users, 54.8% among current chewing tobacco users, and 42.5% among current snuff users. After controlling for other covariates, gender and race/ethnicity did not show consistent associations with poly-use across these four groups of current tobacco users; however, a positive association of young adulthood, less than high school education, and binge drinking with poly-use was consistently found among all these groups. Conclusions: Polytobacco use is extremely popular among current users of non-cigarette tobacco products. Polytobacco use patterns differ across sociodemographic subpopulations, and the gender and racial/ethnic profiles in poly-users vary across different groups of current tobacco users. Tobacco control strategies need to consider the interrelationships in the use of different tobacco products and the diverse profiles of poly-users in order to develop tailored tobacco prevention and intervention policies to further reduce the burden of tobacco use. PMID:26136525

Use of provider-based complementary and alternative medicine by adult smokers in the United States: Comparison from the 2002 and 2007 NHIS survey.

PubMed

Hamm, Eric; Muramoto, Myra L; Howerter, Amy; Floden, Lysbeth; Govindarajan, Lubna

2014-01-01

To provide a snapshot of provider-based complementary and alternative medicine (pbCAM) use among adult smokers and assess the opportunity for these providers to deliver tobacco cessation interventions. Cross-sectional analysis of data from the 2002 and 2007 National Health Interview Surveys. Nationally representative sample. A total of 54,437 (31,044 from 2002; 23,393 from 2007) adults 18 years and older. The analysis focuses on 10 types of pbCAM, including acupuncture, Ayurveda, biofeedback, chelation therapy, chiropractic care, energy therapy, folk medicine, hypnosis, massage, and naturopathy. The proportions of current smokers using any pbCAM as well as specific types of pbCAM in 2002 and 2007 are compared using SAS SURVEYLOGISTIC. Between 2002 and 2007, the percentage of recent users of any pbCAM therapy increased from 12.5% to 15.4% (p = .001). The largest increases occurred in massage, chiropractic, and acupuncture. Despite a decrease in the national average of current smokers (22.0% to 19.4%; p = .001), proportions of smokers within specific pbCAM disciplines remained consistent. Complementary and alternative medicine (CAM) practitioners, particularly those in chiropractic, acupuncture, and massage, represent new cohorts in the health care community to promote tobacco cessation. There is an opportunity to provide brief tobacco intervention training to CAM practitioners and engage them in public health efforts to reduce the burden of tobacco use in the United States.

Adult and adolescent exposure to tobacco and alcohol content in contemporary YouTube music videos in Great Britain: a population estimate

PubMed Central

Cranwell, Jo; Opazo-Breton, Magdalena; Britton, John

2016-01-01

Background We estimate exposure of British adults and adolescents to tobacco and alcohol content from a sample of popular YouTube music videos. Methods British viewing figures were generated from 2 representative online national surveys of adult and adolescent viewing of the 32 most popular videos containing content. 2068 adolescents aged 11–18 years (1010 boys, 1058 girls), and 2232 adults aged 19+years (1052 male, 1180 female) completed the surveys. We used the number of 10 s intervals in the 32 most popular videos containing content to estimate the number of impressions. We extrapolated gross and per capita impressions for the British population from census data and estimated numbers of adults and adolescents who had ever watched the sampled videos. Results From video release to the point of survey, the videos delivered an estimated 1006 million gross impressions of alcohol (95% CI 748 to 1264 million), and 203 million of tobacco (95% CI 151 to 255 million), to the British population. Per capita exposure was around 5 times higher for alcohol than for tobacco, and nearly 4 times higher in adolescents, who were exposed to an average of 52.1 (95% CI 43.4 to 60.9) and 10.5 (95% CI 8.8 to 12.3) alcohol and tobacco impressions, respectively, than in adults (14.1 (95% CI 10.2 to 18.1) and 2.9 (95% CI 2.1 to 3.6)). Exposure rates were higher in girls than in boys. Conclusions YouTube music videos deliver millions of gross impressions of alcohol and tobacco content. Adolescents are exposed much more than adults. Music videos are a major global medium of exposure to such content. PMID:26767404

Monitoring of Non-cigarette Tobacco Use using Google Trends

PubMed Central

Cavazos-Rehg, Patricia A.; Krauss, Melissa J.; Spitznagel, Edward L.; Lowery, Ashley; Grucza, Richard A.; Chaloupka, Frank J.; Bierut, Laura Jean

2014-01-01

Background Google Trends is an innovative monitoring system with unique potential to monitor and predict important phenomena that may be occurring at a population-level. We sought to validate whether Google Trends can additionally detect regional trends in youth and adult tobacco use. Methods We compared 2011 Google Trends relative search volume data for cigars, cigarillos, little cigars and smokeless tobacco with state prevalence of youth (grades 9–12) and adult (age 18 and older) use of these products using data from the 2011 United States state-level Youth Risk Behaviors Surveillance System and the 2010–2011 United States National Survey on Drug Use and Health (NSDUH), respectively. We used the Pearson correlation coefficient to measure the associations. Results We found significant positive correlations between state Google Trends cigar relative search volume and prevalence of cigar use among youth (r=0.39, R-square=0.154, p= .018) and adults (r=0.49, R-square=0.243, p<.001). Similarly, we found that the correlations between state Google trends smokeless tobacco relative search volume and prevalence of smokeless tobacco use among youth and adults were both positive and significant (r=0.46, R-square=0.209, p=.003 and r=0.48, R-square=0.226, p<.001, respectively). Conclusion The results of this study validate that Google Trends has the potential to be a valuable monitoring tool for tobacco use. The near real-time monitoring features of Google Trends may complement traditional surveillance methods and lead to faster and more convenient monitoring of emerging trends in tobacco use. What this paper adds Efforts to promptly track tobacco use at a population-level are an important endeavor that could assist key stakeholders with making informed decisions about prevention plans and policies. Our findings establish the validity of Google Trends as an indicator of cigar and smokeless tobacco use by demonstrating that states with higher relative volumes of Google searches for cigar and smokeless tobacco products have higher prevalence of tobacco use of these products. The near real-time monitoring features of Google Trends could be used to supplement traditional survey methods to obtain deeper insight about youth and adult tobacco use. PMID:24500269

Multiple tobacco product use among US adolescents and young adults.

PubMed

Soneji, Samir; Sargent, James; Tanski, Susanne

2016-03-01

To assess the extent to which multiple tobacco product use among adolescents and young adults falls outside current Food and Drug Administration (FDA) regulatory authority. We conducted a web-based survey of 1596 16-26-year-olds to assess use of 11 types of tobacco products. We ascertained current (past 30 days) tobacco product use among 927 respondents who ever used tobacco. Combustible tobacco products included cigarettes, cigars (little filtered, cigarillos, premium) and hookah; non-combustible tobacco products included chew, dip, dissolvables, e-cigarettes, snuff and snus. We then fitted an ordinal logistic regression model to assess demographic and behavioural associations with higher levels of current tobacco product use (single, dual and multiple product use). Among 448 current tobacco users, 54% were single product users, 25% dual users and 21% multiple users. The largest single use category was cigarettes (49%), followed by hookah (23%), little filtered cigars (17%) and e-cigarettes (5%). Most dual and multiple product users smoked cigarettes, along with little filtered cigars, hookah and e-cigarettes. Forty-six per cent of current single, 84% of dual and 85% of multiple tobacco product users consumed a tobacco product outside FDA regulatory authority. In multivariable analysis, the adjusted risk of multiple tobacco use was higher for males, first use of a non-combustible tobacco product, high sensation seeking respondents and declined for each additional year of age that tobacco initiation was delayed. Nearly half of current adolescent and young adult tobacco users in this study engaged in dual and multiple tobacco product use; the majority of them used products that fall outside current FDA regulatory authority. This study supports FDA deeming of these products and their incorporation into the national media campaign to address youth tobacco use. 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/

Exposure to Secondhand Smoke and Attitudes Toward Smoke-Free Workplaces Among Employed U.S. Adults: Findings From the National Adult Tobacco Survey

PubMed Central

King, Brian A.; Homa, David M.; Dube, Shanta R.; Babb, Stephen D.

2015-01-01

Introduction This study assessed the prevalence and correlates of secondhand smoke (SHS) exposure and attitudes toward smoke-free workplaces among employed U.S. adults. Methods Data came from the 2009–2010 National Adult Tobacco Survey, a landline and cellular telephone survey of adults aged ≥18 years in the United States and the District of Columbia. National and state estimates of past 7-day workplace SHS exposure and attitudes toward indoor and outdoor smoke-free workplaces were assessed among employed adults. National estimates were calculated by sex, age, race/ethnicity, education, annual household income, sexual orientation, U.S. region, and smoking status. Results Among employed adults who did not smoke cigarettes, 20.4% reported past 7-day SHS exposure at their workplace (state range: 12.4% [Maine] to 30.8% [Nevada]). Nationally, prevalence of exposure was higher among males, those aged 18–44 years, non-Hispanic Blacks, Hispanics, and non-Hispanic American Indians/Alaska natives compared to non-Hispanic Whites, those with less education and income, those in the western United States, and those with no smoke-free workplace policy. Among all employed adults, 83.8% and 23.2% believed smoking should never be allowed in indoor and outdoor areas of workplaces, respectively. Conclusions One-fifth of employed U.S. adult nonsmokers are exposed to SHS in the workplace, and disparities in exposure exist across states and subpopulations. Most employed adults believe indoor areas of workplaces should be smoke free, and nearly one-quarter believe outdoor areas should be smoke free. Efforts to protect employees from SHS exposure and to educate the public about the dangers of SHS and benefits of smoke-free workplaces could be beneficial. PMID:24812025

Training in Tobacco Treatments in Psychiatry: A National Survey of Psychiatry Residency Training Directors

ERIC Educational Resources Information Center

Prochaska, Judith J.; Fromont, Sebastien C.; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

2006-01-01

Objective: Nicotine dependence is the most prevalent substance abuse disorder among adult psychiatric patients and is a leading cause of death and disability. This study examines training in tobacco treatment in psychiatry residency programs across the United States. Method: The authors recruited training directors to complete a survey of their…

Electronic Data Collection and Management System for Global Adult Tobacco Survey

PubMed Central

Pujari, Sameer J; Palipudi, Krishna M; Morton, Jeremy; Levinsohn, Jay; Litavecz, Steve; Green, Michael

2012-01-01

Introduction: Portable handheld computers and electronic data management systems have been used for national surveys in many high-income countries, however their use in developing countries has been challenging due to varying geographical, economic, climatic, political and cultural environments. In order to monitor and measure global adult tobacco use, the World Health Organization and the US Centers for Disease Control and Prevention initiated the Global Adult Tobacco Survey, a nationally representative household survey of adults, 15 years of age or older, using a standard core questionnaire, sample design, and data collection and management procedures. The Survey has been conducted in 14 low- and middle-income countries, using an electronic data collection and management system. This paper describes implementation of the electronic data collection system and associated findings. Methods: The Survey was based on a comprehensive data management protocol, to enable standardized, globally comparable high quality data collection and management. It included adaptation to specific country needs, selection of appropriate handheld hardware devices, use of open source software, and building country capacity and provide technical support. Results: In its first phase, the Global Adult Tobacco Survey was successfully conducted between 2008 and 2010, using an electronic data collection and management system for interviews in 302,800 households in 14 countries. More than 2,644 handheld computers were fielded and over 2,634 fieldworkers, supervisors and monitors were trained to use them. Questionnaires were developed and programmed in 38 languages and scripts. The global hardware failure rate was < 1% and data loss was almost 0%. Conclusion: Electronic data collection and management systems can be used effectively for conducting nationally representative surveys, particularly in low- and middle-income countries, irrespective of geographical, climatic, political and cultural environments, and capacity-building at the country level is an important vehicle for Health System Strengthening. PMID:23569638

Tobacco Use among Foster Youth: Evidence of Health Disparities

PubMed Central

Braciszewski, Jordan M.; Colby, Suzanne M.

2015-01-01

Youth aging out of foster care face a challenging road to independence. Following exposure to myriad risk factors such as abuse, neglect, parental substance use, and severe housing mobility, supportive services decrease upon exit from care, often increasing risk for substance use, homelessness, and unemployment. Although tobacco use is also highly prevalent, little attention has been paid to screening, assessment, and treatment of tobacco use in this vulnerable group. The current study (N = 116) reports on tobacco use prevalence, consequences, and co-occurrence with other substances in a sample of youth (ages 18 to 19) exiting the foster care system. In the face of an overall decrease in tobacco use among general population adolescents and young adults, results suggest disproportionate levels of lifetime, recent, and daily use among foster youth. Prevalence of recent tobacco use (46%) is nearly triple national rates, while daily smoking (32%) is almost four times that of general population young adults. Tobacco users were more likely than non-users to drink (70% vs. 40%) and to smoke marijuana (72% vs. 25%). We strongly encourage researchers and practitioners to increase attention to this tobacco-related health disparity. PMID:26478645

Flavored E-cigarette Use and Cigarette Smoking Reduction and Cessation-A Large National Study among Young Adult Smokers.

PubMed

Chen, Julia Cen

2018-04-06

E-cigarette use prevalence has increased drastically among young adult cigarette smokers in recent years. This study seeks to understand which e-cigarette flavors-sweet and fruity or tobacco and menthol/mint-are more likely to be associated with smoking reduction and cessation among young adults. Longitudinal data (waves 1 and 2) of the Population Assessment of Tobacco and Health (PATH) Study from young adult (aged 18-34) cigarette smokers (n = 4,645) at wave 1 and current e-cigarette users (n = 844) at wave 2 were used. Univariate and multivariate regressions were conducted to examine the associations between past-year smoking reduction and cessation and current e-cigarette flavor use at wave 2. At wave 2, 25.9% of respondents either reduced or quit smoking, and 6.7%, 5.2%, and 6.3% of them reported currently using e-cigarettes with tobacco/menthol (TM) flavors, one non-tobacco/non-menthol (NTM) flavor, and multiple NTM flavors, respectively. E-cigarette users with one (AOR = 2.5, p < 0.001) and multiple NTM flavors (AOR = 3.0, p < 0.001) were more likely to have reduced or quit smoking over the past year compared to non-e-cigarette users. NTM flavor use was positively associated with e-cigarette use of a higher frequency and larger amount. The positive association between past-year smoking reduction and cessation and current NTM flavored e-cigarette use may be explained by young adults' escalated e-cigarette use with NTM flavors. Public health professionals should prevent and reduce multiple tobacco use through enhanced education about the harm of vaping NTM flavors and by advising young adult smokers to quit tobacco altogether using evidence-based methods.

Trends in annual sales and current use of cigarettes, cigars, roll-your-own tobacco, pipes, and smokeless tobacco among US adults, 2002-2012.

PubMed

Agaku, Israel T; Alpert, Hillel R

2016-07-01

Regulatory imbalances exist in the treatment of cigarettes and non-cigarette tobacco products in the USA. We assessed whether declines in cigarette consumption during 2002-2012 were offset by increased use of non-cigarette tobacco products-cigars, pipes, roll-your-own (RYO) and smokeless tobacco. Industry-reported taxable removals (actual sales) were converted into packs for cigarettes and cigarette pack equivalents (CPEs) for loose tobacco (RYO plus pipe tobacco) and moist snuff. Cigars were not converted to CPEs because of their heterogeneity in size/tobacco content. Per capita sales were calculated for the US adult population aged ≥18 years based on the US Census Bureau data. Self-reported data on current (past 30-day) tobacco use among US adults aged ≥18 years were from the National Survey on Drug Use and Health (NSDUH). Joinpoint and logistic regression were used to assess linear trends during 2002-2012. During 2002-2012, cigarette sales declined from 96.91 to 59.85 cigarette packs per capita; increases occurred for sale of cigars (30.51-57.42 cigars per capita), loose tobacco (2.50-5.63 CPEs per capita) and moist snuff (10.64-14.58 CPEs per capita; all p<0.05 for trend). Self-reported current cigarette smoking declined during 2002-2012 (27.4-23.6%); increases were noted for current RYO (2.6-3.6%) and smokeless tobacco use (3.5-3.7%; all p<0.05 for trend). The increase in non-cigarette tobacco consumption is a public health concern because all tobacco products are harmful. Eliminating imbalances in tax structure and regulations between cigarettes and non-cigarette tobacco products may help reduce aggregate tobacco consumption. 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/

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

PubMed

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

2018-04-06

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

Poverty Does Not Limit Tobacco Consumption in Cambodia: Quantitative Estimate of Tobacco Use Under Conditions of No Income and Adult Malnutrition

PubMed Central

Singh, Pramil N.; Washburn, Dawn; Yel, Daravuth; Kheam, They; Job, Jayakaran S.

2014-01-01

Current data indicate that under conditions of poverty, tobacco is consumed at the expense of basic needs. In a large national sample from Cambodia, we sought to determine whether tobacco consumption declines under extreme conditions of no income and malnutrition. Our major findings are as follows: (1) Among men, there was no significant difference in the number of cigarettes smoked for no income (425, 95% confidence interval [CI] = 395-456) versus >US$2 per day (442, 95% CI = 407-477); (2) among women, there was no significant difference in the amount of loose tobacco (ie, betel quid) consumed for no income (539 g, 95% CI = 441-637) versus >US$2 per day (558 g, 95% CI = 143-973); (3) for the contrast of no income + malnutrition versus >US$2 per day + no malnutrition in a linear model, there was no significant difference for men who smoked (462 vs 517 cigarettes/month, P = .82) or women who chewed (316 vs 404 g tobacco/month, P = .34), adjusting for confounders. Among the poorest and malnourished Cambodian adults, lack of resources did not appear to prevent them from obtaining smoked or smokeless tobacco. PMID:23666843

Correlates of poly-tobacco use among youth and young adults: Findings from the Population Assessment of Tobacco and Health study, 2013-2014.

PubMed

Osibogun, Olatokunbo; Taleb, Ziyad Ben; Bahelah, Raed; Salloum, Ramzi G; Maziak, Wasim

2018-06-01

Poly-tobacco use is common among youth and young adults. This study examined sociodemographic, tobacco-related, and substance use characteristics of poly-tobacco use compared to mono-tobacco use among youth and young adults (12-34 years) in the United States. We conducted a descriptive analysis by age-group of 12898 youth (12-17 years), 8843 younger young adults (18-24 years), and 6081 older young adults (24-34 years) from the 2013-2014 Population Assessment of Tobacco and Health study. Multiple logistic regression modeling was conducted to assess the sociodemographic, tobacco-related, and substance use associations with current (past 30 days) tobacco use on a binary scale (poly- versus mono-tobacco use) among tobacco users. Between 2013 and 2014, 3.6% of youth, 21.7% of younger young adults, and 15.8% of older young adults were current poly-tobacco users in the general population. In the regression analyses, among youth tobacco users, heavy drinking was the only factor associated with higher odds of poly-tobacco use. Factors associated with higher odds of poly-tobacco use among younger young adults included being male, having less than high school diploma or GED, residing in the South, having 2 and ≥3 quit attempts, heavy drinking, and marijuana use. Residing in the South, older ages of exposure to tobacco use, and marijuana use were associated with higher odds of poly-tobacco use among older young adults. Regardless of tobacco product type, poly-tobacco use was common among youth and young adults. Interventions designed to address factors associated with poly-tobacco use among youth and young adults are warranted. Published by Elsevier B.V.

The Changing Face of Tobacco Use Among United States Youth

PubMed Central

Lauterstein, Dana; Hoshino, Risa; Gordon, Terry; Watkins, Beverly-Xaviera; Weitzman, Michael; Zelikoff, Judith

2015-01-01

Tobacco use, primarily in the form of cigarettes, is the leading cause of preventable morbidity and mortality in the United States (U.S.). The adverse effects of tobacco use began to be recognized in the 1940’s and new hazards of active smoking and secondhand smoke (SHS) exposure from cigarettes continue to be identified to this day. This has led to a sustained and wide-ranging array of highly effective regulatory, public health, and clinical efforts that have been informed by extensive scientific data, resulting in marked decreases in the use of cigarettes. Unfortunately, the dramatic recent decline in cigarette use in the U.S., has been accompanied by an upsurge in adolescent and young adult use of new, non-cigarette tobacco and nicotine-delivery products, commonly referred to as alternative tobacco products (ATPs). Commonly used ATPs include hookah, cigars, smokeless tobacco, and electronic cigarettes. While there have been a number of review articles that focus on adult ATP use, the purpose of this review is to provide an overview of what is, and is not known about emerging ATP use among U.S. adolescents on a national scale; as well as to identify research gaps in knowledge, and discuss future health and policy needs for this growing public health concern. This paper is not meant to systemically review all published survey data, but to present clear depiction of selected ATP usage in youth populations using national survey data. PMID:25323124

Smoke-Free Rules and Secondhand Smoke Exposure in Vehicles among U.S. Adults-National Adult Tobacco Survey, 2009-2010 and 2013-2014.

PubMed

Kruger, Judy; Jama, Amal; Kegler, Michelle; Baker Holmes, Carissa; Hu, Sean; King, Brian

2016-10-26

In the United States (U.S.), secondhand smoke (SHS) exposure causes more than 41,000 deaths among nonsmoking adults annually. Adoption of smoke-free laws in public areas has increased, but private settings such as vehicles remain a source of SHS exposure. This study assessed change in voluntary smoke-free vehicle rules and SHS exposure in personal vehicles among U.S. adults between two periods, 2009-2010 and 2013-2014, using data from the National Adult Tobacco Survey (NATS). NATS is a national landline and cellular telephone survey of non-institutionalized adults aged ≥18 years in the 50 U.S. states and the District of Columbia. We assessed percentage change in the prevalence of smoke-free vehicle rules among all adults and SHS exposure in vehicles among nonsmoking adults, overall, by sociodemographic factors (sex, age, race/ethnicity, education, marital status, annual household income, U.S. region), and by cigarette smoking status. During 2009-2010 to 2013-2014, the percentage of adults with a 100% smoke-free vehicle rule increased from 73.6% to 79.5% (% change = +8.0%; p < 0.05). Among nonsmokers, SHS exposure in vehicles in the previous 7 days decreased from 9.2% to 8.2% (% change = -10.9%; p < 0.05). Smoke-free rules in private settings such as vehicles, in coordination with comprehensive smoke-free policies in indoor public settings, can help reduce SHS exposure and promote smoke-free norms.

Tobacco denormalization and industry beliefs among smokers from four countries.

PubMed

Hammond, David; Fong, Geoffrey T; Zanna, Mark P; Thrasher, James F; Borland, Ron

2006-09-01

Tobacco denormalization is an important concept for understanding smoking behavior. The present study sought to assess beliefs about the tobacco industry and the social acceptability of smoking among nationally representative samples of adult smokers from four countries, and to assess the relationship of these measures to cessation behavior and tobacco-control policy. A longitudinal survey of 9058 adult smokers from Canada (n = 2214), the United States (n = 2138), the United Kingdom (n = 2401), and Australia (n = 2305), was conducted in October-December 2002 and again in June and August 2003 (75% follow-up rate). The analyses were conducted in 2005. The findings indicate that few smokers perceive approval for their smoking, and most hold relatively antagonistic beliefs toward the tobacco industry. For example, 80% of smokers reported that society disapproves of smoking, and more than three quarters reported that tobacco companies cannot be trusted to tell the truth. Social and industry denormalization were independently associated with intentions to quit smoking. Baseline levels of social denormalization were associated with abstinence at the 8-month follow-up, as were changes in industry denormalization beliefs between baseline and follow-up. Anti-industry beliefs at baseline did not predict abstinence at follow-up. A similar pattern of findings was observed across all four countries. In addition, social denormalization and anti-industry beliefs were significantly associated with tobacco-control policies, such as noticing health warnings on packages and greater workplace smoking restrictions. Tobacco denormalization constructs were independently linked to cessation-related outcomes among adults from four countries. Tobacco-industry denormalization themes in mass media campaigns may help to reduce tobacco use above and beyond more traditional communications that target social norms.

Impact of Total Vending Machine Restrictions on US Young Adult Smoking.

PubMed

Vuolo, Mike; Kelly, Brian C; Kadowaki, Joy

2016-11-01

In an analysis of smoking using a longitudinal sample of US young adults, we extend research on tobacco vending machine restrictions beyond its prior focus on minors by examining the influence of total vending machine restrictions, which apply to adult-only facilities and represents the only remaining vending machine exemption since the enactment of the Family Smoking Prevention and Tobacco Control Act. We identify whether the passage of a restriction influences an individual's smoking on repeated observations, and if the propensity is lower among those who live in locations with a restriction. Combining a repository of US tobacco policies at all geographic levels with the nationally-representative geocoded National Longitudinal Survey of Youth 1997 and Census data, we use multilevel logistic regression to examine the impact of total vending machine restrictions on any past 30-day smoking and past 30-day smoking of one pack per day among young adults (ages 19-31), while accounting for other tobacco control policy, community, and individual covariates. We find that total vending machine restrictions decrease any recent smoking (OR = 0.451; p < .01), net of other covariates. Though the passage of a restriction does not alter an individual's smoking over time, living longer in an area that has a restriction lowers the propensity that an individual will smoke at all (OR = 0.442; p < .05). We find no effect of total vending machine restrictions on smoking a pack daily. Total vending machine restrictions appear to be an effective, yet highly underutilized, means of tobacco control. Past scientific inquiries examining vending machine restrictions have focused upon minor access, adolescent perceptions of availability, and subsequent smoking. The potential for total vending machine restrictions, which extend to adult-only facilities, to influence patterns of smoking among those of legal age, remains significant. Those who are subject to total vending machine restrictions for longer periods are less likely to have recently smoked, but individuals do not change their smoking behavior in response to the passage of a restriction. These restrictions do not affect heavy smokers. Such policies are an effective but underutilized policy mechanism to prevent smoking among young adults. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Impact of Total Vending Machine Restrictions on US Young Adult Smoking

PubMed Central

Kelly, Brian C.; Kadowaki, Joy

2016-01-01

Introduction: In an analysis of smoking using a longitudinal sample of US young adults, we extend research on tobacco vending machine restrictions beyond its prior focus on minors by examining the influence of total vending machine restrictions, which apply to adult-only facilities and represents the only remaining vending machine exemption since the enactment of the Family Smoking Prevention and Tobacco Control Act. We identify whether the passage of a restriction influences an individual’s smoking on repeated observations, and if the propensity is lower among those who live in locations with a restriction. Methods: Combining a repository of US tobacco policies at all geographic levels with the nationally-representative geocoded National Longitudinal Survey of Youth 1997 and Census data, we use multilevel logistic regression to examine the impact of total vending machine restrictions on any past 30-day smoking and past 30-day smoking of one pack per day among young adults (ages 19–31), while accounting for other tobacco control policy, community, and individual covariates. Results: We find that total vending machine restrictions decrease any recent smoking (OR = 0.451; p < .01), net of other covariates. Though the passage of a restriction does not alter an individual’s smoking over time, living longer in an area that has a restriction lowers the propensity that an individual will smoke at all (OR = 0.442; p < .05). We find no effect of total vending machine restrictions on smoking a pack daily. Conclusions: Total vending machine restrictions appear to be an effective, yet highly underutilized, means of tobacco control. Implications: Past scientific inquiries examining vending machine restrictions have focused upon minor access, adolescent perceptions of availability, and subsequent smoking. The potential for total vending machine restrictions, which extend to adult-only facilities, to influence patterns of smoking among those of legal age, remains significant. Those who are subject to total vending machine restrictions for longer periods are less likely to have recently smoked, but individuals do not change their smoking behavior in response to the passage of a restriction. These restrictions do not affect heavy smokers. Such policies are an effective but underutilized policy mechanism to prevent smoking among young adults. PMID:27281606

Contextual determinants of health behaviours in an aboriginal community in Canada: pilot project.

PubMed

Joseph, Pamela; Davis, A Darlene; Miller, Ruby; Hill, Karen; McCarthy, Honey; Banerjee, Ananya; Chow, Clara; Mente, Andrew; Anand, Sonia S

2012-11-07

Rapid change in food intake, physical activity, and tobacco use in recent decades have contributed to the soaring rates of obesity, type 2 diabetes and cardiovascular disease (CVD) in Aboriginal populations living in Canada. The nature and influence of contextual factors on Aboriginal health behaviours are not well characterized. To describe the contextual determinants of health behaviours associated with cardiovascular risk factors on the Six Nations reserve, including the built environment, access and affordability of healthy foods, and the use of tobacco.In this cross-sectional study, 63 adults from the Six Nations Reserve completed the modified Neighbourhood Environment Walkability Scale (NEWS), questionnaire assessing food access and availability, tobacco pricing and availability, and the Environmental Profile of Community Health (EPOCH) tool. The structured environment of Six Nations Reserve scored low for walkability, street connectivity, aesthetics, safety, and access to walking and cycling facilities. All participants purchased groceries off-reserve, although fresh fruits and vegetables were reported to be available and affordable both on and off-reserve. On average $151/week is spent on groceries per family. Ninety percent of individuals report tobacco use is a problem in the community. Tobacco is easily accessible for children and youth, and only three percent of community members would accept increased tobacco taxation as a strategy to reduce tobacco access. The built environment, access and affordability of healthy food and tobacco on the Six Nations Reserve are not perceived favourably. Modification of these contextual factors described here may reduce adverse health behaviours in the community.

Association Between Electronic Cigarette Use and Openness to Cigarette Smoking Among US Young Adults

PubMed Central

Apelberg, Benjamin J.; Ambrose, Bridget K.; Green, Kerry M.; Choiniere, Conrad J.; Bunnell, Rebecca; King, Brian A.

2015-01-01

Introduction: Use of electronic nicotine delivery systems (ENDS), including electronic cigarettes (e-cigarettes), is increasing. One concern is the appeal of these products to youth and young adults and the potential to influence perceptions and use of conventional cigarettes. Methods: Using data from the 2012–2013 National Adult Tobacco Survey, characteristics of adults aged 18–29 years who had never established cigarette smoking behavior were examined by ever use of e-cigarettes, demographics, and ever use of other tobacco products (smokeless tobacco, cigars, hookah, and cigarettes). Multivariate logistic regression was used to examine the relationship between e-cigarette use and openness to cigarette smoking among young adults, defined as the lack of a firm intention not to smoke soon or in the next year. Results: Among young adults who had never established cigarette smoking behavior (unweighted n = 4,310), 7.9% reported having ever tried e-cigarettes, and 14.6% of those who reported having ever tried e-cigarettes also reported current use of the product. Ever e-cigarette use was associated with being open to cigarette smoking (adjusted odds ratio = 2.4; 95% confidence interval = 1.7, 3.3), as was being male, aged 18–24 years, less educated, and having ever used hookah or experimented with conventional cigarettes. Conclusions: Ever use of e-cigarettes and other tobacco products was associated with being open to cigarette smoking. This study does not allow us to assess the directionality of this association, so future longitudinal research is needed to illuminate tobacco use behaviors over time as well as provide additional insight on the relationship between ENDS use and conventional cigarette use among young adult populations. PMID:25378683

Adult and adolescent exposure to tobacco and alcohol content in contemporary YouTube music videos in Great Britain: a population estimate.

PubMed

Cranwell, Jo; Opazo-Breton, Magdalena; Britton, John

2016-05-01

We estimate exposure of British adults and adolescents to tobacco and alcohol content from a sample of popular YouTube music videos. British viewing figures were generated from 2 representative online national surveys of adult and adolescent viewing of the 32 most popular videos containing content. 2068 adolescents aged 11-18 years (1010 boys, 1058 girls), and 2232 adults aged 19+years (1052 male, 1180 female) completed the surveys. We used the number of 10 s intervals in the 32 most popular videos containing content to estimate the number of impressions. We extrapolated gross and per capita impressions for the British population from census data and estimated numbers of adults and adolescents who had ever watched the sampled videos. From video release to the point of survey, the videos delivered an estimated 1006 million gross impressions of alcohol (95% CI 748 to 1264 million), and 203 million of tobacco (95% CI 151 to 255 million), to the British population. Per capita exposure was around 5 times higher for alcohol than for tobacco, and nearly 4 times higher in adolescents, who were exposed to an average of 52.1 (95% CI 43.4 to 60.9) and 10.5 (95% CI 8.8 to 12.3) alcohol and tobacco impressions, respectively, than in adults (14.1 (95% CI 10.2 to 18.1) and 2.9 (95% CI 2.1 to 3.6)). Exposure rates were higher in girls than in boys. YouTube music videos deliver millions of gross impressions of alcohol and tobacco content. Adolescents are exposed much more than adults. Music videos are a major global medium of exposure to such content. 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/

Association between electronic cigarette use and openness to cigarette smoking among US young adults.

PubMed

Coleman, Blair N; Apelberg, Benjamin J; Ambrose, Bridget K; Green, Kerry M; Choiniere, Conrad J; Bunnell, Rebecca; King, Brian A

2015-02-01

Use of electronic nicotine delivery systems (ENDS), including electronic cigarettes (e-cigarettes), is increasing. One concern is the appeal of these products to youth and young adults and the potential to influence perceptions and use of conventional cigarettes. Using data from the 2012-2013 National Adult Tobacco Survey, characteristics of adults aged 18-29 years who had never established cigarette smoking behavior were examined by ever use of e-cigarettes, demographics, and ever use of other tobacco products (smokeless tobacco, cigars, hookah, and cigarettes). Multivariate logistic regression was used to examine the relationship between e-cigarette use and openness to cigarette smoking among young adults, defined as the lack of a firm intention not to smoke soon or in the next year. Among young adults who had never established cigarette smoking behavior (unweighted n = 4,310), 7.9% reported having ever tried e-cigarettes, and 14.6% of those who reported having ever tried e-cigarettes also reported current use of the product. Ever e-cigarette use was associated with being open to cigarette smoking (adjusted odds ratio = 2.4; 95% confidence interval = 1.7, 3.3), as was being male, aged 18-24 years, less educated, and having ever used hookah or experimented with conventional cigarettes. Ever use of e-cigarettes and other tobacco products was associated with being open to cigarette smoking. This study does not allow us to assess the directionality of this association, so future longitudinal research is needed to illuminate tobacco use behaviors over time as well as provide additional insight on the relationship between ENDS use and conventional cigarette use among young adult populations. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Correlates of current menthol cigarette and flavored other tobacco product use among U.S. young adults.

PubMed

Rath, Jessica M; Villanti, Andrea C; Williams, Valerie F; Richardson, Amanda; Pearson, Jennifer L; Vallone, Donna M

2016-11-01

Flavored and menthol tobacco products are particularly appealing to young adults. However, little is known about factors associated with their use in this population. To examine characteristics associated with using menthol cigarettes, flavored other tobacco products (OTP), and flavored e-cigarettes among young adults. Using a nationally representative online sample of young adults (n=4239) from the Truth Initiative Young Adult Cohort Study, mutually exclusive groups were created from the subset of current tobacco users (N=1037) for users of menthol cigarettes (N=311; 30%), non-menthol cigarettes (N=426; 41%), flavored OTP only users (N=114; 11%), and non-flavored OTP only users (N=186; 18%) to examine factors of being in any one group. Data were collected in July 2012. In the full multivariable model, significant correlates of current menthol cigarette use were female gender (AOR=2.08), Black race (AOR=5.31), other race (AOR=2.72), Hispanic ethnicity (AOR=2.46) and self-identifying as a smoker, social smoker, or occasional smoker (AOR=10.42). Significant correlates of current flavored OTP use were younger age (18-24; AOR=3.50), self-identifying as a smoker, social smoker, or occasional smoker (AOR=30) and generalized anxiety (AOR=0.30). This study highlights female gender, Blacks/other race/Hispanics, smokers, social smokers and sexual minorities as correlates of menthol cigarette use and younger age as a predictor of flavored OTP use. Restricting access to flavored tobacco products may be one intervention to help slow the tobacco epidemic, particularly among many of the most vulnerable groups-young women and racial and/or ethnic minorities. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Monitoring of non-cigarette tobacco use using Google Trends.

PubMed

Cavazos-Rehg, Patricia A; Krauss, Melissa J; Spitznagel, Edward L; Lowery, Ashley; Grucza, Richard A; Chaloupka, Frank J; Bierut, Laura Jean

2015-05-01

Google Trends is an innovative monitoring system with unique potential to monitor and predict important phenomena that may be occurring at a population level. We sought to validate whether Google Trends can additionally detect regional trends in youth and adult tobacco use. We compared 2011 Google Trends relative search volume data for cigars, cigarillos, little cigars and smokeless tobacco with state prevalence of youth (grades 9-12) and adult (age 18 and older) use of these products using data from the 2011 United States state-level Youth Risk Behaviors Surveillance System and the 2010-2011 United States National Survey on Drug Use and Health (NSDUH), respectively. We used the Pearson correlation coefficient to measure the associations. We found significant positive correlations between state Google Trends cigar relative search volume and prevalence of cigar use among youth (r=0.39, R(2) = 0.154, p=0.018) and adults (r=0.49, R(2) = 0.243, p<0.001). Similarly, we found that the correlations between state Google Trends smokeless tobacco relative search volume and prevalence of smokeless tobacco use among youth and adults were both positive and significant (r=0.46, R(2) = 0.209, p=0.003 and r=0.48, R(2) = 0.226, p<0.001, respectively). The results of this study validate that Google Trends has the potential to be a valuable monitoring tool for tobacco use. The near real-time monitoring features of Google Trends may complement traditional surveillance methods and lead to faster and more convenient monitoring of emerging trends in tobacco use. 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.

Tobacco industry targeting youth in Argentina.

PubMed

Braun, S; Mejia, R; Ling, P M; Pérez-Stable, E J

2008-04-01

Argentina has one of the highest cigarette smoking rates among both men and women in the Americas and no legislated restrictions on tobacco industry advertising. The tobacco industry has traditionally expanded markets by targeting adolescents and young adults. The objective of this study was to determine whether and how the tobacco industry promotes cigarettes to adolescents in Argentina. We conducted a systematic search of tobacco industry documents available through the internet dated between 1995 and 2004 using standard search terms to identify marketing strategies in Argentina. A selected review of the four leading newspapers and nine magazines with reported high readership among adolescents was completed. The selected print media were searched for tobacco images and these were classified as advertisements if associated with a commercial product or as a story if not. The tobacco industry used market segmentation as a strategy to target Argentinean consumers. British American Tobacco (BAT) undertook a young adult psychographic study and classified them as "progressives", "Jurassics" or "conservatives" and "crudos" or "spoiled brats". BAT marketed Lucky Strike to the "progressives" using Hollywood movies as a vehicle. The tobacco industry also targeted their national brands to the conservatives and linked these brands with "nationalistic values" in advertising campaigns. Philip Morris promoted Marlboro by sponsoring activities directed at young people and they launched the 10 cigarettes packet as a starter vehicle. The tobacco industry used psychographic segmentation of the population and developed advertising strategies focused on youth. Tobacco control researchers and advocates must be able to address these strategies in counter-marketing interventions.

Food and Drug Administration tobacco regulation and product judgments.

PubMed

Kaufman, Annette R; Finney Rutten, Lila J; Parascandola, Mark; Blake, Kelly D; Augustson, Erik M

2015-04-01

The Family Smoking Prevention and Tobacco Control Act granted the Food and Drug Administration (FDA) the authority to regulate tobacco products in the U.S. However, little is known about how regulation may be related to judgments about tobacco product-related risks. To understand how FDA tobacco regulation beliefs are associated with judgments about tobacco product-related risks. The Health Information National Trends Survey is a national survey of the U.S. adult population. Data used in this analysis were collected from October 2012 through January 2013 (N=3,630) by mailed questionnaire and analyzed in 2013. Weighted bivariate chi-square analyses were used to assess associations among FDA regulation belief, tobacco harm judgments, sociodemographics, and smoking status. A weighted multinomial logistic regression was conducted where FDA regulation belief was regressed on tobacco product judgments, controlling for sociodemographic variables and smoking status. About 41% believed that the FDA regulates tobacco products in the U.S., 23.6% reported the FDA does not, and 35.3% did not know. Chi-square analyses showed that smoking status was significantly related to harm judgments about electronic cigarettes (p<0.0001). The multinomial logistic regression revealed that uncertainty about FDA regulation was associated with tobacco product harm judgment uncertainty. Tobacco product harm perceptions are associated with beliefs about tobacco product regulation by the FDA. These findings suggest the need for increased public awareness and understanding of the role of tobacco product regulation in protecting public health. Copyright © 2015. Published by Elsevier Inc.

Adult Tobacco Use | Cancer Trends Progress Report

Cancer.gov

The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

Association between use of flavoured tobacco products and quit behaviours: findings from a cross-sectional survey of US adult tobacco users

PubMed Central

Smith, Danielle M; Bansal-Travers, Maansi; Huang, Jidong; Barker, Dianne; Hyland, Andrew J; Chaloupka, Frank

2017-01-01

Background Non-menthol characterising flavours (eg, fruit, candy) are banned in cigarettes, yet are still permitted in non-cigarette tobacco (NCT) products. This study examined associations between first use and current use of flavoured tobacco products, and current flavoured tobacco use and quit behaviours. Methods A nationally representative, telephone-based survey completed in 2012 by 1443 US adult tobacco users asked about use of 9 tobacco products: cigarettes, e-cigarettes, cigars, cigarillos, little filtered cigars, pipes, hookah, smokeless tobacco and snus. Ever users reported first use of flavoured products, while current users also reported current flavoured product use. Current users reported quit attempts made in the past year. Data were weighted to reflect the US adult tobacco user population. Logistic regression models were used to examine associations between first/current flavour use and quit behaviours. Results Over 70% of respondents reported first use of a flavoured tobacco product, while 54% reported current use of at least one flavoured product. Odds of current flavoured product use were greater among those who reported first use of a flavoured product (OR 14.82, 95% CI 9.96 to 22.06). First use of a flavoured product was associated with being a current tobacco user (OR 1.55, 95% CI 1.08 to 2.22). Compared to single product users, polytobacco users exhibited greater odds of reporting current use of flavoured products (OR 2.09, 95% CI 1.47 to 2.97). Forty-four percent of current tobacco users reported a past-year quit attempt. Adjusted analyses among current NCT users of at least one flavoured tobacco product showed reduced odds of reporting a quit attempt. Conclusions First use of a flavoured tobacco product was associated with current flavoured tobacco use and polytobacco use. Users of only flavoured NCT products exhibited reduced odds of reporting a quit attempt. Findings from this study reinforce the importance of flavoured product availability in the USA, which may have significant implications for efforts to reduce tobacco initiation and use at a population level. The relationship between characterising flavours and quit behaviours merits further exploration in longitudinal, population-based samples. PMID:27708123

Trends in the Prevalence of Tobacco Use. National YRBS: 1991-2011

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

A National Survey of Tobacco Cessation Programs for Youths

PubMed Central

Curry, Susan J.; Emery, Sherry; Sporer, Amy K.; Mermelstein, Robin; Flay, Brian R.; Berbaum, Michael; Warnecke, Richard B.; Johnson, Timothy; Mowery, Paul; Parsons, Jennifer; Harmon, Lori; Hund, Lisa; Wells, Henry

2007-01-01

Objectives. We collected data on a national sample of existing community-based tobacco cessation programs for youths to understand their prevalence and overall characteristics. Methods. We employed a 2-stage sampling design with US counties as the first-stage probability sampling units. We then used snowball sampling in selected counties to identify administrators of tobacco cessation programs for youths. We collected data on cessation programs when programs were identified. Results. We profiled 591 programs in 408 counties. Programs were more numerous in urban counties; fewer programs were found in low-income counties. State-level measures of smoking prevalence and tobacco control expenditures were not associated with program availability. Most programs were multisession, school-based group programs serving 50 or fewer youths per year. Program content included cognitive-behavioral components found in adult programs along with content specific to adolescence. The median annual budget was $2000. Few programs (9%) reported only mandatory enrollment, 35% reported mixed mandatory and voluntary enrollment, and 56% reported only voluntary enrollment. Conclusions. There is considerable homogeneity among community-based tobacco cessation programs for youths. Programs are least prevalent in the types of communities for which national data show increases in youths’ smoking prevalence. PMID:17138932

National Survey of Oral/Dental Conditions Related to Tobacco and Alcohol Use in Mexican Adults

PubMed Central

Medina-Solís, Carlo Eduardo; Pontigo-Loyola, América Patricia; Pérez-Campos, Eduardo; Hernández-Cruz, Pedro; Ávila-Burgos, Leticia; Mendoza-Rodríguez, Martha; Maupomé, Gerardo

2014-01-01

Oral diseases are a major burden on individuals and health systems. The aim of this study was to determine whether consumption of tobacco and alcohol were associated with the prevalence of oral/dental problems in Mexican adults. Using data from the National Performance Evaluation Survey 2003, a cross-sectional study part of the World Health Survey, dental information from a representative sample of Mexico (n = 22,229, N = 51,155,740) was used to document self-reported oral/dental problems in the 12 months prior to the survey. Questionnaires were used to collect information related to sociodemographic, socioeconomic, and other risk factors. Three models were generated for each age group (18–30, 31–45 and 46–98 years). The prevalence of oral/dental conditions was 25.7%. Adjusting for sex, schooling, socioeconomic position, diabetes, and self-reported health, those who used tobacco (sometimes or daily) (OR = 1.15, p = 0.070; OR = 1.24, p < 0.01; and OR = 1.16, p < 0.05, for each age group respectively) or alcohol (moderate or high) (OR = 1.26, p < 0.001; OR = 1.18, p < 0.01 and OR = 1.30, p < 0.001, for each age group respectively) had a higher risk of reporting oral/dental problems. Because tobacco and alcohol use were associated with self-reported oral/dental problems in one out of four adults, it appears advisable to ascertain how direct is such link; more direct effects would lend greater weight to adopting measures to reduce consumption of tobacco and alcohol for the specific purpose of improving oral health. PMID:24642844

Prevalence of use and perceptions of risk of novel and other alternative tobacco products among sexual minority adults: Results from an online national survey, 2014-2015.

PubMed

Nayak, Pratibha; Salazar, Laura F; Kota, Krishna K; Pechacek, Terry F

2017-11-01

Sexual minority (lesbian, gay, and bisexual [LGB]) populations experience disparities in cigarette use, but sparse evidence exists about novel and other alternative tobacco product use. In this study, we compared rates of novel and other alternative tobacco product use, risk perceptions, and worldview between LGB and heterosexual (HET) adults. An online survey administered in 2014-2015, using a weighted probability sample of 11,525 U.S. adults, assessed awareness of tobacco products; ever and current use of e-cigarettes, cigars, little cigars and cigarillos, and hookahs; perceptions of e-cigarettes; and worldview (individualism vs. communitarianism). Bivariate and adjusted multivariable analyses were performed to determine differences between LGB and HET groups. In the adjusted analyses, LGB adults were 1.5 times more likely to have ever used e-cigarettes (95% CI 1.2-1.9) and 1.9 times more likely to have ever used hookahs (95% CI 1.5-2.4) as compared to HET adults. A lower percentage of LGB adults, as compared to HET adults (16.7% vs. 19.2%), believed that exposure to vapors from e-cigarettes was "harmful" and reported that they "did not know" of any harm (35.1% vs. 39.8%). LGB were 20% less likely than were HET adults to endorse an individualistic worldview. These results suggest that a disparity exists, whereby LGB adults are more likely to have used e-cigarettes and hookahs. In addition, although vapor from e-cigarettes contains nicotine and other chemicals, LGB adults are less likely to perceive exposure to secondhand vapor as harmful. Tailored awareness campaigns and interventions are needed to convey the risks and curb use of these products. Copyright © 2017 Elsevier Inc. All rights reserved.

Smokers who are also using smokeless tobacco products in the US: a national assessment of characteristics, behaviours and beliefs of 'dual users'.

PubMed

McClave-Regan, Annette K; Berkowitz, Judy

2011-05-01

Marketing and advertising of smokeless tobacco products towards cigarette smokers has increased recently. Because the use of multiple tobacco products is a growing public health concern, the present work assesses the use of smokeless tobacco among cigarette smokers, a behaviour termed as 'dual use', as well as attitudes and beliefs on their 'dual use' of tobacco. Data were used from the 2008 Consumer Styles survey, a nationally representative, mail-in survey of consumers in the USA (n=10,108). 'Dual use' was more common among cigarette smokers who were young, white men living in the Midwest or South. The majority of 'dual users' reported using smokeless tobacco in places where they could not smoke (67.7%) and did not believe smokeless tobacco would help in quitting smoking (75.1%). 'Dual users' reported planning to quit within the next 6 months less often than adults who smoke cigarettes exclusively and close to half (42.3%) never plan to quit smoking. Tobacco use is attributed to a number of diseases and deaths worldwide, and cessation of tobacco use can reduce these health risks. The prevalent use of smokeless tobacco in places with smoking restrictions and lack of planning to quit by 'dual users' suggest the need to promote cessation among these users.

Marijuana and tobacco: a major connection?

PubMed

Tullis, Laura Michelle; Dupont, Robert; Frost-Pineda, Kimberly; Gold, Mark S

2003-01-01

Smoking among teens and college students is a significant public health challenge. Tobacco, marijuana, and alcohol continue to be the most commonly abused drugs by teens and young adults. Educational efforts have resulted in increased awareness of the mortality and morbidity attributed to smoking, second-hand smoke, and prenatal exposure to tobacco. Short- and long-term consequences of marijuana use are well documented in the literature, but they have received less wide spread attention. Even less well known is the relationship between these substances. Does use of one lead to use of the other? Are there synergistic and/or antagonistic effects when these substances are used together? We need answers to these questions to understand the prevalence of use and the impact of these drugs on our nations youth and young adults. The gateway theory of drug use is often used to describe the progression from using alcohol or tobacco, to marijuana, and later use of other drugs like MDMA, cocaine, and heroin. While tobacco use does commonly precede marijuana use, we propose that marijuana may be a "gateway drug" to tobacco smoking. Our research with university students is suggesting that cigarette-smoking initiation often follows or coincides with marijuana.

The influence of menthol, e-cigarettes and other tobacco products on young adults' self-reported changes in past year smoking.

PubMed

Delnevo, Cristine D; Villanti, Andrea C; Wackowski, Olivia A; Gundersen, Daniel A; Giovenco, Daniel P

2016-09-01

Progression to regular smoking often occurs during young adulthood. This study examines self-reported changes in past year smoking among young adults and the potential influence of tobacco products on these trajectories. Respondents to the 2011 National Young Adult Health Survey who smoked 100 cigarettes in their lifetime (n=909) described smoking behaviour at the time of the survey and 1 year prior. Cigarette smoking trajectories were categorised as: no change, quit, decreased smoking or increased smoking. Participants were also asked about current use of menthol cigarettes and other tobacco products (ie, cigars, smokeless tobacco, hookah) and ever use of e-cigarettes. Most young adults (73.1%) reported stable cigarette smoking behaviours, while 8.2% reported having quit, 5.8% reported that they smoke on fewer days, 5% progressed from someday to daily smoking and 8% increased from not at all to current smoking. The youngest smokers (18-20) had significantly higher odds (adjusted OR (AOR) =2.6) of increasing cigarette use over the past year compared to those aged 30-34, as did blacks versus whites (AOR=2.35). Menthol cigarette use nearly doubled (AOR=1.87) the odds of increased smoking behaviour. E-cigarette and other tobacco product (OTP) use were not associated with increasing smoking but OTP use was negatively associated with remaining quit from cigarettes. Young adulthood is a critical period for smoking interventions, particularly among those most vulnerable to increasing smoking behaviours (ie, black and younger young adults). Policy efforts to restrict menthol cigarettes may reduce young adult smoking 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/

Cigarettes point of purchase patterns in 19 low-income and middle-income countries: Global Adult Tobacco Survey, 2008-2012.

PubMed

Mbulo, Lazarous; Kruger, Judy; Hsia, Jason; Yin, Shaoman; Salandy, Simone; Orlan, Elizabeth N; Agaku, Israel; Ribisl, Kurt M

2018-04-05

There is little information on cigarette-purchasing behaviour among smokers globally. Understanding cigarette purchase and point-of-sale patterns can help guide the development and implementation of tobacco-control strategies in retail environments. The purpose of this study was to identify where adults in 19 countries last purchased cigarettes. Data were from 19 low-income and middle-income countries that conducted the Global Adult Tobacco Survey (GATS) during 2008-2012. GATS is a nationally representative household survey of adults aged 15 years or older using a standardised protocol to measure tobacco-related behaviours. Data were weighted to yield nationally representative estimates within each country and summarised by using descriptive statistics. Overall prevalence of current cigarette smoking ranged from 3.7% in Nigeria to 38.5% in the Russian Federation. Among current cigarette smokers, locations of last purchase were as follows: stores, from 14.6% in Argentina to 98.7% in Bangladesh (median=66.8%); street vendors, from 0% in Thailand to 35.7% in Vietnam (median=3.0%); kiosks, from 0.1% in Thailand to 77.3% in Argentina (median=16.1%); other locations, from 0.3% in China and Egypt to 57.5% in Brazil (median=2.6%). Cigarettes are purchased at various retail locations globally. However, stores and kiosks were the main cigarette purchase locations in 18 of the 19 countries assessed. Knowledge of where cigarette purchases occur could help guide interventions to reduce cigarette accessibility and use. © 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.

Smoking trends among women in India: Analysis of nationally representative surveys (1993-2009).

PubMed

Goel, Sonu; Tripathy, Jaya Prasad; Singh, Rana J; Lal, Pranay

2014-10-01

There is growing concern among policy makers with respect to alarming growth in smoking prevalence among women in the developing countries. USING DISAGGREGATED DATA FROM FIVE NATIONALLY REPRESENTATIVE SURVEYS: Global Adult Tobacco Survey 2010, National Family Health Survey-III (NFHS-III) 2004-2005, NFHS-II 1998-1999, National Sample Survey (NSS) 52(nd) Round 1995-1996, NSS 50(th) Round 1993-1994 we analysed female smoking trend from 1993-2009. Tobacco use among females was monitored for almost two decades focusing on gender, literacy, and state-specific trends among respondents aged >15 years. Smoking use among women has doubled from 1.4% to 2.9% (P < 0.001) during the period 2005-2010. The prevalence of smoking increased with decrease in per capita State Gross Domestic Product and literacy status for both men and women. As the overall smoking prevalence grows, female smoking is growing at a faster rate than smoking among males, which is an emerging concern for tobacco control in India and requires the attention of policymakers.

Influence of point-of-sale tobacco displays and graphic health warning signs on adults: evidence from a virtual store experimental study.

PubMed

Kim, Annice E; Nonnemaker, James M; Loomis, Brett R; Shafer, Paul R; Shaikh, Asma; Hill, Edward; Holloway, John W; Farrelly, Matthew C

2014-05-01

We tested the impact of banning tobacco displays and posting graphic health warning signs at the point of sale (POS). We designed 3 variations of the tobacco product display (open, enclosed [not visible], enclosed with pro-tobacco ads) and 2 variations of the warning sign (present vs absent) with virtual store software. In December 2011 and January 2012, we randomized a national convenience sample of 1216 adult smokers and recent quitters to 1 of 6 store conditions and gave them a shopping task. We tested for the main effects of the enclosed display, the sign, and their interaction on urge to smoke and tobacco purchase attempts. The enclosed display significantly lowered current smokers' (B = -7.05; 95% confidence interval [CI] = -13.20, -0.91; P < .05) and recent quitters' (Β = -6.00, 95% CI = -11.00, -1.00; P < .01) urge to smoke and current smokers' purchase attempts (adjusted odds ratio = 0.06; 95% CI = 0.03, 0.11; P < .01). The warning sign had no significant main effect on study outcomes or interaction with enclosed display. These data show that POS tobacco displays influence purchase behavior. Banning them may reduce cues to smoke and unplanned tobacco purchases.

Not Just Cigarettes: A More Comprehensive Look at Marijuana and Tobacco Use Among African American and White Youth and Young Adults.

PubMed

Kennedy, Sara M; Caraballo, Ralph S; Rolle, Italia V; Rock, Valerie J

2016-04-01

Cigarettes, cigars, and marijuana have generally been studied in isolation yet their use does not occur in isolation. Focus on cigarette smoking may overstate the observation that African American youth and young adults are less likely to smoke any combustible product compared with their white counterparts. Assessing cigarette, cigar, and marijuana use trends may help identify the extent of this difference. Data from the 2002-2012 National Survey on Drug Use and Health (N = 25 541 to N = 28 232) were used to investigate past 30-day cigarette, cigar, and marijuana use trends among African American and white youth (12-17) and young adults (18-25). Logistic regressions assessed trends in combustible tobacco (cigarettes and cigars) and marijuana use, alone and in combination. From 2002-2012, the absolute difference in cigarette smoking prevalence between African American and white youth (9.6%-4.2%) and young adults (19.0%-10.5%) narrowed. Any combustible tobacco/marijuana use was significantly lower among African Americans than whites but, relative to cigarettes, the absolute difference was much smaller among youth (7.2%-2.2%) and young adults (15.8%-5.6%). Among any combustible tobacco/marijuana users, using two or more substances ranged from 31.4% to 40.3% among youth and 29.1% to 39.8% among young adults. Any combustible tobacco/marijuana use trends suggest the smoking prevalence difference between African American and white youth and young adults is real, but less pronounced than when assessing cigarette smoking alone. Policies and programs addressing smoking behaviors may benefit from broadening focus to monitor and address cigar and marijuana use as well. Trends in any use of cigarettes, cigars, and/or marijuana suggest the difference in smoking prevalence between African American and white youth and young adults is real, but less pronounced than when cigarette smoking is assessed alone. In 2012, more than 10% of African American and white youth, more than a third of African American young adults, and nearly half of white young adults reported past 30-day use of cigarette, cigars, and/or marijuana. Public health programs aimed at reducing these behaviors among youth and young adults could be informed by considering detailed, race-specific information regarding tobacco and marijuana use patterns. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Exposure to Tobacco Advertising, Promotion Among the Adult Population in Vietnam and Its Implications for Public Health.

PubMed

Huong, Le Thi Thanh; Long, Tran Khanh; Van Anh, Tran Thi; Tuyet-Hanh, Tran Thi; Giang, Kim Bao; Hai, Phan Thi; Huyen, Doan Thu; Khue, Luong Ngoc; Lam, Nguyen Tuan; Nga, Pham Quynh; Quan, Nguyen The; Linh, Tran Nu Quy; Ha, Nguyen Thanh; Van Minh, Hoang

2017-10-01

The Law on Tobacco Control and the Law on Advertisement prohibit the advertising of any tobacco product in Vietnam. Tobacco promotion and marketing are alsostrictly prohibited. However, the violation of tobacco adverting and promotion is still common in Vietnam. This article aims at describing the exposure to tobacco advertising and promotion among the population aged 15+ years in Vietnam based on the data from the Global Adult Tobacco Survey 2015 from the view of the community, identifying any possible associations between the exposure to tobacco advertising and promotion and other individual factors, and discussing its possible public health implications. A cross-sectional study with the nationwide scale. Secondary data from the Global Adult Tobacco Survey 2015 was explored and analyzed. Chi-square test and multivariate logistic regressions were applied in the data analysis. The most common type of adults' exposure to tobacco advertising and promotion was points of sale (8.6%); 9.8% adults exposure to one source of tobacco advertising and 4.0% of them exposed to one source of tobacco promotion. Around 13.3% of Vietnamese adults were exposed to tobacco advertisement, while 2.0% were exposed to tobacco promotion, 5.3% were exposed to both tobacco advertising and promotion, and 16.6% were exposed to tobacco advertising or promotion. Gender, educational level, age, occupation, marital status, socioeconomic status, location (urban, rural), and current smoking status were associated with the exposure to tobacco advertising, tobacco promotion, tobacco advertising and promotion, and tobacco advertising or promotion. Although there are comprehensive bans on tobacco advertising and promotion in Vietnam, adults aged 15+ years still reported their exposure to tobacco advertising and promotion. There should be a strict enforcement of the ban on tobacco advertising and promotion in Vietnam.

Not Just Cigarettes: A More Comprehensive Look at Marijuana and Tobacco Use Among African American and White Youth and Young Adults

PubMed Central

Kennedy, Sara M.; Caraballo, Ralph S.; Rolle, Italia V.; Rock, Valerie J.

2016-01-01

Introduction Cigarettes, cigars, and marijuana have generally been studied in isolation yet their use does not occur in isolation. Focus on cigarette smoking may overstate the observation that African American youth and young adults are less likely to smoke any combustible product compared with their white counterparts. Assessing cigarette, cigar, and marijuana use trends may help identify the extent of this difference. Methods Data from the 2002–2012 National Survey on Drug Use and Health (N = 25 541 to N = 28 232) were used to investigate past 30-day cigarette, cigar, and marijuana use trends among African American and white youth (12–17) and young adults (18–25). Logistic regressions assessed trends in combustible tobacco (cigarettes and cigars) and marijuana use, alone and in combination. Results From 2002–2012, the absolute difference in cigarette smoking prevalence between African American and white youth (9.6%–4.2%) and young adults (19.0%–10.5%) narrowed. Any combustible tobacco/marijuana use was significantly lower among African Americans than whites but, relative to cigarettes, the absolute difference was much smaller among youth (7.2%–2.2%) and young adults (15.8%–5.6%). Among any combustible tobacco/marijuana users, using two or more substances ranged from 31.4% to 40.3% among youth and 29.1% to 39.8% among young adults. Conclusion Any combustible tobacco/marijuana use trends suggest the smoking prevalence difference between African American and white youth and young adults is real, but less pronounced than when assessing cigarette smoking alone. Policies and programs addressing smoking behaviors may benefit from broadening focus to monitor and address cigar and marijuana use as well. Implications Trends in any use of cigarettes, cigars, and/or marijuana suggest the difference in smoking prevalence between African American and white youth and young adults is real, but less pronounced than when cigarette smoking is assessed alone. In 2012, more than 10% of African American and white youth, more than a third of African American young adults, and nearly half of white young adults reported past 30-day use of cigarette, cigars, and/or marijuana. Public health programs aimed at reducing these behaviors among youth and young adults could be informed by considering detailed, race-specific information regarding tobacco and marijuana use patterns. PMID:26980865

Examining vulnerability to smokeless tobacco use among adolescents and adults meeting diagnostic criteria for major depressive disorder.

PubMed

Redner, Ryan; White, Thomas J; Harder, Valerie S; Higgins, Stephen T

2014-08-01

Smoking prevalence is unevenly distributed in the U.S. population, with those with mental illness, other substance use disorders, and lower socioeconomic status being especially vulnerable. Less research has been conducted on the association between these same vulnerabilities and smokeless tobacco (ST) use. The present study examined cigarette and ST use among adolescents and adults who met diagnostic criteria for major depressive disorder in the National Survey on Drug Use and Health (NSDUH). Utilizing the most recent (2011) NSDUH, we compared odds for current cigarette smoking and ST use among adolescents and adults meeting criteria for past-year major depressive disorder to the general population, after adjusting for potential confounding influences of sociodemographic and other substance use characteristics. Analyses were conducted to examine sex as a moderator of the relation between major depressive disorder and tobacco use. Odds for current cigarette smoking among those classified with major depressive disorder were increased among adolescents (OR = 1.33, 95% CI [1.05, 1.69], p = .021) and adults (OR = 1.70, 95% CI [1.47, 1.97], p < .0005), and odds for current ST use did not differ among adolescents (OR = 0.90, 95% CI [0.54, 1.49], p = .678) and were lower among adults (OR = 0.68, 95% CI [0.51, 0.91], p = .010). Sex was not a significant moderator in adolescents or adults. Major depressive disorder is associated with increased risk for smoking but not ST use among adolescents and adults further demonstrating heterogeneity in predictors of vulnerability to use of different tobacco products.

Correlates of Cessation Success among Romanian Adults

PubMed Central

Dziankowska-Zaborszczyk, Elżbieta; Makowiec-Dąbrowska, Teresa

2014-01-01

Background. Tobacco smoking and its consequences are a serious public health problem in Romania. Evidence-based data on factors associated with successful smoking cessation are crucial to optimize tobacco control. The aim of the study was to determine the sociodemographic and other factors associated with smoking cessation success among adults. Materials and Methods. Data was from a sample of 4,517 individuals derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Romania in 2011. Data was analyzed with logistic regression. Results. Among females, the quit rate was 26.3% compared with 33.1% in males (P < 0.02). We found disparities in cessation success among the analyzed groups of respondents. Being economically active, being aged 40 and above, and having an awareness of smoking health consequences were associated with long-term quitting smoking among men, while initiating smoking at a later age increased the odds of quitting smoking among women. However, cohabitation with nonsmokers was the strongest predictor of successful cessation among both genders. Conclusion. Programs increasing quit rates and encourage cessation among groups less likely to quit, adopting voluntary smoke-free homes, and increasing the awareness of smoking and tobacco pollution risks are needed. PMID:24995319

Correlates of cessation success among Romanian adults.

PubMed

Kaleta, Dorota; Usidame, Bukola; Dziankowska-Zaborszczyk, Elżbieta; Makowiec-Dąbrowska, Teresa

2014-01-01

Tobacco smoking and its consequences are a serious public health problem in Romania. Evidence-based data on factors associated with successful smoking cessation are crucial to optimize tobacco control. The aim of the study was to determine the sociodemographic and other factors associated with smoking cessation success among adults. Data was from a sample of 4,517 individuals derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Romania in 2011. Data was analyzed with logistic regression. Among females, the quit rate was 26.3% compared with 33.1% in males (P < 0.02). We found disparities in cessation success among the analyzed groups of respondents. Being economically active, being aged 40 and above, and having an awareness of smoking health consequences were associated with long-term quitting smoking among men, while initiating smoking at a later age increased the odds of quitting smoking among women. However, cohabitation with nonsmokers was the strongest predictor of successful cessation among both genders. Programs increasing quit rates and encourage cessation among groups less likely to quit, adopting voluntary smoke-free homes, and increasing the awareness of smoking and tobacco pollution risks are needed.

Monitoring the Future National Survey Results on Drug Use, 1975-2010. Volume I, Secondary School Students

ERIC Educational Resources Information Center

Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.; Schulenberg, John E.

2011-01-01

The Monitoring the Future (MTF) study involves an ongoing series of national surveys of American adolescents and adults that has provided the nation with a vital window into the important, but largely hidden, problem behaviors of illegal drug use, alcohol use, tobacco use, anabolic steroid use, and psychotherapeutic drug use. For more than a third…

Are tobacco control policies effective in reducing young adult smoking?

PubMed

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

2014-04-01

We examined the influence of tobacco control program funding, smoke-free air laws, and cigarette prices on young adult smoking outcomes. 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. 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 < .01). Greater coverage of 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. Smoke-free air laws and state tobacco control programs are effective strategies for curbing young adult smoking. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Are Tobacco Control Policies Effective in Reducing Young Adult Smoking?

PubMed Central

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

2015-01-01

Purpose We examined the influence of tobacco control program funding, smoke-free air laws, and cigarette prices on young adult smoking outcomes. Methods We use a natural experimental design approach that uses the variation in tobacco control policies across states and over time to understand their influence on tobacco outcomes. We combine individual outcome data with annual state-level policy data to conduct multivariable logistic regression models, controlling for an extensive set of sociodemographic factors. The participants are 18- to 25-year-olds from the 2002–2009 National Surveys on Drug Use and Health. The three main outcomes are past-year smoking initiation, and current and established smoking. A current smoker was one who had smoked on at least 1 day in the past 30 days. An established smoker was one who had smoked 1 or more cigarettes in the past 30 days and smoked at least 100 cigarettes in his or her lifetime. Results Higher levels of tobacco control program funding and greater smoke-free-air law coverage were both associated with declines in current and established smoking (p < .01). Greater coverage of 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

Health Care Utilization and Expenditures Attributable to Cigar Smoking Among US Adults, 2000-2015.

PubMed

Wang, Yingning; Sung, Hai-Yen; Yao, Tingting; Lightwood, James; Max, Wendy

Cigar use in the United States is a growing public health concern because of its increasing popularity. We estimated health care utilization and expenditures attributable to cigar smoking among US adults aged ≥35. We analyzed data on 84 178 adults using the 2000, 2005, 2010, and 2015 National Health Interview Surveys. We estimated zero-inflated Poisson (ZIP) regression models on hospital nights, emergency department (ED) visits, physician visits, and home-care visits as a function of tobacco use status-current sole cigar smokers (ie, smoke cigars only), current poly cigar smokers (smoke cigars and smoke cigarettes or use smokeless tobacco), former sole cigar smokers (used to smoke cigars only), former poly cigar smokers (used to smoke cigars and smoke cigarettes or use smokeless tobacco), other tobacco users (ever smoked cigarettes and used smokeless tobacco but not cigars), and never tobacco users (never smoked cigars, smoked cigarettes, or used smokeless tobacco)-and other covariates. We calculated health care utilization attributable to current and former sole cigar smoking based on the estimated ZIP models, and then we calculated total health care expenditures attributable to cigar smoking. Current and former sole cigar smoking was associated with excess annual utilization of 72 137 hospital nights, 32 748 ED visits, and 420 118 home-care visits. Annual health care expenditures attributable to sole cigar smoking were $284 million ($625 per sole cigar smoker), and total annual health care expenditures attributable to sole and poly cigar smoking were $1.75 billion. Comprehensive tobacco control policies and interventions are needed to reduce cigar smoking and the associated health care burden.

The effects of parental divorce on adult tobacco and alcohol consumption.

PubMed

Wolfinger, N H

1998-09-01

I use data from the 1977-1994 National Opinion Research Council General Social Survey to examine the impact of parental divorce on the alcohol and tobacco consumption of adult offspring. Divorce greatly increases the likelihood of being a smoker and, for men, a problem drinker. Parental remarriage completely offsets the effects of parental divorce on men's drinking but does not substantially affect cigarette use. Respondent socioeconomic characteristics accounted for a portion of the relationship between parental divorce and smoking but did not affect rates of problem drinking. Social control and psychosocial adjustment--two established explanations for the effects of parental divorce--could not adequately explain my findings.

Tobacco industry targeting youth in Argentina

PubMed Central

Braun, S; Mejia, R; Ling, P M; Pérez-Stable, E J

2013-01-01

Background/aim Argentina has one of the highest cigarette smoking rates among both men and women in the Americas and no legislated restrictions on tobacco industry advertising. The tobacco industry has traditionally expanded markets by targeting adolescents and young adults. The objective of this study was to determine whether and how the tobacco industry promotes cigarettes to adolescents in Argentina. Methods We conducted a systematic search of tobacco industry documents available through the internet dated between 1995 and 2004 using standard search terms to identify marketing strategies in Argentina. A selected review of the four leading newspapers and nine magazines with reported high readership among adolescents was completed. The selected print media were searched for tobacco images and these were classified as advertisements if associated with a commercial product or as a story if not. Results The tobacco industry used market segmentation as a strategy to target Argentinean consumers. British American Tobacco (BAT) undertook a young adult psychographic study and classified them as “progressives”, “Jurassics” or “conservatives” and “crudos” or “spoiled brats”. BAT marketed Lucky Strike to the “progressives” using Hollywood movies as a vehicle. The tobacco industry also targeted their national brands to the conservatives and linked these brands with “nationalistic values” in advertising campaigns. Philip Morris promoted Marlboro by sponsoring activities directed at young people and they launched the 10 cigarettes packet as a starter vehicle. Conclusions The tobacco industry used psychographic segmentation of the population and developed advertising strategies focused on youth. Tobacco control researchers and advocates must be able to address these strategies in counter-marketing interventions. PMID:18299308

The quarter that changed the world.

PubMed

Roeseler, April; Burns, David

2010-04-01

The California Department of Public Health (CDPH), California Tobacco Control Program (CTCP) is one of the longest-running comprehensive tobacco control programmes in the USA, resulting from a 1988 ballot initiative that added a 25-cent tax on each pack of cigarettes and a proportional tax increase on other tobacco products. This programme used a social norm change approach to reduce tobacco use. The operation, structure, evolution, programme dissemination and results are reviewed. The sustained programme implementation has reduced adult per capita cigarette consumption by over 60% and adult smoking prevalence by 35%, from 22.7% in 1988 to 13.8% in 2007. From 1988 to 2004, lung and bronchus cancer rates in California declined at nearly four times the rate of decline seen in the rest of the USA and the programme is associated with an $86 billion savings in healthcare costs. Youth smoking rates among 12-17 years olds are the second lowest in the nation. The social norm change approach is effective at reducing tobacco consumption, adult smoking and youth uptake. This approach resulted in declines in tobacco-related diseases and is associated with savings in healthcare expenditures. In considering CTCP's effectiveness, the takeaway message is that it should be viewed as a unified programme rather than a collection of independent interventions. The programme was designed and implemented as one where the parts complement and reinforce each other. Its effectiveness is dependent on its comprehensive strategy rather than any one part of the intervention.

The quarter that changed the world

PubMed Central

Burns, David

2010-01-01

Background The California Department of Public Health (CDPH), California Tobacco Control Program (CTCP) is one of the longest-running comprehensive tobacco control programmes in the USA, resulting from a 1988 ballot initiative that added a 25-cent tax on each pack of cigarettes and a proportional tax increase on other tobacco products. This programme used a social norm change approach to reduce tobacco use. Methods The operation, structure, evolution, programme dissemination and results are reviewed. Results The sustained programme implementation has reduced adult per capita cigarette consumption by over 60% and adult smoking prevalence by 35%, from 22.7% in 1988 to 13.8% in 2007. From 1988 to 2004, lung and bronchus cancer rates in California declined at nearly four times the rate of decline seen in the rest of the USA and the programme is associated with an $86 billion savings in healthcare costs. Youth smoking rates among 12–17 years olds are the second lowest in the nation. Conclusions The social norm change approach is effective at reducing tobacco consumption, adult smoking and youth uptake. This approach resulted in declines in tobacco-related diseases and is associated with savings in healthcare expenditures. In considering CTCP's effectiveness, the takeaway message is that it should be viewed as a unified programme rather than a collection of independent interventions. The programme was designed and implemented as one where the parts complement and reinforce each other. Its effectiveness is dependent on its comprehensive strategy rather than any one part of the intervention. PMID:20382647

Deficiencies in public understanding about tobacco harm reduction: results from a United States national survey.

PubMed

Kiviniemi, Marc T; Kozlowski, Lynn T

2015-07-02

Tobacco products differ in their relative health harms. The need for educating consumers about such harms is growing as different tobacco products enter the marketplace and as the FDA moves to regulate and educate the public about different products. However, little is known about the patterns of the public's knowledge of relative harms. Data were analyzed from the Health Information National Trends Survey (HINTS) 4 Cycle 2, a population-representative survey of US adults conducted between October 2012 and January 2013 (N = 3630). Participants reported their perceptions of the relative risks of e-cigarettes, smokeless tobacco, and different types of cigarettes compared to "traditional" cigarettes. Relative risk perceptions for each product type, as well as the consistency and accuracy of harm reduction beliefs, were analyzed. About 65% of the respondents accurately reported that no cigarettes were less harmful than any others. Slightly more than half of U.S. adults perceived e-cigarettes to be safer than regular cigarettes, a belief in line with current scientific evidence. By contrast, only 9% of respondents perceived some smokeless tobacco products to be safer, a belief strongly supported by the evidence. Only 3.5% of respondents had patterns of relative risk perceptions in line with current scientific evidence for all three modalities. The discrepancy between current evidence and public perceptions of relative risk of various tobacco/nicotine products was marked; for most tobacco types, a large proportion of the population held inaccurate harm reduction beliefs. Although there was substantial awareness that no cigarettes were safer than any other cigarettes, there could be benefits from increasing the percentage of the public that appreciates this fact, especially among current smokers. Given the potential benefits of tobacco risk reduction strategies, public health education efforts to increase understanding of basic harm reduction principles are needed to address these misperceptions.

Nicotine and Toxicant Exposure Among US Smokeless Tobacco Users: Results from 1999-2012 National Health and Nutrition Examination Survey Data

PubMed Central

Rostron, Brian L.; Chang, Cindy M.; van Bemmel, Dana M.; Xia, Yang; Blount, Benjamin C.

2016-01-01

Background It has been suggested that smokeless tobacco users have high levels of exposure to nicotine and some toxic substances as measured by biomarker concentrations, but studies with nationally representative data have been limited. Methods We analyzed biomarkers of tobacco exposure for 23,684 adult participants from the National Health and Nutrition and Examination Survey (NHANES) from 1999-2012. The biomarkers analyzed were serum cotinine, urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), blood lead, blood cadmium, blood mercury, urinary arsenic, and urinary N-acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA). We calculated geometric mean concentrations for each biomarker by tobacco use category (exclusive smokeless tobacco use, exclusive cigarette smoking, dual cigarette and smokeless tobacco use, and non-cigarette and smokeless tobacco use) and geometric mean ratios adjusting for demographic factors. Results Exclusive smokeless tobacco users had higher geometric mean concentrations of cotinine (178.9 ng/mL, 95% CI = 145.5, 220.0) and NNAL (583.0 pg/mg creatinine, 95% CI = 445.2, 763.5) than exclusive cigarette smokers, (130.6 ng/mL, 95% CI = 122.3, 139.6 and 217.6 pg/mg creatinine, 95% CI = 193.0, 245.2, respectively). Smokeless tobacco users also had higher concentrations of blood lead compared with non-tobacco users (adjusted geometric mean ratio = 1.30, 95% CI = 1.21, 1.38). Differences in concentrations of cadmium, mercury, and CYMA between smokeless tobacco users and non-tobacco users were not observed. Based on limited sample sizes, NNAL concentrations for smokeless tobacco users appear to have declined from 2007-2008 (geometric mean = 1013.7 pg/mg creatinine, 95% CI = 738.9, 1390.8) to 2011-2012 (geometric mean = 325.7 pg/mg creatinine, 95% CI = 159.6, 664.9). Conclusions Smokeless tobacco users have higher observed levels of exposure to nicotine and carcinogenic tobacco-specific nitrosamines, as measured by cotinine and NNAL biomarker concentrations, than cigarette smokers. Impact High levels of exposure to known harmful constituents for smokeless tobacco users is a cause of concern for individual and public health. PMID:26582044

Association between use of flavoured tobacco products and quit behaviours: findings from a cross-sectional survey of US adult tobacco users.

PubMed

Smith, Danielle M; Bansal-Travers, Maansi; Huang, Jidong; Barker, Dianne; Hyland, Andrew J; Chaloupka, Frank

2016-11-01

Non-menthol characterising flavours (eg, fruit, candy) are banned in cigarettes, yet are still permitted in non-cigarette tobacco (NCT) products. This study examined associations between first use and current use of flavoured tobacco products, and current flavoured tobacco use and quit behaviours. A nationally representative, telephone-based survey completed in 2012 by 1443 US adult tobacco users asked about use of 9 tobacco products: cigarettes, e-cigarettes, cigars, cigarillos, little filtered cigars, pipes, hookah, smokeless tobacco and snus. Ever users reported first use of flavoured products, while current users also reported current flavoured product use. Current users reported quit attempts made in the past year. Data were weighted to reflect the US adult tobacco user population. Logistic regression models were used to examine associations between first/current flavour use and quit behaviours. Over 70% of respondents reported first use of a flavoured tobacco product, while 54% reported current use of at least one flavoured product. Odds of current flavoured product use were greater among those who reported first use of a flavoured product (OR 14.82, 95% CI 9.96 to 22.06). First use of a flavoured product was associated with being a current tobacco user (OR 1.55, 95% CI 1.08 to 2.22). Compared to single product users, polytobacco users exhibited greater odds of reporting current use of flavoured products (OR 2.09, 95% CI 1.47 to 2.97). Forty-four percent of current tobacco users reported a past-year quit attempt. Adjusted analyses among current NCT users of at least one flavoured tobacco product showed reduced odds of reporting a quit attempt. First use of a flavoured tobacco product was associated with current flavoured tobacco use and polytobacco use. Users of only flavoured NCT products exhibited reduced odds of reporting a quit attempt. Findings from this study reinforce the importance of flavoured product availability in the USA, which may have significant implications for efforts to reduce tobacco initiation and use at a population level. The relationship between characterising flavours and quit behaviours merits further exploration in longitudinal, population-based samples. 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/.

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.

PubMed

Emory, Kristen; Buchting, Francisco O; Trinidad, Dennis R; Vera, Lisa; Emery, Sherry L

2018-03-12

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 (p<0.05). LGBT more frequently reported exposure to, searching for, or sharing messages related to tobacco couponing, e-cigarettes, and anti-tobacco on new or social media (e.g. Twitter, Facebook, 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.

Trends in the Prevalence of Tobacco, Alcohol, and Illegal Drug Use on School Property. National YRBS: 1991-2011

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2011

2011-01-01

The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

A cross-country comparison of secondhand smoke exposure among adults: findings from the Global Adult Tobacco Survey (GATS).

PubMed

King, Brian A; Mirza, Sara A; Babb, Stephen D

2013-07-01

Exposure to secondhand smoke (SHS) from burning tobacco products causes disease and premature death among non-smoking adults and children. The objective of this study was to determine the nature, extent and demographic correlates of SHS exposure among adults in low- and middle-income countries with a high burden of tobacco use. Data were obtained from the Global Adult Tobacco Survey (GATS), a nationally representative household survey of individuals 15 years of age or older. Interviews were conducted during 2008-2010 in Bangladesh, Brazil, China, Egypt, India, Mexico, the Philippines, Poland, Russia, Thailand, Turkey, Ukraine, Uruguay and Vietnam. Descriptive statistics were used to determine the prevalence and correlates of SHS exposure in homes, workplaces, government buildings, restaurants, public transportation and healthcare facilities. Exposure to SHS in the home ranged from 17.3% (Mexico) to 73.1% (Vietnam). Among those who work in an indoor area outside the home, SHS exposure in the workplace ranged from 16.5% (Uruguay) to 63.3% (China). Exposure to SHS ranged from 6.9% (Uruguay) to 72.7% (Egypt) in government buildings, 4.4% (Uruguay) to 88.5% (China) in restaurants, 5.4% (Uruguay) to 79.6% (Egypt) on public transportation, and 3.8% (Uruguay) to 49.2% (Egypt) in healthcare facilities. A large proportion of adults living in low- and middle-income countries are exposed to SHS in their homes, workplaces, and other public places. Countries can enact and enforce legislation requiring 100% smoke-free public places and workplaces, and can also conduct educational initiatives to reduce SHS exposure in homes.

Flavored Tobacco Product Use in Youth and Adults: Findings From the First Wave of the PATH Study (2013-2014).

PubMed

Villanti, Andrea C; Johnson, Amanda L; Ambrose, Bridget K; Cummings, K Michael; Stanton, Cassandra A; Rose, Shyanika W; Feirman, Shari P; Tworek, Cindy; Glasser, Allison M; Pearson, Jennifer L; Cohn, Amy M; Conway, Kevin P; Niaura, Raymond S; Bansal-Travers, Maansi; Hyland, Andrew

2017-08-01

The 2009 Family Smoking Prevention and Tobacco Control Act banned characterizing flavors other than menthol in cigarettes but did not restrict their use in other forms of tobacco (e.g., smokeless, cigars, hookah, e-cigarettes). A cross-sectional analysis of Wave 1 data from 45,971 U.S. adults and youth, aged ≥12 years in the Population Assessment of Tobacco and Health (PATH) Study collected in 2013-2014, was conducted in 2016. This study examined (1) the prevalence and reasons for use of flavored tobacco products; (2) the proportion of ever tobacco users reporting that their first product was flavored; and (3) correlates of current flavored tobacco product use. Current flavored (including menthol) tobacco product use was highest in youth (80%, aged 12-17 years); and young adult tobacco users (73%, aged 18-24 years); and lowest in older adult tobacco users aged ≥65 years (29%). Flavor was a primary reason for using a given tobacco product, particularly among youth. Eighty-one percent of youth and 86% of young adult ever tobacco users reported that their first product was flavored versus 54% of adults aged ≥25 years. In multivariable models, reporting that one's first tobacco product was flavored was associated with a 13% higher prevalence of current tobacco use among youth ever tobacco users and a 32% higher prevalence of current tobacco use among adult ever users. These results add to the evidence base that flavored tobacco products may attract young users and serve as starter products to regular tobacco use. Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.

Influence of Point-of-Sale Tobacco Displays and Graphic Health Warning Signs on Adults: Evidence From a Virtual Store Experimental Study

PubMed Central

Kim, Annice E.; Nonnemaker, James M.; Loomis, Brett R.; Shafer, Paul R.; Shaikh, Asma; Hill, Edward; Holloway, John W.; Farrelly, Matthew C.

2014-01-01

Objectives. We tested the impact of banning tobacco displays and posting graphic health warning signs at the point of sale (POS). Methods. We designed 3 variations of the tobacco product display (open, enclosed [not visible], enclosed with pro-tobacco ads) and 2 variations of the warning sign (present vs absent) with virtual store software. In December 2011 and January 2012, we randomized a national convenience sample of 1216 adult smokers and recent quitters to 1 of 6 store conditions and gave them a shopping task. We tested for the main effects of the enclosed display, the sign, and their interaction on urge to smoke and tobacco purchase attempts. Results. The enclosed display significantly lowered current smokers’ (B = −7.05; 95% confidence interval [CI] = −13.20, −0.91; P < .05) and recent quitters’ (Β = −6.00, 95% CI = −11.00, −1.00; P < .01) urge to smoke and current smokers’ purchase attempts (adjusted odds ratio = 0.06; 95% CI = 0.03, 0.11; P < .01). The warning sign had no significant main effect on study outcomes or interaction with enclosed display. Conclusions. These data show that POS tobacco displays influence purchase behavior. Banning them may reduce cues to smoke and unplanned tobacco purchases. PMID:24625149

Adult recall of tobacco advertising on the Internet.

PubMed

Hrywna, Mary; Delnevo, Cristine D; Lewis, M Jane

2007-11-01

This study examined the prevalence and characteristics of New Jersey adults who reported seeing tobacco products advertised on the Internet and described the means by which these products were advertised. Data were analyzed from the New Jersey Adult Tobacco Survey (NJATS), a repeated, cross-sectional, random-digit-dial telephone survey conducted with a statewide representative sample. We used logistic regression to determine factors associated with recall of tobacco Internet advertising, adjusting for demographics, smoking behavior variables, and receipt of tobacco industry direct mail. Participants included 3,930 adults who completed the 2001 NJATS, 4,004 adults who completed the 2002 survey, and 3,062 adults who completed the 2005 survey. The proportion of adult Internet users reporting exposure to tobacco product advertising on the Internet has increased each year (6.9% in 2001, 15.6% in 2002, 17.8% in 2005). Based on 2005 data, recall of tobacco product advertising on the Internet was higher among males young adults aged 18-24 years, Asians, adults who reported receipt of direct mail advertising, and adults with a postcollege education. In addition, adult Internet users most often reported seeing tobacco products advertised on the Internet via pop-up or banner ads (60.7%), followed by E-mail messages (24.6%), and Web sites (14.9%). Recall of tobacco advertising by Internet users increased between 2001 and 2005 and was particularly high among certain subgroups. An urgent need exists for expanded surveillance of Internet tobacco sales and marketing practices.

Gender, age, social disadvantage and quitting smoking in Argentina and Uruguay.

PubMed

Niedzin, Mirosław; Gaszyńska, Ewelina; Krakowiak, Jan; Saran, Tomasz; Szatko, Franciszek; Kaleta, Dorota

2018-03-14

Cessation of tobacco use has the potential to provide the greatest immediate benefits for tobacco control. Understanding the social determinants of smoking cessation is an essential requirement for increasing smoking cessation at the population level. The purpose of this study was to analyze the socio-economic dimensions associated with cessation success among adults in Argentina and Uruguay. Data from the Global Adult Tobacco Survey (GATS), a cross-sectional, population-based, nationally representative survey conducted in Argentina (n=5,383) and Uruguay (n=4,833) was utilized. Univariable and multivariable logistic regression analyses with results being presented as odds ratios (OR) with 95% confidence intervals were applied to study differences among those respondents who sustained smoking abstinence (≥1 year) and those who continued smoking. The GATS study revealed that social gradients in tobacco quitting exist in Argentina and Uruguay. Being aged 25-34, particularly men in Uruguay, women in Argentina, low educated men in Argentina and having a lower asset index were associated with reduced odds for quitting. Factors that are driving differences in smoking cessation between diverse social groups in Latin America countries need to be considered when implementing relevant interventions to ensure tobacco control strategies work effectively for all population segments.

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

PubMed

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

2005-06-01

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

Smoke-free rules and secondhand smoke exposure in homes and vehicles among US adults, 2009-2010.

PubMed

King, Brian A; Dube, Shanta R; Homa, David M

2013-05-16

An increasing number of US states and localities have implemented comprehensive policies prohibiting tobacco smoking in all indoor areas of public places and worksites. However, private settings such as homes and vehicles remain a major source of exposure to secondhand smoke (SHS) for many people. This study assessed the prevalence and correlates of voluntary smoke-free rules and SHS exposure in homes and vehicles among US adults. We obtained data from the 2009-2010 National Adult Tobacco Survey, a landline and cellular-telephone survey of adults aged 18 years or older residing in the 50 US states or the District of Columbia. We calculated national and state estimates of smoke-free rules and past-7-day SHS exposure in homes and vehicles and examined national estimates by sex, age, race/ethnicity, and education. The national prevalence of voluntary smoke-free home rules was 81.1% (state range, 67.9%-92.9%), and the prevalence of household smoke-free vehicle rules was 73.6% (state range, 58.6%-85.8%). Among nonsmokers, the prevalence of SHS exposure was 6.0% in homes (state range, 2.4%-13.0%) and 9.2% in vehicles (state range, 4.8%-13.7%). SHS exposure among nonsmokers was greatest among men, younger adults, non-Hispanic blacks, and those with a lower level of education. Most US adults report having voluntary smoke-free home and vehicle rules; however, millions of people remain exposed to SHS in these environments. Disparities in exposure also exist among certain states and subpopulations. Efforts are needed to warn about the dangers of SHS and to promote voluntary smoke-free home and vehicle rules.

Predictors of change on the smoking uptake continuum among adolescents.

PubMed

Kaufman, Nancy J; Castrucci, Brian C; Mowery, Paul D; Gerlach, Karen K; Emont, Seth; Orleans, C Tracy

2002-06-01

Understanding how advertising and other risk and demographic factors affect adolescent susceptibility to smoking would allow for the development of more effective youth-targeted tobacco prevention and cessation programs and policies. To examine the effect of various demographic and risk factors on different stages of smoking among adolescents. A nationally representative cross-sectional survey, The Robert Wood Johnson Foundation's Survey of Tobacco Price Sensitivity, Behavior, and Attitudes Among Teenagers and Young Adults. The Robert Wood Johnson Foundation's Survey of Tobacco Price Sensitivity, Behavior, and Attitudes Among Teenagers and Young Adults included 17,287 adolescent respondents (aged, 13-19 years) in 1996. Stage of susceptibility and correlates of progression toward regular smoking. Of all never [corrected] smoking adolescents, 32% were susceptible smokers (have never smoked, but might) with younger adolescents almost 3 times more likely than older adolescents to be susceptible. Female subjects were 50% [corrected] more likely than male subjects to be susceptible. In addition to exposure to others' smoking, owning or willingness to own tobacco promotional items, having a favorite cigarette advertisement, skipping school, poor school performance, and lack of attendance in religious activities were associated with progression along the uptake continuum. Improved understanding of the tobacco use trajectories of adolescents and the risk factors associated with progression will help clinicians and tobacco control advocates create effective youth-targeted interventions and policies. Findings suggest that physicians and other health care providers should redouble their efforts to ask preadolescents and young adults about smoking or the likelihood of their smoking. Nonsmokers should also be advised about the addictive nature of tobacco products and the resulting loss of control that accompanies addiction.

Non-cigarette tobacco and poly-tobacco use among persons living with HIV drawn from a nationally representative sample*

PubMed Central

Pacek, Lauren R.; Sweitzer, Maggie M.; McClernon, F. Joseph

2016-01-01

Introduction Smoking is more prevalent among persons living with HIV (PLWH) than the general population. Little is known about the prevalence of non-cigarette tobacco and poly-tobacco use (PTU; using multiple tobacco products) among this population, which, in the general population is associated with poor health and cessation outcomes. We aimed to characterize the prevalence of cigarette and non-cigarette tobacco use, PTU, and correlates of tobacco use status among a nationally-representative sample of PLWH. Methods Data came from 472 HIV-positive adults from the 2005-2013 National Survey on Drug Use and Health (NSDUH). Results The prevalence of PTU overall was 8.7% (95% CI=5.6-13.2), and 16.6% (95% CI=10.2-25.7) among past-year tobacco users. In multinomial logistic regression analyses, participants with a high school education or greater (aRRR=2.03, 95% CI=1.03-4.00) were more likely to be non-tobacco users than single product users. Past year drug users (aRRR=0.35, 95% CI=0.19-0.66) and past month binge drinkers (aRRR=0.24, 95% CI=0.12-0.50) were less likely to be non-tobacco users than single product users. Compared to 18-25 year olds, individuals age 26-34 (aRRR=0.13, 95% CI=0.03-0.65) and 35+ (aRRR=0.24, 95% CI=0.09-0.63), and with lifetime anxiety disorder(s) (aRRR=0.18, 95% CI=0.06-0.57) were less likely to be PTUs as compared to single product users. Individuals who reported liking to test themselves by doing risky things were more likely to be PTUs than single product users (aRRR=2.95, 95% CI=1.27-6.84). Conclusions PTU was slightly higher than in the general population, and should be taken into account when developing cessation interventions tailored to tobacco users living with HIV. PMID:27049581

Partnering with education and job and training programs for sustainable tobacco control among Baltimore african american young adults.

PubMed

Smith, Katherine Clegg; Bone, Lee; Clay, Eric A; Owings, Kerry; Thames, Sean; Stillman, Frances

2009-01-01

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.

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

PubMed Central

Hussain, A. K. M. Ghulam; Ruthbah, Ummul H.; Quah, Anne C. K.; Abdullah, Abu S.

2015-01-01

Background 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. Methods 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. Results Between 2009 and 2012, overall tobacco use went down from 42.4% to 36.3%. The decline is more pronounced with respect to smokeless tobacco use than smoking. The prevalence of exclusive cigarette smoking went up from 7.2% to 10.6%; exclusive bidi smoking remained stable at around 2%; while smoking both cigarette and bidi went down from 4.6% to 1.8%; exclusive smokeless tobacco use went down from 20.2% to 16.9%; and both smokeless tobacco use and smoking went down from 8.4% to 5.1%. In general, the prevalence of tobacco use is higher among men, increases from younger to older age groups, and is higher among poorer people. Smoking prevalence is the highest among the slum population, followed by the tribal population, the national population and the border area population, suggesting greater burden of tobacco use among the disadvantaged groups. Conclusions The overall decline in tobacco use can be viewed as a structural shift in the tobacco market in Bangladesh from low value products such as bidi and smokeless tobacco to high value cigarettes, which is expected with the growth in income and purchasing power of the general population. Despite the reduction in overall tobacco use, the male smoking prevalence in Bangladesh is still high at 37%. The world average of daily smoking among men is 31.1%. The Tobacco Control Act 2005 and the Amendment have yet to make a significant impact in curbing tobacco usage in Bangladesh. The findings in this paper further suggest that the tobacco control policies in Bangladesh need to include targeted interventions to restrain the use of particular types of tobacco products among specific demographic and socio-economic groups of the population, such as smoked tobacco among men, smokeless tobacco among women, and both smoked and smokeless tobacco among those living in rural areas, those in low socio-economic status and those belonging to the tribal and the slum population. PMID:26559051

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

PubMed

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

2015-01-01

Smoking and passive smoking are collectively the biggest preventable cause of death in Bangladesh, with major public health burden of morbidity, disability, mortality and community costs. The available studies of tobacco use in Bangladesh, however, do not necessarily employ nationally representative samples needed to monitor the problem at a national scale. This paper examines the prevalence and patterns of tobacco use among adults in Bangladesh and the changes over time using large nationally representative comparable surveys. Using data from two enumerations of the International Tobacco Control (ITC) Bangladesh Project conducted in 2009 and 2012, prevalence estimates are obtained for all tobacco products by socio-economic determinants and sample types of over 90,000 individuals drawn from over 30,000 households. Household level sample weights are used to obtain nationally representative prevalence estimates and standard errors. Statistical tests of difference in the estimates between two time periods are based on a logistic regression model that accounts for the complex sampling design. Using a multinomial logit model, the time trend in tobacco use status is identified to capture the effects of macro level determinants including changes in tobacco control policies. Between 2009 and 2012, overall tobacco use went down from 42.4% to 36.3%. The decline is more pronounced with respect to smokeless tobacco use than smoking. The prevalence of exclusive cigarette smoking went up from 7.2% to 10.6%; exclusive bidi smoking remained stable at around 2%; while smoking both cigarette and bidi went down from 4.6% to 1.8%; exclusive smokeless tobacco use went down from 20.2% to 16.9%; and both smokeless tobacco use and smoking went down from 8.4% to 5.1%. In general, the prevalence of tobacco use is higher among men, increases from younger to older age groups, and is higher among poorer people. Smoking prevalence is the highest among the slum population, followed by the tribal population, the national population and the border area population, suggesting greater burden of tobacco use among the disadvantaged groups. The overall decline in tobacco use can be viewed as a structural shift in the tobacco market in Bangladesh from low value products such as bidi and smokeless tobacco to high value cigarettes, which is expected with the growth in income and purchasing power of the general population. Despite the reduction in overall tobacco use, the male smoking prevalence in Bangladesh is still high at 37%. The world average of daily smoking among men is 31.1%. The Tobacco Control Act 2005 and the Amendment have yet to make a significant impact in curbing tobacco usage in Bangladesh. The findings in this paper further suggest that the tobacco control policies in Bangladesh need to include targeted interventions to restrain the use of particular types of tobacco products among specific demographic and socio-economic groups of the population, such as smoked tobacco among men, smokeless tobacco among women, and both smoked and smokeless tobacco among those living in rural areas, those in low socio-economic status and those belonging to the tribal and the slum population.

Surveillance of moist snuff: total nicotine, moisture, pH, un-ionized nicotine, and tobacco-specific nitrosamines.

PubMed

Richter, Patricia; Hodge, Knachelle; Stanfill, Stephen; Zhang, Liqin; Watson, Clifford

2008-11-01

In 2005, approximately 2.3% of U.S. adults used smokeless tobacco. Moist snuff leads all types of smokeless tobacco in revenues and marketing expenditures. The U.S. Surgeon General has concluded that smokeless tobacco use can lead to nicotine addiction. The National Toxicology Program of the National Institutes of Health has classified smokeless tobacco as a human carcinogen. Tobacco-specific nitrosamines (TSNAs) are potent carcinogens in smokeless tobacco products, and the pH of the product influences the content of un-ionized nicotine which is the form of nicotine most rapidly absorbed in the mouth. The Centers for Disease Control and Prevention analyzed 40 top-selling brands of moist snuff to measure nicotine, moisture, pH, un-ionized nicotine, and TSNAs, including 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL). The study findings indicate that moist snuff brands varied widely in content of rapidly absorbed, addictive un-ionized nicotine (500-fold range) and of carcinogenic TSNAs (18-fold range). Product characteristics such as packaging and moisture content appeared to be correlated with concentrations of un-ionized nicotine, and flavor characteristics of low-priced brands may correlate with TSNA concentrations. These findings warrant further study in light of (a) the marketing of smokeless tobacco for use in places where smoking is prohibited, (b) the promotion of smokeless tobacco as a harm-reduction product, and (c) the ever-expanding number of highly flavored smokeless varieties brought to the market.

Tobacco industry direct mail receipt and coupon use among young adult smokers.

PubMed

Jane Lewis, M; Bover Manderski, Michelle T; Delnevo, Cristine D

2015-02-01

To examine young adult smokers' receipt of tobacco industry direct mail and use of coupons to purchase cigarettes. A total of 699 young adults from a 2011 national survey who reported smoking every day/some days provided self-report data on past-six month receipt of direct mail and past-six month use of coupons to purchase cigarettes. Multivariable logistic regression models were used to calculate adjusted odds of direct mail receipt and coupon use. Overall, 25.1% of young adult smokers reported receiving direct mail from a tobacco company and 24.2% had used a coupon to buy cigarettes in the past 6 months. Direct mail receipt and coupon use to purchase cigarettes were significantly higher among females, daily smokers, and whites. Nearly 70% of smokers who received direct mail had also used a coupon to purchase cigarettes in the preceding 6 months. Brand websites were the most commonly reported means of joining a direct mailing list. This study adds to limited research showing receipt of direct mail and use of price reducing coupons by young adults. Also, higher rates of direct mail receipt and coupon use among females suggest that these strategies may be especially effective in encouraging smoking in females. Copyright © 2014 Elsevier Inc. All rights reserved.

Indicators of dependence for different types of tobacco product users: Descriptive findings from Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) study.

PubMed

Strong, David R; Pearson, Jennifer; Ehlke, Sarah; Kirchner, Thomas; Abrams, David; Taylor, Kristie; Compton, Wilson M; Conway, Kevin P; Lambert, Elizabeth; Green, Victoria R; Hull, Lynn C; Evans, Sarah E; Cummings, K Michael; Goniewicz, Maciej; Hyland, Andrew; Niaura, Raymond

2017-09-01

With no established standard for assessing tobacco dependence (TD) across tobacco products in surveys, the Population Assessment of Tobacco and Health (PATH) Study provides a unique platform for examining the psychometric properties and validity of multiple indicators of tobacco dependence across a range of tobacco products. A U.S. nationally representative sample from the 32,320 adult Wave 1 interviews with analyses focused on 14,287 respondents who were current established users of tobacco products. This analysis confirms a single primary latent construct underlying responses to TD indicators for cigarettes, e-cigarettes, cigars, hookah, and smokeless tobacco products. Mutually exclusive past year tobacco-user groups included: cigarette only (n=8689), e-cigarette only (n=437), cigar only (traditional, cigarillo, or filtered) (n=706), hookah only (n=461), smokeless tobacco only (n=971), cigarette plus e-cigarette (n=709), and multiple tobacco product users (n=2314). Differential Item Functioning (DIF) analyses supported use of 16 of the 24 examined TD indicators for comparisons across tobacco users. With cigarette users as a reference (mean=0.0, SD=1.0), we observed a range of TD with hookah (mean=-1.71) and cigar (mean=-1.92) only users being the lowest, and cigarette plus e-cigarette product users being the highest (mean=0.35). Regression models including sociodemographic factors supported concurrent validity with increased product use frequency and TD among cigarette-only (p<0.001), e-cigarette only (p<0.002), cigar (p<0.001), hookah only (p<0.001), and smokeless tobacco users (p<0.001). The PATH Study Adult Wave 1 Questionnaire provided psychometrically valid measures of TD that enables future regulatory investigations of nicotine dependence across tobacco products. Copyright © 2017 Elsevier B.V. All rights reserved.

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

PubMed

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

2006-06-01

The aim of the programme was to ultimately affect public health practice and policy in the Kingdom of Cambodia and Lao People's Democratic Republic (Lao PDR) by training key health professionals to conduct tobacco control research. Encouraged by the World Health Organization's Framework Convention on Tobacco Control, a global partnership formed to build effective leadership to develop and guide national tobacco control agendas. The partners were the Ministries of Health (Cambodia and Lao PDR), non-government organisations (Adventist Development and Relief Agency in Cambodia and Laos) and an academic institution (Loma Linda University, Loma Linda, California, USA). 16 health professionals, 10 from Cambodia and 6 from Lao PDR, were selected by local advisory committees to enter a two-year, intensive tobacco research graduate certificate and research training programme. We developed a "Global Tobacco Control Methods" (GTCM) 28 unit certificate programme that was offered in five sessions from September 2003 to September 2005 at the National Institute of Public Health, Phnom Penh, Cambodia. As part of their coursework, the 16 trainees actively participated in the development and implementation of two research projects. In the first project, "Healthy Doc Healthy Patient" (HDHP), trainees adapted an existing, self-administered questionnaire designed to assess health practices and beliefs of medical students in Cambodia and Lao PDR. The second project involved the design of a national prevalence of tobacco use and health beliefs study in Cambodia using a multi-stage, cluster sample method. Trainees were sponsored to attend and present at international tobacco control conferences to enhance their awareness of the tobacco epidemic. As of September 2005, 14 trainees (8 from Cambodia and 6 from Lao PDR) completed the courses in the GTCM certificate programme. The HDHP study sampled four medical school classes (years 3, 4, 5 and 6) in both Cambodia (n = 330, 71.1% response rate) and Lao PDR (n = 386, 87.3% response rate). As part of the Cambodian adult tobacco prevalence study in Cambodia, 13,988 adults (ages > or = 18 years) were interviewed from all 22 provinces during the summer of 2005. Over the two years, more than half of the trainees participated substantially in local and regional tobacco control and research activities. Programme challenges included the trainees' limited English language and computer proficiency skills, both of which improved during the two years. With the successful completion of the certificate programme, the remaining two years of the grant will be used to prepare the trainees for positions of leadership within their Ministries of Health and other agencies to implement effective tobacco control policies based on locally-derived research findings.

Affect, risk perception, and the use of cigarettes and e-cigarettes: a population study of U.S. adults.

PubMed

Popova, Lucy; Owusu, Daniel; Weaver, Scott R; Kemp, Catherine B; Mertz, C K; Pechacek, Terry F; Slovic, Paul

2018-03-22

Tobacco companies argue that the decision to smoke is made by well-informed rational adults who have considered all the risks and benefits of smoking. Yet in promoting their products, the tobacco industry frequently relies on affect, portraying their products as part of a desirable lifestyle. Research examining the roles of affect and perceived risks in smoking has been scant and non-existent for novel tobacco products, such as electronic cigarettes (e-cigarettes). We examined the relationship between affect, perceived risk, and current use for cigarettes and e-cigarettes in 2015 in a nationally representative sample of 5398 U.S. adults who were aware of e-cigarettes. Participants held various affective associations with tobacco products, and affect towards cigarettes was more negative than affect towards e-cigarettes. Using structural equation modeling (SEM), affect towards cigarettes and e-cigarettes was associated with cigarette smoking and e-cigarette use respectively, and these associations were both direct and partially mediated by risk perceptions towards smoking and e-cigarette use. More positive affect towards cigarettes or e-cigarettes was associated with lower perceived risks, which in turn was associated with higher odds of being a current cigarette or e-cigarette user. In developing models explaining tobacco use behavior, or in creating public communication campaigns aimed at curbing tobacco use, it is useful to focus not only on the reason based predictors, such as perceptions of risks and benefits, but also on affective predictors. Educational efforts aimed at further smoking reductions should highlight and reinforce negative images and associations with cigarettes.

Monitoring the Future: National Survey Results on Drug Use, 1975-2009. Volume I: Secondary School Students. NIH Publication No. 10-7584

ERIC Educational Resources Information Center

Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.; Schulenberg, John E.

2010-01-01

The Monitoring the Future (MTF) study is an ongoing series of national surveys of American adolescents and adults that has provided the nation with a vital window into the important, but largely hidden, problem behaviors of illegal drug use, alcohol use, tobacco use, anabolic steroid use, and psychotherapeutic drug use. For more than a third of…

Monitoring the Future. National Survey Results on Drug Use, 1975-2009. Volume I, Secondary School Students. NIH Publication Number 10-7584

ERIC Educational Resources Information Center

Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.; Schulenberg, John E.

2010-01-01

The Monitoring the Future (MTF) study is an ongoing series of national surveys of American adolescents and adults that has provided the nation with a vital window into the important, but largely hidden, problem behaviors of illegal drug use, alcohol use, tobacco use, anabolic steroid use, and psychotherapeutic drug use. For more than a third of a…

Characteristics of smoker support for increasing a dedicated tobacco tax: national survey data from New Zealand.

PubMed

Wilson, Nick; Weerasekera, Deepa; Edwards, Richard; Thomson, George; Devlin, Miranda; Gifford, Heather

2010-02-01

To examine smoker support for tobacco tax and for increased dedicated tobacco taxes, along with associations forany such support. The New Zealand (NZ) arm of the International Tobacco Control Policy Evaluation Survey utilizes the NZ Health Survey (a national sample). From this sample, we surveyed adult smokers (N = 1,376). Most smokers considered that the current level of tobacco tax is "too high" (68%), but a majority (59%) would support an increase in tobacco tax if the extra revenue was used to promote healthy lifestyles and support quitting. There was majority support for a dedicated tobacco tax increase among all sociodemographic groups of smokers (including Māori, Pacific, and Asian smokers). In the fully adjusted multivariate model, significant associations with support for a dedicated tax increase included higher deprivation level (adjusted odds ratio [AOR] = 1.15) and suffering one form of financial stress (AOR = 1.81, 95% CI = 1.18-2.78). Other significant associations with support included concern about the smoking impacts on health and quality of life (AOR = 1.41), expressing support for tobacco control regulation (AOR = 1.83), and strength of intention to quit (AOR = 1.30). A majority of smokers from all sociodemographic groups supported an increase in tobacco tax if it was dedicated to quitting support and health promotion. The higher support among smokers with stronger intentions to quit is consistent with other evidence that smokers value tobacco control regulation such as high taxes to help them achieve their long-term quitting goals.

Support for Marijuana Legalization and Predictors of Intentions to Use Marijuana More Often in Response to Legalization Among U.S. Young Adults.

PubMed

Cohn, Amy M; Johnson, Amanda L; Rose, Shyanika W; Rath, Jessica M; Villanti, Andrea C

2017-01-28

As of 2015, more than half of U.S. states have legalized, medicalized, or decriminalized marijuana. This study examined the prevalence and correlates of support for marijuana legalization in a national sample of young adults and the intention to use marijuana more frequently if it were legalized. Data were from Wave 7 (weighted N = 3532) of the Truth Initiative Young Adult Cohort, a national sample of men and women aged 18-34. We assessed demographics, past 30-day substance (alcohol, tobacco, marijuana, other drug use), depression and anxiety, social smoking, marijuana harm perceptions (relative to cigarettes), and state-level marijuana policies as correlates of support for marijuana legalization and intentions to use marijuana more often if it were legalized. Multivariable models of correlates of support for legalization and intentions to use marijuana were conducted separately for the full sample and for nonmarijuana users. Weighted estimates showed that 39% of the full sample and 9% of nonmarijuana users supported marijuana legalization. Multivariable models showed that lower marijuana harm perceptions and lifetime and past 30-day tobacco use were common predictors of support for marijuana legalization and intentions to use marijuana among non-users of marijuana. Conclusions/Importance: Over a third of the sample supported marijuana legalization. Tobacco use and perceptions that marijuana is less harmful than cigarettes were robust risk correlates of support for marijuana legalization and intentions to use more frequently among nonusers. Public health campaigns should target these factors to deter marijuana-related harm in susceptible young adults.

Predictors of long-term smoking cessation: results from the global adult tobacco survey in Poland (2009–2010)

PubMed Central

2012-01-01

Background Expanding the information on determinants of smoking cessation is crucial for developing and implementing more effective tobacco control measures at the national as well as European levels. Data on smoking cessation and its social correlates among adults from middle-income countries of Central and Eastern Europe are still poorly reported in the literature. The aim of the study was to analyze the association of socio-demographic indicators with long term tobacco smoking cessation (quit smoking for at least one year prior to interview) among adults. Moreover, we evaluated motives for giving up smoking from former smokers. Methods Data on former as well as current smokers’ socio-demographic and smoking-related characteristics were derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Poland between 2009 and 2010. GATS collected data on a representative sample of 7,840 individuals including 1,206 individuals who met the criteria of long-term smoking cessation and 2,233 current smokers. Smoking cessation rate was calculated as the number of former smokers divided by the number of ever smokers. Logistic regression analyses were used to obtain odds ratios (ORs) and 95% confidence interval (CI) of the broad number of variables on successful cessation of smoking. Results Among females the quit rate was 30.4% compared to 37.9% in males (p < 0.01). Former smokers declared concerns about the health hazard of smoking (60.8%) and the high price of cigarettes (11.6%) as primary reasons for smoking cessation. Older age, high education attainment, awareness of smoking health consequences was associated with long-term quitting among both genders. Also employed males had over twice the probability of giving up smoking compared with unemployed, and being religious did not contribute to successful smoking cessation. Conclusion Results indicated that smoking cessation policies focused on younger age groups are vital for curbing tobacco epidemic in Poland and should become a public health main concern. There is also the need for interventions to raise awareness on smoking health risks and quitting benefits are crucial to increase cessation potential among adult smokers. Nevertheless further effort needs to be done to prevent smoking uptake. PMID:23173904

Predictors of long-term smoking cessation: results from the global adult tobacco survey in Poland (2009-2010).

PubMed

Kaleta, Dorota; Korytkowski, Przemysław; Makowiec-Dąbrowska, Teresa; Usidame, Bukola; Bąk-Romaniszyn, Leokadia; Fronczak, Adam

2012-11-22

Expanding the information on determinants of smoking cessation is crucial for developing and implementing more effective tobacco control measures at the national as well as European levels. Data on smoking cessation and its social correlates among adults from middle-income countries of Central and Eastern Europe are still poorly reported in the literature. The aim of the study was to analyze the association of socio-demographic indicators with long term tobacco smoking cessation (quit smoking for at least one year prior to interview) among adults. Moreover, we evaluated motives for giving up smoking from former smokers. Data on former as well as current smokers' socio-demographic and smoking-related characteristics were derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Poland between 2009 and 2010. GATS collected data on a representative sample of 7,840 individuals including 1,206 individuals who met the criteria of long-term smoking cessation and 2,233 current smokers. Smoking cessation rate was calculated as the number of former smokers divided by the number of ever smokers. Logistic regression analyses were used to obtain odds ratios (ORs) and 95% confidence interval (CI) of the broad number of variables on successful cessation of smoking. Among females the quit rate was 30.4% compared to 37.9% in males (p < 0.01). Former smokers declared concerns about the health hazard of smoking (60.8%) and the high price of cigarettes (11.6%) as primary reasons for smoking cessation. Older age, high education attainment, awareness of smoking health consequences was associated with long-term quitting among both genders. Also employed males had over twice the probability of giving up smoking compared with unemployed, and being religious did not contribute to successful smoking cessation. Results indicated that smoking cessation policies focused on younger age groups are vital for curbing tobacco epidemic in Poland and should become a public health main concern. There is also the need for interventions to raise awareness on smoking health risks and quitting benefits are crucial to increase cessation potential among adult smokers. Nevertheless further effort needs to be done to prevent smoking uptake.

Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys.

PubMed

Giovino, Gary A; Mirza, Sara A; Samet, Jonathan M; Gupta, Prakash C; Jarvis, Martin J; Bhala, Neeraj; Peto, Richard; Zatonski, Witold; Hsia, Jason; Morton, Jeremy; Palipudi, Krishna M; Asma, Samira

2012-08-18

Despite the high global burden of diseases caused by tobacco, valid and comparable prevalence data for patterns of adult tobacco use and factors influencing use are absent for many low-income and middle-income countries. We assess these patterns through analysis of data from the Global Adult Tobacco Survey (GATS). Between Oct 1, 2008, and March 15, 2010, GATS used nationally representative household surveys with comparable methods to obtain relevant information from individuals aged 15 years or older in 14 low-income and middle-income countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Poland, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam). We compared weighted point estimates and 95% CIs of tobacco use between these 14 countries and with data from the 2008 UK General Lifestyle Survey and the 2006-07 US Tobacco Use Supplement to the Current Population Survey. All these surveys had cross-sectional study designs. In countries participating in GATS, 48·6% (95% CI 47·6-49·6) of men and 11·3% (10·7-12·0) of women were tobacco users. 40·7% of men (ranging from 21·6% in Brazil to 60·2% in Russia) and 5·0% of women (0·5% in Egypt to 24·4% in Poland) in GATS countries smoked a tobacco product. Manufactured cigarettes were favoured by most smokers (82%) overall, but smokeless tobacco and bidis were commonly used in India and Bangladesh. For individuals who had ever smoked daily, women aged 55-64 years at the time of the survey began smoking at an older age than did equivalently aged men in most GATS countries. However, those individuals who had ever smoked daily and were aged 25-34-years when surveyed started to do so at much the same age in both sexes. Quit ratios were very low (<20% overall) in China, India, Russia, Egypt, and Bangladesh. The first wave of GATS showed high rates of smoking in men, early initiation of smoking in women, and low quit ratios, reinforcing the view that efforts to prevent initiation and promote cessation of tobacco use are needed to reduce associated morbidity and mortality. Bloomberg Philanthropies' Initiative to Reduce Tobacco Use, Bill and Melinda Gates Foundation, Brazilian and Indian Governments. Copyright © 2012 Elsevier Ltd. All rights reserved.

Why and How the Tobacco Industry Sells Cigarettes to Young Adults: Evidence From Industry Documents

PubMed Central

Ling, Pamela M.; Glantz, Stanton A.

2002-01-01

Objectives. To improve tobacco control campaigns, we analyzed tobacco industry strategies that encourage young adults (aged 18 to 24) to smoke. Methods. Initial searches of tobacco industry documents with keywords (e.g., “young adult”) were extended by using names, locations, and dates. Results. Approximately 200 relevant documents were found. Transitions from experimentation to addiction, with adult levels of cigarette consumption, may take years. Tobacco marketing solidifies addiction among young adults. Cigarette advertisements encourage regular smoking and increased consumption by integrating smoking into activities and places where young adults' lives change (e.g., leaving home, college, jobs, the military, bars). Conclusions. Tobacco control efforts should include both adults and youths. Life changes are also opportunities to stop occasional smokers' progress to addiction. Clean air policies in workplaces, the military, bars, colleges, and homes can combat tobacco marketing. (Am J Public Health. 2002;92:908–916) PMID:12036776

Factors Associated With Exposure to Antismoking Information Among Adults in Vietnam, Global Adult Tobacco Survey, 2010

PubMed Central

Giang, Kim Bao; Nga, Pham Quynh; Hai, Phan Thi; Quan, Nguyen The; Tong, Van T.; Xuan, Le Thi Thanh; Hsia, Jason

2013-01-01

Introduction The media play a critical role in tobacco control. Knowledge about the exposure of a population to antismoking information can provide information for planning communication activities in tobacco control. We examined exposure to antismoking information associated with socioeconomic and demographic factors among adults (≥15 years) in Vietnam. Methods The Global Adult Tobacco Survey (GATS) is a nationally representative household survey of noninstitutionalized men and women aged 15 years or older and was conducted in Vietnam in 2010 (N = 9,925). We used GATS data on exposure to sources of antismoking information and analyzed associations among socioeconomic and demographic groups. Results An estimated 91.6% of the adult population was exposed to at least 1 source of antismoking information, and the mean number of sources of exposure was 3.7. Compared with their counterparts, respondents who were older, had higher education levels, higher economic status, and higher knowledge levels about the health consequences of smoking were more likely to be exposed to any source of antismoking information and to more informational sources. The most common source of exposure was television (85.9%). Respondents of higher social class (education, occupation, wealth) had more exposure through modern media sources (television), and respondents of lower social class were exposed to more traditional sources such as radio or loudspeakers. Conclusion Exposure to at least 1 source of antismoking information is high in Vietnam, and the number and type of source varied by sociodemographic group. Use of multiple communication channels is recommended to reinforce antismoking messages and to reach different groups in the population. PMID:24028833

From the American Academy of Pediatrics: Policy statement--Tobacco use: a pediatric disease.

PubMed

2009-11-01

Tobacco use and secondhand tobacco-smoke (SHS) exposure are major national and international health concerns. Pediatricians and other clinicians who care for children are uniquely positioned to assist patients and families with tobacco-use prevention and treatment. Understanding the nature and extent of tobacco use and SHS exposure is an essential first step toward the goal of eliminating tobacco use and its consequences in the pediatric population. The next steps include counseling patients and family members to avoid SHS exposures or cease tobacco use; advocacy for policies that protect children from SHS exposure; and elimination of tobacco use in the media, public places, and homes. Three overarching principles of this policy can be identified: (1) there is no safe way to use tobacco; (2) there is no safe level or duration of exposure to SHS; and (3) the financial and political power of individuals, organizations, and government should be used to support tobacco control. Pediatricians are advised not to smoke or use tobacco; to make their homes, cars, and workplaces tobacco free; to consider tobacco control when making personal and professional decisions; to support and advocate for comprehensive tobacco control; and to advise parents and patients not to start using tobacco or to quit if they are already using tobacco. Prohibiting both tobacco advertising and the use of tobacco products in the media is recommended. Recommendations for eliminating SHS exposure and reducing tobacco use include attaining universal (1) smoke-free home, car, school, work, and play environments, both inside and outside, (2) treatment of tobacco use and dependence through employer, insurance, state, and federal supports, (3) implementation and enforcement of evidence-based tobacco-control measures in local, state, national, and international jurisdictions, and (4) financial and systems support for training in and research of effective ways to prevent and treat tobacco use and SHS exposure. Pediatricians, their staff and colleagues, and the American Academy of Pediatrics have key responsibilities in tobacco control to promote the health of children, adolescents, and young adults.

Tobacco use transitions in the United States: The National Longitudinal Study of Adolescent Health

PubMed Central

Kaufman, Annette R.; Land, Stephanie; Parascandola, Mark; Augustson, Erik; Backinger, Cathy L.

2015-01-01

Objectives The purpose of this study is to evaluate and describe transitions in cigarette and smokeless tobacco (ST) use, including dual use, prospectively from adolescence into young adulthood. Methods The current study utilizes four waves of the National Longitudinal Study of Adolescent Health (Add Health) to examine patterns of cigarette and ST use (within 30 days of survey) over time among a cohort in the United States beginning in 7th–12th grade (1995) into young adulthood (2008–2009). Transition probabilities were estimated using Markov modeling. Results Among the cohort (N = 20,774), 48.7% reported using cigarettes, 12.8% reported using ST, and 7.2% reported dual use (cigarettes and ST in the same wave) in at least one wave. In general, the risk for transitioning between cigarettes and ST was higher for males and those who were older. Dual users exhibited a high probability (81%) of continuing dual use over time. Conclusions Findings suggest that adolescents who use multiple tobacco products are likely to continue such use as they move into young adulthood. When addressing tobacco use among adolescents and young adults, multiple forms of tobacco use should be considered. PMID:26361752

Public Support for Family Smoking Prevention and Tobacco Control Act Point-of-Sale Provisions: Results of a National Study.

PubMed

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

2015-10-01

We assessed public and smoker support for enacted and potential point-of-sale (POS) tobacco-control policies under the Family Smoking Prevention and Tobacco Control Act. We surveyed a US nationally representative sample of 17, 507 respondents (6595 smokers) in January through February 2013, and used linear regression to calculate weighted point estimates and identify factors associated with support for POS policies among adults and smokers. Overall, nonsmokers were more supportive than were smokers. Regardless of smoking status, African Americans, Hispanics, women, and those of older ages were more supportive than White, male, and younger respondents, respectively. Policy support varied by provision. More than 80% of respondents supported minors' access restrictions and more than 45% supported graphic warnings. Support was lowest for plain packaging (23%), black-and-white advertising (26%), and a ban on menthol cigarettes (36%). Public support for marketing and POS provisions is low relative to other areas of tobacco control. Tobacco-control advocates and the Food and Drug Administration should build on existing levels of public support to promote and maintain evidence-based, but controversial, policy changes in the retail environment.

Public Support for Family Smoking Prevention and Tobacco Control Act Point-of-Sale Provisions: Results of a National Study

PubMed Central

Emery, Sherry L.; Ennett, Susan; McNaughton Reyes, Heath Luz; Scott, John C.; Ribisl, Kurt M.

2015-01-01

Objectives. We assessed public and smoker support for enacted and potential point-of-sale (POS) tobacco-control policies under the Family Smoking Prevention and Tobacco Control Act. Methods. We surveyed a US nationally representative sample of 17 507 respondents (6595 smokers) in January through February 2013, and used linear regression to calculate weighted point estimates and identify factors associated with support for POS policies among adults and smokers. Results. Overall, nonsmokers were more supportive than were smokers. Regardless of smoking status, African Americans, Hispanics, women, and those of older ages were more supportive than White, male, and younger respondents, respectively. Policy support varied by provision. More than 80% of respondents supported minors’ access restrictions and more than 45% supported graphic warnings. Support was lowest for plain packaging (23%), black-and-white advertising (26%), and a ban on menthol cigarettes (36%). Conclusions. Public support for marketing and POS provisions is low relative to other areas of tobacco control. Tobacco-control advocates and the Food and Drug Administration should build on existing levels of public support to promote and maintain evidence-based, but controversial, policy changes in the retail environment. PMID:26270303

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

PubMed

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

2016-01-01

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

Global Adult Tobacco Survey (GATS) in Poland 2009-2010--study strengths, limitations and lessons learned.

PubMed

Kaleta, Dorota; Usidame, Bukola; Biliński, Przemysław; Raciborski, Filip; Samoliński, Bolesław; Wojtyła, Andrzej; Fronczak, Adam

2012-01-01

A tobacco surveillance system is crucial for improving the planning and implementation of effective tobacco control policies. The purpose of the presented study was to describe a review of the process of implementation and methodological assumption of a Global Adult Tobacco Survey (GATS) conducted in Poland. The study strengths and limitations are evaluated, as well as some recommendations given for further tobacco surveillance activities in Poland. The Global Adult Tobacco Survey (GATS) was implemented in Poland between 2008-2010. The survey population selection process was based on a three-stage stratified geographically-clustered sample of a non-institutional population aged 15 years and over. Those who lived in institutions were not surveyed. The GATS questionnaire was very detailed and provides a significant amount of data. The filed work was preceded by several training sessions for all survey staff and the pretest. Questionnaires were administered in respondents' homes during the face-to-face interviews. Of the 14,000 households selected for the survey, 8,948 (63.9%) households and 7,840 (93.9%) sampled individuals completed the interviews. The total survey response rate was 65.1%. GATS was an important step towards obtaining representative, current data on the tobacco epidemic in Poland. Basic results of the study are currently available. More in-depth analysis will provide useful data for public health experts and policymakers to assign resources and establish health priorities. Unfortunately, competing targets and lack of awareness on the part of stakeholders still constrains the financial resources available to those undertaking tobacco control research in Poland. The circumscribed capacity to undertake multidisciplinary policy research limits both the quality and quantity of such studies. There is an urgent need to establish a nationally coordinated plan for surveillance of data collection, use, access and dissemination, with defined institutional roles for each of these functions and the funds dedicated to the research.

Why Have Tobacco Control Policies Stalled? Using Genetic Moderation to Examine Policy Impacts

PubMed Central

Fletcher, Jason M.

2012-01-01

Background Research has shown that tobacco control policies have helped produce the dramatic decline in use over the decades following the 1964 surgeon general’s report. However, prevalence rates have stagnated during the past two decades in the US, even with large tobacco taxes and expansions of clean air laws. The observed differences in tobacco control policy effectiveness and why policies do not help all smokers are largely unexplained. Objective The aim of this study was to determine the importance of genetics in explaining response to tobacco taxation policy by testing the potential of gene-policy interaction in determining adult tobacco use. Methods A moderated regression analysis framework was used to test interactive effects between genotype and tobacco policy in predicting tobacco use. Cross sectional data of US adults from the National Health and Nutrition Examination Survey (NHANES) linked with genotype and geocodes were used to identify tobacco use phenotypes, state-level taxation rates, and variation in the nicotinic acetylcholine receptor (CHRNA6) genotype. Tobacco use phenotypes included current use, number of cigarettes smoked per day, and blood serum cotinine measurements. Results Variation in the nicotinic acetylcholine receptor was found to moderate the influence of tobacco taxation on multiple measures of tobacco use. Individuals with the protective G/G polymorphism (51% of the sample) responded to taxation while others had no response. The estimated differences in response by genotype were C/C genotype: b = −0.016 se  = 0.018; G/C genotype: b = 0.014 se  = 0.017; G/G genotype: b = −0.071 se 0.029. Conclusions This study provides novel evidence of “gene-policy” interaction and suggests a genetic mechanism for the large differences in response to tobacco policies. The inability for these policies to reduce use for individuals with specific genotypes suggests alternative methods may be needed to further reduce use. PMID:23227187

Social determinants of health and tobacco use in thirteen low and middle income countries: evidence from Global Adult Tobacco Survey.

PubMed

Palipudi, Krishna M; Gupta, Prakash C; Sinha, Dhirendra N; Andes, Linda J; Asma, Samira; McAfee, Tim

2012-01-01

Tobacco use has been identified as the single biggest cause of inequality in morbidity. The objective of this study is to examine the role of social determinants on current tobacco use in thirteen low-and-middle income countries. We used nationally representative data from the Global Adult Tobacco Survey (GATS) conducted during 2008-2010 in 13 low-and-middle income countries: Bangladesh, China, Egypt, India, Mexico, Philippines, Poland, Russian Federation, Thailand, Turkey, Ukraine, Uruguay, and Viet Nam. These surveys provided information on 209,027 respondent's aged 15 years and above and the country datasets were analyzed individually for estimating current tobacco use across various socio-demographic factors (gender, age, place of residence, education, wealth index, and knowledge on harmful effects of smoking). Multiple logistic regression analysis was used to predict the impact of these determinants on current tobacco use status. Current tobacco use was defined as current smoking or use of smokeless tobacco, either daily or occasionally. Former smokers were excluded from the analysis. Adjusted odds ratios for current tobacco use after controlling other cofactors, was significantly higher for males across all countries and for urban areas in eight of the 13 countries. For educational level, the trend was significant in Bangladesh, Egypt, India, Philippines and Thailand demonstrating decreasing prevalence of tobacco use with increasing levels of education. For wealth index, the trend of decreasing prevalence of tobacco use with increasing wealth was significant for Bangladesh, India, Philippines, Thailand, Turkey, Ukraine, Uruguay and Viet Nam. The trend of decreasing prevalence with increasing levels of knowledge on harmful effects of smoking was significant in China, India, Philippines, Poland, Russian Federation, Thailand, Ukraine and Viet Nam. These findings demonstrate a significant but varied role of social determinants on current tobacco use within and across countries.

Waterpipe tobacco smoking prevalence among young people in Great Britain, 2013-2016.

PubMed

Jawad, Mohammed; Cheeseman, Hazel; Brose, Leonie S

2018-06-01

One percent of adults in Great Britain use waterpipe tobacco at least monthly, however national epidemiological evidence among young people is absent. This study aims to assess waterpipe tobacco prevalence and correlates among young people in Great Britain. Data were analyzed from online surveys conducted annually from 2013 to 2016 with weighted national samples of 11 to 18-year olds in Great Britain (annual n = 1936-2059). Primary outcome measures were at least monthly waterpipe tobacco use and lifetime waterpipe tobacco use. Binary logistic regression models tested the association between these outcomes and age, sex, country of residence and other tobacco consumption. Between 2013 and 2016, 1.7% (95% CI 1.5-2.1%) used waterpipe tobacco at least monthly and 9.9% (95% CI 9.2-10.7%) used waterpipe in their lifetime. There were no changes in prevalence over time. At least monthly use was associated with older age groups [16-18 years vs. 11-15 years, adjusted odds ratio (AOR) 2.63, 95% CI 1.55-4.46], male sex (AOR 1.82, 95% CI 1.23-2.71) and other tobacco consumption (e.g. lifetime cigarette use AOR 10.30, 95% CI 5.22-20.29). Lifetime use had similar correlates, but was not associated with male sex (AOR 0.97, 95% CI 0.80-1.17). One in 10 young people in Great Britain have tried waterpipe tobacco, though more frequent use appears low. We found no evidence of increasing or decreasing prevalence of waterpipe use between 2013 and 2016. Being male, older and a concurrent user of other tobacco products were correlated with waterpipe tobacco use.

Influence of point-of-sale tobacco displays and plain black and white cigarette packaging and advertisements on adults: Evidence from a virtual store experimental study.

PubMed

Nonnemaker, James; Kim, Annice; Shafer, Paul; Loomis, Brett; Hill, Edward; Holloway, John; Farrelly, Matthew

2016-05-01

We examined the potential impact of banning tobacco displays and mandating plain packaging and cigarette advertisements at the point of sale (POS) on adult outcomes. A virtual convenience store was created with scenarios in which the tobacco product display was either fully visible (status quo) or enclosed behind a cabinet (display ban), and cigarette packs and advertisements were either in full color (status quo) or black and white, text only (plain). A national convenience sample of 1313 adult current smokers and recent quitters was randomized to 1 of 4 conditions and given a shopping task to complete in the virtual store. Main outcomes were participants' self-reported urge to smoke and tobacco purchase attempts in the virtual store. Compared with recent quitters in the status quo conditions, recent quitters in the display ban condition had lower urges to smoke (β=-4.82, 95% CI=-8.16--1.49, p<0.01). Compared with current smokers in the status quo conditions, smokers in the display ban conditions were less likely to attempt to purchase cigarettes in the virtual store (OR=0.05, 95% CI=0.03-0.08, P<0.01). Smokers exposed to plain packs and ads were significantly less likely to attempt to purchase cigarettes (OR=0.31, 95% CI=0.20-0.47, P<0.01) than those exposed to color packs and ads. Policies that ban the display of tobacco products or require plain packaging and advertising at the POS may help reduce adult smoking. Copyright © 2016 Elsevier Ltd. All rights reserved.

Smokeless tobacco use in Myanmar.

PubMed

Kyaing, N N; Sein, T; Sein, A A; Than Htike, M M; Tun, A; Shein, N N N

2012-01-01

Smokeless tobacco (SLT) use in various forms is highly prevalent in Myanmar. The aim of this paper is to study the socio-cultural background of SLT use and products of SLT in Myanmar and the prevalence of SLT based on surveys and from other published data bases. Information was obtained from the literature review and through search on PubMed and Google. The use of SLT is deep rooted in Myanmar culture, and there is also wide-spread belief that it is not as dangerous as smoking. SLT use is growing in Myanmar. About 9.8% of the 13-15-year-old school children and 20.8% adults use SLT; it is many-fold higher among men. The use of SLT is prevalent using many different types of tobacco and forms of its use in Myanmar. The socio-cultural acceptance and the myths were compounded by the lack of specific SLT control component in the National Tobacco Control Legislation adopted needs to be addressed as a priority through intensified community awareness programs, public education programs, and advocacy campaigns. Effective enforcement of the law and amendment to include specific components of SLT in the provisions of the law is highly recommended. The prevalence of SLT is high among school children and adults (especially in men) in Myanmar. Betel quid and tobacco is a common form of SLT use. Although control of smoking and consumption of tobacco product law exists, its implementation is weak.

Tobacco control challenges in East Asia: proposals for change in the world's largest epidemic region

PubMed Central

Katanoda, Kota; Jiang, Yuan; Park, Sohee; Lim, Min Kyung; Qiao, You-Lin; Inoue, Manami

2014-01-01

East Asia is one of the world's largest tobacco epidemic regions. Although several international studies have evaluated the status of tobacco control in this region, the findings have not been integrated with knowledge on domestic activities at the national and municipal levels. We analysed the current tobacco control situation in three East Asian countries, Japan, China and the Republic of Korea, using both international and domestic data sources. We collected data between 2008 and 2011 in each country according to the framework of WHO's MPOWER (Monitoring, Protect, Offer, Warn, Enforcement and Raise) approach for guiding implementation of the WHO Framework Convention on Tobacco Control. Analysis revealed that 37–53% of adult men were current smokers and that smoking prevalence among middle-aged men reached 63%. Less than 20% of male smokers plan to quit and the use of nicotine replacement drugs was 14% at maximum. Forty-six percent or more of men and 20% or more of women were exposed to passive smoking at workplaces and at home, respectively. Many tobacco industry activities remain unrestricted and prevalent. Our findings indicate an urgent need for the following set of policies: raise cigarette prices to increase the quit attempt rate, particularly among adult men; develop a multi-component quitting assistance system to provide adequate assistance for smoking cessation; implement effective smoke-free policies in workplaces and public places to reduce exposure to passive smoking; and rebuild the administrative structure to denormalise tobacco industry activities. The importance of these standard approaches should be reaffirmed by all tobacco control policymakers in East Asia. PMID:23596197

Waterpipe tobacco smoking among sexual minorities in the United States: Evidence from the National Adult Tobacco Survey (2012-2014).

PubMed

Ortiz, Kasim; Mamkherzi, Jamal; Salloum, Ramzi; Matthews, Alicia K; Maziak, Wasim

2017-11-01

The current study examined differences in waterpipe smoking (both lifetime and current) comparing sexual minority populations - those identifying with lesbian, gay, or bisexual identity - to their heterosexual counterparts using a nationally representative dataset. The current study used pooled data from the 2012-2013 & 2013-2014 National Adult Tobacco Survey (NATS). Log-Poisson multivariable regression models were deployed to determine the prevalence of waterpipe smoking behavior among sexual minority individuals controlling for sociodemographic characteristics and stratified by current gender status. In fully-adjusted models assessing lifetime WTS, lesbian/gay and bisexual respondents reported higher prevalence of WTS compared to their heterosexual counterparts. This trend held true in gender-stratified models among gay men [gay men: PR 1.25, 95%CI [1.06, 1.47] and women ([lesbians: PR 1.38, 95%CI [1.12, 1.69] and bisexual women: 1.69, 95%CI [1.45, 1.97]). In fully-adjusted models assessing current WTS, lesbian/gay and bisexual respondents reported higher risk of WTS compared to their heterosexual counterparts. This trend held true in gender-stratified models, only for among gay men [gay men: PR 1.56, 95%CI [1.18, 2.05] and bisexual women: 2.38, 95%CI [1.84, 3.09]). Among the US general adult population, sexual minorities exhibited increased prevalence of current waterpipe smoking compared to their heterosexual counterparts. This pattern is also shaped by gender and variation of sexual orientation identification (e.g., lesbian/gay vs. bisexual). This warrants development of tailored interventions aimed at decreasing waterpipe smoking among sexual minority populations. Copyright © 2017. Published by Elsevier Ltd.

Smokeless tobacco use among American Indian women--southeastern North Carolina, 1991.

PubMed

1995-02-17

Rates of smokeless tobacco use among U.S. adults are highest for young males, American Indians/Alaskan Natives, persons residing in the South or rural areas of the country, and those of low socioeconomic status (1). In addition, the prevalence of smokeless tobacco use has been reported to be high in tobacco-producing regions, including rural North Carolina and Kentucky (2,3). In southeastern North Carolina, reports from physicians and dentists suggested a high prevalence of smokeless tobacco use in the local American Indian population, the Lumbee--particularly among women and children. In response to these reports, the Department of Family and Community Medicine at the Bowman Gray School of Medicine of Wake Forest University analyzed data from a National Cancer Institute-sponsored cervical cancer prevention program to estimate the prevalence of smokeless tobacco use during 1991 among Lumbee women aged > or = 18 years residing in Robeson County, North Carolina (1990 population: 105,179).(ABSTRACT TRUNCATED AT 250 WORDS)

Tracking Young Adults' Attitudes Toward Tobacco Marketing Using Ecological Momentary Assessment (EMA).

PubMed

Roberts, Megan E; Lu, Bo; Browning, Christopher R; Ferketich, Amy K

2017-07-29

Decades of research demonstrate the pernicious effects of targeted cigarette marketing on young people. Now, with tobacco marketing shifting toward greater incorporation of alternative products, it is critical to identify current attitudes toward the new landscape of tobacco advertisements. The purpose of this study was to understand the present landscape of tobacco marketing to which young adults are exposed, and to assess how they respond to it. During 2015-2016, we used ecological momentary assessment (EMA), in which 44 young adults (aged 18-28) carried smartphones equipped with a survey app. Seventy-seven percent were ever-users of tobacco and 29.5% were intermittent users of tobacco (someday users of cigarettes and/or those who used another tobacco product >5 times within the past year). For ten days, participants were prompted at three random times/day to complete a brief survey about their exposures and responses to tobacco-related advertising. Analyses used t-test and multilevel modeling. Intermittent users reported greater exposure than non-intermittent users to tobacco advertising. Further, both intermittent and ever-users reported more positive attitudes toward the tobacco advertising. Of the tobacco advertisements reported, 22% were for products unregulated by the FDA at the time of data collection. Conclusions/Importance: These findings indicate that young adults, and especially young adults who use tobacco, are exposed to a fair amount of tobacco advertising on a weekly basis. As the tobacco users in our sample were largely experimental and occasional users, these marketing exposures could put young adults at risk for progression toward regular use.

Smoking status, knowledge of health effects and attitudes towards tobacco control in South Africa.

PubMed

Reddy, P; Meyer-Weitz, A; Yach, D

1996-11-01

To provide data on the South African adult population's smoking status, their knowledge of the health effects of tobacco and their attitudes towards tobacco control in South Africa. A national representative sample of 2,238 adult (> 18 years) South Africans was surveyed by means of an interviewer-administered questionnaire. Thirty-four per cent of adult South Africans smoke (52% male, 17% female). There were notable differences in gender smoking rates for Indians (61% of men and only 7% of women smoke) and blacks (53% of men and 10% of women smoke) but not for coloureds (58% of men and 59% of women smoke). Provinces with the highest smoking rates are the Northern Cape (55%), Western Cape (48%) and North-West (46%). Forty-eight per cent of respondents reported that at least one household member smoked. The majority of the respondents (87%) acknowledged the harmful effects of direct smoking. Fifty-eight per cent were aware that cancer is associated with smoking but only 36% associated heart disease with smoking. Sixty per cent of the respondents have tried to quit at least once for reasons such as the protection of their own health, the expense of tobacco products and because of a medical doctor's advice. Confusion existed with regard to the effects of the cigarette constituents described on cigarette packages. Forty-two per cent of adults incorrectly indicated that nicotine causes cancer while 28% correctly indicated that it causes addiction, and 44% correctly indicated that condensate causes cancer. There is substantial support for a total ban of tobacco advertising on radio (61%), for local authorities to regulate smoking in public places (78%), for government assistance to farmers for tobacco crop replacement (53%) and for an increase in tobacco excise tax if the money is used for health purposes (50%). The extremely high proportion of both male and female coloured smokers is a cause for concern and requires prompt action. Knowledge of the specific effects of tobacco in respect of active and passive smoking needs to be improved and this could be a first step towards facilitating behaviour change. The public support that exists for stronger measures against tobacco use, promotion, pricing and growing provides many opportunities for health promotion action.

Adult Tobacco Use Levels After Intensive Tobacco Control Measures: New York City, 2002–2003

PubMed Central

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

2005-01-01

Objectives. We sought to determine the impact of comprehensive tobacco control measures in New York City. Methods. In 2002, New York City implemented a tobacco control strategy of (1) increased cigarette excise taxes; (2) legal action that made virtually all work-places, including bars and restaurants, smoke free; (3) increased cessation services, including a large-scale free nicotine-patch program; (4) education; and (5) evaluation. The health department also began annual surveys on a broad array of health measures, including smoking. Results. From 2002 to 2003, smoking prevalence among New York City adults decreased by 11% (from 21.6% to 19.2%, approximately 140000 fewer smokers). Smoking declined among all age groups, race/ethnicities, and education levels; in both genders; among both US-born and foreign-born persons; and in all 5 boroughs. Increased taxation appeared to account for the largest proportion of the decrease; however, between 2002 and 2003 the proportion of cigarettes purchased outside New York City doubled, reducing the effective price increase by a third. Conclusions. Concerted local action can sharply reduce smoking prevalence. However, further progress will require national action, particularly to increase cigarette taxes, reduce cigarette tax evasion, expand education and cessation services, and limit tobacco marketing. PMID:15914827

Behavioral Associations with Waterpipe Tobacco Smoking Dependence among U.S. Young Adults

PubMed Central

Sidani, Jaime E.; Shensa, Ariel; Shiffman, Saul; Switzer, Galen E.; Primack, Brian A.

2015-01-01

Background and Aims Waterpipe tobacco smoking (WTS) is increasingly prevalent in the U.S., especially among young adults. We aimed to (1) adapt items from established dependence measures into a WTS dependence scale for U.S. young adults (the “U.S. Waterpipe Dependence Scale”), (2) determine the factor structure of the items, and (3) assess associations between scale values and behavioral use characteristics known to be linked to dependence. Design Cross-sectional survey. Setting United States. Participants 436 past-year waterpipe tobacco users ages 18 to 30 selected at random from a national probability-based panel. Measurements Participants responded to 6 tobacco dependence items adapted for WTS in U.S. populations. Behavioral use characteristics included factors such as frequency of use and age of initiation. Findings Principal components analysis yielded an unambiguous one-factor solution. About half (52.9%) of past-year waterpipe tobacco users received a score of 0, indicating none of the 6 WTS dependence items were endorsed. About one-quarter (25.4%) endorsed one dependence item, and 22.7% endorsed two or more items). Higher WTS dependence scores were significantly associated with all 5 behavioral use characteristics. For example, compared with those who endorsed no dependence items, those who endorsed 2 or more had an adjusted odds ratio (AOR) of 3.90 (95% CI = 1.56–9.78) for having had earlier age of initiation and an AOR of 32.75 (95% CI = 9.76–109.86) for more frequent WTS sessions. Conclusions Scores on a 6-item waterpipe tobacco smoking dependence scale (the “U.S. Waterpipe Dependence Scale”) correlate with measures that would be expected to be related to dependence, such as amount used and age of initiation. PMID:26417942

Health Conditions and Functional Status in Adults with Autism: A Cross-Sectional Evaluation.

PubMed

Fortuna, Robert J; Robinson, Laura; Smith, Tristram H; Meccarello, Jon; Bullen, Beth; Nobis, Kathryn; Davidson, Philip W

2016-01-01

Children and adolescents with autism spectrum disorder (ASD) have many well-known health concerns, yet health conditions in adults with ASD remain poorly defined. To examine health conditions and functional status in adults with ASD and identify factors associated with health and functional status across age cohorts. We collected cross-sectional data from 255 adult subjects aged 18 to 71 years with ASD using the Rochester Health Status Survey IV (RHSS-IV), a 58-item validated survey instrument. We used the National Health and Nutritional Examination Survey and National Health Interview Survey to provide comparative prevalence rates in the general population. Compared to the general population, young adults aged 18-29 with ASD had a substantially higher prevalence of seizure disorder (11.2 % vs. 1.4 %; p = 0.002), depression (16.4 % vs. 6.4 %; p = 0.007), hypertension (12.9 % vs. 6.3 %; p = 0.05), and allergies (39.7 % vs. 8.4 %; p < 0.001). In contrast, young adults with ASD had considerably lower rates of sexually transmitted illness (STI) (0.9 % vs. 4.3 %; p = 0.03), tobacco use (5.2 % vs. 31.9 %; p < 0.001), and alcohol misuse (0.9 % vs. 11.9 %; p < 0.001). Adults 40 and over with ASD also had higher rates of seizure disorder (29.2 % vs. 1.7 %; p < 0.001), lower tobacco use (2.8 % vs. 24.5 %; p < 0.001), and lower alcohol misuse (1.4 % vs. 18.2 %; p < 0.001) compared to the general population. Amongst the 55 % of participants with a documented IQ score, 91 % had an intellectual disability (IQ < 70). Within the cohort aged 40 years old and older, only 54.2 % were independent with eating, 43.0 % independent with dressing, and 43.1 % independent with bathing. Lower IQ and depression were associated with lower functional status. Adults with ASD have a high prevalence of seizure disorders and depression, but low rates of STIs, tobacco use, and alcohol misuse. Within our cohort, the majority of older adults with ASD required some assistance with activities of daily living.

Is Exposure to Tobacco Advertising, Promotion and Sponsorship Associated with Initiation of Tobacco Use among Current Tobacco Users in Youth in India?

PubMed

Sardana, Mohini; Goel, Sonu; Gupta, Madhu; Sardana, Veera; Singh, B S

2015-01-01

The rise in consumption of tobacco products among youth is a public health concern in India. Several studies have shown that advertisements promoting tobacco products influence decisions and behaviour of youth towards smoking. To ascertain which method of Tobacco Advertising, Promotion and Sponsorship (TAPS) was more influential for initiating tobacco use in youth in India. The secondary data of youth (15-24 years) from nationally representative Global Adult Tobacco Survey (GATS) conducted in 2009-2010 was analyzed. Odds ratio and p-value were used to know the association between TAPS and initiation of use of tobacco products among youth. Logistic regression was used to determine the most significant means of TAPS altering the youth's behaviour towards tobacco products. Out of 13,383 youths, 1,982 (14.7%) used smokeless forms of tobacco and 860 (6.38%) used smoke forms. Logistic regression reveals that promotional activities mainly through cinemas (p<0.05) and providing free samples of tobacco products (p<=.001) were most influential means of initiating consumption of tobacco products among youth. The smoking in youth is associated with watching advertisements particularly in cinema and promotional activities like distribution of free samples, coupons and sales on the price of tobacco products. Stronger legislative measures should be enforced to curb promotional advertisements in cinemas and distribution of free samples.

The effect of taxation on tobacco consumption and public revenues in Lebanon.

PubMed

Salti, Nisreen; Chaaban, Jad; Nakkash, Rima; Alaouie, Hala

2015-01-01

Tobacco consumption rates in Lebanon are among the highest worldwide. The country ratified the Framework Convention on Tobacco Control in 2005. A law was passed in 2011 which regulates smoking in closed public spaces, bans advertising, and stipulates larger warnings. Despite international evidence confirming that increasing taxation on tobacco products lowers tobacco consumption, no such policy has yet been adopted: a cigarette pack costs on average US$1.50. To date no studies in Lebanon have addressed the welfare and public finance effects of increasing taxes on tobacco products. Using the 2005 national survey of household living conditions, we estimate an almost ideal demand system to generate price elasticities of demand for tobacco. Using estimated elasticities and a conservative scenario for expected smuggling, we simulate the consumption and tax revenue effects of a change in the price of tobacco under various tax schemes. Increasing taxes on all tobacco products so as to double the price of imported cigarettes would lower their consumption by 7% and consumption of domestically produced cigarettes by over 90%. Young adults (ages 15-30) are more sensitive: consumption would drop by 9% for imported cigarettes and by 100% for domestic cigarettes. Government revenues would increase by approximately 52%. The estimated elasticities indicate that an increase in taxes on all tobacco products would lead to a reduction in consumption and an increase in government revenue. Evidence from Lebanon on the effectiveness of increased taxation may help initiate national debate on the need to raise taxes. 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.

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

PubMed

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

2011-08-01

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

Misperceptions of harm among Natural American Spirit smokers: results from wave 1 of the Population Assessment of Tobacco and Health (PATH) study (2013-2014).

PubMed

Pearson, Jennifer L; Johnson, Amanda; Villanti, Andrea; Glasser, Allison M; Collins, Lauren; Cohn, Amy; Rose, Shyanika W; Niaura, Raymond; Stanton, Cassandra A

2017-03-01

This study estimated differences in cigarette harm perceptions among smokers of the Natural American Spirit (NAS) brand-marketed as 'natural', 'organic' and 'additive-free'-compared to other smokers, and examined correlates of NAS use. Data were drawn from wave 1 of the Population Assessment of Tobacco and Health (PATH) study, a nationally representative study of US adults (2013-2014). Weighted analyses using a subset of current adult smokers (n=10 565) estimated the prevalence of NAS use (vs all other brands) and examined associations between NAS use and sociodemographics, tobacco/substance use, tobacco harm perceptions, quit intentions, quit attempts and mental/behavioural health. Overall, 2.3% of adult smokers (920 000 people in the USA) reported NAS as their usual brand. Nearly 64% of NAS smokers inaccurately believed that their brand is less harmful than other brands compared to 8.3% of smokers of other brands, after controlling for potential confounders (aOR 22.82). Younger age (18-34 vs 35+; aOR 1.54), frequent thinking about tobacco harms (aOR 1.84), past 30-day alcohol use (aOR 1.57), past 30-day marijuana use (aOR 1.87) and sexual orientation (lesbian, gay, bisexual, 'other' or 'questioning' vs heterosexual; aOR 2.07) were also associated with increased odds of smoking NAS. The majority of NAS smokers inaccurately believes that their cigarettes are less harmful than other brands. Given the brand's rapid growth and its more common use in vulnerable groups (eg, young adults, lesbian, gay, bisexual, 'other' or 'questioning' adults), corrective messaging and enforcement action are necessary to correct harm misperceptions of NAS cigarettes. 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/.

Influence of tobacco industry advertisements and promotions on tobacco use in India: findings from the Global Adult Tobacco Survey 2009-2010.

PubMed

Sinha, D N; Palipudi, K M; Oswal, K; Gupta, P C; Andes, L J; Asma, S

2014-12-01

The developing world, including countries like India, has become a major target for the tobacco industry to market its products. This study examines the influence of the marketing (advertising and promotion) of tobacco products on the use of tobacco by adults (ages 15 and over) in India. Data from Global Adult Tobacco Survey 2009-2010 was analyzed using methods for complex (clustered) sample designs. Multivariate logistic regression was employed to predict the use of different tobacco products by level of exposure to tobacco marketing using adults who have never used tobacco as the reference category. Odds ratios (ORs) were adjusted for education, gender, age, state of residence, wealth index, and place of residence (urban/rural). Adults in India were almost twice as likely to be current smokers (versus never users) when they were exposed to a moderate level of bidi or cigarette marketing. For bidis, among adults with high exposure, the OR for current use was 4.57 (95% confidence interval [CI]: 1.6, 13.0). Adults were more likely to be current users of smokeless tobacco (SLT) with even a low level of exposure to SLT marketing (OR = 1.24 [95% CI: 1.1, 1.4]). For SLT, the ORs showed an increasing trend (P for trend < 0.001) with greater level of exposure (moderate, OR = 1.55 [95% CI: 1.1, 2.2]; high, OR = 2.05 [95% CI: 0.8, 5.1]). The risk of any current tobacco use rose with increasing level of exposure to any marketing (minimum, OR = 1.25 [1.1-1.4]; moderate, OR = 1.38 [1.1-1.8]; and high, OR = 2.73 [1.8-4.2]), with the trend highly significant (P < 0.001). Exposure to the marketing of tobacco products, which may take the form of advertising at the point of sale, sales or a discounted price, free coupons, free samples, surrogate advertisements, or any of several other modalities, increased prevalence of tobacco use among adults. An increasing level of exposure to direct and indirect advertisement and promotion is associated with an increased likelihood of tobacco use.

Patterns of Alcohol and Tobacco Use in Cambodia

PubMed Central

Banta, Jim E.; Addison, Askari; Job, Jayakaran S.; Yel, Daravuth; Kheam, They; Singh, Pramil N.

2014-01-01

Few studies have considered whether the habitual use of tobacco in Southeast Asia is part of an established pattern of addiction that includes regular alcohol use. As part of a national survey of adult tobacco use in Cambodia (n = 13 988), we found that men who smoked were 2 times more likely to have drank alcohol in the past week (odds ratio = 2.53, 95% confidence interval = 2.10–3.03). By age 18 to 25 years, 47% of male smokers drank alcohol, and this pattern of alcohol and tobacco use increased to >55% through the fifth decade. Women using smokeless tobacco with betel quid were more likely to be alcohol drinkers (odds ratio = 1.49, 95% confidence interval = 1.12–1.98). Past week's drinking declined by late middle age and was associated with lower education and being currently married; the behavior was lower in some ethnic groups (ie, Cham). Our findings indicate an important association between alcohol and tobacco use, and raise the possibility that reducing alcohol consumption can be an important component of tobacco control. PMID:23165486

The role of reported tobacco-specific media exposure on adult attitudes towards proposed policies to limit the portrayal of smoking in movies.

PubMed

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

2010-06-01

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.

Prevalence and correlates of binge drinking among older adults with multimorbidity.

PubMed

Han, Benjamin H; Moore, Alison A; Sherman, Scott E; Palamar, Joseph J

2018-06-01

Binge drinking among older adults has increased in the past decade. Binge drinking is associated with unintentional injuries, medical conditions, and lower health-related quality of life. No studies have characterized multimorbidity among older binge drinkers. We examined past 30-day binge alcohol use and lifetime medical conditions among adults age ≥50 from the National Survey on Drug Use and Health from 2005 to 2014. Self-reported lifetime prevalence of 13 medical conditions and medical multimorbidity (≥2 diseases) among binge drinkers were compared to non-binge drinkers. Multivariable logistic regression models were used to examine correlates of binge alcohol use among older adults with medical multimorbidity. Among adults aged ≥50, 14.4% reported past-month binge drinking. Estimated prevalence of medical multimorbidity was lower (21.4%) among binge drinkers than non-binge drinkers (28.3%; p < 0.01). Binge drinkers were more likely to use tobacco and illegal drugs than non-binge drinkers (ps < 0.001). In the adjusted model, among older adults with multimorbidity, higher income (AOR = 1.44, p < 0.05), past-month tobacco use (AOR = 2.55, p < 0.001) and substance use disorder for illegal drugs (AOR = 1.80, p < 0.05) was associated with increased odds of binge alcohol use. The prevalence of multimorbidity was lower among current binge drinkers compared to non-binge drinkers, possibly because older adults in good health are apt to drink more than adults in poorer health. Current use of tobacco and substance use disorder were associated with an increased risk for binge drinking among older adults with multimorbidity. Binge drinking by older adults with multimorbidity may pose significant health risks especially with the concurrent use of other substances. Copyright © 2018 Elsevier B.V. All rights reserved.

Young adults' perceptions about established and emerging tobacco products: results from eight focus groups.

PubMed

Wray, Ricardo J; Jupka, Keri; Berman, Susan; Zellin, Stacie; Vijaykumar, Santosh

2012-02-01

In order to sustain their market, tobacco producers target young adults through novel product design and marketing strategies. Public health professionals need to understand young adults' risks perceptions about and use of new tobacco products to best inform tobacco control interventions. In 2009, researchers conducted 8 focus groups with 67 young adults stratified by self-reported tobacco use and nonuse, residence in rural and urban areas, and living in a state with or without a statewide smoking restriction policy. Participants provided feedback about their knowledge and risk perceptions about and use of tobacco products and marketing. Participants reported a high level of familiarity with a wide range of novel tobacco products. A great deal of confusion and disagreement appeared with regard to absolute and relative risk of different tobacco products. Participants readily discussed using smokeless tobacco products as alternatives to smoking when smoking is prohibited. Fewer differences in tobacco-related knowledge risk perceptions and use were found between urban and rural participants and those in smoke-free policy and nonpolicy states than between user and nonuser groups. Both users and nonusers were familiar with and skeptical about tobacco marketing and prevention efforts. Young adults are familiar with many tobacco products, but they convey little understanding of relative risks of new or trendy tobacco products, such as snus or hookah. Mindful of industry innovation, tobacco control advocates must continuously update prevention efforts, seeking new strategies to limit promotion, marketing, and use of new and conventional products.

Current Cigarette Smoking Among Adults - United States, 2016.

PubMed

Jamal, Ahmed; Phillips, Elyse; Gentzke, Andrea S; Homa, David M; Babb, Stephen D; King, Brian A; Neff, Linda J

2018-01-19

The U.S. Surgeon General has concluded that the burden of death and disease from tobacco use in the United States is overwhelmingly caused by cigarettes and other combusted tobacco products (1). Cigarettes are the most commonly used tobacco product among U.S. adults, and about 480,000 U.S. deaths per year are caused by cigarette smoking and secondhand smoke exposure (1). To assess progress toward the Healthy People 2020 target of reducing the proportion of U.S. adults aged ≥18 years who smoke cigarettes to ≤12.0% (objective TU-1.1),* CDC analyzed data from the 2016 National Health Interview Survey (NHIS). In 2016, the prevalence of current cigarette smoking among adults was 15.5%, which was a significant decline from 2005 (20.9%); however, no significant change has occurred since 2015 (15.1%). In 2016, the prevalence of cigarette smoking was higher among adults who were male, aged 25-64 years, American Indian/Alaska Native or multiracial, had a General Education Development (GED) certificate, lived below the federal poverty level, lived in the Midwest or South, were uninsured or insured through Medicaid, had a disability/limitation, were lesbian, gay, or bisexual (LGB), or had serious psychological distress. During 2005-2016, the percentage of ever smokers who quit smoking increased from 50.8% to 59.0%. Proven population-based interventions are critical to reducing the health and economic burden of smoking-related diseases among U.S. adults, particularly among subpopulations with the highest smoking prevalences (1,2).

Misplaced Trust: Racial Differences in Use of Tobacco Products and Trust in Sources of Tobacco Health Information.

PubMed

Alcalá, Héctor E; Sharif, Mienah Z; Morey, Brittany N

2017-10-01

Recently, the rates of utilization of alternative tobacco products have increased. Providing health information about tobacco products from trustworthy sources may help decrease the popularity of these products. Using a nationally representative study of adults, we fill the current gap in research on racial and ethnic disparities in utilization of alternative tobacco products as well as in trust of sources of health information about tobacco products. Data came from the Health Information National Trends Survey (N = 3738), which was collected in 2015. Logistic regression models were used to calculate odds of use of seven different tobacco product (eg, hookah, e-cigarettes, etc.), trust in seven different sources of e-cigarette health information (eg, family or friends, health care providers, etc.), and trust in six different sources of tobacco health information, adjusting for control variables. There were disparities in utilization of alternative tobacco products and in trust, in tobacco companies across racial and ethnic groups. Blacks and Asians were far more likely than whites to trust tobacco (adjusted odds ratios = 8.67 and 4.34) and e-cigarette companies (adjusted odds ratios = 6.97 and 3.13) with information about the health effects of e-cigarettes than whites. The popularity of alternative tobacco products appears to be high and may offset recent observed decreases in cigarette use. Blacks and Asians appear to trust tobacco companies as sources of information when compared to whites. Higher levels of trust in tobacco companies among Asians and blacks may translate to greater susceptibility to utilize tobacco products among these groups, thereby increasing disparities. There is a need for social marketing and education efforts focused on increasing awareness of adverse health effects of using alternative tobacco products as well as on the untrustworthiness of tobacco and e-cigarette companies, especially among racial and ethnic minorities. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

PubMed

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

2008-02-01

To examine the impact of tobacco advertising policy on adult smokers' awareness of tobacco promotion in two developing countries--Malaysia and Thailand. Data from 2004 Malaysian and 2000 Thai adult smokers who participated in the baseline wave of the International Tobacco Control Southeast Asia survey (ITC-SEA). Respondents were asked in a face-to-face interview conducted between January and March 2005 to indicate their levels of awareness of tobacco advertising and promotional activities in the last six months. Unprompted awareness of any tobacco marketing activities was very low in Thailand (20%) but significantly higher in Malaysia (53%; OR = 5.6, 95% CI: 3.5 to 8.9, p<0.001). When prompted about specific locations, Thai adult smokers reported very low recall of tobacco 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.

Susceptibility to tobacco product use among youth in wave 1 of the population Assessment of tobacco and health (PATH) study.

PubMed

Trinidad, Dennis R; Pierce, John P; Sargent, James D; White, Martha M; Strong, David R; Portnoy, David B; Green, Victoria R; Stanton, Cassandra A; Choi, Kelvin; Bansal-Travers, Maansi; Shi, Yuyan; Pearson, Jennifer L; Kaufman, Annette R; Borek, Nicolette; Coleman, Blair N; Hyland, Andrew; Carusi, Charles; Kealey, Sheila; Leas, Eric; Noble, Madison L; Messer, Karen

2017-08-01

The purpose of this study was to investigate susceptibility and ever use of tobacco products among adolescents and young adults in the US. Cross-sectional analysis of Wave 1(2013-2014) adolescent (12-17year-olds; n=13,651) and young adult (18-24year-olds; n=9112) data from the nationally-representative Population Assessment of Tobacco and Health (PATH) Study was conducted. At 12years, 5% were ever tobacco users and 36% were susceptible to use. Seventy percent were susceptible at age 17years, and the same proportion were ever users at age 22years. Susceptibility levels were comparable for cigarettes and e-cigarette (28.6% and 27.4%, respectively), followed by hookah (22.0%), pipes (17.5%), cigars (15.2%), and smokeless tobacco (9.7%). Non-Hispanic (NH) Black (Adjusted Odds Ratio [ORadj]=1.36; 95% Confidence Limit [CL], 1.18-1.56) and Hispanic (ORadj=1.34: 95% CL,1.19-1.49) adolescent never- users were more likely to be susceptible to future use of a tobacco product than NH Whites. Susceptibility was higher with age (15-17yrs. vs 12-14yrs.: OR adj =1.69; 95% CL, 1.55-1.85) and parental education (college graduates vs less than HS education: OR adj =1.22, 95% CL, 1.08-1.39). Compared to exclusive users of hookah, cigars, or smokeless products, larger proportions of exclusive e-cigarette ever users were also susceptible to cigarette use. Among adolescents, lower levels of ever use of tobacco products are often counterbalanced by higher levels of susceptibility for future use, which may suggest delayed initiation in some groups. Ever users of a given tobacco product were more susceptible to use other tobacco products, putting them at risk for future multiple tobacco product use. Copyright © 2017 Elsevier Inc. All rights reserved.

The Social Prioritization Index and Tobacco Use among Young Adult Bar Patrons

ERIC Educational Resources Information Center

Lisha, Nadra E.; Neilands, Torsten B.; Jordan, Jeffrey W.; Holmes, Louisa M.; Ling, Pamela M.

2016-01-01

Social benefits likely play a role in young adult tobacco use. The Social Prioritization Index (SPI) was developed to measure the degree to which young adults place a great importance on their social lives. We examined the usefulness of this measure as a potential predictor of tobacco use controlling for demographics and tobacco-related attitudes.…

Direct Marketing Promotion and Electronic Cigarette Use Among US Adults, National Adult Tobacco Survey, 2013–2014

PubMed Central

Hao, Jianqiang

2017-01-01

Introduction The use of electronic cigarettes (e-cigarettes) among US adults has increased since 2007. The objective of this study was to investigate the prevalence of direct marketing promotion of e-cigarettes and its association with e-cigarette use among US adults. Methods We used using data from the 2013–2014 National Adult Tobacco Survey (NATS) to estimate prevalence of e-cigarette promotions received by mail or email. Multinomial logistic regression was used to examine the associations between e-cigarette promotions and the prevalence and frequency of e-cigarette use among US adults. Results In the 2013–2014 survey period, 7.1% of adults (about 16.0 million) reported receiving mail or email e-cigarette promotions in the previous 6 months; 3.2% received mail promotions, and 5.1% received email promotions. A higher prevalence of promotions was found among men versus women, adults aged under 65 years versus those older, current e-cigarette users, current smokers, and people with no smoking restriction rules in their homes or vehicles. In the multivariable analysis, receiving mail or email e-cigarette promotions was associated with higher odds of being current e-cigarette users (adjusted odds ratio [aOR] = 2.0; P < .001) than being noncurrent e-cigarette users. Receiving promotions was also associated with higher odds of using e-cigarettes some days (aOR = 1.6; P = .006) or every day (aOR = 1.7; P = .008) than using e-cigarettes rarely. Conclusion Receipt of e-cigarette direct marketing promotions was prevalent among US adults. Receiving e-cigarette promotions was associated with increased odds of both prevalence and frequency of e-cigarette use. Future longitudinal studies are needed to measure causal effects of e-cigarette promotions on e-cigarette use among adults. PMID:28934079

Direct Marketing Promotion and Electronic Cigarette Use Among US Adults, National Adult Tobacco Survey, 2013-2014.

PubMed

Dai, Hongying; Hao, Jianqiang

2017-09-21

The use of electronic cigarettes (e-cigarettes) among US adults has increased since 2007. The objective of this study was to investigate the prevalence of direct marketing promotion of e-cigarettes and its association with e-cigarette use among US adults. We used using data from the 2013-2014 National Adult Tobacco Survey (NATS) to estimate prevalence of e-cigarette promotions received by mail or email. Multinomial logistic regression was used to examine the associations between e-cigarette promotions and the prevalence and frequency of e-cigarette use among US adults. In the 2013-2014 survey period, 7.1% of adults (about 16.0 million) reported receiving mail or email e-cigarette promotions in the previous 6 months; 3.2% received mail promotions, and 5.1% received email promotions. A higher prevalence of promotions was found among men versus women, adults aged under 65 years versus those older, current e-cigarette users, current smokers, and people with no smoking restriction rules in their homes or vehicles. In the multivariable analysis, receiving mail or email e-cigarette promotions was associated with higher odds of being current e-cigarette users (adjusted odds ratio [aOR] = 2.0; P < .001) than being noncurrent e-cigarette users. Receiving promotions was also associated with higher odds of using e-cigarettes some days (aOR = 1.6; P = .006) or every day (aOR = 1.7; P = .008) than using e-cigarettes rarely. Receipt of e-cigarette direct marketing promotions was prevalent among US adults. Receiving e-cigarette promotions was associated with increased odds of both prevalence and frequency of e-cigarette use. Future longitudinal studies are needed to measure causal effects of e-cigarette promotions on e-cigarette use among adults.

Warning about the harms of tobacco use in 22 countries: findings from a cross-sectional household survey.

PubMed

Chiosi, John J; Andes, Linda; Asma, Samira; Palipudi, Krishna; McAfee, Tim

2016-07-01

Knowledge about the harms of tobacco use deters initiation and is associated with cessation. Most studies on this knowledge in the general population have been in high-income countries, but the tobacco use burden is increasing in low-income and middle-income countries. We sought to estimate levels of knowledge about tobacco-related diseases in 22 countries and determine the factors associated with differences in knowledge. We used data from the Global Adult Tobacco Survey (GATS), a nationally representative survey of persons aged ≥15 years. GATSs were conducted from 2008 to 2013 in 22 low-income and middle-income countries. Information was gathered on tobacco-related knowledge and noticing of antismoking mass media messages and health warning labels on cigarette packages. We constructed a four-point knowledge scale and performed multivariate regression analyses. Median country values for the proportion of adults who believed smoking causes a specific illness were 95.9% for lung cancer, 82.5% for heart attack and 74.0% for stroke. Knowledge scores ranged from 2.1 to 3.8. In multivariate regressions, adults scored significantly higher on the knowledge scale if they noticed antismoking media messages (22 countries) or health warning labels (17 countries). Significantly higher knowledge scores occurred in all 9 countries with pictorial health warning labels compared with only 8 out of 13 countries with text-only warning labels. Antismoking media messages appear effective for warning the public about the harms from tobacco use in all 22 countries, while warning labels are effective in the majority of these countries. Our findings suggest opportunities to motivate smoking cessation globally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Tobacco industry research on smoking cessation. Recapturing young adults and other recent quitters.

PubMed

Ling, Pamela M; Glantz, Stanton A

2004-05-01

Smoking rates are declining in the United States, except for young adults (age 18 to 24). Few organized programs target smoking cessation specifically for young adults, except programs for pregnant women. In contrast, the tobacco industry has invested much time and money studying young adult smoking patterns. Some of these data are now available in documents released through litigation. Review tobacco industry marketing research on smoking cessation to guide new interventions and improve clinical practice, particularly to address young adult smokers' needs. Analysis of previously secret tobacco industry documents. Compared to their share of the smoking population, young adult smokers have the highest spontaneous quitting rates. About 10% to 30% of smokers want to quit; light smokers and brand switchers are more likely to try. Tobacco companies attempted to deter quitting by developing products that appeared to be less addictive or more socially acceptable. Contrary to consumer expectations, "ultra low tar" cigarette smokers were actually less likely to quit. Tobacco industry views of young adult quitting behavior contrast with clinical practice. Tobacco marketers concentrate on recapturing young quitters, while organized smoking cessation programs are primarily used by older smokers. As young people have both the greatest propensity to quit and the greatest potential benefits from smoking cessation, targeted programs for young adults are needed. Tobacco marketing data suggest that aspirational messages that decrease the social acceptability of smoking and support smoke-free environments resonate best with young adult smokers' motivations.

Validity and reliability of survey items and pictograms for use in a national household survey of tobacco use in Cambodia.

PubMed

Singh, Pramil N; Khieng, Sothy; Yel, Daravuth; Nguyen, Duc; Job, Jayakaran S

2013-09-01

The validity of survey measures of smoked and smokeless tobacco use in the Western Pacific Region is often unknown. We conducted a validation study (n = 201) in a random sample of rural adults in Cambodia. A comparison with salivary cotinine indicated (1) that survey items and pictograms of current tobacco use had an 87% (95% confidence interval [CI] = 78%-93%) sensitivity, 94% specificity (95% CI = 87%-98%), and 93% (95% CI = 85%-97%) positive predictive value in detecting cotinine levels >10 ng/mL; (2) a positive correlation with number of cigarettes smoked (R = 0.34; P = .01); and (3) a positive correlation with the amount of tobacco chewed (R = 0.44; P = .02). The validity of the index for the amount of smokeless tobacco used was enhanced by adding to the index the data from pictograms that were utilized to help participants estimate the amount of loose tobacco used per session. These tobacco items and pictograms were found to have excellent reliability (κ = 0.80-1) over 2 to 3 weeks. Interviewer-administered survey items and pictograms can provide an accurate, quantitative measure of smoked and smokeless tobacco use in rural Cambodia.

Tax, price and cigarette brand preferences: a longitudinal study of adult smokers from the ITC Mexico Survey.

PubMed

Sáenz de Miera Juárez, Belén; Thrasher, James F; Reynales Shigematsu, Luz Myriam; Hernández Ávila, Mauricio; Chaloupka, Frank J

2014-03-01

Recent tax increases in Mexico differed in structure and provided an opportunity to better understand tobacco industry pricing strategies, as well as smokers' responses to any resulting price changes. To assess if taxes were passed onto consumers of different cigarette brands, the extent of brand switching and predictors of preference for cheaper national brands. Using data from three waves of the Mexican administration of the International Tobacco Control Survey, we analysed self-reported brand and price paid at last cigarette purchase. Generalised estimating equations were used to determine predictors of price and preference for national brands. The average price of premium/international brands increased each year from 2008 to 2011; however, the price for discount/national brands increased only from 2010 to 2011. The percentage of smokers who smoked national brands remained stable between 2008 and 2010 but dropped in 2011. Factors related to smoking national brands as opposed to international brands included being male and having relatively older age, lower education, lower income and higher consumption. Tobacco industry pricing strategies in the wake of ad valorem taxes implemented in Mexico prior to 2011 had the impact of segmenting the market into discount national brands and premium international brands. The specific tax increase implemented in 2011 reduced the price gap between these two segments by raising the price of the national brands relative to the international brands. Evidence for trading up was found after the 2011 tax increase. These results provide further evidence for the relevance of tax policy as a tobacco control strategy; in particular, they illustrate the importance of how specific rather than ad valorem taxes can reduce the potential for downward brand switching in the face of decreasing cigarette affordability.

Impact of the 2009 Taiwan tobacco hazards prevention act on smoking cessation.

PubMed

Chang, Fong-Ching; Sung, Hai-Yen; Zhu, Shu-Hong; Chiou, Shu-Ti

2014-01-01

In January 2009, the government of Taiwan amended the 1997 Tobacco Hazards Prevention Act by extending smoke-free areas to include almost all enclosed work-places and public places, adding graphic health warnings to cigarette packages, totally banning tobacco advertisements, promotion and sponsorship and increasing tobacco taxes. This study examined the impact of the 2009 amended Act on smoking cessation in Taiwan. Taiwan Adult Tobacco Surveys 2007 and 2010, each with a nationally representative sample of adults aged 18 years and older (n = 16 588, and n = 16 295, respectively). All recent active smokers (current smokers plus former smokers who quit smoking within the past 12 months) were used for the analyses (n = 3783 in 2007, and n = 2777 in 2010). Quit attempt rate and annual cessation rate (defined as having succeeded in quitting for at least 3 months) among recent active smokers were compared between the pre-Act (2007) and post-Act (2010) periods. The quit attempt rate increased significantly from 39.4% in 2007 to 42.9% in 2010. The annual cessation rate increased significantly from 7.1 to 8.9%. A multivariate analysis, controlling for demographic characteristics, showed that the implementation of the 2009 Act was associated with an increase in the quit attempt rate [odds ratio (OR) = 1.14; 95% confidence interval (CI) = 1.03-1.25] and the annual cessation rate (OR = 1.28; 95% CI = 1.08-1.53). The comprehensive tobacco control programme introduced in 2009 in Taiwan, which combined smoke-free legislation with a tobacco tax increase, graphic health warning labels and a total ban on tobacco advertisements, was associated with increases in quit attempt rate and annual cessation rate. © 2013 Society for the Study of Addiction.

Smoking among Patients in Substance Use Disorders Treatment: Associations with Tobacco Advertising, Anti-tobacco Messages and Perceived Health Risk

PubMed Central

Campbell, Barbara K.; Le, Thao; Andrews, K. Blakely; Pramod, Sowmya; Guydish, Joseph

2016-01-01

Background Although tobacco control efforts have contributed to an overall decline in smoking, individuals with substance use disorders (SUDs) continue to smoke at high rates and remain targets of advertising to vulnerable groups, including those with mental health disorders and SUDs. Objective We examined associations of tobacco advertising exposure and receptivity, anti-tobacco message awareness, and health-risk perception with smoking status and cigarettes-per-day (CPD) in a national sample of SUD treatment patients. Method Patients (N=1,113) in 24 programs chosen randomly, stratified by program type, from among publicly funded, adult treatment programs within the National Drug Abuse Treatment Clinical Trials Network completed surveys of smoking, advertising exposure and receptivity, anti-tobacco message awareness and perceived health risks. Results Current smokers (77.9% of the sample) smoked a daily median of 10 cigarettes (IQR= 13). Participants reporting daily advertising exposure were 1.41 times more likely to be smokers (p=0.019) than others. Those highly receptive to advertising were 2.34 times more likely to be smokers (p<0.001) than those with low/moderate receptivity. Higher perceived health risk was associated with lower odds of smoking (OR=0.99, 95% CI: 0.98- 0.99, p<0.001). CPD for smokers highly receptive to advertising was 11.1% (95% CI: 2.8%-20.0%) higher than for smokers with low/moderate advertising receptivity. Anti-tobacco message awareness was not associated with smoking status or CPD. Conclusion The high rate of smoking among SUD treatment patients is associated with daily exposure and high receptivity to tobacco advertisements, and lower perception of health-related, smoking risks. Tobacco control efforts should target this vulnerable population. PMID:27314450

DSM-5 Tobacco Use Disorder and Sleep Disturbance: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III).

PubMed

Hayley, Amie C; Stough, Con; Downey, Luke A

2017-12-06

The DSM-5 Tobacco use disorder diagnosis incorporates tobacco misuse, addictive behaviors and withdrawal symptomology. Tobacco use is bidirectionally associated with sleep pathology; however, no epidemiological studies have yet evaluated the associations between DSM-5 Tobacco use disorder and self-reported sleep disturbance. The current study aimed to evaluate health, medical and sleep-related factors among individuals within this diagnostic stratum. A total of N = 36,177 adults who participated in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III) were included for analyses. The adjusted odd ratios (AOR) for individual classifications of DSM-5 Tobacco use disorder among those with subjective sleep disturbances were used as the primary outcome measure and relevant demographic, clinical and medical factors were considered in all univariate and multivariable analyses. Current and lifetime DSM-5 tobacco use disorder diagnoses were associated with poorer health and medical outcomes and higher rates of subjective sleep disturbances (all p < 0.001). Associations between current and lifetime DSM-5 tobacco use disorder and subjective sleep disturbances were maintained in multivariable analyses following adjustment for a range of health, lifestyle, and psychiatric factors (adjusted OR 1.11, 95%CI 1.00-1.23 and adjusted OR = 1.24, 95%CI 1.15-1.34, respectively); however, these relationships were fully explained by diagnoses of DSM-5 alcohol use disorder. Data from this large, representative survey indicate that the association between DSM-5 Tobacco use disorder and sleep disturbance is explained by underlying diagnoses of DSM-5 alcohol use disorder. Multifaceted substance abuse treatment protocols may improve treatment outcomes for affected patient groups.

Smoking among patients in substance use disorders treatment: associations with tobacco advertising, anti-tobacco messages, and perceived health risks.

PubMed

Campbell, Barbara K; Le, Thao; Andrews, K Blakely; Pramod, Sowmya; Guydish, Joseph

2016-11-01

Although tobacco control efforts have contributed to an overall decline in smoking, individuals with substance use disorders (SUDs) continue to smoke at high rates and remain targets of advertising to vulnerable groups, including those with mental health disorders and SUDs. We examined associations of tobacco advertising exposure and receptivity, anti-tobacco message awareness, and health-risk perception with smoking status and cigarettes-per-day (CPD) in a national sample of SUD treatment patients. The patients (N = 1,113) in 24 programs chosen randomly, stratified by program type, from among publicly funded adult treatment programs within the National Drug Abuse Treatment Clinical Trials Network completed surveys of smoking, advertising exposure and receptivity, anti-tobacco message awareness, and perceived health risks. Current smokers (77.9% of the sample) smoked a daily median of 10 cigarettes (IQR = 13). The participants reporting daily advertising exposure were 1.41 times more likely to be smokers (p = 0.019) than others. Those highly receptive to advertising were 2.34 times more likely to be smokers (p < 0.001) than those with low/moderate receptivity. Higher perceived health risk was associated with lower odds of smoking (OR = 0.99, 95% CI: 0.98-0.99, p < 0.001). CPD for smokers highly receptive to advertising was 11.1% (95% CI: 2.8%-20.0%) higher than for smokers with low/moderate advertising receptivity. Anti-tobacco message awareness was not associated with smoking status or CPD. The high rate of smoking among SUD treatment patients is associated with daily exposure and high receptivity to tobacco advertisements and lower perception of health-related smoking risks. Tobacco control efforts should target this vulnerable population.

Physician tobacco screening and advice to quit among U.S. adolescents - National Survey on Drug Use and Health, 2013.

PubMed

Collins, Lauren; Smiley, Sabrina L; Moore, Rakiya A; Graham, Amanda L; Villanti, Andrea C

2017-01-01

Initiating tobacco use in adolescence increases the risk of nicotine dependence and continued smoking. Physician screening for tobacco use increases the odds of physicians intervening with patients who smoke; However, without appropriate follow-through by the physician, screening for tobacco use is not enough to significantly increase cessation rates. Given the critical phase of development adolescence poses in tobacco use and evidence that physician intervention improves adult cessation efforts, we sought to examine physician tobacco use screening and advice to quit among adolescents (12-17 years). Using data from the 2013 National Survey on Drug Use and Health (NSDUH), we examined the prevalence and correlates of tobacco use screening in adolescent respondents who reported visiting their physician within the past year ( N  = 12,798). Multivariable logistic regression analyses explored the relationship between tobacco use screening and physician advice to quit in a sub-set of the sample who reported on physician advice to quit ( n  = 1,868), controlling for sociodemographics, cigarette use, and substance use and screening. Only 49% of adolescents who visited a physician within the past year reported being screened for tobacco use. Adolescents who were screened by their physician were predominantly female (56.6%), White (60.1%), in late adolescence (83.0%), and covered by private health insurance (63.8%). Screening for tobacco use was highly correlated with physician advice to quit smoking, controlling for sociodemographic characteristics and cigarette use; this relationship was attenuated, but remained significant, after screening for alcohol and marijuana were added to the model. Hispanic adolescents were significantly less likely to receive physician advice to quit in all multivariable models. Our findings suggest missed opportunities for youth tobacco use prevention and cessation efforts in the clinical setting. Further research is needed to better facilitate an open dialogue on tobacco use between physicians and their adolescent patients.

Young adults' support for adult-ratings for movies depicting smoking and for restrictions on tobacco magazine advertising.

PubMed

Choi, Kelvin; Fabian, Lindsey; Jansen, Jim; Lenk, Kathleen; Forster, Jean

2013-12-01

Smoking images in movies and tobacco advertisements in magazines are influential on adolescent smoking behaviors, and restrictions of these advertising strategies can reduce the prevalence of adolescent smoking. We assessed young adults' level of support for adult ratings for movies depicting smoking and for restrictions on tobacco magazine advertising. Young adults from the U.S. Midwest were surveyed between 2010-2011 (n=2622). We assessed their level of support for (a) adult-rating all movies depicting smoking, and (b) restrictions on tobacco magazine advertising. Multivariate regression models were used to investigate the characteristics associated with higher level of support for these policies. Overall, 34% of the participants favored adult ratings for movies with smoking images, and 68% favored restrictions on tobacco magazine advertising. Characteristics associated with higher level of support differed somewhat by policy. Further educating young adults about the influence of smoking images in movies on adolescent smoking may be necessary to gain more support for the policy. With the majority supporting restrictions on tobacco magazine advertising, it may be possible to tighten these restrictions to further protect adolescents. Future research is needed to identify how tobacco control advocates can frame these issues to gain further public support.

Monitoring the Future: National Survey Results on Drug Use, 1975-2008. Volume I, Secondary School Students. NIH Publication No. 09-7402

ERIC Educational Resources Information Center

Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.; Schulenberg, John E.

2009-01-01

The Monitoring the Future study has provided the nation with a window into the important, but largely hidden, problem behaviors of illicit drug use, alcohol use, and tobacco use. It has provided a clearer view of the changing topography of these problems among adolescents and adults, a better understanding of the dynamics of factors that drive…

Monitoring the Future: National Survey Results on Drug Use, 1975-2007. Volume I, Secondary School Students. NIH Publication No. 08-6418A

ERIC Educational Resources Information Center

Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.; Schulenberg, John E.

2008-01-01

The Monitoring the Future study has provided the nation with a window into the important, but largely hidden, problem behaviors of illicit drug use, alcohol use, and tobacco use. It has provided a clearer view of the changing topography of these problems among adolescents and adults, a better understanding of the dynamics of factors that drive…

Monitoring the Future: National Survey Results on Drug Use, 1975-2006. Volume I: Secondary School Students. NIH Publication No. 07-6205

ERIC Educational Resources Information Center

Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.; Schulenberg, John E.

2007-01-01

The Monitoring the Future study has provided the nation with a window into the important, but largely hidden, problem behaviors of illicit drug use, alcohol use, and tobacco use. It has provided a clearer view of the changing topography of these problems among adolescents and adults, a better understanding of the dynamics of factors that drive…

Little Cigars and Cigarillos Use Among Young Adult Cigarette Smokers in the United States: Understanding Risk of Concomitant Use Subtypes

PubMed Central

Fryer, Craig S.; Pagano, Ian; Fagan, Pebbles

2016-01-01

Introduction: In 2016, the Food and Drug Administration announced that it would regulate little cigars and cigarillos (LCCs) and expressed concern about the concomitant use of combustible tobacco products. To understand LCC use among socially-disadvantaged cigarette smokers, we assessed (1) the prevalence of concomitant use of subtypes of LCCs: LCC-tobacco, LCC-blunt, and LCC- poly use, which includes use of both LCC-tobacco and LCC-blunt and (2) and its association with sociodemographic factors and substance use behaviors using race/ethnicity and gender stratified models. Methods: In 2015, a web-based survey was administered to a national probability sample of black/African American, Hispanic/Latino, and white cigarette smokers aged 18–44 (n = 1018). Weighted estimates were used to assess current LCC-tobacco, LCC-blunt, and LCC-poly use. Multinomial regression models assessed sociodemographic, other tobacco and substance use correlates associated with LCC user subtypes. Results: Of cigarette smokers, 63% did not smoke LCCs; 15.1% were LCC-tobacco users; 11.1% were LCC-blunt users; and 10.5% were LCC-poly users. Black/African American and Hispanic/Latino cigarette smokers had higher odds of LCC-tobacco, LCC-blunt, and LCC-poly use compared to white cigarette smokers. Blacks/African Americans who initiated cigarette smoking before age 18 and smoked other tobacco products had greater odds of LCC-tobacco use than whites. Male cigarette smokers who smoked other tobacco products and females who had early onset of cigarette use also had greater odds of LCC-tobacco use. Conclusions: Over 30% of cigarette smokers concomitantly used LCCs, which may prolong smoking. Accurate estimates of diverse LCC use behaviors may increase our understanding of the potential harms of concomitant use. Implications: Aggregate measures of LCC smoking do not distinguish subtypes of use among socially-disadvantaged cigarette smokers (ie, young adults, blacks/African Americans, Hispanics/Latinos), who may engage in these unique smoking behaviors. We document the prevalence of young adult cigarette smokers who dual use LCC-tobacco and LCC-blunts and are poly users of LCC-tobacco + LCC-blunts, and identify sociodemographic groups at risk for use. The Food and Drug Administration is concerned about concomitant behavior, which may increase chronic disease risk and addiction. Accurate estimates of LCC smoking behaviors may increase our understanding of the harms of concomitant use; which can inform prevention programs that specifically target LCC subtypes. PMID:27613889

Promotion of waterpipe tobacco use, its variants and accessories in young adult newspapers: a content analysis of message portrayal

PubMed Central

Sterling, Kymberle L.; Fryer, Craig S.; Majeed, Ban; Duong, Melissa M.

2015-01-01

The objective of our study was to identify waterpipe tobacco smoking advertisements and those that promoted a range of products and accessories used to smoke waterpipe tobacco. The content of these advertisements was analyzed to understand the messages portrayed about waterpipe tobacco smoking in young adult (aged 18–30) newspapers. The study methods include monitoring of six newspapers targeting young adults from four major cities in the Southeastern United States over a 6-month period. A total of 87 advertisements were found; 73.5% (64) were distinct and content analyzed. The study results showed that of the advertisements analyzed, 25% advertised waterpipe tobacco smoking, 54.7% featured waterpipe tobacco smoking and other tobacco use, 14.1% featured non-tobacco waterpipe variants (i.e. vaporizers), and 6.3% featured waterpipe apparatus accessories (e.g. charcoal, hoses). The sociability (34%) and sensuality (29.7%) of waterpipe smoking were promoted themes. Alternative to cigarette use messages (3.1%), and harm-reduction messages (17.1%) emphasized that smoking waterpipe tobacco using the featured accessory or waterpipe variant was a healthier experience than cigarette smoking. The study concluded that the messages that promoted waterpipe tobacco smoking to young adults are parallel to those used to promote cigarette use. Tobacco control professionals should continue to monitor young adult newspapers as a source of waterpipe-related advertising. PMID:24957675

Tobacco Industry Research on Smoking Cessation

PubMed Central

Ling, Pamela M; Glantz, Stanton A

2004-01-01

BACKGROUND Smoking rates are declining in the United States, except for young adults (age 18 to 24). Few organized programs target smoking cessation specifically for young adults, except programs for pregnant women. In contrast, the tobacco industry has invested much time and money studying young adult smoking patterns. Some of these data are now available in documents released through litigation. OBJECTIVE Review tobacco industry marketing research on smoking cessation to guide new interventions and improve clinical practice, particularly to address young adult smokers’ needs. METHODS Analysis of previously secret tobacco industry documents. RESULTS Compared to their share of the smoking population, young adult smokers have the highest spontaneous quitting rates. About 10% to 30% of smokers want to quit; light smokers and brand switchers are more likely to try. Tobacco companies attempted to deter quitting by developing products that appeared to be less addictive or more socially acceptable. Contrary to consumer expectations, “ultra low tar” cigarette smokers were actually less likely to quit. CONCLUSIONS Tobacco industry views of young adult quitting behavior contrast with clinical practice. Tobacco marketers concentrate on recapturing young quitters, while organized smoking cessation programs are primarily used by older smokers. As young people have both the greatest propensity to quit and the greatest potential benefits from smoking cessation, targeted programs for young adults are needed. Tobacco marketing data suggest that aspirational messages that decrease the social acceptability of smoking and support smoke-free environments resonate best with young adult smokers’ motivations. PMID:15109339

Cigarette Brand Preference and Pro-Tobacco Advertising Among Middle and High School Students - United States, 2012-2016.

PubMed

Perks, Siobhan N; Armour, Brian; Agaku, Israel T

2018-02-02

Nearly all adult smokers first try cigarettes before age 18 years (1), and adolescents can show symptoms of nicotine dependence within days to weeks of the onset of occasional cigarette smoking (2). Having a usual cigarette brand among adolescent smokers could reflect exposure and receptivity to pro-tobacco advertising and tobacco product appeal (1). To identify usual cigarette brands smoked among U.S. middle and high school students who were current (past 30-day) cigarette smokers, CDC analyzed data from the 2012-2016 National Youth Tobacco Survey (NYTS). Marlboro, Newport, and Camel were the most commonly reported brands smoked during 2012-2016; in 2016, these three were the brands usually smoked for 73.1% and 78.7% of current cigarette smokers in middle and high school, respectively. These three brands also were the three most commonly identified as having a "favorite cigarette ad" in 2012. Efforts to reduce youth exposure to pro-tobacco advertising could help reduce youth smoking (1,3).

Tobacco outlet density and tobacco knowledge, beliefs, purchasing behaviours and price among adolescents in Scotland.

PubMed

Tunstall, Helena; Shortt, Niamh K; Niedzwiedz, Claire L; Richardson, Elizabeth A; Mitchell, Richard J; Pearce, Jamie R

2018-06-01

Despite long-term falls in global adult smoking prevalence and over 50 years of tobacco control policies, adolescent smoking persists. Research suggests greater densities of tobacco retail outlets in residential neighbourhoods are associated with higher adolescent smoking rates. Policies to reduce retail outlets have therefore been identified by public health researchers as a potential 'new frontier' in tobacco control. Better understanding of the pathways linking density of tobacco retailers and smoking behaviour could support these policies. In this study we use path analysis to assess how outlet density in the home environment is related to adolescent tobacco knowledge, beliefs, retail purchases and price in Scotland. We assessed 22,049 13 and 15 year old respondents to the nationally representative cross-sectional 2010 Scottish School Adolescent Lifestyle and Substance Use Survey. Outlet density was based on Scottish Tobacco Retailers Register, 2012, data. A spatially-weighted Kernel Density Estimation measure of outlet density within 400 m of respondents' home postcode was grouped into tertiles. The analysis considered whether outlet density was associated with the number of cigarette brands adolescents could name, positive beliefs about smoking, whether smokers purchased cigarettes from shops themselves or through adult proxies and perceived cost of cigarettes. Models were stratified by adolescent smoking status. The path analyses indicated that outlet density was not associated with most outcomes, but small, significant direct effects on knowledge of cigarette brands among those who had never smoked were observed. With each increase in outlet density tertile the mean number of brands adolescents could name rose by 0.07 (mean = 1.60; SD = 1.18; range = 4). This suggests greater outlet densities may have affected adolescents' knowledge of cigarette brands but did not encourage positive attitudes to smoking, purchases from shops or lower cigarette prices. Exposure to tobacco outlets may influence adolescents' awareness of tobacco products, a potential pathway to smoking behaviour. Copyright © 2018 Elsevier Ltd. All rights reserved.

Salience and Impact of Health Warning Label on Cigarette Packs in Vietnam: Findings From the Global Adult Tobacco Survey 2015.

PubMed

Ngoc Bich, Nguyen; Thu Ngan, Tran; Bao Giang, Kim; Thi Hai, Phan; Thi Thu Huyen, Doan; Ngoc Khue, Luong; Tuan Lam, Nguyen; Van Minh, Hoang; Thi Quynh Nga, Pham; The Quan, Nguyen; Loan, Vu Hoang

2018-04-13

Viet Nam is among the countries having highest rate of male smokers in the world. The country has joined the Global Tobacco Surveillance System since 2010. Under this system, two rounds of Global Adult Tobacco Survey (GATS) were conducted in 2010 and 2015. Those two surveys provide excellent comparable data on tobacco usage and its related aspects in Vietnam. This study using the data from GATS 2015 to examine the salience and impact of cigarette pack health warnings on quitting intention in Vietnam. The Vietnam GATS 2015 was a nationally representative survey in which 9,513 households were selected using two-stage random systematic sampling method. Results of multivariate analysis showed that the strongest predictor for quit intention because of health warnings was "ever made a quit attempt in the past 12 months" followed by "believes that tobacco smoking causes serious illness". Compared to GATS 2010, GATS 2015 observed the increase in salience of cigarette health warnings. However, the current pictorial health warnings are losing their impact on motivating intention to quit. The results highlight that it is time to start the rotation cycle to refresh the current health warning set. Actions to select a new and more impressive set of pictorial health warnings should be developed as soon as possible.

Smooth moves: bar and nightclub tobacco promotions that target young adults.

PubMed

Sepe, Edward; Ling, Pamela M; Glantz, Stanton A

2002-03-01

This article describes the tobacco industry's use of bars and nightclubs to encourage smoking among young adults. Previously secret tobacco industry marketing documents were analyzed. Tobacco industry bar and nightclub promotions in the 1980s and 1990s included aggressive advertising, tobacco brand--sponsored activities, and distribution of samples. Financial incentives for club owners and staff were used to encourage smoking through peer influence. Increased use of these strategies occurred concurrently with an increase in smoking among persons aged 18 through 24 years. The tobacco industry's bar and nightclub promotions are not yet politically controversial and are not regulated by the 1998 Master Settlement Agreement between the industry and the states. Tobacco control advocates should include young adults in research and advocacy efforts and should design interventions to counter this industry strategy to solidify smoking patterns and recruit young adult smokers.

Smooth Moves: Bar and Nightclub Tobacco Promotions That Target Young Adults

PubMed Central

Sepe, Edward; Ling, Pamela M.; Glantz, Stanton A.

2002-01-01

Objectives. This article describes the tobacco industry's use of bars and nightclubs to encourage smoking among young adults. Methods. Previously secret tobacco industry marketing documents were analyzed. Results. Tobacco industry bar and nightclub promotions in the 1980s and 1990s included aggressive advertising, tobacco brand–sponsored activities, and distribution of samples. Financial incentives for club owners and staff were used to encourage smoking through peer influence. Increased use of these strategies occurred concurrently with an increase in smoking among persons aged 18 through 24 years. Conclusions. The tobacco industry's bar and nightclub promotions are not yet politically controversial and are not regulated by the 1998 Master Settlement Agreement between the industry and the states. Tobacco control advocates should include young adults in research and advocacy efforts and should design interventions to counter this industry strategy to solidify smoking patterns and recruit young adult smokers. PMID:11867322

Recruiting and retaining youth and young adults: challenges and opportunities in survey research for tobacco control.

PubMed

Cantrell, Jennifer; Hair, Elizabeth C; Smith, Alexandria; Bennett, Morgane; Rath, Jessica Miller; Thomas, Randall K; Fahimi, Mansour; Dennis, J Michael; Vallone, Donna

2018-03-01

Evaluation studies of population-based tobacco control interventions often rely on large-scale survey data from numerous respondents across many geographic areas to provide evidence of their effectiveness. Significant challenges for survey research have emerged with the evolving communications landscape, particularly for surveying hard-to-reach populations such as youth and young adults. This study combines the comprehensive coverage of an address-based sampling (ABS) frame with the timeliness of online data collection to develop a nationally representative longitudinal cohort of young people aged 15-21. We constructed an ABS frame, partially supplemented with auxiliary data, to recruit this hard-to-reach sample. Branded and tested mail-based recruitment materials were designed to bring respondents online for screening, consent and surveying. Once enrolled, respondents completed online surveys every 6 months via computer, tablet or smartphone. Numerous strategies were utilized to enhance retention and representativeness RESULTS: Results detail sample performance, representativeness and retention rates as well as device utilization trends for survey completion among youth and young adult respondents. Panel development efforts resulted in a large, nationally representative sample with high retention rates. This study is among the first to employ this hybrid ABS-to-online methodology to recruit and retain youth and young adults in a probability-based online cohort panel. The approach is particularly valuable for conducting research among younger populations as it capitalizes on their increasing access to and comfort with digital communication. We discuss challenges and opportunities of panel recruitment and retention methods in an effort to provide valuable information for tobacco control researchers seeking to obtain representative, population-based samples of youth and young adults in the U.S. as well as across the globe. © 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.

Tobacco Product Use Among Military Veterans - United States, 2010-2015.

PubMed

Odani, Satomi; Agaku, Israel T; Graffunder, Corinne M; Tynan, Michael A; Armour, Brian S

2018-01-12

In 2015, an estimated 18.8 million U.S. adults were military veterans (1). Although the prevalence of tobacco-attributable conditions is high among veterans (2), there is a paucity of data on use of tobacco products, other than cigarettes, in this population. To monitor tobacco product use among veterans, CDC analyzed self-reported current (i.e., past 30-day) use of five tobacco product types (cigarettes, cigars [big cigars, cigarillos, or little cigars], roll-your-own tobacco, pipes, and smokeless tobacco [chewing tobacco, snuff, dip, or snus]) from the National Survey on Drug Use and Health (NSDUH). Overall, 29.2% of veterans reported current use of any of the assessed tobacco products. Cigarettes were the most commonly used tobacco product (21.6%), followed by cigars (6.2%), smokeless tobacco (5.2%), roll-your-own tobacco (3.0%), and pipes (1.5%); 7.0% of veterans currently used two or more tobacco products. Within subgroups of veterans, current use of any of the assessed tobacco products was higher among persons aged 18-25 years (56.8%), Hispanics (34.0%), persons with less than a high school diploma (37.9%), those with annual family income <$20,000 (44.3%), living in poverty (53.7%), reporting serious psychological distress (48.2%), and with no health insurance (60.1%). By age and sex subgroups, use of any of the assessed tobacco products was significantly higher among all veteran groups than their nonveteran counterparts, except males aged ≥50 years. Expanding the reach of evidence-based tobacco control interventions among veterans could reduce tobacco use prevalence in this population.

How Philip Morris built Marlboro into a global brand for young adults: implications for international tobacco control.

PubMed

Hafez, N; Ling, P M

2005-08-01

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.

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

PubMed

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

2010-02-01

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

Support for smoke-free cars when children are present: a secondary analysis of 164,819 U.S. adults in 2010/2011.

PubMed

Agaku, Israel T; Odukoya, Oluwakemi O; Olufajo, Olubode; Filippidis, Filippos T; Vardavas, Constantine I

2014-11-01

Comprehensive smoke-free legislations prohibiting smoking in indoor areas of workplaces, bars, and restaurants have been adopted in most of the USA; however, limited efforts have focused on regulating secondhand smoke (SHS) exposure in the family car. The objective of this study was to identify the determinants and national/state-specific population support for smoke-free cars, in the presence of any occupant in general, but particularly when children are present. National data of US adults aged ≥18 years (n = 164,819) were obtained from the 2010/2011 Tobacco Use Supplement of the Current Population Survey. Among all US adults, a significantly greater proportion supported smoke-free cars when it was specified that the occupant was a child compared to when not specified (93.4 vs. 73.7 %, p < 0.05). Age, race/ethnicity, gender, current tobacco use, marital status, and the existence of household smoke-free regulations all mediated population support for smoke-free cars. While differences within the US population were noted, this study however showed overwhelming support for smoke-free car policies, particularly when children are present. Policies which prohibit smoking in indoor or confined areas such as cars may benefit public health by protecting nonsmoking children and adults from involuntary SHS exposure.

Youth tobacco surveillance--United States, 1998-1999.

PubMed

2000-10-13

Tobacco use is the single leading preventable cause of death in the United States, accounting for approximately, 430,000 deaths each year. The prevalence of cigarette smoking nationwide among high school students increased during the 1990s, peaking in 1996-1997, then began a gradual decline. Approximately 80% of tobacco users initiate use before the age of 18 years. If the trend in early initiation of cigarette smoking continues, approximately 5 million children aged <18 years who are living today will die prematurely as adults because they began to smoke cigarettes during adolescence. The economic liability associated with tobacco use ranges from $50 billion to $73 billion per year in medical expenses alone. Because of these health and economic consequences, CDC has recommended that states establish and maintain comprehensive tobacco control programs to reduce tobacco use among youth. February 1998 through December 1999. To assist states in developing and maintaining their state-based comprehensive tobacco prevention and control programs, CDC developed the Youth Tobacco Surveillance and Evaluation System, which includes international, national, and state school-based surveys of middle school and high school students. Two components of this system are discussed--the National Youth Tobacco Survey and the state Youth Tobacco Surveys. The national survey is representative of students in the 50 states and the District of Columbia; 15,061 students in 131 schools completed questionnaires in 1999. The state surveys were first conducted in 1998, when three states participated, and in 1999, when 13 states participated (13 states conducted middle school surveys and 10 states conducted high school surveys); state sample sizes ranged from 452 to 15,478 students. This report summarizes data from the 1999 national survey and the 1998 and 1999 state surveys. Findings from the National Youth Tobacco Survey show current tobacco use ranges from 12.8% among middle school students to 34.8% among high school students. Cigarette smoking is the most prevalent form of tobacco used, followed by cigars and smokeless tobacco. Young people have strong cigarette brand preferences. Almost half of current smokers in both middle school and high school report that they usually smoke Marlboro cigarettes. Black students are more likely to smoke Newport cigarettes than any other brand. Half of current smokers in middle school and high school report that they want to completely stop smoking. Nearly one fourth of middle school and high school students who have never smoked cigarettes indicate that they are susceptible to initiating smoking in the next year. Environmental tobacco smoke exposure is very high among both middle school and high school students. During the week before the survey, approximately 9 out of 10 current smokers and half of never smokers were in the same room with someone who was smoking; 8 out of 10 current smokers and 3 out of 10 never smokers rode in a car with someone who was smoking. Six out of 10 current smokers and 3 out of 10 never smokers live in a home where someone else smokes cigarettes. Approximately 70% of middle school and 60% of high school students who currently smoke and are aged <18 years were not asked to show proof of age when they purchased cigarettes. Approximately three fourths of middle school and high school students have seen antismoking commercials; however, 90% report having seen actors smoking on television or in the movies. Approximately 2% of middle school and high school students who had never used tobacco would wear or use something with a tobacco company name or picture on it. This rate increases to approximately 20% for current tobacco users. Youth Tobacco Survey data are used by health and education officials to improve national and state programs to prevent and control youth tobacco use. (ABSTRACT TRUN

Rural Versus Urban Use of Traditional and Emerging Tobacco Products in the United States, 2013-2014.

PubMed

Roberts, Megan E; Doogan, Nathan J; Stanton, Cassandra A; Quisenberry, Amanda J; Villanti, Andrea C; Gaalema, Diann E; Keith, Diana R; Kurti, Allison N; Lopez, Alexa A; Redner, Ryan; Cepeda-Benito, Antonio; Higgins, Stephen T

2017-10-01

To examine urban-rural differences in US prevalences of traditional and emerging tobacco product use as well as dual or polytobacco use of these products. Our data were derived from wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) Study. We estimated weighted prevalences of adult tobacco use across urban-rural geographies and examined prevalences classified by gender, poverty level, and region of the country. Nationally, cigarette use and smokeless tobacco use, as well as dual or polytobacco use of traditional products, were more prevalent in rural than in urban areas. Conversely, cigarillo and hookah use and dual or polytobacco use of emerging products were higher in urban areas. There was no significant urban-rural difference in use of e-cigarettes. Gender, poverty, and region of the country did not seem to be driving most urban-rural differences, although differences related to cigarillo use and dual or polytobacco use of emerging products became nonsignificant after control for covariates. Our findings highlight important urban-rural differences in tobacco use. Whether the changing tobacco product landscape will contribute to a continuation of rural health disparities remains to be seen.

Principal component analysis of early alcohol, drug and tobacco use with major depressive disorder in US adults.

PubMed

Wang, Kesheng; Liu, Ying; Ouedraogo, Youssoufou; Wang, Nianyang; Xie, Xin; Xu, Chun; Luo, Xingguang

2018-05-01

Early alcohol, tobacco and drug use prior to 18 years old are comorbid and correlated. This study included 6239 adults with major depressive disorder (MDD) in the past year and 72,010 controls from the combined data of 2013 and 2014 National Survey on Drug Use and Health (NSDUH). To deal with multicollinearity existing among 17 variables related to early alcohol, tobacco and drug use prior to 18 years old, we used principal component analysis (PCA) to infer PC scores and then use weighted multiple logistic regression analyses to estimate the associations of potential factors and PC scores with MDD. The odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. The overall prevalence of MDD was 6.7%. The first four PCs could explain 57% of the total variance. Weighted multiple logistic regression showed that PC 1 (a measure of psychotherapeutic drugs and illicit drugs other than marijuana use), PC 2 (a measure of cocaine and hallucinogens), PC 3 (a measure of early alcohol, cigarettes, and marijuana use), and PC 4 (a measure of cigar, smokeless tobacco use and illicit drugs use) revealed significant associations with MDD (OR = 1.12, 95% CI = 1.08-1.16, OR = 1.08, 95% CI = 1.04-1.12, OR = 1.13, 95% CI = 1.07-1.18, and OR = 1.15, 95% CI = 1.09-1.21, respectively). In conclusion, PCA can be used to reduce the indicators in complex survey data. Early alcohol, tobacco and drug use prior to 18 years old were found to be associated with increased odds of adult MDD. Copyright © 2018 Elsevier Ltd. All rights reserved.

Tobacco Marketing Receptivity and Other Tobacco Product Use Among Young Adult Bar Patrons.

PubMed

Thrul, Johannes; Lisha, Nadra E; Ling, Pamela M

2016-12-01

Use of other tobacco products (smokeless tobacco, hookah, cigarillo, and e-cigarettes) is increasing, particularly among young adults, and there are few regulations on marketing for these products. We examined the associations between tobacco marketing receptivity and other tobacco product (OTP) use among young adult bar patrons (aged 18-26 years). Time-location sampling was used to collect cross-sectional surveys from 7,540 young adult bar patrons from January 2012 through March of 2014. Multivariable logistic regression analyses in 2015 examined if tobacco marketing receptivity was associated (1) with current (past 30 day) OTP use controlling for demographic factors and (2) with dual/poly use among current cigarette smokers (n = 3,045), controlling for demographics and nicotine dependence. Among the entire sample of young adult bar patrons (Mean age  = 23.7, standard deviation = 1.8; 48.1% female), marketing receptivity was consistently associated with current use of all OTP including smokeless tobacco (adjusted odds ratio [AOR]= 2.56, 95% confidence interval [CI] 2.08-3.16, p < .001), hookah (AOR = 1.97, 95% CI 1.58-2.43, p < .001), cigarillos (AOR = 3.00, 95% CI 2.21-4.08, p < .001), electronic cigarettes (AOR = 2.43, 95% CI 1.93-3.04, p < .001), and multiple tobacco products (AOR = 2.93, 95% CI 2.45-3.51, p < .001). Among current smokers, marketing receptivity was significantly associated with use of smokeless tobacco (AOR = 1.63, 95% CI 1.22-2.18, p < .01), cigarillos (AOR = 1.81, 95% CI 1.22-2.70, p < .01), and multiple tobacco products (AOR = 1.58, 95% CI 1.27-1.97, p < .001). OTP use is common among young adult bar patrons, and it is associated with tobacco marketing receptivity. Efforts to limit tobacco marketing should address OTP in addition to cigarettes. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Tobacco marketing receptivity and other tobacco product use among young adult bar patrons

PubMed Central

Thrul, Johannes; Lisha, Nadra E.; Ling, Pamela M.

2016-01-01

Purpose Use of other tobacco products (smokeless tobacco, hookah, cigarillo, e-cigarettes) is increasing, particularly among young adults, and there are few regulations on marketing for these products. We examined the associations between tobacco marketing receptivity and other tobacco product (OTP) use among young adult bar patrons (aged 18-26 years). Methods Time-location sampling was used to collect cross-sectional surveys from 7,540 young adult bar patrons from January 2012 through March of 2014. Multivariable logistic regression analyses in 2015 examined if tobacco marketing receptivity was associated (1) with current (past 30 day) OTP use controlling for demographic factors, and (2) with dual/poly use among current cigarette smokers (n=3,045), controlling for demographics and nicotine dependence. Results Among the entire sample of young adult bar patrons (Mage=23.7, SD=1.8; 48.1% female), marketing receptivity was consistently associated with current use of all OTP including smokeless tobacco (adjusted odds ratio [AOR]= 2.49, 95% confidence interval [CI] 1.90-3.27, p<.001), hookah (AOR=1.97, 95% CI 1.58-2.43, p<.001), cigarillos/cigars (AOR=3.00, 95% CI 2.21-4.08, p<.001), electronic cigarettes (AOR=2.43, 95% CI 1.93-3.04, p<.001), and multiple tobacco products (AOR=2.93, 95% CI 2.45-3.51, p<.001). Among current smokers, marketing receptivity was significantly associated with use of smokeless tobacco (AOR=1.44, 95% CI 1.05-1.98, p<.05), cigarillos/cigars (AOR=1.81, 95% CI 1.22-2.70, p<.01), and multiple tobacco products (AOR=1.58, 95% CI 1.27-1.97, p<.001). Conclusions OTP use is common among young adult bar patrons and it is associated with tobacco marketing receptivity. Efforts to limit tobacco marketing should address OTP in addition to cigarettes. PMID:27707516

Marijuana use among US tobacco users: Findings from wave 1 of the population assessment of tobacco health (PATH) study.

PubMed

Strong, David R; Myers, Mark G; Pulvers, Kim; Noble, Madison; Brikmanis, Kristin; Doran, Neal

2018-05-01

With an increase in marijuana use among adults in the United States (US), understanding the potential impact of marijuana use on tobacco use and associated behavioral and health consequences, including respiratory conditions, is necessary. Survey responses from Wave 1 of the nationally representative Population Assessment of Tobacco and Health (PATH) Study were used to assess tobacco use and marijuana use among non-current tobacco users (n = 17,952) and current established tobacco-users classified as: cigarette only users (n = 8689), e-cigarette only users (n = 437), cigar only (traditional, cigarillo, or filtered) users (n = 706), hookah only users (n = 461), smokeless tobacco only users (n = 971), cigarette + e-cigarette users (n = 709), and users of multiple tobacco products (n = 2314). When compared to non-current tobacco users, each tobacco user group except smokeless only users had higher odds (odds ratios ranging from 3.86-8.07) of reporting current marijuana use. Among current tobacco users, higher levels of tobacco dependence did not explain the relationship between tobacco use and marijuana use. Additionally, concurrent marijuana use was associated with lower odds of attempts to quit tobacco (OR = 0.86, 95% CI = 0.79, 0.94, p < 0.001) and a higher probability (OR = 1.35, 95CI = 1.21, 1.51, p < 0.01) of reporting a history of respiratory disease. The association between concurrent use of tobacco and marijuana and higher tobacco dependence and lower rates of quit attempts suggests the potential for sustained tobacco use and deleterious health effects. Further, marijuana use may represent an additive risk for respiratory harm among concurrent users of tobacco and marijuana. Copyright © 2018 Elsevier B.V. All rights reserved.

Combustible and Smokeless Tobacco Use Among High School Athletes - United States, 2001-2013.

PubMed

Agaku, Israel T; Singh, Tushar; Jones, Sherry Everett; King, Brian A; Jamal, Ahmed; Neff, Linda; Caraballo, Ralph S

2015-09-04

Athletes are not a typical at-risk group for smoking combustible tobacco products, because they are generally health conscious and desire to remain fit and optimize athletic performance (1). In contrast, smokeless tobacco use historically has been associated with certain sports, such as baseball (2). Athletes might be more likely to use certain tobacco products, such as smokeless tobacco, if they perceive them to be harmless (3); however, smokeless tobacco use is not safe and is associated with increased risk for pancreatic, esophageal, and oral cancers (4). Tobacco use among youth athletes is of particular concern, because most adult tobacco users first try tobacco before age 18 years (5). To examine prevalence and trends in current (≥1 day during the past 30 days) use of combustible tobacco (cigarettes, cigars) and smokeless tobacco (chewing tobacco, snuff, or dip [moist snuff]) products among athlete and nonathlete high school students, CDC analyzed data from the 2001–2013 National Youth Risk Behavior Surveys. Current use of any tobacco (combustible or smokeless tobacco) significantly declined from 33.9% in 2001 to 22.4% in 2013; however, current smokeless tobacco use significantly increased from 10.0% to 11.1% among athletes, and did not change (5.9%) among nonathletes. Furthermore, in 2013, compared with nonathletes, athletes had significantly higher odds of being current smokeless tobacco users (adjusted odds ratio [AOR] = 1.77, p<0.05), but significantly lower odds of being current combustible tobacco users (AOR = 0.80, p<0.05). These findings suggest that opportunities exist for development of stronger tobacco control and prevention measures targeting youth athletes regarding the health risks associated with all forms of tobacco use.

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

PubMed

Pesko, Michael F; Robarts, Adam M T

2017-07-01

Adults and adolescents who reside in rural areas of the United States are traditionally more likely to be tobacco users. This urban-rural disparity remains largely unexplained and, more recently, it is unclear what impact the emergence of electronic cigarettes (e-cigarettes) has had on adolescent tobacco use in urban and rural areas. Our objective is to evaluate the influence of sociodemographics and tobacco control policy environments on adolescent tobacco use in urban versus rural areas, as well as to identify the effect of e-cigarettes on traditional patterns of urban-rural tobacco use. This study analyzes repeated cross-sectional data from the National Youth Tobacco Survey for the years 2011-2014. We estimate the associations between rural residence, cigarette taxes, tobacco advertisement exposure, and ease of access to tobacco with six tobacco use outcomes: current (past 30-day) use of cigarettes, e-cigarettes, cigars, smokeless tobacco, multiple tobacco products, and any tobacco. E-cigarette use among urban youths aged 11-17 years in the United States increased from .82% in 2011 to 8.62% in 2014 (p < .001). Tobacco advertisement exposure was significantly positively associated with all current tobacco use outcomes (p < .001) except for e-cigarettes. Our predictors account for approximately 40% of the difference in urban-rural cigarette use. Sociodemographics, cigarette taxes, and tobacco advertisement exposure are significant predictors of adolescent tobacco use in the United States but do not entirely explain urban-rural disparities. In addition, e-cigarettes appear to be rapidly changing traditional patterns of tobacco use, particularly in urban areas. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

The role of reported tobacco-specific media exposure on adult attitudes towards proposed policies to limit the portrayal of smoking in movies

PubMed Central

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

2011-01-01

Objective 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. Methods 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. Results 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. Conclusion 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. PMID:20008152

Sex-stratified and age-adjusted social gradients in tobacco in Argentina and Uruguay: evidence from the Global Adult Tobacco Survey (GATS).

PubMed

De Maio, F G; Konfino, J; Ondarsuhu, D; Goldberg, L; Linetzky, B; Ferrante, D

2015-11-01

To examine social gradients in tobacco use in Argentina and Uruguay, using newly available directly comparable data sets. Secondary analysis of Global Adult Tobacco Survey data from Argentina (N=6645) and Uruguay (N=5581). Social gradients in current tobacco use, exposure to secondhand smoke, and cessation attempt were examined with sex-stratified and age-adjusted logistic regression. Among men, there is evidence of higher odds of being a current smoker among respondents with lower levels of education, but the association is only statistically significant for respondents with less than primary education in Uruguay (OR=2.15, 95% CI 1.22 to 3.77). Similarly, women with lower levels of education have higher odds of being a current smoker in Uruguay. The association between education and exposure to secondhand smoke is broadly similar for both sexes in both countries, with generally higher odds among groups with low education, though the relationship is only statistically significant among men in Uruguay (OR=1.77, 95% CI 1.08 to 2.92). In both countries, respondents with lower levels of education in general have higher odds of having attempted to quit smoking in the past year, although these associations did not attain statistical significance. Social gradients in tobacco use, exposure to secondhand smoke and cessation attempts are broadly similar in both countries. Efforts to evaluate the long-term effects of tobacco control efforts in these countries should monitor how policies affect national averages, and the social gradients that are embedded in aggregate data. 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/

Retail impact of raising tobacco sales age to 21 years.

PubMed

Winickoff, Jonathan P; Hartman, Lester; Chen, Minghua L; Gottlieb, Mark; Nabi-Burza, Emara; DiFranza, Joseph R

2014-11-01

The majority of tobacco use emerges in individuals before they reach 21 years of age, and many adult distributors of tobacco to youths are young adults aged between 18 and 20 years. Raising the tobacco sales minimum age to 21 years across the United States would decrease tobacco retailer and industry sales by approximately 2% but could contribute to a substantial reduction in the prevalence of youths' tobacco use and dependency by limiting access.

Population receptivity to tobacco advertising/promotions and exposure to anti-tobacco media: effect of Master Settlement Agreement in California: 1992-2002.

PubMed

Gilpin, Elizabeth A; Distefan, Janet M; Pierce, John P

2004-07-01

Tobacco marketing contributes to adolescent smoking initiation, and the Master Settlement Agreement (MSA), therefore, included relevant restrictions. We analyzed data from large population surveys of Californians, conducted in 1992 (11,905 adults, ages 18 years and older), 1993 (5,531 adolescents, ages 12 to 17 years), and 1996 (6,252 adolescents, 18,616 adults) before the MSA, and in 1999 (6,090 adolescents, 14,729 adults) and 2002 (5,857 adolescents, 20,525 adults) following its implementation. Camel lost favorite-advertisement popularity after 1996, and between 1999 and 2002, there were large increases in the percentages declining to name a favorite advertisement. Ownership of tobacco promotional items declined from its peak in 1996. Furthermore, in 2002, close to 90% of adolescents and young adults reported seeing anti-tobacco messages on television in the past month, significantly higher than 1996. These trends indicate less receptivity to tobacco advertising and promotions following the MSA but leave room for additional restrictions to further reduce receptivity.

Predictors of smoking initiation--results from the Global Adult Tobacco Survey (GATS) in Poland 2009-2010.

PubMed

Kaleta, Dorota; Makowiec-Dąbrowska, Teresa; Dziankowska-Zaborszczyk, Elżbieta; Fronczak, Adam

2013-01-01

Improving the access to information on determinants of the smoking epidemic is essential for increasing the effectiveness of tobacco control policies. While the statistics of smoking prevalence in Poland are available, data on smoking initiation and its social correlates are still poorly described. To investigate the association of socio-demographic indicators with regular smoking initiation among adults. Data from the Global Adult Tobacco Survey (GATS) on socio-demographic and smoking-related characteristics of respondents were used. GATS is a nationally representative household survey. GATS provided data on a representative sample of 7,840 adult individuals--2,207 male and 1,321 female ever smokers. Logistic regression analysis was performed and the χ2 test for relevant calculations. Among males, the regular smoking initiation rate was significantly higher compared to females (59.2% vs. 34.2%; p<0.01). Mean age of smoking initiation was lower in men compared to women (18.4±3.6 vs. 20.0± 4.7 p < 0.01). Lack of awareness on smoking health consequences was strongly associated with initiating of regular smoking among both genders (unaware vs. aware respondents: OR = 3.0 CI 2.3-4.0; p < 0.001 in men and OR = 3.07 CI 2.3-3.9; p<0.001 in women). Older age, vocational education and unemployment were associated with regular smoking initiation among men and women. Also, not being religious considerably contributed to increased likelihood of smoking initiation in women (OR = 4.4 CI 2.5-7.7; p<0.001). The results indicate that policies focused on preventing smoking onset among Poles are needed to reduce tobacco epidemic, with the ultimate goal of translating evidence into policy.

Health consequences of using smokeless tobacco: summary of the Advisory Committee's report to the Surgeon General.

PubMed Central

Cullen, J W; Blot, W; Henningfield, J; Boyd, G; Mecklenburg, R; Massey, M M

1986-01-01

On March 25, 1986, the Surgeon General of the Public Health Service released a report that detailed the results of the first comprehensive, indepth review of the relationship between smokeless tobacco use and health. This review, prepared under the auspices of the Surgeon General's Advisory Committee on the Health Consequences of Using Smokeless Tobacco, is summarized in this article. In the United States, smokeless tobacco is used predominantly in the forms of chewing tobacco and snuff. During the past 20 years, the production and consumption of these products have risen significantly in marked contrast to the decline in smokeless tobacco use during the first half of the century. National estimates indicate that more than 12 million persons age 12 and older in the United States used some form of smokeless tobacco in 1985, and half of these were regular users. The highest rates of smokeless tobacco use occurred among adolescent and young adult males. Examination of the relevant epidemiologic, experimental, and clinical data revealed that oral use of smokeless tobacco is a significant health risk. This behavior can cause cancer in humans, and the evidence is strongest for cancer of the oral cavity, particularly at the site of tobacco placement. Smokeless tobacco use can also lead to the development of noncancerous oral conditions, particularly, oral leukoplakias and gingival recession. Further, the levels of nicotine in the body resulting from smokeless tobacco can lead to nicotine addiction and dependence. PMID:3090602

"Such a smoking nation as this I never saw...": smoking, nationalism, and manliness in nineteenth-century Hungary.

PubMed

Maxwell, Alexander

2006-01-01

Tobacco smoking became an important marker of Hungarian national identity during the nineteenth century. this national symbol ultimately had an economic origin: Hungarian tobacco producers resisted the tobacco monopoly of the Habsburg central government, and led an ultimately successful consumer boycott of Austrian products. Tobacco nationalism, however, became a common theme in Hungarian popular culture in its own right, as tobacco use came to symbolize community and fraternity. The use of tobacco was also highly gendered; smoking as a metaphor for membership shows that the Hungarian nation was a gender-exclusive "national brotherhood."

Adult Cigarette Smoking in the United States: Current Estimates

MedlinePlus

... Tobacco Use Hispanics/Latinos and Tobacco Use Lesbian, Gay, Bisexual, and Transgender Persons and Tobacco Use Cigarette ... limitation (14.4%) By Sexual Orientation 2 Lesbian/gay/bisexual adults were more likely to be current ...

Impact of non-menthol flavours in tobacco products on perceptions and use among youth, young adults and adults: a systematic review

PubMed Central

Baker, Hannah M; Meernik, Clare; Ranney, Leah M; Richardson, Amanda; Goldstein, Adam O

2017-01-01

Objective This systematic review examines the impact of non-menthol flavours in tobacco products on tobacco use perceptions and behaviours among youth, young adults and adults. Data sources English-language peer-reviewed publications indexed in 4 databases were searched through April 2016. Study selection A search strategy was developed related to tobacco products and flavours. Of 1688 articles identified, we excluded articles that were not English-language, were not peer-reviewed, were qualitative, assessed menthol-flavoured tobacco products only and did not contain original data on outcomes that assessed the impact of flavours in tobacco products on perceptions and use behaviour. Data extraction Outcome measures were identified and tabulated. 2 researchers extracted the data independently and used a validated quality assessment tool to assess study quality. Data synthesis 40 studies met the inclusion criteria. Data showed that tobacco product packaging with flavour descriptors tended to be rated as more appealing and as less harmful by tobacco users and non-users. Many tobacco product users, especially adolescents, reported experimenting, initiating and continuing to use flavoured products because of the taste and variety of the flavours. Users of many flavoured tobacco products also showed decreased likelihood of intentions to quit compared with non-flavoured tobacco product users. Conclusions Flavours in most tobacco products appear to play a key role in how users and non-users, especially youth, perceive, initiate, progress and continue using tobacco products. Banning non-menthol flavours from tobacco products may ultimately protect public health by reducing tobacco use, particularly among youth. PMID:27872344

The Big-Five Personality Traits, Maternal Smoking during Pregnancy, and Educational Qualifications as Predictors of Tobacco Use in a Nationally Representative Sample.

PubMed

Cheng, Helen; Furnham, Adrian

2016-01-01

To investigate the associations between the Big-Five personality traits, parental social class, maternal smoking status during pregnancy, childhood cognitive ability, education and occupation, and tobacco use in a longitudinal birth cohort study. 17,415 babies born in Great Britain in 1958 and followed up at 11, 33, and 50 years of age. Lifelong tobacco use status (ever/never) and current tobacco use status (yes/no) at age 50 years were the outcome measures respectively. Logistic regression analyses showed that among the 5,840 participants with complete data, whilst maternal smoking status, educational qualifications, and all the big-5 personality traits were significant predictors of adult lifelong tobacco use; educational qualifications, own occupational levels, traits Extraversion, Conscientiousness, and Openness were significant predictors of current smoking status. In lifelong measure men tended to have a greater rate of tobacco use than women (52.1% in men and 49.2% in women). However, the sex effect on lifelong tobacco use ceased to be significant once a set of socio-economic and psychological variables in childhood and adulthood were taken into account. Educational qualifications and the Big-Five personality traits were significantly associated with both current and lifelong tobacco use status.

The Big-Five Personality Traits, Maternal Smoking during Pregnancy, and Educational Qualifications as Predictors of Tobacco Use in a Nationally Representative Sample

PubMed Central

Cheng, Helen; Furnham, Adrian

2016-01-01

Objective To investigate the associations between the Big-Five personality traits, parental social class, maternal smoking status during pregnancy, childhood cognitive ability, education and occupation, and tobacco use in a longitudinal birth cohort study. Method 17,415 babies born in Great Britain in 1958 and followed up at 11, 33, and 50 years of age. Lifelong tobacco use status (ever/never) and current tobacco use status (yes/no) at age 50 years were the outcome measures respectively. Results Logistic regression analyses showed that among the 5,840 participants with complete data, whilst maternal smoking status, educational qualifications, and all the big-5 personality traits were significant predictors of adult lifelong tobacco use; educational qualifications, own occupational levels, traits Extraversion, Conscientiousness, and Openness were significant predictors of current smoking status. In lifelong measure men tended to have a greater rate of tobacco use than women (52.1% in men and 49.2% in women). However, the sex effect on lifelong tobacco use ceased to be significant once a set of socio-economic and psychological variables in childhood and adulthood were taken into account. Conclusion Educational qualifications and the Big-Five personality traits were significantly associated with both current and lifelong tobacco use status. PMID:26731730

Comparing Intervention Strategies among Rural, Low SES, Young Adult Tobacco Users

ERIC Educational Resources Information Center

Zanis, David A.; Hollm, Ronald E.; Derr, Daniel; Ibrahim, Jennifer K.; Collins, Bradley N.; Coviello, Donna; Melochick, Jennifer Ryan

2011-01-01

Objective: To evaluate 3-month tobacco quit rates of young adult tobacco users randomized to 2 intervention conditions. Methods: Overall 192 non-treatment-seeking 18-to-24-year-old tobacco users received educational information and advice to quit smoking. Participants were then block randomized to 2 brief intervention conditions: (1) a telephone…

The Effect of Branding to Promote Healthy Behavior: Reducing Tobacco Use among Youth and Young Adults

PubMed Central

Vallone, Donna; Greenberg, Marisa; Xiao, Haijun; Bennett, Morgane; Cantrell, Jennifer; Rath, Jessica; Hair, Elizabeth

2017-01-01

Policy interventions such as public health mass media campaigns disseminate messages in order to improve health-related knowledge, attitudes, beliefs and behaviors at the population level. Only more recently have campaigns that promote health-related behaviors adopted branding, a well-established marketing strategy, to influence how consumers think and feel about a message. This study examines whether positive brand equity for the national truth® campaign is associated with lower likelihood of cigarette use over time using the nationally representative Truth Longitudinal Cohort of youth and young adults, aged 15–21. Logistic regression models were used to examine the relationship between brand equity and the likelihood of reporting past 30-day smoking over a 12-month period. Respondents who reported positive brand equity were significantly less likely to report past 30-day smoking 12 months later (OR = 0.66, p < 0.05), controlling for covariates known to influence tobacco use behavior. Findings also translate the effect size difference to a population estimate of more than 300,000 youth and young adults having been prevented from current smoking over the course of a year. Building brand equity is a strategic process for health promotion campaigns, not only to improve message recall and salience but also to influence behavioral outcomes. PMID:29215555

The Effect of Branding to Promote Healthy Behavior: Reducing Tobacco Use among Youth and Young Adults.

PubMed

Vallone, Donna; Greenberg, Marisa; Xiao, Haijun; Bennett, Morgane; Cantrell, Jennifer; Rath, Jessica; Hair, Elizabeth

2017-12-07

Policy interventions such as public health mass media campaigns disseminate messages in order to improve health-related knowledge, attitudes, beliefs and behaviors at the population level. Only more recently have campaigns that promote health-related behaviors adopted branding, a well-established marketing strategy, to influence how consumers think and feel about a message. This study examines whether positive brand equity for the national truth ® campaign is associated with lower likelihood of cigarette use over time using the nationally representative Truth Longitudinal Cohort of youth and young adults, aged 15-21. Logistic regression models were used to examine the relationship between brand equity and the likelihood of reporting past 30-day smoking over a 12-month period. Respondents who reported positive brand equity were significantly less likely to report past 30-day smoking 12 months later (OR = 0.66, p < 0.05), controlling for covariates known to influence tobacco use behavior. Findings also translate the effect size difference to a population estimate of more than 300,000 youth and young adults having been prevented from current smoking over the course of a year. Building brand equity is a strategic process for health promotion campaigns, not only to improve message recall and salience but also to influence behavioral outcomes.

How Philip Morris built Marlboro into a global brand for young adults: implications for international tobacco control

PubMed Central

Hafez, N; Ling, P

2005-01-01

Objective: To describe Philip Morris' global market research and international promotional strategies targeting young adults. Methods: : Analysis of previously secret tobacco industry documents. Results: 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. Conclusions: 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. PMID:16046690

Effects of tobacco-related media campaigns on smoking among 20-30-year-old adults: longitudinal data from the USA.

PubMed

Terry-McElrath, Yvonne M; Emery, Sherry; Wakefield, Melanie A; O'Malley, Patrick M; Szczypka, Glen; Johnston, Lloyd D

2013-01-01

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.

Effects of Tobacco-Related Media Campaigns on Young Adult Smoking: Longitudinal Data from the United States

PubMed Central

Terry-McElrath, Yvonne M.; Emery, Sherry; Wakefield, Melanie A.; O’Malley, Patrick M.; Szczypka, Glen; Johnston, Lloyd D.

2012-01-01

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

Smokeless and flavored tobacco products in the U.S.: 2009 Styles survey results.

PubMed

Regan, Annette K; Dube, Shanta R; Arrazola, René

2012-01-01

A number of noncigarette tobacco products, including some novel products, recently have been marketed by the tobacco industry, which raises concerns from tobacco control authorities. This study aimed to assess current popularity of several noncigarette tobacco products in the U.S. In 2009, a total of 10,587 adults completed a consumer mail-in survey (ConsumerStyles). Based on survey results, the weighted percentages of adults who heard and tried snus, dissolvable tobacco products, flavored little cigars, and flavored cigarettes were computed in 2010. A subset of this sample (n=4556) completed the HealthStyles survey, which included items about health perceptions of these products and use in the past 30 days. The percentage of U.S. adults in the sample who were aware of these products ranged from 10.4% (dissolvable tobacco) to 44.6% (flavored little cigars). One third of adults who had heard of flavored little cigars tried them and 10.1% had used them in the past 30 days; among those who had heard of them, 27.4% tried flavored cigarettes and 12.6% tried snus. In general, young adults, men, and smokers were most likely to have heard of each product. At least one third of adults were uncertain if these products were as harmful as cigarettes (range=37.3% [snus] to 50.3% [dissolvable tobacco]). The awareness of these tobacco products in this sample varied. Groups with a higher prevalence of smoking and tobacco use (e.g., men, people with low levels of education) may be a target audience for marketing and promotions. As availability of products change, continued surveillance is warranted in the U.S. Published by Elsevier Inc.

[Importance for surveillance on chronic obstructive pulmonary disease among Chinese adults].

PubMed

Fang, L W; Wang, L H

2018-05-10

The first national surveillance of COPD in mainland China was carried out in 2014, with the nationally representative data obtained. The national surveillance was significantly important for the monitoring of prevalence, risk factors, and changing trend of COPD among Chinese adults aged ≥ 40. The surveillance was also important in the development of national COPD prevention and control policy, the evaluation of prevention and control progress, the establishment of COPD comprehensive surveillance system, and the building of a professional COPD monitoring and prevention team. In this editorial, we briefly introduced the method and content of COPD surveillance, and reported the rate of spirometry examination and COPD awareness among adults aged ≥40 in China. We also analyzed the rate of main risk factors for COPD, such as tobacco smoking, occupational exposure to dust or chemical and indoor exposure to biomass or coal, and the distribution of high-risk population. This study provided fundamental data for the prevention and control of COPD in China.

High school journalists' perspectives on tobacco.

PubMed

Malone, Ruth E; Wenger, Lynn D; Bero, Lisa A

2002-01-01

How issues are covered in the media is an important factor in influencing public opinion, policy, and individual behavior. During the 1990s, the tobacco control movement developed a youth focus, prompted by research showing that most adult smokers begin tobacco use as teens. However, concern has been raised that this youth focus has derailed the overall goal of achieving a smoke-free society. Numerous studies have analyzed tobacco coverage and documented the impacts of media messages on youth. To learn how tobacco is covered in a medium primarily produced by and for youth, we conducted an analysis of tobacco coverage in high school newspapers. High school newspapers, like other media, communicate social messages through both content selection and framing. We surveyed a national sample of high school journalists and conducted content and frames analyses of tobacco articles (n = 257) from their publications. The most commonly used frame was "kids" (46%), followed by "killer" (31%), "nonsmokers' rights" (10%), and "choice" (5%). "Kids"-framed articles were less likely to mention health effects and less likely to be favorable toward tobacco control policies than "killer"-framed articles. In addition, many "kids" articles included "resistance statements" congruent with viewing tobacco use as rebellion and/or independence. Lack of a consistently used frame has been identified as a barrier to effective tobacco control. Tobacco control media advocacy should focus on developing frames that are easily communicated, consistently used, and compatible with the developmental tasks of adolescents. Youth journalists should also be included in media advocacy efforts.

Consumer perceptions of the sale of tobacco products in pharmacies and grocery stores among U.S. adults.

PubMed

Patwardhan, Pallavi; McMillen, Robert; Winickoff, Jonathan P

2013-07-09

Pharmacy-based tobacco sales are a rapidly increasing segment of the U.S. retail tobacco market. Growing evidence links easy access to tobacco retail outlets such as pharmacies to increased tobacco use. This mixed-mode survey was the first to employ a nationally representative sample of consumers (n = 3057) to explore their opinions on sale of tobacco products in pharmacies and grocery stores. The majority reported that sale of tobacco products should be either 'allowed if products hidden from view' (29.9%, 25.6%) or 'not allowed at all' (24.0%, 31.3%) in grocery stores and pharmacies, respectively. Significantly fewer smokers, compared to non-smokers, reported agreement on point-of-sale restrictions on sales of tobacco products (grocery stores: 27.1% vs. 59.6%, p < .01; pharmacy: 32.8% vs. 62.0%, p < .01). Opinions also varied significantly by demographic characteristics and factors such as presence of a child in the household and urban/rural location of residence. Overall, a majority of consumers surveyed either supported banning sales of tobacco in grocery stores and pharmacies or allowing sales only if the products are hidden from direct view. Both policy changes would represent a departure from the status quo. Consistent with the views of practicing pharmacists and professional pharmacy organizations, consumers are also largely supportive of more restrictive policies.

Consumer perceptions of the sale of tobacco products in pharmacies and grocery stores among U.S. adults

PubMed Central

2013-01-01

Background Pharmacy-based tobacco sales are a rapidly increasing segment of the U.S. retail tobacco market. Growing evidence links easy access to tobacco retail outlets such as pharmacies to increased tobacco use. This mixed-mode survey was the first to employ a nationally representative sample of consumers (n = 3057) to explore their opinions on sale of tobacco products in pharmacies and grocery stores. Results The majority reported that sale of tobacco products should be either ‘allowed if products hidden from view’ (29.9%, 25.6%) or ‘not allowed at all’ (24.0%, 31.3%) in grocery stores and pharmacies, respectively. Significantly fewer smokers, compared to non-smokers, reported agreement on point-of-sale restrictions on sales of tobacco products (grocery stores: 27.1% vs. 59.6%, p < .01; pharmacy: 32.8% vs. 62.0%, p < .01). Opinions also varied significantly by demographic characteristics and factors such as presence of a child in the household and urban/rural location of residence. Conclusions Overall, a majority of consumers surveyed either supported banning sales of tobacco in grocery stores and pharmacies or allowing sales only if the products are hidden from direct view. Both policy changes would represent a departure from the status quo. Consistent with the views of practicing pharmacists and professional pharmacy organizations, consumers are also largely supportive of more restrictive policies. PMID:23837647

Equity impact of population-level interventions and policies to reduce smoking in adults: a systematic review.

PubMed

Brown, Tamara; Platt, Stephen; Amos, Amanda

2014-05-01

There is strong evidence about which tobacco control policies reduce smoking. However, their equity impact is uncertain. The aim was to assess the effectiveness of population-level interventions/policies to reduce socioeconomic inequalities in adult smoking. Systematic review of studies of population-level interventions/policies reporting smoking-related outcomes in adults of lower compared to higher socioeconomic status (SES). References were screened and independently checked. Studies were quality assessed. Results are presented in a narrative synthesis. Equity impact was assessed as: positive (reduced inequality), neutral (no difference by SES), negative (increased inequality), mixed (equity impact varied) or unclear. 117 studies of 130 interventions/policies were included: smokefree (44); price/tax (27); mass media campaigns (30); advertising controls (9); cessation support (9); settings-based interventions (7); multiple policies (4). The distribution of equity effects was: 33 positive, 36 neutral, 38 negative, 6 mixed, 17 unclear. Most neutral equity studies benefited all SES groups. Fourteen price/tax studies were equity positive. Voluntary, regional and partial smokefree policies were more likely to be equity negative than national, comprehensive smokefree policies. Mass media campaigns had inconsistent equity effects. Cigarette marketing controls were equity positive or neutral. Targeted national smoking cessation services can be equity positive by achieving higher reach among low SES, compensating for lower quit rates. Few studies have assessed the equity impact of tobacco control policy/interventions. Price/tax increases had the most consistent positive equity impact. More research is needed to strengthen the evidence-base for reducing smoking inequalities and to develop effective equity-orientated tobacco control strategies. Copyright © 2014. Published by Elsevier Ireland Ltd.

Impact of non-menthol flavours in tobacco products on perceptions and use among youth, young adults and adults: a systematic review.

PubMed

Huang, Li-Ling; Baker, Hannah M; Meernik, Clare; Ranney, Leah M; Richardson, Amanda; Goldstein, Adam O

2017-11-01

This systematic review examines the impact of non-menthol flavours in tobacco products on tobacco use perceptions and behaviours among youth, young adults and adults. English-language peer-reviewed publications indexed in 4 databases were searched through April 2016. A search strategy was developed related to tobacco products and flavours. Of 1688 articles identified, we excluded articles that were not English-language, were not peer-reviewed, were qualitative, assessed menthol-flavoured tobacco products only and did not contain original data on outcomes that assessed the impact of flavours in tobacco products on perceptions and use behaviour. Outcome measures were identified and tabulated. 2 researchers extracted the data independently and used a validated quality assessment tool to assess study quality. 40 studies met the inclusion criteria. Data showed that tobacco product packaging with flavour descriptors tended to be rated as more appealing and as less harmful by tobacco users and non-users. Many tobacco product users, especially adolescents, reported experimenting, initiating and continuing to use flavoured products because of the taste and variety of the flavours. Users of many flavoured tobacco products also showed decreased likelihood of intentions to quit compared with non-flavoured tobacco product users. Flavours in most tobacco products appear to play a key role in how users and non-users, especially youth, perceive, initiate, progress and continue using tobacco products. Banning non-menthol flavours from tobacco products may ultimately protect public health by reducing tobacco use, particularly among youth. 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/.

78 FR 2678 - Proposed Collection; Comment Request (60-Day FRN): The National Cancer Institute (NCI...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-14

... text message smoking cessation intervention designed for young adult smokers ages 18-29. The SmokefreeTXT program is a component of a larger series of eHealth/mHealth tobacco cessation intervention... using the bidirectional aspect of text- messaging service and a series of web-based surveys. All web...

Smoking Cessation: Uni-Modal and Multi-Modal Hypnotic and Non-Hypnotic Approaches.

ERIC Educational Resources Information Center

Habicht, Manuela H.

A survey of Queensland's population in 1993 determined that 24% of the adults were smokers. National data compiled in 1992 indicated that 72% of the drug-related deaths were related to tobacco use. In light of the need for effective smoking cessation approaches, a literature review was undertaken to determine the efficacy of hypnotic and…

Peer crowd affiliation as a segmentation tool for young adult tobacco use.

PubMed

Lisha, Nadra E; Jordan, Jeffrey W; Ling, Pamela M

2016-10-01

In California, young adult tobacco prevention is of prime importance; 63% of smokers start by the age of 18 years, and 97% start by the age of 26 years. We examined social affiliation with 'peer crowd' (eg, Hipsters) as an innovative way to identify high-risk tobacco users. Cross-sectional surveys were conducted in 2014 (N=3368) among young adult bar patrons in 3 California cities. We examined use rates of five products (cigarettes, e-cigarettes, hookah, cigars and smokeless tobacco) by five race/ethnicity categories. Peer crowd affiliation was scored based on respondents' selecting pictures of young adults representing those most and least likely to be in their friend group. Respondents were classified into categories based on the highest score; the peer crowd score was also examined as a continuous predictor. Logistic regression models with each tobacco product as the outcome tested the unique contribution of peer crowd affiliation, controlling for race/ethnicity, age, sex, sexual orientation and city. Respondents affiliating with Hip Hop and Hipster peer crowds reported significantly higher rates of tobacco use. As a categorical predictor, peer crowd was related to tobacco use, independent of associations with race/ethnicity. As a continuous predictor, Hip Hop peer crowd affiliation was also associated with tobacco use, and Young Professional affiliation was negatively associated, independent of demographic factors. Tobacco product use is not the same across racial/ethnic groups or peer crowds, and peer crowd predicts tobacco use independent of race/ethnicity. Antitobacco interventions targeting peer crowds may be an effective way to reach young adult tobacco users. NCT01686178, Pre-results. 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/.

Prevalence and characteristics of young adult smokers in the U.S. in the precontemplation stage of smoking cessation.

PubMed

Andrews, Mary E; Sabado, Melanie; Choi, Kelvin

2018-09-01

The precontemplation stage of smoking cessation refers to having no intention to quit smoking in the next six months. We aimed to estimate the prevalence of and characteristics associated with the precontemplation stage of smoking cessation among U.S. young adult smokers to inform the development of targeted interventions. We analyzed data in 2017 from the 2013-2014 National Adult Tobacco Survey. Young adult (18-29 years old) daily and non-daily smokers were included (n = 1809). We applied weighted multiple logistic regression models to examine the associations between demographics, tobacco use behaviors, exposure to pro- and anti-tobacco messages, and the precontemplation stage of smoking cessation. 59.0% of U.S. young adult smokers are in the precontemplation stage of smoking cessation. Unemployment was positively associated with being in the precontemplation stage of smoking cessation (AOR = 1.42 95% CI = 1.05, 1.91). Smoking every day (vs. some days), more cigarettes smoked per day, using roll-your-own cigarettes (vs. manufactured cigarettes only), currently smoking cigars, and signing up for promotional offers were positively associated with being in the precontemplation stage of smoking cessation (p < 0.05). Non-Hispanic Black was negatively associated with precontemplation stage (AOR = 0.40, 95% CI = 0.27, 0.59). Not smoking after viewing a health warning on a cigarette pack was negatively associated with the precontemplation stage of smoking cessation (AOR = 0.36, 95% CI = 0.25, 0.51). Many U.S. young adult smokers classify as being in the precontemplation stage of smoking cessation. Interventions to motivate these smokers to quit smoking with considerations of their specific characteristics (e.g., being unemployed) are warranted. Copyright © 2018 Elsevier Ltd. All rights reserved.

US college students' exposure to tobacco promotions: prevalence and association with tobacco use.

PubMed

Rigotti, Nancy A; Moran, Susan E; Wechsler, Henry

2005-01-01

We assessed young adults' exposure to the tobacco industry marketing strategy of sponsoring social events at bars, nightclubs, and college campuses. We analyzed data from the 2001 Harvard College Alcohol Study, a random sample of 10904 students enrolled in 119 nationally representative 4-year colleges and universities. During the 2000-2001 school year, 8.5% of respondents attended a bar, nightclub, or campus social event where free cigarettes were distributed. Events were reported by students attending 118 of the 119 schools (99.2%). Attendance was associated with a higher student smoking prevalence after we adjusted for demographic factors, alcohol use, and recent bar/nightclub attendance. This association remained for students who did not smoke regularly before 19 years of age but not for students who smoked regularly by 19 years of age. Attendance at a tobacco industry-sponsored event at a bar, nightclub, or campus party was associated with a higher smoking prevalence among college students. Promotional events may encourage the initiation or the progression of tobacco use among college students who are not smoking regularly when they enter college.

Promotion of Waterpipe Tobacco Use, Its Variants and Accessories in Young Adult Newspapers: A Content Analysis of Message Portrayal

ERIC Educational Resources Information Center

Sterling, Kymberle L.; Fryer, Craig S.; Majeed, Ban; Duong, Melissa M.

2015-01-01

The objective of our study was to identify waterpipe tobacco smoking advertisements and those that promoted a range of products and accessories used to smoke waterpipe tobacco. The content of these advertisements was analyzed to understand the messages portrayed about waterpipe tobacco smoking in young adult (aged 18-30) newspapers. The study…

Worldviews and trust of sources for health information on electronic nicotine delivery systems: Effects on risk perceptions and use.

PubMed

Weaver, Scott R; Jazwa, Amelia; Popova, Lucy; Slovic, Paul; Rothenberg, Richard B; Eriksen, Michael P

2017-12-01

Public health agencies, the news media, and the tobacco/vapor industry have issued contradictory statements about the health effects of electronic nicotine delivery systems (ENDS). We investigated the levels of trust that consumers place in different information sources and how trust is associated with cultural worldviews, risk perceptions, ENDS use, and sociodemographic characteristics using a nationally representative sample of 6051 U.S. adults in 2015. Seventeen percent of adults were uncertain about their trust for one or more potential sources. Among the rest, the Centers for Disease Control and Prevention (CDC), health experts, and the Food & Drug Administration (FDA) elicited the highest levels of trust. In contrast, tobacco and vapor manufacturers, vape shop employees, and, to a lesser extent, the news media were distrusted. Adults who had higher incomes and more education or espoused egalitarian and communitarian worldviews expressed more trust in health sources and the FDA, whereas those identifying as non-Hispanic Black or multiracial reported less trust. Current smokers, those who identified as non-Hispanic Black or other race, had lower incomes, and espoused hierarchy and individualism worldviews expressed less distrust toward the tobacco and vapor industry. Greater trust (or less distrust) toward the tobacco and vapor industry and an individualism worldview were associated with perceptions of lower risk of premature death from daily ENDS use, greater uncertainty about those risks, and greater odds of using ENDS. Public health and the FDA should consider consumer trust and worldviews in the design and regulation of public education campaigns regarding the potential health risks and benefits of ENDS.

Correlates of smoking among young adults: the role of lifestyle, attitudes/beliefs, demographics, and exposure to anti-tobacco media messaging.

PubMed

Dietz, Noella A; Sly, David F; Lee, David J; Arheart, Kristopher L; McClure, Laura A

2013-06-01

Young adults (18-24 years) have the highest smoking rate of any age group. Unlike youth/adult populations where there is one primary message targeting behavior, anti-tobacco campaigns targeting young adults should contain messages of prevention and cessation. The objective was to identify factors influencing young adult cigarette use, employing the Centers for Disease Control and Prevention logic model, with an emphasis on the role of lifestyle, tobacco use tolerance, and attitudes/beliefs. Cross-sectional data were collected from 4401 young adults using telephone interviews in 2010 as part of the evaluation for the Tobacco Free Florida Campaign. Multivariate logistic regression was used to examine the relationship between current smoking status and lifestyles, tolerance of tobacco use, and attitude/belief variables. The young adult cigarette prevalence rate is 20.3%, with males more likely to be smokers (25.1%) than females (15.6%) and non-Hispanic Whites more likely to be smokers than other racial/ethnic groups (23.8%). Significant associations were found between lifestyle variables (frequent bar/club, drinks per month, and number of friends who smoke), tolerance of tobacco use (allow smoke in house/car and moderate tobacco use), and four attitude/belief indices and current smoking behavior. Results suggest lifestyles and attitudes/beliefs should be key behavioral targets of prevention programs aimed at young adults. Data strongly suggest that as young adults reject negative labels attached to smokers, they are more likely to smoke. Prevention (and cessation) programs may need to reduce barriers that result in segregating nonsmokers/smokers so smokers can have an increased chance of adopting attitudes/beliefs of nonsmokers. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

From the American Academy of Pediatrics: Technical report--Tobacco as a substance of abuse.

PubMed

Sims, Tammy H

2009-11-01

Tobacco use is the leading preventable cause of morbidity and death in the United States. Because 80% to 90% of adult smokers began during adolescence, and two thirds became regular, daily smokers before they reached 19 years of age, tobacco use may be viewed as a pediatric disease. Every year in the United States, approximately 1.4 million children younger than 18 years start smoking, and many of them will die prematurely from a smoking-related disease. Moreover, there is recent evidence that adolescents report symptoms of tobacco dependence early in the smoking process, even before becoming daily smokers. The prevalence of tobacco use is higher among teenagers and young adults than among older adult populations. The critical role of pediatricians in helping to reduce tobacco use and addiction and secondhand tobacco-smoke exposure in the pediatric population includes education and prevention, screening and detection, and treatment and referral.

Results of global youth tobacco surveys in public schools in Bogotá, Colombia.

PubMed

Pardo, Constanza; Piñeros, Marion; Jones, Nathan R; Warren, Charles W

2010-03-01

The purpose of this paper is to use data from the Global Youth Tobacco Survey (GYTS) conducted in Bogotá, Colombia, in 2001 and 2007 to examine changes in tobacco use among youth 13-15 years of age. The current tobacco control effort in Bogotá will be accessed relative to Colombia ratifying the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in 2008. GYTS was implemented in public schools in Bogotá, Colombia, by the Colombian National Cancer Institute. Data were collected from students in classrooms using self-administered procedures. Between 2001 and 2007, ever having smoked cigarettes decreased along with exposure to secondhand smoke (SHS) at home, having an object with a tobacco logo on it, and having been offered free cigarettes by a tobacco company representative. Prevalence of current cigarette smoking did not change from 2001 to 2007 (32.9% and 29.9%). Exposure to pro-tobacco advertising increased, reaching 71.4%, and 73.4% respectively, in 2007. Having been taught about the harmful effects of tobacco use did not change over time. The government of Colombia ratified the WHO FCTC in 2008. However, Colombia has one of the highest levels of cigarette smoking among 13-15 year olds in the Region of the Americas. The tobacco control effort in Colombia has much work to do, including recognition that the levels of smoking among adolescents are already as high as those of adults. Future declines in tobacco use among adolescents in Bogotá will likely depend on development of a comprehensive tobacco control program.

Facility-level, state, and financial factors associated with changes in the provision of smoking cessation services in US substance abuse treatment facilities: Results from the National Survey of Substance Abuse Treatment Services 2006 to 2012.

PubMed

Cohn, Amy; Elmasry, Hoda; Niaura, Ray

2017-06-01

Cigarette smoking is common among patients in substance abuse treatment. Tobacco control programs have advocated for integrated tobacco dependence treatment into behavioral healthcare, including within substance abuse treatment facilities (SATFs) to reduce the public health burden of tobacco use. This study used data from seven waves (2006 to 2012) of the National Survey of Substance Abuse Treatment Services (n=94,145) to examine state and annual changes in the provision of smoking cessation services within US SATFs and whether changes over time could be explained by facility-level (private vs public ownership, receipt of earmarks, facility admissions, acceptance of government insurance) and state-level factors (cigarette tax per pack, smoke free policies, and percent of CDC recommended tobacco prevention spending). Results showed that the prevalence of SATFs offering smoking cessation services increased over time, from 13% to 65%. The amount of tax per cigarette pack, accepting government insurance, government (vs private) ownership, facility admissions, and CDC recommended tobacco prevention spending (per state) were the strongest correlates of the provision of smoking cessation programs in SATFs. Facilities that received earmarks were less likely to provide cessation services. Adult smoking prevalence and state-level smoke free policies were not significant correlates of the provision of smoking cessation services over time. Policies aimed at increasing the distribution of tax revenues to cessation services in SATFs may offset tobacco-related burden among those with substance abuse problems. Copyright © 2017. Published by Elsevier Inc.

Predictors of Quitting Attempts Among Tobacco Users in Bangladesh After a Communication Campaign to Launch Graphic Warning Labels on Packaging.

PubMed

Turk, Tahir; Newton, Fiona; Choudhury, Sohel; Islam, Md Shafiqul

2018-06-01

Tobacco use contributes to an estimated 14.6% of male and 5.7% of female deaths in Bangladesh. We examine the determinants of tobacco-related quit attempts among Bangladeshis with and without awareness of the synergized "People Behind the Packs" (PBTP) communication campaign used to support the introduction of pack-based graphic warning labels (GWLs) in 2016. Data from 1,796 adults were collected using multistage sampling and a cross-sectional face-to-face survey. Analyses used a normalized design weight to ensure representativeness to the national population of smokers within Bangladesh. For the overall sample, the multivariable logistic regression model revealed quit attempts were associated with having seen the pack-based GWLs, recalling ≥1 PBTP campaign message, higher levels of self-efficacy to quit, and recognizing more potential side-effects associated with using tobacco products. Conversely, the likelihood of quitting attempts were lower among dual tobacco users (relative to smokers) and those using tobacco at least daily (vs. less than daily). The hierarchical multivariable logistic regression model among those aware of ≥1 PBTP campaign message indicated quitting attempts were positively associated with recalling more of the campaign messages and discussing them with others. This national evaluation of pack-based GWLs and accompanying PBTP campaign within Bangladesh supports the efficacy of using synergized communication messages when introducing such labels. That quit attempts are more likely among those discussing PBTP campaign messages with others and recalling more PBTP campaign messages highlights the importance of ensuring message content is both memorable and engaging.

Traversing the triangulum: the intersection of tobacco, legalised marijuana and electronic vaporisers in Denver, Colorado

PubMed Central

McDonald, Emily Anne; Popova, Lucy; Ling, Pamela M

2016-01-01

Objective To explore the intersection of tobacco, legalised marijuana and electronic vaporiser use among young adults in the ‘natural laboratory’ of Colorado, the first state with legalised retail marijuana. Methods We conducted semistructured interviews with 32 young adults (18–26 years old) in Denver, Colorado, in 2015 to understand the beliefs and practices related to the use of tobacco, marijuana and vaporisers. Results We found ambiguity about whether the phrase ‘to smoke’ refers to the use of tobacco or marijuana products. Smoking marijuana blunts (emptied cigarillo or tobacco wrap filled with marijuana) was common, but few interpreted this as tobacco use. Marijuana vaporisers were used to circumvent public consumption laws (eg, while at work or when driving). Young adults considered secondhand tobacco smoke dangerous, but perceived secondhand marijuana smoke as benign. Discussion Using tobacco products as a delivery method for marijuana (eg, blunts) might be increasing and normalising tobacco use among young adults. Surveillance should explicitly ask about use of tobacco products for marijuana. Marijuana vaporisers, often indistinguishable from nicotine vaporisers, may be used to circumvent public consumption laws; communities concerned about use of marijuana in public spaces should include vaporisers (for nicotine or marijuana) in smoke-free regulations. Tobacco, marijuana and electronic vaporisers should be studied together, rather than separately. This approach is essential in informing research and policy as more US states and countries worldwide move to legalise marijuana. PMID:27697954

Race/Ethnic Variations in Quitline Use Among US Adult Tobacco Users in 45 States, 2011-2013.

PubMed

Marshall, LaTisha L; Zhang, Lei; Malarcher, Ann M; Mann, Nathan H; King, Brian A; Alexander, Robert L

2017-11-07

State quitlines provide free telephone-based cessation services and are available in all states. However, quitlines presently reach 1% of US cigarette smokers. We assessed variations in quitline reach by race/ethnicity across 45 US states included in the National Quitline Data Warehouse, a repository on non-identifiable data reported by state quitlines. During 2011 to 2013, we analyzed 1 220 171 records from the National Quitline Data Warehouse. Annual quitline reach was defined as the proportion of cigarette smokers and smokeless tobacco users who utilized quitline services during each year, and was calculated by dividing the number of state-specific quitline registrants in each year by the number of adult cigarette smokers and smokeless tobacco users in the state. Average annual reach ranged from: 0.08% (Tennessee) to 3.42% (Hawaii) among non-Hispanic whites; 0.17% (Tennessee) to 3.85% (Delaware) among non-Hispanic blacks; 0.27% (Nevada) to 9.98% (Delaware) among non-Hispanic American Indians/Alaska Native; 0.03% (Alabama) to 2.43% (Hawaii) among non-Hispanic Asian/Pacific Islanders; and from 0.08% (Tennessee) to 3.18% (Maine) among Hispanics. Average annual reach was highest among non-Hispanic American Indians/Alaska Native in 27 states, non-Hispanic blacks in 14 states, and non-Hispanic whites in four states. Quitlines appear to be reaching minority populations; however, overall reach remains low and variations in quitline reach exist by race/ethnicity. Opportunities exist to increase the utilization of quitlines and other effective cessation treatments among racial/ethnic minority populations. Some studies have assessed quitline reach across demographic groups in individual states; however, no studies have provided multistate data about quitline reach across race/ethnic groups. Ongoing monitoring of the use of state quitlines can help guide targeted outreach to particular race/ethnic groups with the goal of increasing the overall proportion and number of tobacco users that use quitlines. These efforts should be complemented by comprehensive tobacco control initiatives that increase cessation including mass media campaigns, smoke-free policies, increased tobacco prices, expansion of health insurance coverage, and health systems change. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

How risky is it to use e-cigarettes? Smokers' beliefs about their health risks from using novel and traditional tobacco products.

PubMed

Pepper, Jessica K; Emery, Sherry L; Ribisl, Kurt M; Rini, Christine M; Brewer, Noel T

2015-04-01

We sought to understand smokers' perceived likelihood of health problems from using cigarettes and four non-cigarette tobacco products (NCTPs: e-cigarettes, snus, dissolvable tobacco, and smokeless tobacco). A US national sample of 6,607 adult smokers completed an online survey in March 2013. Participants viewed e-cigarette use as less likely to cause lung cancer, oral cancer, or heart disease compared to smoking regular cigarettes (all p < .001). This finding was robust for all demographic groups. Participants viewed using NCTPs other than e-cigarettes as more likely to cause oral cancer than smoking cigarettes but less likely to cause lung cancer. The dramatic increase in e-cigarette use may be due in part to the belief that they are less risky to use than cigarettes, unlike the other NCTPs. Future research should examine trajectories in perceived likelihood of harm from e-cigarette use and whether they affect regular and electronic cigarette use.

How risky is it to use e-cigarettes? Smokers’ beliefs about their health risks from using novel and traditional tobacco products

PubMed Central

Emery, Sherry L.; Ribisl, Kurt M.; Rini, Christine M.; Brewer, Noel T.

2015-01-01

We sought to understand smokers’ perceived likelihood of health problems from using cigarettes and four non-cigarette tobacco products (NCTPs: e-cigarettes, snus, dissolvable tobacco, and smokeless tobacco). A US national sample of 6,607 adult smokers completed an online survey in March 2013. Participants viewed e-cigarette use as less likely to cause lung cancer, oral cancer, or heart disease compared to smoking regular cigarettes (all p < .001). This finding was robust for all demographic groups. Participants viewed using NCTPs other than e-cigarettes as more likely to cause oral cancer than smoking cigarettes but less likely to cause lung cancer. The dramatic increase in e-cigarette use may be due in part to the belief that they are less risky to use than cigarettes, unlike the other NCTPs. Future research should examine trajectories in perceived likelihood of harm from e-cigarette use and whether they affect regular and electronic cigarette use. PMID:25348584

Involving older Americans in the war on tobacco. The American Stop Smoking Intervention Study for Cancer Prevention.

PubMed

Cummings, K M

1994-10-01

The American Stop Smoking Intervention Study for Cancer Prevention (ASSIST) is a collaborative effort of the National Cancer Institute, the American Cancer Society, state health departments, and other public and private organizations to develop comprehensive tobacco use control programs in 17 states. The two main goals of the project are to reduce adult smoking prevalence to 15% or less and to reduce the rates of smoking initiation among adolescents by 50% by the year 2000. There is strong consensus within the tobacco-control field of what needs to be done to accomplish these goals. The key elements of a comprehensive tobacco control effort include (1) an excise tax policy based on raising the real price of tobacco, (2) a ban on all forms of tobacco advertising and promotion, (3) product regulation to reduce the harmful constituents found in tobacco and enforce the use of strong and prominent package warnings, (4) the enactment of policies that protect nonsmokers from inhaling tobacco smoke, (5) comprehensive efforts to eliminate minors' access to tobacco products, (6) ongoing and adequately funded efforts to educate the public about the harmful effects of tobacco, (7) the availability of cessation assistance to persons interested in discontinuing the use of tobacco, and (8) the ending of all financial assistance to the tobacco-growing industry. Because older Americans represent a growing and political influential segment of our society, the enactment of effective tobacco control policies depends in part on generating support for such measures among older citizens. This article outlines several ways in which organizations such as American Association of Retired Persons and the American Cancer Society can work together to advocate meaningful tobacco control policies (e.g., higher excise taxes, clean indoor air laws, etc.).

Policy measures on strengthening and developing capabilities for national tobacco control in Thailand.

PubMed

Kengkarnpanich, Mondha; Termsirikulchai, Lakkhana; Benjakul, Sarunya

2012-06-01

To assess the situation and report on a national capacity plan for tobacco control under the National Strategic Plan for Tobacco Control (NSPTC) 2010-2014. Systematic documentary review and analysis were managed by the working group. The results were discussed and provided recommendations by the sub-committee on developing the NSPTC 2010-2014. Seven meetings were organized from March 2009-January 2010. Eventually, the NSPCT 2010-2014 was approved by the National Committee for Tobacco Control, chaired by the Minister of Public Health on 22 April 2010. The major result of the present study was brought to the National Capacity in Tobacco Control Plan under the NSPTC 2010-2014. The purpose of the plan is to strengthen and develop national tobacco control capacity before 2011. Seven strategic areas for National Tobacco Control Capacity have been proposed. They are, 1) tobacco control policy and leadership development, 2) developing an organizational structure and management systems, 3) developing surveillance, monitoring and evaluation systems, 4)formulate measures to support research and knowledge management, 5) capacity building and network expansion for tobacco control in various sectors, 6) capacity building and expansion of a collaborative network for tobacco control at regional levels and 7) improving and strengthening tobacco control laws. In addition, the indicators, key players and support partners were addressed. Although the strength of the strategic plan on National Capacity in Tobacco Control is participatory planning process and result in the integrated and comprehensive capacity in tobacco control plan, but some concerns should be considers. They are infrastructure, evidence and networking and leadership.

Health Warnings, Smoking Rules, and Smoking Status: A Cross-National Comparison of Turkey and the United States.

PubMed

Wintemberg, Jenna; Yu, Mansoo; Caman, Ozge Karadag

2018-05-12

This study aimed to compare the prevalence of smoking status (i.e., current, former and never) between the United States and Turkey in terms of age and gender, and examine how smoking rules and health warnings are associated with smoking status within and between the two countries. The study used data from the 2012-2013 National Adult Tobacco Survey (U.S. sample, N = 60,196) and the 2012 Global Adult Tobacco Survey (Turkey sample, N = 9,581). SAS PROC SURVEYLOGISTIC with a weighted variable was used to examine the associations between demographics (age, gender and education), smoking rules, health warnings, and smoking status within and between the two countries. There was an 18% current smoking prevalence among U.S. sample, compared to 27% of the Turkey sample. The U.S. sample had a higher rate of former smoking compared to the Turkey sample (25% vs. 22%). In both countries, being older and male gender predicted former smoking while being younger and female gender predicted never smoking. Having seen a health warning, and not allowing smoking in the vehicle and home positively predicted former and never smoking status. Higher education predicted both smoking statuses in the U.S. only. It is important to work with partners particularly in low- and middle-income countries (e.g., Turkey) to combat the global tobacco epidemic. In both counties, cessation endeavors should emphasize a comprehensive understanding of smoking status in terms of smoking rules in personal spaces and health warnings.

Tobacco Industry Lifestyle Magazines Targeted to Young Adults

PubMed Central

Cortese, Daniel K.; Lewis, M. Jane; Ling, Pamela M.

2010-01-01

Purpose This is the first study describing the tobacco industry’s objectives developing and publishing lifestyle magazines, linking them to tobacco marketing strategies, and how these magazines may encourage smoking. Methods Analysis of previously secret tobacco industry documents and content analysis of 31 lifestyle magazines to understand the motives behind producing these magazines and the role they played in tobacco marketing strategies. Results Philip Morris (PM) debuted Unlimited in 1996 to nearly 2 million readers and RJ Reynolds (RJR) debuted CML in 1999 targeting young adults with their interests. Both magazines were developed as the tobacco companies faced increased advertising restrictions Unlimited contained few images of smoking, but frequently featured elements of the Marlboro brand identity in both advertising and article content. CML featured more smoking imagery and fewer Camel brand identity elements. Conclusions Lifestyle promotions that lack images of smoking may still promote tobacco use through brand imagery. The tobacco industry still uses the “under the radar” strategies used in development of lifestyle magazines in branded websites. Prohibiting lifestyle advertising including print and electronic media that associate tobacco with recreation, action, pleasures, and risky behaviors or that reinforces tobacco brand identity may be an effective strategy to curb young adult smoking. PMID:19699423

Tobacco industry lifestyle magazines targeted to young adults.

PubMed

Cortese, Daniel K; Lewis, M Jane; Ling, Pamela M

2009-09-01

This is the first study describing the tobacco industry's objectives developing and publishing lifestyle magazines, linking them to tobacco marketing strategies, and how these magazines may encourage smoking. Analysis of previously secret tobacco industry documents and content analysis of 31 lifestyle magazines to understand the motives behind producing these magazines and the role they played in tobacco marketing strategies. Philip Morris (PM) debuted Unlimited in 1996 to nearly 2 million readers and RJ Reynolds (RJR) debuted CML in 1999, targeting young adults with their interests. Both magazines were developed as the tobacco companies faced increased advertising restrictions. Unlimited contained few images of smoking, but frequently featured elements of the Marlboro brand identity in both advertising and article content. CML featured more smoking imagery and fewer Camel brand identity elements. Lifestyle promotions that lack images of smoking may still promote tobacco use through brand imagery. The tobacco industry still uses the "under-the-radar" strategies used in development of lifestyle magazines in branded Websites. Prohibiting lifestyle advertising including print and electronic media that associate tobacco with recreation, action, pleasures, and risky behaviors or that reinforces tobacco brand identity may be an effective strategy to curb young adult smoking.

The Social Prioritization Index and Tobacco Use Among Young Adult Bar Patrons

PubMed Central

Lisha, Nadra E.; Neilands, Torsten B.; Jordan, Jeffrey W.; Holmes, Louisa M.; Ling, Pamela M.

2016-01-01

Social benefits likely play a role in young adult tobacco use. The Social Prioritization Index (SPI) was developed to measure the degree to which young adults place a great importance on their social lives. We examined the usefulness of this measure as a potential predictor of tobacco use controlling for demographics and tobacco-related attitudes. Young adults completed cross-sectional surveys between 2012 and 2014 in bars in seven U.S. cities (N = 5,503). The SPI is a 13-item scale that includes personality items and information on how frequently participants attend bars and how late they stay out. Three step-by-step multinomial regression models were run using the SPI as a predictor of smoking status (nondaily and daily smoking vs. nonsmoking): (1) SPI as the sole predictor, (2) SPI and demographics, and (3) SPI, demographics, and tobacco-related attitude variables. Next, we conducted an exploratory factor analysis to examine if the number of items in SPI could be reduced and retain its strong relationship with smoking. Higher scores on the SPI were related to an increased probability of being a Nondaily Smoker (odds ratio = 1.09, 95% confidence interval [1.04, 1.14], p < .001) or Daily Smoker (odds ratio = 1.14, 95% confidence interval [1.07, 1.22], p < .0001) compared to a Nonsmoker, controlling for demographics and other tobacco-related attitudes. The SPI and reduced SPI were independently related to young adult tobacco use. The measure’s brevity, ease of use, and strong association with tobacco use may make it useful to tobacco and other prevention researchers. PMID:26706863

Cultural perspectives concerning adolescent use of tobacco and alcohol in the Appalachian mountain region.

PubMed

Meyer, Michael G; Toborg, Mary A; Denham, Sharon A; Mande, Mary J

2008-01-01

Appalachia has high rates of tobacco use and related health problems, and despite significant impediments to alcohol use, alcohol abuse is common. Adolescents are exposed to sophisticated tobacco and alcohol advertising. Prevention messages, therefore, should reflect research concerning culturally influenced attitudes toward tobacco and alcohol use. With 4 grants from the National Institutes of Health, 34 focus groups occurred between 1999 and 2003 in 17 rural Appalachian jurisdictions in 7 states. These jurisdictions ranged between 4 and 8 on the Rural-Urban Continuum Codes of the Economic Research Service of the US Department of Agriculture. Of the focus groups, 25 sought the perspectives of women in Appalachia, and 9, opinions of adolescents. The family represented the key context where residents of Appalachia learn about tobacco and alcohol use. Experimentation with tobacco and alcohol frequently commenced by early adolescence and initially occurred in the context of the family home. Reasons to abstain from tobacco and alcohol included a variety of reasons related to family circumstances. Adults generally displayed a greater degree of tolerance for adolescent alcohol use than tobacco use. Tobacco growing represents an economic mainstay in many communities, a fact that contributes to the acceptance of its use, and many coal miners use smokeless tobacco since they cannot light up in the mines. The production and distribution of homemade alcohol was not a significant issue in alcohol use in the mountains even though it appeared not to have entirely disappeared. Though cultural factors support tobacco and alcohol use in Appalachia, risk awareness is common. Messages tailored to cultural themes may decrease prevalence.

Knowledge of the health consequences of tobacco smoking: a cross-sectional survey of Vietnamese adults

PubMed Central

Minh An, Dao Thi; Van Minh, Hoang; Huong, Le Thi; Giang, Kim Bao; Xuan, Le Thi Thanh; Thi Hai, Phan; Quynh Nga, Pham; Hsia, Jason

2013-01-01

Background Although substantial efforts have been made to curtail smoking in Vietnam, the 2010 Global Adult Tobacco Survey (GATS) revealed that the proportion of male adults currently smoking remains high at 47.4%. Objectives To determine the level of, and characteristics associated with, knowledge of the health consequences of smoking among Vietnamese adults. Design GATS 2010 was designed to survey a nationally representative sample of Vietnamese men and women aged 15 and older drawn from 11,142 households using a two-stage sampling design. Descriptive statistics were calculated and multivariate logistic regression was used to examine associations between postulated exposure factors (age, education, access to information, ethnic group etc.) and knowledge on health risks. Results General knowledge on the health risks of active smoking (AS) and exposure to second hand smoke (SHS) was good (90% and 83%, respectively). However, knowledge on specific diseases related to tobacco smoking (stroke, heart attack, and lung cancer) appeared to be lower (51.5%). Non-smokers had a significantly higher likelihood of demonstrating better knowledge on health risks related to AS (OR 1.6) and SHS (OR 1.7) than smokers. Adults with secondary education, college education or above also had significantly higher levels knowledge of AS/SHS health risks than those with primary education (AS: ORs 1.6, 1.7, and 1.9, respectively, and SHS: ORs 2.4, 3.9, and 5.7 respectively). Increasing age was positively associated with knowledge of the health consequences of SHS, and access to information was significantly associated with knowledge of AS/SHS health risks (ORs 2.3 and 1.9 respectively). Otherwise, non-Kinh ethnic groups had significantly less knowledge on health risks of AS/SHS than Kinh ethnic groups. Conclusions It may be necessary to target tobacco prevention programs to specific subgroups including current smokers, adults with low education, non-Kinh ethnics in order to increase their knowledge on health risks of smoking. Comprehensive messages and/or images about specific diseases related to AS/SHS should be conveyed using of different channels and modes specific to local cultures to increase knowledge on smoking health consequences for general population. PMID:23374702

Knowledge of the health consequences of tobacco smoking: a cross-sectional survey of Vietnamese adults.

PubMed

Minh An, Dao Thi; Van Minh, Hoang; Huong, Le Thi; Giang, Kim Bao; Xuan, Le Thi Thanh; Hai, Phan Thi; Quynh Nga, Pham; Hsia, Jason

2013-01-31

Although substantial efforts have been made to curtail smoking in Vietnam, the 2010 Global Adult Tobacco Survey (GATS) revealed that the proportion of male adults currently smoking remains high at 47.4%. To determine the level of, and characteristics associated with, knowledge of the health consequences of smoking among Vietnamese adults. GATS 2010 was designed to survey a nationally representative sample of Vietnamese men and women aged 15 and older drawn from 11,142 households using a two-stage sampling design. Descriptive statistics were calculated and multivariate logistic regression was used to examine associations between postulated exposure factors (age, education, access to information, ethnic group etc.) and knowledge on health risks. General knowledge on the health risks of active smoking (AS) and exposure to second hand smoke (SHS) was good (90% and 83%, respectively). However, knowledge on specific diseases related to tobacco smoking (stroke, heart attack, and lung cancer) appeared to be lower (51.5%). Non-smokers had a significantly higher likelihood of demonstrating better knowledge on health risks related to AS (OR 1.6) and SHS (OR 1.7) than smokers. Adults with secondary education, college education or above also had significantly higher levels knowledge of AS/SHS health risks than those with primary education (AS: ORs 1.6, 1.7, and 1.9, respectively, and SHS: ORs 2.4, 3.9, and 5.7 respectively). Increasing age was positively associated with knowledge of the health consequences of SHS, and access to information was significantly associated with knowledge of AS/SHS health risks (ORs 2.3 and 1.9 respectively). Otherwise, non-Kinh ethnic groups had significantly less knowledge on health risks of AS/SHS than Kinh ethnic groups. It may be necessary to target tobacco prevention programs to specific subgroups including current smokers, adults with low education, non-Kinh ethnics in order to increase their knowledge on health risks of smoking. Comprehensive messages and/or images about specific diseases related to AS/SHS should be conveyed using of different channels and modes specific to local cultures to increase knowledge on smoking health consequences for general population.

Prevalence and sociodemographic determinants of tobacco use among adults in Pakistan: findings of a nationwide survey conducted in 2012

PubMed Central

2013-01-01

Background Smoking is one of the leading causes of preventable mortality. The World Health Organization recommends that countries should monitor tobacco use regularly. In Pakistan, the last national study on smoking in the general population was conducted in 2002 to 2003. Methods We conducted a cross-sectional survey of a nationally representative sample of men and women living in rural and urban areas of four main provinces of Pakistan from March through April 2012. Face-to-face in-house interviews were undertaken using a pre-tested structured questionnaire that asked about smoking and other forms of tobacco use. Multistage stratified random area probability sampling was used. To determine the national prevalence of tobacco use, the sample was weighted to correspond to rural–urban population proportions in each of the four provinces as in the 1998 census conducted by Pakistan’s Population Census Organization. Associations between sociodemographic variables and tobacco use were investigated using multivariable robust regression. Results Out of 2,644 respondents (1,354 men and 1,290 women), 354 men and 4 women reported being current cigarette smokers. The weighted prevalence of current cigarette smoking was 15.2% (95% confidence interval [CI]; 11.2, 19.3) overall, 26.6% (95% CI: 19.1, 34.1) among males, and 0.4% (95% CI: -0.2, 1.0) among females. Among females, 1.8% (95% CI: 0.4, 3.1) used any smoked tobacco and 4.6% (95% CI: 1.8, 7.4) used any smokeless tobacco daily or on some days of the week. Among males, odds of current cigarette smoking decreased with increasing level of education (OR = 0.75; 95% CI: 0.68, 0.84) and increased with having a father who used tobacco (OR = 2.11; 95% CI: 1.39, 3.22) after adjusting for other sociodemographic characteristics. Lower household income was associated with current cigarette smoking among rural males only (odds ratio [OR] = 0.67; 95% CI: 0.48, 0.92 per category increase in monthly household income). Conclusion A large proportion of males smoked cigarettes. Cigarette use was negligible among females, but they used other forms of tobacco. Low education was a determinant of cigarette smoking among males irrespective of socioeconomic status and area of residence. Tobacco control campaigns should target uneducated and rural poor men and monitor all forms of tobacco used by the population. PMID:24004968

Exploring Exclusive and Poly-tobacco Use among Adult Cigarette Smokers in Minnesota.

PubMed

O'Gara, Erin; Sharma, Eva; Boyle, Raymond G; Taylor, Kristie A

2017-01-01

In recent decades, the United States has seen dramatic reductions in cigarette smoking. In contrast, other tobacco products (OTPs) have increased in popularity, particularly electronic cigarettes. The availability of new OTPs also has led to the use of multiple tobacco products that includes combustible cigarettes (poly-use). This study examines patterns of exclusive cigarette and polyuse among adult smokers in Minnesota. Data from 5 rounds of the Minnesota Adult Tobacco Survey (MATS) series 1999-2014 were analyzed. Weighted estimates of the prevalence of exclusive and poly-tobacco use were calculated. The use of multiple tobacco products was contrasted with past 30-day exclusive cigarette smoking. Poly-use was measured as the current use of combustible cigarettes plus past 30-day use of another tobacco product. The percentage of Minnesota adults who used at least 2 tobacco products increased from 3.2 in 1999 to 5.8 in 2014. The most common combination of products in 2014 was combustible cigarettes and electronic nicotine delivery systems (ENDS), a combination that increased significantly between 2010 and 2014. Compared to exclusive cigarette smoking, poly-users were more likely to be younger and male. In this state-based survey, the number of people using multiple tobacco products remains modest but nearly doubled from 1999 to 2014. Further surveillance should discern motivations and patterns of use among poly-users.

Young adult social smokers: their co-use of tobacco and alcohol, tobacco-related attitudes, and quitting efforts

PubMed Central

Jiang, Nan; Lee, Youn O.; Ling, Pamela M.

2014-01-01

Objective Young adults frequently report social smoking. This study examined the relationship between different social smoking definitions and the co-use of cigarettes and alcohol, tobacco-related attitudes, and quitting efforts. Method Cross-sectional data were collected at bars using randomized time location sampling among young adults aged 21–26 in San Diego, CA from 2010–2011 (73% response rate). Multivariable logistic regression examined if current smoking and quit attempts were associated with tobacco-related attitudes, and whether social smoking self-identification or behavior was associated with cigarette-and-alcohol co-use, tobacco-related attitudes, quit attempts, or quitline use. Results Among 537 current smokers, 80% self-identified and 49% behaved as social smokers. Social smoking self-identification was positively associated with cigarette-and-alcohol co-use, and quit attempts. Social smoking behavior was negatively associated with tobacco marketing receptivity, quit attempts, quitline use. Tobacco-related attitudes were associated with smoking but did not generally differ by social smoking status. Conclusion Identification and behavior as a social smoker have opposing associations with co-use of cigarettes and alcohol and quit attempts. Tobacco cessation programs for self-identified social smokers should address co-use. Interventions denormalizing the tobacco industry or emphasizing the health effects of temporary smoking/secondhand smoke may address smoking among young adult bar patrons regardless of social smoking status. PMID:25280439

A cross-sectional analysis of how young adults perceive tobacco brands: implications for FCTC signatories.

PubMed

Gendall, Philip; Hoek, Janet; Edwards, Richard; McCool, Judith

2012-09-17

The Framework Convention on Tobacco Control calls for the elimination of tobacco advertising, promotion and sponsorship. To test whether tobacco packaging functions as advertising by communicating attractive and distinctive brand attributes, we explored how young adult smokers and non-smokers interpreted familiar and unfamiliar tobacco brands. We conducted an on-line survey of 1035 young adult smokers and non-smokers aged 18-30. Participants evaluated eight tobacco brands using ten attributes based on brand personality scales. We used factor analysis and ANOVA to examine patterns in brand-attribute associations. Young adults distinguished between brands on the basis of their packaging alone, associated each brand with specific attributes, and were equally able to interpret familiar and unfamiliar brands. Contrary to our expectations, non-smokers made more favourable brand-attribute associations than smokers, but both groups described Basic, a near generic brand, as 'plain' or 'budget'. There were no significant gender or ethnicity differences. Tobacco packaging uses logos, colours and imagery to create desirable connotations that promote and reinforce smoking. By functioning in the same way as advertising, on-pack branding breaches Article 13 of the FCTC and refutes tobacco companies' claims that pack livery serves only as an indentifying device that simplifies smokers' decision-making. Given this evidence, signatories should see plain packaging policies as a priority consistent with their FCTC obligations to eliminate all tobacco advertising and promotion.

Young adult social smokers: their co-use of tobacco and alcohol, tobacco-related attitudes, and quitting efforts.

PubMed

Jiang, Nan; Lee, Youn O; Ling, Pamela M

2014-12-01

Young adults frequently report social smoking. This study examined the relationship between different social smoking definitions and the co-use of cigarettes and alcohol, tobacco-related attitudes, and quitting efforts. Cross-sectional data were collected at bars using randomized time location sampling among young adults aged 21-26 in San Diego, California from 2010 to 2011 (73% response rate). Multivariable logistic regression examined if current smoking and quit attempts were associated with tobacco-related attitudes, and whether social smoking self-identification or behavior was associated with cigarette-and-alcohol co-use, tobacco-related attitudes, quit attempts, or quitline use. Among 537 current smokers, 80% self-identified and 49% behaved as social smokers. Social smoking self-identification was positively associated with cigarette-and-alcohol co-use, and quit attempts. Social smoking behavior was negatively associated with tobacco marketing receptivity, quit attempts, and quitline use. Tobacco-related attitudes were associated with smoking but did not generally differ by social smoking status. Identification and behavior as a social smoker have opposing associations with co-use of cigarettes and alcohol and quit attempts. Tobacco cessation programs for self-identified social smokers should address co-use. Interventions denormalizing the tobacco industry or emphasizing the health effects of temporary smoking and secondhand smoke may address smoking among young adult bar patrons regardless of social smoking status. Copyright © 2014 Elsevier Inc. All rights reserved.

Tobacco and alcohol use among Arab adults in Israel: findings from a nationwide study.

PubMed

Lawental, Maayan; Shoham, Meyrav; Ron, Pnina; Azaiza, Faisal

2014-05-01

This comprehensive study focuses exclusively on adult Arabs in Israel and is aimed at examining tobacco and alcohol use rates and their predictors. One thousand and two hundred Arab adults were randomly sampled via cluster sampling and interviewed using a structured questionnaire. Forty-four per cent of respondents reported tobacco use while 39% reported alcohol use. There were notable gender gaps in use, as well as differences between Muslims and Christians. Odds of using both tobacco and alcohol increased with having a greater tendency towards risk-taking and more time spent partying. Odds of alcohol use also increased with having positive attitudes towards use, lower perceived risk and greater intention to use. These findings add a more complete understanding to the phenomenon of tobacco and alcohol use among Arab adults in Israel and carry important implications for future research and practice. © 2014 Australasian Professional Society on Alcohol and other Drugs.

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

PubMed

Jackson-Morris, Angela; Latif, Ehsan

2017-03-01

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

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

PubMed Central

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

2011-01-01

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

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

PubMed

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

2011-02-01

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

[TOBACCO CONSUMPTION AMONG ADULTS IN MONTERREY: RELATION TO EXERCISE REGULARLY AND FAMILY].

PubMed

Ruiz-Juan, Francisco; Isorna-Folgar, Manuel; Ruiz-Risueño, Jorge; Vaquero-Cristóbal, Raquel

2015-08-01

determine the relationship among tobacco consumption, physical activity, sociodemographic variables and family behaviours in Mexican adults. 978 Mexican adults (483 males and 495 females) were interviewed by a random routes questionnaire. Multinomial logistic regression was used to calculate odds ratio (OR) and confidence interval (CI = 95%). men have a high risk factor of tobacco comsumption in frequency and/or amount. 18 to 45 years-old is the age range with high probability of tobacco comsumption, while the more age, the less comsumption. The tobacco consumption risk is significantly low in people who have less that a primary education. Participants who have never done physical exercise have a low possibility of tobacco consumption, while the consumption is high in the group of people who have abandoned physical activity. The family context is a risk factor of tobacco consumption in frequency. About alcohol consumption, it was found that people who drink alcohol have a high probability of smoke. tobacco consumption at high frequencies and amounts and physical activity are inversely relationship. It has been also detected a direct relationship between the frequency and the amount of tobacco and alcohol consumptions; and between the frequency and the amount of tobacco consumption and the family in the tobacco consumption. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

A Cross Sectional Study of Kretek Smoking in Indonesia as a Major Risk to Public Health.

PubMed

Palipudi, Krishna; Mbulo, Lazarous; Kosen, Soewarte; Tjandra, Aditama; Kadarmanto; Qureshi, Farukh; Andes, Linda; Sinha, Dhirendra N; Asma, Samira

2015-01-01

Tobacco smoking is a major cause of preventable disease and death worldwide. Kreteks are clove-flavored cigarettes made from a combination of tobacco and ground-clove mixed with a sauce, smoked widely in Indonesia. Because health and social consequences of kretek smoking are potentially as great as those of traditional cigarettes, this study examines the prevalence of kretek smoking in Indonesia and associated risk factors. The study used nationally representative Indonesia Global Adult Tobacco Survey data. Multiple logistic regression analysis was employed to identify correlates of kretek smoking. One- third of Indonesian adults smoked tobacco of which about 90.0% smoked kreteks. Prevalence of kretek smoking among men (60.9%) was more than 25 times the rate among women (2.3%). Overall, the highest prevalence of kretek use was in the age group 45-54 years (36.5%), followed by 34-44 (35.1%), 25-34 (34.2 %), and 55-64 years (32.8%). By wealth index, prevalence of kreteks smoking among those in the middle index was almost 50% above the rate for the wealthiest group (36.4% vs 24.8% respectively). Logistic regression results showed that being male, being older, having less education, and being less wealthy were significant predictors of kretek smoking, while urban vs rural residence was not. Kretek smoking is common in Indonesia and is entrenched in the sociocultural fabric of the country. However, potential consequences of kretek smoking, particularly as risks for noncommunicable diseases, underscore the importance of a comprehensive approach to tobacco control as outlined in the World Health Organization's MPOWER strategies.

New Zealand's tobacco control programme 1985-1998

PubMed Central

Laugesen, M.; Swinburn, B.

2000-01-01

OBJECTIVE—To review the impact of New Zealand's tobacco control programme from 1985 to 1998 on smoking prevalence and tobacco consumption, and to estimate the scope for further reduction.
DESIGN—Country case study; interventions, with outcomes ranked internationally across time.
SETTING—New Zealand 1985-98; for 1985-95, 23 OECD countries.
INTERVENTIONS—Between 1985 and 1998, New Zealand eliminated tobacco advertising, halved the affordability of cigarettes, and reduced smoke exposure in work time by 39%.
MAIN OUTCOME MEASURE—Reduction in adult smoking prevalence and in tobacco products consumption per adult.
RESULTS—Changes in prevalence 1985-98: in adults (aged 15+ years), −17% (from 30% to 25%) but short of the 20% target for 2000; in youth (aged 15-24 years), −20% (from 35% to 28%); and in Maori adults (aged 15+ years), −17% (from 56% in 1981 to 46% in 1996). Changes in consumption 1985-98: tobacco products per adult aged 15+ years, −45% (2493 to 1377 cigarette equivalents); cigarettes smoked per smoker, −34% (22.7 to 15.0 per day). Between 1985 and 1995 New Zealand reduced tobacco products consumption per adult more rapidly than any other OECD country, and reduced youth prevalence more rapidly than most. The acceleration of the decline in cigarette attributable mortality rates in men and in women age 35-69 years averted an additional 1400 deaths between 1985 and 1996. Between 1981 and 1996 smoking prevalence among blue collar workers decreased only marginally, and in 14-15 year olds, rose by one third between 1992 and 1997.
CONCLUSION—In 13 years, New Zealand's tobacco control programme has been successful in almost halving tobacco products consumption, particularly by lowering consumption per smoker. With strong political support for quit campaigns, increased taxation, and the elimination of displays of tobacco products on sale, the consumption could theoretically be halved again in as little as 3-6 years.


Keywords: New Zealand; tobacco control policy; Organisation for Economic Cooperation and Development PMID:10841851

Prevalence and sociodemographic determinants of tobacco use in four countries of the World Health Organization: South-East Asia region: findings from the Global Adult Tobacco Survey.

PubMed

Palipudi, K; Rizwan, S A; Sinha, D N; Andes, L J; Amarchand, R; Krishnan, A; Asma, S

2014-12-01

Tobacco use is a leading cause of deaths and Disability Adjusted Life Years lost worldwide, particularly in South-East Asia. Health risks associated with exclusive use of one form of tobacco alone has a different health risk profile when compared to dual use. In order to tease out specific profiles of mutually exclusive categories of tobacco use, we carried out this analysis. The Global Adult Tobacco Survey (GATS) data was used to describe the profiles of three mutually exclusive tobacco use categories ("Current smoking only," "Current smokeless tobacco [SLT] use only," and "Dual use") in four World Health Organization South-East Asia Region countries, namely Bangladesh, India, Indonesia and Thailand. GATS was a nationally representative household-based survey that used a stratified multistage cluster sampling design proportional to population size. Prevalence of different forms of usage were described as proportions. Logistics regression analyses was performed to calculate odds ratios (OR) with 95% confidence intervals. All analyses were weighted, accounted for the complex sampling design and conducted using SPSS version 18. The prevalence of different forms of tobacco use varied across countries. Current tobacco use ranged from 27.2% in Thailand to 43.3% in Bangladesh. Exclusively smoking was more common in Indonesia (34.0%) and Thailand (23.4%) and less common in Bangladesh (16.1%) and India (8.7%). Exclusively using SLT was more common in Bangladesh (20.3%) and India (20.6%) and less common on Indonesia (0.9%) and Thailand (3.5%). Dual use of smoking and SLT was found in Bangladesh (6.8%) and India (5.3%), but was negligible in Indonesia (0.8) and Thailand (0.4%). Gender, age, education and wealth had significant effects on the OR for most forms of tobacco use across all four countries with the exceptions of SLT use in Indonesia and dual use in both Indonesia and Thailand. In general, the different forms of tobacco use increased among males and with increasing age; and decreased with higher education and wealth. The results for urban versus rural residence were mixed and frequently not significant once controlling for the other demographic factors. This study addressed the socioeconomic disparities, which underlie health inequities due to tobacco use. Tobacco control activities in these countries should take in account local cultural, social and demographic factors for successful implementation.

Perceived Racial/Ethnic Harassment and Tobacco Use Among African American Young Adults

PubMed Central

Bennett, Gary G.; Wolin, Kathleen Yaus; Robinson, Elwood L.; Fowler, Sherrye; Edwards, Christopher L.

2005-01-01

We examined the association between perceived racial/ethnic harassment and tobacco use in 2129 African American college students in North Carolina. Age-adjusted and multivariate analyses evaluated the effect of harassment on daily and less-than-daily tobacco use. Harassed participants were twice as likely to use tobacco daily (odds ratio = 2.01; 95% confidence interval=1.94, 2.08) compared with those with no reported harassment experiences. Experiences of racial/ethnic harassment may contribute to tobacco use behaviors among some African American young adults. PMID:15671457

Effect of Exposure to Smoking in Movies on Young Adult Smoking in New Zealand

PubMed Central

Gendall, Philip; Hoek, Janet; Edwards, Richard; Glantz, Stanton

2016-01-01

Onscreen Smoking Is a Form of Tobacco Marketing Tobacco advertising has been prohibited in New Zealand since 1990, and the government has set a goal of becoming a smokefree nation by 2025. However, tobacco marketing persists indirectly through smoking in motion pictures, and there is strong evidence that exposure to onscreen smoking causes young people to start smoking. We investigated the relationship between exposure to smoking in movies and youth smoking initiation among New Zealand young adults. Data from an online survey of 419 smokers and non-smokers aged 18 to 25 were used to estimate respondents’ exposure to smoking occurrences in 50 randomly-selected movies from the 423 US top box office movies released between 2008 and 2012. Analyses involved calculating movie smoking exposure (MSE) for each respondent, using logistic regression to analyse the relationship between MSE and current smoking behaviour, and estimating the attributable fraction due to smoking in movies. Effect of Smoking in Movies on New Zealand Youth Exposure to smoking occurrences in movies was associated with current smoking status. After allowing for the influence of family, friends and co-workers, age and rebelliousness, respondents’ likelihood of smoking increased by 11% for every 100-incident increase in exposure to smoking incidents, (aOR1.11; p< .05). The estimated attributable fraction due to smoking in movies was 54%; this risk could be substantially reduced by eliminating smoking from movies currently rated as appropriate for youth. We conclude that exposure to smoking in movies remains a potent risk factor associated with smoking among young adults, even in a progressive tobacco control setting such as New Zealand. Harmonising the age of legal tobacco purchase (18) with the age at which it is legal to view smoking in movies would support New Zealand’s smokefree 2025 goal. PMID:26960189

One size fits all? Disentangling the effects of tobacco taxes, laws, and control spending on adult subgroups in the United States.

PubMed

Yu, Hao; Engberg, John; Scharf, Deborah

2018-03-07

To determine the relative impact of each of the 3 state-level tobacco control policies (cigarette taxation, tobacco control spending, and smoke-free air [SFA] laws) on adult smoking rate overall and separately for adult subgroups in the United States. A difference-in-differences analysis was conducted with generalized propensity scores. State-level policies were merged with the individual-level Behavioral Risk Factor Surveillance System in 1995-2009. State cigarette taxation was the only policy that significantly impacted smoking among the general adult population, with a 1-standard deviation increase in taxes (i.e., $0.68 in constant 2014 dollars) lowering the adult smoking rate by about a quarter of a percentage point. The taxation impact was consistent, regardless of the presence of, or interactions with, other policies. Taxation was also the only policy that significantly reduced smoking for some adult subgroups, including females, non-Hispanic whites, adults aged 51 or older, and adults with more than a high school education. However, other adult subgroups responded to the other 2 types of policies, either by mediating the taxation effect or by reducing smoking independently. Specifically, tobacco control spending reduced smoking among young adults (ages 18-25 years) and Hispanics. SFA laws affected smoking among men, young adults, non-Hispanic blacks, and Hispanics. State cigarette taxation is the single most important policy for reducing smoking among the general adult population. However, adult subgroups' reactions to taxes are diverse and mediated by tobacco control spending and SFA laws.

Mass media interventions for smoking cessation in adults.

PubMed

Bala, Malgorzata M; Strzeszynski, Lukasz; Topor-Madry, Roman; Cahill, Kate

2013-06-06

Mass media tobacco control campaigns can reach large numbers of people. Much of the literature is focused on the effects of tobacco control advertising on young people, but there are also a number of evaluations of campaigns targeting adult smokers, which show mixed results. Campaigns may be local, regional or national, and may be combined with other components of a comprehensive tobacco control policy. To assess the effectiveness of mass media interventions in reducing smoking among adults. The Cochrane Tobacco Addiction Group search strategy was combined with additional searches for any studies that referred to tobacco/smoking cessation, mass media and adults. We also searched the Cochrane Register of Controlled Trials (CENTRAL) and a number of electronic databases. The last search was carried out in February 2013. Controlled trials allocating communities, regions or states to intervention or control conditions; interrupted time series. Adults, 25 years or older, who regularly smoke cigarettes. Studies which cover all adults as defined in studies were included. Mass media are defined here as channels of communication such as television, radio, newspapers, billboards, posters, leaflets or booklets intended to reach large numbers of people, and which are not dependent on person-to-person contact. The purpose of the mass media campaign must be primarily to encourage smokers to quit. They could be carried out alone or in conjunction with tobacco control programmes. The primary outcome was change in smoking behaviour. This could be reported as changes in prevalence, changes in cigarette consumption, quit rates, odds of being a smoker. Two authors independently assessed all studies for inclusion criteria and for study quality. One author (MB) extracted data, and a second author (LS) checked them.Results were not pooled due to heterogeneity of the included studies and are presented narratively and in table form. Eleven campaigns met the inclusion criteria for this review. Studies differed in design, settings, duration, content and intensity of intervention, length of follow-up, methods of evaluation and also in definitions and measures of smoking behaviour used. Among nine campaigns reporting smoking prevalence, significant decreases were observed in the California and Massachusetts statewide tobacco control campaigns compared with the rest of the USA. Some positive effects on prevalence in the whole population or in the subgroups were observed in three of the remaining seven studies. Three large-scale campaigns of the seven presenting results for tobacco consumption found statistically significant decreases. Among the seven studies presenting abstinence or quit rates, four showed some positive effect, although in one of them the effect was measured for quitting and cutting down combined. Among the three that did not show significant decreases, one demonstrated a significant intervention effect on smokers and ex-smokers combined. There is evidence that comprehensive tobacco control programmes which include mass media campaigns can be effective in changing smoking behaviour in adults, but the evidence comes from a heterogeneous group of studies of variable methodological quality. One state-wide tobacco control programme (Massachusetts) showed positive results up to eight years after the campaign. Another (California) showed positive results during the period of adequate funding and implementation and in final evaluation since the beginning of the programme. Six of nine studies carried out in communities or regions showed some positive effects on smoking behaviour and at least one significant change in smoking prevalence (Sydney). The intensity and duration of mass media campaigns may influence effectiveness, but length of follow-up and concurrent secular trends and events can make this difficult to quantify. No consistent relationship was observed between campaign effectiveness and age, education, ethnicity or gender.

Mass media interventions for smoking cessation in adults.

PubMed

Bala, Malgorzata M; Strzeszynski, Lukasz; Topor-Madry, Roman

2017-11-21

Mass media tobacco control campaigns can reach large numbers of people. Much of the literature is focused on the effects of tobacco control advertising on young people, but there are also a number of evaluations of campaigns targeting adult smokers, which show mixed results. Campaigns may be local, regional or national, and may be combined with other components of a comprehensive tobacco control policy. To assess the effectiveness of mass media interventions in reducing smoking among adults. The Cochrane Tobacco Addiction Group search strategy was combined with additional searches for any studies that referred to tobacco/smoking cessation, mass media and adults. We also searched the Cochrane Central Register of Controlled Trials (CENTRAL) and a number of electronic databases. The last search was carried out in November 2016. Controlled trials allocating communities, regions or states to intervention or control conditions; interrupted time series.Adults, 25 years or older, who regularly smoke cigarettes. Studies which cover all adults as defined in studies were included.Mass media are defined here as channels of communication such as television, radio, newspapers, billboards, posters, leaflets or booklets intended to reach large numbers of people, and which are not dependent on person-to-person contact. The purpose of the mass media campaign must be primarily to encourage smokers to quit. They could be carried out alone or in conjunction with tobacco control programmes.The primary outcome was change in smoking behaviour. This could be reported as changes in prevalence, changes in cigarette consumption, quit rates, or odds of being a smoker. Two authors independently assessed all studies for inclusion criteria and for study quality (MB, LS, RTM). One author (MB) extracted data, and a second author (LS) checked them.Results were not pooled due to heterogeneity of the included studies and are presented narratively and in table form. Eleven campaigns met the inclusion criteria for this review. Studies differed in design, settings, duration, content and intensity of intervention, length of follow-up, methods of evaluation and also in definitions and measures of smoking behaviour used. Among seven campaigns reporting smoking prevalence, significant decreases were observed in the California and Massachusetts statewide tobacco control campaigns compared with the rest of the USA. Some positive effects on prevalence in the whole population or in the subgroups were observed in three of the remaining seven studies. Three large-scale campaigns of the seven presenting results for tobacco consumption found statistically significant decreases. Among the eight studies presenting abstinence or quit rates, four showed some positive effect, although in one of them the effect was measured for quitting and cutting down combined. Among the three that did not show significant decreases, one demonstrated a significant intervention effect on smokers and ex-smokers combined. There is evidence that comprehensive tobacco control programmes which include mass media campaigns can be effective in changing smoking behaviour in adults, but the evidence comes from a heterogeneous group of studies of variable methodological quality. One state-wide tobacco control programme (Massachusetts) showed positive results up to eight years after the campaign. Another (California) showed positive results during the period of adequate funding and implementation and in final evaluation since the beginning of the programme. Six of nine studies carried out in communities or regions showed some positive effects on smoking behaviour and at least one significant change in smoking prevalence (Sydney). The intensity and duration of mass media campaigns may influence effectiveness, but length of follow-up and concurrent secular trends and events can make this difficult to quantify. No consistent relationship was observed between campaign effectiveness and age, education, ethnicity or gender.

Young adults: vulnerable new targets of tobacco marketing.

PubMed

Biener, Lois; Albers, Alison B

2004-02-01

We examined young adult smoking patterns and receptivity to cigarette advertising to assess vulnerability to tobacco marketing strategies. We obtained data from a telephone survey of 12,072 Massachusetts adults. Smokers aged 18 to 30 years were more likely than older adults to smoke only occasionally and to consume fewer than 10 cigarettes per day. They also were more receptive to cigarette marketing and were more likely to be frequent patrons of bars and clubs. Many young adult smokers are in the initiation phase of smoking and are likely to undergo a transition to either nonsmoking or heavier smoking. If unimpeded by regulation, tobacco promotion in bars and clubs is likely to lead to increased adult smoking prevalence.

Prevalence and Disparities in Tobacco Product Use Among American Indians/Alaska Natives - United States, 2010-2015.

PubMed

Odani, Satomi; Armour, Brian S; Graffunder, Corinne M; Garrett, Bridgette E; Agaku, Israel T

2017-12-22

An overarching goal of Healthy People 2020 is to achieve health equity, eliminate disparities, and improve health among all groups.* Although significant progress has been made in reducing overall commercial tobacco product use, † disparities persist, with American Indians or Alaska Natives (AI/ANs) having one of the highest prevalences of cigarette smoking among all racial/ethnic groups (1,2). Variations in cigarette smoking among AI/ANs have been documented by sex and geographic location (3), but not by other sociodemographic characteristics. Furthermore, few data exist on use of tobacco products other than cigarettes among AI/ANs (4). CDC analyzed self-reported current (past 30-day) use of five tobacco product types among AI/AN adults from the 2010-2015 National Survey on Drug Use and Health (NSDUH); results were compared with six other racial/ethnic groups (Hispanic; non-Hispanic white [white]; non-Hispanic black [black]; non-Hispanic Native Hawaiian or other Pacific Islander [NHOPI]; non-Hispanic Asian [Asian]; and non-Hispanic multirace [multirace]). Prevalence of current tobacco product use was significantly higher among AI/ANs than among non-AI/ANs combined for any tobacco product, cigarettes, roll-your-own tobacco, pipes, and smokeless tobacco. Among AI/ANs, prevalence of current use of any tobacco product was higher among males, persons aged 18-25 years, those with less than a high school diploma, those with annual family income <$20,000, those who lived below the federal poverty level, and those who were never married. Addressing the social determinants of health and providing evidence-based, population-level, and culturally appropriate tobacco control interventions could help reduce tobacco product use and eliminate disparities in tobacco product use among AI/ANs (1).

Global Tobacco Surveillance System (GTSS): purpose, production, and potential.

PubMed

2005-01-01

The World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and Canadian Public Health Association (CPHA) developed the Global Tobacco Surveillance System (GTSS) to assist all 192 WHO Member States in collecting data on youth and adult tobacco use. The flexible GTSS system includes common data items but allows countries to include important unique information at their discretion. It uses a common survey methodology, similar field procedures for data collection, and similar data management and processing techniques. The GTSS includes collection of data through three surveys: the Global Youth Tobacco Survey (GYTS) for youth, and the Global School Personnel Survey (GSPS) and the Global Health Professional Survey (GHPS) for adults. GTSS data potentially can be applied in four ways. First, countries and research partners can disseminate data through publications, presentations, and an active GTSS web site. Second, countries can use GTSS data to inform politicians about the tobacco problem in their country, leading to new policy decisions to prevent and control tobacco use. Third, GTSS can provide countries with valuable feedback to evaluate and improve Country National Action Plans or develop new plans. Fourth, in response to the WHO FCTC call for countries to use consistent methods and procedures in their surveillance efforts, GTSS offers such consistency in sampling procedures, core questionnaire items, training infield procedures, and analysis of data across all survey sites. The GTSS represents the most comprehensive tobacco surveillance system ever developed and implemented. As an example, this paper describes development of the GYTS and discusses potential uses of the data. Sample data were drawn from 38 sites in 24 countries in the African Region, 82 sites in 35 countries in the Americas Region, 20 sites in 17 countries and the Gaza Strip/West Bank region in the Eastern Mediterranean Region, 25 sites in 22 countries in the European Region, 34 sites in six countries in the Southeast Asia Region, and 25 sites in 14 countries in the Western Pacific Region.

Testing messages to reduce smokers’ openness to using novel smokeless tobacco products

PubMed Central

Popova, Lucy; Neilands, Torsten B.; Ling, Pamela M.

2013-01-01

Introduction Tobacco manufacturers’ aggressive promotion of new smokeless tobacco products such as snus warrants a timely and effective public health response. This study tested potential counter-marketing messages to discourage current and former smokers from becoming dual users of smokeless tobacco and cigarettes. Methods In a pretest – post-test experiment, 1,836 adult current and recently former smokers from a national sample were randomized to view one of six anti-smokeless tobacco ads followed by a snus ad, to view a control ad followed by a snus ad; or to view two control ads. Perceived effectiveness of ads and actual changes in attitudes and openness to snus were compared across groups using analyses of variance. Results Some ads that were perceived as most effective did not change attitudes or openness to trying snus, and conversely, some ads not perceived as effective changed attitudes and openness to snus. Ads portraying the negative health effects of smokeless tobacco were perceived as most effective, but ads with anti-tobacco industry themes significantly decreased favorable attitudes toward snus. Responses to ads were different for smokers who had ever used smokeless tobacco: for this group health effects and humorous/testimonial ads were effective. Conclusions Measures of perceived effectiveness of anti-tobacco ads need to be augmented with measures of actual effectiveness to assess counter-marketing messages. Some of the developed ads, such as ads with anti-industry themes, were effective for the overall population of smokers whereas humorous/testimonial and health effects ads were particularly effective in changing attitudes of past users of smokeless tobacco. PMID:23467655

Frequency of Tobacco Use Among Middle and High School Students -- United States, 2014

MedlinePlus

... during the preceding 30 days — National Youth Tobacco Survey, United States, 2014 Days of use Tobacco product ... smokers, and smokeless tobacco users † — National Youth Tobacco Survey, United States, 2014 * Current use was assessed for ...

Wanna know about vaping? Patterns of message exposure, seeking and sharing information about e-cigarettes across media platforms.

PubMed

Emery, Sherry L; Vera, Lisa; Huang, Jidong; Szczypka, Glen

2014-07-01

Awareness and use of electronic cigarettes has rapidly grown in the USA recently, in step with increased product marketing. Using responses to a population survey of US adults, we analysed demographic patterns of exposure to, searching for and sharing of e-cigarette-related information across media platforms. An online survey of 17,522 US adults was conducted in 2013. The nationally representative sample was drawn from GfK Group's KnowledgePanel plus off-panel recruitment. Fixed effects logit models were applied to analyse relationships between exposure to, searching for and sharing of e-cigarette-related information and demographic characteristics, e-cigarette and tobacco use, and media behaviours. High levels of awareness about e-cigarettes were indicated (86% aware; 47% heard through media channels). Exposure to e-cigarette-related information was associated with tobacco use, age, gender, more education, social media use and time spent online. Although relatively small proportions of the sample had searched for (∼5%) or shared (∼2%) e-cigarette information, our analyses indicated demographic patterns to those behaviours. Gender, high income and using social media were associated with searching for e-cigarette information; lesbian, gay and bisexual and less education were associated with sharing. Current tobacco use, age, being Hispanic and time spent online were associated with both searching and sharing. US adults are widely exposed to e-cigarette marketing through the media; such marketing may differentially target specific demographic groups. Further research should longitudinally examine how exposure to, searching for and sharing of e-cigarette information relate to subsequent use of e-cigarettes and/or combustible tobacco. 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.

Wanna know about vaping? Patterns of message exposure, seeking and sharing information about e-cigarettes across media platforms

PubMed Central

Emery, Sherry L; Vera, Lisa; Huang, Jidong; Szczypka, Glen

2014-01-01

Background Awareness and use of electronic cigarettes has rapidly grown in the USA recently, in step with increased product marketing. Using responses to a population survey of US adults, we analysed demographic patterns of exposure to, searching for and sharing of e-cigarette-related information across media platforms. Methods An online survey of 17 522 US adults was conducted in 2013. The nationally representative sample was drawn from GfK Group's KnowledgePanel plus off-panel recruitment. Fixed effects logit models were applied to analyse relationships between exposure to, searching for and sharing of e-cigarette-related information and demographic characteristics, e-cigarette and tobacco use, and media behaviours. Results High levels of awareness about e-cigarettes were indicated (86% aware; 47% heard through media channels). Exposure to e-cigarette-related information was associated with tobacco use, age, gender, more education, social media use and time spent online. Although relatively small proportions of the sample had searched for (∼5%) or shared (∼2%) e-cigarette information, our analyses indicated demographic patterns to those behaviours. Gender, high income and using social media were associated with searching for e-cigarette information; lesbian, gay and bisexual and less education were associated with sharing. Current tobacco use, age, being Hispanic and time spent online were associated with both searching and sharing. Conclusions US adults are widely exposed to e-cigarette marketing through the media; such marketing may differentially target specific demographic groups. Further research should longitudinally examine how exposure to, searching for and sharing of e-cigarette information relate to subsequent use of e-cigarettes and/or combustible tobacco. PMID:24935893

Effect of Exposure to Smoking in Movies on Young Adult Smoking in New Zealand.

PubMed

Gendall, Philip; Hoek, Janet; Edwards, Richard; Glantz, Stanton

2016-01-01

Tobacco advertising has been prohibited in New Zealand since 1990, and the government has set a goal of becoming a smokefree nation by 2025. However, tobacco marketing persists indirectly through smoking in motion pictures, and there is strong evidence that exposure to onscreen smoking causes young people to start smoking. We investigated the relationship between exposure to smoking in movies and youth smoking initiation among New Zealand young adults. Data from an online survey of 419 smokers and non-smokers aged 18 to 25 were used to estimate respondents' exposure to smoking occurrences in 50 randomly-selected movies from the 423 US top box office movies released between 2008 and 2012. Analyses involved calculating movie smoking exposure (MSE) for each respondent, using logistic regression to analyse the relationship between MSE and current smoking behaviour, and estimating the attributable fraction due to smoking in movies. Exposure to smoking occurrences in movies was associated with current smoking status. After allowing for the influence of family, friends and co-workers, age and rebelliousness, respondents' likelihood of smoking increased by 11% for every 100-incident increase in exposure to smoking incidents, (aOR1.11; p< .05). The estimated attributable fraction due to smoking in movies was 54%; this risk could be substantially reduced by eliminating smoking from movies currently rated as appropriate for youth. We conclude that exposure to smoking in movies remains a potent risk factor associated with smoking among young adults, even in a progressive tobacco control setting such as New Zealand. Harmonising the age of legal tobacco purchase (18) with the age at which it is legal to view smoking in movies would support New Zealand's smokefree 2025 goal.

Young adult non-smokers' exposure to real-world tobacco marketing: results of an ecological momentary assessment pilot study.

PubMed

Rose, Shyanika W; Anesetti-Rothermel, Andrew; Elmasry, Hoda; Niaura, Ray

2017-08-31

The aims of this pilot study were to assess and characterize non-current smoking young adults' exposure to tobacco marketing through an ecological momentary assessment protocol. Ecological momentary assessment (EMA) consists of repeated measurement of momentary phenomena and is well-suited to capture sporadic experiences in the real-world, such as exposure to tobacco marketing. EMA has the potential to capture detailed information about real-world marketing exposures in ways that reduce recall bias and increase ecological validity. In this study, young adults (n = 31; ages 18-25) responded to random prompts regarding their momentary exposure to tobacco marketing via text messages on their smartphones for 14 days (n = 1798 observations). Unadjusted and adjusted analyses were conducted using multilevel logistic regression to assess the odds of exposure accounting for correlation of multiple repeated measures within individuals while controlling for variability between individuals. Respondents reported, on average, two momentary exposures to tobacco advertising in the 14-day study period. In adjusted analyses, African-American (aOR 3.36; 95% CI 1.07, 10.54) and Hispanic respondents (aOR 5.08; 95% CI 1.28, 20.13) were more likely to report exposure to tobacco advertising. Respondents were also more likely to report exposure when also exposed to others using tobacco products and when they were at stores compared with at home (aOR 14.82; 95% CI 3.61, 60.88). Non-smoking young adults report exposure to tobacco marketing particularly at the point-of-sale, with the highest likelihood of exposure among African-American and Hispanic young people. EMA protocols can be effective in assessing the potential impact of point-of-sale tobacco marketing on young adults.

Talking about tobacco on Twitter is associated with tobacco product use.

PubMed

Unger, Jennifer B; Urman, Robert; Cruz, Tess Boley; Majmundar, Anuja; Barrington-Trimis, Jessica; Pentz, Mary Ann; McConnell, Rob

2018-06-10

Tobacco-related content appears on social media in the form of advertising and messages by individuals. However, little is known about associations between posting social media messages and tobacco product use among adolescents and young adults. Self-reports of tobacco product use were obtained from the Children's Health Study of young adults in Southern California. Among the 1486 respondents in the most recent wave of the cohort (2016-2017), 284 provided tobacco product use data and their Twitter user names to access publicly available Twitter account data (mean age = 20.1 yrs. (SD = 0.6), 54% female, 49% Hispanic). We obtained the tweets that those respondents posted on Twitter, searched the tweets for 14 nicotine- and tobacco-related keywords, and coded these statements as positive or negative/neutral. Logistic regression analyses were conducted to determine whether respondents who posted positive tobacco-related tweets were more likely to report tobacco product use, relative to those who did not post any positive tobacco-related tweets. Respondents who posted any positive messages about tobacco had significantly higher odds of reporting past month use of cigarettes (OR = 3.15, 95% CI = 1.36, 7.30) and any tobacco product (OR = 2.41, 95% CI = 1.16, 5.01), relative to respondents who did not post about tobacco. This is the first study to establish an empirical link between adolescents' and young adults' tobacco-related Twitter activity and their tobacco product use. Health communications about the risks of tobacco use could target adolescents who post positive messages about tobacco products on Twitter. Copyright © 2018 Elsevier Inc. All rights reserved.

History of Bhutan's prohibition of cigarettes: implications for neo-prohibitionists and their critics.

PubMed

Givel, Michael S

2011-07-01

Recently, cigarette neo-prohibitionists have argued that a cigarette ban can be obtained from a de-facto phase-out of cigarettes based on a combination of effective anti-tobacco regulations and high taxes in conjunction with aggressive application of nicotine replacement therapies. The purpose of this study was to ascertain whether these claims were valid in Bhutan, which enacted a national cigarette sales prohibition law in 2004. Did Bhutan from 2004 to 2009 eliminate or nearly eliminate cigarette consumption and avoid a significant cigarette black market and smuggling? This study is a historical, qualitative, descriptive statistical, and archival content overview from 2004 to 2009 of smoking prevalence rates and smuggling and black market trends subsequent to the enactment of the Bhutan Penal Code Act of 2004. For adults in Bhutan, tobacco prevalence rates are fairly low compared with other nations but in 2008 remained a serious health issue for those who consumed cigarettes. For minors, tobacco consumption and second hand smoke exposure in 2008 was a significant health issue. In addition, the best available evidence indicates that illegal tobacco smuggling including black market sales due to the sales ban in Bhutan remains robust. So far, in Bhutan, cigarette neo-prohibitionist arguments that stringent anti-tobacco tax and regulatory approaches including a sales prohibition will induce tobacco consumption to cease or nearly cease has not occurred. In addition, the best scientific evidence indicates that a harm reduction-oriented nicotine replacement therapy approach will not be entirely effective. The results of this study provide an important lesson learned for health practitioners and advocates considering or advocating, albeit a gradual, but total cigarette ban as public policy. Copyright © 2011 Elsevier B.V. All rights reserved.

Young adult smokers' perceptions of illicit tobacco and the possible impact of plain packaging on purchase behaviour.

PubMed

Moodie, Crawford; Hastings, Gerard; Joossens, Luk

2012-04-01

Plain (unbranded) packaging for cigarettes is at the top of the tobacco control agenda in both Australia and Europe. The evidence suggests that it will benefit public health by decreasing the appeal of tobacco products and increasing the power of the health warning. The tobacco industry instead argues that plain packaging would make it easier to counterfeit cigarettes, which would both confuse consumers and reduce price; thereby increasing consumption. Using focus group research we examined young adult smokers (N = 54) perceptions of, and ability to recognize, illicit tobacco and the possible impact of plain packaging on illicit tobacco purchasing behaviour. We found that the pack has no impact on the decision to buy illicit tobacco. Smokers were easily able to identify counterfeit cigarettes, not least by the pack, and buy it knowingly and in the full expectation that it will be inferior in quality. Illicit tobacco purchase, including that for counterfeit tobacco, was instead driven by availability and price. Given the extremely low manufacturing cost, per pack, of certain types of illicit cigarettes, it is difficult to envisage how plain packaging would alter the price of illicit tobacco in any meaningful way. The findings therefore suggest that a move to plain packaging would have no impact on young adult smokers' purchase behaviour.

Tobacco control in California compared with the rest of the USA: trends in adult per capita cigarette consumption.

PubMed

Pierce, John P; Shi, Yuyan; Hendrickson, Erik M; White, Martha M; Noble, Madison L; Kealey, Sheila; Strong, David R; Trinidad, Dennis R; Hartman, Anne M; Messer, Karen

2017-11-27

In the 1990s, California led the USA in state-level tobacco control strategies. However, after 2000, California lost ground on cigarette taxes, although it maintained higher levels of smoke-free homes among smokers. Trends in per capita cigarette consumption were assessed through taxed sales data and from self-report in repeated national cross-sectional surveys. Linear regressions identified changes in trends after year 2000 separately for California and the rest of the USA. Using data from each state, a linear regression tested the association between different tobacco control strategies and per capita consumption. Change in self-reported per capita consumption was partitioned into contributions associated with initiation, quitting and reduction in cigarette consumption level. Both taxed cigarette sales and per capita consumption declined rapidly in the USA from 1985 to 2015. Declines were particularly fast in California before 2000 but slowed thereafter. In 2014, per capita consumption in California was 29.4 packs/adult/year, but 90% higher in the rest of the USA. Modelling state-level data, every $1 increase in cigarette taxes reduced consumption by 4.8 (95% CI 2.9 to 6.8) packs/adult/year. Every 5% increase in the proportion of smokers with smoke-free homes reduced consumption by 8.0 (95% CI 7.0 to 8.9) packs/adult/year. The different patterns in California and the rest of the USA are at least partially explained by these two variables. The slow down in per capita consumption in California can be attributed to changes in initiation, quitting and especially smokers reducing their consumption level. Tobacco control strategies need to be continually updated to maintain momentum towards a smoke-free society. © 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.

Tax, price, and cigarette brand preferences: A longitudinal study of adult smokers from the ITC Mexico Survey

PubMed Central

Sáenz de Miera Juárez, Belén; Thrasher, James F; Reynales Shigematsu, Luz Myriam; Hernández Ávila, Mauricio; Chaloupka, Frank J

2014-01-01

Background Recent tax increases in Mexico differed in structure and provide an opportunity to better understand tobacco industry pricing strategies, as well as smokers’ responses to any resulting price changes. Objectives To assess if taxes were passed onto consumers of different cigarette brands, the extent of brand switching, and predictors of preference for cheaper national brands. Methods Using data from three waves of the Mexican administration of the ITC Survey, we analyzed self-reported brand and price paid at last cigarette purchase. Generalized estimating equations were used to determine predictors of price and preference for national brands. Results The average price of premium/international brands increased each year from 2008–2011; however, the price for discount/national brands increased only from 2010 to 2011. The percentage of smokers who smoked national brands remained stable between 2008 and 2010 but dropped in 2011. Factors related to smoking national as opposed to international brands included being male and having relatively older age, lower education, lower income, and higher consumption. Conclusions Tobacco industry pricing strategies in the wake of ad valorem taxes implemented in Mexico prior to 2011 had the impact of segmenting the market into discount national brands and premium international brands. The specific tax increase implemented in 2011 reduced the price gap between these two segments, by raising the price of the national brands relative to the international brands. Evidence for trading up was found after the 2011 tax increase. These results provide further evidence for the relevance of tax policy as a tobacco control strategy; in particular, they illustrate the importance of how specific rather than ad valorem taxes can reduce the potential for downward brand switching in the face of decreasing cigarette affordability. PMID:24114563

Tobacco-, Alcohol-, and Drug-Attributable Deaths and Their Contribution to Mortality Disparities in a Cohort of Homeless Adults in Boston

PubMed Central

Chang, Yuchiao; Singer, Daniel E.; Porneala, Bianca C.; Gaeta, Jessie M.; O’Connell, James J.; Rigotti, Nancy A.

2015-01-01

Objectives. We quantified tobacco-, alcohol-, and drug-attributable deaths and their contribution to mortality disparities among homeless adults. Methods. We ascertained causes of death among 28 033 adults seen at the Boston Health Care for the Homeless Program in 2003 to 2008. We calculated population-attributable fractions to estimate the proportion of deaths attributable to tobacco, alcohol, or drug use. We compared attributable mortality rates with those for Massachusetts adults using rate ratios and differences. Results. Of 1302 deaths, 236 were tobacco-attributable, 215 were alcohol-attributable, and 286 were drug-attributable. Fifty-two percent of deaths were attributable to any of these substances. In comparison with Massachusetts adults, tobacco-attributable mortality rates were 3 to 5 times higher, alcohol-attributable mortality rates were 6 to 10 times higher, and drug-attributable mortality rates were 8 to 17 times higher. Disparities in substance-attributable deaths accounted for 57% of the all-cause mortality gap between the homeless cohort and Massachusetts adults. Conclusions. In this clinic-based cohort of homeless adults, over half of all deaths were substance-attributable, but this did not fully explain the mortality disparity with the general population. Interventions should address both addiction and non-addiction sources of excess mortality. PMID:25521869

A cross-sectional analysis of how young adults perceive tobacco brands: implications for FCTC signatories

PubMed Central

2012-01-01

Background The Framework Convention on Tobacco Control calls for the elimination of tobacco advertising, promotion and sponsorship. To test whether tobacco packaging functions as advertising by communicating attractive and distinctive brand attributes, we explored how young adult smokers and non-smokers interpreted familiar and unfamiliar tobacco brands. Methods We conducted an on-line survey of 1035 young adult smokers and non-smokers aged 18–30. Participants evaluated eight tobacco brands using ten attributes based on brand personality scales. We used factor analysis and ANOVA to examine patterns in brand-attribute associations. Results Young adults distinguished between brands on the basis of their packaging alone, associated each brand with specific attributes, and were equally able to interpret familiar and unfamiliar brands. Contrary to our expectations, non-smokers made more favourable brand-attribute associations than smokers, but both groups described Basic, a near generic brand, as ‘plain’ or ‘budget’. There were no significant gender or ethnicity differences. Conclusions Tobacco packaging uses logos, colours and imagery to create desirable connotations that promote and reinforce smoking. By functioning in the same way as advertising, on-pack branding breaches Article 13 of the FCTC and refutes tobacco companies’ claims that pack livery serves only as an indentifying device that simplifies smokers’ decision-making. Given this evidence, signatories should see plain packaging policies as a priority consistent with their FCTC obligations to eliminate all tobacco advertising and promotion. PMID:22985407

Mixed methods research in tobacco control with youth and young adults: A methodological review of current strategies.

PubMed

Fryer, Craig S; Seaman, Elizabeth L; Clark, Rachael S; Plano Clark, Vicki L

2017-01-01

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.

Mixed methods research in tobacco control with youth and young adults: A methodological review of current strategies

PubMed Central

Seaman, Elizabeth L.; Clark, Rachael S.; Plano Clark, Vicki L.

2017-01-01

Introduction 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. Methods 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. Results 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. Conclusions 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. PMID:28841689

Frequency and characteristics associated with exposure to tobacco direct mail marketing and its prospective effect on smoking behaviors among young adults from the US Midwest.

PubMed

Choi, Kelvin; Forster, Jean L

2014-11-01

We examined the exposure to tobacco direct mail marketing and its effect on subsequent smoking behaviors in a US Midwest regional cohort of young adults. Data were collected from 2622 young adults (mean age = 24 years) in 2010 to 2011 (baseline) and 2011 to 2012 (follow-up). We collected information on demographics, tobacco use, and exposure to tobacco direct mail materials in the previous 6 months at baseline. Smoking behaviors were reassessed at follow-up. We investigated the characteristics associated with receiving these materials at baseline, and the associations between receiving cigarette coupons in the mail at baseline and smoking behaviors at follow-up. Thirteen percent of participants reported receiving tobacco direct mail materials in the previous 6 months. Receipt of these materials was associated with age, education, and tobacco use (P < .05). Among those who received these materials, 77% and 56% reported receiving coupons for cigarettes and other tobacco products, respectively. Among baseline nonsmokers and ex-smokers, receiving coupons was associated with becoming current smokers at follow-up (P < .05). Among baseline current smokers, receiving coupons was associated with lower likelihood of smoking cessation at follow-up (P < .05). Tobacco direct mail marketing promoted and sustained smoking behaviors among US Midwest young adults. Regulating this marketing strategy might reduce the prevalence of smoking in this population.

The neighbourhood effects of geographical access to tobacco retailers on individual smoking behaviour.

PubMed

Pearce, J; Hiscock, R; Moon, G; Barnett, R

2009-01-01

To investigate whether neighbourhood measures of geographical accessibility to outlets selling tobacco (supermarkets, convenience stores and petrol stations) are associated with individual smoking behaviour in New Zealand. Using geographical information systems, travel times from the population-weighted centroid of each neighbourhood to the closest outlet selling tobacco were calculated for all 38,350 neighbourhoods across New Zealand. These measures were appended to the 2002/03 New Zealand Health Survey, a national survey of 12, 529 adults. Two-level logistic regression models were fitted to examine the effects of neighbourhood locational access upon individual smoking behaviour after controlling for potential individual- and neighbourhood-level confounding factors, including deprivation and urban/rural status. After controlling for individual-level demographic and socioeconomic variables, individuals living in the quartiles of neighbourhoods with the best access to supermarkets (OR 1.23, 95% CI 1.06 to 1.42) and convenience stores (OR 1.19, 95% CI 1.03 to 1.38) had a higher odds of smoking compared with individuals in the worst access quartiles. However, the association between neighbourhood accessibility to supermarkets and convenience stores was not apparent once other neighbourhood-level variables (deprivation and rurality) were included. At the national level, there is little evidence to suggest that, after adjustment for neighbourhood deprivation, better locational access to tobacco retail provision in New Zealand is associated with individual-level smoking behaviour.

Review of hookah tobacco smoking among college students: policy implications and research recommendations.

PubMed

Gathuru, Irene M; Tarter, Ralph E; Klein-Fedyshin, Michele

2015-01-01

About 30% of college students have smoked hookah tobacco. Although most students perceive this product to be innocuous and non-addictive, hookah tobacco increases the risk for disease and nicotine dependence. Currently, the US Food and Drug Administration (FDA) does not regulate the manufacture, distribution, or sale of hookah tobacco. Empirical literature pertaining to hookah tobacco smoking is reviewed with a focus on the implications for regulatory policy. PubMed, PsycINFO, and Scopus databases were searched to locate articles published in English. The literature search combined several key words including "hookahs", "college", "advertising", "health effects", and "health policy". Smoking hookah tobacco may play a role in the initiation of smoking among tobacco-naïve college students and may portend persistent smoking among those who have smoked cigarettes. College students are typically nondaily, social smokers. They do not perceive that their heightened risk for tobacco diseases and nicotine dependence relates to their smoking behavior. However, few public health messages target college-age adults to counter media messages that endorse hookah tobacco smoking. Given that the FDA is not authorized to ban specific tobacco products, policy actions should focus on the development of effective risk communication strategies that target college-age adults and on limiting the accessibility of hookah tobacco products to these adults. Accordingly, a research agenda that would inform these policy actions is proposed.

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

PubMed

Ling, Pamela M; Glantz, Stanton A

2002-06-12

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

Patterns and predictors of smokeless tobacco use among adults in Bangladesh: findings from the International Tobacco Control (ITC) Bangladesh survey.

PubMed

Abdullah, Abu S; Driezen, Pete; Ruthbah, Ummul H; Nargis, Nigar; Quah, Anne C K; Fong, Geoffrey T

2014-01-01

Although smokeless tobacco (SLT) use is prevalent in South Asian countries including Bangladesh, information about the pattern and correlates of SLT use is scarce. This study described the pattern and predictors of SLT use among Bangladeshi adults. The data for this study were derived from the International Tobacco Control Policy Evaluation Bangladesh (ITC BD) Survey, a prospective cohort survey of a nationally representative sample of smokers and non-smokers, conducted during November 2011 and May 2012. The study included 5522 adults aged 15 or above. We used multiple logistic regression models to identify predictors of SLT use. Of the respondents (N = 5522), 20% were SLT users. In general, SLT use was significantly higher among women, the illiterate and residents of the Dhaka slums or non-tribal/non-border areas outside Dhaka; SLT use increased with age. Several attitudinal factors were also associated with SLT use. Multivariable logistic regression analyses revealed several predictors of SLT use: being female (OR = 1.96, 95% confidence interval, CI: 1.18-3.24), an increasing age, being a resident of a Dhaka slum (OR = 5.86; 95% CI: 3.73-9.21) or non-tribal/non-border areas outside Dhaka (OR = 3.42; 95% CI: 1.94-6.03), being illiterate (OR = 3.37; 95% CI: 1.99-5.71), holding positive opinion towards societal approval of SLT use (OR = 5.84; 95% CI: 3.38-10.09), holding positive opinion towards SLT use by women (OR = 2.63; 95% CI: 1.53-4.54), believing that SLT is addictive (OR = 2.96; 95% CI: 1.51-5.81), and believing SLT is less harmful than bidi (OR = 2.22; 95% CI: 1.36-3.62). The findings suggest that coordinated efforts of governmental and non-governmental organizations, targeting both smoked tobacco and SLT use reduction and cessation, could be modified to reach each level of population including those who are marginalized, female, less educated and elderly. As most tobacco control programs in Bangladesh target mainly cigarette or bidi smoking, coordinated programs are needed that will also include SLT use within the tobacco control policy and prevention strategies.

Patterns and Predictors of Smokeless Tobacco Use among Adults in Bangladesh: Findings from the International Tobacco Control (ITC) Bangladesh Survey

PubMed Central

Abdullah, Abu S.; Driezen, Pete; Ruthbah, Ummul H.; Nargis, Nigar; Quah, Anne C. K.; Fong, Geoffrey T.

2014-01-01

Background Although smokeless tobacco (SLT) use is prevalent in South Asian countries including Bangladesh, information about the pattern and correlates of SLT use is scarce. This study described the pattern and predictors of SLT use among Bangladeshi adults. Methods The data for this study were derived from the International Tobacco Control Policy Evaluation Bangladesh (ITC BD) Survey, a prospective cohort survey of a nationally representative sample of smokers and non-smokers, conducted during November 2011 and May 2012. The study included 5522 adults aged 15 or above. We used multiple logistic regression models to identify predictors of SLT use. Results Of the respondents (N = 5522), 20% were SLT users. In general, SLT use was significantly higher among women, the illiterate and residents of the Dhaka slums or non-tribal/non-border areas outside Dhaka; SLT use increased with age. Several attitudinal factors were also associated with SLT use. Multivariable logistic regression analyses revealed several predictors of SLT use: being female (OR = 1.96, 95% confidence interval, CI: 1.18–3.24), an increasing age, being a resident of a Dhaka slum (OR = 5.86; 95% CI: 3.73–9.21) or non-tribal/non-border areas outside Dhaka (OR = 3.42; 95% CI: 1.94–6.03), being illiterate (OR = 3.37; 95% CI: 1.99–5.71), holding positive opinion towards societal approval of SLT use (OR = 5.84; 95% CI: 3.38–10.09), holding positive opinion towards SLT use by women (OR = 2.63; 95% CI: 1.53–4.54), believing that SLT is addictive (OR = 2.96; 95% CI: 1.51–5.81), and believing SLT is less harmful than bidi (OR = 2.22; 95% CI: 1.36–3.62). Conclusion The findings suggest that coordinated efforts of governmental and non-governmental organizations, targeting both smoked tobacco and SLT use reduction and cessation, could be modified to reach each level of population including those who are marginalized, female, less educated and elderly. As most tobacco control programs in Bangladesh target mainly cigarette or bidi smoking, coordinated programs are needed that will also include SLT use within the tobacco control policy and prevention strategies. PMID:25007266

Association of Noncigarette Tobacco Product Use With Future Cigarette Smoking Among Youth in the Population Assessment of Tobacco and Health (PATH) Study, 2013-2015.

PubMed

Watkins, Shannon Lea; Glantz, Stanton A; Chaffee, Benjamin W

2018-02-01

Approximately 90% of adult smokers first tried a cigarette by 18 years of age, and even infrequent smoking in adolescence is associated with established adult smoking. Noncigarette tobacco use is increasing and could stimulate subsequent conventional cigarette smoking in youths. To estimate the longitudinal association between noncigarette tobacco use and subsequent cigarette smoking initiation among US youth. In this prospective cohort study of the Population Assessment of Tobacco and Health (PATH) waves 1 (September 12, 2013, to December 14, 2014) and 2 (October 23, 2014, to October 30, 2015), a nationally representative sample of youths who never smoked a conventional cigarette at baseline and completed wave 2 follow-up (N = 10 384) was studied. PATH retention at follow-up was 87.9%. Ever use and past 30-day use of electronic cigarettes (e-cigarettes), hookah, noncigarette combustible tobacco, or smokeless tobacco at baseline. Ever use and past 30-day use of cigarettes at follow-up. The present analysis was based on the 10 384 PATH youth respondents who reported never having smoked a cigarette in wave 1 and whose cigarette ever or past 30-day use was reported in wave 2 (mean [SD] age, 14.3 [1.7] years; age range, 12-17 years; 5087 [49.1%] female; 4829 [52.5%] white). At 1-year follow-up, 469 (4.6%) of all baseline never-smoking youths had tried a cigarette and 219 (2.1%) had smoked a cigarette within the past 30 days. Cigarette ever use at follow-up was higher among youths who had ever used e-cigarettes (78 [19.1%]), hookah (60 [18.3%]), noncigarette combustible tobacco (45 [19.2%]), or smokeless tobacco (29 [18.8%]) at baseline. After adjusting for sociodemographic, environmental, and behavioral smoking risk factors and for baseline ever use of other tobacco products, the odds of past 30-day cigarette use at follow-up were approximately twice as high among baseline ever users of e-cigarettes (odds ratio [OR], 1.87; 95% CI, 1.15-3.05), hookah (OR, 1.92; 95% CI, 1.17-3.17), noncigarette combustible tobacco (OR, 1.78; 95% CI, 1.00-3.19), and smokeless tobacco (OR, 2.07; 95% CI, 1.10-3.87). Youths who had tried more than 1 type of tobacco product at baseline had 3.81 (95% CI, 2.22-6.54) greater adjusted odds of past 30-day cigarette smoking at follow-up than did baseline never tobacco users. Any use of e-cigarettes, hookah, noncigarette combustible tobacco, or smokeless tobacco was independently associated with cigarette smoking 1 year later. Use of more than 1 product increased the odds of progressing to cigarette use.

Public Experience with Psychoactive Substances: A Nationwide Study Among Adults and Youth. Part 1, Main Findings.

ERIC Educational Resources Information Center

Abelson, Herbert I.; Atkinson, Ronald B.

This is a study of beliefs, attitudes, and behavior with regard to a wide range of legal and illegal drugs. Included are data about coffee, tea, tobacco, and illicit drugs such as marihuana and heroin. The report covers the current situation and highlights trends from two prior studies on drug abuse conducted for the National Commission on…

Magazine hyped: Trends in tobacco advertising and readership characteristics, 2010–2014

PubMed Central

El-Toukhy, Sherine M.; Choi, Kelvin

2016-01-01

We tracked magazine advertisements for seven tobacco products in US magazines from 2010 to 2014 and examined magazine readership characteristics that are associated with advertising placement in 2014. Advertising data came from Kantar Media’s Intelligence and readership data came from a 2014 Experian’s nationally representative survey of 4,667 adult tobacco users. At magazine level, we aggregated total and product-specific number of advertisements and expenditures by year and calculated readership demographics. We used linear and Poisson regression models to examine trends in number of tobacco advertisements and expenditures and readership characteristics associated with number of tobacco advertisements in 2014. Analyses were conducted in 2015. There were 5,317 tobacco advertisements with expenditures of $796 million that appeared in 322 magazines during 2010–2014. Cigarette advertisements accounted for 2,928 (55%), followed by e-cigarettes (n = 862, 16%), and snus (n = 534, 10%). Advertisements increased by 2.79 ad/year for cigarettes, 1.94 ad/year for e-cigarettes, and 0.78 ad/year for chewing tobacco (p < 0.05). In 2014, number of advertisements was associated with select readership characteristics (p < 0.05). For every 10% increase in 18–39 year-old readers, advertisement rate increased by 1.48 times for cigarettes, 3.44 times for e-cigarettes, and 2.15 times for chewing tobacco. For every 10% increase in readers who earn ≤$24,999, advertisement rate increased by 1.37 times for cigarettes and 1.70 times for e-cigarettes. Magazine tobacco advertising has increased especially for cigarettes and is targeted toward certain demographic subgroups. Regulating tobacco magazine advertising should be integral to tobacco control policies. PMID:27519170

Cultural Perspectives Concerning Adolescent Use of Tobacco and Alcohol in the Appalachian Mountain Region

PubMed Central

Meyer, Michael G.; Toborg, Mary A.; Denham, Sharon A.; Mande, Mary J.

2008-01-01

Context Appalachia has high rates of tobacco use and related health problems, and despite significant impediments to alcohol use, alcohol abuse is common. Adolescents are exposed to sophisticated tobacco and alcohol advertising. Prevention messages, therefore, should reflect research concerning culturally influenced attitudes toward tobacco and alcohol use. Methods With 4 grants from the National Institutes of Health, 34 focus groups occurred between 1999 and 2003 in 17 rural Appalachian jurisdictions in 7 states. These jurisdictions ranged between 4 and 8 on the Rural-Urban Continuum Codes of the Economic Research Service of the US Department of Agriculture. Of the focus groups, 25 sought the perspectives of women in Appalachia, and 9, opinions of adolescents. Findings The family represented the key context where residents of Appalachia learn about tobacco and alcohol use. Experimentation with tobacco and alcohol frequently commenced by early adolescence and initially occurred in the context of the family home. Reasons to abstain from tobacco and alcohol included a variety of reasons related to family circumstances. Adults generally displayed a greater degree of tolerance for adolescent alcohol use than tobacco use. Tobacco growing represents an economic mainstay in many communities, a fact that contributes to the acceptance of its use, and many coal miners use smokeless tobacco since they cannot light up in the mines. The production and distribution of homemade alcohol was not a significant issue in alcohol use in the mountains even though it appeared not to have entirely disappeared. Conclusions Though cultural factors support tobacco and alcohol use in Appalachia, risk awareness is common. Messages tailored to cultural themes may decrease prevalence. PMID:18257873

Magazine hyped: Trends in tobacco advertising and readership characteristics, 2010-2014.

PubMed

El-Toukhy, Sherine M; Choi, Kelvin

2016-10-01

We tracked magazine advertisements for seven tobacco products in U.S. magazines from 2010 to 2014 and examined magazine readership characteristics that are associated with advertising placement in 2014. Advertising data came from Kantar Media's Intelligence and readership data came from a 2014 Experian's nationally representative survey of 4667 adult tobacco users. At magazine level, we aggregated total and product-specific number of advertisements and expenditures by year and calculated readership demographics. We used linear and poisson regression models to examine trends in number of tobacco advertisements and expenditures and readership characteristics associated with number of tobacco advertisements in 2014. Analyses were conducted in 2015. There were 5317 tobacco advertisements with expenditures of $796 million that appeared in 322 magazines during 2010-2014. Cigarette advertisements accounted for 2928 (55%), followed by e-cigarettes (n=862, 16%), and snus (n=534, 10%). Advertisements increased by 2.79ad/year for cigarettes, 1.94ad/year for e-cigarettes, and 0.78ad/year for chewing tobacco (p<0.05). In 2014, number of advertisements was associated with select readership characteristics (p<0.05). For every 10% increase in 18-39year-old readers, advertisement rate increased by 1.48 times for cigarettes, 3.44 times for e-cigarettes, and 2.15 times for chewing tobacco. For every 10% increase in readers who earn ≤$24,999, advertisement rate increased by 1.37 times for cigarettes and 1.70 times for e-cigarettes. Magazine tobacco advertising has increased especially for cigarettes and is targeted toward certain demographic subgroups. Regulating tobacco magazine advertising should be integral to tobacco control policies. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed

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

2015-03-14

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

Evidence for a young adult-targeted tobacco control campaign stimulating cessation-related responses among adult smokers and recent quitters.

PubMed

Li, Judy; Guiney, Hayley; Walton, Darren

2016-02-19

Young adults are an important group for tobacco control interventions because of their high smoking prevalence. In 2014, New Zealand launched a young adult-targeted tobacco control campaign: 'Stop Before You Start'. The evaluation undertaken with young adults (aged 18 to 24 years) showed that the campaign exerted positive impacts on this age group. This study aimed to investigate the collateral effects of this campaign on older adults. Data were collected from a fortnightly survey of adult smokers and recent quitters, where respondents were maintained on a panel and interviewed every fortnight, up to six times. This paper reports on data collected over three consecutive fortnights (540 interviews). Ten measures were used to assess campaign effectiveness (eg, felt regret, tried to quit). After adjusting for recent quit attempt status and socio-demographic characteristics, age differences were not found in any of the outcome variables (aged 25-44 years and 45+ years were compared against 18-24 years). Internationally, little is known about the effectiveness of young adult-targeted tobacco control campaigns. Alongside data from the campaign evaluation with young adults, findings from the current study suggest that this young adult-targeted campaign also created a desirable impact on older adults.

Trends in bidi and cigarette smoking in India from 1998 to 2015, by age, gender and education

PubMed Central

Mishra, Sujata; Joseph, Renu Ann; Gupta, Prakash C; Pezzack, Brendon; Ram, Faujdar; Sinha, Dhirendra N; Dikshit, Rajesh; Patra, Jayadeep; Jha, Prabhat

2016-01-01

Objectives Smoking of cigarettes or bidis (small, locally manufactured smoked tobacco) in India has likely changed over the last decade. We sought to document trends in smoking prevalence among Indians aged 15–69 years between 1998 and 2015. Design Comparison of 3 nationally representative surveys representing 99% of India's population; the Special Fertility and Mortality Survey (1998), the Sample Registration System Baseline Survey (2004) and the Global Adult Tobacco Survey (2010). Setting India. Participants About 14 million residents from 2.5 million homes, representative of India. Main outcome measures Age-standardised smoking prevalence and projected absolute numbers of smokers in 2015. Trends were stratified by type of tobacco smoked, age, gender and education level. Findings The age-standardised prevalence of any smoking in men at ages 15–69 years fell from about 27% in 1998 to 24% in 2010, but rose at ages 15–29 years. During this period, cigarette smoking in men became about twofold more prevalent at ages 15–69 years and fourfold more prevalent at ages 15–29 years. By contrast, bidi smoking among men at ages 15–69 years fell modestly. The age-standardised prevalence of any smoking in women at these ages was 2.7% in 2010. The smoking prevalence in women born after 1960 was about half of the prevalence in women born before 1950. By contrast, the intergenerational changes in smoking prevalence in men were much smaller. The absolute numbers of men smoking any type of tobacco at ages 15–69 years rose by about 29 million or 36% in relative terms from 79 million in 1998 to 108 million in 2015. This represents an average increase of about 1.7 million male smokers every year. By 2015, there were roughly equal numbers of men smoking cigarettes or bidis. About 11 million women aged 15–69 smoked in 2015. Among illiterate men, the prevalence of smoking rose (most sharply for cigarettes) but fell modestly among men with grade 10 or more education. The ex-smoking prevalence in men at ages 45–59 years rose modestly but was low: only 5% nationally with about 4 current smokers for every former smoker. Conclusions Despite modest decreases in smoking prevalence, the absolute numbers of male smokers aged 15–69 years has increased substantially over the last 15 years. Cigarettes are displacing bidi smoking, most notably among young adult men and illiterate men. Tobacco control policies need to adapt to these changes, most notably with higher taxation on tobacco products, so as to raise the currently low levels of adult smoking cessation. PMID:28588906

Picture Me Smokefree: a qualitative study using social media and digital photography to engage young adults in tobacco reduction and cessation.

PubMed

Haines-Saah, Rebecca J; Kelly, Mary T; Oliffe, John L; Bottorff, Joan L

2015-01-26

Young adults have high rates of tobacco use compared to other subpopulations, yet there are relatively few tobacco interventions specifically targeted to this group. Picture Me Smokefree is an online tobacco reduction and cessation intervention for young adults that uses digital photography and social networking. The main goal of the project was to determine the feasibility of engaging young adults in participating in user-driven, online forums intended to provide peer support and motivate critical reflection about tobacco use and cessation among this high-use, hard-to-reach population. A related aim was to explore the influence of gender-related factors on participation, in order to determine the need for online interventions to be tailored to the specific gender preferences reflecting young men and women's participation styles. A total of 60 young adults ages 19-24 years who self-identified as current cigarette smokers or who had quit within the last year were recruited from across British Columbia, Canada, and participated in an online photo group on Facebook over a period of 12 consecutive weeks. A variety of data collection methods were used including tracking online activity, a brief online follow-up survey, and qualitative interviews with study participants. Data analysis involved descriptive statistics on recruitment, retention, and participation and qualitative (eg, narrative analysis, synthesis of feedback) feedback about participant engagement. Findings from this study suggest good potential for Facebook as an accessible, low-cost platform for engaging young adults to reflect on the reasons for their tobacco use, the benefits of quitting or reducing, and the best strategies for tobacco reduction. Young adults' frequent use of mobile phones and other mobile devices to access social networking permitted ease of access and facilitated real-time peer-to-peer support across a diverse group of participants. However, our experience of conducting the study suggests that working with young tobacco users can be accompanied by considerable recruitment, participation, and retention challenges. Our findings also pointed to differences in how young women and men engaged the photo-group intervention that should be considered, bearing in mind that in follow-up interviews participants indicated their preference for a mixed gender and "gender neutral" group format. Tobacco interventions for youth and young adults should be embedded within the existing social networking platforms they access most frequently, rather than designing a stand-alone online prevention or intervention resource. This subpopulation would likely benefit from tobacco reduction interventions that are gender-sensitive rather than gender-specific.

Building capacity for implementation of the framework convention for tobacco control in Vietnam: lessons for developing countries

PubMed Central

Stillman, Frances A.; David, Annette M.; Kibria, Naseeb; Phan, Hai Thi

2014-01-01

Effective implementation of the WHO international Framework Convention on Tobacco Control (FCTC) is the key to controlling the tobacco epidemic. Within countries, strong national tobacco control capacity is the primary determinant for successful implementation of the FCTC. This case study of tobacco control policy describes the experience of building national tobacco control capacity in Vietnam under the Reduce Smoking in Vietnam Partnership project within a national capacity-building framework. In the Vietnam experience, four components of tobacco control capacity emerged as especially important to achieve ‘quality’ outputs and measurable outcomes at the implementation level: (i) organizational structure/infrastructure; (ii) leadership and expertise; (iii) partnerships and networks and (iv) data and evidence from research. The experience gained in this project helps in adapting our tobacco control capacity-building model, and the lessons that emerged from this country case study can provide guidance to global funders, tobacco control technical assistance providers and nations as governments endeavor to meet their commitment to the FCTC. PMID:23411160

Discussions with adults and youth to inform the development of a community-based tobacco control programme

PubMed Central

Arora, Monika; Tewari, Abha; Dhavan, Poonam; Nazar, Gaurang P.; Stigler, Melissa H.; Juneja, Neeru S.; Perry, Cheryl L.; Reddy, K. Srinath

2013-01-01

Project Advancing Cessation of Tobacco in Vulnerable Indian Tobacco Consuming Youth (ACTIVITY) is a community-based group randomized intervention trial focused on disadvantaged youth (aged 10–19 years) residing in 14 low-income communities (slums and resettlement colonies) in Delhi, India. This article discusses the findings of Focus Group Discussions (FGDs) conducted to inform the development and test the appropriateness of Project ACTIVITY’s intervention model. The findings of the FGDs facilitated the understanding of factors contributing to increased tobacco uptake and cessation (both smoking and smokeless tobacco) among youth in this setting. Twenty-two FGDs were conducted with youth (10–19 years) and adults in two urban slums in Delhi. Key findings revealed: (i) youth and adults had limited knowledge about long-term health consequences of tobacco use; (ii) socio-environmental determinants and peer pressure were important variables influencing initiation of tobacco use; (iii) lack of motivation, support and sufficient skills hinder tobacco cessation and (iv) active involvement of community, family, religious leaders, local policy makers and health professionals is important in creating and reinforcing tobacco-free norms. The results of these FGDs aided in finalizing the intervention model for Project ACTIVITY and guided its intervention development. PMID:22824533

Socioeconomic Gradients in Different Types of Tobacco Use in India: Evidence from Global Adult Tobacco Survey 2009-10.

PubMed

Singh, Ankur; Arora, Monika; English, Dallas R; Mathur, Manu R

2015-01-01

Socioeconomic differences in tobacco use have been reported, but there is a lack of evidence on how they vary according to types of tobacco use. This study explored socioeconomic differences associated with cigarette, bidi, smokeless tobacco (SLT), and dual use (smoking and smokeless tobacco use) in India and tested whether these differences vary by gender and residential area. Secondary analysis of Global Adult Tobacco Survey (GATS) 2009-10 (n = 69,296) was conducted. The primary outcomes were self-reported cigarette, bidi smoking, SLT, and dual use. The main explanatory variables were wealth, education, and occupation. Associations were assessed using multinomial logistic regressions. 69,030 adults participated in the study. Positive association was observed between wealth and prevalence of cigarette smoking while inverse associations were observed for bidi smoking, SLT, and dual use after adjustment for potential confounders. Inverse associations with education were observed for all four types after adjusting for confounders. Significant interactions were observed for gender and area in the association between cigarette, bidi, and smokeless tobacco use with wealth and education. The probability of cigarette smoking was higher for wealthier individuals while the probability of bidi smoking, smokeless tobacco use, and dual use was higher for those with lesser wealth and education.

Socioeconomic Gradients in Different Types of Tobacco Use in India: Evidence from Global Adult Tobacco Survey 2009-10

PubMed Central

Singh, Ankur; Arora, Monika; English, Dallas R.; Mathur, Manu R.

2015-01-01

Socioeconomic differences in tobacco use have been reported, but there is a lack of evidence on how they vary according to types of tobacco use. This study explored socioeconomic differences associated with cigarette, bidi, smokeless tobacco (SLT), and dual use (smoking and smokeless tobacco use) in India and tested whether these differences vary by gender and residential area. Secondary analysis of Global Adult Tobacco Survey (GATS) 2009-10 (n = 69,296) was conducted. The primary outcomes were self-reported cigarette, bidi smoking, SLT, and dual use. The main explanatory variables were wealth, education, and occupation. Associations were assessed using multinomial logistic regressions. 69,030 adults participated in the study. Positive association was observed between wealth and prevalence of cigarette smoking while inverse associations were observed for bidi smoking, SLT, and dual use after adjustment for potential confounders. Inverse associations with education were observed for all four types after adjusting for confounders. Significant interactions were observed for gender and area in the association between cigarette, bidi, and smokeless tobacco use with wealth and education. The probability of cigarette smoking was higher for wealthier individuals while the probability of bidi smoking, smokeless tobacco use, and dual use was higher for those with lesser wealth and education. PMID:26273649

Longitudinal Tobacco Use Transitions Among Adolescents and Young Adults: 2014-2016.

PubMed

Hair, Elizabeth C; Romberg, Alexa R; Niaura, Raymond; Abrams, David B; Bennett, Morgane A; Xiao, Haijun; Rath, Jessica M; Pitzer, Lindsay; Vallone, Donna

2018-02-13

Among youth, the frequency and prevalence of using more than one tobacco (small cigar, cigarette, and hookah) or nicotine-containing product (e-cigarettes-ENDS) are changing. These shifts pose challenges for regulation, intervention, and prevention campaigns because of scant longitudinal data on the stability of use patterns in this changing product landscape. A nationally representative longitudinal survey of 15- to 21-year olds (n = 15,275) was used to describe transitions between never use, noncurrent use, and past 30-day use of combustible tobacco, e-cigarettes (ENDS), and dual use of both kinds of products. A multistate model was fit to observations collected every 6 months across 2.5 years to estimate the probability of transitions between states (TPs), the average time in state (sojourn time), and the effect of age on transitions. Current state strongly predicted future state over time intervals of 1 year or less, but only weakly predicted future state at longer intervals: TP to noncurrent use was higher for ENDS-only than combustible-only users over a 6-month interval but was similar for both groups over a 2-year interval. Sojourn time was significantly longer for combustible-only (0.52 years) and dual use (0.55 years) than ENDS-only use (0.27 years); older youth were more likely than younger youth to stay combustible tobacco users or noncurrent users. The dynamics of transitions between combustible tobacco products and ENDS in a population of youth and young adults suggest that policy and prevention efforts must consider the frequent changes and instability over a 1-year or less time period in use patterns among young people. The study addresses an urgent need in public health for timely information on how youth and young adults use tobacco and nicotine products. We found that youth, particularly adolescents, moved frequently between using ENDS and combustible tobacco products either alone or together. Importantly, the utility of current-use states for predicting future use states declined for time horizons longer than 1 year. Our results demonstrate a need for caution in interpreting product transitions. Longitudinal data with frequent observations and coverage of a wide range of possible product types is required to fully characterize usage patterns in youth. © The Author 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Clinical effort against secondhand smoke exposure: development of framework and intervention.

PubMed

Winickoff, Jonathan P; Park, Elyse R; Hipple, Bethany J; Berkowitz, Anna; Vieira, Cecilia; Friebely, Joan; Healey, Erica A; Rigotti, Nancy A

2008-08-01

The purpose of this work was to describe a novel process and present results of formative research to develop a pediatric office intervention that uses available systems of care for addressing parental smoking. The scientific development of the intervention occurred in 3 stages. In stage 1, we designed an office system for parental tobacco control in the pediatric outpatient setting on the basis of complementary conceptual frameworks of preventive services delivery, conceptualized for the child health care setting through a process of key interviews with leaders in the field of implementing practice change; existing Public Health Service guidelines that had been shown effective in adult practices; and adaptation of an evidence-based adult office system for tobacco control. This was an iterative process that yielded a theoretically framed intervention prototype. In stage 2, we performed focus-group testing in pediatric practices with pediatricians, nurses, clinical assistants, and key office staff. Using qualitative methods, we adapted the intervention prototype on the basis of this feedback to include 5 key implementation steps for the child health care setting. In stage 3, we presented the intervention to breakout groups at 2 national meetings of pediatric practitioners for additional refinements. The main result was a theoretically grounded intervention that was responsive to the barriers and suggestions raised in the focus groups and at the national meetings. The Clinical Effort Against Secondhand Smoke Exposure intervention was designed to be flexible and adaptable to the particular practices' staffing, resources, and physical configuration. Practice staff can choose materials relevant to their own particular systems of care (www.ceasetobacco.org). Conceptually grounded and focus-group-tested strategies for parental tobacco control are now available for implementation in the pediatric outpatient setting. The tobacco-control intervention-development process might have particular relevance for other chronic pediatric conditions that have a strong evidence base and have available treatments or resources that are underused.

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

PubMed

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

2008-09-01

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

Pattern, correlates and implications of non-communicable disease multimorbidity among older adults in selected Indian states: a cross-sectional study.

PubMed

Mini, G K; Thankappan, K R

2017-03-08

The objective of the present study was to estimate the proportion of older adults with non-communicable disease (NCD) multimorbidity, its correlates and implications in selected Indian states. The study used data of 9852 older adults (≥60 years) (men 47%, mean age 68 years) collected by the United Nations Population Fund from seven selected Indian states. Multiple logistic regression analysis was used to assess the correlates of NCD multimorbidity and hospitalisation. NCD multimorbidity was reported by 30.7% (95% CI 29.8 to 31.7). Those in the highest wealth group, aged ≥70 years, alcohol users, women and tobacco users were more likely to report NCD multimorbidity compared to those without any NCD and single NCD. Those with multimorbidity, the wealthiest, ever tobacco users and those who had formal education were more likely to be hospitalised compared to their counterparts after adjusting for age, sex and ever use of alcohol. Multimorbidity needs to be considered for planning NCD healthcare services provision particularly inpatient facilities focusing on alcohol users, tobacco users and women. Further studies are required to find out reasons for higher rates of multimorbidity among the wealthier group other than higher healthcare services usage and detection rates. 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/.

Point-of-sale tobacco advertising in Beirut, Lebanon following a national advertising ban

PubMed Central

2013-01-01

Background The objective of this study was to conduct an audit of point-of-sale (POS) tobacco advertising and assess compliance with an advertising ban in a large district of Beirut, Lebanon. Methods The audit was conducted 3 months following the ban on tobacco advertising. Trained students observed all tobacco retail outlets (n = 100) and entered data into a web-based form using iPad® technology. Presence of tobacco advertisements was assessed to determine compliance with the national advertising ban. Results Among the 100 tobacco retail outlets, 62% had tobacco advertisements, including 7% with a tobacco brand logo as part of the main exterior store sign. Conclusions POS tobacco advertising is widespread in Beirut despite the national advertising ban. These findings point to an urgent need for the enforcement of the advertisement ban with tobacco retail outlets in Lebanon. PMID:23731766

Preventing tobacco epidemic in LMICs with low tobacco use - Using Nigeria GATS to review WHO MPOWER tobacco indicators and prevention strategies.

PubMed

Mbulo, Lazarous; Ogbonna, Nwokocha; Olarewaju, Isiaka; Musa, Emmanuel; Salandy, Simone; Ramanandraibe, Nivo; Palipudi, Krishna

2016-10-01

Tobacco is a major preventable cause of disease and death globally and increasingly shifting its burden to low and middle-income countries (LMICs) including African countries. We use Nigeria Global Adult Tobacco Survey data to examine indications of a potential tobacco epidemic in a LMIC setting and provide potential interventions to prevent the epidemic. Global Adult Tobacco Survey data from Nigeria (2012; sample=9765) were analyzed to examine key tobacco indicators. Estimates and confidence intervals for each indicator were computed using SPSS software version 21 for complex samples. 5.5% of adult Nigerians use any tobacco and exposure to secondhand smoke was mainly high in bars (80.0%) and restaurants (29.3%). Two-thirds of smokers (66.3%) are interested in quitting. Among those who attempted to quit, 15.0% used counseling/advice and 5.2% pharmacotherapy. Awareness was high that tobacco use causes serious illnesses (82.4%), heart attack (76.8%) and lung cancer (73.0%) but only 51.4% for stroke. Awareness that secondhand smoke can cause serious illness was also high (74.5%). Overall 88.5% support tobacco products tax increase. Although tobacco use is relatively low in Nigeria as in other African countries, high smoking rate among men compared to women might indicate potential increase in prevalence. Challenges to preventing increasing smoking rate include limited use of evidence-based cessation methods among quit attempters, social acceptability of smoking particularly in bars and restaurants, and gap in knowledge on tobacco-related diseases. However, ratification of WHO FCTC and signing into law of the Tobacco Control law provide the impetus to implement evidence-based interventions. Published by Elsevier Inc.

Trends in Smoking Among Adults With Mental Illness and Association Between Mental Health Treatment and Smoking Cessation

PubMed Central

Lê Cook, Benjamin; Wayne, Geoff Ferris; Kafali, E. Nilay; Liu, Zimin; Shu, Chang; Flores, Michael

2017-01-01

IMPORTANCE Significant progress has been made in reducing the prevalence of tobacco use in the United States. However, tobacco cessation efforts have focused on the general population rather than individuals with mental illness, who demonstrate greater rates of tobacco use and nicotine dependence. OBJECTIVES To assess whether declines in tobacco use have been realized among individuals with mental illness and examine the association between mental health treatment and smoking cessation. DESIGN, SETTING, AND PARTICIPANTS Use of nationally representative surveys of noninstitutionalized US residents to compare trends in smoking rates between adults with and without mental illness and across multiple disorders (2004–2011 Medical Expenditure Panel Survey [MEPS]) and to compare rates of smoking cessation among adults with mental illness who did and did not receive mental health treatment (2009–2011 National Survey of Drug Use and Health [NSDUH]).The MEPS sample included 32 156 respondents with mental illness (operationalized as reporting severe psychological distress, probable depression, or receiving treatment for mental illness) and 133 113 without mental illness. The NSDUH sample included 14 057 lifetime smokers with mental illness. MAIN OUTCOME SAND MEASURES Current smoking status (primary analysis; MEPS sample) and smoking cessation, operationalized as a lifetime smoker who did not smoke in the last 30 days (secondary analysis; NSDUH sample). RESULTS Adjusted smoking rates declined significantly among individuals without mental illness (19.2% [95% CI, 18.7–19.7%] to 16.5% [95% CI, 16.0%–17.0%]; P < .001) but changed only slightly among those with mental illness (25.3% [95% CI, 24.2%–26.3%] to 24.9% [95% CI, 23.8%–26.0%]; P = .50), a significant difference in difference of 2.3% (95% CI, 0.7%–3.9%) (P = .005). Individuals with mental illness who received mental health treatment within the previous year were more likely to have quit smoking (37.2% [95% CI, 35.1%–39.4%]) than those not receiving treatment (33.1% [95% CI, 31.5%–34.7%]) (P = .005). CONCLUSIONS AND RELEVANCE Between 2004 and 2011, the decline in smoking among individuals with mental illness was significantly less than among those without mental illness, although quit rates were greater among those receiving mental health treatment. This suggests that tobacco control policies and cessation interventions targeting the general population have not worked as effectively for persons with mental illness. PMID:24399556

Testing anti-smoking messages for Air Force trainees

PubMed Central

Popova, Lucy; Linde, Brittany D.; Bursac, Zoran; Talcott, G. Wayne; Modayil, Mary V.; Little, Melissa A.; Ling, Pamela M.; Glantz, Stanton A.; Klesges, Robert C.

2015-01-01

Introduction Young adults in the military are aggressively targeted by tobacco companies and are at high risk of tobacco use. Existing anti-smoking advertisements developed for the general population might be effective in educating young adults in the military. This study evaluated the effects of different themes of existing anti-smoking advertisements on perceived harm and intentions to use cigarettes and other tobacco products among Air Force trainees. Methods In a pretest-posttest experiment, 782 Airmen were randomized to view anti-smoking advertisements in one of six conditions: anti-industry, health effects+anti-industry, sexual health, secondhand smoke, environment+anti-industry, or control. We assessed the effect of different conditions on changes in perceived harm and intentions to use cigarettes, electronic cigarettes (e-cigarettes), smokeless tobacco, hookah and cigarillos from pretest to posttest with multivariable linear regression models (perceived harm) and zero-inflated Poisson regression model (intentions). Results Anti-smoking advertisements increased perceived harm of various tobacco products and reduced intentions to use. Advertisements featuring negative effects of tobacco on health and sexual performance coupled with revealing tobacco industry manipulations had the most consistent pattern of effects on perceived harm and intentions. Conclusion Anti-smoking advertisements produced for the general public might also be effective with a young adult military population and could have spillover effects on perceptions of harm and intentions to use other tobacco products besides cigarettes. Existing anti-smoking advertising may be a cost-effective tool to educate young adults in the military. PMID:26482786

Frequency and Characteristics Associated With Exposure to Tobacco Direct Mail Marketing and Its Prospective Effect on Smoking Behaviors Among Young Adults From the US Midwest

PubMed Central

Forster, Jean L.

2014-01-01

Objectives. We examined the exposure to tobacco direct mail marketing and its effect on subsequent smoking behaviors in a US Midwest regional cohort of young adults. Methods. Data were collected from 2622 young adults (mean age = 24 years) in 2010 to 2011 (baseline) and 2011 to 2012 (follow-up). We collected information on demographics, tobacco use, and exposure to tobacco direct mail materials in the previous 6 months at baseline. Smoking behaviors were reassessed at follow-up. We investigated the characteristics associated with receiving these materials at baseline, and the associations between receiving cigarette coupons in the mail at baseline and smoking behaviors at follow-up. Results. Thirteen percent of participants reported receiving tobacco direct mail materials in the previous 6 months. Receipt of these materials was associated with age, education, and tobacco use (P < .05). Among those who received these materials, 77% and 56% reported receiving coupons for cigarettes and other tobacco products, respectively. Among baseline nonsmokers and ex-smokers, receiving coupons was associated with becoming current smokers at follow-up (P < .05). Among baseline current smokers, receiving coupons was associated with lower likelihood of smoking cessation at follow-up (P < .05). Conclusions. Tobacco direct mail marketing promoted and sustained smoking behaviors among US Midwest young adults. Regulating this marketing strategy might reduce the prevalence of smoking in this population. PMID:25211739

Tobacco branding, plain packaging, pictorial warnings, and symbolic consumption.

PubMed

Hoek, Janet; Gendall, Philip; Gifford, Heather; Pirikahu, Gill; McCool, Judith; Pene, Gina; Edwards, Richard; Thomson, George

2012-05-01

We use brand association and symbolic consumption theory to explore how plain cigarette packaging would influence the identities young adults cocreate with tobacco products. Group discussions and in-depth interviews with 86 young adult smokers and nonsmokers investigated how participants perceive tobacco branding and plain cigarette packaging with larger health warnings. We examined the transcript data using thematic analysis and explored how removing tobacco branding and replacing this with larger warnings would affect the symbolic status of tobacco brands and their social connotations. Smokers used tobacco brand imagery to define their social attributes and standing, and their connection with specific groups. Plain cigarette packaging usurped this process by undermining aspirational connotations and exposing tobacco products as toxic. Replacing tobacco branding with larger health warnings diminishes the cachet brand insignia creates, weakens the social benefits brands confer on users, and represents a potentially powerful policy measure.

Time series analysis of the impact of tobacco control policies on smoking prevalence among Australian adults, 2001-2011.

PubMed

Wakefield, Melanie A; Coomber, Kerri; Durkin, Sarah J; Scollo, Michelle; Bayly, Megan; Spittal, Matthew J; Simpson, Julie A; Hill, David

2014-06-01

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.

Tobacco control and the reduction in smoking-related premature deaths in the United States, 1964-2012.

PubMed

Holford, Theodore R; Meza, Rafael; Warner, Kenneth E; Meernik, Clare; Jeon, Jihyoun; Moolgavkar, Suresh H; Levy, David T

2014-01-08

January 2014 marks the 50th anniversary of the first surgeon general's report on smoking and health. This seminal document inspired efforts by governments, nongovernmental organizations, and the private sector to reduce the toll of cigarette smoking through reduced initiation and increased cessation. To model reductions in smoking-related mortality associated with implementation of tobacco control since 1964. Smoking histories for individual birth cohorts that actually occurred and under likely scenarios had tobacco control never emerged were estimated. National mortality rates and mortality rate ratio estimates from analytical studies of the effect of smoking on mortality yielded death rates by smoking status. Actual smoking-related mortality from 1964 through 2012 was compared with estimated mortality under no tobacco control that included a likely scenario (primary counterfactual) and upper and lower bounds that would capture plausible alternatives. National Health Interview Surveys yielded cigarette smoking histories for the US adult population in 1964-2012. Number of premature deaths avoided and years of life saved were primary outcomes. Change in life expectancy at age 40 years associated with change in cigarette smoking exposure constituted another measure of overall health outcomes. In 1964-2012, an estimated 17.7 million deaths were related to smoking, an estimated 8.0 million (credible range [CR], 7.4-8.3 million, for the lower and upper tobacco control counterfactuals, respectively) fewer premature smoking-related deaths than what would have occurred under the alternatives and thus associated with tobacco control (5.3 million [CR, 4.8-5.5 million] men and 2.7 million [CR, 2.5-2.7 million] women). This resulted in an estimated 157 million years (CR, 139-165 million) of life saved, a mean of 19.6 years for each beneficiary (111 million [CR, 97-117 million] for men, 46 million [CR, 42-48 million] for women). During this time, estimated life expectancy at age 40 years increased 7.8 years for men and 5.4 years for women, of which tobacco control is associated with 2.3 years (CR, 1.8-2.5) (30% [CR, 23%-32%]) of the increase for men and 1.6 years (CR, 1.4-1.7) (29% [CR, 25%-32%]) for women. Tobacco control was estimated to be associated with avoidance of 8 million premature deaths and an estimated extended mean life span of 19 to 20 years. Although tobacco control represents an important public health achievement, efforts must continue to reduce the effect of smoking on the nation's death toll.

Patient-reported recall of smoking cessation interventions from a health professional.

PubMed

King, Brian A; Dube, Shanta R; Babb, Stephen D; McAfee, Timothy A

2013-11-01

To determine the prevalence and characteristics of current cigarette smokers who report receiving health care provider interventions ('5A's': ask, advise, assess, assist, arrange) for smoking cessation. Data came from the 2009-2010 National Adult Tobacco Survey, a telephone survey of United States adults aged ≥ 18 years. Among current cigarette smokers who reported visiting a health professional in the past year (n=16,542), estimates were calculated overall and by sex, age, race/ethnicity, education, income, health insurance coverage, and sexual orientation. Among smokers who visited a health professional (75.2%), 87.9% were asked if they used tobacco, 65.8% were advised to quit, and 42.6% were asked if they wanted to quit. Among those wanting to quit, 78.2% were offered assistance and 17.5% had follow-up arranged. Receipt of the 'ask' component was lower among males and uninsured individuals. Receipt of the 'advise' and 'assess' components was lower among those aged 18-24 and uninsured individuals. Receipt of the 'assist' component was lower among non-Hispanic blacks. No differences were observed for the 'arrange' component. Many current smokers report receiving health care provider interventions for smoking cessation. Continued efforts to educate, encourage, and support all health professionals to provide effective, comprehensive tobacco cessation interventions to their patients may be beneficial. © 2013.

Smokeless tobacco product prices and taxation in Bangladesh: Findings from the ITC survey

PubMed Central

Nargis, N; Hussain, AKMG; Fong, GT

2015-01-01

Context Smokeless tobacco use is well-recognized as occupying 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. Aims The aims of this paper are to examine the price distribution of various smoked and smokeless tobacco products and estimate the effects of changes in the prices of tobacco products on the consumption of smokeless tobacco. Settings and Design The data for this paper came from the Wave 3 ITC Bangladesh (ITC BD) Survey conducted between November 2011 and May 2012. It is a cohort survey of a nationally representative sample of adult tobacco users and non-users in Bangladesh selected using a stratified multistage cluster sampling design. Two measures of smokeless tobacco use are used in the analysis—prevalence of smokeless tobacco use indicating the decision to use smokeless tobacco products, and the frequency of using smokeless tobacco per day indicating intensity of smokeless tobacco use. Methods and Material The regression analysis involves estimation of the demand function for the most widely used smokeless tobacco product in Bangladesh, zarda. Statistical analysis used The descriptive analysis looks at the characteristics of the price distribution of cigarette, bidi, zarda, and gul using the univariate Epanechnikov kernel density estimation. Results It estimates the price elasticity of lower price brands of zarda (the most commonly used smokeless tobacco product in Bangladesh) at -0.64 and of higher-priced brands at -0.39, and the cross-price elasticity of zarda with respect to cigarettes at 0.35. Conclusions The tax increase on smokeless tobacco products needs to be greater than the tax increase on smoked tobacco products to bridge the wide price differential between the two types of products that currently encourages downward substitution and discourages quitting behaviour. Finally, a specific excise system replacing the existing ad valorem excise tax can substantially contribute to the revenue collection performance from smokeless tobacco products. PMID:25526246

The Consequences of High Cigarette Excise Taxes for Low-Income Smokers

PubMed Central

Farrelly, Matthew C.; Nonnemaker, James M.; Watson, Kimberly A.

2012-01-01

Background To illustrate the burden of high cigarette excise taxes on low-income smokers. Methodology/Principal Findings Using data from the New York and national Adult Tobacco Surveys from 2010–2011, we estimated how smoking prevalence, daily cigarette consumption, and share of annual income spent on cigarettes vary by annual income (less than $30,000; $30,000–$59,999; and more than $60,000). The 2010–2011 sample includes 7,536 adults and 1,294 smokers from New York and 3,777 adults and 748 smokers nationally. Overall, smoking prevalence is lower in New York (16.1%) than nationally (22.2%) and is strongly associated with income in New York and nationally (P<.001). Smoking prevalence ranges from 12.2% to 33.7% nationally and from 10.1% to 24.3% from the highest to lowest income group. In 2010–2011, the lowest income group spent 23.6% of annual household income on cigarettes in New York (up from 11.6% in 2003–2004) and 14.2% nationally. Daily cigarette consumption is not related to income. Conclusions/Significance Although high cigarette taxes are an effective method for reducing cigarette smoking, they can impose a significant financial burden on low-income smokers. PMID:22984447

Social Marketing in Malaysia: Cognitive, Affective, and Normative Mediators of the TAK NAK Antismoking Advertising Campaign.

PubMed

Lee, Wonkyong Beth; Fong, Geoffrey T; Dewhirst, Timothy; Kennedy, Ryan D; Yong, Hua-Hie; Borland, Ron; Awang, Rahmat; Omar, Maizurah

2015-01-01

Antismoking mass media campaigns are known to be effective as part of comprehensive tobacco control programs in high-income countries, but such campaigns are relatively new in low- and middle-income countries and there is a need for strong evaluation studies from these regions. This study examines Malaysia's first national antismoking campaign, TAK NAK. The data are from the International Tobacco Control Malaysia Survey, which is an ongoing cohort survey of a nationally representative sample of adult smokers (18 years and older; N = 2,006). The outcome variable was quit intentions of adult smokers, and the authors assessed the extent to which quit intentions may have been strengthened by exposure to the antismoking campaign. The authors also tested whether the impact of the campaign on quit intentions was related to cognitive mechanisms (increasing thoughts about the harm of smoking), affective mechanisms (increasing fear from the campaign), and perceived social norms (increasing perceived social disapproval about smoking). Mediational regression analyses revealed that thoughts about the harm of smoking, fear arousal, and social norms against smoking mediated the relation between TAK NAK impact and quit intentions. Effective campaigns should prompt smokers to engage in both cognitive and affective processes and encourage consideration of social norms about smoking in their society.

Tobacco control in the Russian Federation--a policy analysis.

PubMed

Lunze, Karsten; Migliorini, Luigi

2013-01-23

The Russian Federation (Russia) has one of the highest smoking rates in the world. The purpose of this study is to analyze past and current trends of the tobacco epidemic in the Russian Federation, review current tobacco control policy responses, and identify areas of opportunity for policy priorities. We used a policy triangle as analytical framework to examine content, context, and processes of Russian tobacco control policy. The analysis was based on secondary data on supply and demand sides of the Russian tobacco epidemic, tobacco-related economic and health effects during Russia's economic transition, and compliance of Russian tobacco policy with international standards and regulations. Tobacco-promoting strategies have specifically targeted women and youth. Russia's approval of a "National Tobacco Control Concept" and draft for a comprehensive tobacco control bill increasingly align national legislature with the WHO Framework Convention on Tobacco Control (FCTC). However, several structural and cultural factors represent substantial barriers to the policy process. The influence of transnational tobacco companies on policy processes in Russia has so far impeded a full implementation of the FCTC mandates. Several strategies have been identified as having the potential to reduce the prevalence of tobacco use in Russia and decrease tobacco-related national health and economic burden: adjusting national tobacco policy by raising tobacco tax from the current lowest level in Europe to at least 70%; consequent enforcement of a complete smoking ban in public places; marketing restrictions; and smoking cessation interventions integrated into primary care. Russia's tobacco control efforts need to target women and youths specifically to efficiently counter industry efforts.

Tobacco control in the Russian Federation- a policy analysis

PubMed Central

2013-01-01

Background The Russian Federation (Russia) has one of the highest smoking rates in the world. The purpose of this study is to analyze past and current trends of the tobacco epidemic in the Russian Federation, review current tobacco control policy responses, and identify areas of opportunity for policy priorities. Methods We used a policy triangle as analytical framework to examine content, context, and processes of Russian tobacco control policy. The analysis was based on secondary data on supply and demand sides of the Russian tobacco epidemic, tobacco-related economic and health effects during Russia’s economic transition, and compliance of Russian tobacco policy with international standards and regulations. Results Tobacco-promoting strategies have specifically targeted women and youth. Russia’s approval of a “National Tobacco Control Concept” and draft for a comprehensive tobacco control bill increasingly align national legislature with the WHO Framework Convention on Tobacco Control (FCTC). However, several structural and cultural factors represent substantial barriers to the policy process. The influence of transnational tobacco companies on policy processes in Russia has so far impeded a full implementation of the FCTC mandates. Conclusions Several strategies have been identified as having the potential to reduce the prevalence of tobacco use in Russia and decrease tobacco-related national health and economic burden: adjusting national tobacco policy by raising tobacco tax from the current lowest level in Europe to at least 70%; consequent enforcement of a complete smoking ban in public places; marketing restrictions; and smoking cessation interventions integrated into primary care. Russia’s tobacco control efforts need to target women and youths specifically to efficiently counter industry efforts. PMID:23339756

Understanding Tobacco-Related Attitudes among College and Noncollege Young Adult Hookah and Cigarette Users

ERIC Educational Resources Information Center

Lee, Youn Ok; Bahreinifar, Sareh; Ling, Pamela M.

2014-01-01

Objective: To examine differences in tobacco-related attitudes and hookah and cigarette use among college and noncollege young adults. Participants: Time-location samples of young adult bar patrons in San Diego, California ("N" = 2,243), Tulsa ("N" = 2,095) and Oklahoma City ("N" = 2,200), Oklahoma, Albuquerque…

Perceived harms and benefits of tobacco, marijuana, and electronic vaporizers among young adults in Colorado: implications for health education and research.

PubMed

Popova, Lucy; McDonald, Emily Anne; Sidhu, Sohrab; Barry, Rachel; Richers Maruyama, Tracey A; Sheon, Nicolas M; Ling, Pamela M

2017-10-01

To evaluate how young adults perceive and compare harms and benefits of marijuana and tobacco products in the context of a legal marijuana market in Colorado. Semi-structured qualitative interviews. Denver, CO, USA. Thirty-two young adults (aged 18-26 years) who used tobacco/marijuana/vaporizers. Semi-structured interviews addressed perceived harms and benefits of various tobacco and marijuana products and personal experiences with these products. Young adults evaluated harms and benefits using five dimensions: (1) combustion-smoking was considered more harmful than non-combustible products (e.g. e-cigarettes, vaporizers and edibles); (2) potency-edibles and marijuana concentrates were perceived as more harmful than smoking marijuana flower because of potential to receive too large a dose of tetrahydrocannabinol (THC); (3) chemicals-products containing chemical additives were seen as more harmful than 'pure' or 'natural' plant products; (4) addiction-participants recognized physiological addiction to nicotine, but talked primarily about psychological or life-style dependence on marijuana; and (5) source of knowledge-personal experiences, warning labels, campaigns, the media and opinions of product retailers and medical practitioners affected perceptions of harms and benefits. Among young adults in Colorado, USA, perceived harms and benefits of tobacco and marijuana include multiple dimensions. Health educational campaigns could benefit from addressing these dimensions, such as the potency of nicotine and cannabis concentrates and harmful chemicals present in the organic material of tobacco and marijuana. Descriptors such as 'natural' and 'pure' in the promotion or packaging of tobacco and marijuana products might be misleading. © 2017 Society for the Study of Addiction.

Campaign to counter a deteriorating consumer market: Philip Morris's Project Sunrise.

PubMed

Givel, M

2013-02-01

From 1997 to 2000, Philip Morris implemented Project Sunrise. This paper discusses the impact of this project on national and Philip Morris's cigarette unit sales, public opinion about smoking and secondhand tobacco smoke, and national prevalence trends for tobacco use. A qualitative archival content analysis of Project Sunrise from 1997 to 2000, and a descriptive statistical analysis of cigarette unit sales and operating profits, acceptability of smoking and secondhand tobacco smoke, and national prevalence trends for tobacco use from 1996 to 2006. Qualitative data sources related to Project Sunrise found on WebCat, Pubmed.com, LexisNexis Academic and Philip Morris's website, and archived tobacco industry documents were analysed using NVivo Version 9.0. A descriptive statistical analysis of cigarette unit sales, public opinion about smoking and secondhand tobacco smoke, and national prevalence trends for tobacco use was undertaken. Project Sunrise was a high-level strategic corporate plan to maintain profits that included four possible scenarios resulting in seven interwoven strategies. However, national prevalence rates for tobacco use declined, sales of national and Philip Morris cigarettes declined, operating profits remained at substantially lower levels after 2000 from 2001 to 2006, and a large majority of Americans agreed that there were significant health dangers associated with smoking and secondhand tobacco smoke. The impact of Project Sunrise, including countering the anti-tobacco movement, was less than successful in the USA. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Prevalence, distribution and correlates of tobacco smoking and chewing in Nepal: a secondary data analysis of Nepal Demographic and Health Survey-2006.

PubMed

Sreeramareddy, Chandrashekhar T; Ramakrishnareddy, N; Harsha Kumar, Hn; Sathian, Brijesh; Arokiasamy, John T

2011-12-20

Nearly four-fifths of estimated 1.1 million smokers live in low or middle-income countries. We aimed to provide national estimates for Nepal on tobacco use prevalence, its distribution across demographic, socio-economic and spatial variables and correlates of tobacco use. A secondary data analysis of 2006 Nepal Demographic and Health Survey (DHS) was done. A representative sample of 9,036 households was selected by two-stage stratified, probability proportional to size (PPS) technique. We constructed three outcome variables 'tobacco smoke', 'tobacco chewer' and 'any tobacco use' based on four questions about tobacco use that were asked in DHS questionnaires. Socio-economic, demographic and spatial predictor variables were used. We computed overall prevalence for 'tobacco smoking', 'tobacco chewing' and 'any tobacco use' i.e. point estimates of prevalence rates, 95% confidence intervals (CIs) after adjustment for strata and clustering at primary sampling unit (PSU) level. For correlates of tobacco use, we used multivariate analysis to calculate adjusted odds ratios (AORs) and their 95% CIs. A p-value < 0.05 was considered as significant. Total number of households, eligible women and men interviewed was 8707, 10793 and 4397 respectively. The overall prevalence for 'any tobacco use', 'tobacco smoking' and 'tobacco chewing' were 30.3% (95% CI 28.9, 31.7), 20.7% (95% CI 19.5, 22.0) and 14.6% (95% CI 13.5, 15.7) respectively. Prevalence among men was significantly higher than women for 'any tobacco use' (56.5% versus 19.6%), 'tobacco smoking' (32.8% versus 15.8%) and 'tobacco chewing' (38.0% versus 5.0%). By multivariate analysis, older adults, men, lesser educated and those with lower wealth quintiles were more likely to be using all forms of tobacco. Divorced, separated, and widowed were more likely to smoke (OR 1.49, 95% CI 1.14, 1.94) and chew tobacco (OR 1.36, 95% CI 0.97, 1.93) as compared to those who were currently married. Prevalence of 'tobacco chewing' was higher in eastern region (19.7%) and terai/plains (16.2%). 'Tobacco smoking' and 'any tobacco use' were higher in rural areas, mid-western and far western and mountainous areas. Prevalence of tobacco use is considerably high among Nepalese people. Demographic and socioeconomic determinants and spatial distribution should be considered while planning tobacco control interventions.

Electronic Nicotine Delivery System Use Among U.S. Adults, 2014.

PubMed

Caraballo, Ralph S; Jamal, Ahmed; Nguyen, Kimberly H; Kuiper, Nicole M; Arrazola, René A

2016-02-01

Electronic nicotine delivery system (ENDS) use has increased rapidly in the U.S. in recent years. The availability and use of ENDS raise new issues for public health practice and tobacco regulation, as it is unknown whether patterns of ENDS use enhance, deter, or have no impact on combustible tobacco product use. This study assessed past-month, lifetime, and frequency of ENDS use among current, former, and never adult cigarette smokers. Data were analyzed from the 2014 Styles, a national consumer-based probability-based web panel survey of U.S. adults aged ≥18 years (n=4,269) conducted during June and July. Lifetime ENDS users were defined as those who reported having used ENDS ≥1 day in their lifetime. Past-month ENDS users were defined as those who reported using ENDS in the past 30 days. In 2014, overall lifetime and past-month ENDS use was 14.1% and 4.8%, respectively. By smoking status, 49.5% of current, 14.7% of former, and 4.1% of never cigarette smokers had used ENDS in their lifetime, whereas 20.6% of current, 4.0% of former, and 0.8% of never smokers used ENDS in the past month. Among current and former cigarette smokers who ever used ENDS, 44.1% and 44.7% reported using ENDS >10 days in their lifetime, respectively. Because the effect ENDS use has on combustible tobacco products use is unknown, and lifetime and past-month ENDS use is more common among current than former or never smokers, continued surveillance of ENDS use among adults is critical to programs and policies. Published by Elsevier Inc.

Is Every Smoker Interested in Price Promotions? An Evaluation of Price-Related Discounts by Cigarette Brands

PubMed Central

Xu, Xin; Wang, Xu; Caraballo, Ralph S.

2015-01-01

Context Raising unit price is one of the most effective ways of reducing cigarette consumption. A large proportion of US adult smokers use generic brands or price discounts in response to higher prices, which may mitigate the public health impacts of raising unit price. Objective The main purpose of this study was to evaluate the retail price impact and the determinants of price-related discount use among US adult smokers by their most commonly used cigarette brand types. Methods Data from the 2009–2010 National Adult Tobacco Survey, a telephone survey of US adults 18 years or older, was used to assess price-related discount use by cigarette brands. Price-related discounts included coupons, rebates, buy 1 get 1 free, 2 for 1, or any other special promotions. Multivariate logistic regression was used to assess sociodemographic and tobacco use determinants of discount use by cigarette brands. Results Discount use was most common among premium brand users (22.1%), followed by generic (13.3%) and other brand (10.8%) users. Among premium brand users, those who smoked 10 to 20 cigarettes per day were more likely to use discounts, whereas elderly smokers, non-Hispanic blacks, those with greater annual household income, dual users of cigarettes and other combustible tobacco products, and those who had no quit intentions were less likely to do so. Among generic brand users, those who had no quit intentions and those who smoked first cigarette within 60 minutes after waking were more likely to use discounts. Conclusions Frequent use of discounts varies between smokers of premium and generic cigarette brands. Setting a high minimum price, together with limiting the use of coupons and promotions, may uphold the effect of cigarette excise taxes to reduce smoking prevalence. PMID:26598952

Is Every Smoker Interested in Price Promotions? An Evaluation of Price-Related Discounts by Cigarette Brands.

PubMed

Xu, Xin; Wang, Xu; Caraballo, Ralph S

2016-01-01

Raising unit price is one of the most effective ways of reducing cigarette consumption. A large proportion of US adult smokers use generic brands or price discounts in response to higher prices, which may mitigate the public health impacts of raising unit price. The main purpose of this study was to evaluate the retail price impact and the determinants of price-related discount use among US adult smokers by their most commonly used cigarette brand types. Data from the 2009-2010 National Adult Tobacco Survey, a telephone survey of US adults 18 years or older, was used to assess price-related discount use by cigarette brands. Price-related discounts included coupons, rebates, buy 1 get 1 free, 2 for 1, or any other special promotions. Multivariate logistic regression was used to assess sociodemographic and tobacco use determinants of discount use by cigarette brands. Discount use was most common among premium brand users (22.1%), followed by generic (13.3%) and other brand (10.8%) users. Among premium brand users, those who smoked 10 to 20 cigarettes per day were more likely to use discounts, whereas elderly smokers, non-Hispanic blacks, those with greater annual household income, dual users of cigarettes and other combustible tobacco products, and those who had no quit intentions were less likely to do so. Among generic brand users, those who had no quit intentions and those who smoked first cigarette within 60 minutes after waking were more likely to use discounts. Frequent use of discounts varies between smokers of premium and generic cigarette brands. Setting a high minimum price, together with limiting the use of coupons and promotions, may uphold the effect of cigarette excise taxes to reduce smoking prevalence.

Building capacity for implementation of the framework convention for tobacco control in Vietnam: lessons for developing countries.

PubMed

Stillman, Frances A; David, Annette M; Kibria, Naseeb; Phan, Hai Thi

2014-09-01

Effective implementation of the WHO international Framework Convention on Tobacco Control (FCTC) is the key to controlling the tobacco epidemic. Within countries, strong national tobacco control capacity is the primary determinant for successful implementation of the FCTC. This case study of tobacco control policy describes the experience of building national tobacco control capacity in Vietnam under the Reduce Smoking in Vietnam Partnership project within a national capacity-building framework. In the Vietnam experience, four components of tobacco control capacity emerged as especially important to achieve 'quality' outputs and measurable outcomes at the implementation level: (i) organizational structure/infrastructure; (ii) leadership and expertise; (iii) partnerships and networks and (iv) data and evidence from research. The experience gained in this project helps in adapting our tobacco control capacity-building model, and the lessons that emerged from this country case study can provide guidance to global funders, tobacco control technical assistance providers and nations as governments endeavor to meet their commitment to the FCTC. © The Author (2013). Published by Oxford University Press.

Tobacco use and second-hand smoke exposure in young adolescents aged 12-15 years: data from 68 low-income and middle-income countries.

PubMed

Xi, Bo; Liang, Yajun; Liu, Yunxia; Yan, Yinkun; Zhao, Min; Ma, Chuanwei; Bovet, Pascal

2016-11-01

Tobacco use is an important risk factor for non-communicable diseases worldwide. However, the global extent and prevalence of tobacco use in adolescents is poorly described. Using previously collected survey data, we aimed to assess tobacco use and second-hand smoke exposure in young adolescents aged 12-15 years in 68 low-income and middle-income countries. We used data from the Global School-based Student Health Survey (2006-13) and the China Global Tobacco Youth Survey (2013), which are school-based surveys of young adolescents aged 12-15 years that assess health behaviours using a standardised, anonymous, self-reported questionnaire. We calculated the prevalence of current tobacco use and exposure to second-hand smoke in young adolescents from 68 low-income and middle-income countries that collected these data in the surveys. We used a multilevel model to estimate the association between parental tobacco use, second-hand smoke, and adolescent tobacco use, adjusting for sex, age, school, school class, country's purchasing power parity, smoking initiation age, national prevalence of tobacco use among adults, year the WHO FCTC was ratified for each country, proxy of socioeconomic status, and survey year. The mean prevalence of current tobacco use was 13·6%, ranging from 2·8% in Tajikistan to 44·7% in Samoa. In most countries, the prevalence of tobacco use was higher for boys than girls, and higher for adolescents aged 14-15 years than for those aged 12-13 years. The overall prevalence of second-hand smoke exposure was 55·9%, ranging from 16·4% in Tajikistan to 85·4% in Indonesia. Parental tobacco use (as reported by the young adolescents), especially maternal use, was associated with tobacco use in young adolescents (odds ratio 2·06, 95% CI 1·93-2·19, for maternal and 1·29, 1·23-1·35 for paternal use). Second-hand smoke exposure was also a risk factor for young adolescents' tobacco use (2·56, 2·43-2·69). However, the prevalence of tobacco use was not associated with a country's purchasing power parity. Tobacco use and second-hand smoke exposure were frequent among young adolescents aged 12-15 years in low-income and middle-income countries. Parental tobacco use and second-hand smoke exposure were strongly associated with young adolescents' tobacco use. The data emphasise the need to strengthen tobacco control interventions and programmes in young adolescents from low-income and middle-income countries. This work was partly supported by the Young Scholars Program of Shandong University (2015WLJH51), the Shandong Provincial Natural Science Foundation (ZR2012HQ033), and the National Natural Science Foundation (81302496). Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND license. Published by Elsevier Ltd.. All rights reserved.

Annual Report to the Nation on the Status of Cancer, 1975–2005, Featuring Trends in Lung Cancer, Tobacco Use, and Tobacco Control

PubMed Central

Thun, Michael J.; Ries, Lynn A. G.; Howe, Holly L.; Weir, Hannah K.; Center, Melissa M.; Ward, Elizabeth; Wu, Xiao-Cheng; Eheman, Christie; Anderson, Robert; Ajani, Umed A.; Kohler, Betsy; Edwards, Brenda K.

2008-01-01

Background The American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updated information on cancer occurrence and trends in the United States. This year’s report includes trends in lung cancer incidence and death rates, tobacco use, and tobacco control by state of residence. Methods Information on invasive cancers was obtained from the NCI, CDC, and NAACCR and information on mortality from the CDC's National Center for Health Statistics. Annual percentage changes in the age-standardized incidence and death rates (2000 US population standard) for all cancers combined and for the top 15 cancers were estimated by joinpoint analysis of long-term (1975–2005) trends and by least squares linear regression of short-term (1996–2005) trends. All statistical tests were two-sided. Results Both incidence and death rates from all cancers combined decreased statistically significantly (P < .05) in men and women overall and in most racial and ethnic populations. These decreases were driven largely by declines in both incidence and death rates for the three most common cancers in men (lung, colorectum, and prostate) and for two of the three leading cancers in women (breast and colorectum), combined with a leveling off of lung cancer death rates in women. Although the national trend in female lung cancer death rates has stabilized since 2003, after increasing for several decades, there is prominent state and regional variation. Lung cancer incidence and/or death rates among women increased in 18 states, 16 of them in the South or Midwest, where, on average, the prevalence of smoking was higher and the annual percentage decrease in current smoking among adult women was lower than in the West and Northeast. California was the only state with decreasing lung cancer incidence and death rates in women. Conclusions Although the decrease in overall cancer incidence and death rates is encouraging, large state and regional differences in lung cancer trends among women underscore the need to maintain and strengthen many state tobacco control programs. PMID:19033571

Surveillance for selected tobacco-use behaviors--United States, 1900-1994.

PubMed

Giovino, G A; Schooley, M W; Zhu, B P; Chrismon, J H; Tomar, S L; Peddicord, J P; Merritt, R K; Husten, C G; Eriksen, M P

1994-11-18

Surveillance of tobacco use is an essential component of any tobacco-control program. The information gathered can be used to guide research initiatives, intervention programs, and policy decisions. REPORTING PERIODS: This report covers the period 1900-1994 for per capita cigarette consumption; 1965-1991 for trends in cigarette smoking prevalence and cessation; 1974-1991 for trends in the number of cigarettes smoked daily by current smokers; 1987-1991 for recent patterns of tobacco use; 1970, 1987, and 1991 for trends in cigar/pipe smoking and snuff/chewing tobacco use; 1984-1992 for trends in state-specific prevalences of regular cigarette smoking; 1987-1992 for state-specific estimates of smokeless-tobacco use; and 1976-1993 for trends in cigarette smoking among U.S. high school seniors. Estimates of cigarette consumption are reported by the U.S. Department of Agriculture, which uses data from the U.S. Department of the Treasury, the U.S. Department of Commerce, the Tobacco Institute, and other sources. The National Health Interview Survey uses household interviews to provide nationally representative estimates (for the civilian, noninstitutionalized population) of cigarette smoking and other behaviors related to tobacco use. The Behavioral Risk Factor surveillance System uses telephone surveys of civilian, noninstitutionalized adults (> or = 18 years of age) to provide state-specific estimates of current cigarette smoking and use of smokeless tobacco. The University of Michigan's Institute for Social Research uses school-based, self-administered questionnaires to gather data on cigarette smoking from a representative sample of U.S. high school seniors. During the period 1900-1963, per capita cigarette consumption increased; after 1964, consumption declined. During the years 1965-1991, current cigarette smoking prevalence among persons ages > or = 18 years declined overall and in every sociodemographic category examined. Decrease in current smoking prevalence was slow in some groups (e.g., among persons with fewer years of formal education). Both the prevalence of never smoking and the prevalence of cessation increased from 1965 through 1991. The prevalence of current cigarette smoking, any tobacco smoking, and any tobacco use was highest among American Indians/Alaska Natives and non-Hispanic blacks and lowest among Asians/Pacific Islanders. The prevalence of cigar smoking and pipe smoking has declined substantially since 1970. The prevalence of smokeless-tobacco use among white males ages 18-34 years was higher in 1987 and 1991 than in 1970; among persons > or = 45 years of age, the use of smokeless tobacco was more common among blacks than whites in 1970 and 1987. Cigarette smoking prevalence has decreased in most states. The prevalence of smokeless tobacco use was especially high among men in West Virginia, Montana, and several southern states. From 1984-1993, prevalence of cigarette smoking remained constant among U.S. high school seniors. However, prevalence increased slightly for male seniors and white seniors, decreased slightly for female high school seniors, and decreased sharply for black high school seniors. With the exceptions of increases in cigarette smoking among white and male high school seniors and in the use of smokeless tobacco among white males ages 18-34 years, reductions in tobacco use occurred in every subgroup examined. This decrease must continue if the national health objectives for the year 2000 are to be reached. Surveillance of tobacco use is ongoing. Effective interventions that discourage initiation and encourage cessation are being disseminated throughout the United States.

Picture Me Smokefree: A Qualitative Study Using Social Media and Digital Photography to Engage Young Adults in Tobacco Reduction and Cessation

PubMed Central

Kelly, Mary T; Oliffe, John L; Bottorff, Joan L

2015-01-01

Background Young adults have high rates of tobacco use compared to other subpopulations, yet there are relatively few tobacco interventions specifically targeted to this group. Picture Me Smokefree is an online tobacco reduction and cessation intervention for young adults that uses digital photography and social networking. Objective The main goal of the project was to determine the feasibility of engaging young adults in participating in user-driven, online forums intended to provide peer support and motivate critical reflection about tobacco use and cessation among this high-use, hard-to-reach population. A related aim was to explore the influence of gender-related factors on participation, in order to determine the need for online interventions to be tailored to the specific gender preferences reflecting young men and women’s participation styles. Methods A total of 60 young adults ages 19-24 years who self-identified as current cigarette smokers or who had quit within the last year were recruited from across British Columbia, Canada, and participated in an online photo group on Facebook over a period of 12 consecutive weeks. A variety of data collection methods were used including tracking online activity, a brief online follow-up survey, and qualitative interviews with study participants. Data analysis involved descriptive statistics on recruitment, retention, and participation and qualitative (eg, narrative analysis, synthesis of feedback) feedback about participant engagement. Results Findings from this study suggest good potential for Facebook as an accessible, low-cost platform for engaging young adults to reflect on the reasons for their tobacco use, the benefits of quitting or reducing, and the best strategies for tobacco reduction. Young adults’ frequent use of mobile phones and other mobile devices to access social networking permitted ease of access and facilitated real-time peer-to-peer support across a diverse group of participants. However, our experience of conducting the study suggests that working with young tobacco users can be accompanied by considerable recruitment, participation, and retention challenges. Our findings also pointed to differences in how young women and men engaged the photo-group intervention that should be considered, bearing in mind that in follow-up interviews participants indicated their preference for a mixed gender and “gender neutral” group format. Conclusions Tobacco interventions for youth and young adults should be embedded within the existing social networking platforms they access most frequently, rather than designing a stand-alone online prevention or intervention resource. This subpopulation would likely benefit from tobacco reduction interventions that are gender-sensitive rather than gender-specific. PMID:25624064

Mechanisms underlying the lifetime co-occurrence of tobacco and cannabis use in adolescent and young adult twins

PubMed Central

Agrawal, Arpana; Silberg, Judy L.; Lynskey, Michael T.; Maes, Hermine H.; Eaves, Lindon J.

2009-01-01

Using twins assessed during adolescence (Virginia Twin Study of Adolescent Behavioral Development: 8–17 years) and followed up in early adulthood (Young Adult Follow-Up, 18–27 years), we tested 13 genetically informative models of co-occurrence, adapted for the inclusion of covariates. Models were fit, in Mx, to data at both assessments allowing for a comparison of the mechanisms that underlie the lifetime co-occurrence of cannabis and tobacco use in adolescence and early adulthood. Both cannabis and tobacco use were influenced by additive genetic (38–81%) and non-shared environmental factors with the possible role of non-shared environment in the adolescent assessment only. Causation models, where liability to use cannabis exerted a causal influence on the liability to use tobacco fit the adolescent data best, while the reverse causation model (tobacco causes cannabis) fit the early adult data best. Both causation models (cannabis to tobacco and tobacco to cannabis) and the correlated liabilities model fit data from the adolescent and young adult assessments well. Genetic correlations (0.59–0.74) were moderate. Therefore, the relationship between cannabis and tobacco use is fairly similar during adolescence and early adulthood with reciprocal influences across the two psychoactive substances. However, our study could not exclude the possibility that ‘gateways’ and ‘reverse gateways’, particularly within a genetic context, exist, such that predisposition to using one substance (cannabis or tobacco) modifies predisposition to using the other. Given the high addictive potential of nicotine and the ubiquitous nature of cannabis use, this is a public health concern worthy of considerable attention. PMID:20047801

Direct-to-Consumer Tobacco Marketing and Its Association with Tobacco Use Among Adolescents and Young Adults

PubMed Central

Soneji, Samir; Ambrose, Bridget K.; Lee, Won; Sargent, James; Tanski, Susanne

2014-01-01

Objective We assess exposure to direct-to-consumer tobacco marketing and its association with ever having tried smoking, smoking within past 30 days (‘current’), and smoking ≥100 cigarettes in lifetime (‘established’) among adolescents and young adults. Methods We surveyed a U.S. telephone sample of 3,342 15–23 year olds and 2,541 respondents subsequently completed a web-based survey. Among respondents completing both the telephone and web-based surveys (N=2,541 [75%]), we assessed their exposure to direct-to-consumer tobacco marketing (receiving direct mail from tobacco companies and seeing tobacco company websites) and their associations with ever having tried smoking, current smoking, and established smoking. Results Overall, 12% of 15–17 year olds and 26% of 18–23 year olds were exposed to direct-to-consumer tobacco marketing. Racial/ethnic minority non-smoking respondents were more likely to see tobacco websites than non-smoking Whites. Respondents exposed to either form of direct-to-consumer tobacco marketing were more likely to currently smoke (adjusted odds ratio[AOR]: 2.2; 95% CI 1.3–3.8), while those exposed to both forms of marketing experienced even higher odds of currently smoking (AOR: 2.7; 95% CI 1.1–6.6). We observed similar relationships for ever having tried smoking and established smoking. Conclusions Direct-to-consumer tobacco marketing reaches adolescent and young adult non-smokers and is associated with smoking behavior. PMID:24661738

Direct-to-consumer tobacco marketing and its association with tobacco use among adolescents and young adults.

PubMed

Soneji, Samir; Ambrose, Bridget K; Lee, Won; Sargent, James; Tanski, Susanne

2014-08-01

We assess exposure to direct-to-consumer tobacco marketing and its association with ever having tried smoking, smoking within past 30 days (current), and smoking ≥100 cigarettes in lifetime (established) among adolescents and young adults. We surveyed a U.S. telephone sample of 3,342 15- to 23-year-olds and 2,541 respondents subsequently completed a web-based survey. Among respondents completing both the telephone and web-based surveys (N = 2,541 [75%]), we assessed their exposure to direct-to-consumer tobacco marketing (receiving direct mail from tobacco companies and seeing tobacco company websites) and their associations with ever having tried smoking, current smoking, and established smoking. Overall, 12% of 15- to 17-year-olds and 26% of 18- to 23-year-olds were exposed to direct-to-consumer tobacco marketing. Racial/ethnic minority nonsmoking respondents were more likely to see tobacco websites than nonsmoking whites. Respondents exposed to either form of direct-to-consumer tobacco marketing were more likely to currently smoke (adjusted odds ratio 2.2, 95% confidence interval 1.3-3.8), while those exposed to both forms of marketing experienced even higher odds of currently smoking (adjusted odds ratio 2.7, 95% confidence interval 1.1-6.6). We observed similar relationships for ever having tried smoking and established smoking. Direct-to-consumer tobacco marketing reaches adolescent and young adult nonsmokers and is associated with smoking behavior. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Predictors of quitting behaviour with special reference to nicotine dependence among adult tobacco-users in a slum of Burdwan district, West Bengal, India.

PubMed

Islam, Kamirul; Saha, Indranil; Saha, Rajib; Samim Khan, Sufi Abdul; Thakur, Rupali; Shivam, Swapnil

2014-04-01

Information on predictors of quitting behaviour in adult tobacco users is scarce in Indian context. Hence, this study was undertaken to assess the intention of tobacco-users towards quitting and its predictors with reference to nicotine dependence. A community-based observational, cross-sectional study was conducted on 128 adult tobacco-users (89.8% male) with mean age of 41.1 ± 15.7 yr selected by complete enumeration method. Data were collected by interview using pre-designed, pre-tested schedule. Nicotine dependence was assessed by Fagerstrφm Test for Nicotine Dependence (FTND) questionnaire. Of the 128 users, 63.3 per cent had intention to quit. Majority of the tobacco users who did not intend to quit belonged to the age group of > 40 yr (66.0%), were illiterate (55.3%), started tobacco use at 11 - 15 yr of age (57.4%), had been using tobacco for 20 yr or more (70.2%), were daily tobacco users (91.5%), and highly dependent on nicotine (80.9%). Tobacco users having high FTND score and who started tobacco use early in life were 1.83 and 3.30 times more unintended to quit, respectively. Suitable plan for quitting should be developed depending on the FTND score of an individual, the most important determinant of quitting that would be beneficial for categorization of the treatment leading to successful quitting.

The Epidemiology of Tobacco Use among Khat Users: A Systematic Review

PubMed Central

Kassim, Saba; Jawad, Mohammed; Croucher, Ray; Akl, Elie A.

2015-01-01

Khat, an “amphetamine-like green leaf,” may influence the consumption of tobacco. This study reviews the epidemiology of tobacco use among khat users. Electronic database searches using appropriate keywords/terms were conducted to identify observational studies of khat use. Assessment of quality and risk of bias of all included studies was conducted, and the results were synthesised descriptively. Nine eligible cross-sectional studies were identified. All assessed self-reported tobacco among khat users and were carried out in Africa and the Middle East. Eight reported cigarettes and one reported waterpipes as the mode of use. Methods of tobacco use prevalence assessment varied. Prevalence of “current” tobacco use among students and university teachers ranged from 29 to 37%; “lifetime” tobacco use in university teachers was 58% and “undefined” tobacco use in nonspecific adults and students ranged from 17 to 78%. Daily tobacco use among adults was reported as 17% whilst simultaneous tobacco and khat use was reported as between 14 and 30% in students. In conclusion, tobacco prevalence among khat users appears significant. Findings should be interpreted cautiously due to self-reported tobacco use, diversity in questions assessing tobacco use, and type of tobacco consumption. Future research should address the methodological shortcomings identified in this review before appropriate policy interventions can be developed. PMID:26273606

Youth curiosity about cigarettes, smokeless tobacco, and cigars: prevalence and associations with advertising.

PubMed

Portnoy, David B; Wu, Charles C; Tworek, Cindy; Chen, Jiping; Borek, Nicolette

2014-08-01

Curiosity about cigarettes is a reliable predictor of susceptibility to smoking and established use among youth. Related research has been limited to cigarettes, and lacks national-level estimates. Factors associated with curiosity about tobacco products, such as advertising, have been postulated but rarely tested. To describe the prevalence of curiosity about cigarettes, smokeless tobacco, and cigars among youth and explore the association between curiosity and self-reported tobacco advertising exposure. Data from the 2012 National Youth Tobacco Survey, a nationally representative survey of 24,658 students, were used. In 2013, estimates weighted to the national youth school population were calculated for curiosity about cigarettes, smokeless tobacco, and cigars among never users of any tobacco product. Associations between tobacco advertising and curiosity were explored using multivariable regressions. Curiosity about cigarettes (28.8%); cigars (19.5%); and smokeless tobacco (9.7%) was found, and many youth were curious about more than one product. Exposure to point-of-sale advertising (e.g., OR=1.35, 95% CI=1.19, 1.54 for cigarette curiosity); tobacco company communications (e.g., OR=1.70, 95% CI=1.38, 2.09 for cigarette curiosity); and tobacco products, as well as viewing tobacco use in TV/movies (e.g., OR=1.37, 95% CI=1.20, 1.58 for cigarette curiosity) were associated with curiosity about each examined tobacco product. Despite decreasing use of tobacco products, youth remain curious about them. Curiosity is associated with various forms of tobacco advertising. These findings suggest the importance of measuring curiosity as an early warning signal for potential future tobacco use and evaluating continued efforts to limit exposure to tobacco marketing among youth. Published by Elsevier Inc.

Testing antismoking messages for Air Force trainees.

PubMed

Popova, Lucy; Linde, Brittany D; Bursac, Zoran; Talcott, G Wayne; Modayil, Mary V; Little, Melissa A; Ling, Pamela M; Glantz, Stanton A; Klesges, Robert C

2016-11-01

Young adults in the military are aggressively targeted by tobacco companies and are at high risk of tobacco use. Existing antismoking advertisements developed for the general population might be effective in educating young adults in the military. This study evaluated the effects of different themes of existing antismoking advertisements on perceived harm and intentions to use cigarettes and other tobacco products among Air Force trainees. In a pretest-post-test experiment, 782 Airmen were randomised to view antismoking advertisements in 1 of 6 conditions: anti-industry, health effects+anti-industry, sexual health, secondhand smoke, environment+anti-industry or control. We assessed the effect of different conditions on changes in perceived harm and intentions to use cigarettes, electronic cigarettes, smokeless tobacco, hookah and cigarillos from pretest to post-test with multivariable linear regression models (perceived harm) and zero-inflated Poisson regression model (intentions). Antismoking advertisements increased perceived harm of various tobacco products and reduced intentions to use. Advertisements featuring negative effects of tobacco on health and sexual performance coupled with revealing tobacco industry manipulations had the most consistent pattern of effects on perceived harm and intentions. Antismoking advertisements produced for the general public might also be effective with a young adult military population and could have spillover effects on perceptions of harm and intentions to use other tobacco products besides cigarettes. Existing antismoking advertising may be a cost-effective tool to educate young adults in the military. 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/.

Global statistics on addictive behaviours: 2014 status report.

PubMed

Gowing, Linda R; Ali, Robert L; Allsop, Steve; Marsden, John; Turf, Elizabeth E; West, Robert; Witton, John

2015-06-01

Addictive behaviours are among the greatest scourges on humankind. It is important to estimate the extent of the problem globally and in different geographical regions. Such estimates are available, but there is a need to collate and evaluate these to arrive at the best available synthetic figures. Addiction has commissioned this paper as the first of a series attempting to do this. Online sources of global, regional and national information on prevalence and major harms relating to alcohol use, tobacco use, unsanctioned psychoactive drug use and gambling were identified through expert review and assessed. The primary data sources located were the websites of the World Health Organization (WHO), the United Nations Office on Drugs and Crime (UNODC) and the Alberta Gambling Research Institute. Summary statistics were compared with recent publications on the global epidemiology of addictive behaviours. An estimated 4.9% of the world's adult population (240 million people) suffer from alcohol use disorder (7.8% of men and 1.5% of women), with alcohol causing an estimated 257 disability-adjusted life years lost per 100 000 population. An estimated 22.5% of adults in the world (1 billion people) smoke tobacco products (32.0% of men and 7.0% of women). It is estimated that 11% of deaths in males and 6% of deaths in females each year are due to tobacco. Of 'unsanctioned psychoactive drugs', cannabis is the most prevalent at 3.5% globally, with each of the others at < 1%; 0.3% of the world's adult population (15 million people) inject drugs. Use of unsanctioned psychoactive drugs accounts for an estimated 83 disability-adjusted life years lost per 100 000 population. Global estimates of problem gambling are not possible, but in countries where it has been assessed the prevalence is estimated at 1.5%. Tobacco and alcohol use are by far the most prevalent addictive behaviours and cause the large majority of the harm. However, the quality of data on prevalence and addiction-related harms is mostly low, and comparisons between countries and regions must be viewed with caution. There is an urgent need to review the quality of data on which global estimates are made and coordinate efforts to arrive at a more consistent approach. © 2015 Reviews.

Effects of State-Level Tobacco Environment on Cigarette Smoking are Stronger Among Those With Individual-Level Risk Factors

PubMed Central

Shmulewitz, Dvora; Stohl, Malka; Keyes, Katherine M.; Brown, Qiana; Saha, Tulshi D.

2016-01-01

Introduction: To better understand the impact of the state-level tobacco environment (eg, tobacco control policies, attitudes towards smoking) on cigarette smoking, we examined whether the relationship of state tobacco environments to smoking is modified by individual-level vulnerability factors. Methods: In a nationally representative sample of US adults (N = 34 638), past-year smoking and heavy smoking were examined. State-level tobacco environment was defined by tobacco-related control policies and attitudes, ranging from permissive to restrictive; individual vulnerability was defined by childhood maltreatment and/or parental substance problems. Additive interaction tested differences in state-level tobacco environment effects on smoking and heavy smoking by individual-level vulnerability. Results: Significant interactions (P values < .01) indicated that the state tobacco environment had the strongest relationship to smoking outcomes among individuals with greatest individual vulnerability. For example, among respondents with childhood maltreatment and parental substance problems, those in states with permissive tobacco environments had 13.3% greater prevalence of smoking than those in restrictive states. Among respondents with neither individual-level risk factor, those in permissive states had 2.8% greater prevalence than those in restrictive states (interaction P value = .0002). Conclusions: Further restricting states’ smoking environments could help reduce the prevalence of smoking and heavy smoking, particularly among those at increased individual risk in the general population. Implications: This study shows that the protective effect of restrictive state-level tobacco environments on smoking or heavy smoking was stronger among those especially vulnerable due to individual-level risk factors (parental substance problems, childhood maltreatment). Thus, public health campaigns to influence attitudes towards smoking or legislation to strengthen tobacco control could have a broad effect, particularly impacting those with vulnerability to smoking, which may help decrease smoking prevalence and reduce the massive public health burden of tobacco-related morbidity and mortality. PMID:27130948

Tobacco Product Use Patterns, and Nicotine and Tobacco-Specific Nitrosamine Exposure: NHANES 1999-2012.

PubMed

Choi, Kelvin; Sabado, Melanie; El-Toukhy, Sherine; Vogtmann, Emily; Freedman, Neal D; Hatsukami, Dorothy

2017-10-01

Background: Few studies have examined differences in product consumption patterns and nicotine and tobacco-specific nitrosamines (TSNA) exposure between single versus dual- and poly-tobacco users. We applied the Tobacco Product Use Patterns (T-PUPs) model to fill this gap in the literature. Methods: Data from adults (age ≥18 years) who used any tobacco products during the 5 days prior to participating in the 1999-2012 National Health and Nutrition Examination Survey (NHANES) were analyzed. Participants were classified into seven T-PUPs: (1) cigarettes only, (2) noncigarette combustibles only, (3) noncombustibles only, (4) dual noncigarette combustibles and noncombustibles, (5) dual cigarettes and noncombustibles, (6) dual cigarettes and noncigarette combustibles, and (7) poly-tobacco use. Weighted regression models were used to compare product consumption, serum cotinine, and urinary total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (i.e., NNAL) levels between single-, dual-, and poly-tobacco T-PUPs. Results: Dual- and poly-tobacco T-PUPs were associated with lower product consumption compared with single-product T-PUPs only in some cases (e.g., dual cigarette and noncombustible users smoked cigarettes on 0.6 fewer days in the past 5 days compared with cigarette-only users; P < 0.05). Dual- and poly-tobacco T-PUPs had either nondistinguishable or higher levels of serum cotinine and urinary total NNAL than corresponding single-product T-PUPs. Conclusions: Product consumption, and nicotine and TSNAs exposure of dual- and poly-tobacco product category users somewhat differ from those of single-product category users as defined by the T-TUPs model. Impact: Higher levels of cotinine and NNAL among dual- and poly-tobacco T-TUPs users compared with the single-product T-TUPs users may indicate health concerns. Cancer Epidemiol Biomarkers Prev; 26(10); 1525-30. ©2017 AACR . ©2017 American Association for Cancer Research.

The Moderating Role of Gender in the Relationship Between Tobacco Outlet Exposure and Tobacco Use Among African American Young Adults.

PubMed

Brown, Qiana; Milam, Adam J; Bowie, Janice V; Ialongo, Nicholas S; Gaskin, Darrell J; Furr-Holden, Debra

2016-04-01

Tobacco outlet exposure is a correlate of tobacco use with potential differences by gender that warrant attention. The aim of this study is to explore the moderating role of gender in the relationship between tobacco outlet exposure and past month tobacco use among African American young adults 21 to 24 years old. This cross-sectional study (n = 283) used geospatial methods to determine the number of tobacco outlets within walking distance (i.e., a quarter mile) of participants' homes and distance to the nearest outlet. Logistic regression models were used to test interactions between gender and tobacco outlet exposure (i.e., density and proximity). Tobacco outlets were classified based on whether or not they were licensed to sell tobacco only (TO outlets) or tobacco and alcohol (TA outlets). Neither density nor proximity was associated with past month tobacco use in the pooled models. However, gender modified the relationship between TO outlet density and tobacco use, and this relationship was significant only among women (OR = 1.02; p < 0.01; adjusted OR = 1.01; p < 0.05). This study underscores the importance of reducing tobacco outlet density in residential neighborhoods, especially TO outlets, as well as highlights potential gender differences in the relationship between tobacco outlet density and tobacco use.

[Does consumption of tobacco, alcohol, and cannabis in adolescents and young adults with cancer affect the use of analgesics during hospitalizations?].

PubMed

Bertrand, A; Boyle, H; Moreaux, J; Guillot, L; Chvetzoff, G; Charbonnel, J-F; Marec-Berard, P

2016-04-01

The specificities of adolescents and young adults (AYAs) aged 15-25 years with cancer are now well recognized. Dedicated care was initiated in 2012 in France under the leadership of the INCa (National Cancer Institute). Research on supportive care and particularly pain management are still rare. This study aimed to evaluate the consumption of toxic substances (tobacco, cannabis, alcohol) in AYAs with cancer as well as its progression during the month following the diagnosis and to analyze its influence on opioid analgesic prescriptions during treatment. This is a prospective study including all new patients aged 15-25 years in two centers between January and June 2013. Data on consumption of psychoactive substances were obtained during an individual interview with a questionnaire. National surveys were used to compare this cohort with the general population. Data on opioid treatments were collected from the computerized prescription software and computerized patient record. Thirty-seven AYAs were eligible and 30 were included; 67% of them were male and the median age was 18.7 years. The questionnaire on tobacco, alcohol, and cannabis consumption at diagnosis was well accepted. Consumption profiles were comparable to the general population. Changes in behavior were observed during the 1st month after diagnosis, with a decrease or cessation of consumption, particularly among young people. This study showed differences in the use and requirements for opioid analgesics during hospitalization according to these consumption data. Prevention and support for AYAs who are regular consumers of toxic substances must be organized during initial care in oncology. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Trends in Sales of Flavored and Menthol Tobacco Products in the United States During 2011-2015.

PubMed

Kuiper, Nicole M; Gammon, Doris; Loomis, Brett; Falvey, Kyle; Wang, Teresa W; King, Brian A; Rogers, Todd

2018-05-03

Flavors can mask the harshness of tobacco and make it appealing to young people. This study assessed flavored and menthol tobacco product sales at the national and state levels. Universal Product Code tobacco sales data collected by Nielsen were combined for convenience stores and all-outlets-combined during October 22, 2011-January 9, 2016. Products were characterized as flavored, menthol, or non-flavored/non-menthol. Total unit sales, and the proportion of flavored and menthol unit sales, were assessed nationally and by state for seven tobacco products. Joinpoint regression was used to assess trends in average monthly percentage change. Nationally, the proportion of flavored and menthol sales in 2015 was as follows: cigarettes (32.5% menthol), large cigars (26.1% flavored), cigarillos (47.5% flavored, 0.2% menthol), little cigars (21.8% flavored, 19.4% menthol), chewing tobacco (1.4% flavored, 0.7% menthol), moist snuff (3.0% flavored, 57.0% menthol), and snus (88.5% menthol). From 2011 to 2015, sales increased for flavored cigarillos and chewing tobacco, as well as for menthol cigarettes, little cigars, moist snuff, and snus. Sales decreased for flavored large cigars, moist snuff, and snus, and for menthol chewing tobacco. State-level variations were observed by product; for example, flavored little cigar sales ranged from 4.4% (Maine) to 69.3% (Utah) and flavored cigarillo sales ranged from 26.6% (Maine) to 63.0% (Maryland). Menthol and flavored sales have increased since 2011, particularly for the products with the highest number of units sold, and significant state variation exists. Efforts to restrict flavored tobacco product sales could reduce overall U.S. tobacco consumption. Flavors in tobacco products can mask the harshness of tobacco and make these products more appealing to young people. This is the first study to assess national and state-level trends in flavored and menthol tobacco product sales. These findings underscore the importance of population-based interventions to address flavored tobacco product use at the national, state, and local levels. Additionally, further monitoring of flavored and menthol tobacco product sales can inform potential future regulatory efforts at the national, state, and local levels.

Raising the Legal Age of Tobacco Sales: Policy Support and Trust in Government, 2014-2015, U.S.

PubMed

Lee, Joseph G L; Boynton, Marcella H; Richardson, Amanda; Jarman, Kristen; Ranney, Leah M; Goldstein, Adam O

2016-12-01

The National Academy of Medicine has called for an increase in the minimum age of tobacco product sales. It is not clear what age increase would garner the greatest public support, or whether trust in the U.S. government predicts policy support. The data for these analyses are from a nationally representative telephone sample of U.S. adults (N=4,880) conducted from September 2014 to May 2015. The authors assessed whether support varied by the proposed minimum age of tobacco sales using a survey experiment (i.e., random assignment to the 19-, 20-, or 21-year age minimum condition) and, in cross-sectional analyses, whether smoking status, individual demographics, state-level politics, and general trust in the government predicted policy support. Analyses were conducted from May to December 2015. Odds of support for raising the minimum sales age to 21 years trended higher than support for raising to age 20 or 19 years (AOR=1.22, 95% CI=0.97, 1.53, p=0.09). There was majority support for raising the age of sales for cigarettes in all regions of the U.S. (66.3%, 95% CI=64.0, 68.6). Race, age, and trust in government were significant predictors of support. Raising the age of tobacco sales is broadly supported by the public. An age 21 years tobacco sales policy trends toward garnering more support than a policy at age 19 or 20 years. Trust in government may be an important consideration in understanding policy support beyond demographics. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Time series analysis of the impact of tobacco control policies on smoking prevalence among Australian adults, 2001–2011

PubMed Central

Coomber, Kerri; Durkin, Sarah J; Scollo, Michelle; Bayly, Megan; Spittal, Matthew J; Simpson, Julie A; Hill, David

2014-01-01

Abstract Objective To determine the impact of tobacco control policies and mass media campaigns on smoking prevalence in Australian adults. Methods 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. Findings 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. Conclusion 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. PMID:24940015

Bar and club tobacco promotions in the alternative press: targeting young adults.

PubMed

Sepe, Edward; Glantz, Stanton A

2002-01-01

This study examined changes in tobacco promotions in the alternative press in San Francisco and Philadelphia from 1994 to 1999. A random sample of alternative newspapers was analyzed, and a content analysis was conducted. Between 1994 and 1999, numbers of tobacco advertisements increased from 8 to 337 in San Francisco and from 8 to 351 in Philadelphia. Product advertisements represented only 45% to 50% of the total; the remaining advertisements were entertainment-focused promotions, mostly bar-club and event promotions. The tobacco industry has increased its use of bars and clubs as promotional venues and has used the alternative press to reach the young adults who frequent these establishments. This increased targeting of young adults may be associated with an increase in smoking among this group.

Impact of increasing tobacco taxes on working-age adults: short-term health gain, health equity and cost savings.

PubMed

Cleghorn, Christine L; Blakely, Tony; Kvizhinadze, Giorgi; van der Deen, Frederieke S; Nghiem, Nhung; Cobiac, Linda J; Wilson, Nick

2017-11-16

The health gains and cost savings from tobacco tax increase peak many decades into the future. Policy-makers may take a shorter-term perspective and be particularly interested in the health of working-age adults (given their role in economic productivity). Therefore, we estimated the impact of tobacco taxes in this population within a 10-year horizon. As per previous modelling work, we used a multistate life table model with 16 tobacco-related diseases in parallel, parameterised with rich national data by sex, age and ethnicity. The intervention modelled was 10% annual increases in tobacco tax from 2011 to 2020 in the New Zealand population (n=4.4 million in 2011). The perspective was that of the health system, and the discount rate used was 3%. For this 10-year time horizon, the total health gain from the tobacco tax in discounted quality-adjusted life years (QALYs) in the 20-65 year age group (age at QALY accrual) was 180 QALYs or 1.6% of the lifetime QALYs gained in this age group (11 300 QALYs). Nevertheless, for this short time horizon: (1) cost savings in this group amounted to NZ$10.6 million (equivalent to US$7.1 million; 95% uncertainty interval: NZ$6.0 million to NZ$17.7 million); and (2) around two-thirds of the QALY gains for all ages occurred in the 20-65 year age group. Focusing on just the preretirement and postretirement ages, the QALY gains in each of the 60-64 and 65-69 year olds were 11.5% and 10.6%, respectively, of the 268 total QALYs gained for all age groups in 2011-2020. The majority of the health benefit over a 10-year horizon from increasing tobacco taxes is accrued in the working-age population (20-65 years). There remains a need for more work on the associated productivity benefits of such health gains. © 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.

The impact of TV mass media campaigns on calls to a National Quitline and the use of prescribed nicotine replacement therapy: a structural vector autoregression analysis

PubMed Central

Haghpanahan, Houra; Mackay, Daniel F.; Pell, Jill P.; Bell, David; Langley, Tessa

2017-01-01

Abstract Aims To estimate (1) the immediate impact; (2) the cumulative impact; and (3) the duration of impact of Scottish tobacco control TV mass media campaigns (MMCs) on smoking cessation activity, as measured by calls to Smokeline and the volume of prescribed nicotine replacement therapy (NRT). Design Multivariate time–series analysis using secondary data on population level measures of exposure to TV MMCs broadcast and smoking cessation activity between 2003 and 2012. Setting and participants Population of Scotland. Measurements Adult television viewer ratings (TVRs) as a measure of exposure to Scottish mass media campaigns in the adult population; monthly calls to NHS Smokeline; and the monthly volume of prescribed NRT as measured by gross ingredient costs (GIC). Findings Tobacco control TVRs were associated with an increase in calls to Smokeline but not an increase in the volume of prescribed NRT. A 1 standard deviation (SD) increase of 194 tobacco control TVRs led to an immediate and significant increase of 385.9 [95% confidence interval (CI) = 171.0, 600.7] calls to Smokeline (unadjusted model) within 1 month. When adjusted for seasonality the impact was reduced, but the increase in calls remained significant (226.3 calls, 95% CI = 37.3, 415.3). The cumulative impact on Smokeline calls remained significant for 6 months after broadcast in the unadjusted model and 18 months in the adjusted model. However, an increase in tobacco control TVRs of 194 failed to have a significant impact on the GIC of prescribed NRT in either the unadjusted (£1361.4, 95% CI = –£9138.0, £11860.9) or adjusted (£6297.1, 95% CI = –£2587.8, £15182.1) models. Conclusions Tobacco control television mass media campaigns broadcast in Scotland between 2003 and 2012 were effective in triggering calls to Smokeline, but did not increase significantly the use of prescribed nicotine replacement therapy by adult smokers. The impact on calls to Smokeline occurred immediately within 1 month of broadcast and was sustained for at least 6 months. PMID:28192615

E-Cigarette Prevalence and Correlates of Use among Adolescents versus Adults: A Review and Comparison

PubMed Central

Chapman, Shawna L. Carroll; Wu, Li-Tzy

2014-01-01

Perceived safer than tobacco cigarettes, prevalence of electronic cigarette (e-cigarette) use is increasing. Analyses of cartridges suggest that e-cigarettes may pose health risks. In light of increased use and the potential for consequences, we searched Google Scholar and Pubmed in July of 2013 using keywords, such as e-cigarette and vaping, to compare differences and similarities in prevalence and correlates of e-cigarette use among adolescents (grades 6-12) versus adults (aged ≥18 years). Twenty-one studies focused on e-cigarette use. Ever-use increased among various age groups. In 2011, ever-use was highest among young adults (college students and those aged 20-28; 4.9%-7.0%), followed by adults (aged ≥18; 0.6%-6.2%), and adolescents (grades 6-12 and aged 11-19; <1%-3.3%). However, in 2012 adolescent ever-use increased to 6.8% and, among high school students, went as high as 10.0%. While the identified common correlate of e-cigarette use was a history of cigarette smoking, a notable proportion of adolescents and young adults who never smoked cigarettes had ever-used e-cigarettes. E-cigarette use was not consistently associated with attempting to quit tobacco among young adults. Adults most often reported e-cigarettes as a substitute for tobacco, although not always to quit. Reviewed studies showed a somewhat different pattern of e-cigarette use among young people (new e-cigarette users who had never used tobacco) versus adults (former or current tobacco users). Research is needed to better characterize prevalences, use correlates, and motives of use in different population groups, including how adolescent and young adult experimentation with e-cigarettes relates to other types of substance use behaviors. PMID:24680203

What Does Having Your Pack in Your Pocket Say about You? Characteristics and Attitude Differences of Youth Carrying Tobacco at a Music Festival

ERIC Educational Resources Information Center

Ilakkuvan, Vinu; Reubenstein, Rebecca; Xiao, Haijun; Rath, Jessica

2017-01-01

The purpose of this study is to understand differences in demographics, frequency of tobacco use, and tobacco-related attitudes between youth/young adults who carry tobacco products and those who do not. Carrying tobacco is hypothesized to affect individuals' smoker identity and thereby their tobacco-related attitudes. Carriers are an influential…

Do Brief Alcohol Interventions Reduce Tobacco Use among Adolescents and Young Adults? A Systematic Review and Meta-Analysis

PubMed Central

Hennessy, Emily A.; Tanner-Smith, Emily E.; Steinka-Fry, Katarzyna T.

2015-01-01

This meta-analysis synthesizes studies of brief interventions (BIs) that targeted alcohol consumption and reported both alcohol and tobacco outcomes. It examines whether BIs reduce alcohol and tobacco use for adolescents and young adults among interventions that (1) directly targeted tobacco and alcohol use, or (2) did not target tobacco use but measured it as a secondary outcome. Multiple databases and grey literature sources were searched (1980–2012) resulting in the identification of 18 randomized or controlled quasi-experimental studies (5949 participants). Analyses were conducted using random effects inverse-variance weighted three-level models. BIs were associated with a significant reduction in alcohol consumption relative to control groups (ḡ = 0.11, 95% CI [0.04, 0.17]) but not with a significant decrease in tobacco use (ḡ = 0.07, 95% CI [−0.01, 0.16]). Directly addressing tobacco was not a significant moderator affecting tobacco use outcomes. Post-hoc exploratory analysis revealed potential questions to address with future research. PMID:26130030

Multiple tobacco product use among young adult bar patrons in New Mexico

PubMed Central

Kalkhoran, Sara; Padilla, James L.; Neilands, Torsten B.; Ling, Pamela M.

2017-01-01

Introduction Use of non-cigarette tobacco products is common, and e-cigarette use is increasing among young adults. We aimed to identify use of other tobacco products among young adult bar patrons in the context of a bar-based intervention to decrease cigarette smoking. Methods 2291 cross-sectional surveys were collected from young adults in bars in Albuquerque, New Mexico using time–location sampling between 2011 and 2013 (N = 1142 in 2011, N = 1149 in 2012–2013), 2 and 3 years into an intervention to reduce cigarette use, and analyzed in 2014–2015. Participants reported current (i.e. past 30-day) use of cigarettes, snus, dip, cigarillos, hookah, and e-cigarettes, demographics, and tobacco-related attitudes. Multiple imputation was used to account for planned missing data. Logistic regression determined correlates of multiple tobacco product use. Results Cigarette smoking in the population decreased during the intervention from 43% to 37%. Over 60% of current cigarette smokers reported poly-use, most frequently with e-cigarettes (46%) and hookah (44%), followed by cigarillos (24%), dip (15%), and snus (14%) in 2012–2013. Among cigarette smokers, current e-cigarette use increased, while use of other products decreased during the intervention. Odds of poly-use (versus smoking cigarettes only) were greater among males and those reporting past 30-day binge drinking, and lower in those who strongly believed secondhand smoke exposure is harmful. Conclusions Among young adult bar patrons in Albuquerque, New Mexico, most cigarette smokers reported currently using at least one other tobacco product. Public health interventions should address use of all tobacco products, use of which may rise despite decreased cigarette use. PMID:26666395

Multiple tobacco product use among young adult bar patrons in New Mexico.

PubMed

Kalkhoran, Sara; Padilla, James L; Neilands, Torsten B; Ling, Pamela M

2016-02-01

Use of non-cigarette tobacco products is common, and e-cigarette use is increasing among young adults. We aimed to identify use of other tobacco products among young adult bar patrons in the context of a bar-based intervention to decrease cigarette smoking. 2291 cross-sectional surveys were collected from young adults in bars in Albuquerque, New Mexico using time-location sampling between 2011 and 2013 (N=1142 in 2011, N=1149 in 2012-2013), 2 and 3years into an intervention to reduce cigarette use, and analyzed in 2014-2015. Participants reported current (i.e. past 30-day) use of cigarettes, snus, dip, cigarillos, hookah, and e-cigarettes, demographics, and tobacco-related attitudes. Multiple imputation was used to account for planned missing data. Logistic regression determined correlates of multiple tobacco product use. Cigarette smoking in the population decreased during the intervention from 43% to 37%. Over 60% of current cigarette smokers reported poly-use, most frequently with e-cigarettes (46%) and hookah (44%), followed by cigarillos (24%), dip (15%), and snus (14%) in 2012-2013. Among cigarette smokers, current e-cigarette use increased, while use of other products decreased during the intervention. Odds of poly-use (versus smoking cigarettes only) were greater among males and those reporting past 30-day binge drinking, and lower in those who strongly believed secondhand smoke exposure is harmful. Among young adult bar patrons in Albuquerque, New Mexico, most cigarette smokers reported currently using at least one other tobacco product. Public health interventions should address use of all tobacco products, use of which may rise despite decreased cigarette use. Copyright © 2015. Published by Elsevier Inc.

Tobacco industry direct mail marketing and participation by New Jersey adults.

PubMed

Lewis, M Jane; Delnevo, Cristine D; Slade, John

2004-02-01

We examined adult participation in tobacco industry direct marketing: receipt of direct mail and use of coupons and brand reward programs. Participation was highest for direct mail; participation in all 3 forms differed by gender, age, and race/ethnicity; current smokers, Whites, and persons aged 25 to 64 years reported greater participation. Although tobacco industry direct marketing may influence smoking initiation, its potential to increase consumption and impede cessation is unquestionable.

Hazards of New Media: Youth’s Exposure to Tobacco Ads/Promotions

PubMed Central

2014-01-01

Background: A gap in knowledge exists about the youth’s exposure to protobacco campaigns via new electronic media outlets. In response, we use national data to delineate the associations between tobacco ads/promotions delivered through new media outlets (i.e., social network sites and text messages) and youth attitudes/beliefs about tobacco and intent to use (among youth who had not yet used tobacco). Methods: Data were derived from the 2011 National Youth Tobacco Survey, a nationally representative sample of U.S. youth enrolled in both public and private schools (N = 15,673). Logistic regression models were used to examine associations between demographic characteristics and reported exposure to tobacco ads/promotions via social networking sites and text messages. Logistic regression models were also used to investigate associations between exposure tobacco ads/promotions and attitudes toward tobacco. Results: We found that highly susceptible youth (i.e., minorities, very young youth, and youth who have not yet used tobacco) have observed tobacco ads/promotions on social networking sites and text messages. These youth are more likely to have favorable attitudes toward tobacco, including the intention to use tobacco among those who had not yet used tobacco. Conclusions: Our findings underscore the need for policy strategies to more effectively monitor and regulate tobacco advertising via new media outlets. PMID:24163285

Tobacco industry successfully prevented tobacco control legislation in Argentina

PubMed Central

Sebrie, E; Barnoya, J; Perez-Stable, E; Glantz, S

2005-01-01

Objective: To evaluate how transnational tobacco companies, working through their local affiliates, influenced tobacco control policymaking in Argentina between 1966 and 2005. Methods: Analysis of internal tobacco industry documents, local newspapers and magazines, internet resources, bills from the Argentinean National Congress Library, and interviews with key individuals in Argentina. Results: Transnational tobacco companies (Philip Morris International, British American Tobacco, Lorillard, and RJ Reynolds International) have been actively influencing public health policymaking in Argentina since the early 1970s. As in other countries, in 1977 the tobacco industry created a weak voluntary self regulating code to avoid strong legislated restrictions on advertising. In addition to direct lobbying by the tobacco companies, these efforts involved use of third party allies, public relations campaigns, and scientific and medical consultants. During the 1980s and 1990s efforts to pass comprehensive tobacco control legislation intensified, but the organised tobacco industry prevented its enactment. There has been no national activity to decrease exposure to secondhand smoke. Conclusions: The tobacco industry, working through its local subsidiaries, has subverted meaningful tobacco control legislation in Argentina using the same strategies as in the USA and other countries. As a result, tobacco control in Argentina remains governed by a national law that is weak and restricted in its scope. PMID:16183967

Hazards of new media: youth's exposure to tobacco Ads/promotions.

PubMed

Cavazos-Rehg, Patricia A; Krauss, Melissa J; Spitznagel, Edward L; Grucza, Richard A; Bierut, Laura Jean

2014-04-01

A gap in knowledge exists about the youth's exposure to protobacco campaigns via new electronic media outlets. In response, we use national data to delineate the associations between tobacco ads/promotions delivered through new media outlets (i.e., social network sites and text messages) and youth attitudes/beliefs about tobacco and intent to use (among youth who had not yet used tobacco). Data were derived from the 2011 National Youth Tobacco Survey, a nationally representative sample of U.S. youth enrolled in both public and private schools (N = 15,673). Logistic regression models were used to examine associations between demographic characteristics and reported exposure to tobacco ads/promotions via social networking sites and text messages. Logistic regression models were also used to investigate associations between exposure tobacco ads/promotions and attitudes toward tobacco. We found that highly susceptible youth (i.e., minorities, very young youth, and youth who have not yet used tobacco) have observed tobacco ads/promotions on social networking sites and text messages. These youth are more likely to have favorable attitudes toward tobacco, including the intention to use tobacco among those who had not yet used tobacco. Our findings underscore the need for policy strategies to more effectively monitor and regulate tobacco advertising via new media outlets.

Young adults' favorable perceptions of snus, dissolvable tobacco products, and electronic cigarettes: findings from a focus group study.

PubMed

Choi, Kelvin; Fabian, Lindsey; Mottey, Neli; Corbett, Amanda; Forster, Jean

2012-11-01

We explored young adults' perceptions of snus (spitless moist snuff packed in porous bags), dissolvable tobacco products, and electronic cigarettes and intention to try these products. We conducted 11 focus group discussions involving a total of 66 young adults (18-26 years old) on these new tobacco products (e.g., harmfulness, potential as quit aids, intention to try) held between July and December 2010. We analyzed discussions using a thematic approach. Participants generally reported positive perceptions of the new products, particularly because they came in flavors. Few negative perceptions were reported. Although some participants believed these products were less harmful than cigarettes and helpful in quitting smoking, others thought the opposite, particularly regarding electronic cigarettes. Participants also commented that these products could be gateways to cigarette smoking. Half of the participants, including a mix of smokers and nonsmokers, admitted they would try these products if offered by a friend. Young adults perceive the new tobacco products positively and are willing to experiment with them. Eliminating flavors in these products may reduce young adults' intentions to try these products.

Tobacco industry issues management organizations: creating a global corporate network to undermine public health.

PubMed

McDaniel, Patricia A; Intinarelli, Gina; Malone, Ruth E

2008-01-17

The global tobacco epidemic claims 5 million lives each year, facilitated by the ability of transnational tobacco companies to delay or thwart meaningful tobacco control worldwide. A series of cross-company tobacco industry "issues management organizations" has played an important role in coordinating and implementing common strategies to defeat tobacco control efforts at international, national, and regional levels. This study examines the development and enumerates the activities of these organizations and explores the implications of continuing industry cooperation for global public health. Using a snowball sampling strategy, we collected documentary data from tobacco industry documents archives and assembled them into a chronologically organized case study. The International Committee on Smoking Issues (ICOSI) was formed in 1977 by seven tobacco company chief executives to create common anti-tobacco control strategies and build a global network of regional and national manufacturing associations. The organization's name subsequently changed to INFOTAB. The multinational companies built the organization rapidly: by 1984, it had 69 members operating in 57 countries. INFOTAB material, including position papers and "action kits" helped members challenge local tobacco control measures and maintain tobacco-friendly environments. In 1992 INFOTAB was replaced by two smaller organizations. The Tobacco Documentation Centre, which continues to operate, distributes smoking-related information and industry argumentation to members, some produced by cross-company committees. Agro-Tobacco Services, and now Hallmark Marketing Services, assists the INFOTAB-backed and industry supported International Tobacco Growers Association in advancing claims regarding the economic importance of tobacco in developing nations. The massive scale and scope of this industry effort illustrate how corporate interests, when threatened by the globalization of public health, sidestep competitive concerns to coordinate their activities. The global network of national and regional manufacturing associations created and nurtured by INFOTAB remains active, particularly in relation to the recently negotiated global health treaty, the Framework Convention on Tobacco Control. Policymakers should be aware that although these associations claim to represent only national or regional interests, they are allied to and coordinated with a confederation of transnational tobacco companies seeking to protect profits by undermining public health.

Tobacco industry issues management organizations: Creating a global corporate network to undermine public health

PubMed Central

McDaniel, Patricia A; Intinarelli, Gina; Malone, Ruth E

2008-01-01

Background The global tobacco epidemic claims 5 million lives each year, facilitated by the ability of transnational tobacco companies to delay or thwart meaningful tobacco control worldwide. A series of cross-company tobacco industry "issues management organizations" has played an important role in coordinating and implementing common strategies to defeat tobacco control efforts at international, national, and regional levels. This study examines the development and enumerates the activities of these organizations and explores the implications of continuing industry cooperation for global public health. Methods Using a snowball sampling strategy, we collected documentary data from tobacco industry documents archives and assembled them into a chronologically organized case study. Results The International Committee on Smoking Issues (ICOSI) was formed in 1977 by seven tobacco company chief executives to create common anti-tobacco control strategies and build a global network of regional and national manufacturing associations. The organization's name subsequently changed to INFOTAB. The multinational companies built the organization rapidly: by 1984, it had 69 members operating in 57 countries. INFOTAB material, including position papers and "action kits" helped members challenge local tobacco control measures and maintain tobacco-friendly environments. In 1992 INFOTAB was replaced by two smaller organizations. The Tobacco Documentation Centre, which continues to operate, distributes smoking-related information and industry argumentation to members, some produced by cross-company committees. Agro-Tobacco Services, and now Hallmark Marketing Services, assists the INFOTAB-backed and industry supported International Tobacco Growers Association in advancing claims regarding the economic importance of tobacco in developing nations. Conclusion The massive scale and scope of this industry effort illustrate how corporate interests, when threatened by the globalization of public health, sidestep competitive concerns to coordinate their activities. The global network of national and regional manufacturing associations created and nurtured by INFOTAB remains active, particularly in relation to the recently negotiated global health treaty, the Framework Convention on Tobacco Control. Policymakers should be aware that although these associations claim to represent only national or regional interests, they are allied to and coordinated with a confederation of transnational tobacco companies seeking to protect profits by undermining public health. PMID:18201375

Markers of the denormalisation of smoking and the tobacco industry.

PubMed

Chapman, S; Freeman, B

2008-02-01

In nations with histories of declining smoking prevalence and comprehensive tobacco control policies, smoking-positive cultures have been severely eroded. Smoking, smokers and the tobacco industry are today routinely depicted in everyday discourse and media representations in a variety of overwhelmingly negative ways. Several authors have invoked Erving Goffman's notions of stigmatization to describe the process and impact of this radical transformation, which importantly includes motivating smoking cessation. Efforts to describe nations' progress toward comprehensive tobacco control have hitherto taken little account of the role of cultural change to the meaning of smoking and the many ways in which it has become denormalised. This paper identifies a diversity of generally undocumented yet pervasive markers of the "spoiled identity" of smoking, smokers and the tobacco industry, illustrated with examples from Australia, a nation with advanced tobacco control. We caution about some important negative consequences arising from the stigmatization of smokers. We recommend that schemes rating the comprehensiveness of national tobacco control should be supplemented by documentation of markers of this denormalisation.

Monitoring the tobacco use epidemic IV. The vector: Tobacco industry data sources and recommendations for research and evaluation.

PubMed

Cruz, Tess Boley

2009-01-01

This Vector paper (IV of V on monitoring the tobacco use epidemic) presents the data sources and methods that can be used to monitor tobacco marketing and makes recommendations for creating a national surveillance system. In 2002, the Vector Work Group of the National Tobacco Monitoring, Research and Evaluation Workshop identified priority indicators of tobacco marketing: tobacco brand pricing strategies, retail environment advertising and promotional allowances, gray market or smuggling activities, lobbying, direct mail marketing, tobacco brand placements in films, Internet promotions, and sponsorship at bars and events. This paper reviews and identifies data sources and gaps for these priority indicators and for 12 other indicators of interest. There are 38 commercial data sites and Internet sources, as well as individual research efforts that address the priority indicators. These sources are not integrated, often costly, and limited in standardization. Tobacco marketing could be more effectively monitored with the development of a national research network. Surveillance of the tobacco industry's methods to push tobacco and pull consumers can help the public health community identify new markets and campaigns, justify and tailor effective tobacco control strategies, and evaluate existing counter-marketing efforts.

Under the Radar: Smokeless Tobacco Advertising in Magazines With Substantial Youth Readership

PubMed Central

Morrison, Margaret A.; Krugman, Dean M.; Park, Pumsoon

2008-01-01

Objectives. In light of the Smokeless Tobacco Master Settlement Agreement (STMSA) and the fact that smokeless tobacco advertising has received little attention, we examined industry data to assess smokeless tobacco advertising in popular magazines. Of particular interest was the level of advertising in magazines with high youth readership and the amount of reach and frequency that was generated among readers aged 12 to 17 years. Methods. We used readership data from Mediamark Research Inc, advertising expenditure data from TNS Media Intelligence, and Adplus, a media planning program from Telmar to document the composition of adult and youth readership of magazines in which smokeless tobacco products were advertised, industry expenditures on advertising, and adolescents’ exposure to smokeless tobacco advertising. Results. The STMSA appears to have had a limited effect on the advertising of smokeless tobacco products to youth; both before and after the agreement, smokeless tobacco companies advertised in magazines with high adolescent readership. Conclusions. Popular magazines with smokeless tobacco advertising reach a large number of adolescents through a combination of both youth-oriented and adult magazines. These exposure levels have generally increased since the STMSA. PMID:17600263

Under the radar: smokeless tobacco advertising in magazines with substantial youth readership.

PubMed

Morrison, Margaret A; Krugman, Dean M; Park, Pumsoon

2008-03-01

In light of the Smokeless Tobacco Master Settlement Agreement (STMSA) and the fact that smokeless tobacco advertising has received little attention, we examined industry data to assess smokeless tobacco advertising in popular magazines. Of particular interest was the level of advertising in magazines with high youth readership and the amount of reach and frequency that was generated among readers aged 12 to 17 years. We used readership data from Mediamark Research Inc, advertising expenditure data from TNS Media Intelligence, and Adplus, a media planning program from Telmar to document the composition of adult and youth readership of magazines in which smokeless tobacco products were advertised, industry expenditures on advertising, and adolescents' exposure to smokeless tobacco advertising. The STMSA appears to have had a limited effect on the advertising of smokeless tobacco products to youth; both before and after the agreement, smokeless tobacco companies advertised in magazines with high adolescent readership. Popular magazines with smokeless tobacco advertising reach a large number of adolescents through a combination of both youth-oriented and adult magazines. These exposure levels have generally increased since the STMSA.

Smoke-Free and Tobacco-Free Policies in Colleges and Universities - United States and Territories, 2017.

PubMed

Wang, Teresa W; Tynan, Michael A; Hallett, Cynthia; Walpert, Laura; Hopkins, Maggie; Konter, Darryl; King, Brian A

2018-06-22

Each year in the United States, cigarette smoking causes an estimated 480,000 deaths, including approximately 41,000 deaths from secondhand smoke exposure among nonsmoking adults (1). Smoke-free policies protect nonsmokers from secondhand smoke exposure, reduce the social acceptability of smoking, help in preventing youth and young adult smoking initiation, and increase smokers' efforts to quit smoking (1,2). Given that 99% of adult cigarette smokers first start smoking before age 26 years and many smokers transition to regular, daily use during young adulthood (2),* colleges and universities represent an important venue for protecting students, faculty, staff members, and guests from secondhand smoke exposure through tobacco control policies (3). To assess smoke-free and tobacco-free policies in U.S. colleges and universities, CDC and the American Nonsmokers' Rights Foundation (ANRF) determined the number of campuses nationwide that completely prohibit smoking (smoke-free) or both smoking and smokeless tobacco product use (tobacco-free) in all indoor and outdoor areas. As of November 2017, at least 2,082 U.S. college and university campuses had smoke-free policies. Among these campuses, 1,743 (83.7%) were tobacco-free; 1,658 (79.6%) specifically prohibited electronic cigarette (e-cigarette) use; and 854 (41.0%) specifically prohibited hookah smoking. Smoke-free and tobacco-free policies on college and university campuses can help reduce secondhand smoke exposure, tobacco use initiation, and the social acceptability of tobacco use (1-3).

Exposure to tobacco smoke among adults in Bangladesh.

PubMed

Palipudi, Krishna Mohan; Sinha, Dhirendra N; Choudhury, Sohel; Mustafa, Zaman; Andes, Linda; Asma, Samira

2011-01-01

To examine exposure to second-hand smoke (SHS) at home, in workplace, and in various public places in Bangladesh. Data from 2009 Global Adult Tobacco Survey (GATS) conducted in Bangladesh was analyzed. The data consists of 9,629 respondents from a nationally representative multi-stage probability sample of adults aged 15 years and above. Exposure to second-hand smoke was defined as respondents who reported being exposed to tobacco smoke in the following locations: Indoor workplaces, homes, government building or office, health care facilities, public transportation, schools, universities, restaurants, and cafes, coffee shops or tea houses. Exposure to tobacco smoke in these places was examined by gender across various socioeconomic and demographic sub-groups that include age, residence, education and wealth index using SPSS 17.0 for complex samples. The study shows high prevalence of SHS exposure at home and in workplace and in public places. Exposure to SHS among adults was reported high at home (54.9%) (male-58.2% and female-51.7%), in workplace (63%) (male-67.8% and female-30.4%), and in any public place (57.8%) (male-90.4% and female-25.1%) 30 days preceding the survey. Among the public places examined exposure was low in the educational institutions (schools-4.3%) and health care facilities (5.8%); however, exposure was high in public transportation (26.3%), and restaurants (27.6%). SHS exposure levels at home, in workplace and public places were varied widely across various socioeconomic and demographic sub-groups. Exposure was reported high in settings having partial ban as compared to settings having a complete ban. Following the WHO FCTC and MPOWER measures, strengthening smoke-free legislation may further the efforts in Bangladesh towards creating and enforcing 100% smoke-free areas and educating the public about the dangers of SHS. Combining these efforts can have a complementary effect on protecting the people from hazardous effect of SHS as well as reducing the social acceptance of smoking both at home and in public and workplaces. Ongoing surveillance in Bangladesh is necessary to measure progress towards monitoring SHS exposure.

Attitudes toward nonsmoking policies and tobacco tax increases: a cross-sectional study among Vietnamese adults.

PubMed

Dao, Thi Minh An; Hoang, Van Minh; Le, Thi Huong; Kim, Bao Giang; Le, Thi Thanh Xuan; Pham, Thi Quynh Nga; Hsia, Jason

2015-03-01

Following the 2009 update of the 2005 Framework Convention on Tobacco Control, Vietnam issued a new policy to ban smoking at workplaces and public places. This cross-sectional survey explored public attitudes toward this new regulation and provides evidence to inform future laws. Using stratified cluster sampling, 10 383 Vietnamese people older than 15 years were drawn from 11 142 selected households. Policies mandating "no smoking at workplaces" were supported by 88.7% of Vietnamese adults, whereas "no smoking in public places" and "increasing the tobacco tax" received less support. Educational level, knowledge of health effects, access to information on quitting and smoking health risks, smoking status, ethnicity, and region had significant associations with positive attitudes toward all 3 tobacco control policies. Adults belonging to the non-Kinh ethnic group, those who do not live in the Red river delta, people with lower educational levels, and current smokers should be targeted in tobacco control communication programs. © 2012 APJPH.

Rural print media portrayal of secondhand smoke and smoke-free policy.

PubMed

Helme, Donald W; Rayens, Mary Kay; Kercsmar, Sarah E; Adkins, Sarah M; Amundsen, Shelby J; Lee, Erin; Riker, Carol A; Hahn, Ellen J

2012-11-01

The purpose of this article is to describe how the print media portrays secondhand smoke and smoke-free policy in rural communities. Baseline print media clips from an ongoing 5-year study of smoke-free policy development in 40 rural communities were analyzed. The authors hypothesized that community population size would be positively associated with media favorability toward smoke-free policy. Conversely, pounds of tobacco produced and adult smoking prevalence would be negatively associated with media favorability. There was a positive correlation between population size and percentage of articles favorable toward smoke-free policy. The authors did not find a correlation between adult smoking or tobacco produced and media favorability toward smoke-free policy, but we did find a positive relationship between tobacco produced and percentage of pro-tobacco articles and a negative relationship between adult smoking prevalence and percentage of articles about health/comfort. Implications for targeting pro-health media in rural communities as well as policy-based initiatives for tobacco control are discussed.

Investigating Male Tobacco Use and Expenditure Patterns across Socio-Economic Groups in Nigeria

PubMed Central

Uguru, Nkoli P.; Mbachu, Chinyere; Ibe, Ogochukwu P.; Uguru, Chibuzo C.; Odukoya, Oluwakemi; Okwuosa, Chinenye; Onwujekwe, Obinna

2015-01-01

The magnitude of variation in economic costs of tobacco consumption among socio-economic status (SES) groups in Nigeria is unclear. Understanding the factors that influence tobacco use and expenditure among different socio-economic groups would inform decisions on interventions for tobacco control in Nigeria. Secondary data was obtained from the 2008 National demographic and health survey. Information on tobacco use and expenditure in households and individual males were extracted from the database. A total of 34,070 households and 15,846 individual males were sampled. Analysis was done using descriptive statistics and binary logistic regression analysis. Information on wealth index obtained were categorized into socio-economic quintile groups (Q1 to Q5), representing poorest to richest socio-economic groups. To estimate expenditure on cigarettes, the average cost of a stick of cigarette was obtained and multiplied with the number of sticks smoked per day. The proportion of households that use tobacco in Nigeria is 5.25% with a greater percentage (89.6%) residing in the rural areas. Prevalence of cigarette smoking in individual males is 8.59%, and the poorer SES group smoked more cigarettes (20.9%) and spent more (0.60–1.19USD) than the richest SES group. Low education level, traditional beliefs, literacy levels, SES and employment status all influence cigarette smoking in adult males. Although poor people smoked more and spent more of their income on cigarettes, other factors like educational level and traditional beliefs were found to influence practice of cigarette smoking in men. This implies that tobacco control legislation through increased taxes alone may not effectively reduce the use of tobacco and its products in Nigeria. A consolidated approach that includes behavioral change procedures, enforcing bans on tobacco advertisement and the use of strong graphic anti-tobacco messages targeted at both the poor and rich as well as the educated and uneducated need to be effected to reduce tobacco use. PMID:25856074

Youth and tobacco.

PubMed

Tanski, S E; Prokhorov, A V; Klein, J D

2004-12-01

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.

Now is the time to advocate for interventions designed specifically to prevent and control waterpipe tobacco smoking.

PubMed

Lopez, A A; Eissenberg, T; Jaafar, M; Afifi, R

2017-03-01

Waterpipe tobacco usage is spreading rapidly worldwide, with reports of more youth being waterpipe users compared to adults. In many areas of the world, waterpipe usage surpasses cigarette smoking. Waterpipes and cigarettes are both mechanisms for inhalation of tobacco smoke and therefore have serious health consequences. However, because of the many differences between the two products, prevention and control strategies that have proven effective for cigarettes may not transfer readily to waterpipe. This report highlights the differences between waterpipes and cigarettes in toxicant exposure and physiologic effects, patterns of use, social norms, the extent of evidence, and the policy environment. There is little evidence to date around effective interventions for waterpipe prevention and control. The current state of evidence for intervention to curb or control waterpipe is at ground zero and critically needs attention from both scientists and policy makers. National and global efforts aimed at cigarette prevention have succeeded, particularly in developed countries. We suggest the time has come to harness what we know works for cigarette prevention and control and adapt it to tackle the growing epidemic of waterpipe tobacco use. Copyright © 2016 Elsevier Ltd. All rights reserved.

Now is the Time to Advocate for Interventions Designed Specifically to Prevent and Control Waterpipe Tobacco Smoking

PubMed Central

Lopez, A.A.; Eissenberg, T.; Jaafar, M.; Afifi, R.

2016-01-01

Waterpipe tobacco usage is spreading rapidly worldwide, with reports of more youth being waterpipe users compared to adults. In many areas of the world, waterpipe usage surpasses cigarette smoking. Waterpipes and cigarettes are both mechanisms for inhalation of tobacco smoke and therefore have serious health consequences. However, because of the many differences between the two products, prevention and control strategies that have proven effective for cigarettes may not transfer readily to waterpipe. This report highlights the differences between waterpipes and cigarettes in toxicant exposure and physiologic effects, patterns of use, social norms, the extent of evidence, and the policy environment. There is little evidence to date around effective interventions for waterpipe prevention and control. The current state of evidence for intervention to curb or control waterpipe is at ground zero and critically needs attention from both scientists and policy makers. National and global efforts aimed at cigarette prevention have succeeded, particularly in developed countries. We suggest the time has come to harness what we know works for cigarette prevention and control and adapt it to tackle the growing epidemic of waterpipe tobacco use. PMID:27871044

Contrasting Trends of Smoking Cessation Status: Insights From the Stages of Change Theory Using Repeat Data From the Global Adult Tobacco Survey, Thailand (2009 and 2011) and Turkey (2008 and 2012).

PubMed

Mbulo, Lazarous; Murty PhD, Komanduri S; Husain PhD, Muhammad Jami; Bashir Msc, Rizwan; Blutcher-Nelson BSc, Glenda; Benjakul PhD, Sarunya; Kengganpanich PhD, Mondha; Erguder Md PhD, Toker; Keskinkilic Md, Bekir; Polat Md, Sertac; Sinha Md PhD, Dhirendra N; Palipudi PhD, Krishna; Ahluwalia PhD, Indu B

2017-06-01

The World Health Organization recommends that smokers be offered help to quit. A better understanding of smokers' interest in and commitment to quitting could guide tobacco control efforts. We assessed temporal differences in stages of change toward quitting among smokers in Thailand and Turkey. Two waves (independent samples) of data from the Global Adult Tobacco Survey, a national household survey of adults aged 15 years or older, were assessed for Thailand (2009 and 2011) and Turkey (2008 and 2012). Current smokers were categorized into 3 stages of change based on their cessation status: precontemplation, contemplation, and preparation. Relative change in the proportion of smokers in each stage between waves 1 and 2 was computed for each country. Between waves, overall current tobacco smoking did not change in Thailand (23.7% to 24.0%) but declined in Turkey (31.2% to 27.1%; P < .001). Between 2009 and 2011, precontemplation increased among smokers in Thailand (76.1% to 85.4%; P < .001), whereas contemplation (17.6% to 12.0%; P < .001) and preparation (6.3% to 2.6%; P < .001) declined. Between 2008 and 2012, there were declines in precontemplation among smokers in Turkey (72.2% to 64.6%; P < .001), whereas there were increases in contemplation (21.2% to 26.9%; P = .008) and no significant change in preparation (6.5% to 8.5%; P = .097). Nearly two-thirds of smokers in Turkey and more than two-thirds in Thailand were in the precontemplation stage during the last survey wave assessed. The proportion of smokers in the preparation stage increased in Turkey but declined in Thailand. Identifying stages of cessation helps guide population-based targeted interventions to support smokers at varying stages of change toward quitting.

Determinants of heavy smoking: results from the global adult tobacco survey in Poland (2009-2010).

PubMed

Kaleta, Dorota; Makowiec-Dąbrowska, Teresa; Dziankowska-Zaborszczyk, Elżbieta; Fronczak, Adam

2012-03-01

The aim of current analysis was to identify socio-demographic correlates of heavy smoking. Global Adult Tobacco Survey (GATS), a nationally representative household study was implemented in Poland between 2009 and 2010. We used data on representative sample of 1915 adults, age 25 years and older. The Odds Ratios (OR) and 95% Confidence Intervals (CI) for heavy smoking to the broad number of variables including age, age at smoking onset, education, occupational classification, living conditions, place of residence, place of residence at age about 14 years, awareness of smoking health consequences were tested in logistic regression model. Among daily smokers the rate of heavy smokers was 63% in males and 45% in females (p < 0.001). The present study indicated that three characteristics: age, early age at smoking onset and lack of awareness of smoking health consequences were significantly associated with heavy smoking among both genders. Significantly higher risk of heavy smoking was observed among the 50-59 years of age population compared to the youngest group. The heavy smoking rate was highest among males who started smoking under age 14 years (OR = 3.1; 95% CI: 1.4-6.7; p < 0.001) and females that started smoking at age 14-17 years (OR = 2.3; 95% CI: 1.5-3.5; p < 0.0001) compared to those who started smoking at age 21 years or older. Heavy smoking was significantly correlated to lack of awareness of adverse health consequences of smoking (OR = 1.5; 95% CI: 1.1-2.03; p < 0.01 and OR = 1.5; 95% CI: 1.0-2.2; p < 0.01 for men and women, respectively) compared to aware respondents. These outcomes should be taken into account while developing tobacco control measures. Among other things, educational interventions to increase knowledge of adverse tobacco health effects should be widely implemented.

Contrasting Trends of Smoking Cessation Status: Insights From the Stages of Change Theory Using Repeat Data From the Global Adult Tobacco Survey, Thailand (2009 and 2011) and Turkey (2008 and 2012)

PubMed Central

Murty, PhD, Komanduri S.; Husain, PhD, Muhammad Jami; Bashir, MSC, Rizwan; Blutcher-Nelson, BSc, Glenda; Benjakul, PhD, Sarunya; Kengganpanich, PhD, Mondha; Erguder, MD, PhD, Toker; Keskinkilic, MD, Bekir; Polat, MD, Sertac; Sinha, MD, PhD, Dhirendra N.; Palipudi, PhD, Krishna; Ahluwalia, PhD, Indu B.

2017-01-01

Objective The World Health Organization recommends that smokers be offered help to quit. A better understanding of smokers’ interest in and commitment to quitting could guide tobacco control efforts. We assessed temporal differences in stages of change toward quitting among smokers in Thailand and Turkey. Methods Two waves (independent samples) of data from the Global Adult Tobacco Survey, a national household survey of adults aged 15 years or older, were assessed for Thailand (2009 and 2011) and Turkey (2008 and 2012). Current smokers were categorized into 3 stages of change based on their cessation status: precontemplation, contemplation, and preparation. Relative change in the proportion of smokers in each stage between waves 1 and 2 was computed for each country. Results Between waves, overall current tobacco smoking did not change in Thailand (23.7% to 24.0%) but declined in Turkey (31.2% to 27.1%; P < .001). Between 2009 and 2011, precontemplation increased among smokers in Thailand (76.1% to 85.4%; P < .001), whereas contemplation (17.6% to 12.0%; P < .001) and preparation (6.3% to 2.6%; P < .001) declined. Between 2008 and 2012, there were declines in precontemplation among smokers in Turkey (72.2% to 64.6%; P < .001), whereas there were increases in contemplation (21.2% to 26.9%; P = .008) and no significant change in preparation (6.5% to 8.5%; P = .097). Conclusion Nearly two-thirds of smokers in Turkey and more than two-thirds in Thailand were in the precontemplation stage during the last survey wave assessed. The proportion of smokers in the preparation stage increased in Turkey but declined in Thailand. Identifying stages of cessation helps guide population-based targeted interventions to support smokers at varying stages of change toward quitting. PMID:28570209

Comparing adult cannabis treatment-seekers enrolled in a clinical trial with national samples of cannabis users in the United States

PubMed Central

McClure, Erin A.; King, Jacqueline S.; Wahle, Aimee; Matthews, Abigail G.; Sonne, Susan C.; Lofwall, Michelle R.; McRae-Clark, Aimee L.; Ghitza, Udi E.; Martinez, Melissa; Cloud, Kasie; Virk, Harvir S.; Gray, Kevin M.

2017-01-01

Background Cannabis use rates are increasing among adults in the United States (US) while the perception of harm is declining. This may result in an increased prevalence of cannabis use disorder and the need for more clinical trials to evaluate efficacious treatment strategies. Clinical trials are the gold standard for evaluating treatment, yet study samples are rarely representative of the target population. This finding has not yet been established for cannabis treatment trials. This study compared demographic and cannabis use characteristics of a cannabis cessation clinical trial sample (run through National Drug Abuse Treatment Clinical Trials Network) with three nationally representative datasets from the US; 1) National Survey on Drug Use and Health, 2) National Epidemiologic Survey on Alcohol and Related Conditions-III, and 3) Treatment Episodes Data Set – Admissions. Methods Comparisons were made between the clinical trial sample and appropriate cannabis using sub-samples from the national datasets, and propensity scores were calculated to determine the degree of similarity between samples. Results Results showed that the clinical trial sample was significantly different from all three national datasets, with the clinical trial sample having greater representation among older adults, African Americans, Hispanic/Latinos, adults with more education, non-tobacco users, and daily and almost daily cannabis users. Conclusions These results are consistent with previous studies of other substance use disorder populations and extend sample representation issues to a cannabis use disorder population. This illustrates the need to ensure representative samples within cannabis treatment clinical trials to improve the generalizability of promising findings. PMID:28511033

Comparing adult cannabis treatment-seekers enrolled in a clinical trial with national samples of cannabis users in the United States.

PubMed

McClure, Erin A; King, Jacqueline S; Wahle, Aimee; Matthews, Abigail G; Sonne, Susan C; Lofwall, Michelle R; McRae-Clark, Aimee L; Ghitza, Udi E; Martinez, Melissa; Cloud, Kasie; Virk, Harvir S; Gray, Kevin M

2017-07-01

Cannabis use rates are increasing among adults in the United States (US) while the perception of harm is declining. This may result in an increased prevalence of cannabis use disorder and the need for more clinical trials to evaluate efficacious treatment strategies. Clinical trials are the gold standard for evaluating treatment, yet study samples are rarely representative of the target population. This finding has not yet been established for cannabis treatment trials. This study compared demographic and cannabis use characteristics of a cannabis cessation clinical trial sample (run through National Drug Abuse Treatment Clinical Trials Network) with three nationally representative datasets from the US; 1) National Survey on Drug Use and Health, 2) National Epidemiologic Survey on Alcohol and Related Conditions-III, and 3) Treatment: Episodes Data Set - Admissions. Comparisons were made between the clinical trial sample and appropriate cannabis using sub-samples from the national datasets, and propensity scores were calculated to determine the degree of similarity between samples. showed that the clinical trial sample was significantly different from all three national datasets, with the clinical trial sample having greater representation among older adults, African Americans, Hispanic/Latinos, adults with more education, non-tobacco users, and daily and almost daily cannabis users. These results are consistent with previous studies of other substance use disorder populations and extend sample representation issues to a cannabis use disorder population. This illustrates the need to ensure representative samples within cannabis treatment clinical trials to improve the generalizability of promising findings. Copyright © 2017 Elsevier B.V. All rights reserved.

Do Emotions Spark Interest in Alternative Tobacco Products?

ERIC Educational Resources Information Center

Popova, Lucy; So, Jiyeon; Sangalang, Angeline; Neilands, Torsten B.; Ling, Pamela M.

2017-01-01

Background: Exposure to advertisements for tobacco products and tobacco warning labels evokes emotions. This study evaluated the association of discrete positive and negative emotions with interest in alternative tobacco products. Method: In 2013, 1,226 U.S. adult nonsmokers and current smokers viewed advertisements for moist snuff, snus, and…

Application of the Smokeless Tobacco Expectancies Questionnaire to Snus

PubMed Central

Adkison, Sarah E.; Bansal-Travers, Maansi; Rees, Vaughan W.; Hatuskami, Dorothy K.; Cummings, K. Michael; O'Connor, Richard J.

2016-01-01

Objective Measures of consumer perceptions of emerging tobacco products are needed for understanding the potential for product adoption and use. The purpose of this research was to evaluate the applicability of the Smokeless Tobacco Expectancies questionnaire to snus, and examine its association with interest in using snus. Methods A web-based recruited 116 adolescents (14-17 years of age), 463 young adults (18-34 years of age), and 596 older adults (35-65 years of age) from a web-based opt-in panel. Participants completed a 10-item Snus Expectancies Questionnaire and questions about their interest in trying snus in the next month. Results Confirmatory factor analysis supported a latent factor structure representing Positive Reinforcement (PR) and Negative Health Consequences (NHC) within each age group. The scales differentiate smokers and smokeless tobacco users and nonusers. Each scale was associated with interest in purchasing snus for younger (PR: OR 1.90; NHC: OR 0.66) and older (PR: OR 1.36; NHC: OR 0.69) adults controlling for tobacco use status. Conclusions The modified Smokeless Tobacco Expectancies Questionnaire is a valid measure of snus-related outcome expectancies, which are in turn associated with self-reported tobacco use, and may help to identify groups who are susceptible to snus initiation and use. PMID:27561868

Young Adult Perceptions of the British American Tobacco New Zealand Agree/Disagree Plain Packaging Counter-Campaign.

PubMed

McCool, Judith; Wong-Cornall, Cecilia; Freeman, Becky

2017-10-01

In 2012, British American Tobacco New Zealand (BATNZ) launched a mass media campaign branded "Agree/ Disagree" as a response to the New Zealand government's plans to introduce plain packaging. We examined young adult's views about the campaign to assist tobacco control policymakers in planning future interventions. Interviews with young adults living in the Auckland area were conducted. Interviews covered existing knowledge about plain packaging of tobacco, knowledge about the tobacco industry, and perceptions of specific advertisements included in the campaign. Interview data were analyzed to determine the dominant views about the campaign. Perspectives from 12 interviews reflect the dominant discourse in New Zealand on the benefits of serving economic progress and international trade. Pervasive views about the campaigns reflected perceptions of the risk to the New Zealand image, trade, and economy. Similarly, participants expressed concern about the potential for plain packaging to creep toward other products, such as alcohol. Perceptions of the tobacco industry were mixed but reflect a tolerant view of the ethics of business if viewed to be beneficial to the economy. Participants were broadly accepting of the campaign messages. We identified a tendency toward quasi-libertarian leanings when discussing economics and trade, commercial versus personal responsibility, and the value of freedom (commercial and social). These perspectives were often held simultaneously with conflicting socially responsive values and references to the hegemonic position of "big business." This study affirms the importance of closely monitoring public opinion about tobacco control and of broadening denormalization strategies to reflect the critical role the tobacco industry plays in prolonging the tobacco epidemic. To date there is little evidence on the perceptions young adults hold toward to the tobacco industry and their arguments regarding the introduction of plain packaged cigarettes. Our findings indicate that some young people are attuned to the social discourse regarding the importance of economics, individuality, choice, and freedom as expressed by the tobacco industry. Tobacco control initiatives could challenge core values such as fairness and justice as related to corporate behaviors to retain public support, particularly among young people. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Exploring the relationship between cigarette prices and smoking among adults: a cross-country study of low- and middle-income nations.

PubMed

Kostova, Deliana; Tesche, Jean; Perucic, Anne-Marie; Yurekli, Ayda; Asma, Samira

2014-01-01

Evidence on the relationship between cigarette prices and adult smoking in low- and middle-income countries (LMICs) is relatively limited. This study offers new descriptive evidence on this relationship using data from a set of 13 LMICs. We use Global Adult Tobacco Survey (GATS) cross-country data from approximately 200,000 participants aged 15 and older. Estimates on the relationship between prices and adult smoking were obtained from logit models of smoking participation and ordinary least squares models of conditional cigarette demand. Higher prices were associated with lower demand across countries, in terms of both smoking prevalence and daily number of cigarettes smoked among smokers. Our estimates suggest that the total price elasticity of cigarette demand in LMICs is approximately -0.53. We find that higher socioeconomic status (SES), represented through wealth and education effects is associated with lower chance of smoking overall, but among existing smokers, it may be associated with a larger number of cigarettes smoked. After controlling for a set of individual demographic and country characteristics, cigarette prices retain a significant role in shaping cigarette demand across LMICs. Because higher SES is associated with a reduced chance of smoking overall but also with increased daily consumption among current smokers, optimal tobacco tax policies in LMICs may face an added need to accommodate to shifting SES structures within the populations of these countries.

Prevalence, distribution and correlates of tobacco smoking and chewing in Nepal: a secondary data analysis of Nepal Demographic and Health Survey-2006

PubMed Central

2011-01-01

Background Nearly four-fifths of estimated 1.1 million smokers live in low or middle-income countries. We aimed to provide national estimates for Nepal on tobacco use prevalence, its distribution across demographic, socio-economic and spatial variables and correlates of tobacco use. Methods A secondary data analysis of 2006 Nepal Demographic and Health Survey (DHS) was done. A representative sample of 9,036 households was selected by two-stage stratified, probability proportional to size (PPS) technique. We constructed three outcome variables 'tobacco smoke', 'tobacco chewer' and 'any tobacco use' based on four questions about tobacco use that were asked in DHS questionnaires. Socio-economic, demographic and spatial predictor variables were used. We computed overall prevalence for 'tobacco smoking', 'tobacco chewing' and 'any tobacco use' i.e. point estimates of prevalence rates, 95% confidence intervals (CIs) after adjustment for strata and clustering at primary sampling unit (PSU) level. For correlates of tobacco use, we used multivariate analysis to calculate adjusted odds ratios (AORs) and their 95% CIs. A p-value < 0.05 was considered as significant. Results Total number of households, eligible women and men interviewed was 8707, 10793 and 4397 respectively. The overall prevalence for 'any tobacco use', 'tobacco smoking' and 'tobacco chewing' were 30.3% (95% CI 28.9, 31.7), 20.7% (95% CI 19.5, 22.0) and 14.6% (95% CI 13.5, 15.7) respectively. Prevalence among men was significantly higher than women for 'any tobacco use' (56.5% versus 19.6%), 'tobacco smoking' (32.8% versus 15.8%) and 'tobacco chewing' (38.0% versus 5.0%). By multivariate analysis, older adults, men, lesser educated and those with lower wealth quintiles were more likely to be using all forms of tobacco. Divorced, separated, and widowed were more likely to smoke (OR 1.49, 95% CI 1.14, 1.94) and chew tobacco (OR 1.36, 95% CI 0.97, 1.93) as compared to those who were currently married. Prevalence of 'tobacco chewing' was higher in eastern region (19.7%) and terai/plains (16.2%). 'Tobacco smoking' and 'any tobacco use' were higher in rural areas, mid-western and far western and mountainous areas. Conclusions Prevalence of tobacco use is considerably high among Nepalese people. Demographic and socioeconomic determinants and spatial distribution should be considered while planning tobacco control interventions. PMID:22185233

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

PubMed

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

2015-06-01

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

Prevalence of tobacco use among junior high and senior high school students in Taiwan.

PubMed

Chen, Ping-Ling; Huang, Weigang; Chuang, Yi-Li; Warren, Charles W; Jones, Nathan R; Asma, Samira

2008-12-01

Tobacco use is a major preventable cause of death in the world. This article describes and compares tobacco use prevalence for students attending junior high schools and senior high schools in Taiwan. This report uses data from the Global Youth Tobacco Survey (GYTS) completed among 4689 junior high school students and 4426 senior high school students in Taiwan in 2004-2005. The GYTS uses a 2-stage sampling design to produce nationally representative data for junior and senior high students in general and vocational schools. Higher smoking prevalence was observed among senior high (10.1% general schools and 15.9% vocational schools) than junior high (5.5%) school students. Smoking prevalence of girls in junior high (3.2%) and senior high schools (4.6% general and 11.1% vocational) was almost as high or higher than adult females' (4.3%) smoking rates. The pattern of smoking intensity across school years and type of school shows that the percentage of smokers who were experimenters (47.1%) was higher in junior high school and the percentage of smokers who were regular/established smokers (over 50%) was higher in senior high school. Smoking prevalence described in this report shows that there are challenges facing the tobacco prevention and control program in Taiwan. The findings suggest that schools should increase their smoking initiation prevention efforts and make available cessation programs and counseling to help students quit smoking. If effective youth tobacco control programs are not developed and implemented in Taiwan, future morbidity and mortality attributed to tobacco will surely increase, especially among women.

Public health obesity-related TV advertising: lessons learned from tobacco.

PubMed

Emery, Sherry L; Szczypka, Glen; Powell, Lisa M; Chaloupka, Frank J

2007-10-01

Over the past 25 years, the percent of overweight and obese adults and children in the United States has increased dramatically. The magnitude and scope of the public health threat from obesity have resulted in calls for a national comprehensive obesity prevention strategy, akin to tobacco use prevention strategies undertaken over the past two decades. The purpose of this paper is to describe and compare population exposure to paid media campaigns for tobacco and obesity prevention, draw lessons from tobacco advertising, and compare tobacco and obesity behaviors/influences to identify priorities and pitfalls for further research on obesity adverting. This is a descriptive study. Ratings data for the years 1999-2003, for the top 75 designated market areas in the U.S. were used to quantify exposure levels to anti-obesity and anti-smoking advertising in the U.S. Anti-tobacco campaigns preceded anti-obesity campaigns by several years, and in each year exposure levels--both total and average--for anti-tobacco media campaigns far outweighed those of anti-obesity campaigns. It is important to compare both similarities and differences between smoking- and obesity-related behaviors, which might affect the potential impact of anti-obesity media campaigns. Given the scope of the public health risks attributable to obesity, and the amount of federal, state, and other resources devoted to anti-obesity media campaigns, there is a clear need to evaluate the potential impact of such campaigns efforts. Nonetheless, the challenges are significant in both motivating and monitoring such complex behavior change, and in attributing changes to a given media campaign.

Public Health Obesity-Related TV Advertising: Lessons Learned from Tobacco

PubMed Central

Emery, Sherry L.; Szczypka, Glen; Powell, Lisa M.; Chaloupka, Frank J.

2013-01-01

Background Over the past 25 years, the percent of overweight and obese adults and children in the United States has increased dramatically. The magnitude and scope of the public health threat from obesity have resulted in calls for a national comprehensive obesity prevention strategy, akin to tobacco use prevention strategies undertaken over the past two decades. The purpose of this paper is to describe and compare population exposure to paid media campaigns for tobacco and obesity prevention, draw lessons from tobacco advertising, and compare tobacco and obesity behaviors/influences to identify priorities and pitfalls for further research on obesity adverting. Methods This is a descriptive study. Ratings data for the years 1999–2003, for the top 75 designated market areas in the U.S. were used to quantify exposure levels to anti-obesity and anti-smoking advertising in the U.S. Results Anti-tobacco campaigns preceded anti-obesity campaigns by several years, and in each year exposure levels—both total and average—for anti-tobacco media campaigns far outweighed those of anti-obesity campaigns. Conclusions It is important to compare both similarities and differences between smoking- and obesity-related behaviors, which might affect the potential impact of anti-obesity media campaigns. Given the scope of the public health risks attributable to obesity, and the amount of federal, state, and other resources devoted to anti-obesity media campaigns, there is a clear need to evaluate the potential impact of such campaigns efforts. Nonetheless, the challenges are significant in both motivating and monitoring such complex behavior change, and in attributing changes to a given media campaign. PMID:17884574

A cluster randomized controlled trial of a brief tobacco cessation intervention for low-income communities in India: study protocol.

PubMed

Sarkar, Bidyut K; Shahab, Lion; Arora, Monika; Lorencatto, Fabiana; Reddy, K Srinath; West, Robert

2014-03-01

India has 275 million adult tobacco users and tobacco use is estimated to contribute to more than a million deaths in the country each year. There is an urgent need to develop and evaluate affordable, practicable and scalable interventions to promote cessation of tobacco use. Because tobacco use is so harmful, an increase of as little as 1 percentage point in long-term quit success rates can have an important public health impact. This protocol paper describes the rationale and methods of a large randomized controlled trial which aims to evaluate the effectiveness of a brief scalable smoking cessation intervention delivered by trained health professionals as an outreach programme in poor urban communities in India. This is a pragmatic, two-arm, community-based cluster randomized controlled trial focused on tobacco users in low-income communities. The treatment arm is a brief intervention comprising brief advice including training in craving control using simple yogic breathing exercises (BA-YBA) and the control arm is very brief advice (VBA). Of a total of 32 clusters, 16 will be allocated to the intervention arm and 16 to the control arm. Each cluster will have 31 participants, making a total of 992 participants. The primary outcome measure will follow the Russell Standard: self-report of sustained abstinence for at least 6 months following the intervention confirmed at the final follow-up by salivary cotinine. This trial will inform national and international policy on delivery of scalable and affordable brief outreach interventions to promote tobacco use cessation in low resource settings where tobacco users have limited access to physicians and medications. © 2014 Society for the Study of Addiction.

Testing messages to reduce smokers' openness to using novel smokeless tobacco products.

PubMed

Popova, Lucy; Neilands, Torsten B; Ling, Pamela M

2014-07-01

Tobacco manufacturers' aggressive promotion of new smokeless tobacco products such as snus warrants a timely and effective public health response. This study tested potential countermarketing messages to discourage current and former smokers from becoming dual users of smokeless tobacco and cigarettes. In a pretest-post-test experiment, 1836 adult current and recently former smokers from a national sample were randomised to view one of six antismokeless tobacco ads followed by a snus ad, to view a control ad followed by a snus ad; or to view two control ads. Perceived effectiveness of ads and actual changes in attitudes and openness to snus were compared across groups using analyses of variance. Some ads that were perceived as most effective did not change attitudes or openness to trying snus, and conversely, some ads not perceived as effective changed attitudes and openness to snus. Ads portraying the negative health effects of smokeless tobacco were perceived as most effective, but ads with antitobacco industry themes significantly decreased favourable attitudes toward snus. Responses to ads were different for smokers who had ever used smokeless tobacco: for this group health effects and humorous/testimonial ads were effective. Measures of perceived effectiveness of antitobacco ads need to be augmented with measures of actual effectiveness to assess countermarketing messages. Some of the developed ads, such as ads with anti-industry themes, were effective for the overall population of smokers whereas humorous/testimonial and health effects ads were particularly effective in changing attitudes of past users of smokeless tobacco. 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.

Real Time Assessment of Young Adults' Attitudes toward Tobacco Messages.

PubMed

Hébert, Emily T; Vandewater, Elizabeth A; Businelle, Michael S; Harrell, Melissa B; Kelder, Steven H; Perry, Cheryl L

2018-01-01

We used ecological momentary assessment (EMA) to examine young adults' attitudes towards pro-tobacco messages encountered in real time and their association with intentions to use tobacco. Young adults (N = 92, ages 18-29) recorded sightings of marketing or social media related to tobacco in real time via mobile app for 28 days. Participants reported message characteristics, their attitudes towards the message, and intentions to use the depicted product for each submission. We used generalized linear mixed models to examine factors related to attitude towards message and intentions to use tobacco. Messages depicting e-cigarettes (p < .001) or hookah (p < .05) were associated with significantly more favorable attitudes compared with traditional cigarettes. Positive attitude towards the message was significantly associated with intention to use the depicted product (p < .001). Messages depicting e-cigarettes and hookah were significantly associated with higher intention to use. Message source was not significantly related to attitudes towards the message or product use intentions. Marketing featuring e-cigarettes and hookah is an important target for future regulation. Given that pro-tobacco and e-cigarette messages are prevalent online, future research should consider the Internet and social media as important venues for counter-marketing and intervention efforts.

Epidemiology of tobacco use and dependence in adults in a poor peri-urban community in Lima, Peru

PubMed Central

2012-01-01

Background Tobacco smoking is an important public health concern worldwide leading to both chronic disease and early death. In Latin America, smoking prevalence is estimated at approximately 30% and prior studies suggest that the prevalence in Peru is 22% to 38%. We sought to determine the prevalence of daily smoking in a poor peri-urban community in Lima, Peru. Methods We conducted a cross-sectional survey in a random sample of adults ≥40 years of age living in Pampas de San Juan de Miraflores, Lima, Peru. We asked participants to respond to a survey that included questions on sociodemographics, tobacco use and dependence. Results We enrolled 316 participants. Average monthly household income was ≤ 400 USD and nearly all homes had running water, sewage, and electricity. Most individuals had not completed high school. Smoking prevalence was 16% overall, yet daily smoking prevalence was 1.9%. Former daily smokers comprised 3.8% of current nonsmokers and 9.1% current occasional smokers. Average scores for the Fagerstrom Test for Nicotine Dependence for daily smokers and occasional smokers were 1.5 and 0, respectively. Conclusions Daily use of tobacco is uncommon among adults in peri-urban communities of Lima, Peru, unlike their counterparts in Lima and other Latin American capital cities. Tobacco dependence is also low. Hence, efforts aimed at primary prevention are of utmost importance in these communities. This study provides an accurate baseline using an internationally recognized assessment tool (Global Adult Tobacco Survey), allowing for accurate assessment of tobacco control interventions over time. PMID:22429737

Epidemiology of tobacco use and dependence in adults in a poor peri-urban community in Lima, Peru.

PubMed

Weygandt, Paul Logan; Vidal-Cardenas, Elisa; Gilman, Robert H; Avila-Tang, Erika; Cabrera, Lilia; Checkley, William

2012-03-19

Tobacco smoking is an important public health concern worldwide leading to both chronic disease and early death. In Latin America, smoking prevalence is estimated at approximately 30% and prior studies suggest that the prevalence in Peru is 22% to 38%. We sought to determine the prevalence of daily smoking in a poor peri-urban community in Lima, Peru. We conducted a cross-sectional survey in a random sample of adults ≥40 years of age living in Pampas de San Juan de Miraflores, Lima, Peru. We asked participants to respond to a survey that included questions on sociodemographics, tobacco use and dependence. We enrolled 316 participants. Average monthly household income was ≤ 400 USD and nearly all homes had running water, sewage, and electricity. Most individuals had not completed high school. Smoking prevalence was 16% overall, yet daily smoking prevalence was 1.9%. Former daily smokers comprised 3.8% of current nonsmokers and 9.1% current occasional smokers. Average scores for the Fagerstrom Test for Nicotine Dependence for daily smokers and occasional smokers were 1.5 and 0, respectively. Daily use of tobacco is uncommon among adults in peri-urban communities of Lima, Peru, unlike their counterparts in Lima and other Latin American capital cities. Tobacco dependence is also low. Hence, efforts aimed at primary prevention are of utmost importance in these communities. This study provides an accurate baseline using an internationally recognized assessment tool (Global Adult Tobacco Survey), allowing for accurate assessment of tobacco control interventions over time.

Joe Camel with Feathers. How the NRA with Gun and Tobacco Industry Dollars Uses Its Eddie Eagle Program To Market Guns to Kids.

ERIC Educational Resources Information Center

Glick, Susan; Sugarmann, Josh

The National Rifle Association (NRA) has developed its Eddie Eagle program as a school-based curriculum that claims to teach gun safety to children in preschool through grade six. The program uses a four-part message for children to follow when they see a gun, admonishing them to stop, not touch it, leave the area, and tell an adult. The NRA has…

Tobacco smoking.

PubMed

Charles, Janice; Valenti, Lisa; Britt, Helena

2014-06-01

Worldwide, 22% of adults aged ≥15 years currently smoke tobacco. Up to half of current smokers will eventually die of a tobacco-related disease, and smoking is the leading cause of ill health, drug-related death and hospital separations in Australia.

Impact of a U.S. antismoking national media campaign on beliefs, cognitions and quit intentions

PubMed Central

Duke, Jennifer C.; Davis, Kevin C.; Alexander, Robert L.; MacMonegle, Anna J.; Fraze, Jami L.; Rodes, Robert M.; Beistle, Diane M.

2015-01-01

In 2012, the Centers for Disease Control and Prevention launched a national tobacco education campaign, Tips From Former Smokers, that consisted of graphic, emotionally evocative, testimonial-style advertisements. This longitudinal study examines changes in beliefs, tobacco-related cognitions and intentions to quit smoking among U.S. adult smokers after a 12-week airing of the campaign (n=4040 adult smokers pre- and post-campaign). Exposure to the campaign was associated with greater odds of intending to quit within the next 30 days [odds ratio (OR)=1.28, P < 0.01] and within the next 6 months (OR=1.12, P < 0.05), and quit intentions were stronger among respondents with greater campaign exposure (OR=1.12, P < 0.01). Campaign exposure was also associated with significant changes in beliefs about smoking-related risks (ORs=1.15–2.40) and increased worries about health (b=0.30, P < 0.001). Based on study change rates applied to U.S. census data, an estimated 566 000 additional U.S. smokers reported their intention to quit smoking within the next 6 months as a result of viewing campaign advertisements. Campaign effects were consistent with the theory of reasoned action and an expanding body of research demonstrating that graphic, emotional advertisements are highly effective for prompting positive cessation-related cognitions and behavioral intentions. PMID:25976009

Effect of smokeless tobacco product marketing and use on population harm from tobacco use policy perspective for tobacco-risk reduction.

PubMed

Kozlowski, Lynn T

2007-12-01

This article presents policy perspectives on the marketing of smokeless tobacco products to reduce population harm from tobacco use. Despite consensus that smokeless tobacco products as sold in the United States are less dangerous than cigarettes, there is no consensus on how to proceed. Diverse factions have different policy concerns. While the tobacco industry is exempted from U.S. Food and Drug Administration (FDA) oversight, the pharmaceutical industry whose nicotine replacement therapy (NRT) medicines compete with smokeless tobacco as noncombustible nicotine-delivery systems are regulated by the FDA. Some public health experts support smokeless tobacco use to reduce population harm from tobacco; other public health experts oppose promoting smokeless tobacco for harm reduction. Adult consumers can freely purchase currently-marketed smokeless tobacco products and even more-deadly cigarettes. Concerns with and advantages of smokeless tobacco products are discussed. In that noncombustible medicinal nicotine-delivery systems have been proven to be effective smoking-cessation aids, smokeless tobacco, as another source of psychoactive doses of nicotine, could be used similarly, in a dose-response fashion as a smoking-cessation aid (consistent with FDA principles for evaluating generic versions of drugs). Price measures should be used on tobacco products to make costs to consumers proportional to product health risks (which would make smokeless tobacco much cheaper than cigarettes), and smokeless tobacco should be encouraged as an option for smoking cessation in adult smokers, particularly for those who have failed to stop smoking using NRT or other methods.

Tobacco and alcohol sales in community pharmacies: policy statements from U.S. professional pharmacy associations.

PubMed

Corelli, Robin L; Chai, Tiffany; Karic, Alda; Fairman, Melinda; Baez, Karina; Hudmon, Karen Suchanek

2014-01-01

To characterize the extent to which state and national professional pharmacy associations have implemented formal policies addressing the sale of tobacco and alcohol products in community pharmacies. To determine existence of tobacco and alcohol policies, national professional pharmacy associations (n = 10) and state-level pharmacy associations (n = 86) affiliated with the American Pharmacists Association (APhA) and/or the American Society of Health-System Pharmacists (ASHP) were contacted via telephone and/or e-mail, and a search of the association websites was conducted. Of 95 responding associations (99%), 14% have a formal policy opposing the sale of tobacco products in pharmacies and 5% have a formal policy opposing the sale of alcohol in pharmacies. Of the associations representing major tobacco-producing states, 40% have a formal policy against tobacco sales in pharmacies, significantly more than the 8% of non-tobacco state associations with such policies. Among national professional pharmacy associations, only APhA and ASHP have formal policy statements opposing the sale of both tobacco and alcohol in pharmacies. Most state-level professional pharmacy associations affiliated with these two national organizations have no formal policy statement or position.

Achieving the Framework Convention on Tobacco Control's potential by investing in national capacity.

PubMed

Wipfli, H; Stillman, F; Tamplin, S; da Costa e Silva, V Luiza; Yach, D; Samet, J

2004-12-01

May 2003 marked a critical achievement in efforts to stem the global tobacco epidemic, as the member states of the World Health Organization unanimously endorsed the Framework Convention on Tobacco Control (FCTC). However, the adoption of the FCTC signifies only the end of the beginning of effective global action to control tobacco. Over the next several years the utility of the FCTC process and the treaty itself will be tested as individual countries seek to ratify and implement the treaty's obligations. Significant barriers to the treaty's long term success exist in many countries. It is crucial that the international tobacco control community now refocuses its efforts on national capacity building and ensures that individual countries have the knowledge, tools, data, people, and organisations needed to implement the convention and develop sustained tobacco control programmes. This paper provides a model of national tobacco control capacity and offers a prioritised agenda for action.

Bar and Club Tobacco Promotions in the Alternative Press: Targeting Young Adults.

ERIC Educational Resources Information Center

Sepe, Edward; Glantz, Stanton A.

2002-01-01

Investigated changes in tobacco promotions in two alternative newspapers in San Francisco and Philadelphia from 1994-99. Results indicated that the numbers of tobacco advertisements increased dramatically during those years. The tobacco industry increased its use of bars and clubs as promotional venues and used the alternative press to reach young…

Flavored e-cigarette use: Characterizing youth, young adult, and adult users.

PubMed

Harrell, M B; Weaver, S R; Loukas, A; Creamer, M; Marti, C N; Jackson, C D; Heath, J W; Nayak, P; Perry, C L; Pechacek, T F; Eriksen, M P

2017-03-01

The purpose of this study is to investigate how the use of flavored e-cigarettes varies between youth (12-17 years old), young adults (18-29 years old), and older adults (30 + years old). Cross-sectional surveys of school-going youth ( n  = 3907) and young adult college students ( n  = 5482) in Texas, and young adults and older adults ( n  = 6051) nationwide were administered in 2014-2015. Proportions and 95% confidence intervals were used to describe the percentage of e-cigarette use at initiation and in the past 30 days that was flavored, among current e-cigarette users. Chi-square tests were applied to examine differences by combustible tobacco product use and demographic factors. Most e-cigarette users said their first and "usual" e-cigarettes were flavored. At initiation, the majority of Texas school-going youth (98%), Texas young adult college students (95%), and young adults (71.2%) nationwide said their first e-cigarettes were flavored to taste like something other than tobacco, compared to 44.1% of older adults nationwide. Fruit and candy flavors predominated for all groups; and, for youth, flavors were an especially salient reason to use e-cigarettes. Among adults, the use of tobacco flavor at initiation was common among dual users (e-cigarettes + combustible tobacco), while other flavors were more common among former cigarette smokers (P = 0.03). Restricting the range of e-cigarette flavors (e.g., eliminating sweet flavors, like fruit and candy) may benefit youth and young adult prevention efforts. However, it is unclear what impact this change would have on adult smoking cessation.

Perceived Effectiveness of Tobacco Countermarketing Advertisements among Young Adults

ERIC Educational Resources Information Center

Murphy-Hoefer, Rebecca; Hyland, Andrew; Higbee, Cheryl

2008-01-01

Objectives: To measure relative effectiveness of tobacco countermarketing advertisements by category and emotive execution style among young adults. Methods: Participants (n = 1011) from 2 US 4-year colleges, one southern and one northern were surveyed before and after viewing advertisements in one of 3 categories: social norms, health…

Effects of State-Level Tobacco Environment on Cigarette Smoking are Stronger Among Those With Individual-Level Risk Factors.

PubMed

Shmulewitz, Dvora; Stohl, Malka; Keyes, Katherine M; Brown, Qiana; Saha, Tulshi D; Hasin, Deborah

2016-10-01

To better understand the impact of the state-level tobacco environment (eg, tobacco control policies, attitudes towards smoking) on cigarette smoking, we examined whether the relationship of state tobacco environments to smoking is modified by individual-level vulnerability factors. In a nationally representative sample of US adults (N = 34 638), past-year smoking and heavy smoking were examined. State-level tobacco environment was defined by tobacco-related control policies and attitudes, ranging from permissive to restrictive; individual vulnerability was defined by childhood maltreatment and/or parental substance problems. Additive interaction tested differences in state-level tobacco environment effects on smoking and heavy smoking by individual-level vulnerability. Significant interactions (P values < .01) indicated that the state tobacco environment had the strongest relationship to smoking outcomes among individuals with greatest individual vulnerability. For example, among respondents with childhood maltreatment and parental substance problems, those in states with permissive tobacco environments had 13.3% greater prevalence of smoking than those in restrictive states. Among respondents with neither individual-level risk factor, those in permissive states had 2.8% greater prevalence than those in restrictive states (interaction P value = .0002). Further restricting states' smoking environments could help reduce the prevalence of smoking and heavy smoking, particularly among those at increased individual risk in the general population. This study shows that the protective effect of restrictive state-level tobacco environments on smoking or heavy smoking was stronger among those especially vulnerable due to individual-level risk factors (parental substance problems, childhood maltreatment). Thus, public health campaigns to influence attitudes towards smoking or legislation to strengthen tobacco control could have a broad effect, particularly impacting those with vulnerability to smoking, which may help decrease smoking prevalence and reduce the massive public health burden of tobacco-related morbidity and mortality. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Tobacco Retail Environments and Social Inequalities in Individual-Level Smoking and Cessation Among Scottish Adults.

PubMed

Pearce, Jamie; Rind, Esther; Shortt, Niamh; Tisch, Catherine; Mitchell, Richard

2016-02-01

Many neighborhood characteristics may constrain or enable smoking. This study investigated whether the neighborhood tobacco retail environment was associated with individual-level smoking and cessation in Scottish adults, and whether inequalities in smoking status were related to tobacco retailing. Tobacco outlet density measures were developed for neighborhoods across Scotland using the September 2012 Scottish Tobacco Retailers Register. The outlet data were cleaned and geocoded (n = 10,161) using a Geographic Information System. Kernel density estimation was used to calculate an outlet density measure for each postcode. The kernel density estimation measures were then appended to data on individuals included in the 2008-2011 Scottish Health Surveys (n = 28,751 adults aged ≥16), via their postcode. Two-level logistic regression models examined whether neighborhood density of tobacco retailing was associated with current smoking status and smoking cessation and whether there were differences in the relationship between household income and smoking status, by tobacco outlet density. After adjustment for individual- and area-level confounders, compared to residents of areas with the lowest outlet densities, those living in areas with the highest outlet densities had a 6% higher chance of being a current smoker, and a 5% lower chance of being an ex-smoker. There was little evidence to suggest that inequalities in either current smoking or cessation were narrower in areas with lower availability of tobacco retailing. The findings suggest that residents of environments with a greater availability of tobacco outlets are more likely to start and/or sustain smoking, and less likely to quit. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Developing a Point-of-Sale Health Communication Campaign for Cigarillos and Waterpipe Tobacco.

PubMed

Sutfin, Erin L; Cornacchione Ross, Jennifer; Lazard, Allison J; Orlan, Elizabeth; Suerken, Cynthia K; Wiseman, Kimberly D; Reboussin, Beth A; Wolfson, Mark; Noar, Seth M

2017-12-13

Adolescents and young adults smoke waterpipe tobacco (WT) and cigarillos, at least in part, based on erroneous beliefs that these products are safer than cigarettes. To address this challenge, we used a systematic, three-phase process to develop a health communication campaign to discourage WT and cigarillo smoking among at-risk (tobacco users and susceptible non-users) 16- to 25-year-olds. In Phase 1, we used a national phone survey (N = 896) to determine salient message beliefs. Participants reported constituents (i.e., harmful chemicals) emitted by the products were worrisome. In Phase 2, we developed and evaluated four message executions, with varying imagery, tone, and unappealing products with the same constituents, using focus groups (N = 38). Participants rated one execution highly, resulting in our development of a campaign where each message: (1) identified a tobacco product and constituent in the smoke; (2) included an image of an unappealing product containing the constituent (e.g., pesticides, gasoline) to grab attention; and (3) used a humorous sarcastic tone. In Phase 3, we tested the campaign messages (17 intervention and six control) with a nationally representative online survey (N = 1,636). Participants rated intervention and control messages highly with few differences between them. Exposure to messages resulted in significant increases in all risk beliefs from pre to post (p < 0.05). For WT, intervention messages increased beliefs about addiction more than control messages (p < 0.05). This systematic, iterative approach resulted in messages that show promise for discouraging WT and cigarillo use.

China: the tipping point in tobacco control.

PubMed

Mackay, Judith

2016-12-01

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

Associations Between Initial Water Pipe Tobacco Smoking and Snus Use and Subsequent Cigarette Smoking Results From a Longitudinal Study of US Adolescents and Young Adults

PubMed Central

Soneji, Samir; Sargent, James D.; Tanski, Susanne E.; Primack, Brian A.

2015-01-01

IMPORTANCE Many adolescents and young adults use alternative tobacco products, such as water pipes and snus, instead of cigarettes. OBJECTIVE To assess whether prior water pipe tobacco smoking and snus use among never smokers are risk factors for subsequent cigarette smoking. DESIGN, SETTING, AND PARTICIPANTS We conducted a 2-wave national longitudinal study in the United States among 2541 individuals aged 15 to 23 years old. At baseline (October 25, 2010, through June 11, 2011), we ascertained whether respondents had smoked cigarettes, smoked water pipe tobacco, or used snus. At the 2-year follow-up (October 27, 2012, through March 31, 2013), we determined whether baseline non–cigarette smokers had subsequently tried cigarette smoking, were current (past 30 days) cigarette smokers, or were high-intensity cigarette smokers. We fit multivariable logistic regression models among baseline non–cigarette smokers to assess whether baseline water pipe tobacco smoking and baseline snus use were associated with subsequent cigarette smoking initiation and current cigarette smoking, accounting for established sociodemographic and behavioral risk factors. We fit similarly specified multivariable ordinal logistic regression models to assess whether baseline water pipe tobacco smoking and baseline snus use were associated with high-intensity cigarette smoking at follow-up. EXPOSURES Water pipe tobacco smoking and the use of snus at baseline. MAIN OUTCOMES AND MEASURES Among baseline non–cigarette smokers, cigarette smoking initiation, current (past 30 days) cigarette smoking at follow-up, and the intensity of cigarette smoking at follow-up. RESULTS Among 1596 respondents, 1048 had never smoked cigarettes at baseline, of whom 71 had smoked water pipe tobacco and 20 had used snus at baseline. At follow-up, accounting for behavioral and sociodemographic risk factors, baseline water pipe tobacco smoking and snus use were independently associated with cigarette smoking initiation (adjusted odds ratios: 2.56; 95% CI, 1.46-4.47 and 3.73; 95% CI, 1.43-9.76, respectively), current cigarette smoking (adjusted odds ratios: 2.48; 95% CI, 1.01-6.06 and 6.19; 95% CI, 1.86-20.56, respectively), and higher intensity of cigarette smoking (adjusted proportional odds ratios: 2.55; 95% CI, 1.48-4.38 and 4.45; 95% CI, 1.75-11.27, respectively). CONCLUSIONS AND RELEVANCE Water pipe tobacco smoking and the use of snus independently predicted the onset of cigarette smoking and current cigarette smoking at follow-up. Comprehensive Food and Drug Administration regulation of these tobacco products may limit their appeal to youth and curb the onset of cigarette smoking. PMID:25485959

Tobacco-Related Mortality

MedlinePlus

... 770-488-5493. Fact Sheets Adult Data Cessation Economics Fast Facts Health Effects Secondhand Smoke Smokeless Tobacco Tobacco Marketing and Products ... Instagram Listen Watch RSS ABOUT About CDC Jobs Funding LEGAL ... U.S. Department of Health & Human Services HHS/Open USA.gov TOP

Waterpipe Tobacco Smoking in Turkey: Policy Implications and Trends from the Global Adult Tobacco Survey (GATS)

PubMed Central

Erdöl, Cevdet; Ergüder, Toker; Morton, Jeremy; Palipudi, Krishna; Gupta, Prakash; Asma, Samira

2015-01-01

Waterpipe tobacco smoking (WTS) is an emerging tobacco product globally, especially among adolescents and young adults who may perceive WTS as a safe alternative to smoking cigarettes. Monitoring the use of WTS in Turkey in relation to the tobacco control policy context is important to ensure that WTS does not become a major public health issue in Turkey. The Global Adult Tobacco Survey (GATS) was conducted in Turkey in 2008 and was repeated in 2012. GATS provided prevalence estimates on current WTS and change over time. Other indicators of WTS were also obtained, such as age of initiation and location of use. Among persons aged 15 and older in Turkey, the current prevalence of WTS decreased from 2.3% in 2008 to 0.8% in 2012, representing a 65% relative decline. Among males, WTS decreased from 4.0% to 1.1% (72% relative decline). While the overall smoking prevalence decreased among females, there was no change in the rate of WTS (0.7% in 2008 vs. 0.5% in 2012), though the WTS prevalence rate was already low in 2008. Comprehensive tobacco control efforts have been successful in reducing the overall smoking prevalence in Turkey, which includes the reduction of cigarette smoking and WTS. However, it is important to continue monitoring the use of waterpipes in Turkey and targeting tobacco control efforts to certain groups that may be vulnerable to future WTS marketing (e.g., youth, women). PMID:26670238

Waterpipe Tobacco Smoking in Turkey: Policy Implications and Trends from the Global Adult Tobacco Survey (GATS).

PubMed

Erdöl, Cevdet; Ergüder, Toker; Morton, Jeremy; Palipudi, Krishna; Gupta, Prakash; Asma, Samira

2015-12-08

Waterpipe tobacco smoking (WTS) is an emerging tobacco product globally, especially among adolescents and young adults who may perceive WTS as a safe alternative to smoking cigarettes. Monitoring the use of WTS in Turkey in relation to the tobacco control policy context is important to ensure that WTS does not become a major public health issue in Turkey. The Global Adult Tobacco Survey (GATS) was conducted in Turkey in 2008 and was repeated in 2012. GATS provided prevalence estimates on current WTS and change over time. Other indicators of WTS were also obtained, such as age of initiation and location of use. Among persons aged 15 and older in Turkey, the current prevalence of WTS decreased from 2.3% in 2008 to 0.8% in 2012, representing a 65% relative decline. Among males, WTS decreased from 4.0% to 1.1% (72% relative decline). While the overall smoking prevalence decreased among females, there was no change in the rate of WTS (0.7% in 2008 vs. 0.5% in 2012), though the WTS prevalence rate was already low in 2008. Comprehensive tobacco control efforts have been successful in reducing the overall smoking prevalence in Turkey, which includes the reduction of cigarette smoking and WTS. However, it is important to continue monitoring the use of waterpipes in Turkey and targeting tobacco control efforts to certain groups that may be vulnerable to future WTS marketing (e.g., youth, women).

Tobacco sales in pharmacies: time to quit

PubMed Central

Hudmon, K Suchanek; Fenlon, C M; Corelli, R L; Prokhorov, A V; Schroeder, S A

2006-01-01

Objective To assess the pharmacy profession's perceptions of tobacco sales in US pharmacies and explore whether a policy prohibiting sales of tobacco in pharmacies would alter adult consumer shopping behaviour. Subjects and design In California, surveys were administered to 1168 licensed pharmacists and 1518 pharmacy students, and telephone interviews were conducted with 988 adult consumers. Results Most (58.1%) licensed pharmacists were strongly against sales of tobacco in pharmacies, 23.6% were against it, 16.7% were neutral, 1.2% were in favour of it, and 0.4% were strongly in favour of it. Pharmacists who were current tobacco users were more likely to be in favour of tobacco sales in pharmacies than were pharmacists who were current non‐users (p < 0.005). Similar statistics were observed for pharmacy students. Most consumers (72.3%) disagreed with the statement, “I am in favour of tobacco products being sold in drugstores”; 82.6% stated that if the drugstore where they most commonly shopped were to stop selling tobacco products, they would shop there just as often, 14.2% would shop there more often, and 3.2% would shop there less often. Conclusion Little professional or public support exists for tobacco sales in pharmacies. PMID:16436403

Tobacco sales in pharmacies: time to quit.

PubMed

Hudmon, K Suchanek; Fenlon, C M; Corelli, R L; Prokhorov, A V; Schroeder, S A

2006-02-01

To assess the pharmacy profession's perceptions of tobacco sales in US pharmacies and explore whether a policy prohibiting sales of tobacco in pharmacies would alter adult consumer shopping behaviour. In California, surveys were administered to 1168 licensed pharmacists and 1518 pharmacy students, and telephone interviews were conducted with 988 adult consumers. Most (58.1%) licensed pharmacists were strongly against sales of tobacco in pharmacies, 23.6% were against it, 16.7% were neutral, 1.2% were in favour of it, and 0.4% were strongly in favour of it. Pharmacists who were current tobacco users were more likely to be in favour of tobacco sales in pharmacies than were pharmacists who were current non-users (p < 0.005). Similar statistics were observed for pharmacy students. Most consumers (72.3%) disagreed with the statement, "I am in favour of tobacco products being sold in drugstores"; 82.6% stated that if the drugstore where they most commonly shopped were to stop selling tobacco products, they would shop there just as often, 14.2% would shop there more often, and 3.2% would shop there less often. Little professional or public support exists for tobacco sales in pharmacies.

[Factors related to awareness on tobacco advertisement and promotion among adults in six cities in China].

PubMed

Yang, Yan; Wu, Xi; Li, Qiang; Jiao, Shu-fang; Li, Xun; Li, Xin-jian; Zhu, Guo-ping; Du, Lin; Zhao, Jian-hua; Jiang, Yuan; Feng, Guo-ze

2009-04-01

To know the situation of tobacco advertisement, promotions and related factors in six cities in China. 4815 adults (above 18 years), selected form Beijing, Shanghai, Shenyang, Changsha, Guangzhou and Yinchuan through probability proportionate sampling and simple random sampling, were investigated through questionnaires. The most commonly reported channels that smokers noticed tobacco advertisements were billboards (35.6%) and television (34.4%). The most commonly reported tobacco promotional activities that were noticed by smokers were free gifts when buying cigarettes (23.1%) and free samples of cigarettes (13.9%). Smokers in Changsha were more likely to report noticing tobacco advertisement on billboards (chi2 = 562.474, P < 0.00 1), and on television (chi2 = 265.570, P < 0.001). Smokers in Changsha (chi2 = 58.314, P < 0.001) were more likely to notice tobacco related news and games. A logistic regression analysis showed that the living and education level were related to awareness of tobacco advertisement and promotion. It was universal to see tobacco advertisement and promotions in cities in China but the laws and regulations about tobacco-control were not uniformly executed in different cities. It is necessary to perfect and uniform related laws and regulations.

Adult mortality of diseases and injuries attributable to selected metabolic, lifestyle, environmental, and infectious risk factors in Taiwan: a comparative risk assessment.

PubMed

Lo, Wei-Cheng; Ku, Chu-Chang; Chiou, Shu-Ti; Chan, Chang-Chuan; Chen, Chi-Ling; Lai, Mei-Shu; Lin, Hsien-Ho

2017-05-03

To facilitate priority-setting in health policymaking, we compiled the best available information to estimate the adult mortality (>30 years) burden attributable to 13 metabolic, lifestyle, infectious, and environmental risk factors in Taiwan. We obtained data on risk factor exposure from nationally representative health surveys, cause-specific mortality from the National Death Registry, and relative risks from epidemiological studies and meta-analyses. We applied the comparative risk assessment framework to estimate mortality burden attributable to individual risk factors or risk factor clusters. In 2009, high blood glucose accounted for 14,900 deaths (95% UI: 11,850-17,960), or 10.4% of all deaths in that year. It was followed by tobacco smoking (13,340 deaths, 95% UI: 10,330-16,450), high blood pressure (11,190 deaths, 95% UI: 8,190-14,190), ambient particulate matter pollution (8,600 deaths, 95% UI: 7,370-9,840), and dietary risks (high sodium intake and low intake of fruits and vegetables, 7,890 deaths, 95% UI: 5,970-9,810). Overweight-obesity and physical inactivity accounted for 7,620 deaths (95% UI: 6,040-9,190), and 7,400 deaths (95% UI: 6,670-8,130), respectively. The cardiometabolic risk factors of high blood pressure, high blood glucose, high cholesterol, and overweight-obesity jointly accounted for 12,120 deaths (95% UI: 11,220-13,020) from cardiovascular diseases. For domestic risk factors, infections from hepatitis B virus (HBV) and hepatitis C virus (HCV) were responsible for 6,300 deaths (95% UI: 5,610-6,980) and 3,170 deaths (95% UI: 1,860-4,490), respectively, and betel nut use was associated with 1,780 deaths from oral, laryngeal, and esophageal cancer (95% UI: 1,190-2,360). The leading risk factors for years of life lost were similar, but the impact of tobacco smoking and alcohol use became larger because the attributable deaths from these risk factors occurred among young adults aged less than 60 years. High blood glucose, tobacco smoking, and high blood pressure are the major risk factors for deaths from diseases and injuries among Taiwanese adults. A large number of years of life would be gained if the 13 modifiable risk factors could be removed or reduced to the optimal level.

Characterizing Young Adults' Susceptibility to Waterpipe Tobacco Use and Their Reactions to Messages About Product Harms and Addictiveness.

PubMed

Lipkus, Isaac M; Mays, Darren; P Tercyak, Kenneth

2017-10-01

There is very little insight into the psychosocial characteristics of young adults susceptible to waterpipe tobacco use and their reactions to messages about harms of waterpipe tobacco smoking (WTS). We investigated how young adults who were or were not susceptible to WTS differed on various characteristics and their reactions to messages about WTS harms. Young adults ages 18 to 30 who had never used waterpipe tobacco were recruited through an online crowdsourcing site. Participants were stratified on susceptibility status (susceptible or not) and randomized to receive messages about harms and addictiveness of WTS or a control condition that received no messages. Participants' perceptions of risk and worry, their attitudes toward, and willingness/curiosity to try WTS were assessed. Compared to nonsusceptible participants, susceptible participants perceived themselves to be at lower risk and worried less about harms and addictiveness of WTS, had more positive attitudes toward use, and expressed a greater willingness and curiosity to try it. Among susceptible participants, messages decreased willingness/curiosity to try WTS; messages had no effect on nonsusceptible participants. The message effects among susceptible participants were explained by more negative attitudes and less ambivalence toward WTS. Susceptible young adults' psychosocial characteristics place them at high risk for future uptake of WTS. Brief public health messages about harm and addiction may deter susceptible young adults' willingness to try WTS and prevent WTS initiation and progression. Findings suggest that in order to curb the initiation of WTS among susceptible young adults, interventions should target risk appraisals and attitudes toward WTS. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Snuffing tobacco out of sport.

PubMed Central

Connolly, G N; Orleans, C T; Blum, A

1992-01-01

Use of oral snuff has risen sharply among baseball players following a tobacco industry marketing campaign that linked smokeless tobacco with athletic performance and virility. Millions of adolescents have copied these professional role models and, today, are at risk of developing oral cancer and other mouth disorders. New policies and programs are needed to break the powerful grip that the tobacco industry has on professional sport. Health agencies, including the National Cancer Institute and the National Institute for Dental Research, have teamed up with major league baseball to help players quit and reduce public use of oral tobacco. If these efforts are successful, our national pastime will once again become America's classroom for teaching health and fitness, not nicotine addiction. PMID:1536348

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

PubMed

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

2012-03-07

Media coverage of tobacco-related issues can potentially shape individual beliefs, attitudes and behaviors about tobacco use. This study aims to describe news coverage of tobacco control related issues in Chinese newspapers from 2000 to 2010. All 1149 articles related to tobacco control were extracted from the Database of Chinese Important Newspapers and content analyzed for the period Jan 1, 2000 to Dec 31, 2010. The changing pattern of tobacco control topic, article type, viewpoint, and article origin, and their relationship were analysed. News coverage of tobacco control related issues increased significantly (p < 0.01) from 2000 to 2010, with news coverage being relatively intensive in May and June (p < 0.01), around World No Tobacco Day. 24.9% (n = 286) of all articles focused on secondhand smoke, 25.3% (n = 291) warned about the dangers of active smoking, and 10.0% (n = 115) focused on prevention and cessation programs and campaigns. Tobacco control topics varied significantly between national vs city/regional newspapers (χ2 = 24.09, p = 0.002) and article types (χ2 = 193.35, p < 0.001). Articles in national newspapers had more coverage of the dangers of tobacco and on enforcing bans on tobacco-advertising. News stories centered around monitoring tobacco use and smoke free activity, while editorials focused on enforcing bans on tobacco-advertising, youth access and programs and campaigns. Letters to editors focused on the dangers of smoking, raising tax, and smoking cessation. More articles (50.4%) took an anti-tobacco position (compared with 10.5% which were pro-smoking), with the amount of negative coverage growing significantly across the decade. National articles tended to lean toward anti-tobacco, however, local articles tended mix of pro-tobacco and neutral/balance positions. Editorials seemed to be more anti-tobacco oriented, but letters to the editor tended to show a mix of anti-tobacco and pro-tobacco positions. Chinese newspapers are giving increasing attention to tobacco control, but coverage remains lower than in the USA and Australia. Health workers need to give higher priority to efforts to increase news coverage beyond the present concentration around World No Tobacco Day and to develop strategies for making tobacco control issues more newsworthy to both national and local news outlets.

How U.S. adults find out about electronic cigarettes: implications for public health messages.

PubMed

Pepper, Jessica K; Emery, Sherry L; Ribisl, Kurt M; Brewer, Noel T

2014-08-01

Electronic cigarettes (e-cigarettes) are battery-powered nicotine delivery systems that have become increasingly popular in the United States. We sought to understand how U.S. adults hear about e-cigarettes. A national sample of 17,522 U.S. adults (≥ 18 years old) completed an online survey in March 2013 assessing their awareness of and sources of information about e-cigarettes. Most respondents (86%) had heard of e-cigarettes. Current and former smokers were more likely to be aware of e-cigarettes than non-smokers. Males, younger adults, non-Hispanic Whites, and those with higher education were also more likely to have heard of e-cigarettes. The most commonly reported sources of information were another person, ads on television, and seeing e-cigarettes being sold, although the relative frequency of these sources differed for current, former, and never-smokers. Former and current smokers were more likely to have heard about e-cigarettes from e-cigarette users than were never-smokers. Adults age 30 years or younger were more likely than adults older than 30 years to have heard about e-cigarettes online. Nearly all U.S. adults had heard of e-cigarettes in 2013. By focusing on the most common channels of information, public health campaigns can more efficiently communicate information about e-cigarette safety and consider necessary regulations should companies use these channels for marketing that targets youth, non-tobacco users, and other at-risk groups. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

27 CFR 479.161 - National Firearms Act stamps.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 3 2011-04-01 2010-04-01 true National Firearms Act stamps. 479.161 Section 479.161 Alcohol, Tobacco Products, and Firearms BUREAU OF ALCOHOL, TOBACCO, FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION MACHINE GUNS, DESTRUCTIVE DEVICES...

27 CFR 479.161 - National Firearms Act stamps.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 3 2014-04-01 2014-04-01 false National Firearms Act stamps. 479.161 Section 479.161 Alcohol, Tobacco Products, and Firearms BUREAU OF ALCOHOL, TOBACCO, FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION MACHINE GUNS, DESTRUCTIVE DEVICES...

27 CFR 479.161 - National Firearms Act stamps.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 3 2013-04-01 2013-04-01 false National Firearms Act stamps. 479.161 Section 479.161 Alcohol, Tobacco Products, and Firearms BUREAU OF ALCOHOL, TOBACCO, FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION MACHINE GUNS, DESTRUCTIVE DEVICES...

27 CFR 479.161 - National Firearms Act stamps.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 3 2010-04-01 2010-04-01 false National Firearms Act stamps. 479.161 Section 479.161 Alcohol, Tobacco Products, and Firearms BUREAU OF ALCOHOL, TOBACCO, FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION MACHINE GUNS, DESTRUCTIVE DEVICES...

27 CFR 479.161 - National Firearms Act stamps.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 3 2012-04-01 2010-04-01 true National Firearms Act stamps. 479.161 Section 479.161 Alcohol, Tobacco Products, and Firearms BUREAU OF ALCOHOL, TOBACCO, FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION MACHINE GUNS, DESTRUCTIVE DEVICES...

Use of Conventional and Novel Smokeless Tobacco Products Among US Adolescents

PubMed Central

Ayo-Yusuf, Olalekan A.; Vardavas, Constantine I.; Alpert, Hillel R.; Connolly, Gregory N.

2013-01-01

OBJECTIVES: To assess the prevalence and correlates of use of conventional and novel smokeless tobacco products among a national sample of US middle and high school students. METHODS: Data from the 2011 National Youth Tobacco Survey were analyzed to determine national estimates of current use of conventional (“chewing tobacco”, “snuff,” or “dip”), novel (“snus” and “dissolvable tobacco products”), and any smokeless tobacco products (novel and/or conventional products) within the past 30 days. RESULTS: The overall prevalence of current use of any smokeless tobacco product was 5.6% (n = 960). Among all students, 5.0% used chewing tobacco, snuff, or dip; 1.9% used snus; and 0.3% used dissolvable tobacco products. Among users of any smokeless tobacco, 64.0% used only conventional products, 26.8% were concurrent users of novel plus conventional products, whereas 9.2% exclusively used novel products. Approximately 72.1% of current any smokeless tobacco users concurrently smoked combustible tobacco products, and only 40.1% expressed an intention to quit all tobacco use. Regression analyses indicated that peer (adjusted odds ratio [aOR]: 9.56; 95% confidence interval [CI]: 7.14–12.80) and household (aOR: 3.32; 95% CI: 2.23–4.95) smokeless tobacco use were associated with smokeless tobacco use, whereas believing that all forms of tobacco are harmful was protective (aOR: 0.55; 95% CI: 0.38–0.79). CONCLUSIONS: Conventional smokeless tobacco products remain the predominant form of smokeless tobacco use. Most users of novel smokeless tobacco products also concurrently smoked combustible tobacco products. Smokeless tobacco use was associated with lower perception of harm from all tobacco products and protobacco social influences, indicating the need to change youth perceptions about the use of all tobacco products and to engage pediatricians in tobacco use prevention and cessation interventions. PMID:23918889

Effects of Antismoking Advertising–Based Beliefs on Adult Smokers’ Consideration of Quitting

PubMed Central

Netemeyer, Richard G.; Andrews, J. Craig; Burton, Scot

2005-01-01

Objectives. We examined whether specific antismoking advertising–based beliefs regarding the addictiveness of smoking, the dangers of environmental tobacco smoke, and the tobacco industry’s use of deceptive advertising practices are associated with adult smokers’ consideration of quitting. We also assessed whether interactions between such beliefs and having children living in the home were associated with consideration of quitting. Methods. We used analyses of smokers’ responses to a telephone survey conducted after completion of the Wisconsin Anti-Tobacco Media Campaign to test hypotheses associated with our study objectives. Results. Results indicated that advertising-based beliefs regarding smoking addictiveness and the dangers of environmental tobacco smoke were associated with consideration of quitting. The findings also showed that consideration of quitting was positively affected by the interaction between number of children living at home and advertising-based beliefs about deceptive tobacco industry advertising practices designed to induce people to smoke. Conclusions. Creating advertisements that target specific antismoking beliefs may be the most effective approach to enhancing consideration of quitting among adult smokers, particularly those with children living at home. PMID:15914834

Effects of antismoking advertising--based beliefs on adult smokers' consideration of quitting.

PubMed

Netemeyer, Richard G; Andrews, J Craig; Burton, Scot

2005-06-01

We examined whether specific antismoking advertising-based beliefs regarding the addictiveness of smoking, the dangers of environmental tobacco smoke, and the tobacco industry's use of deceptive advertising practices are associated with adult smokers' consideration of quitting. We also assessed whether interactions between such beliefs and having children living in the home were associated with consideration of quitting. We used analyses of smokers' responses to a telephone survey conducted after completion of the Wisconsin Anti-Tobacco Media Campaign to test hypotheses associated with our study objectives. Results indicated that advertising-based beliefs regarding smoking addictiveness and the dangers of environmental tobacco smoke were associated with consideration of quitting. The findings also showed that consideration of quitting was positively affected by the interaction between number of children living at home and advertising-based beliefs about deceptive tobacco industry advertising practices designed to induce people to smoke. Creating advertisements that target specific antismoking beliefs may be the most effective approach to enhancing consideration of quitting among adult smokers, particularly those with children living at home.

CDC grand rounds: current opportunities in tobacco control.

PubMed

2010-04-30

Tobacco use is the world's leading single preventable cause of death. Worldwide tobacco-related deaths now exceed 5 million a year. Left unchecked, the number is expected to exceed 8 million a year by 2030, and 80% of those tobacco-related deaths will occur in low- and middle-income countries. In the United States, tobacco use is the single leading preventable cause of disease, disability, and death. Each year, 443,000 U.S. residents die from cigarette smoking and exposure to secondhand smoke, and another 8.6 million have a serious illness caused by smoking. In 2008, 20.6% (approximately 46 million) of U.S. adults were current smokers. Smoking costs the United States $96 billion in medical costs and $97 billion in lost productivity annually. A particular concern is that progress in reducing smoking rates among young persons and adults has stalled. After a substantial decline from 1997 (36.4%) to 2003 (21.9%), the decline in smoking rates among high school students slowed and remained relatively unchanged from 2003 (21.9%) to 2007 (20.0%). Adult smoking prevalence declined steadily from 1965 (42.4%) through the 1980s; however, the decline in smoking rates among adults began to slow in the 1990s and remained relatively unchanged from 2004 (20.9%) to 2008 (20.6%). By achieving a modest decline in smoking prevalence worldwide (from 25% to 20%) through further use of tobacco control measures, 100 million deaths can be prevented by 2020.

Marijuana and tobacco co-use among a nationally representative sample of US pregnant and non-pregnant women: 2005-2014 National Survey on Drug Use and Health findings.

PubMed

Coleman-Cowger, Victoria H; Schauer, Gillian L; Peters, Erica N

2017-08-01

Marijuana and tobacco are the most commonly used illicit and licit drugs during pregnancy. This study aimed to examine a nationally representative sample of US pregnant women and to: (1) determine the prevalence of past month marijuana and tobacco co-use, (2) identify characteristics that distinguish marijuana and tobacco co-users from users of marijuana only, tobacco only, or neither, and (3) compare characteristics that differ between pregnant and non-pregnant co-users of marijuana and tobacco. Data were obtained from 497,218 US women (8721 pregnant) ages 12-49 who participated in the 2005-2014 National Survey on Drug Use and Health. Prevalence and demographic and substance use characteristics were compared across groups using weighted estimates and chi-squared tests. Multinomial logistic regression identified demographic and substance use correlates of co-use. Co-use among pregnant and non-pregnant women was significantly more prevalent than marijuana-only use but was less common than tobacco-only use. In unadjusted frequencies, pregnant co-users significantly differed from non-pregnant co-users across several domains. Among pregnant women, multivariate correlates of co-use of tobacco and marijuana vs. tobacco-only use were ages 12-17, non-Hispanic black race, Hispanic ethnicity, and past month polytobacco, any alcohol, and other drug use (all adjusted odds ratios≥2.0). In this first examination of the prevalence and correlates of co-use of marijuana and tobacco among a nationally representative group of pregnant women, pregnant co-users were more likely to report other high risk behaviors compared with non-pregnant co-users and users of a single substance, suggesting disparities worthy of further investigation. Copyright © 2017 Elsevier B.V. All rights reserved.

Awareness and Current Use of Electronic Cigarettes in Indonesia, Malaysia, Qatar, and Greece: Findings From 2011-2013 Global Adult Tobacco Surveys.

PubMed

Palipudi, Krishna Mohan; Mbulo, Lazarous; Morton, Jeremy; Mbulo, Lazarous; Bunnell, Rebecca; Blutcher-Nelson, Glenda; Kosen, Soewarta; Tee, Guat Hiong; Abdalla, Amani Mohamed Elkhatim; Mutawa, Kholood Ateeq Al; Barbouni, Anastasia; Antoniadou, Eleni; Fouad, Heba; Khoury, Rula N; Rarick, James; Sinha, Dhirendra N; Asma, Samira

2016-04-01

Increases in electronic cigarette (e-cigarette) awareness and current use have been documented in high income countries but less is known about middle and low income countries. Nationally representative household survey data from the first four Global Adult Tobacco Surveys to assess e-cigarettes were analyzed, including Indonesia (2011), Malaysia (2011), Qatar (2013), and Greece (2013). Correlates of e-cigarette awareness and current use were calculated. Sample sizes for Greece and Qatar allowed for further analysis of e-cigarette users. Awareness of e-cigarettes was 10.9% in Indonesia, 21.0% in Malaysia, 49.0% in Qatar, and 88.5% in Greece. In all four countries, awareness was higher among male, younger, more educated, and wealthier respondents. Current e-cigarette use among those aware of e-cigarettes was 3.9% in Malaysia, 2.5% in Indonesia, 2.2% in Greece and 1.8% in Qatar. Across these four countries, an estimated 818 500 people are currently using e-cigarettes. Among current e-cigarette users, 64.4% in Greece and 84.1% in Qatar also smoked cigarettes, and, 10.6% in Greece and 6.0% in Qatar were never-smokers. E-cigarette awareness and use was evident in all four countries. Ongoing surveillance and monitoring of awareness and use of e-cigarettes in these and other countries could help inform tobacco control policies and public health interventions. Future surveillance should monitor use of e-cigarettes among current smokers and uptake among never-smokers and relapsing former smokers. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A Systematic Review of Tobacco Smoking Prevalence and Description of Tobacco Control Strategies in Sub-Saharan African Countries; 2007 to 2014.

PubMed

Brathwaite, Rachel; Addo, Juliet; Smeeth, Liam; Lock, Karen

2015-01-01

To systematically review current smoking prevalence among adults in sub-Saharan Africa from 2007 to May 2014 and to describe the context of tobacco control strategies in these countries. Five databases, Medline, Embase, Africa-wide Information, Cinahl Plus, and Global Health were searched using a systematic search strategy. There were no language restrictions. 26 included studies measured current smoking prevalence in nationally representative adult populations in sub-Saharan African countries. Study details were independently extracted using a standard datasheet. Data on tobacco control policies, taxation and trends in prices were obtained from the Implementation Database of the WHO FCTC website. Studies represented 13 countries. Current smoking prevalence varied widely ranging from 1.8% in Zambia to 25.8% in Sierra Leone. The prevalence of smoking was consistently lower in women compared to men with the widest gender difference observed in Malawi (men 25.9%, women 2.9%). Rwanda had the highest prevalence of women smokers (12.6%) and Ghana had the lowest (0.2%). Rural, urban patterns were inconsistent. Most countries have implemented demand-reduction measures including bans on advertising, and taxation rates but to different extents. Smoking prevalence varied widely across sub-Saharan Africa, even between similar country regions, but was always higher in men. High smoking rates were observed among countries in the eastern and southern regions of Africa, mainly among men in Ethiopia, Malawi, Rwanda, and Zambia and women in Rwanda and rural Zambia. Effective action to reduce smoking across sub-Saharan Africa, particularly targeting population groups at increased risk remains a pressing public health priority.

Should College Campuses become Tobacco Free without an Enforcement Plan?

ERIC Educational Resources Information Center

Fennell, Reginald

2012-01-01

Tobacco-free campuses are a great public health initiative. "Healthy People 2020" and "Healthy Campus 2020" address tobacco use and young adults including college students. Sources indicate that of the more than 6,000 colleges and universities in the United States, less than 800 are either smoke free or tobacco free. An increasing number of…

Correlates of Young Adult Tobacco Use: Application of a Transition Framework

ERIC Educational Resources Information Center

Lenz, Brenda K.

2003-01-01

Anticipatory guidance is a traditional nursing intervention. The purpose of this study was to identify factors to serve as targets for anticipatory guidance prior to high school graduation to reduce tobacco initiation among young adults after graduation. A sample of 203 randomly selected freshmen and sophomore students at a major midwestern…

The Case to Include Brand of Moist Snuff in Health Surveys.

PubMed

Timberlake, David S

2016-08-01

Brand of smokeless tobacco was added to the most recent Tobacco Use Supplement to the Current Population Survey (TUS-CPS), but deleted from the Centers for Disease Control's National Adult Tobacco Survey. The objective of this study was to assess the utility of brand in distinguishing users of moist snuff. The sample consisted of participants from the 2010-2011 TUS-CPS who reported having used one of 14 brands of moist snuff in the past month (n = 2334). The brands were categorized into one of three types: snus, discount snuff, premium snuff. Multinomial logistic regression was employed for testing for associations between brand type and a series of demographic and tobacco use measures. Females, metropolitan residents, current smokers, and moderate users of snuff had significantly greater odds of using snus relative to premium snuff in the adjusted model (P < .001). Frequent users of snuff (eg, daily users), current smokers, young adults, participants with low household income, and those exhibiting dependence on nicotine had greater odds of using discount versus premium snuff. Separate analyses among current smokers (n = 470) and former smokers (n = 70) revealed positive associations between smoking cessation attempts and smokers' switch to discount snuff. Differences among the three categories of snuff users are likely attributed to variations in marketing campaigns. The differences are sufficient to warrant inclusion of snuff brand in health surveys because brand type could serve as a proxy measure for snuff use and dependence. Inclusion of brand of moist snuff in health surveys will enable researchers to categorize snuff users by brand type. Findings from this study indicate that brand type, defined according to cost (ie, discount vs. premium brands) and type of preferred snuff (ie, snus vs. other moist snuff), can distinguish snuff users by various demographic and tobacco use measures. Consequently, categorization by brand type could be used as a proxy measure for studies whose surveys do not include detailed information on snuff use and behavior. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Assessment of short reports using a human rights-based approach to tobacco control to the Commitee on Economics, Cultural and Social Rights.

PubMed

Dresler, Carolyn; Henry, Kirsten; Loftus, John; Lando, Harry

2017-07-28

The health impact of tobacco use remains a major global public health concern and a human rights issue. The Human Rights and Tobacco Control Network (HRTCN) was established to increase the visibility of tobacco as a human rights issue. HRTCN submitted short reports to the UN Committee on Economic Social and Cultural Rights evaluating individual nations' tobacco control policies and offering recommendations. HRTCN reviewed Concluding Observations documents for nations for which the HRTCN submitted reports. If tobacco was mentioned in the Concluding Observations through acknowledging the Framework Convention on Tobacco Control ratification, policy changes or discussing tobacco in the recommendations, this was scored as a positive finding. HRTCN also reviewed Concluding Observations for nations for which HRTCN did not submit reports as a comparison. Thirty-eight HRTCN reports were submitted and tobacco was mentioned in Concluding Observations for 11 nations for a rate of 28.9%. In a comparison set of Concluding Observations (n=59), 7% had comments or recommendations relative to tobacco. This was not a controlled study and the 28.9% 'success rate' for impacting the Concluding Observations, although encouraging, is less than optimal-and leaves room for improvement. The higher rate of tobacco mentions for the cases where the HRTCN short reports were submitted provides preliminary indications that the short reports may have potential to increase the state focus on tobacco control. Future work will seek to improve the design and scope of the reports, and the specificity of the background information and recommendations offered. © 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.

School Absenteeism Among Children Living With Smokers

PubMed Central

Winickoff, Jonathan P.; Rigotti, Nancy A.

2011-01-01

OBJECTIVE: Involuntary tobacco smoke exposure causes substantial morbidity in children. We hypothesized that children exposed to tobacco smoke in the home would have increased school absenteeism with associated costs due to lost caregiver wages/time. METHODS: We analyzed data on health and absenteeism among schoolchildren aged 6 to 11 years identified in the 2005 National Health Interview Survey (NHIS). We used multivariate models to assess the relationships between adult-reported household smoking and child health and school absenteeism. Analyses were adjusted for children's and parents' demographic and socioeconomic characteristics. The value of lost caregiver time was estimated by using self-reported employment and earnings data in the NHIS and publicly available time-use data. RESULTS: Children living with 1 or ≥2 adults who smoked in the home had 1.06 (95% confidence interval [CI]: 0.54–1.55) and 1.54 (95% CI: 0.95–2.12) more days absent from school per year, respectively, than children living with 0 smokers in the home. Living with ≥2 adults who smoked in the home was associated with increased reports of having ≥3 ear infections in the previous 12 months (adjusted odds ratio [aOR]: 2.65 [95% CI: 1.36–5.16]) and having a chest cold in the 2 weeks before interview (aOR: 1.77 [95% CI: 1.03–3.03]) but not with having vomiting/diarrhea in the previous 2 weeks (aOR: 0.93 [95% CI: 0.45–1.89]). Caregivers' time tending children absent from school was valued at $227 million per year. CONCLUSIONS: Tobacco smoke exposure has significant consequences for children and families above and beyond child morbidity, including academic disadvantage and financial burden. PMID:21890826

Results of a national mass media campaign in India to warn against the dangers of smokeless tobacco consumption.

PubMed

Murukutla, Nandita; Turk, Tahir; Prasad, C V S; Saradhi, Ranjana; Kaur, Jagdish; Gupta, Shefali; Mullin, Sandra; Ram, Faujdar; Gupta, Prakash C; Wakefield, Melanie

2012-01-01

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.

The added value of accounting for activity space when examining the association between tobacco retailer availability and smoking among young adults.

PubMed

Shareck, Martine; Kestens, Yan; Vallée, Julie; Datta, Geetanjali; Frohlich, Katherine L

2016-07-01

Despite a declining prevalence in many countries, smoking rates remain consistently high among young adults. Targeting contextual influences on smoking, such as the availability of tobacco retailers, is one promising avenue of intervention. Most studies have focused on residential or school neighbourhoods, without accounting for other settings where individuals spend time, that is, their activity space. We investigated the association between tobacco retailer availability in the residential neighbourhood and in the activity space, and smoking status. Cross-sectional baseline data from 1994 young adults (aged 18-25) participating in the Interdisciplinary Study of Inequalities in Smoking (Montreal, Canada, 2011-2012) were analysed. Residential and activity locations served to derive two measures of tobacco retailer availability: counts within 500 m buffers and proximity to the nearest retailer. Prevalence ratios for the association between each tobacco retailer measure and smoking status were estimated using log-binomial regression. Participants encountering high numbers of tobacco retailers in their residential neighbourhood, and both medium and high retailer counts in their activity space, were more likely to smoke compared to those exposed to fewer retailers. While residential proximity was not associated with smoking, we found 36% and 42% higher smoking prevalence among participants conducting activities within medium and high proximity to tobacco retailers compared to those conducting activities further from such outlets. This study adds to the sparse literature on contextual correlates of smoking among young adults, and illustrates the added value of considering individuals' activity space in contextual studies of smoking. 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 impact of a state-sponsored mass media campaign on use of telephone quitline and web-based cessation services.

PubMed

Duke, Jennifer C; Mann, Nathan; Davis, Kevin C; MacMonegle, Anna; Allen, Jane; Porter, Lauren

2014-12-24

Most US smokers do not use evidence-based interventions as part of their quit attempts. Quitlines and Web-based treatments may contribute to reductions in population-level tobacco use if successfully promoted. Currently, few states implement sustained media campaigns to promote services and increase adult smoking cessation. This study examines the effects of Florida's tobacco cessation media campaign and a nationally funded media campaign on telephone quitline and Web-based registrations for cessation services from November 2010 through September 2013. We conducted multivariable analyses of weekly media-market-level target rating points (TRPs) and weekly registrations for cessation services through the Florida Quitline (1-877-U-CAN-NOW) or its Web-based cessation service, Web Coach (www.quitnow.net/florida). During 35 months, 141,221 tobacco users registered for cessation services through the Florida Quitline, and 53,513 registered through Web Coach. An increase in 100 weekly TRPs was associated with an increase of 7 weekly Florida Quitline registrants (β = 6.8, P < .001) and 2 Web Coach registrants (β = 1.7, P = .003) in an average media market. An increase in TRPs affected registrants from multiple demographic subgroups similarly. When state and national media campaigns aired simultaneously, approximately one-fifth of Florida's Quitline registrants came from the nationally advertised portal (1-800-QUIT-NOW). Sustained, state-sponsored media can increase the number of registrants to telephone quitlines and Web-based cessation services. Federally funded media campaigns can further increase the reach of state-sponsored cessation services.

The Impact of a State-Sponsored Mass Media Campaign on Use of Telephone Quitline and Web-Based Cessation Services

PubMed Central

Mann, Nathan; Davis, Kevin C.; MacMonegle, Anna; Allen, Jane; Porter, Lauren

2014-01-01

Introduction Most US smokers do not use evidence-based interventions as part of their quit attempts. Quitlines and Web-based treatments may contribute to reductions in population-level tobacco use if successfully promoted. Currently, few states implement sustained media campaigns to promote services and increase adult smoking cessation. This study examines the effects of Florida’s tobacco cessation media campaign and a nationally funded media campaign on telephone quitline and Web-based registrations for cessation services from November 2010 through September 2013. Methods We conducted multivariable analyses of weekly media-market–level target rating points (TRPs) and weekly registrations for cessation services through the Florida Quitline (1-877-U-CAN-NOW) or its Web-based cessation service, Web Coach (www.quitnow.net/florida). Results During 35 months, 141,221 tobacco users registered for cessation services through the Florida Quitline, and 53,513 registered through Web Coach. An increase in 100 weekly TRPs was associated with an increase of 7 weekly Florida Quitline registrants (β = 6.8, P < .001) and 2 Web Coach registrants (β = 1.7, P = .003) in an average media market. An increase in TRPs affected registrants from multiple demographic subgroups similarly. When state and national media campaigns aired simultaneously, approximately one-fifth of Florida’s Quitline registrants came from the nationally advertised portal (1-800-QUIT-NOW). Conclusion Sustained, state-sponsored media can increase the number of registrants to telephone quitlines and Web-based cessation services. Federally funded media campaigns can further increase the reach of state-sponsored cessation services. PMID:25539129

Developing and testing new smoking measures for the Health Plan Employer Data and Information Set.

PubMed

Pbert, Lori; Vuckovic, Nancy; Ockene, Judith K; Hollis, Jack F; Riedlinger, Karen

2003-04-01

To develop and test items for the Health Plan Employee Data and Information Set (HEDIS) that assess delivery of the full range of provider-delivered tobacco interventions. The authors identified potential items via literature review; items were reviewed by national experts. Face validity of candidate items was tested in focus groups. The final survey was sent to a random sample of 1711 adult primary care patients; the re-test survey was sent to self-identified smokers. The process identified reliable items to capture provider assessment of motivation and provision of assistance and follow-up. One can reliably assess patient self-report of provider delivery of the full range of brief tobacco interventions. Such assessment and feedback to health plans and providers may increase use of evidence-based brief interventions.

Tobacco marketing in California and implications for the future

PubMed Central

Feighery, Ellen C; Cruz, Tess Boley

2010-01-01

Background 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. Methods 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. Results 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. Conclusions 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. PMID:20382646

The impact of tobacco promotion at the point of sale: a systematic review.

PubMed

Paynter, Janine; Edwards, Richard

2009-01-01

Tobacco promotion increases the likelihood that adolescents will start smoking. Much of the tobacco industry's promotional budget is spent on point of sale (PoS) promotion in many jurisdictions. Consequently, tobacco is an eye-catching feature at the PoS in many places. We reviewed the evidence that PoS tobacco promotion influences key smoking-related behaviors and beliefs, increases susceptibility to smoking in youth, undermines smokers' quit attempts, and promotes relapse among ex-smokers. We found 12 peer-reviewed studies, 10 of which were focused on children. Seven of 8 observational studies found statistically significant associations between exposure to tobacco promotion at the PoS and smoking initiation or susceptibility to smoking. Two experimental studies of children found statistically significant associations between exposure to PoS tobacco promotions and beliefs about ease of getting tobacco and smoking prevalence among their peers. An experimental study with adults found that a picture of collected tobacco pack elicited cravings for cigarettes among smokers. A cross-sectional study found that 25% of adult smokers reported impulse purchasing and a third of recent ex-smokers reported urges to start smoking after seeing tobacco displayed. More prospective studies are needed to clarify the temporal relationship between exposure to PoS tobacco and outcome. However, given the addictiveness of tobacco, the severity of the health hazards posed by smoking, the evidence that tobacco promotion encourages children to start smoking, and the consistency of the evidence that PoS promotion influences children's smoking, we believe that ample justification exists for banning PoS advertising and displays of smoked tobacco products.

Tobacco marketing in California and implications for the future.

PubMed

Roeseler, April; Feighery, Ellen C; Cruz, Tess Boley

2010-04-01

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.

Global frameworks, local strategies: Women's rights, health, and the tobacco control movement in Argentina.

PubMed

Muñoz Martínez, Hepzibah; Pederson, Ann

2018-02-23

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.

Prevalence and correlates of tobacco use among urban adult men in India: a comparison of slum dwellers vs non-slum dwellers.

PubMed

Rooban, T; Joshua, Elizabeth; Rao, Umadevi K; Ranganathan, K

2012-01-01

Tobacco use is reported to be rampant in urban slums in developing countries. Demographical variations in tobacco use between males living in urban slums vs those living in non-slum areas in India has not been reported, and this study was undertaken to address this issue. Secondary data analysis of National Family Health Survey-3 (NFHS-3) was undertaken to study demographical variations in tobacco use between urban slum dwellers and non-slum dwellers in eight Indian cities. Demographic determinants for use of smoking and chewing forms of tobacco in the two groups were analyzed. SPSS version 16.0 (SPSS Inc., IL, USA) was used for statistical analysis. The study population comprised 6887 (41.8%) males from slum areas and 9588 (58.2%) from non-slum areas of eight urban cities. Cigarette/beedi smoking was the commonest form of tobacco use among the study population. Pan masala use was the least common form of smokeless tobacco use, next only to snuff. There was a high statistical significance observed within the various demographic parameter studied in both the slum and non-slum dwelling males in study population. However, on studying the differences between the two groups, it was observed that statistical significance of P≤.001 was observed with age (15-49), secondary education, religion, household structure and marital status. The difference between the two groups in the mean number of cigarettes/beedis smoked was not statistically significant (P=.598). Male slum dwellers are a distinct urban population, whose health needs assessment requires a different approach than that for non-slum dwellers who often can afford the services that an urban Indian city can offer.

Factors Associated with Perceptions of Hookah Addictiveness and Harmfulness among Young Adults

ERIC Educational Resources Information Center

Noonan, Devon; Patrick, Megan E.

2013-01-01

Hookah smoking is a form of tobacco use that is growing in popularity in the United States. College-aged students, who are known to experiment with multiple forms of tobacco, are particularly vulnerable to this tobacco trend. There is a common misconception that hookah smoking is not as dangerous as other forms of tobacco, which may help explain…

Educational Differences in Associations of Noticing Anti-Tobacco Information with Smoking-Related Attitudes and Quit Intentions: Findings from the International Tobacco Control Europe Surveys

ERIC Educational Resources Information Center

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.

2015-01-01

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…

Adults only: the prevalence of tobacco promotions in bars and clubs in the Boston area.

PubMed

Biener, L; Nyman, A L; Kline, R L; Albers, A B

2004-12-01

To document the nature and prevalence of tobacco promotions in bars and clubs in a major US city. We conducted systematic observations in a representative sample of 38 establishments in the Boston area, half of which had been advertised in a tobacco company ad. We also observed seven events in six additional clubs hosting Camel Casbah promotions. Telephone interviews were later completed with club managers. Use of branded give-away items, distribution of free cigarette samples, managers' reports of costs and benefits of hosting promotions. The majority of the 38 clubs were observed to use bar paraphernalia including matchbooks with tobacco brand logos, regardless of their history of appearing in tobacco sponsored ads. Free cigarette samples were not observed at any of the sampled clubs, but were a feature of every Casbah event. Managers of clubs in the advertised group were somewhat more likely to report having hosted promotions, but 44% of managers of non-advertised clubs indicated that tobacco promotions had occurred in their establishments in the past. Approximately one third of club managers viewed public links with a tobacco company as a negative feature of hosting promotions. Based on managers' reports, tobacco promotions occurred in more than 50% of the Boston area entertainment venues frequented by young adults. Cigarette companies should be required to inform the attorney general of plans to conduct promotions in adult-only venues to facilitate monitoring of compliance with the Master Settlement Agreement. The negative health and business consequences of hosting promotions should be communicated to bar owners.

[Understand the tobacco industry's strategy for recruiting teens: Lessons from a 1973 marketing document].

PubMed

Dautzenberg, B

2018-06-01

For years, the tobacco industry has organized the inoculation of tobacco addiction to adolescents. The analysis of a 1973 RJReynols ® document identified ten physical and psychological factors in order to increase the number of young users for a brand of cigarettes. These young people are classified into three groups: pre-smokers, learners and smokers. The taste for pre-smokers and learners and nicotine for smokers are main physical parameters. The industry clearly knows that tobacco is mainly consumed because of nicotine addiction, so it is necessary to make adolescents addict. It is interesting to note that cigarette pack was in 1973 a positive factor to attract young smokers, whereas now with the arrival of the neutral packaging, the tobacco industry declares that packaging has no influence to attract teenagers ! Of the psychological factors, the only negative factor is the self-image of the smoker. The tobacco industry already recognized in 1973 that smokers were unhappy about smoking. For learners, self-image and the experience of adults are most important factor, which is why the industry strives to create a positive image and convey message that smoking initiation is a ritual to become adult. According to the tobacco industry, stress and alleviation of boredom are also important points in turning pre-smokers into learners and learners into smokers. This article aims to provide practical tools for understanding industry initiatives targeting adolescents. The attached tool can be used by the teens or adults involved to understand the optimization of teenagers tobacco marketing. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Adults only: the prevalence of tobacco promotions in bars and clubs in the Boston area

PubMed Central

Biener, L; Nyman, A; Kline, R; Albers, A

2004-01-01

Objective: To document the nature and prevalence of tobacco promotions in bars and clubs in a major US city. Design: We conducted systematic observations in a representative sample of 38 establishments in the Boston area, half of which had been advertised in a tobacco company ad. We also observed seven events in six additional clubs hosting Camel Casbah promotions. Telephone interviews were later completed with club managers. Main outcome measure: Use of branded give-away items, distribution of free cigarette samples, managers' reports of costs and benefits of hosting promotions. Results: The majority of the 38 clubs were observed to use bar paraphernalia including matchbooks with tobacco brand logos, regardless of their history of appearing in tobacco sponsored ads. Free cigarette samples were not observed at any of the sampled clubs, but were a feature of every Casbah event. Managers of clubs in the advertised group were somewhat more likely to report having hosted promotions, but 44% of managers of non-advertised clubs indicated that tobacco promotions had occurred in their establishments in the past. Approximately one third of club managers viewed public links with a tobacco company as a negative feature of hosting promotions. Conclusions: Based on managers' reports, tobacco promotions occurred in more than 50% of the Boston area entertainment venues frequented by young adults. Cigarette companies should be required to inform the attorney general of plans to conduct promotions in adult-only venues to facilitate monitoring of compliance with the Master Settlement Agreement. The negative health and business consequences of hosting promotions should be communicated to bar owners. PMID:15564626

Correlates and Prevalence of Menthol Cigarette Use Among Adults With Serious Mental Illness

PubMed Central

Young-Wolff, Kelly C.; Hickman, Norval J.; Kim, Romina; Gali, Kathleen

2015-01-01

Introduction: With a focus on protecting vulnerable groups from initiating and continuing tobacco use, the FDA has been considering the regulation of menthol in cigarettes. Using a large sample of adult smokers with serious mental illness (SMI) in the San Francisco Bay Area, we examined demographic and clinical correlates of menthol use, and we compared the prevalence of menthol use among our study participants to that of adult smokers in the general population in California. Methods: Adult smokers with SMI (N = 1,042) were recruited from 7 acute inpatient psychiatric units in the San Francisco Bay Area. Demographic, tobacco, and clinical correlates of menthol use were examined with bivariate and multivariate logistic regression analyses, and prevalence of menthol use was compared within racial/ethnic groups to California population estimates from the 2008–2011 National Survey on Drug Use and Health. Results: A sample majority (57%) reported smoking menthol cigarettes. Multivariate logistic regression analyses indicated that adult smokers with SMI who were younger, who had racial/ethnic minority status, who had fewer perceived interpersonal problems, and who had greater psychotic symptoms also had a significantly greater likelihood of menthol use. Smokers with SMI had a higher prevalence of menthol use relative to the general population in California overall (24%). Conclusions: Individuals with SMI—particularly those who are younger, have racial/ethnic minority status, and have been diagnosed with a psychotic disorder—are vulnerable to menthol cigarette use. FDA regulation of menthol may prevent initiation and may encourage cessation among smokers with SMI. PMID:25190706