Openness to Using Non-cigarette Tobacco Products Among U.S. Young Adults

PubMed Central

Mays, Darren; Arrazola, René A.; Tworek, Cindy; Rolle, Italia V.; Neff, Linda J.; Portnoy, David B.

2017-01-01

Introduction National data indicate that the prevalence of non-cigarette tobacco product use is highest among young adults; however, little is known about their openness to use these products in the future and associated risk factors. This study sought to characterize openness to using non-cigarette tobacco products and associated factors among U.S. young adults. Methods In 2014, National Adult Tobacco Survey data (2012–2013) were analyzed to characterize openness to using the following tobacco products among all young adults aged 18–29 years (N=5,985): cigars; electronic cigarettes (“e-cigarettes”); hookah; pipe tobacco; chew, snuff, or dip; snus; and dissolvables. Among those who were not current users of each product, multivariable logistic regression was used to examine associations between demographics, cigarette smoking status, lifetime use of other non-cigarette products, perceived harm and addictiveness of smoking, and receipt of tobacco industry promotions and openness to using each product. Results Among all young adults, openness to using non-cigarette tobacco products was greatest for hookah (28.2%); e-cigarettes (25.5%); and cigars (19.1%). In multivariable analyses, which included non-current users of each product, non-current ever, current, and former smokers were more likely than never smokers to be open to using most examined products, as were men and adults aged 18–24 years. Receipt of tobacco industry promotions was associated with openness to using e-cigarettes; chew, snuff, or dip; and snus. Conclusions There is substantial openness to trying non-cigarette tobacco products among U.S. young adults. Young adults are an important population to consider for interventions targeting non-cigarette tobacco product use. PMID:26549502

Openness to Using Non-cigarette Tobacco Products Among U.S. Young Adults.

PubMed

Mays, Darren; Arrazola, René A; Tworek, Cindy; Rolle, Italia V; Neff, Linda J; Portnoy, David B

2016-04-01

National data indicate that the prevalence of non-cigarette tobacco product use is highest among young adults; however, little is known about their openness to use these products in the future and associated risk factors. This study sought to characterize openness to using non-cigarette tobacco products and associated factors among U.S. young adults. In 2014, National Adult Tobacco Survey data (2012-2013) were analyzed to characterize openness to using the following tobacco products among all young adults aged 18-29 years (N=5,985): cigars; electronic cigarettes ("e-cigarettes"); hookah; pipe tobacco; chew, snuff, or dip; snus; and dissolvables. Among those who were not current users of each product, multivariable logistic regression was used to examine associations between demographics, cigarette smoking status, lifetime use of other non-cigarette products, perceived harm and addictiveness of smoking, and receipt of tobacco industry promotions and openness to using each product. Among all young adults, openness to using non-cigarette tobacco products was greatest for hookah (28.2%); e-cigarettes (25.5%); and cigars (19.1%). In multivariable analyses, which included non-current users of each product, non-current ever, current, and former smokers were more likely than never smokers to be open to using most examined products, as were men and adults aged 18-24 years. Receipt of tobacco industry promotions was associated with openness to using e-cigarettes; chew, snuff, or dip; and snus. There is substantial openness to trying non-cigarette tobacco products among U.S. young adults. Young adults are an important population to consider for interventions targeting non-cigarette tobacco product use. Published by Elsevier Inc.

Smoke-free home and vehicle rules by tobacco use status among US adults.

PubMed

Kruger, Judy; Jama, Amal; Homa, David M; Babb, Stephen D; King, Brian A

2015-09-01

To assess the prevalence and characteristics of smoke-free home and vehicle rules by tobacco use. Data came from the 2012-2013 National Adult Tobacco Survey, a telephone survey of adults aged ≥18. Respondents who reported smoking is 'never allowed' inside their home or any family vehicle were considered to have smoke-free home and vehicle rules, respectively. Prevalence and characteristics of smoke-free rules were assessed overall and by current tobacco use (combustible only, noncombustible only, combustible and noncombustible, no current tobacco use). Assessed characteristics included: sex, age, race/ethnicity, education, marital status, income, region, and sexual orientation. Nationally, 83.7% of adults (n=48,871) had smoke-free home rules and 78.1% (n=46,183) had smoke-free vehicle rules. By tobacco use, prevalence was highest among nonusers of tobacco (homes: 90.8%; vehicles: 88.9%) and lowest among combustible-only users (homes: 53.7%; vehicles: 34.2%). Prevalence of smoke-free home and vehicle rules was higher among males, adults with a graduate degree, and adults living in the West. Most adults have smoke-free home and vehicle rules, but differences exist by tobacco use. Opportunities exist to educate adults about the dangers of secondhand smoke and the benefits of smoke-free environments, particularly among combustible tobacco users. Published by Elsevier Inc.

Multiple tobacco product use among adults in the United States: cigarettes, cigars, electronic cigarettes, hookah, smokeless tobacco, and snus.

PubMed

Lee, Youn O; Hebert, Christine J; Nonnemaker, James M; Kim, Annice E

2014-05-01

Noncigarette tobacco products are increasingly popular. Researchers need to understand multiple tobacco product use to assess the effects of these products on population health. We estimate national prevalence and examine risk factors for multiple product use. We calculated prevalence estimates of current use patterns involving cigarettes, cigars, electronic cigarettes, hookah, smokeless tobacco, and snus using data from the 2012 RTI National Adult Tobacco Survey (N=3627), a random-digit-dial telephone survey of adults aged 18 and over. Associations between use patterns (exclusive single product and multiple products) and demographic characteristics were examined using Pearson chi-square tests and logistic regression. 32.1% of adults currently use 1 or more tobacco products; 14.9% use cigarettes exclusively, and 6.6% use one noncigarette product exclusively, 6.9% use cigarettes with another product (dual use), 1.3% use two noncigarette products, and 2.4% use three or more products (polytobacco use). Smokers who are young adult, male, never married, reside in the West, and made prior quit attempts were at risk for multiple product use. Over 10% of U.S. adults use multiple tobacco products. A better understanding of multiple product use involving combustible products, like cigars and hookah, is needed. Multiple product use may be associated with past quit attempts. Copyright © 2014 Elsevier Inc. All rights reserved.

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

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.

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.

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

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

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/.

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.

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

Tobacco-Product Use by Adults and Youths in the United States in 2013 and 2014.

PubMed

Kasza, Karin A; Ambrose, Bridget K; Conway, Kevin P; Borek, Nicolette; Taylor, Kristie; Goniewicz, Maciej L; Cummings, K Michael; Sharma, Eva; Pearson, Jennifer L; Green, Victoria R; Kaufman, Annette R; Bansal-Travers, Maansi; Travers, Mark J; Kwan, Jonathan; Tworek, Cindy; Cheng, Yu-Ching; Yang, Ling; Pharris-Ciurej, Nikolas; van Bemmel, Dana M; Backinger, Cathy L; Compton, Wilson M; Hyland, Andrew J

2017-01-26

Noncigarette tobacco products are evolving rapidly, with increasing popularity in the United States. We present prevalence estimates for 12 types of tobacco products, using data from 45,971 adult and youth participants (≥12 years of age) from Wave 1 (September 2013 through December 2014) of the Population Assessment of Tobacco and Health (PATH) Study, a large, nationally representative, longitudinal study of tobacco use and health in the United States. Participants were asked about their use of cigarettes, e-cigarettes, traditional cigars, cigarillos, filtered cigars, pipe tobacco, hookah, snus pouches, other smokeless tobacco, dissolvable tobacco, bidis, and kreteks. Estimates of the prevalence of use for each product were determined according to use category (e.g., current use or use in the previous 30 days) and demographic subgroup, and the prevalence of multiple-product use was explored. More than a quarter (27.6%) of adults were current users of at least one type of tobacco product in 2013 and 2014, although the prevalence varied depending on use category. A total of 8.9% of youths had used a tobacco product in the previous 30 days; 1.6% of youths were daily users. Approximately 40% of tobacco users, adults and youths alike, used multiple tobacco products; cigarettes plus e-cigarettes was the most common combination. Young adults (18 to 24 years of age), male adults and youths, members of racial minorities, and members of sexual minorities generally had higher use of tobacco than their counterparts. During this study, 28% of U.S. adults were current users of tobacco, and 9% of youths had used tobacco in the previous 30 days. Use of multiple products was common among tobacco users. These findings will serve as baseline data to examine between-person differences and within-person changes over time in the use of tobacco products. (Funded by the National Institute on Drug Abuse and the Food and Drug Administration.).

Tobacco-Product Use by Adults and Youths in the United States in 2013 and 2014

PubMed Central

Kasza, Karin A.; Ambrose, Bridget K.; Conway, Kevin P.; Borek, Nicolette; Taylor, Kristie; Goniewicz, Maciej L.; Cummings, K. Michael; Sharma, Eva; Pearson, Jennifer L.; Green, Victoria R.; Kaufman, Annette R.; Bansal-Travers, Maansi; Travers, Mark J.; Kwan, Jonathan; Tworek, Cindy; Cheng, Yu-Ching; Yang, Ling; Pharris-Ciurej, Nikolas; van Bemmel, Dana M.; Backinger, Cathy L.; Compton, Wilson M.; Hyland, Andrew J.

2017-01-01

BACKGROUND Noncigarette tobacco products are evolving rapidly, with increasing popularity in the United States. METHODS We present prevalence estimates for 12 types of tobacco products, using data from 45,971 adult and youth participants (≥12 years of age) from Wave 1 (September 2013 through December 2014) of the Population Assessment of Tobacco and Health (PATH) Study, a large, nationally representative, longitudinal study of tobacco use and health in the United States. Participants were asked about their use of cigarettes, e-cigarettes, traditional cigars, cigarillos, filtered cigars, pipe tobacco, hookah, snus pouches, other smokeless tobacco, dissolvable tobacco, bidis, and kreteks. Estimates of the prevalence of use for each product were determined according to use category (e.g., current use or use in the previous 30 days) and demographic subgroup, and the prevalence of multiple-product use was explored. RESULTS More than a quarter (27.6%) of adults were current users of at least one type of tobacco product in 2013 and 2014, although the prevalence varied depending on use category. A total of 8.9% of youths had used a tobacco product in the previous 30 days; 1.6% of youths were daily users. Approximately 40% of tobacco users, adults and youths alike, used multiple tobacco products; cigarettes plus e-cigarettes was the most common combination. Young adults (18 to 24 years of age), male adults and youths, members of racial minorities, and members of sexual minorities generally had higher use of tobacco than their counterparts. CONCLUSIONS During this study, 28% of U.S. adults were current users of tobacco, and 9% of youths had used tobacco in the previous 30 days. Use of multiple products was common among tobacco users. These findings will serve as baseline data to examine between-person differences and within-person changes over time in the use of tobacco products. (Funded by the National Institute on Drug Abuse and the Food and Drug Administration.) PMID

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.

Young Adults' Risk Perceptions of Various Tobacco Products Relative to Cigarettes: Results from the National Young Adult Health Survey

ERIC Educational Resources Information Center

Wackowski, Olivia A.; Delnevo, Cristine D.

2016-01-01

Objectives: Tobacco product risk perceptions may influence whether individuals use those products instead of or in addition to regular cigarettes. This study aimed to explore risk perceptions of various tobacco products relative to traditional cigarettes with young adults, a group with higher rates of tobacco use. Method: We examined risk…

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.

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.

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

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.

[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.

Prevalence, correlates, and trends in tobacco use and cessation among current, former, and never adult marijuana users with a history of tobacco use, 2005-2014.

PubMed

Schauer, Gillian L; King, Brian A; McAfee, Timothy A

2017-10-01

Approximately 70% of current (past 30-day) adult marijuana users are current tobacco users, which may complicate tobacco cessation. We assessed prevalence and trends in tobacco cessation among adult ever tobacco users, by marijuana use status. Data came from the National Survey on Drug Use and Health, a cross-sectional, nationally representative, household survey of U.S. civilians. Analyses included current, former, and never marijuana users aged≥18 reporting ever tobacco use (cigarette, cigar, chew/snuff). We computed weighted estimates (2013-2014) of current tobacco use, recent tobacco cessation (quit 30days to 12months), and sustained tobacco cessation (quit>12months) and adjusted trends in tobacco use and cessation (2005-2014) by marijuana use status. We also assessed the association between marijuana and tobacco use status. In 2013-2014, among current adult marijuana users reporting ever tobacco use, 69.1% were current tobacco users (vs. 38.5% of former marijuana users, p<0.0001, and 28.2% of never marijuana users, p<0.0001); 9.1% reported recent tobacco cessation (vs. 8.4% of former marijuana users, p<0.01, and 6.3% of never marijuana users, p<0.001), and 21.8% reported sustained tobacco cessation (vs. 53.1% of former marijuana users, p<0.01, and 65.5% of never marijuana users, p<0.0001). Between 2005 and 2014, current tobacco use declined and sustained tobacco cessation increased among all marijuana use groups. Current marijuana users who ever used tobacco had double the prevalence (vs. never-marijuana users) of current tobacco use, and significantly lower sustained abstinence. Interventions addressing tobacco cessation in the context of use of marijuana and other substances may be warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

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

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.

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

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.

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.

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

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

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

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.

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

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

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

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.

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

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.

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

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.

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

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).

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

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

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

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.

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.

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 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

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

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.

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

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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/

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.

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.

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/.

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

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.

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

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

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

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.

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 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.

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.…

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.

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

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

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

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

Tobacco use pattern among a national firefighter cohort.

PubMed

Jitnarin, Nattinee; Poston, Walker S C; Haddock, Christopher K; Jahnke, Sara A; Day, Rena S

2015-01-01

To date, there have been no large-scale, national epidemiological studies of tobacco use patterns among firefighters, particularly with a focus on smokeless tobacco (SLT) and dual use with cigarettes. While rates of firefighters' smoking are relatively low compared to the general population, SLT use typically is substantially higher than the populations they protect. In the current study, we systemically examine tobacco use, including SLT and dual use, and the health-related profiles of various tobacco use groups in a national sample of career firefighters. Data are from a national cohort study of career departments (N = 20) comprised of 947 male firefighters. Among 947 participants, 197 (21%) were tobacco users, of which, 34.5% used cigarettes, 53.2% used SLT, and 12.2% used both cigarettes and SLT. Adjusted rates of smoking, SLT use, and dual use were 13.2%, 10.5%, and 12.2%, respectively. Tobacco users of all types were significantly younger and had served fewer years in fire service and were significantly more likely to engage in heavy and binge drinking, as well as more likely to show signs of depressive symptoms compared to nontobacco users. Detailed information on tobacco use pattern will aid in better understanding what factors are contributing to the high rates of SLT and dual use among firefighters in order to guide and develop an appropriate treatment program for the fire service. © 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.

Tobacco Use Pattern Among a National Firefighter Cohort

PubMed Central

Poston, Walker SC; Haddock, Christopher K.; Jahnke, Sara A.; Day, Rena S.

2015-01-01

Introduction: To date, there have been no large-scale, national epidemiological studies of tobacco use patterns among firefighters, particularly with a focus on smokeless tobacco (SLT) and dual use with cigarettes. While rates of firefighters’ smoking are relatively low compared to the general population, SLT use typically is substantially higher than the populations they protect. In the current study, we systemically examine tobacco use, including SLT and dual use, and the health-related profiles of various tobacco use groups in a national sample of career firefighters. Methods: Data are from a national cohort study of career departments (N = 20) comprised of 947 male firefighters. Results: Among 947 participants, 197 (21%) were tobacco users, of which, 34.5% used cigarettes, 53.2% used SLT, and 12.2% used both cigarettes and SLT. Adjusted rates of smoking, SLT use, and dual use were 13.2%, 10.5%, and 12.2%, respectively. Tobacco users of all types were significantly younger and had served fewer years in fire service and were significantly more likely to engage in heavy and binge drinking, as well as more likely to show signs of depressive symptoms compared to nontobacco users. Conclusions: Detailed information on tobacco use pattern will aid in better understanding what factors are contributing to the high rates of SLT and dual use among firefighters in order to guide and develop an appropriate treatment program for the fire service. PMID:25145378

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.

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

Young adults' interpretations of tobacco brands: implications for tobacco control.

PubMed

Gendall, Philip; Hoek, Janet; Thomson, George; Edwards, Richard; Pene, Gina; Gifford, Heather; Pirikahu, Gill; McCool, Judith

2011-10-01

Marketers have long recognized the power and importance of branding, which creates aspirational attributes that increase products' attractiveness. Although brand imagery has traditionally been communicated via mass media, packaging's importance in promoting desirable brand-attribute associations has increased. Knowledge of how groups prone to smoking experimentation interpret tobacco branding would inform the debate over plain packaging currently occurring in many countries. We conducted 12 group discussions and four in-depth interviews with 66 young adult smokers and nonsmokers of varying ethnicities from two larger New Zealand cities and one provincial city. Participants evaluated 10 familiar and unfamiliar tobacco brands using brand personality attributes and discussed the associations they had made. Participants ascribed very different images to different brands when exposed to the packaging alone, regardless of whether they had seen or heard of the brands before. Perceptual mapping of brands and image attributes highlighted how brand positions varied from older, more traditional, and male oriented to younger, feminine, and "cool." Our findings emphasize the continuing importance of tobacco branding as a promotion tool, even when communicated only by packaging. The ease with which packaging alone enabled young people to identify brand attributes and the desirable associations these connoted illustrate how tobacco packaging functions as advertising. The results support measures such as plain packaging of tobacco products to reduce exposure to these overt behavioral cues.

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.

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.

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.

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

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.

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/.

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

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.

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.

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.

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

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.

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.

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.

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

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

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…

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

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).

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

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

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

[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.

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.

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

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.

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.

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.

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.

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.

[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.

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

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.

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

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.

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

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/

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

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

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

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

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.

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.

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

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.

Public support for raising the age of sale for tobacco to 21 in the United States.

PubMed

Winickoff, Jonathan P; McMillen, Robert; Tanski, Susanne; Wilson, Karen; Gottlieb, Mark; Crane, Robert

2016-05-01

The vast majority of tobacco users began before the age of 21. Raising the tobacco sales age to 21 has the potential to reduce tobacco use initiation and progression to regular smoking. Our objective was to assess the level of public support nationally for 'Tobacco 21' initiatives in the USA. The Social Climate Survey of Tobacco Control, a cross-sectional dual-frame survey representing national probability samples of adults was administered in 2013. Respondents were asked to state their agreement level with, 'The age to buy tobacco should be raised to 21.' Of 3245 respondents, 70.5% support raising the age to buy tobacco to 21. The majority of adults in every demographic and smoking status category supported raising the tobacco sales age to 21. In multivariable analyses, support was highest among never smokers, females, African-Americans and older adults. This national study demonstrates broad public support for raising the sales age of tobacco to 21 and will help facilitate wide dissemination of initiatives to increase the legal purchase age at national, state and local levels. Increasing public awareness about the susceptibility and rapid addiction of youth to nicotine may further increase public support for raising the tobacco sale age to 21. 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/

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.

Tobacco may mask poorer episodic memory among young adult cannabis users.

PubMed

Schuster, Randi M; Crane, Natania A; Mermelstein, Robin; Gonzalez, Raul

2015-09-01

Co-occurring cannabis and tobacco use has become increasingly prevalent among young adults, but it is not clear how tobacco use may alter the neurocognitive profile typically observed among cannabis users. Although there is substantial evidence citing cannabis and tobacco's individual effect on episodic memory and related brain structures, few studies have examined the effect of combined cannabis and tobacco use on memory. This investigation examined relationships between amount of past year cannabis and tobacco use on 4 different indices of episodic memory among a sample of young adults who identified cannabis as their drug of choice. Results indicated that more cannabis use was linked with poorer initial acquisition, total learning, and delayed recall on the Hopkins Verbal Learning Test-Revised, but only among cannabis users who sporadically smoked cigarettes in the past year. Conversely, the amount of past year cannabis use was not associated with episodic memory performance among individuals who more consistently smoked cigarettes in the past year. These differences could not be explained by several relevant potential confounds. These findings provide important insight into a potential mechanism (i.e., attenuation of cognitive decrements) that might reinforce use of both substances and hamper cessation attempts among cannabis users who also smoke cigarettes. Ongoing and future research will help to better understand how co-use of cannabis and tobacco affects memory during acute intoxication and abstinence and the stability of these associations over time. (c) 2015 APA, all rights reserved).

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

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.

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

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.

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

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

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

Adult awareness of tobacco advertising, promotion, and sponsorship--14 countries.

PubMed

2012-05-25

According to the 2012 Report of the U.S. Surgeon General, exposure to tobacco advertising, promotion, and sponsorship (TAPS) is associated with the initiation and continuation of smoking among young persons. The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) requires countries to prohibit all forms of TAPS; the United States signed the agreement in 2004, but the action has not yet been ratified. Many countries have adopted partial bans covering direct advertising in traditional media channels; however, few countries have adopted comprehensive bans on all types of direct and indirect marketing. To assess progress toward elimination of TAPS and the level of awareness of TAPS among persons aged ≥15 years, CDC used data from the Global Adult Tobacco Survey (GATS) collected in 14 countries during 2008-2010. Awareness of any TAPS ranged from 12.4% in Turkey to 70.4% in the Philippines. In the four countries where awareness of TAPs was ≤15%, three of the countries had comprehensive bans covering all nine channels assessed by GATS, and the fourth country banned seven of the nine channels. In 12 countries, more persons were aware of advertising in stores than advertising via any other channel. Reducing exposure to TAPS is important to prevent initiation of tobacco use by youths and young adults and to help smokers quit.

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

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.

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/.

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

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.

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

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/

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.

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…

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/

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

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

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.

DECOY: Documenting Experiences with Cigarettes and Other Tobacco in Young Adults

PubMed Central

Berg, Carla J.; Haardörfer, Regine; Lewis, Michael; Getachew, Betelihem; Lloyd, Steven A.; Thomas, Sarah Fretti; Lanier, Angela; Trepanier, Kelleigh; Johnston, Teresa; Grimsley, Linda; Foster, Bruce; Benson, Stephanie; Smith, Alicia; Barr, Dana Boyd; Windle, Michael

2016-01-01

Objectives We examined psychographic characteristics associated with tobacco use among Project DECOY participants. Methods Project DECOY is a 2-year longitudinal mixed-methods study examining risk for tobacco use among 3418 young adults across 7 Georgia colleges/universities. Baseline measures included sociodemographics, tobacco use, and psychographics using the Values, Attitudes, and Lifestyle Scale. Bivariate and multivariable analyses were conducted to identify correlates of tobacco use. Results Past 30-day use prevalence was: 13.3% cigarettes; 11.3% little cigars/cigarillos (LCCs); 3.6% smokeless tobacco; 10.9% e-cigarettes; and 12.2% hookah. Controlling for sociodemographics, correlates of cigarette use included greater novelty seeking (p < .001) and intellectual curiosity (p = .010) and less interest in tangible creation (p = .002) and social conservatism (p < .001). Correlates of LCC use included greater novelty seeking (p < .001) and greater fashion orientation (p = .007). Correlates of smokeless tobacco use included greater novelty seeking (p = .006) and less intellectual curiosity (p < .001). Correlates of e-cigarette use included greater novelty seeking (p < .001) and less social conservatism (p = .002). Correlates of hookah use included greater novelty seeking (p < .001), fashion orientation (p = .044), and self-focused thinking (p = .002), and less social conservatism (p < .001). Conclusions Psychographic characteristics distinguish users of different tobacco products. PMID:27103410

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 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.

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.

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.

Tobacco use and self-reported morbidity among rural Indian adults.

PubMed

Barik, Anamitra; Rai, Rajesh Kumar; Chowdhury, Abhijit

2016-09-01

Aim To measure the prevalence of self-reported morbidity and its associated factors among adults (aged ⩾15 years) in a select rural Indian population. Self-reporting of smoking has been validated as population-based surveys using self-reported data provide reasonably consistent estimates of smoking prevalence, and are generally considered to be sufficiently accurate for tracking the general pattern of morbidity associated with tobacco use in populations. However, to gauge the true disease burden using self-reported morbidity data requires cautious interpretation. During 2010-2011, a cross-sectional survey was conducted under the banner of the Health and Demographic Surveillance System, Birbhum, an initiative of the Department of Health and Family Welfare, Government of West Bengal, India. With over 93.6% response rate from the population living in 12 300 households, this study uses the responses from 16 354 individuals: 8012 smokers, and 8333 smokeless tobacco users. Smokers and smokeless tobacco users were asked whether they have developed any morbidity symptoms due to smoking, or smokeless tobacco use. Bivariate, as well as multivariate logistic regression analyses were deployed to attain the study objective. Findings Over 20% of smokers and over 9% of smokeless tobacco users reported any morbidity. Odds ratio (OR) with 95% confidence interval (CI) estimated using logistic regression shows that women are less likely to report any morbidity attributable to smoking (OR: 0.69; CI: 0.54-0.87), and more likely to report any morbidity due to smokeless tobacco use (OR: 1.68; CI: 1.36-2.09). Non-Hindus have higher odds, whereas the wealthiest respondents have lower odds of reporting any morbidity. With a culturally appropriate intervention to change behaviour, youth (both men and women) could be targeted with comprehensive tobacco cessation assistance programmes. A focussed intervention could be designed for unprocessed tobacco users to curb hazardous effects of

Adolescents' and Young Adults' Knowledge and Beliefs About Constituents in Novel Tobacco Products.

PubMed

Wiseman, Kimberly D; Cornacchione, Jennifer; Wagoner, Kimberly G; Noar, Seth M; Moracco, Kathryn E; Teal, Randall; Wolfson, Mark; Sutfin, Erin L

2016-07-01

Novel tobacco products, such as little cigars, cigarillos, hookah, and e-cigarettes, and their smoke or aerosol contain chemicals which the FDA has determined to be Harmful or Potentially Harmful Constituents. We explored adolescents' and young adults' knowledge and beliefs about constituents in novel tobacco products and their smoke or aerosol, in order to inform risk communication messages. Seventy-seven adolescents and young adults (ages 13-25) participated in 10 focus groups, including 47 novel tobacco product users and 30 susceptible nonusers. Participants were asked to discuss 10 pre-selected constituents found in novel tobacco products and their smoke or aerosol. The first author analyzed the discussion for emergent themes. Participants were generally familiar with arsenic, carbon monoxide, formaldehyde, and nicotine, but unfamiliar with acetaldehyde, acrolein, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanon (NNK), and N-nitrosonornicotine (NNN). All participants had negative beliefs about most constituents, although users had positive beliefs about nicotine. "Unfamiliar" constituents were associated with similarly-sounding words (eg, acetaldehyde sounds like acetaminophen), and some participants recognized words in the chemical names of NNK/NNN (eg, "nitro"). "Familiar" constituents were associated with negative health effects and other common products the constituents are found in. All participants wanted more information about the constituents' health effects, toxicity, and other common products. Most participants were unaware the constituents discussed are in novel tobacco products and their smoke or aerosol. Risk communication messages could capitalize on negative associations with familiar constituents, or attempt to educate about unfamiliar constituents, to discourage novel tobacco product use among adolescents and young adults. The results of this study have implications for how the FDA and other agencies can communicate about the risks of novel

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

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.

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

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

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

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.

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.

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 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

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.

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

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

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 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

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.

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.

Tobacco promotion 'below-the-line': exposure among adolescents and young adults in NSW, Australia.

PubMed

Perez, Donna A; Grunseit, Anne C; Rissel, Chris; Kite, James; Cotter, Trish; Dunlop, Sally; Bauman, Adrian

2012-06-12

Exposure to tobacco advertising and promotion increases the likelihood of smoking amongst young people. While there is a universal ban on traditional or ‘above-the-line’ advertising in Australia, the types and extent of exposure of young people to ‘below-the-line’ tobacco advertising and promotion is largely unknown. In this study we aim to identify levels of exposure of New South Wales (NSW) adolescents and young adults to tobacco promotion at the point-of-sale (PoS), on the internet, in entertainment media and at venues such as events or festivals and pubs, clubs, nightclubs, or bars; and to identify those most at risk of exposure. A telephone survey of 1000 NSW adolescents and young adults aged 12 to 24 years was conducted. Self-reported exposure to tobacco promotions or advertising in the last month were measured in four areas: (1) promotions or advertising at (a) events or festivals and (b) pubs, clubs, nightclubs or bars, (2) on the internet, (3) people smoking cigarettes in (a) movies, (b) TV shows, (c) video games and (d) on the internet, and (4) displays of cigarette packs for sale at (a) large supermarkets, (b) grocery stores or small supermarkets, (c) convenience stores, and (d) service or petrol stations. Smoking status and susceptibility to smoking was also assessed. A substantial proportion of the young people surveyed reported seeing tobacco promotion sometimes or often in the last month over most of the channels studied.The highest levels of exposure were at the PoS (approx. two-thirds) and to people smoking cigarettes in movies(77%). Lower levels of exposure to tobacco promotions and imagery were reported on the internet (20%); at events or festivals (22.5%); in pubs, clubs, nightclubs or bars (31%); and in video games (23%). However, the odds of exposure through video games increased by 8% for every additional hour spent on the internet per day. This study shows that adolescents and young adults in NSW are exposed to tobacco advertising or

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.

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.

Tobacco control: consensus report of the National Medical Association.

PubMed

Marable, Sharon; Crim, Courtney; Dennis, Gary C; Epps, Roselyn Payne; Freeman, Harold; Mills, Sherry; Coolchan, Eric T; Robinson, Lawrence; Robinson, Robert; Cole, Lorraine; Payne, Pamela H

2002-02-01

Tobacco Control remains one of the greatest determinants for reducing the morbidity and mortality of African Americans. To examine the scope and consequences of tobacco use among African Americans and characterize its implications for the National Medical Association physician membership and their patients, and identify policy, education, advocacy and research issues in Tobacco Control for the organization. Literature review using the MEDLINE database from January 1966 to August 1999 Week 1, searching Medical Subject Heading (MeSH) reading combined with text words "Black" or "African American" and "Tobacco" as a search term, identified 130 articles/110 abstracts published between 1988 and February 1999. The panel selected 61 appropriate articles and a paper summarizing the literature review was developed. The summary paper was used as background material for a formal consensus panel discussion on July 16-17, 1999. Consensus among committee members was reached via mail, fax and e-mail using the summary review paper, annotated bibliographies key informant surveys, and previous NMA resolutions on tobacco control. A formal working session was held on July 16-17, 1999 in which four areas of concentration of issues were determined: Policy, Advocacy, Education and Research. All committee members approved the final report. Because tobacco control issues in African Americans are both complex and poorly understood, the panel views the NMA's role as pivotal in the coordination of resources and capacity-building to address all four areas identified. Stronger partner-ships with traditional federal and nonprofit agencies associated with tobacco control/advocacy in African Americans as well as nontraditional organizations (i.e., churches, academia, marketing and media organizations) also must occur to strengthen the infra-structure needed to assess needs, design appropriate interventions and evaluate the appropriateness, effectiveness and efficacy of tobacco control efforts in

Collective Actors and Corporate Targets in Tobacco Control: A Cross-National Comparison

ERIC Educational Resources Information Center

Nathanson, Constance A.

2005-01-01

Cross-national comparative analysis of tobacco control strategies can alert health advocates to how opportunities for public health action, types of action, and probabilities for success are shaped by political systems and cultures. This article is based on case studies of tobacco control in the United States, Canada, Britain, and France. Two…

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.

Tobacco Cessation Behaviors Among Older Homeless Adults: Results From the HOPE HOME Study.

PubMed

Vijayaraghavan, Maya; Tieu, Lina; Ponath, Claudia; Guzman, David; Kushel, Margot

2016-08-01

Tobacco-attributable deaths contribute significantly to the increased mortality observed among homeless adults aged 50 years or more. Little is known about the epidemiology of tobacco use among older homeless individuals. This longitudinal cohort study examines smoking behaviors and factors associated with smoking cessation among homeless individuals aged 50 years or more. We recruited a prospective cohort of 350 homeless individuals sampled from the community in Oakland, California. At 6 months follow-up, participants reported their cigarette quit attempts and 30-day abstinence. We used multivariable logistic regression to examine factors associated with making a quit attempt at follow-up, hypothesizing that heavier smokers would be less likely to make a quit attempt. Of the 272 ever-smokers, 229 (84.2%) were current smokers (quit ratio 15.8). Among current smokers at enrollment who had a follow-up interview at 6 months, 43.6% (n = 71) reported making a quit attempt during the follow-up. Of those who reported making a quit attempt, 14.3% (n = 10) reported 30-day abstinence at follow-up. Among those who had reported making a quit attempt at follow-up, 22.5% had used nicotine replacement therapy (NRT). Staying in shelters (adjusted odds ratio [AOR] = 2.5, 95% confidence interval [CI] = 1.0-5.8) was associated with higher odds of making a quit attempt at follow-up. Higher cigarette consumption was associated with lower odds of making a quit attempt (AOR = 0.9, 95% CI = 0.8-0.9). In this study of tobacco use in older homeless adults, rates of quit attempts were similar to that observed in the general population, but successful quitting was lower. The current study is among the first studies to focus specifically on tobacco use and cessation behaviors among older homeless adults. The high prevalence of smoking and the low rates of successful quitting highlight numerous opportunities to intervene to increase quitting rates among this population. Among these, increasing

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

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

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

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

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

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.

The China National Tobacco Corporation: From domestic to global dragon?

PubMed

Fang, Jennifer; Lee, Kelley; Sejpal, Nidhi

2017-03-01

The China National Tobacco Corporation (CNTC), which produces one-third of the world's cigarettes, is the largest tobacco company in the world. Over the past 60 years, the CNTC has been focused on supplying a huge domestic market. As the market has become increasingly saturated, and potential foreign competition looms, the company has turned to expansion abroad. This paper examines the ambitions and prospects of the CNTC to 'go global'. Using Chinese and English language sources, this paper describes the globalisation ambitions of the CNTC, and its global business strategy focused on internal restructuring, brand development and expansion of overseas operations in selected markets. The paper concludes that the company has undergone substantial change over the past two decades and is consequently poised to become a new global player in the tobacco industry. This article is part of the special issue 'The Emergence of Asian Tobacco Companies: Implications for Global Health Governance'.

The China National Tobacco Corporation: From domestic to global dragon?

PubMed Central

Fang, Jennifer; Lee, Kelley; Sejpal, Nidhi

2017-01-01

ABSTRACT The China National Tobacco Corporation (CNTC), which produces one-third of the world’s cigarettes, is the largest tobacco company in the world. Over the past 60 years, the CNTC has been focused on supplying a huge domestic market. As the market has become increasingly saturated, and potential foreign competition looms, the company has turned to expansion abroad. This paper examines the ambitions and prospects of the CNTC to ‘go global’. Using Chinese and English language sources, this paper describes the globalisation ambitions of the CNTC, and its global business strategy focused on internal restructuring, brand development and expansion of overseas operations in selected markets. The paper concludes that the company has undergone substantial change over the past two decades and is consequently poised to become a new global player in the tobacco industry. This article is part of the special issue ‘The Emergence of Asian Tobacco Companies: Implications for Global Health Governance’. PMID:27737622

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

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

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.

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.

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…

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.

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.

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

Other Tobacco Product Use Among Sexual Minority Young Adult Bar Patrons.

PubMed

Fallin-Bennett, Amanda; Lisha, Nadra E; Ling, Pamela M

2017-09-01

Lesbian, gay, and bisexual (LGB) individuals smoke at rates 1.5-2 times higher than the general population, but less is known about LGB consumption of other tobacco products (OTPs) and gender differences. OTP use among young adult LGB bar patrons and the relationship among past quit attempts, intention to quit, and binge drinking with OTP use was examined. A cross-sectional survey of young adults (aged 18-26) in bars/nightclubs in seven U.S. cities between 2012 and 2014 (N=8,010; 1,101 LGB participants) was analyzed in 2016. Logistic regressions examined current use of five OTPs (cigarillos, electronic cigarettes, hookah, chewing tobacco, and snus) and sexual minority status, adjusting for demographics and comparing LB women and GB men with their heterosexual counterparts. LGB bar/nightclub patrons used all OTPs more than their heterosexual counterparts. LB women were more likely than heterosexual women to use cigarillos, electronic cigarettes, hookah, chew, and snus. GB men were more likely than heterosexual men to smoke cigarillos, electronic cigarettes, hookah, and use chew and snus. Past-year quit attempt was associated with increased odds of electronic cigarette use in men and women, and increased odds of dual use (cigarettes and OTPs) among men. Intention to quit was negatively associated with dual use among women. Binge drinking was associated with increased use of all OTPs across genders. LGB bar-going young adults are at higher risk for OTP use than their heterosexual counterparts. Bar-based interventions are needed to address all forms of tobacco use in this high-risk group. Copyright © 2017. Published by Elsevier Inc.

Association Between Receptivity to Tobacco Advertising and Progression to Tobacco Use in Youth and Young Adults in the PATH Study.

PubMed

Pierce, John P; Sargent, James D; Portnoy, David B; White, Martha; Noble, Madison; Kealey, Sheila; Borek, Nicolette; Carusi, Charles; Choi, Kelvin; Green, Victoria R; Kaufman, Annette R; Leas, Eric; Lewis, M Jane; Margolis, Katherine A; Messer, Karen; Shi, Yuyan; Silveira, Marushka L; Snyder, Kimberly; Stanton, Cassandra A; Tanski, Susanne E; Bansal-Travers, Maansi; Trinidad, Dennis; Hyland, Andrew

2018-03-26

Cigarette marketing contributes to initiation of cigarette smoking among young people, which has led to restrictions on use of cigarette advertising. However, little is known about other tobacco advertising and progression to tobacco use in youth and young adults. To investigate whether receptivity to tobacco advertising among youth and young adults is associated with progression (being a susceptible never user or ever user) to use of the product advertised, as well as conventional cigarette smoking. The Population Assessment of Tobacco and Health (PATH) Study at wave 1 (2013-2014) and 1-year follow-up at wave 2 (2014-2015) was conducted in a US population-based sample of never tobacco users aged 12 to 24 years from wave 1 of the PATH Study (N = 10 989). Household interviews using audio computer-assisted self-interviews were conducted. Advertising for conventional cigarettes, electronic cigarettes (e-cigarettes), cigars, and smokeless tobacco products at wave 1. Progression to susceptibility or ever tobacco use at 1-year follow-up in wave 2. Of the 10 989 participants (5410 male [weighted percentage, 48.3%]; 5579 female [weighted percentage, 51.7%]), receptivity to any tobacco advertising at wave 1 was high for those aged 12 to 14 years (44.0%; 95% confidence limit [CL], 42.6%-45.4%) but highest for those aged 18 to 21 years (68.7%; 95% CL, 64.9%-72.2%). e-Cigarette advertising had the highest receptivity among all age groups. For those aged 12 to 17 years, susceptibility to use a product at wave 1 was significantly associated with product use at wave 2 for conventional cigarettes, e-cigarettes, cigars, and smokeless tobacco products. Among committed never users aged 12 to 17 years at wave 1, any receptivity was associated with progression toward use of the product at wave 2 (conventional cigarettes: adjusted odds ratio [AOR], 1.43; 95% CL, 1.23-1.65; e-cigarettes: AOR, 1.62; 95% CL, 1.41-1.85; cigars: AOR, 2.01; 95% CL, 1.62-2.49; and smokeless (males only

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

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

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.

Global Adult Tobacco Survey data as a tool to monitor the WHO Framework Convention on Tobacco Control (WHO FCTC) implementation: the Brazilian case.

PubMed

Almeida, Liz; Szklo, André; Sampaio, Mariana; Souza, Mirian; Martins, Luís Felipe; Szklo, Moysés; Malta, Deborah; Caixeta, Roberta

2012-07-01

The Global Adult Tobacco Survey (GATS) was conducted in Brazil to provide data on tobacco use in order to monitor the WHO FCTC implementation in the country. It was carried out in 2008 using an international standardized methodology. The instrument included questions about tobacco use prevalence, cessation, secondhand smoke, knowledge, attitudes, media and advertising. Weighted analysis was used to obtain estimates. A total of 39,425 interviews were conducted. The prevalence of current tobacco use was 17.5%, (22.0%, men; 13.3%, women). The majority of users were smokers (17.2%) and their percentage was higher in rural areas (20.4%) than in urban areas (16.6%). About 20% of individuals reported having been exposed to tobacco smoke in public places. Over 70% of respondents said they had noticed anti-smoking information in several media and around 65% of smokers said they had considered quitting because of warning labels. About 30% of respondents had noticed cigarette advertising at selling points and 96% recognized tobacco use as a risk factor for serious diseases. Data in this report can be used as baseline for evaluation of new tobacco control approaches in Brazil, vis-à-vis WHO FCTC demand reduction measures.

Tobacco and nicotine delivery product use in a national sample of pregnant women.

PubMed

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

2017-11-01

Monitoring use of tobacco products among pregnant women is a public health priority, yet few studies in U.S. national samples have been reported on this topic. We examined prevalence and correlates of using cigarettes, e-cigarettes, and other tobacco/nicotine delivery products in a U.S. national sample of pregnant women. Data were obtained from all pregnant women (≥18 years) in the first wave of the Population Assessment of Tobacco and Health (PATH, 2013-2014) Study (N=388). Prevalence of current and prior use of tobacco/nicotine products was examined overall and among current cigarette smokers. Multiple logistic regression was used to examine correlates of use of cigarettes, e-cigarettes, hookah and cigars. Overall prevalence was highest for cigarettes (13.8%), followed by e-cigarettes (4.9%), hookah (2.5%) and cigars (2.3%), and below 1% for all other products. Prevalence of using other tobacco products is much higher among current smokers than the general population, with e-cigarettes (28.5%) most prevalent followed by cigars (14.0%), hookah (12.4%), smokeless (4.7%), snus (4.6%), and pipes (2.1%). Sociodemographic characteristics (poverty, low educational attainment, White race) and past-year externalizing psychiatric symptoms were correlated with current cigarette smoking. In turn, current cigarette smoking and past year illicit drug use were correlated with using e-cigarettes, hookah, and cigars. These results underscore that tobacco/nicotine use during pregnancy extends beyond cigarettes. The results also suggest that use of these other products should be included in routine clinical screening on tobacco use, and the need for more intensive tobacco control and regulatory strategies targeting pregnant women. Copyright © 2017 Elsevier Inc. All rights reserved.

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…

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.

Should tobacco and alcohol companies be allowed to influence Australia's National Drug Strategy?

PubMed

Freeman, Becky; MacKenzie, Ross; Daube, Mike

2017-04-27

Formation of Australia's National Drug Strategy (NDS) included an extensive consultation process that was open not only to community and public health stakeholders, but also to representatives of the tobacco and alcohol industries. Australia is bound by the World Health Organization Framework Convention on Tobacco Control, which requires governments to protect tobacco control measures from interference by the tobacco industry. NDS consultation submissions made by these conflicted industries are not publicly available for scrutiny. The NDS goals are at odds with the commercial agenda of industries that support regulatory stagnation, oppose and undermine effective action, ignore and distort evidence, and prioritise profits over health.

Impact of Presence of Children on Indoor Tobacco Restrictions in Households of Urban and Rural Adult Tobacco Users.

PubMed

Kopp, Benjamin T; Hinton, Alice; Lu, Rong; Cooper, Sarah; Nagaraja, Haikady; Wewers, Mary Ellen

2018-04-10

Secondhand smoke exposure in children is changing as a result of new public policy and electronic nicotine products (e-cigarettes). We examined factors related to self-imposed indoor household tobacco restrictions, with emphasis on children in the household and associations with combustible and noncombustible product use. A cross-sectional survey of urban and rural Ohio adult tobacco users classified participants as exclusive combustible users, smokeless tobacco (SLT) users, e-cigarette users, or dual users. They were further stratified according to combustible or noncombustible product use and the presence of indoor tobacco use restrictions. Multiple logistic regression determined factors associated with indoor tobacco restrictions. A total of 1210 tobacco users participated, including 25.7% with children living in the home. Half allowed combustible and two thirds allowed noncombustible tobacco use indoors. Urban location (odds ratio [OR] = 1.58), younger age (OR = 0.88 per 5 year), male sex (OR = 1.40), college education (OR = 1.40), household income of more than $15,000 (OR = 1.78), and being married (OR = 2.43) were associated with a higher likelihood of banning combustible products indoors. SLT (OR = 8.12) and e-cigarette (OR = 5.85) users were more likely to have indoor bans compared to combustible users. Children in the household (OR = 1.89), older age (OR = 1.12 per 5 years), and nonwhite race (OR = 1.68) were associated with a higher likelihood of banning noncombustible products indoors. Combustible (OR = 4.54) and e-cigarette (OR = 3.04) users were more likely than SLT users to have indoor bans. Indoor restrictions on tobacco use remain infrequent in homes with children and are associated with user type and socioeconomic factors. Public policy should target modifiable risk factors for in-home secondhand smoke exposure. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All

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

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.

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.

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.

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.

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

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

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

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.

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

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.

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.

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

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

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…

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.

Brazil: balance of the National Tobacco Control Policy in the last decade and dilemmas.

PubMed

Cavalcante, Tânia Maria; Pinho, Mariana Coutinho Marques de; Perez, Cristina de Abreu; Teixeira, Ana Paula Leal; Mendes, Felipe Lacerda; Vargas, Rosa Rulff; Carvalho, Alexandre Octávio Ribeiro de; Rangel, Erica Cavalcanti; Almeida, Liz Maria de

2017-09-21

Since 2005, Brazil has been a Party of the World Health Organization Framework Convention on Tobacco Control, an international treaty whose measures are the foundation of the National Tobacco-Control Policy (NTCP), of Brazil. The results evidence a significant decrease in the prevalence of smokers and in tobacco-related morbidity and mortality. These results, however, could have been even better if there wasn't the interference of the tobacco supply chain (TSC), controlled by transnational corporations, which has become more intense over the last 10 years. These companies made Brazil not only a repository for tobacco, but also for economic and political power capable of threatening NTCP achievements. This Essay recounts the development of NTCP and the tobacco supply chain modus operandi to hamper it, and discusses how the strengthening of policies to promote alternative crops for tobacco could shield NTCP from such interference.

Global Adult Tobacco Survey Data as a Tool to Monitor the WHO Framework Convention on Tobacco Control (WHO FCTC) Implementation: The Brazilian Case

PubMed Central

Almeida, Liz; Szklo, André; Sampaio, Mariana; Souza, Mirian; Martins, Luís Felipe; Szklo, Moysés; Malta, Deborah; Caixeta, Roberta

2012-01-01

The Global Adult Tobacco Survey (GATS) was conducted in Brazil to provide data on tobacco use in order to monitor the WHO FCTC implementation in the country. It was carried out in 2008 using an international standardized methodology. The instrument included questions about tobacco use prevalence, cessation, secondhand smoke, knowledge, attitudes, media and advertising. Weighted analysis was used to obtain estimates. A total of 39,425 interviews were conducted. The prevalence of current tobacco use was 17.5%, (22.0%, men; 13.3%, women). The majority of users were smokers (17.2%) and their percentage was higher in rural areas (20.4%) than in urban areas (16.6%). About 20% of individuals reported having been exposed to tobacco smoke in public places. Over 70% of respondents said they had noticed anti-smoking information in several media and around 65% of smokers said they had considered quitting because of warning labels. About 30% of respondents had noticed cigarette advertising at selling points and 96% recognized tobacco use as a risk factor for serious diseases. Data in this report can be used as baseline for evaluation of new tobacco control approaches in Brazil, vis-à-vis WHO FCTC demand reduction measures. PMID:22851957

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.

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

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

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

A qualitative exploration of young adult smokers’ responses to novel tobacco warnings

PubMed Central

2013-01-01

Background Despite reduced smoking among adolescents, smoking prevalence peaks among young adults aged 18–30, many of whom believe themselves exempt from the health risks of smoking shown in warning labels. We explored how young adult smokers perceived warnings featuring proximal risks, and whether these encouraged cessation more effectively than traditional health messages. Methods We conducted in-depth interviews with 17 young adult smokers and explored their perceptions of current warnings as well as novel warnings representing short-term health consequences; immediate social risks, and tobacco’s toxicity (denormalizing tobacco as an everyday product). We used a thematic analysis approach to explore how participants rationalized existing warnings and interpreted the novel messages. Results Participants considered the immediate social and physiological benefits they gained from smoking outweighed the distal risks shown in health warnings, which they regarded as improbable and irrelevant. Of the novel warnings, those presenting immediate social risks altered the balance of gains and losses young adults associated with smoking; however, those presenting short-term health risks or depicting tobacco as a toxin were less effective. Conclusions Participants regarded warnings featuring proximal social risks as more salient and they were less likely to rationalise these as irrelevant. Social risk messages merit further investigation to examine their potential as a complement to traditional health warnings. PMID:23800292

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

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.

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.

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.

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.

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

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.

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.

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.

Determinants of exposure to secondhand smoke among Vietnamese adults: California Vietnamese Adult Tobacco Use Survey, 2007-2008.

PubMed

Webber, Whitney L; van Erp, Brianna; Stoddard, Pamela; Tsoh, Janice Y

2014-05-15

Because smoking rates are high among Vietnamese men, we used data from the 2007-2008 California Vietnamese Adult Tobacco Use Survey to estimate secondhand smoke exposure and associated risk factors among Vietnamese nonsmokers. Thirty percent of nonsmokers were exposed to secondhand smoke (SHS) at home, 8% at work, 52% in bars, and 67% on a college campus. At home, odds of SHS exposure were greater for women than for men and for adults aged less than 40 years than for older adults. Odds of SHS exposure were higher for former smokers at work (among employed men) and among men when in bars. Future interventions should consider sex, age, and smoking history in efforts to prevent SHS exposure among Vietnamese adults.

Impact on cardiovascular disease events of the implementation of Argentina's national tobacco control law.

PubMed

Konfino, Jonatan; Ferrante, Daniel; Mejia, Raul; Coxson, Pamela; Moran, Andrew; Goldman, Lee; Pérez-Stable, Eliseo J

2014-03-01

Argentina's congress passed a tobacco control law that would enforce 100% smoke-free environments for the entire country, strong and pictorial health warnings on tobacco products and a comprehensive advertising ban. However, the Executive Branch continues to review the law and it has not been fully implemented. Our objective was to project the potential impact of full implementation of this tobacco control legislation on cardiovascular disease. The Coronary Heart Disease (CHD) Policy Model was used to project future cardiovascular events. Data sources for the model included vital statistics, morbidity and mortality data, and tobacco use estimates from the National Risk Factor Survey. Estimated effectiveness of interventions was based on a literature review. Results were expressed as life-years, myocardial infarctions and strokes saved in an 8-year-period between 2012 and 2020. In addition we projected the incremental effectiveness on the same outcomes of a tobacco price increase not included in the law. In the period 2012-2020, 7500 CHD deaths, 16 900 myocardial infarctions and 4300 strokes could be avoided with the full implementation and enforcement of this law. Annual per cent reduction would be 3% for CHD deaths, 3% for myocardial infarctions and 1% for stroke. If a tobacco price increase is implemented the projected avoided CHD deaths, myocardial infarctions and strokes would be 15 500, 34 600 and 11 900, respectively. Implementation of the tobacco control law would produce significant public health benefits in Argentina. Strong advocacy is needed at national and international levels to get this law implemented throughout Argentina.

Social Determinants of Health and Tobacco Use in Five Low and Middle-Income Countries - Results from the Global Adult Tobacco Survey (GATS), 2011 - 2012.

PubMed

Tee, Guat Hiong; Aris, Tahir; Rarick, James; Irimie, Sorina

2016-01-01

Tobacco consumption continues to be the leading cause of preventable deaths globally. The objective of this study was to examine the associaton of selected socio-demographic variables with current tobacco use in five countries that participated in the Phase II Global Adult Tobacco Survey in 2011 - 2012. We analysed internationally comparable representative household survey data from 33,482 respondents aged ≥ 15 years in Indonesia, Malaysia, Romania, Argentina and Nigeria for determinants of tobacco use within each country. Socio-demographic variables analysed included gender, age, residency, education, wealth index and awareness of smoking health consequences. Current tobacco use was defined as smoking or use of smokeless tobacco daily or occasionally. The overall prevalence of tobacco use varied from 5.5% in Nigeria to 35.7% in Indonesia and was significantly higher among males than females in all five countries. Odds ratios for current tobacco use were significantly higher among males for all countries [with the greatest odds among Indonesian men (OR=67.4, 95% CI: 51.2-88.7)] and among urban dwellers in Romania. The odds of current tobacco use decreased as age increased for all countries except Nigeria where. The reverse was true for Argentina and Nigeria. Significant trends for decreasing tobacco use with increasing educational levels and wealth index were seen in Indonesia, Malaysia and Romania. Significant negative associations between current tobacco use and awareness of adverse health consequences of smoking were found in all countries except Argentina. Males and the socially and economically disadvantaged populations are at the greatest risk of tobacco use. Tobacco control interventions maybe tailored to this segment of population and incorporate educational interventions to increase knowledge of adverse health consequences of smoking.

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

PubMed

Ginexi, Elizabeth M; Vollinger, Robert E

2016-10-01

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

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.

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

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.

Influences on Tobacco Use Among Urban Hispanic Young Adults in Baltimore: Findings From a Qualitative Study

PubMed Central

McCleary-Sills, Jennifer D.; Villanti, Andrea; Rosario, Evelyn; Bone, Lee; Stillman, Frances

2011-01-01

Background Among Hispanics, lung cancer is the leading cause of cancer-related death for men and the second leading cause of cancer death for women in the United States. Despite recent growth in Baltimore City’s Hispanic population, few data exist on tobacco use behaviors in this group. Objectives The present research sought to explore the social and environmental influences and norms that encourage or discourage tobacco use among Hispanic young adults in Baltimore. Methods In collaboration with several community stakeholders, we conducted focus groups with Hispanic young adults 18 to 24 years old. Participants were recruited from a community-based service organization and invited to take part in one of four focus groups segregated by gender. Results A total of 13 young men and 11 young women participated. Data from these focus groups indicate that cultural identity and gender norms leverage substantial influence in young adults’ decision about whether, where, and with whom to smoke. The data also suggest multiple social and familial influences on their smoking and nonsmoking behaviors. Participants identified smoking practices and clear brand preferences that they feel distinguish Hispanics from other racial and ethnic groups. Despite acknowledging the high price of cigarettes, cost was not mentioned as a factor influential in their smoking decisions. Conclusion These results provide essential guidance for the development of appropriate tobacco prevention and cessation intervention strategies and policy recommendations to eliminate tobacco use among Hispanic young adults in Baltimore. PMID:21169706

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

A national survey of public support for restrictions on youth access to tobacco.

PubMed

Bailey, W J; Crowe, J W

1994-10-01

A national telephone survey was conducted to measure public support for seven proposals to restrict youth access to tobacco products, including increases in the cigarette excise tax. A random digit dialing survey, using computer-assisted telephone interviews and a two-stage Mitofsky-Waksberg design, was used to generate and replace telephone numbers and to select individuals from within households. More than 94% of respondents believed cigarette smoking by children and adolescents to be a "very serious" or "somewhat serious" problem. Most respondents expressed support for all the proposed measures to restrict youth access to tobacco products (fines for sellers, fines for youthful violators, licensing of all tobacco vendors, restrictions on cigarette vending machines, ban on sponsorship of youth-oriented events, and ban on all tobacco advertising), and for increases in the cigarette excise tax.

[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.

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.

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

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.

Students' opinion of tobacco control policies recommended for US colleges: a national survey

PubMed Central

Rigotti, N; Regan, S; Moran, S; Wechsler, H

2003-01-01

Objective: Comprehensive tobacco control policies for US colleges and universities have been proposed by several groups in order to counter the rising use of tobacco by students enrolled in these institutions. Student opinion of these policies is not known, and concern about student opposition is one barrier that deters administrators from adopting the policies. This study measured student support for recommended college tobacco control policies. Design: Mailed survey of US college students (2001 Harvard School of Public Health College Alcohol Study). Setting: 119 nationally representative, four-year colleges and universities in the USA. Participants: 10 904 randomly selected undergraduate students enrolled at participating schools. Main outcome measures: Students' opinion of 7 proposed tobacco control policies. Results: A majority of students supported each policy. Over three quarters of students favoured smoke-free policies for all college buildings, residences, and dining areas, while 71% supported prohibiting tobacco advertising and sponsorship of campus social events, 59% favoured prohibiting tobacco sales on campus, and 51% supported smoke-free campus bars. All policies had more support among non-smokers than smokers (p < 0.001). Among smokers, support for policies was inversely related to intention to quit and intensity of tobacco consumption. Because college students' tobacco consumption is low, a majority of smokers favoured banning smoking in college buildings and dining areas and prohibiting tobacco marketing on campus. Conclusions: Student support for proposed campus tobacco control policies is strong, even among smokers, and broadly based across demographic subgroups. These findings should provide reassurance to college administrators who are considering adopting these policies. PMID:12958381

The extent of cigarette brand and company switching: results from the Adult Use-of-Tobacco Survey.

PubMed

Siegel, M; Nelson, D E; Peddicord, J P; Merritt, R K; Giovino, G A; Eriksen, M P

1996-01-01

To evaluate the effects of cigarette advertising on brand switching, an accurate estimate of the extent of cigarette brand and company switching among current smokers is needed. Data from the 1986 Adult Use-of-Tobacco Survey were analyzed to estimate the percentage of adult smokers who switched cigarette brands and companies in the previous year. Approximately 9.2% of adult smokers (4.2 million) switched cigarette brands in 1986, and 6.7% (3.1 million) switched cigarette companies. The aggregate profitability of brand switching in 1986 was approximately $362 million. Based on this analysis, brand switching alone justifies only a small percentage of a cigarette company's advertising and promotion expenditures, suggesting that future research should address other potential effects of advertising, including maintenance of brand loyalty and expanding the cigarette market. Medical Subject Headings (MeSH): addictive behavior, advertising, smoking, tobacco.

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.

Tobacco-Control Policies in Tobacco-Growing States: Where Tobacco Was King

PubMed Central

Fallin, Amanda; Glantz, Stanton A

2015-01-01

Context The 5 major tobacco-growing states (Kentucky, North Carolina, South Carolina, Tennessee, and Virginia) are disproportionately affected by the tobacco epidemic, with higher rates of smoking and smoking-induced disease. These states also have fewer smoke-free laws and lower tobacco taxes, 2 evidence-based policies that reduce tobacco use. Historically, the tobacco farmers and hospitality associations allied with the tobacco companies to oppose these policies. Methods This research is based on 5 detailed case studies of these states, which included key informant interviews, previously secret tobacco industry documents (available at http://legacy.library.ucsf.edu), and media articles. This was supplemented with additional tobacco document and media searches specifically for this article. Findings The tobacco companies were particularly concerned about blocking tobacco-control policies in the tobacco-growing states by promoting a pro-tobacco culture, beginning in the late 1960s. Nevertheless, since 2003, there has been rapid progress in the tobacco-growing states’ passage of smoke-free laws. This progress came after the alliance between the tobacco companies and the tobacco farmers fractured and hospitality organizations stopped opposing smoke-free laws. In addition, infrastructure built by National Cancer Institute research projects (COMMIT and ASSIST) led to long-standing tobacco-control coalitions that capitalized on these changes. Although tobacco production has dramatically fallen in these states, pro-tobacco sentiment still hinders tobacco-control policies in the major tobacco-growing states. Conclusions The environment has changed in the tobacco-growing states, following a fracture of the alliance between the tobacco companies and their former allies (tobacco growers and hospitality organizations). To continue this progress, health advocates should educate the public and policymakers on the changing reality in the tobacco-growing states, notably the

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.

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.

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.

Symptoms of Tobacco Dependence Among Middle and High School Tobacco Users

PubMed Central

Apelberg, Benjamin J.; Corey, Catherine G.; Hoffman, Allison C.; Schroeder, Megan J.; Husten, Corinne G.; Caraballo, Ralph S.; Backinger, Cathy L.

2015-01-01

Background A growing body of evidence suggests that tobacco dependence symptoms can occur soon after smoking onset and with low levels of use. However, limited data are available nationally and among non-cigarette tobacco users. Purpose To examine the prevalence and determinants of tobacco dependence symptoms among adolescent tobacco users in the 2012 National Youth Tobacco Survey, a nationally representative, school-based survey of U.S. middle and high school students. Methods Multivariate logistic regression was used to identify independent predictors of dependence symptoms among current users (i.e., past 30-day use) of cigarettes, cigars, or smokeless tobacco. Analyses were conducted in 2013 using SAS-callable SUDAAN, version 11 to account for the complex survey design. Results Prevalence of tobacco dependence symptoms ranged from 20.8% (95% CI=18.6, 23.1) of current tobacco users reporting wanting to use tobacco within 30 minutes of waking to 41.9% (95% CI=39.3, 44.5) reporting recent strong cravings. Reporting of dependence symptoms was most consistently associated with polytobacco use, higher frequency of use, earlier initiation age, and female gender. A 2–4-fold increase in the odds of symptom reporting was found in adolescents using tobacco products on as few as 3–5 days compared to those who only used it for 1–2 of the past 30 days. Conclusions A substantial proportion of U.S. adolescent tobacco users, including those with low levels of use, report symptoms of tobacco dependence. These findings demonstrate the need for full implementation of evidence-based strategies to prevent both experimentation and progression to regular tobacco use among youth. PMID:25044195

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.

Determinants of Exposure to Secondhand Smoke Among Vietnamese Adults: California Vietnamese Adult Tobacco Use Survey, 2007–2008

PubMed Central

van Erp, Brianna; Stoddard, Pamela; Tsoh, Janice Y.

2014-01-01

Because smoking rates are high among Vietnamese men, we used data from the 2007–2008 California Vietnamese Adult Tobacco Use Survey to estimate secondhand smoke exposure and associated risk factors among Vietnamese nonsmokers. Thirty percent of nonsmokers were exposed to secondhand smoke (SHS) at home, 8% at work, 52% in bars, and 67% on a college campus. At home, odds of SHS exposure were greater for women than for men and for adults aged less than 40 years than for older adults. Odds of SHS exposure were higher for former smokers at work (among employed men) and among men when in bars. Future interventions should consider sex, age, and smoking history in efforts to prevent SHS exposure among Vietnamese adults. PMID:24831285

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.

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

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.

Use of illicit tobacco following introduction of standardised packaging of tobacco products in Australia: results from a national cross-sectional survey.

PubMed

Scollo, Michelle; Zacher, Meghan; Coomber, Kerri; Wakefield, Melanie

2015-04-01

To assess whether following standardisation of tobacco packaging in Australia, smokers were, as predicted by the tobacco industry, more likely to use illicit tobacco. National cross-sectional telephone surveys conducted continuously from April 2012 (6 months before implementation of plain packaging (PP)) to March 2014 (15 months after) using responses from current cigarette smokers (n=8679). Changes between pre-PP, the transition to PP and PP phase were examined using logistic regression models. Among those whose factory-made cigarettes were purchased in Australia, compared with pre-PP, there were no significant increases in the PP phase in use of: 'cheap whites' (<0.1%; OR=0.24, 95% CI 0.04 to 1.56, p=0.134); international brands purchased for 20% or more below the recommended retail price (0.2%; OR=3.49, 95% CI 0.66 to 18.35, p=0.140); or packs purchased from informal sellers (<0.1%; OR=0.24, 95% CI 0.04 to 1.47, p=0.124). The prevalence of any use of unbranded illicit tobacco remained at about 3% (adjusted OR=0.79, 95% CI 0.58 to 1.08, p=0.141). While unable to quantify the total extent of use of illicit manufactured cigarettes, in this large national survey we found no evidence in Australia of increased use of two categories of manufactured cigarettes likely to be contraband, no increase in purchase from informal sellers and no increased use of unbranded illicit 'chop-chop' 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.

Adults' response to Massachusetts anti-tobacco television advertisements: impact of viewer and advertisement characteristics

PubMed Central

Biener, L.; McCallum-Keeler, G.; Nyman, A.

2000-01-01

OBJECTIVE—To assess adults' receptivity to the Massachusetts television anti-tobacco campaign. Reactions were examined as a function of respondents' demographics, baseline tobacco control attitudes, changes in smoking status during the campaign, and advertisements' affective qualities.
DESIGN—A random digit dial telephone survey in 1993 at the start of the media campaign and re-interview in 1996 of respondents to the baseline survey.
PARTICIPANTS—Respondents were 1544 adults who completed the baseline and follow up interview.
INTERVENTION—By the time the follow up survey was completed, approximately $49 million had been spent on the media campaign. Approximately 66 spots had been aired.
MAIN OUTCOME MEASURES—Reported exposure to television advertisements; perceived effectiveness of nine specific advertisements each.
RESULTS—56% of respondents reported seeing anti-tobacco advertisements at least once a week during the preceding three years. The average effectiveness rating for all advertisements recalled on a 0-10 scale was 7.29, and did not differ by smoking status group. Advertisements eliciting strong negative emotions (sadness and fear) were rated most effective by quitters, non-smokers, and by smokers who at baseline were planning to quit soon. Humorous, entertaining advertisements were seen as ineffective by all groups.
CONCLUSION—The Massachusetts anti-tobacco campaign achieved high levels of penetration into the population and was well received by both smokers and non-smokers. The results suggest that advertisements depicting suffering as a result of tobacco use may be instrumental in promoting cessation or reinforcing the decision to quit. Further research is needed to lend additional support to the link between perceived effectiveness and smoking behaviour change.


Keywords: mass media; counter advertising; fear appeals PMID:11106710

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

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.

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

Rates and correlates of tobacco cessation service use nationally in the Veterans Health Administration.

PubMed

Kelly, Megan M; Sido, Hannah; Rosenheck, Robert

2016-05-01

Tobacco use is a substantial problem for veterans using Veterans Health Administration (VHA) services, but relatively little is known about the association of specific patient characteristics, patterns of service use, the amount of such services, and the frequency of their use. Analysis of national VHA administrative data (N = 5,531,379) from fiscal year 2012 (FY2012) were used to identify use of tobacco cessation counseling services among veterans with a diagnosed tobacco use disorder, and to examine correlates of such use. Only 3.8% of veterans diagnosed with a tobacco use disorder used VHA tobacco cessation services, and only 0.9% met U.S. Public Health Service clinical practice guidelines for the recommended amount of counseling (i.e., 4 or more sessions). Veterans who used intensive tobacco cessation counseling services were more likely to be homeless, had comorbid mental health and substance use disorders, and used more VHA services overall than veterans who did not use tobacco cessation services. An analysis of the supply of tobacco cessation services (counseling visits provided per 100 veteran users of any services at each facility) showed that increasing the supply by just 1 visit for every 100 veterans would increase the percentage of veterans involved in tobacco cessation counseling by 35%. Veterans diagnosed with tobacco use disorder substantially underuse VHA tobacco cessation counseling services, and use is greatest at facilities that provide more tobacco cessation counseling services. Future efforts should focus on increasing the amount of VHA tobacco cessation services and encouraging veterans' awareness of and motivation to use these services. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

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.

German Public Support for Tobacco Control Policy Measures: Results from the German Study on Tobacco Use (DEBRA), a Representative National Survey

PubMed Central

Shahab, Lion; Kastaun, Sabrina

2018-01-01

Smoking prevalence in Germany remains high at approximately 28%. We assessed public support for tobacco legislation and associations between level of support and smoking and socio-demographic characteristics. Data from 2087 people were collected as part of the German Study on Tobacco Use (“DEBRA”): a nationally representative, face-to-face household survey. Public support was measured on total ban of sale, raising the minimum age for sales, taxation of tobacco industry sales, research into e-cigarettes, and ban of smoking in cars when children are present. Associations were assessed with multivariate logistic regression. Over 50% of the German population support taxing industry profits (57.3%) and assessing e-cigarettes as an aid to quit smoking (55.5%). Over 40% support raising the legal age of sale (43.1%), and 22.9% support a total ban on tobacco sales. A smoking ban in cars when children are present was most popular (71.5%), even among current smokers (67.0%). There is public support for stricter tobacco control measures in Germany. A smoking ban in cars when children are present could be a feasible policy to implement. PMID:29642461

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.

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

Movies and TV influence tobacco use in India: findings from a national survey.

PubMed

Viswanath, K; Ackerson, Leland K; Sorensen, Glorian; Gupta, Prakash C

2010-06-29

Exposure to mass media may impact the use of tobacco, a major source of illness and death in India. The objective is to test the association of self-reported tobacco smoking and chewing with frequency of use of four types of mass media: newspapers, radio, television, and movies. We analyzed data from a sex-stratified nationally-representative cross-sectional survey of 123,768 women and 74,068 men in India. All models controlled for wealth, education, caste, occupation, urbanicity, religion, marital status, and age. In fully-adjusted models, monthly cinema attendance is associated with increased smoking among women (relative risk [RR]: 1.55; 95% confidence interval [CI]: 1.04-2.31) and men (RR: 1.17; 95% CI: 1.12-1.23) and increased tobacco chewing among men (RR: 1.15; 95% CI: 1.11-1.20). Daily television and radio use is associated with higher likelihood of tobacco chewing among men and women, while daily newspaper use is related to lower likelihood of tobacco chewing among women. In India, exposure to visual mass media may contribute to increased tobacco consumption in men and women, while newspaper use may suppress the use of tobacco chewing in women. Future studies should investigate the role that different types of media content and media play in influencing other health behaviors.

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

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.

Balancing quality and cost for Adult Tobacco Telephone Surveys.

PubMed

Fernandez, Barbara M; Hannah, Kristie M; Wallack, Randal S Zu; Hicks, Jennifer K D; Gorrigan, Anne M; Mariolis, Peter

2007-01-01

To demonstrate the ability to cost-effectively coordinate Adult Tobacco Survey stakeholder interests while reducing the risk of potential bias. Key smoking indicators were compared across 2 surveys and analyzed based on modifications to calling protocols. Mixed results were found when comparing smoking rates across 2 surveys, by early, mid, and late respondents, and by the number of rufusals. Significant cost sayings can be obtained by reducing the number of telephone call attempts. Few significant differences may encourage reductions in protocol, but this must be weighed against the possibility of cost-saving measures resulting in biased estimates.

Tobacco industry allegations of "illegal lobbying" and state tobacco control.

PubMed

Bialous, S A; Fox, B J; Glantz, S A

2001-01-01

This study assessed the perceived effect of tobacco industry allegations of "illegal lobbying" by public health professionals on policy interventions for tobacco control. Structured interviews were conducted with state health department project managers in all 17 National Cancer Institute-funded American Stop Smoking Intervention Study (ASSIST) states. Documentation and media records related to ASSIST from the National Cancer Institute, health advocates, and the tobacco industry were analyzed. The tobacco industry filed formal complaints of illegal lobbying activities against 4 ASSIST states. These complaints had a temporary chilling effect on tobacco control policy interventions in those states. ASSIST states not targeted by the tobacco industry developed an increased awareness of the industry's tactics and worked to prepare for such allegations to minimize disruption of their activities. Some self-reported self-censorship in policy activity occurred in 11 of the 17 states (65%). Public health professionals need to educate themselves and the public about the laws that regulate lobbying activities and develop their strategies, including their policy activities, accordingly.

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.

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.

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

PubMed

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

2015-08-01

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

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.