INCREASED CIGARETTE TAX IS ASSOCIATED WITH REDUCTIONS IN ALCOHOL CONSUMPTION IN A LONGITUDINAL U.S. SAMPLE

PubMed Central

Young-Wolff, Kelly C.; Kasza, Karin A.; Hyland, Andrew J.; McKee, Sherry A.

2013-01-01

Background Cigarette taxation has been recognized as one of the most significant policy instruments to reduce smoking. Smoking and drinking are highly comorbid behaviors, and the public health benefits of cigarette taxation may extend beyond smoking-related outcomes to impact alcohol consumption. The current study is the first to test whether increases in cigarette taxes are associated with reductions in alcohol consumption among smokers using a large, prospective U.S. sample. Method Our sample included 21,473 alcohol consumers from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Multiple linear regression analyses were conducted to evaluate whether increases in cigarette taxes between Waves I (2001–2002) and II (2004–2005) were associated with reductions in quantity and frequency of alcohol consumption, adjusting for demographics, baseline alcohol consumption, and alcohol price. Stratified analyses were conducted by sex, hazardous drinking status, and age and income group. Results Increases in cigarette taxes were associated with modest reductions in typical quantity of alcohol consumption and frequency of binge drinking among smokers. Cigarette taxation was not associated with changes in alcohol consumption among non-smokers. In analyses stratified by sex, the inverse associations of cigarette taxes with typical quantity and binge drinking frequency were found only for male smokers. Further, the inverse association of cigarette taxation and alcohol consumption was stronger among hazardous drinkers (translating into approximately 1/2 a drink less alcohol consumption per episode), young adult smokers, and smokers in the lowest income category. Conclusions Findings from this longitudinal, epidemiological study suggest increases in cigarette taxes are associated with modest to moderate reductions in alcohol consumption among vulnerable groups. Additional research is needed to further quantify the public health benefits of cigarette taxation on alcohol consumption and to evaluate the potential broader crossover effects of cigarette taxation on other health behaviors. PMID:23930623

Increased cigarette tax is associated with reductions in alcohol consumption in a longitudinal U.S. sample.

PubMed

Young-Wolff, Kelly C; Kasza, Karin A; Hyland, Andrew J; McKee, Sherry A

2014-01-01

Cigarette taxation has been recognized as one of the most significant policy instruments to reduce smoking. Smoking and drinking are highly comorbid behaviors, and the public health benefits of cigarette taxation may extend beyond smoking-related outcomes to impact alcohol consumption. The current study is the first to test whether increases in cigarette taxes are associated with reductions in alcohol consumption among smokers using a large, prospective U.S. sample. Our sample included 21,473 alcohol consumers from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Multiple linear regression analyses were conducted to evaluate whether increases in cigarette taxes between Waves 1 (2001 to 2002) and 2 (2004 to 2005) were associated with reductions in quantity and frequency of alcohol consumption, adjusting for demographics, baseline alcohol consumption, and alcohol price. Stratified analyses were conducted by sex, hazardous drinking status, and age and income group. Increases in cigarette taxes were associated with modest reductions in typical quantity of alcohol consumption and frequency of binge drinking among smokers. Cigarette taxation was not associated with changes in alcohol consumption among nonsmokers. In analyses stratified by sex, the inverse associations of cigarette taxes with typical quantity and binge drinking frequency were found only for male smokers. Further, the inverse association of cigarette taxation and alcohol consumption was stronger among hazardous drinkers (translating into approximately 1/2 a drink less alcohol consumption per episode), young adult smokers, and smokers in the lowest income category. Findings from this longitudinal, epidemiological study suggest increases in cigarette taxes are associated with modest to moderate reductions in alcohol consumption among vulnerable groups. Additional research is needed to further quantify the public health benefits of cigarette taxation on alcohol consumption and to evaluate the potential broader crossover effects of cigarette taxation on other health behaviors. Copyright © 2013 by the Research Society on Alcoholism.

The price sensitivity of cigarette consumption in Bangladesh: evidence from the International Tobacco Control (ITC) Bangladesh Wave 1 (2009) and Wave 2 (2010) Surveys.

PubMed

Nargis, Nigar; Ruthbah, Ummul H; Hussain, A K M Ghulam; Fong, Geoffrey T; Huq, Iftekharul; Ashiquzzaman, S M

2014-03-01

In Bangladesh, the average excise tax on cigarettes accounted for just 38% of the average retail price of cigarettes in 2009, and 45% in 2010. Both these rates are well below the WHO recommended share of 70% of the retail price at a minimum. There is thus ample room for raising taxes on cigarettes in Bangladesh. The objective of the present work was therefore to estimate the price elasticity of demand for cigarettes and the effect of tax increases on the consumption of cigarettes and on tax revenue in Bangladesh. Based on data from Wave 1 (2009) and Wave 2 (2010) of the International Tobacco Control Bangladesh Survey, we estimated the overall impact of a price change on cigarette demand using a two-part model. The total price elasticity of cigarettes was measured by the sum of the elasticity of smoking prevalence and the elasticity of average daily consumption conditional on smoking participation. The price elasticity estimates were used in a simulation model to predict changes in cigarette consumption and tax revenue from tax and price increases. The total price elasticity of demand for cigarettes was estimated at -0.49. The elasticity of smoking prevalence accounted for 59% of the total price elasticity. The price elasticity of cigarette consumption is higher for people belonging to lower socioeconomic status. Increases in taxes would result in a significant reduction in cigarette consumption while increasing tax revenue. Raising cigarette prices through increased taxation could lead to a win-win-win situation in Bangladesh: it would reduce cigarette consumption, increase tobacco tax revenue and potentially decrease socioeconomic inequities.

The Price Sensitivity of Cigarette Consumption in Bangladesh: Evidence from the International Tobacco Control (ITC) Bangladesh Wave 1 (2009) and Wave 2 (2010) Surveys

PubMed Central

Nargis, Nigar; Ruthbah, Ummul H.; Hussain, AKM Ghulam; Fong, Geoffrey T.; Huq, Iftekharul; Ashiquzzaman, SM

2014-01-01

Background In Bangladesh, the average excise tax on cigarettes accounted for merely 38% in 2009 and 45% in 2010 of the average retail price of cigarettes. It is well below the WHO recommended share of 70% of the retail price at a minimum. There is thus ample room for raising taxes on cigarettes in Bangladesh. Objective The objective of the paper is to estimate the price elasticity of demand for cigarettes and the effect of tax increases on the consumption of cigarettes and on tax revenue in Bangladesh. Methods Based on data from Wave 1 (2009) and Wave 2 (2010) of the International Tobacco Control Bangladesh Survey, we estimate the overall impact of a price change on cigarette demand using a two-part model. The total price elasticity of cigarettes is measured by the sum of the elasticity of smoking prevalence and the elasticity of average daily consumption conditional on smoking participation. The price elasticity estimates are used in a simulation model to predict changes in cigarette consumption and tax revenue from tax and price increases. Findings The total price elasticity of demand for cigarettes is estimated at −0.49. The elasticity of smoking prevalence accounts for 59% of the total price elasticity. The price elasticity of cigarette consumption is higher for people belonging to lower socio-economic status. Increases in taxes would result in significant reduction in cigarette consumption while tax revenue increases. Conclusion Raising cigarette price through increased taxation can lead to a win-win-win situation in Bangladesh—it will reduce cigarette consumption, increase tobacco tax revenue and potentially decrease socio-economic inequities. PMID:24105828

Impact of smoking reduced nicotine content cigarettes on sensitivity to cigarette price: further results from a multi-site clinical trial.

PubMed

Smith, Tracy T; Cassidy, Rachel N; Tidey, Jennifer W; Luo, Xianghua; Le, Chap T; Hatsukami, Dorothy K; Donny, Eric C

2017-02-01

To assess the impact of a reduction in the nicotine content of cigarettes on estimated consumption of reduced nicotine cigarettes and usual brand cigarettes at a variety of hypothetical prices. Double-blind study with participants assigned randomly to receive cigarettes for 6 weeks that were either usual brand or an investigational cigarette with one of five nicotine contents. Ten sites across the United States. A total of 839 eligible adult smokers randomized from 2013 to 2014. Participants received their usual brand or an investigational cigarette with one of five nicotine contents: 15.8 (primary control), 5.2, 2.4, 1.3, or 0.4 mg/g. The Cigarette Purchase Task was completed at baseline and at the week 6 post-randomization visit. Compared with normal nicotine content controls, the lowest nicotine content (0.4 mg/g) reduced the number of study cigarettes participants estimated they would smoke at a range of prices [mean reduction relative to 15.8 mg/g at a price of $4.00/pack: 9.50, 95% confidence interval (CI) = 6.81,12.19]. The lowest nicotine content also reduced the maximum amount of money allocated to study cigarettes and the price at which participants reported they would stop buying study cigarettes [median reduction relative to 15.8 mg/g, 95% CI = $8.21 (4.27,12.15) per day and $0.44 (0.17,0.71) per cigarette, respectively]. A reduction in nicotine content to the lowest level also reduced the maximum amount of money allocated to usual brand cigarettes (median reduction relative to 15.8 mg/g: $4.39 per day, 95% CI = 1.88,6.90). In current smokers, a reduction in nicotine content may reduce cigarette consumption, reduce the reinforcement value of cigarettes and increase cessation if reduced nicotine content cigarettes were the only cigarette available for purchase. © 2016 Society for the Study of Addiction.

Consumption of Combustible and Smokeless Tobacco - United States, 2000-2015.

PubMed

Wang, Teresa W; Kenemer, Brandon; Tynan, Michael A; Singh, Tushar; King, Brian

2016-12-09

Combustible and smokeless tobacco use causes adverse health outcomes, including cardiovascular disease and multiple types of cancer (1,2). Standard approaches for measuring tobacco use include self-reported surveys of use and consumption estimates based on tobacco excise tax data (3,4). To provide the most recently available tobacco consumption estimates in the United States, CDC used federal excise tax data to estimate total and per capita consumption during 2000-2015 for combustible tobacco (cigarettes, roll-your-own tobacco, pipe tobacco, small cigars, and large cigars) and smokeless tobacco (chewing tobacco and dry snuff). During this period, total combustible tobacco consumption decreased 33.5%, or 43.7% per capita. Although total cigarette consumption decreased 38.7%, cigarettes remained the most commonly used combustible tobacco product. Total noncigarette combustible tobacco (i.e., cigars, roll-your-own, and pipe tobacco) consumption increased 117.1%, or 83.8% per capita during 2000-2015. Total consumption of smokeless tobacco increased 23.1%, or 4.2% per capita. Notably, total cigarette consumption was 267.0 billion cigarettes in 2015 compared with 262.7 billion in 2014. These findings indicate that although cigarette smoking declined overall during 2000-2015, and each year from 2000 to 2014, the number of cigarettes consumed in 2015 was higher than in 2014, and the first time annual cigarette consumption was higher than the previous year since 1973. Moreover, the consumption of other combustible and smokeless tobacco products remains substantial. Implementation of proven tobacco prevention interventions (5) is warranted to further reduce tobacco use in the United States.

Overtime work, cigarette consumption, and addiction to cigarette among workers subject to mild smoking restrictions.

PubMed

Mizoue, Tetsuya; Fujino, Yoshihisa; Yamato, Hiroshi; Tokunaga, Shoji; Kubo, Tatsuhiko; Reijula, Kari

2006-04-01

The goal of the present study was to investigate the relation of hours of overtime work to cigarette consumption and addiction to cigarette, which was measured by the heaviness of smoking index. The subjects were 571 male daily smokers who responded to a cross-sectional survey of municipal employees of a Japanese city office, in which smoking was permitted in designated areas. Those who engaged in moderate overtime work (10-29 h per month) consumed less number of cigarettes per day and had lower levels of heaviness of smoking index, compared with those who worked either shorter or longer hours of overtime, although the differences were not statistically significant. In the workplace, men who worked 50 h or longer overtime last month consumed, on average, 4 cigarettes more than men who worked less than 30 h of overtime. Home cigarette consumption decreased as hours of overtime work increased. In stratified analysis, there was a significant difference in daily cigarette consumption according to hours of overtime work among smokers in staff position or under low psychological work stress; showing reduced consumption associated with medium levels of overtime work, compared to either no overtime work or extended overtime hours. The U-shaped relations of hours of overtime work to overall cigarette consumption and addiction to smoking deserve further investigations.

Consumption and production waste: another externality of tobacco use.

PubMed

Novotny, T E; Zhao, F

1999-01-01

To describe the waste produced by and environmental implications of individual cigarette consumption (filter tips, packages, and cartons) and tobacco manufacturing. All available articles and reports published since 1970 related to cigarette consumption and production waste were reviewed. Global cigarette consumption data were used to estimate cigarette butt and packaging waste quantities. Data from the Center for Marine Conservation's International Coastal Cleanup Project were used to describe some environmental impacts of tobacco-related trash. Data from the United States Environmental Protection Agency's (EPA's) Toxics Release Inventory and reported global cigarette consumption totals were used to estimate waste production from cigarette manufacturing. In 1995, an estimated 5.535 trillion cigarettes (27,675 million cartons and 276,753 million packages) were sold by the tobacco industry globally. Some of the wastes from these products were properly deposited, but a large amount of tobacco consumption waste ends up in the environment. Some is recovered during environmental clean-up days. For the past eight years (1990-1997), cigarette butts have been the leading item found during the International Coastal Cleanup Project; they accounted for 19.1% of all items collected in 1997. The tobacco manufacturing process produces liquid, solid, and airborne waste. Among those wastes, some materials, including nicotine, are designated by the EPA as Toxics Release Inventory (TRI) chemicals. These are possible environmental health hazards. In 1995, the global tobacco industry produced an estimated 2262 million kilograms of manufacturing waste and 209 million kilograms of chemical waste. In addition, total nicotine waste produced in the manufacture of reduced nicotine cigarettes was estimated at 300 million kilograms. Laws against littering relative to cigarette butts could be better enforced. Additional taxes might be levied on cigarette products that would then be directed to environmental clean-up efforts. The tobacco industry should improve the biodegradability of filters, reduce packaging waste, and educate its customers. Worksites and public buildings should be encouraged or required to supply appropriate disposal mechanisms at all building entrances. Public awareness campaigns about the magnitude and prevention of cigarette consumption waste could be developed through partnerships among environmental groups, health organisations, and environmental protection agencies. Tobacco production waste should be a source of concern and regulation by governments throughout the world; it contains numerous chemicals which may be considered health hazards, not the least of which is nicotine produced in the manufacture of low-nicotine cigarettes.

A simulation model to predict the fiscal and public health impact of a change in cigarette excise taxes.

PubMed

van Walbeek, Corné

2010-02-01

(1) To present a model that predicts changes in cigarette consumption and excise revenue in response to excise tax changes, and (2) to demonstrate that, if the industry has market power, increases in specific taxes have better tobacco control consequences than increases in ad valorem taxes. All model parameters are user-determined. The model calculates likely changes in cigarette consumption, smoking prevalence and excise tax revenues due to an excise tax change. The model is applicable to countries that levy excise tax as specific or ad valorem taxes. For a representative low-income or middle-income country a 20% excise tax increase decreases cigarette consumption and industry revenue by 5% and increases excise tax revenues by 14%, if there is no change in the net-of-tax price. If the excise tax is levied as a specific tax, the industry has an incentive to raise the net-of-tax price, enhancing the consumption-reducing impact of the tax increase. If the excise tax is levied as an ad valorem tax, the industry has no such incentive. The industry has an incentive to reduce the net-of-tax price in response to an ad valorem excise tax increase, undermining the public health and fiscal benefits of the tax increase. This paper presents a simple web-based tool that allows policy makers and tobacco control advocates to estimate the likely consumption, fiscal and mortality impacts of a change in the cigarette excise tax. If a country wishes to reduce cigarette consumption by increasing the excise tax, a specific tax structure is better than an ad valorem tax structure.

Economic gains and health benefits from a new cigarette tax scheme in Taiwan: a simulation using the CGE model.

PubMed

Ye, Chun-Yuan; Lee, Jie-Min; Chen, Sheng-Hong

2006-03-10

This study evaluates the impact of an increase in cigarette tax in Taiwan in terms of the effects it has on the overall economy and the health benefits that it brings. The multisector computable general equilibrium (CGE) model was used to simulate the impact of reduced cigarette consumption resulting from a new tax scheme on the entire economy gains and on health benefits. The results predict that because of the new tax scheme, there should be a marked reduction in cigarette consumption but a notable increase in health benefits that include saving between 28,125 and 56,250 lives. This could save NTD 1.222 approximately 2.445 billion (where USD 1 = NTD 34.6) annually in life-threatening, cigarette-related health insurance expenses which exceeds the projected decrease of NTD 1.275 billion in Gross Domestic Product (GDP) because of reduced consumption and therefore tax revenue. Overall, the increased cigarette excise tax will be beneficial in terms of both the health of the general public and the economy as a whole.

Economic gains and health benefits from a new cigarette tax scheme in Taiwan: a simulation using the CGE model

PubMed Central

Ye, Chun-Yuan; Lee, Jie-Min; Chen, Sheng-Hong

2006-01-01

Background This study evaluates the impact of an increase in cigarette tax in Taiwan in terms of the effects it has on the overall economy and the health benefits that it brings. Methods The multisector computable general equilibrium (CGE) model was used to simulate the impact of reduced cigarette consumption resulting from a new tax scheme on the entire economy gains and on health benefits. Results The results predict that because of the new tax scheme, there should be a marked reduction in cigarette consumption but a notable increase in health benefits that include saving between 28,125 and 56,250 lives. This could save NT$1.222~2.445 billion (where US$1 = NT$34.6) annually in life-threatening, cigarette-related health insurance expenses which exceeds the projected decrease of NT$1.275 billion in Gross Domestic Product (GDP) because of reduced consumption and therefore tax revenue. Conclusion Overall, the increased cigarette excise tax will be beneficial in terms of both the health of the general public and the economy as a whole. PMID:16529653

Chinese smokers' cigarette purchase behaviours, cigarette prices and consumption: findings from the ITC China Survey.

PubMed

Huang, Jidong; Zheng, Rong; Chaloupka, Frank J; Fong, Geoffrey T; Li, Qiang; Jiang, Yuan

2014-03-01

While cigarette purchasing behaviour has been shown to be linked with certain tobacco use outcomes such as quit intentions and quit attempts, there have been very few studies examining cigarette purchasing behaviours and their impact on cigarette price and consumption in China, the world's largest cigarette consumer. The aim of the present study was to examine the extent and determinants of cost/price-related purchase behaviours, and estimate the impact of these behaviours on cigarette prices paid by Chinese smokers. It also assesses the socioeconomic differences in compensatory purchase behaviours, and examines how they influence the relationship between purchase behaviours, cigarette prices and cigarette consumption. Multivariate analyses using the general estimating equations method were conducted using data from the International Tobacco Control China Survey (the ITC China Survey), a longitudinal survey of adult smokers in seven cities in China: Beijing, Changsha, Guangzhou, Kunming, Shanghai, Shenyang and Yinchuan. In each city, about 800 smokers were surveyed in each wave. The first three waves--wave 1 (conducted between March to December 2006), wave 2 (November 2007 to March 2008) and wave 3 (May to October 2009 and February to March 2010)--of the ITC China Survey data were used in this analysis. Various aspects of smokers' self-reported price/cost-related cigarette purchasing behaviours were analysed. Nearly three-quarters (72%) of smokers surveyed indicated that a major reason they chose their most-used cigarette brand was its low cost/price. Almost half (50.6%) of smokers reported buying in cartons in their most recent cigarette purchase. Smokers with lower income and/or low levels of education were more likely to choose a brand because of its low cost/price. However, those with higher income and/or high levels of education were more likely to buy cartons. Gender and age were also related to type of purchase behaviours. Those behaviours led to reductions in purchase prices. The price savings ranged from ¥0.54 to ¥1.01 per pack of cigarettes, depending on the behaviour examined, representing a price reduction of 8% to 15%. A significant portion of Chinese urban adult smokers engaged in cost/price-reducing purchase behaviours. Such behaviours reduce cigarette purchase prices and are associated with increased cigarette consumption. Smokers of different socioeconomic status engaged in different purchase behaviours to mitigate the impact of higher cigarette prices. Reducing tobacco use through raising tobacco taxes/prices in China needs to take into account these cost/price-reducing behaviours.

Chinese Smokers’ Cigarette Purchase Behaviors, Cigarette Prices and Consumption: Findings from the ITC China Survey

PubMed Central

Huang, Jidong; Zheng, Rong; Chaloupka, Frank J.; Fong, Geoffrey T.; Li, Qiang; Jiang, Yuan

2014-01-01

Background While cigarette purchasing behavior has been shown to be linked with certain tobacco use outcomes such as quit intentions and quit attempts, there have been very few studies examining cigarette purchasing behaviors and their impact on cigarette price and consumption in China, the world’s largest cigarette consumer. Objective The goal of this study is to examine the extent and determinants of cost/price-related purchase behaviors, and estimate the impact of these behaviors on cigarette prices paid by Chinese smokers. It also assesses the socio-economic differences in compensatory purchase behaviors, and examines how they influence the relationship between purchase behaviors, cigarette prices, and cigarette consumption. Methods Multivariate analyses using the general estimating equations (GEE) method were conducted using data from the International Tobacco Control China Survey (the ITC China Survey), a longitudinal survey of adult smokers in seven cities in China: Beijing, Changsha, Guangzhou, Kunming, Shanghai, Shenyang, and Yinchuan. In each city, about 800 smokers were surveyed in each wave. The first three waves - Wave 1 (conducted between March to December 2006), Wave 2 (November 2007 to March 2008) and Wave 3 (May to October 2009 and February to March 2010) - of the ITC China Survey data were used in this analysis. Various aspects of smokers’ self-reported price/cost-related cigarette purchasing behaviors were analyzed. Findings Nearly three-quarters (72%) of smokers surveyed indicated that a major reason they chose their most-used cigarette brand was its low cost/price. Almost half (50.6%) of smokers reported buying in cartons in their most recent cigarette purchase. Smokers with lower income and/or low levels of education were more likely to choose a brand because of its low cost/price. However, those with higher income and/or high levels of education were more likely to buy cartons. Gender and age were also related to type of purchase behaviors. Those behaviors led to reductions in purchase prices. The price savings ranged from 0.54 Yuan to 1.01 Yuan per pack of cigarettes, depending on the behavior examined, representing a price reduction of 8% - 15%. Conclusion A significant portion of Chinese urban adult smokers engaged in cost/price-reducing purchase behaviors. Such behaviors reduce cigarette purchase prices and are associated with increased cigarette consumption. Smokers of different SES engaged in different purchase behaviors to mitigate the impact of higher cigarette prices. Reducing tobacco use through raising tobacco taxes/prices in China needs to take into account these cost/price-reducing behaviors. PMID:24048580

The impact of clean indoor-air laws and cigarette smuggling on demand for cigarettes: an empirical model.

PubMed

Yurekli, A A; Zhang, P

2000-03-01

This study examines the impact of clean indoor-air laws and smuggling activities on states' per capita cigarette consumption and revenues by using a static demand model. The analysis was based on data for 50 states and the District of Columbia (DC) of the United Sates over the period 1970-1995. The estimated price elasticities of demand for cigarettes ranged from -0.48 to -0.62, indicating that a 10% increase in price would reduce consumption per capita by 4.8% to 6.2%. Anti-smoking laws had a significant negative impact on per capita consumption. In 1995, consumption was reduced by 4.7 packs per capita among states with anti-smoking laws, or 1.1 billion fewer packs of cigarettes consumed. Both short-distance smuggling between neighbouring states and long-distance smuggling from Kentucky, North Carolina and Virginia existed and were significant. Smuggling activities from military bases and Indian reservations, however, were not significant. On average, 6% of states' tax revenues were lost due to smuggling activities in 1995. Results also showed that short-distance smuggling was less important than long-distance smuggling as a source of the revenue loss. Copyright 2000 John Wiley & Sons, Ltd.

Per-pack price reductions available from different cigarette purchasing strategies: United States, 2009-2010.

PubMed

Pesko, Michael F; Xu, Xin; Tynan, Michael A; Gerzoff, Robert B; Malarcher, Ann M; Pechacek, Terry F

2014-06-01

Following cigarette excise tax increases, smokers may use cigarette price minimization strategies to continue their usual cigarette consumption rather than reducing consumption or quitting. This reduces the public health benefits of the tax increase. This paper estimates the price reductions for a wide-range of strategies, compensating for overlapping strategies. We performed regression analysis on the 2009-2010 National Adult Tobacco Survey (N=13,394) to explore price reductions that smokers in the United States obtained from purchasing cigarettes. We examined five cigarette price minimization strategies: 1) purchasing discount brand cigarettes, 2) using price promotions, 3) purchasing cartons, 4) purchasing on Indian reservations, and 5) purchasing online. Price reductions from these strategies were estimated jointly to compensate for overlapping strategies. Each strategy provided price reductions between 26 and 99cents per pack. Combined price reductions were possible. Additionally, price promotions were used with regular brands to obtain larger price reductions than when price promotions were used with generic brands. Smokers can realize large price reductions from price minimization strategies, and there are many strategies available. Policymakers and public health officials should be aware of the extent that these strategies can reduce cigarette prices. Published by Elsevier Inc.

Illicit cigarette consumption and government revenue loss in Indonesia.

PubMed

Ahsan, Abdillah; Wiyono, Nur Hadi; Setyonaluri, Diahhadi; Denniston, Ryan; So, Anthony D

2014-11-19

Illicit cigarettes comprise more than 11% of tobacco consumption and 17% of consumption in low- and middle-income countries. Illicit cigarettes, defined as those that evade taxes, lower consumer prices, threaten national tobacco control efforts, and reduce excise tax collection. This paper measures the magnitude of illicit cigarette consumption within Indonesia using two methods: the discrepancies between legal cigarette sales and domestic consumption estimated from surveys, and discrepancies between imports recorded by Indonesia and exports recorded by trade partners. Smuggling plays a minor role in the availability of illicit cigarettes because Indonesians predominantly consume kreteks, which are primarily manufactured in Indonesia. Looking at the period from 1995 to 2013, illicit cigarettes first emerged in 2004. When no respondent under-reporting is assumed, illicit consumption makes up 17% of the domestic market in 2004, 9% in 2007, 11% in 2011, and 8% in 2013. Discrepancies in the trade data indicate that Indonesia was a recipient of smuggled cigarettes for each year between 1995 and 2012. The value of this illicit trade ranges from less than $1 million to nearly $50 million annually. Singapore, China, and Vietnam together accounted for nearly two-thirds of trade discrepancies over the period. Tax losses due to illicit consumption amount to between Rp 4.1 and 9.3 trillion rupiah, 4% to 13% of tobacco excise revenue, in 2011 and 2013. Due to the predominance of kretek consumption in Indonesia and Indonesia's status as the predominant producer of kreteks, illicit domestic production is likely the most important source for illicit cigarettes, and initiatives targeted to combat this illicit production carry the promise of the greatest potential impact.

Tobacco control policies are egalitarian: a vulnerabilities perspective on clean indoor air laws, cigarette prices, and tobacco use disparities.

PubMed

Dinno, Alexis; Glantz, Stanton

2009-04-01

This study models independent associations of state or local strong clean indoor air laws and cigarette prices with current smoker status and consumption in a multilevel framework, including interactions with educational attainment, household income and race/ethnicity and the relationships of these policies to vulnerabilities in smoking behavior. Cross sectional survey data are employed from the February 2002 panel of the Tobacco Use Supplement of the Current Population Survey (54,024 individuals representing the US population aged 15-80). Non-linear relationships between both outcome variables and the predictors were modeled. Independent associations of strong clean indoor air laws were found for current smoker status (OR 0.66), and consumption among current smokers (-2.36 cigarettes/day). Cigarette price was found to have independent associations with both outcomes, an effect that saturated at higher prices. The odds ratio for smoking for the highest versus lowest price over the range where there was a price effect was 0.83. Average consumption declined (-1.16 cigarettes/day) over the range of effect of price on consumption. Neither policy varied in its effect by educational attainment, or household income. The association of cigarette price with reduced smoking participation and consumption was not found to vary with race/ethnicity. Population vulnerability in consumption appears to be structured by non-white race categories, but not at the state and county levels at which the policies we studied were enacted. Clean indoor air laws and price increases appear to benefit all socio-economic and race/ethnic groups in our study equally in terms of reducing smoking participation and consumption.

Illicit cigarette trade in Thailand.

PubMed

Pavananunt, Pirudee

2011-11-01

The sale and consumption of illicit tobacco increases consumption, impacts public health, reduces tax revenue and provides an argument against tax increases. Thailand has some of the best tobacco control policies in Southeast Asia with one of the highest tobacco tax rates, but illicit trade has the potential to undermine these policies and needs investigating. Two approaches were used to assess illicit trade between 1991 and 2006: method 1, comparison of tobacco used based on tobacco taxes paid and survey data, and method 2, discrepancies between export data from countries exporting tobacco to Thailand and Thai official data regarding imports. A three year average was used to smooth differences due to lags between exports and imports. For 1991-2006, the estimated manufactured cigarette consumption from survey data was considerably lower than sales tax paid, so method 1 did not provide evidence of cigarette tax avoidance. Using method 2 the trade difference between reported imports and exports, indicates 10% of cigarettes consumed in Thailand (242 million packs per year) between 2004 and 2006 were illicit. The loss of revenue amounted to 4,508 million Baht (2002 prices) in the same year, that was 14% of the total cigarette tax revenue. Cigarette excise tax rates had a negative relationship with consumption trends but no relation with the level of illicit trade. There is a need for improved policies against smuggling to combat the rise in illicit tobacco consumption. Regional coordination and implementation of protocols on illicit trade would help reduce incentives for illegal tax avoidance.

ILLICIT CIGARETTE TRADE IN THAILAND

PubMed Central

Pavananunt, Pirudee

2012-01-01

The sale and consumption of illicit tobacco increases consumption, impacts public health, reduces tax revenue and provides an argument against tax increases. Thailand has some of the best tobacco control policies in Southeast Asia with one of the highest tobacco tax rates, but illicit trade has the potential to undermine these policies and needs investigating. Two approaches were used to assess illicit trade between 1991 and 2006: method 1, comparison of tobacco used based on tobacco taxes paid and survey data, and method 2, discrepancies between export data from countries exporting tobacco to Thailand and Thai official data regarding imports. A three year average was used to smooth differences due to lags between exports and imports. For 1991–2006, the estimated manufactured cigarette consumption from survey data was considerably lower than sales tax paid, so method 1 did not provide evidence of cigarette tax avoidance. Using method 2 the trade difference between reported imports and exports, indicates 10% of cigarettes consumed in Thailand (242 million packs per year) between 2004 and 2006 were illicit. The loss of revenue amounted to 4,508 million Baht (2002 prices) in the same year, that was 14% of the total cigarette tax revenue. Cigarette excise tax rates had a negative relationship with consumption trends but no relation with the level of illicit trade. There is a need for improved policies against smuggling to combat the rise in illicit tobacco consumption. Regional coordination and implementation of protocols on illicit trade would help reduce incentives for illegal tax avoidance. PMID:22299425

Consumption and production waste: another externality of tobacco use

PubMed Central

Novotny, T.; Zhao, F.

1999-01-01

OBJECTIVE—To describe the waste produced by and environmental implications of individual cigarette consumption (filter tips, packages, and cartons) and tobacco manufacturing.
STUDY SELECTION—All available articles and reports published since 1970 related to cigarette consumption and production waste were reviewed.
DATA SOURCES—Global cigarette consumption data were used to estimate cigarette butt and packaging waste quantities. Data from the Center for Marine Conservation's International Coastal Cleanup Project were used to describe some environmental impacts of tobacco-related trash. Data from the United States Environmental Protection Agency's (EPA's) Toxics Release Inventory and reported global cigarette consumption totals were used to estimate waste production from cigarette manufacturing.
DATA EXTRACTION AND SYNTHESIS—In 1995, an estimated 5.535 trillion cigarettes (27 675 million cartons and 276 753 million packages) were sold by the tobacco industry globally. Some of the wastes from these products were properly deposited, but a large amount of tobacco consumption waste ends up in the environment. Some is recovered during environmental clean-up days. For the past eight years (1990-1997), cigarette butts have been the leading item found during the International Coastal Cleanup Project; they accounted for 19.1% of all items collected in 1997. The tobacco manufacturing process produces liquid, solid, and airborne waste. Among those wastes, some materials, including nicotine, are designated by the EPA as Toxics Release Inventory (TRI) chemicals. These are possible environmental health hazards. In 1995, the global tobacco industry produced an estimated 2262 million kilograms of manufacturing waste and 209 million kilograms of chemical waste. In addition, total nicotine waste produced in the manufacture of reduced nicotine cigarettes was estimated at 300 million kilograms.
CONCLUSIONS—Laws against littering relative to cigarette butts could be better enforced. Additional taxes might be levied on cigarette products that would then be directed to environmental clean-up efforts. The tobacco industry should improve the biodegradability of filters, reduce packaging waste, and educate its customers. Worksites and public buildings should be encouraged or required to supply appropriate disposal mechanisms at all building entrances. Public awareness campaigns about the magnitude and prevention of cigarette consumption waste could be developed through partnerships among environmental groups, health organisations, and environmental protection agencies. Tobacco production waste should be a source of concern and regulation by governments throughout the world; it contains numerous chemicals which may be considered health hazards, not the least of which is nicotine produced in the manufacture of low-nicotine cigarettes.


Keywords: tobacco waste; litter; environmental impact PMID:10465821

[The effect of tobacco prices on consumption: a time series data analysis for Mexico].

PubMed

Olivera-Chávez, Rosa Itandehui; Cermeño-Bazán, Rodolfo; de Miera-Juárez, Belén Sáenz; Jiménez-Ruiz, Jorge Alberto; Reynales-Shigematsu, Luz Myriam

2010-01-01

To estimate the price elasticity of the demand for cigarettes in Mexico based on data sources and a methodology different from the ones used in previous studies on the topic. Quarterly time series of consumption, income and price for the time period 1994 to 2005 were used. A long-run demand model was estimated using Ordinary Least Squares (OLS) and the existence of a cointegration relationship was investigated. Also, a model using Dinamic Ordinary Least Squares (DOLS) was estimated to correct for potential endogeneity of independent variables and autocorrelation of the residuals. DOLS estimates showed that a 10% increase in cigarette prices could reduce consumption in 2.5% (p<0.05) and increase government revenue in 16.11%. The results confirmed the effectiveness of taxes as an instrument for tobacco control in Mexico. An increase in taxes can be used to increase cigarette prices and therefore to reduce consumption and increase government revenue.

Attitudes toward E-Cigarettes, Reasons for Initiating E-Cigarette Use, and Changes in Smoking Behavior after Initiation: A Pilot Longitudinal Study of Regular Cigarette Smokers.

PubMed

Berg, Carla J; Barr, Dana Boyd; Stratton, Erin; Escoffery, Cam; Kegler, Michelle

2014-10-01

We examined 1) changes in smoking and vaping behavior and associated cotinine levels and health status among regular smokers who were first-time e-cigarette purchasers and 2) attitudes, intentions, and restrictions regarding e-cigarettes. We conducted a pilot longitudinal study with assessments of the aforementioned factors and salivary cotinine at weeks 0, 4, and 8. Eligibility criteria included being ≥18 years old, smoking ≥25 of the last 30 days, smoking ≥5 cigarettes per day (cpd), smoking regularly ≥1 year, and not having started using e-cigarettes. Of 72 individuals screened, 40 consented, 36 completed the baseline survey, and 83.3% and 72.2% were retained at weeks 4 and 8, respectively. Participants reduced cigarette consumption from baseline to week 4 and 8 (p's < 0.001); 23.1% reported no cigarette use in the past month at week 8. There was no significant decrease in cotinine from baseline to week 4 or 8 (p's = ns). At week 8, the majority reported improved health (65.4%), reduced smoker's cough (57.7%), and improved sense of smell (53.8%) and taste (50.0%). The majority believed that e-cigarettes versus regular cigarettes have fewer health risks (97.2%) and that e-cigarettes have been shown to help smokers quit (80.6%) and reduce cigarette consumption (97.2%). In addition, the majority intended to use e-cigarettes as a complete replacement for regular cigarettes (69.4%) and reported no restriction on e-cigarette use in the home (63.9%) or car (80.6%). Future research is needed to document the long-term impact on smoking behavior and health among cigarette smokers who initiate use of e-cigarettes.

Per-pack price reductions available from different cigarette purchasing strategies: United States, 2009–2010☆

PubMed Central

Pesko, Michael F.; Xu, Xin; Tynan, Michael A.; Gerzoff, Robert B.; Malarcher, Ann M.; Pechacek, Terry F.

2015-01-01

Objective Following cigarette excise tax increases, smokers may use cigarette price minimization strategies to continue their usual cigarette consumption rather than reducing consumption or quitting. This reduces the public health benefits of the tax increase. This paper estimates the price reductions for a wide-range of strategies, compensating for overlapping strategies. Method We performed regression analysis on the 2009–2010 National Adult Tobacco Survey (N = 13,394) to explore price reductions that smokers in the United States obtained from purchasing cigarettes. We examined five cigarette price minimization strategies: 1) purchasing discount brand cigarettes, 2) using price promotions, 3) purchasing cartons, 4) purchasing on Indian reservations, and 5) purchasing online. Price reductions from these strategies were estimated jointly to compensate for overlapping strategies. Results Each strategy provided price reductions between 26 and 99 cents per pack. Combined price reductions were possible. Additionally, price promotions were used with regular brands to obtain larger price reductions than when price promotions were used with generic brands. Conclusion Smokers can realize large price reductions from price minimization strategies, and there are many strategies available. Policymakers and public health officials should be aware of the extent that these strategies can reduce cigarette prices. PMID:24594102

A case-control study of tobacco-related cancers in Colombia.

PubMed

Restrepo, H E; Correa, P; Haenszel, W; Brinton, L A; Franco, A

1989-01-01

The work reported here examined the effects of smoking cigarettes made predominantly of dark tobacco, alcohol consumption, and coffee drinking upon the risk of developing cancers of the bladder, larynx, lung, and oral cavity/hypopharynx in Medellín, Colombia. For this purpose 439 subjects with newly diagnosed cancers at the indicated sites were selected. Each subject was then matched by age, sex, and socioeconomic status with at least one control. Data from interviews with the selected subjects, upon analysis, showed both the intensity and duration of cigarette smoking to be statistically significant predictors of cancer at all four sites. In addition, heavy alcohol consumption and coffee drinking in excess of seven cups daily were associated with some elevation of cancer risk at most of the sites studied. Multivariate analyses of cigarette smoking, alcohol consumption, and coffee drinking showed that adjustment for coffee and alcohol consumption did not change the observed associations between elevated cancer risks and cigarette smoking. However, adjustment of the coffee and alcohol consumption data for cigarette smoking reduced most of the observed relative risks of coffee and alcohol consumption and eliminated the statistical significance of certain associations.

Targeting the affordability of cigarettes: a new benchmark for taxation policy in low-income and-middle-income countries.

PubMed

Blecher, Evan

2010-08-01

To investigate the appropriateness of tax incidence (the percentage of the retail price occupied by taxes) benchmarking in low-income and-middle-income countries (LMICs) with rapidly growing economies and to explore the viability of an alternative tax policy rule based on the affordability of cigarettes. The paper outlines criticisms of tax incidence benchmarking, particularly in the context of LMICs. It then considers an affordability-based benchmark using relative income price (RIP) as a measure of affordability. The RIP measures the percentage of annual per capita GDP required to purchase 100 packs of cigarettes. Using South Africa as a case study of an LMIC, future consumption is simulated using both tax incidence benchmarks and affordability benchmarks. I show that a tax incidence benchmark is not an optimal policy tool in South Africa and that an affordability benchmark could be a more effective means of reducing tobacco consumption in the future. Although a tax incidence benchmark was successful in increasing prices and reducing tobacco consumption in South Africa in the past, this approach has drawbacks, particularly in the context of a rapidly growing LMIC economy. An affordability benchmark represents an appropriate alternative that would be more effective in reducing future cigarette consumption.

The recent and projected public health and economic benefits of cigarette taxation in Greece.

PubMed

Alpert, Hillel R; Vardavas, Constantine I; Chaloupka, Frank J; Vozikis, Athanassios; Athanasakis, Konstantinos; Kyriopoulos, Ioannis; Bertic, Monique; Behrakis, Panagiotis K; Connolly, Gregory N

2014-09-01

Greece is in an economic crisis compounded by the costs caused by smoking. The present investigation estimates the economic and public health benefits ensuing from the recent cigarette excise tax increase in 2011 and projects the potential benefits from an additional €2.00 per pack cigarette tax increase. The effects of the recent cigarette excise tax increase were calculated on outcome measures: total price per pack, including specific excise, ad valorem tax, and value-added tax consumption; tax revenue; and per capita consumption of cigarettes. Additionally, smoking-attributable mortality, years of potential life lost, and productivity losses were estimated. Projected effects of an additional €2.00 per pack tax increase on consumption and tax revenue were also assessed. The cigarette excise tax increase in 2011 created €558 million in new tax revenue. Cigarette consumption reached a recent low of 24.9 billion sticks sold or 2197 sticks per person in 2011, indicating a 16% decrease in per capita cigarette consumption from the previous year. An additional €2.00 per pack increase in Greek cigarette taxes is projected to result in reduced cigarette sales by an additional 20% and lead to an increase in total cigarette tax revenues by nearly €1.2 billion and the prevention of 192,000 premature deaths. Nations such as Greece, should employ taxation as a crucial measure to promote public health and economic development in such dire times. International economic organisations should aggressively pursue programmes and policies that champion the economic benefits of tobacco taxation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Effect of the California Tobacco Control Program on Smoking Prevalence, Cigarette Consumption, and Healthcare Costs: 1989–2008

PubMed Central

Lightwood, James; Glantz, Stanton A.

2013-01-01

Background Previous research has shown that tobacco control funding in California has reduced per capita cigarette consumption and per capita healthcare expenditures. This paper refines our earlier model by estimating the effect of California tobacco control funding on current smoking prevalence and cigarette consumption per smoker and the effect of prevalence and consumption on per capita healthcare expenditures. The results are used to calculate new estimates of the effect of the California Tobacco Program. Methodology/Principal Findings Using state-specific aggregate data, current smoking prevalence and cigarette consumption per smoker are modeled as functions of cumulative California and control states' per capita tobacco control funding, cigarette price, and per capita income. Per capita healthcare expenditures are modeled as a function of prevalence of current smoking, cigarette consumption per smoker, and per capita income. One additional dollar of cumulative per capita tobacco control funding is associated with reduction in current smoking prevalence of 0.0497 (SE.00347) percentage points and current smoker cigarette consumption of 1.39 (SE.132) packs per smoker per year. Reductions of one percentage point in current smoking prevalence and one pack smoked per smoker are associated with $35.4 (SE $9.85) and $3.14 (SE.786) reductions in per capita healthcare expenditure, respectively (2010 dollars), using the National Income and Product Accounts (NIPA) measure of healthcare spending. Conclusions/Significance Between FY 1989 and 2008 the California Tobacco Program cost $2.4 billion and led to cumulative NIPA healthcare expenditure savings of $134 (SE $30.5) billion. PMID:23418411

Then and now: Consumption and dependence in e-cigarette users who formerly smoked cigarettes.

PubMed

Browne, Matthew; Todd, Daniel G

2018-01-01

Electronic cigarette use, or vaping, continues to be a focus for regulators and policy makers in public health, particularly since it can compete with or be a substitute for smoking. This study investigated characteristics of nicotine dependence and consumption in a sample of vapers who formerly smoked cigarettes. We recruited 436 (80% male) vapers from several internet discussion forums; 95% of whom previously smoked, but ceased after commencing vaping. These participants completed a retrospective version of the Fagerström Test for Nicotine Dependence (FTND-R), as well as a version modified to suit current vaping (FTND-V), along with measures of consumption. Nicotine dependence appears to reduce markedly when smokers transition to vaping. However, 'decoupling' is observed in the relationship between consumption and dependence in vaping, and the FTND-V showed inadequate psychometric properties. Older and female vapers tend to employ a low-power, higher nicotine-concentration style of vaping. Overall, nicotine concentration tended to increase over time, although this effect was moderated by users' intentions to reduce their intake. Indicators of smoking addiction do not appear to be applicable to vaping, with respect to both internal consistency and relationship to consumption. This suggests that motivations for vaping are less dominated by nicotine delivery (negative reinforcement), and may be driven more by positive reinforcement factors. Nevertheless, e-liquid nicotine concentration was associated, albeit weakly, with dependence among e-cigarette users. Finally, vapers are heterogeneous group with respect to style of consumption, with a high-power/lower nicotine set-up more common among younger men. Copyright © 2017 Elsevier Ltd. All rights reserved.

The association between e-cigarette use characteristics and combustible cigarette consumption and dependence symptoms: Results from a national longitudinal study.

PubMed

Buu, Anne; Hu, Yi-Han; Piper, Megan E; Lin, Hsien-Chang

2018-09-01

Existing longitudinal surveys focused on the association between ever use of e-cigarettes and combustible cigarette consumption, making it difficult to infer what characteristics of e-cigarette use could potentially change combustible cigarette use behavior, which may have long-term health consequences. Although e-cigarettes' efficacy of alleviating dependence symptoms was supported by studies conducted in laboratory settings, whether the results can be translated into symptom reduction in the real world and over time is an open question. This study conducted secondary analysis on the Waves 1-2 data of the Population Assessment of Tobacco and Health (PATH) Study to examine the association between e-cigarette use characteristics (frequency, flavoring, and voltage adjustment) and combustible cigarette use outcomes (frequency, quantity, and symptoms), using the Heckman 2-step selection procedure with the selection bias controlled. The inclusion criteria ensured that we followed an adult cohort of exclusive combustible cigarette users at Wave 1. The result shows that higher frequency of e-cigarette use was associated with lower combustible cigarette consumption and dependence symptoms, controlling for the corresponding baseline cigarette use variable and other confounders. Given the frequency of e-cigarette use, the feature of voltage adjustment was not significantly associated with any of the cigarette use outcomes. Flavoring, on the other hand, was associated with lower quantity of cigarette use. Exclusive smokers who start using e-cigarettes do indeed change the frequency and quantity with which they smoke cigarettes. E-cigarette use may also help reduce dependence symptoms. Copyright © 2018 Elsevier Ltd. All rights reserved.

Price and consumption of tobacco.

PubMed

Singh, Virendra; Sharma, Bharat Bhushan; Saxena, Puneet; Meena, Hardayal; Mangal, Daya Krishan

2012-07-01

It is thought that price increase in tobacco products leads to reduced consumption. Though many studies have substantiated this concept, it has not been well studied in India. Recently, price of tobacco products was increased due to ban on plastic sachets of chewing tobacco and increased tax in Rajasthan. This study was designed to evaluate the effect of price rise on overall consumption of tobacco in Jaipur city, Rajasthan. This study was carried out in Jaipur city. Two-staged stratified sampling was used. In the first phase of study, cost and consumption of various tobacco products in the months of February and April were enquired from 25 retail tobacco shops. In the second phase, tobacco consumption was enquired from 20 consecutive consumers purchasing any tobacco product from all the above retail tobacco shops. The data were statistically analyzed using descriptive statistics and paired "t" test. The comparison of prices of tobacco products between February and April revealed that the price of cigarette, bidi, and chewing tobacco has increased by 19%, 21%, and 68%, respectively. Average decrease in sales of cigarettes, bidi, and chewing tobacco at shops included in the study were 14%, 23%, and 38%, respectively. The consumers purchasing tobacco also reported decreased consumption. Chewing tobacco showed the maximum reduction (21%). Consumption of cigarette and bidi has also reduced by 15% and 13%, respectively. It may be concluded that reduction in consumption is associated with increased price of tobacco products. Reduced consumption is comparative to the magnitude of price increase.

The Effectiveness of Cigarette Price and Smoke-Free Homes on Low-Income Smokers in the United States

PubMed Central

Vijayaraghavan, Maya; Messer, Karen; White, Martha M.

2013-01-01

Objectives. We examined the effectiveness of state cigarette price and smoke-free homes on smoking behaviors of low-income and high-income populations in the United States. Methods. We used the 2006–2007 Tobacco Use Supplement to the Current Population Survey. The primary outcomes were average daily cigarette consumption and successful quitting. We used multivariable regression to examine the association of cigarette price and smoke-free home policies on these outcomes. Results. High state cigarette price (pack price ≥ $4.50) was associated with lower consumption across all income levels. Although low-income individuals were least likely to adopt smoke-free homes, those who adopted them had consumption levels and successful quit rates that were similar to those among higher-income individuals. In multivariable analysis, both policies were independently associated with lower consumption, but only smoke-free homes were associated with sustained cessation at 90 days. Conclusions. High cigarette prices and especially smoke-free homes have the potential to reduce smoking behaviors among low-income individuals. Interventions are needed to increase adoption of smoke-free homes among low-income populations to increase cessation rates and prevent relapse. PMID:24134354

The Demand for Cigarettes in Tanzania and Implications for Tobacco Taxation Policy

PubMed Central

Kidane, Asmerom; Mduma, John; Naho, Alexis; Ngeh, Ernest Tingum; Hu, Teh-wei

2016-01-01

The study attempts to estimate the demand for cigarettes in Tanzania and presents simulation results on the effect of the cigarette excise tax on smoking participation, government revenue, and related topics. After briefly summarizing the magnitude and spread of cigarette consumption in the country, the paper reviews some empirical estimates from African and other countries. The 2008 Tanzanian household budget survey was used to estimate the demand for cigarettes in Tanzania. The descriptive statistics suggest that the smoking prevalence for Tanzania is 15.35 percent with low variability across expenditure (income) groups. Smoking intensity and per capita consumption were estimated at 7.08 cigarettes and 1.33 cigarettes, respectively, a relatively low value. A two-part demand equation model was used to estimate various elasticities. For the overall equation, the price elasticities of smoking participation, smoking intensity, and total elasticity were estimated at −0.879, −0.853, and −1.732, respectively. Compared to similar results in other developing countries, the estimates appear quite high. When estimated by expenditure (income) groups, the magnitude of the elasticity appears higher among high expenditure groups than among low expenditure groups. Two simulation exercises were undertaken. First, the effect of different excise rates on smoking participation rate, cigarette consumption, tax revenue, and related responses was estimated and highlighted. Second, the same exercise was undertaken to determine the effect of a given increase in the cigarette excise tax on various expenditure groups. The overall results suggest that an increase in the excise tax on cigarettes in Tanzania would reduce cigarette consumption and increase government tax revenue. PMID:27358905

The Demand for Cigarettes in Tanzania and Implications for Tobacco Taxation Policy.

PubMed

Kidane, Asmerom; Mduma, John; Naho, Alexis; Ngeh, Ernest Tingum; Hu, Teh-Wei

2015-10-01

The study attempts to estimate the demand for cigarettes in Tanzania and presents simulation results on the effect of the cigarette excise tax on smoking participation, government revenue, and related topics. After briefly summarizing the magnitude and spread of cigarette consumption in the country, the paper reviews some empirical estimates from African and other countries. The 2008 Tanzanian household budget survey was used to estimate the demand for cigarettes in Tanzania. The descriptive statistics suggest that the smoking prevalence for Tanzania is 15.35 percent with low variability across expenditure (income) groups. Smoking intensity and per capita consumption were estimated at 7.08 cigarettes and 1.33 cigarettes, respectively, a relatively low value. A two-part demand equation model was used to estimate various elasticities. For the overall equation, the price elasticities of smoking participation, smoking intensity, and total elasticity were estimated at -0.879, -0.853, and -1.732, respectively. Compared to similar results in other developing countries, the estimates appear quite high. When estimated by expenditure (income) groups, the magnitude of the elasticity appears higher among high expenditure groups than among low expenditure groups. Two simulation exercises were undertaken. First, the effect of different excise rates on smoking participation rate, cigarette consumption, tax revenue, and related responses was estimated and highlighted. Second, the same exercise was undertaken to determine the effect of a given increase in the cigarette excise tax on various expenditure groups. The overall results suggest that an increase in the excise tax on cigarettes in Tanzania would reduce cigarette consumption and increase government tax revenue.

Why ban the sale of cigarettes? The case for abolition.

PubMed

Proctor, Robert N

2013-05-01

The cigarette is the deadliest artefact in the history of human civilisation. Most of the richer countries of the globe, however, are making progress in reducing both smoking rates and overall consumption. Many different methods have been proposed to steepen this downward slope, including increased taxation, bans on advertising, promotion of cessation, and expansion of smoke-free spaces. One option that deserves more attention is the enactment of local or national bans on the sale of cigarettes. There are precedents: 15 US states enacted bans on the sale of cigarettes from 1890 to 1927, for instance, and such laws are still fully within the power of local communities and state governments. Apart from reducing human suffering, abolishing the sale of cigarettes would result in savings in the realm of healthcare costs, increased labour productivity, lessened harms from fires, reduced consumption of scarce physical resources, and a smaller global carbon footprint. Abolition would also put a halt to one of the principal sources of corruption in modern civilisation, and would effectively eliminate one of the historical forces behind global warming denial and environmental obfuscation. The primary reason for abolition, however, is that smokers themselves dislike the fact they smoke. Smoking is not a recreational drug, and abolishing cigarettes would therefore enlarge rather than restrict human liberties. Abolition would also help cigarette makers fulfil their repeated promises to 'cease production' if cigarettes were ever found to be causing harm.

Attitudes toward E-Cigarettes, Reasons for Initiating E-Cigarette Use, and Changes in Smoking Behavior after Initiation: A Pilot Longitudinal Study of Regular Cigarette Smokers

PubMed Central

Barr, Dana Boyd; Stratton, Erin; Escoffery, Cam; Kegler, Michelle

2015-01-01

Objectives We examined 1) changes in smoking and vaping behavior and associated cotinine levels and health status among regular smokers who were first-time e-cigarette purchasers and 2) attitudes, intentions, and restrictions regarding e-cigarettes. Methods We conducted a pilot longitudinal study with assessments of the aforementioned factors and salivary cotinine at weeks 0, 4, and 8. Eligibility criteria included being ≥18 years old, smoking ≥25 of the last 30 days, smoking ≥5 cigarettes per day (cpd), smoking regularly ≥1 year, and not having started using e-cigarettes. Of 72 individuals screened, 40 consented, 36 completed the baseline survey, and 83.3% and 72.2% were retained at weeks 4 and 8, respectively. Results Participants reduced cigarette consumption from baseline to week 4 and 8 (p’s < 0.001); 23.1% reported no cigarette use in the past month at week 8. There was no significant decrease in cotinine from baseline to week 4 or 8 (p’s = ns). At week 8, the majority reported improved health (65.4%), reduced smoker’s cough (57.7%), and improved sense of smell (53.8%) and taste (50.0%). The majority believed that e-cigarettes versus regular cigarettes have fewer health risks (97.2%) and that e-cigarettes have been shown to help smokers quit (80.6%) and reduce cigarette consumption (97.2%). In addition, the majority intended to use e-cigarettes as a complete replacement for regular cigarettes (69.4%) and reported no restriction on e-cigarette use in the home (63.9%) or car (80.6%). Conclusions Future research is needed to document the long-term impact on smoking behavior and health among cigarette smokers who initiate use of e-cigarettes. PMID:25621193

Responses to increasing cigarette prices in France: how did persistent smokers react?

PubMed

Peretti-Watel, Patrick; L'haridon, Olivier; Seror, Valerie

2012-07-01

(1) To build a typology of persistent smokers' reactions to increasing cigarette prices (persistent smokers were defined as smokers who did not quit because of such increases) and (2) to investigate which factors were correlated with their reactions (we considered three categories: no reaction, trying to quit or smoking less, reducing the cost of smoking). We used a French national telephone survey (n=2000; 621 smokers) that included questions about smokers' reactions to increasing cigarette prices, as well as questions about their socio-demographic background, personal time perspective, smoking behavior and reasons for smoking. We used logistic regressions to identify which of these factors were linked to smokers' reactions. In response to the increasing cigarette prices, 24% of persistent smokers did not change their smoking habits at all, 31% only reduced the cost of smoking (they neither reduced their consumption nor tried to quit) and 45% tried to give up smoking or reduced their consumption (they also frequently reduced the cost of smoking). Male and older smokers, the more educated ones and the wealthier ones more frequently reported no reaction at all, as did those who smoked to improve their concentration or keep their weight down. Younger and unemployed smokers more frequently opted for spending less on cigarettes, as did those who smoked to forget about their problems. Finally, present-oriented smokers were less prone to try to quit or to reduce their consumption. These findings show the need to increase the price of all tobacco products in cooperation with neighboring states. People's reasons for smoking and their personal time perspectives contribute to their reactions to price increases, and different preventive measures are required for each category of persistent smokers. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Taxation, regulation, and addiction: a demand function for cigarettes based on time-series evidence.

PubMed

Keeler, T E; Hu, T W; Barnett, P G; Manning, W G

1993-04-01

This work analyzes the effects of prices, taxes, income, and anti-smoking regulations on the consumption of cigarettes in California (a 25-cent-per-pack state tax increase in 1989 enhances the usefulness of this exercise). Analysis is based on monthly time-series data for 1980 through 1990. Results show a price elasticity of demand for cigarettes in the short run of -0.3 to -0.5 at mean data values, and -0.5 to -0.6 in the long run. We find at least some support for two further hypotheses: that antismoking regulations reduce cigarette consumption, and that consumers behave consistently with the model of rational addiction.

Trends and affordability of cigarette prices: ample room for tax increases and related health gains.

PubMed

Guindon, G E; Tobin, S; Yach, D

2002-03-01

Increasing the price of tobacco products is arguably the most effective method of curbing the prevalence and consumption of tobacco products. Price increases would reduce the global burden of disease brought about by tobacco consumption. To compare cigarette price data from more than 80 countries using varying methods, examine trends in prices and affordability during the 1990s, and explore various policy implications pertaining to tobacco prices. March 2001 cigarette price data from the Economist Intelligence Unit are used to compare cigarette prices across countries. To facilitate comparison and to assess affordability, prices are presented in US dollars, purchasing power parity (PPP) units using the Big Mac index as an indicator of PPP and in terms of minutes of labour required to purchase a pack of cigarettes. Annual real percentage changes in cigarette prices between 1990 and 2000 and annual changes in the minutes of labour required to buy cigarettes between 1991 and 2000 are also calculated to examine trends. Cigarette prices tend to be higher in wealthier countries and in countries that have strong tobacco control programmes. On the other hand, minutes of labour required to purchase cigarettes vary vastly between countries. Trends between 1990 and 2000 in real prices and minutes of labour indicate, with some exceptions, that cigarettes have become more expensive in most developed countries but more affordable in many developing countries. However, in the UK, despite recent increases in price, cigarettes are still more affordable than they were in the 1960s. The results suggest that there is ample room to increase tobacco prices through taxation. In too many countries, cigarette prices have failed to keep up with increases in the general price level of goods and services, rendering them more affordable in 2000 than they were at the beginning of the decade. Opportunities to increase government revenue and improve health through reduced consumption brought about by higher prices have been overlooked in many countries.

Price and consumption of tobacco

PubMed Central

Singh, Virendra; Sharma, Bharat Bhushan; Saxena, Puneet; Meena, Hardayal; Mangal, Daya Krishan

2012-01-01

Background: It is thought that price increase in tobacco products leads to reduced consumption. Though many studies have substantiated this concept, it has not been well studied in India. Recently, price of tobacco products was increased due to ban on plastic sachets of chewing tobacco and increased tax in Rajasthan. This study was designed to evaluate the effect of price rise on overall consumption of tobacco in Jaipur city, Rajasthan. Materials and Methods: This study was carried out in Jaipur city. Two-staged stratified sampling was used. In the first phase of study, cost and consumption of various tobacco products in the months of February and April were enquired from 25 retail tobacco shops. In the second phase, tobacco consumption was enquired from 20 consecutive consumers purchasing any tobacco product from all the above retail tobacco shops. The data were statistically analyzed using descriptive statistics and paired “t” test. Results: The comparison of prices of tobacco products between February and April revealed that the price of cigarette, bidi, and chewing tobacco has increased by 19%, 21%, and 68%, respectively. Average decrease in sales of cigarettes, bidi, and chewing tobacco at shops included in the study were 14%, 23%, and 38%, respectively. The consumers purchasing tobacco also reported decreased consumption. Chewing tobacco showed the maximum reduction (21%). Consumption of cigarette and bidi has also reduced by 15% and 13%, respectively. Conclusion: It may be concluded that reduction in consumption is associated with increased price of tobacco products. Reduced consumption is comparative to the magnitude of price increase. PMID:22919157

Tobacco Control Polices Are Egalitarian: A Vulnerabilities Perspective on Clean Indoor Air Laws, Cigarette Prices, and Tobacco Use Disparities

PubMed Central

Glantz, Stanton; Dinno, Alexis

2009-01-01

This study models independent associations of state or local strong clean indoor air laws and cigarette prices with current smoker status and consumption in a multilevel framework, including interactions with educational attainment, household income and race/ethnicity and the relationships of these policies to vulnerabilities in smoking behavior. Cross sectional survey data are employed from the February 2002 panel of the Tobacco Use Supplement of the Current Population Survey (54,024 individuals representing the US population aged 15 to 80). Nonlinear relationships between both outcome variables and the predictors were modeled. Independent associations of strong clean indoor air laws were found for current smoker status and consumption among current smokers. Cigarette price was found to have independent associations with both outcomes, an effect that saturated at higher prices. The odds ratio for smoking for the highest versus lowest price over the range where there was a price effect was 0.83. Average consumption declined over the range of effect of price on consumption. Neither policy varied in its effect by educational attainment, or household income. The association of cigarette price with reduced smoking participation and consumption was not found to vary with race/ethnicity. Population vulnerability in consumption appears to be structured by non-white race categories, but not at the state and county levels at which the policies we studied were enacted. Clean indoor air laws and price increases appear to benefit all socio-economic and race/ethnic groups in our study equally in terms of reducing smoking participation and consumption. PMID:19282078

Consumption of single cigarettes and quitting behavior: A longitudinal analysis of Mexican smokers

PubMed Central

2011-01-01

Background Previous cross-sectional research has suggested single cigarettes could either promote or inhibit consumption. The present study aimed to assess the effects of single cigarette availability and consumption on downstream quit behavior. Methods We analyzed population-based, longitudinal data from adult smokers who participated in the 2008 and 2010 administrations of the International Tobacco Control Policy Evaluation Survey in Mexico. Results At baseline, 30% of smokers saw single cigarettes for sale on a daily basis, 17% bought singles at their last purchase, and 7% bought singles daily. Smokers who most frequently purchased singles, both in general and specifically to control their consumption, were no more likely to attempt to quit over the 14 month follow-up period than those who did not purchase singles. Frequency of buying singles to reduce consumption had a non-monotonic association with being quit at followup. The odds of being quit was only statistically significant when comparing those who had not bought singles to reduce consumption with those who had done so on a more irregular basis (AOR = 2.30; 95% CI 1.19, 4.45), whereas those who did so more regularly were no more likely to be quit at followup. Frequency of self-reported urges to smoke upon seeing singles for sale was unassociated with either quit attempts or being quit at followup. Conclusions These results suggest that the relationship between singles consumption and quit behavior is complex, with no clear evidence that singles either promote or inhibit downstream quit behavior. PMID:21352526

Are lower income smokers more price sensitive?: the evidence from Korean cigarette tax increases.

PubMed

Choi, Seng Eun

2016-03-01

The cigarette excise taxes and the price of a typical pack of cigarettes in Korea have not increased since 2005, and effective tax rate as a fraction of price and real price of cigarettes have both been falling. As smoking prevalence is higher among lower income people than among higher income people in Korea, the regressivity of cigarette excise taxes is often cited as a barrier to tobacco tax and price policy. While studies in several other high-income countries have shown that higher income individuals are less price sensitive, few studies have examined the differential impact of cigarette tax increases by income group in Korea. Most of the Korean literature has estimated the demand for cigarettes using time-series aggregate sales data or household level survey data, which record household cigarette expenditures rather than individual cigarette consumption. Studies using survey data often lack time-series variation and estimate cigarette demand using household expenditure data, while studies using time-series aggregate sales data lack cross-sectional variation. I examine differences in the effects of cigarette price on the cigarette consumption of various income groups using individual-level cigarette consumption records from the Korea National Health and Nutrition Examination Survey (KHNNES). I also analyse the implications of cigarette taxes and price increases on the relative tax burdens of different income groups. I use pooled data from the KNHNES for the 1998-2011 period to estimate the price elasticity of cigarette consumption of four income groups. Treating cigarette consumption as a latent variable, I employ an econometric procedure that corrects for non-random sample selection, or the fact that some non-smokers might have smoked at a low enough price, and estimate the price elasticity of cigarette consumption by income group. The estimated price elasticities include the responsiveness of potential smokers as well as current smokers. Lower income Korean smokers are more responsive to changes in the price of cigarettes. While the overall price elasticity of cigarettes is estimated to be -0.425, the price elasticity of the lowest income quartile is estimated to be -0.812, whereas that of the highest income quartile is estimated to be -0.325. The estimated price elasticities of different income groups imply that the cigarette tax and price increases in Korea would reduce smoking more in those with lower incomes. For a given price increase, the percentage reduction in cigarette consumption among smokers in the lowest income quartile is 2.5 times greater than among smokers in the top income quartile. The simulated tax burdens of different income groups show that the additional burden of a tax increase and the associated price rise is largely borne by higher income smokers. 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 ban the sale of cigarettes? The case for abolition

PubMed Central

Proctor, Robert N

2013-01-01

The cigarette is the deadliest artefact in the history of human civilisation. Most of the richer countries of the globe, however, are making progress in reducing both smoking rates and overall consumption. Many different methods have been proposed to steepen this downward slope, including increased taxation, bans on advertising, promotion of cessation, and expansion of smoke-free spaces. One option that deserves more attention is the enactment of local or national bans on the sale of cigarettes. There are precedents: 15 US states enacted bans on the sale of cigarettes from 1890 to 1927, for instance, and such laws are still fully within the power of local communities and state governments. Apart from reducing human suffering, abolishing the sale of cigarettes would result in savings in the realm of healthcare costs, increased labour productivity, lessened harms from fires, reduced consumption of scarce physical resources, and a smaller global carbon footprint. Abolition would also put a halt to one of the principal sources of corruption in modern civilisation, and would effectively eliminate one of the historical forces behind global warming denial and environmental obfuscation. The primary reason for abolition, however, is that smokers themselves dislike the fact they smoke. Smoking is not a recreational drug, and abolishing cigarettes would therefore enlarge rather than restrict human liberties. Abolition would also help cigarette makers fulfil their repeated promises to ‘cease production’ if cigarettes were ever found to be causing harm. PMID:23591501

Mouth-Level Intake of Benzo[a]pyrene from Reduced Nicotine Cigarettes

PubMed Central

Ding, Yan S.; Ward, Jennye; Hammond, David; Watson, Clifford H.

2014-01-01

Cigarette smoke is a known source of exposure to carcinogenic polycyclic aromatic hydrocarbons (PAHs), especially benzo[a]pyrene (BaP). Exposure to BaP in cigarette smoke is influenced by how a person smokes and factors, such as tobacco blend. To determine whether sustained use of reduced-nicotine cigarettes is associated with changes in exposure to nicotine and BaP, levels of BaP in spent cigarette filter butts were correlated with levels of BaP in cigarette smoke to estimate mouth-level intake (MLI) of BaP for 72 daily smokers given three progressively reduced nicotine content cigarettes. Urinary cotinine, a marker of nicotine exposure, and urinary 1-hydroxypyrene (1-HOP), a marker of PAH exposure, were measured throughout the study. Median daily BaP MLI and urine cotinine decreased in a similar manner as smokers switched to progressively lower nicotine cigarettes, despite relatively constant daily cigarette consumption. 1-HOP levels were less responsive to the use of reduced nicotine content cigarettes. We demonstrate that spent cigarette filter butt analysis is a promising tool to estimate MLI of harmful chemicals on a per cigarette or per-day basis, which partially addresses the concerns of the temporal influence of smoking behavior or differences in cigarette design on exposure. PMID:25411724

The role of taxation in tobacco control and its potential economic impact in China

PubMed Central

Mao, Zhengzhong; Shi, Jian; Chen, Wendong

2010-01-01

Objectives To identify key economic issues involved in raising the tobacco tax and to recommend possible options for tobacco tax reform in China. Methods Estimated price elasticities of the demand for cigarettes, prevalence data and epidemiology are used to estimate the impact of a tobacco tax increase on cigarette consumption, government tax revenue, lives saved, employment and revenue loss in the cigarette industry and tobacco farming. Results The recent Chinese tax adjustment, if passed along to the retail price, would reduce the number of smokers by 630 000 saving 210 000 lives, at a price elasticity of −0.15. A tax increase of 1 RMB (or US$0.13) per pack of cigarettes would increase the Chinese government's tax revenue by 129 billion RMB (US 17.2 billion), decrease consumption by 3.0 billion packs of cigarettes, reduce the number of smokers by 3.42 million and save 1.14 million lives. Conclusion The empirical economic analysis and tax simulation results clearly indicate that increasing the tobacco tax in China is the most cost-effective instrument for tobacco control. PMID:20008158

The role of taxation in tobacco control and its potential economic impact in China.

PubMed

Hu, Teh-Wei; Mao, Zhengzhong; Shi, Jian; Chen, Wendong

2010-02-01

To identify key economic issues involved in raising the tobacco tax and to recommend possible options for tobacco tax reform in China. Estimated price elasticities of the demand for cigarettes, prevalence data and epidemiology are used to estimate the impact of a tobacco tax increase on cigarette consumption, government tax revenue, lives saved, employment and revenue loss in the cigarette industry and tobacco farming. The recent Chinese tax adjustment, if passed along to the retail price, would reduce the number of smokers by 630,000 saving 210,000 lives, at a price elasticity of -0.15. A tax increase of 1 RMB (or US$0.13) per pack of cigarettes would increase the Chinese government's tax revenue by 129 billion RMB (US 17.2 billion), decrease consumption by 3.0 billion packs of cigarettes, reduce the number of smokers by 3.42 million and save 1.14 million lives. The empirical economic analysis and tax simulation results clearly indicate that increasing the tobacco tax in China is the most cost-effective instrument for tobacco control.

Increasing excise taxes in the presence of an illegal cigarette market: the 2011 Brazil tobacco tax reform.

PubMed

Iglesias, Roberto Magno

2016-10-01

The Brazilian cigarette excise tax reform of 2011 increased tax rates significantly in the presence of a high proportion of illegal and cheap cigarettes contributing to total consumption. Prior to 2011, tobacco tax policy in Brazil had reduced excise tax share on consumer prices, for fear of smuggling. This report examines two hypotheses explaining why tax authorities changed direction. The first is related to lack of concern regarding smuggling in tobacco industry pricing behavior before 2011 (rather than reducing prices following tax reduction, legal companies increased net of tax prices above inflation and key costs). The second hypothesis regards inconsistent industry assessments of the size of the illicit market, which ultimately undermined the credibility of the industry with tax authorities. The author concludes that the 2011 reform was designed to revert the weakness of previous policies, and did indeed succeed. The post-2011 experience in Brazil indicates that increased cigarette excise taxes can increase government revenues and reduce smoking prevalence and consumption despite widespread smuggling of tobacco products.

Fish consumption is inversely associated with male lung cancer mortality in countries with high levels of cigarette smoking or animal fat consumption.

PubMed

Zhang, J; Temme, E H; Kesteloot, H

2000-08-01

A striking difference in fish consumption and lung cancer mortality (LCM) exists among populations worldwide. This study investigated the relation between fish consumption and LCM at the population level. Sex-specific LCM data, mostly around 1993 and fish consumption data for 10 periods 1961-1994 in 36 countries were obtained from WHO and FAO, respectively. A significant inverse correlation exists between log fish consumption and LCM rate in 9 out of the 10 time periods (r = -0.34 to r = -0.46, P = 0.044 to P = 0.005). After adjusting for smoking and other confounders, log fish consumption (% of total energy [% E]) was inversely and significantly associated with LCM rate (per 100 000 per year) in all 10 time periods (beta = -26.3 to beta = -36.7; P = 0.0039 to P < 0.0001). The stratified analysis showed that this inverse relation was significant only in countries with above median level of smoking (>2437 cigarettes/adult/year) or animal fat minus fish fat consumption (22.4% E). An increase in fish consumption by 1% E was calculated to reduce mean male LCM rate of the populations examined in the age class of 45-74 years by 8.4%. In women, no significant relation between fish consumption and LCM could be established. Fish consumption is associated with a reduced risk from LCM, but this possible protective effect is clear-cut only in men and in countries with high levels of cigarette smoking or animal fat consumption.

Factors associated with dual use of tobacco and electronic cigarettes: A case control study.

PubMed

Farsalinos, Konstantinos E; Romagna, Giorgio; Voudris, Vassilis

2015-06-01

Many electronic cigarette (EC) users reduce cigarette consumption without completely quitting. It is important to assess the characteristics and experiences of these users, commonly called "dual users", in comparison with EC users who have completely substituted smoking (non-smoking vapers). A questionnaire was uploaded in an online survey tool. EC users were invited to participate irrespective of their current smoking status. Dual users were matched for age and gender with non-smoking vapers. From 19,441 participants, 3682 were dual users. After random 1:1 matching with non-smoking vapers (all of whom were former smokers), 3530 participants in each group were compared. Dual users had longer smoking history, lower daily cigarette consumption and similar cigarette dependence compared to non-smoking vapers. Their daily consumption was reduced after initiation of EC use from 20 to 4 cigarettes per day. Most of them were using ECs daily, however, more were occasional EC users compared to non-smoking vapers. Use of advanced (third generation) devices and daily liquid consumption was lower in dual users compared to non-smoking vapers. The most important reason for initiating EC use was to reduce smoking and exposure of family members to smoke for both groups, but higher scores were given to "avoid smoking ban in public places" by dual users compared to non-smoking vapers. The strongest predictors of being dual user from multivariate analysis were: higher risk perception for ECs (OR=2.27, 95% CI=1.40-3.68), use of first-generation EC devices (OR=1.98, 95% CI=1.47-2.66), use of prefilled cartomizers (OR=1.94, 95% CI=1.23-3.06) and occasional use of ECs (OR=1.62, 95% CI=1.21-2.17). The results of this case-control study indicate that higher risk perceptions about, and less frequent use of, ECs was associated with dual use of ECs and tobacco cigarettes. Since this is a cross-sectional survey, which explores association but not causation, longitudinal studies are warranted to further explore the reasons for dual use. Copyright © 2015 Elsevier B.V. All rights reserved.

Differential Responsiveness to Cigarette Price by Education and Income among Adult Urban Chinese Smokers

PubMed Central

Huang, Jidong; Zheng, Rong; Chaloupka, Frank J.; Fong, Geoffrey T.; Jiang, Yuan

2015-01-01

Background There are few studies that examine the impact of tobacco tax and price policies in China. In addition, very little is known about the differential responses to tax and price increases based on socioeconomic status in China. Objective The goal of this study is to estimate the conditional cigarette consumption price elasticity among adult urban smokers in China using individual level longitudinal survey data. We also examine the differential responses to cigarette price increases among groups with different income and/or educational levels. Methods Multivariate analyses using the general estimating equations (GEE) method were conducted to estimate the conditional cigarette demand price elasticity using data from the International Tobacco Control (ITC) China Survey, a longitudinal survey of adult smokers in seven cities in China. The first three waves of the ITC China Survey data were used in this analysis. Analyses based on subsample by education and income were conducted. Findings Our results show that overall conditional cigarette demand price elasticity ranges from −0.12 to −0.14, implying a 10% increase in cigarette price would result in a reduction in cigarette consumption among adult urban Chinese smokers by 1.2% to 1.4%. No differential responses to cigarette price increase were found across education levels. The price elasticity estimates do not differ between high income smokers and medium income smokers. However, cigarette consumption among low income smokers did not seem to decrease after a price increase, at least among those who continued to smoke. Conclusion Relative to many other low- and middle-income countries, cigarette consumption among Chinese adult smokers is not very sensitive to changes in cigarette prices. The total impact of cigarette price increase would be larger if its impact on smoking initiation and cessation, as well as the price-reducing behaviors such as brand switching and trading down, were taken into account. PMID:25855640

Estimating Demand and Cross-Price Elasticity for Very Low Nicotine Content (VLNC) Cigarettes Using a Simulated Demand Task.

PubMed

Tucker, Megan R; Laugesen, Murray; Grace, Randolph C

2017-03-03

Very Low Nicotine Content (VLNC) cigarettes might be useful as part of a tobacco control strategy, but relatively little is known about their acceptability as substitutes for regular cigarettes. We compared subjective effects and demand for regular cigarettes and Very Low Nicotine Content (VLNC) cigarettes, and estimated cross-price elasticity for VLNC cigarettes, using simulated demand tasks. 40 New Zealand smokers sampled a VLNC cigarette and completed Cigarette Purchase Tasks to indicate their demand for regular cigarettes and VLNC cigarettes at a range of prices, and a cross-price task indicating how many regular cigarettes and VLNC cigarettes they would purchase at 0.5x, 1x, and 2x the current market price for regular cigarettes, assuming the price of VLNC cigarettes remained constant. They also rated the subjective effects of the VLNC cigarette and their usual-brand regular cigarettes. Cross-price elasticity for VLNC cigarettes was estimated as 0.24 and was significantly positive, indicating that VLNC cigarettes are partially substitutable for regular cigarettes. VLNC cigarettes were rated as less satisfying and psychologically rewarding than regular cigarettes, but this was unrelated to demand or substitutability. VLNC cigarettes are potentially substitutable for regular cigarettes. Their availability may reduce tobacco consumption, nicotine intake and addiction; making it easier for smokers to quit. VLNC cigarettes share the behavioural and sensory components of smoking whilst delivering negligible levels of nicotine. Although smokers rated VLNCs as less satisfying than regular cigarettes, smokers said they would increase their consumption of VLNCs as the price of regular cigarettes increased, if VLNCs were available at a lower price. This suggests that VLNCs are partially substitutable for regular cigarettes. VLNCs can be part of an effective tobacco control strategy, by reducing nicotine dependence and improving health and financial outcomes for smokers. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Price and consumption of tobacco in Spain over the period 1965-2000.

PubMed

Fernández, E; Gallus, S; Schiaffino, A; López-Nicolás, A; La Vecchia, C; Barros, H; Townsend, J

2004-06-01

Changes in cigarette price have had an appreciable impact on smoking prevalence in several countries. We analysed the price elasticity of demand for cigarettes (effect of price of cigarettes on tobacco consumption) between 1965 and 2000 in Spain. For total consumption of cigarettes, a 1% increase in price is associated with a 0.19% decrease of consumption (price elasticity of -0.19; P<0.01). The real price of blond cigarettes was significantly and inversely associated with blond cigarette consumption: on average, smoking prevalence decreased 1.25% for a 1% increase in the real price of cigarettes (significant price elasticity of -1.25). For black cigarettes we found a lower but still high and significant elasticity of -0.61. There is an inverse relation between price and consumption of cigarettes in Spain, indicating that interventions at the economic level (such as real increases in prices) may have an important public health impact in tobacco control.

[Trends of tobacco demand in Mexico: 1992-1998].

PubMed

Sesma-Vázquez, Sergio; Campuzano-Rincón, Julio César; Carreón-Rodríguez, Víctor Gerardo; Knaul, Felicia; López-Antuñano, Francisco Javier; Hernández-Avila, Mauricio

2002-01-01

This paper aims at describing the behavior of tobacco's demand in Mexico across four one-year periods: 1992, 1994, 1996, and 1998, as well as to estimate a cigarette demand function. A cross-sectional study with longitudinal analysis was conducted. Information sources were the Encuesta Nacional de Ingreso y Gasto de los Hogares (ENIGH) (National Survey of Household Income and Spending) (NHSIS) and the tobacco pack prices reported by the Procuraduría Federal del Consumidor (Profeco) (Federal Office of Consumer's Protection) (FOCP). Spending, income, and prices were deflated to 1994 prices; the population was stratified into quintiles of real income, by rural and urban areas. Indicators of daily consumption of cigarettes and packs were constructed and prices per pack calculated. Adjusted prevalence figures were estimated. Logistic and linear regression models were used for statistical inference; a cigarette demand function was estimated using multivariate logistic regression, to find socioeconomic determinants of cigarette consumption. The adjusted prevalence of household tobacco spending fell from 22.4 to 9.9% between 1992 and 1998. Households allocated more than 4% of their income to tobacco consumption. A trend between income level and cigarette spending was observed, with the first quintile (the poorest population) allocated a greater share of their income than higher quintiles. The average daily consumption of cigarettes increased from 7.5 to 9.8 between 1992 and 1998. It was estimated that 90% of "smoker homes" consumed up to one package per day. The proportion of non-filter cigarettes increased from 0.4 to 4.8% between 1992-1998, with a bigger increase in 1996. Finally, it was found that the most important determinants of spending were prices and income. Policies focusing on tobacco prices would help to reduce tobacco consumption and improve the health of the Mexican population.

Use of and Reasons for Using Multiple Other Tobacco Products in Daily and Nondaily Smokers: Associations with Cigarette Consumption and Nicotine Dependence

PubMed Central

Dunbar, Michael S.; Shadel, William G.; Tucker, Joan S.; Edelen, Maria O.

2016-01-01

Background Use of other tobacco products (OTPs) among smokers is increasing. Little is known about types of OTP used and the reasons for use, and how OTP use and reasons for use correlate with smoking patterns and nicotine dependence in daily and nondaily smokers. This paper addresses these gaps in the literature. Methods 656 daily smokers and 203 nondaily smokers provided information on their use of different OTPs (hookah, e-cigarettes, chew/snuff, snus, cigars, dissolvables), and reasons for using OTPs (e.g., “to cut down on smoking”), as well as their cigarette consumption and nicotine dependence. Logistic regression models assessed the association of smoking status with OTP use (ever and current) and reasons for use. Within each smoking group, separate logistic regression models examined the associations of OTP use and reasons for use with cigarette consumption and nicotine dependence. Results Compared to daily smokers, nondaily smokers were more likely to use hookah and cigars, less likely to use dissolvables, and less likely to endorse using OTPs to reduce their smoking. Among non-daily smokers, nicotine dependence was associated with a higher likelihood of current OTP use (OR=1.04 [95% CI 1.01–1.07]; p < .05), whereas cigarette consumption was not. Conclusions Results suggest OTP use in nondaily smokers does not correlate with less frequent smoking, but may correlate with higher nicotine dependence. Use of combustible OTPs among nondaily smokers may offset any potential benefits achieved through less frequent cigarette consumption. Providers should explicitly address OTP use when discussing cigarette cessation and reduction. PMID:27664553

Use of and reasons for using multiple other tobacco products in daily and nondaily smokers: Associations with cigarette consumption and nicotine dependence.

PubMed

Dunbar, Michael S; Shadel, William G; Tucker, Joan S; Edelen, Maria O

2016-11-01

Use of other tobacco products (OTPs) among smokers is increasing. Little is known about types of OTP used and the reasons for use, and how OTP use and reasons for use correlate with smoking patterns and nicotine dependence in daily and nondaily smokers. This paper addresses these gaps in the literature. 656 daily smokers and 203 nondaily smokers provided information on their use of different OTPs (hookah, e-cigarettes, chew/snuff, snus, cigars, dissolvables), and reasons for using OTPs (e.g., "to cut down on smoking"), as well as their cigarette consumption and nicotine dependence. Logistic regression models assessed the association of smoking status with OTP use (ever and current) and reasons for use. Within each smoking group, separate logistic regression models examined the associations of OTP use and reasons for use with cigarette consumption and nicotine dependence. Compared to daily smokers, nondaily smokers were more likely to use hookah and cigars, less likely to use dissolvables, and less likely to endorse using OTPs to reduce their smoking. Among non-daily smokers, nicotine dependence was associated with a higher likelihood of current OTP use (OR=1.04 [95% CI 1.01-1.07]; p<0.05), whereas cigarette consumption was not. Results suggest OTP use in nondaily smokers does not correlate with less frequent smoking, but may correlate with higher nicotine dependence. Use of combustible OTPs among nondaily smokers may offset any potential benefits achieved through less frequent cigarette consumption. Providers should explicitly address OTP use when discussing cigarette cessation and reduction. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Efficacy and security of electronic cigarette for tobacco harm reduction: Systematic review and meta-analysis].

PubMed

Vanderkam, Paul; Boussageon, Rémy; Underner, Michel; Langbourg, Nicolas; Brabant, Yann; Binder, Philippe; Freche, Bernard; Jaafari, Nematollah

2016-11-01

Smoking is the first cause of preventable death in France and in the world. Without help, it was shown that 80 % of smokers who try to quit smoking relapse after one month with a low long-term success rate. Smoking reduction can concern smokers who did not want to quit or failed in their attempt to weaning. The final aim is to increase attractiveness of drug therapies by developing new products, such as electronic cigarettes, that can compete cigarette without reproducing its harmful effects. Assess the capacity of electronic cigarettes to reduce or stop tobacco use among regular smokers. Consultations MEDLINE and COCHRANE databases. e-cigarette; electronic cigarettes; ENDD (electronic nicotine delivery system); ENDS (electronic nicotine delivery device); vaping were used. Randomized controlled trials (RCTs) comparing the electronic cigarette with nicotine versus placebo device. Two randomized controlled trials were included in the quantitative analysis. The nicotine electronic cigarette users have tobacco consumption significantly decreased compared to the placebo group (RR: 1.30, 95 % CI [1.02 to 1.66]) at 6 months. Smoking cessation rate at 3 months was greater with the electronic cigarette contains nicotine (RR: 2.55, 95 % CI [1.31 to 4.98]). The small number of RCTs included does not allow definitive conclusions about the effectiveness of electronic cigarettes, especially in the medium to long term. The use of electronic cigarette with nicotine decreases tobacco consumption among regular smokers. Further studies are needed to specify electronic cigarettes safety profile and its ability to cause a reduction in consumption and a long-term cessation in smokers. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The emerging phenomenon of electronic cigarettes.

PubMed

Caponnetto, Pasquale; Campagna, Davide; Papale, Gabriella; Russo, Cristina; Polosa, Riccardo

2012-02-01

The need for novel and more effective approaches to tobacco control is unquestionable. The electronic cigarette is a battery-powered electronic nicotine delivery system that looks very similar to a conventional cigarette and is capable of emulating smoking, but without the combustion products accountable for smoking's damaging effects. Smokers who decide to switch to electronic cigarettes instead of continuing to smoke would achieve large health gains. The electronic cigarette is an emerging phenomenon that is becoming increasingly popular with smokers worldwide. Users report buying them to help quit smoking, to reduce cigarette consumption, to relieve tobacco withdrawal symptoms due to workplace smoking restrictions and to continue to have a 'smoking' experience but with reduced health risks. The focus of the present article is the health effects of using electronic cigarettes, with consideration given to the acceptability, safety and effectiveness of this product to serve as a long-term substitute for smoking or as a tool for smoking cessation.

Population cigarette consumption in Great Britain: novel insights using retail sales data.

PubMed

Robinson, Mark; Reid, Garth

2017-12-20

Accurate data to measure population cigarette consumption are vital for surveillance and for evaluating the impact of tobacco control policies. This study uses cigarette retail sales data to provide novel insights into trends and patterns in cigarette consumption in Great Britain. Cigarette sales estimates derived from electronic sales from most large grocery stores and a weighted representative sample of smaller convenience stores were obtained from Nielsen. Data on the number of cigarette sticks sold per calendar month and per week were obtained for Scotland and England/Wales (combined) for the period January 2008 to December 2015. Cigarette consumption per adult smoker per month was calculated using survey-based smoking prevalence estimates and mid-year population estimates. Population cigarette consumption in Great Britain declined between 2008 and 2013. Cigarette sales have since stabilised at around 400 cigarettes per adult smoker per month. Cigarettes sold in 14- to 19-packs have substituted a sharp decline in 20-packs and now account for over half of all cigarettes sold in Great Britain. Cigarette consumption has been consistently higher in Scotland than England/Wales. This is due to higher sales of 20-packs in Scotland between 2008 and 2013, which has been substituted by higher sales of 14- to 19-packs in recent years. Cigarette retail sales data provide unique insights into levels and patterns of cigarette consumption and should be used for monitoring and evaluating tobacco control policy in Great Britain.

The substitutability of cigarettes and food: A behavioral economic comparison in normal weight and overweight or obese smokers.

PubMed

Murphy, Cara M; Owens, Max M; Sweet, Lawrence H; MacKillop, James

2016-12-01

Obesity and cigarette smoking contribute to a multitude of preventable deaths in the United States and eating and smoking behavior may influence each other. The field of behavioral economics integrates principles from psychology and economics and permits systematic examination of how commodities interrelate with one another. Using this framework, the current study evaluated the effects of rising food and cigarette prices on consumption to investigate their substitutability and their relationship to BMI and associated variables. Behavioral economics categorizes commodities as substitutable when the consumption of one increases as a function of a price increase in the other. Smokers (N = 86) completed a 2-part hypothetical task in which money was allocated to purchase cigarettes and fast-food-style reinforcers (e.g., hamburgers, ice cream) at various prices. Results indicated that food and cigarettes were not substitutes for one another (cross-price elasticity coefficients < .20). Food purchases were independent of cigarette price, whereas cigarette purchases decreased as food price rose. Cross-price elasticity coefficients were significantly associated with confidence in one's ability to control weight without smoking (rs = -.23 and .29), but not BMI (rs = .04 and .04) or postcessation weight concerns (rs = -.05 and .12). Perceived ability to manage weight without cigarettes may influence who substitutes food for cigarettes when quitting. In addition, given observed decreases in purchases of both commodities as food prices increased, these findings imply that greater taxation of fast-food-style reinforcers could potentially reduce consumption of these foods and also cigarettes among smokers. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Substitutability of Cigarettes and Food: A Behavioral Economic Comparison in Normal Weight and Overweight or Obese Smokers

PubMed Central

Murphy, Cara M.; Owens, Max M.; Sweet, Lawrence H.; MacKillop, James

2017-01-01

Obesity and cigarette smoking contribute to a multitude of preventable deaths in the US and eating and smoking behavior may influence each other. The field of behavioral economics integrates principles from psychology and economics and permits systematic examination of how commodities interrelate with one another. Using this framework, the current study evaluated the effects of rising food and cigarette prices on consumption to investigate their substitutability and their relationship to BMI and associated variables. Behavioral economics categorizes commodities as substitutable when the consumption of one increases as a function of a price increase in the other. Smokers (N = 86) completed a two-part hypothetical task in which money was allocated to purchase cigarettes and fast food-style reinforcers (e.g., hamburgers, ice cream) at various prices. Results indicated that food and cigarettes were not substitutes for one another (cross-price elasticity coefficients > .20). Food purchases were independent of cigarette price, whereas cigarette purchases decreased as food price rose. Cross-price elasticity coefficients were significantly associated with confidence in one’s ability to control weight without smoking (rs = −.23 and .29), but not BMI (rs = .04 and .04) or post-cessation weight concerns (rs = −.05 and .12). Perceived ability to manage weight without cigarettes may influence who substitutes food for cigarettes when quitting. In addition, given observed decreases in purchases of both commodities as food prices increased, these findings imply that greater taxation of fast food-style reinforcers could potentially reduce consumption of these foods and also cigarettes among smokers. PMID:27736143

Did the tobacco industry inflate estimates of illicit cigarette consumption in Asia? An empirical analysis.

PubMed

Chen, Jing; McGhee, Sarah M; Townsend, Joy; Lam, Tai Hing; Hedley, Anthony J

2015-06-01

Estimates of illicit cigarette consumption are limited and the data obtained from studies funded by the tobacco industry have a tendency to inflate them. This study aimed to validate an industry-funded estimate of 35.9% for Hong Kong using a framework taken from an industry-funded report, but with more transparent data sources. Illicit cigarette consumption was estimated as the difference between total cigarette consumption and the sum of legal domestic sales and legal personal imports (duty-free consumption). Reliable data from government reports and scientifically valid routine sources were used to estimate the total cigarette consumption by Hong Kong smokers and legal domestic sales in Hong Kong. Consumption by visitors and legal duty-free consumption by Hong Kong passengers were estimated under three scenarios for the assumptions to examine the uncertainty around the estimate. A two-way sensitivity analysis was conducted using different levels of possible undeclared smoking and under-reporting of self-reported daily consumption. Illicit cigarette consumption was estimated to be about 8.2-15.4% of the total cigarette consumption in Hong Kong in 2012 with a midpoint estimate of 11.9%, as compared with the industry-funded estimate of 35.9% of cigarette consumption. The industry-funded estimate was inflated by 133-337% of the probable true value. Only with significant levels of under-reporting of daily cigarette consumption and undeclared smoking could we approximate the value reported in the industry-funded study. The industry-funded estimate inflates the likely levels of illicit cigarette consumption. 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.

Implications of raising cigarette excise taxes in Peru.

PubMed

Gonzalez-Rozada, Martin; Ramos-Carbajales, Alejandro

2016-10-01

To assess how raising cigarette excise taxes in Peru might impact cigarette consumption, and to determine if higher taxes would be regressive. Total demand price elasticity was estimated by income groups using two datasets: quarterly time-series data from 1993 - 2012 and data from a cross-sectional survey of income and expenses conducted in 2008 - 2009 . A functional form of the cigarette demand in Peru was specified using the quarterly data set, and the demand price elasticity was estimated for the short and long run. Using the second data set and Deaton methodology, the implementation of elasticity estimation and by groups' elasticity was done in a two-step procedure. Demand price elasticity was -0.7, implying that a 10% price increase via a new tax would reduce consumption by 7%. Demand price elasticity estimations by income group suggested that poorer families are not more price sensitive than richer ones, which implies that increasing cigarette taxes could be regressive. Increasing cigarette taxes is the most efficient policy for inducing a reduction in smoking. However, in the case of Peru, an increase in cigarette taxes could be regressive.

Effects of cigarette smoking and nicotine metabolite ratio on leukocyte telomere length.

PubMed

Verde, Zoraida; Reinoso-Barbero, Luis; Chicharro, Luis; Garatachea, Nuria; Resano, Pilar; Sánchez-Hernández, Ignacio; Rodríguez González-Moro, Jose Miguel; Bandrés, Fernando; Santiago, Catalina; Gómez-Gallego, Félix

2015-07-01

Studies of the effects of smoking on leukocyte telomere length (LTL) using cigarettes smoked per day or pack years smoked (PYS) present limitations. Reported high levels of smoking may not increase toxin exposure levels proportionally. Nicotine metabolism ratio (NMR) predicts total cigarette puff volume and overall exposure based on total N-nitrosamines, is highly reproducible and independent of time since the last cigarette. We hypothesized that smokers with higher NMRs will exhibit increased total puff volume, reflecting efforts to extract more nicotine from their cigarettes and increasing toxin exposure. In addition, higher levels of smoking could cause a gross damage in LTL. The urinary cotinine, 3-OH cotinine and nicotine levels of 147 smokers were analyzed using a LC/MS system Triple-Q6410. LTL and CYP2A6 genotype was determined by PCR in blood samples. We found a significant association between NMR and CYP2A6 genotype. Reduction in LTL was seen in relation to accumulated tobacco consumption and years smoking when we adjusted for age and gender. However, there were no significant differences between NMR values and LTL. In our study the higher exposure was associated with lower number of PYS. Smokers with reduced cigarette consumption may exhibit compensatory smoking behavior that results in no reduced tobacco toxin exposure. Our results suggest that lifetime accumulated smoking exposure could cause a gross damage in LTL rather than NMR or PYS. Nevertheless, a combination of smoking topography (NMR) and consumption (PYS) measures may provide useful information about smoking effects on health outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Cigarette trafficking in five northeastern US cities.

PubMed

Davis, Kevin C; Grimshaw, Victoria; Merriman, David; Farrelly, Matthew C; Chernick, Howard; Coady, Micaela H; Campbell, Kelsey; Kansagra, Susan M

2014-05-01

Cigarette taxation is effective in reducing tobacco use in the USA. However, these benefits are reduced when taxes are unpaid. Cigarette trafficking (ie, the illegal importation of cigarettes into a high-tax jurisdiction from a lower-tax jurisdiction) is well documented in high-tax places like New York City (NYC), but the extent of trafficking in other northeastern cities is relatively unknown. To estimate the extent of cigarette trafficking in Boston, NYC, Philadelphia, Providence and Washington, DC, and project the benefits of reducing cigarette trafficking for recouping lost taxes and reducing smoking in these cities. Littered cigarette packs were collected from a random sample of Census tracts in five US cities. Data collection yielded 1439 total littered packs. The share of cigarette packs bearing proper local, known non-local, foreign or unknown, or no tax stamp was calculated for each city. These data were used to estimate tax revenue recovery if cigarette trafficking could be eliminated. We also estimated the extent to which eliminating cigarette trafficking would reduce cigarette consumption. Overall, 58.7% of packs did not have a proper local tax stamp, and 30.5-42.1% were attributed to trafficking. We estimate that eliminating cigarette trafficking would result in declines in youth smoking prevalence ranging from negligible in low-tax cities like Philadelphia to up to 9.3% in higher-tax NYC. We estimate that these five cities could recoup $680-729 million annually in cigarette tax revenue if cigarette trafficking was eliminated. Reducing cigarette trafficking would increase the effectiveness of tobacco taxes in reducing smoking and generate additional tax revenue, particularly in higher-taxed cities. Federal action to reduce cigarette trafficking, such as a track-and-trace system, is needed. 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.

Economic and public health impact of 2007-2010 tobacco tax increases in Ukraine.

PubMed

Ross, Hana; Stoklosa, Michal; Krasovsky, Konstantin

2012-07-01

To evaluate the impact of the dynamic 2007-2010 tobacco tax policy in Ukraine on cigarette prices, cigarette consumption, tobacco tax revenue and the tobacco industry's price strategy. Using data on cigarette sales, cigarette prices, income and tobacco control policies, price elasticities of cigarette demand in Ukraine were estimated using two methods. Annual data were used to generate point price elasticity estimates, while monthly data were used in a two-step Engle-Granger procedure. The point price elasticity estimate is data sensitive and ranges from -0.11 to -0.62, centring around -0.32. The regression model estimates a long-run price elasticity of -0.28. Cigarette consumption fell by 13% in 2009 and 15% in 2010 while the tax revenue increased by US$700 million and by US$500 million in 2009 and 2010, respectively, compared to the previous year. Tax increases have changed the tobacco industry's price strategy from one of shielding consumers from the impact of smaller tax hikes in 2007-2008, to one of increasing industry net-of-tax prices, after recent, larger tax increases. The higher real tobacco excise taxes of 2009 and 2010 have significantly reduced tobacco consumption in Ukraine, resulting in encouraging public health and fiscal gains. It will be important for cigarette prices/taxes to keep pace with inflation and income growth for this impact to be sustained.

Benefits of E-Cigarettes Among Heavy Smokers Undergoing a Lung Cancer Screening Program: Randomized Controlled Trial Protocol.

PubMed

Lucchiari, Claudio; Masiero, Marianna; Veronesi, Giulia; Maisonneuve, Patrick; Spina, Stefania; Jemos, Costantino; Omodeo Salè, Emanuela; Pravettoni, Gabriella

2016-02-03

Smoking is a global public health problem. For this reason, experts have called smoking dependence a global epidemic. Over the past 5 years, sales of electronic cigarettes, or e-cigarettes, have been growing strongly in many countries. Yet there is only partial evidence that e-cigarettes are beneficial for smoking cessation. In particular, although it has been proven that nicotine replacement devices may help individuals stop smoking and tolerate withdrawal symptoms, e-cigarettes' power to increase the quitting success rate is still limited, ranging from 5% to 20% dependent on smokers' baseline conditions as shown by a recent Cochrane review. Consequently, it is urgent to know if e-cigarettes may have a higher success rate than other nicotine replacement methods and under what conditions. Furthermore, the effects of the therapeutic setting and the relationship between individual characteristics and the success rate have not been tested. This protocol is particularly innovative, because it aims to test the effectiveness of electronic devices in a screening program (the COSMOS II lung cancer prevention program at the European Institute of Oncology), where tobacco reduction is needed to lower individuals' lung cancer risks. This protocol was designed with the primary aim of investigating the role of tobacco-free cigarettes in helping smokers improve lung health and either quit smoking or reduce their tobacco consumption. In particular, we aim to investigate the impact of a 3-month e-cigarettes program to reduce smoking-related respiratory symptoms (eg, dry cough, shortness of breath, mouth irritation, and phlegm) through reduced consumption of tobacco cigarettes. Furthermore, we evaluate the behavioral and psychological (eg, well-being, mood, and quality of life) effects of the treatment. This is a prospective, randomized, placebo-controlled, double-blind, three-parallel group study. The study is organized as a nested randomized controlled study with 3 branches: a nicotine e-cigarettes group, a nicotine-free e-cigarettes group, and a control group. The study is nested in a screening program for early lung cancer detection in heavy smokers. The study is open and is still recruiting. Stopping or reducing tobacco consumption should be a main goal of any health organization. However, traditional antismoking programs are expensive and not always effective. Therefore, favoring a partial or complete shift to e-cigarettes in heavy smokers (eg, persons at high risk for a number of diseases) could be considered a moral imperative. However, before following this path, sound and reliable data on large samples and in a variety of contexts are required. Clinicaltrials.gov NCT02422914; https://clinicaltrials.gov/ct2/show/NCT02422914 (Archived by WebCite at http://www.webcitation.org/6etwz1bPL).

The relation between price and daily consumption of cigarettes and bidis: findings from the Tobacco Control Policy Evaluation Wave 1 Survey.

PubMed

Pawar, P S; Pednekar, M S; Gupta, P C; Shang, C; Quah, A C K; Fong, G T

2014-12-01

In India, 14% of the population use smoked tobacco products. Increasing prices of these products is one of the measures to curb their consumption. This study analyzes "unit price" and "daily consumption" of cigarettes and bidis and investigates their relation with each other. A cross-sectional survey was conducted in four states of India (Bihar, West Bengal, Madhya Pradesh and Maharashtra) as a part of the International Tobacco Control Policy (TCP) Evaluation Project (the TCP India Project) during 2010-2011. Information was collected from adult (aged ≥ 15) daily exclusive smokers of cigarette/bidi regarding (a) last purchase (purchase in pack/loose, brand and price) and (b) daily consumption. Average unit price and daily consumption was calculated for different brands and states. Regression model was used to assess the impact of price on daily consumption. Bidis were much less expensive ([symbol in text]0.39) than cigarettes ([symbol in text]3.1). The daily consumption was higher (14) among bidi smokers than cigarette smokers (8). The prices and daily consumption of bidis ([symbol in text]0.33-0.43; 12-15) and cigarettes ([symbol in text]2.9-3.6; 5-9) varied across the four states. The unit prices of bidis and cigarettes did not influence their daily consumption. Smokers purchasing bidis in packs paid substantially less per unit and purchase of bidis and cigarettes in packs influenced their consumption positively. Cigarettes although more expensive than bidis, seem very cheap if compared internationally. Hence, prices of both cigarettes and bidis do not influence their consumption.

The response of young adult smokers and non-smokers in the United Kingdom to dissuasive cigarettes: An online survey.

PubMed

Moodie, Crawford; Gendall, Philip; Hoek, Janet; MacKintosh, Anne Marie; Best, Catherine; Murray, Susan

2017-11-28

The cigarette stick is an important communications tool as well as the object of consumption. We explored young adults' responses to cigarettes designed to be dissuasive. Data come from a cross-sectional online survey, conducted in September 2015, with 16-24 year old smokers and non-smokers (N=997) in the United Kingdom. Participants were shown images of a standard cigarette (white cigarette paper with imitation cork filter), a standard cigarette displaying the warning 'Smoking kills' on the cigarette paper, and an unattractively coloured cigarette (green cigarette paper and filter). They were asked to rate each of the three cigarettes, shown individually, on eight perception items, and to rate the three cigarettes, shown together, on how likely they would be to try them. Ordering of the cigarettes and questions, with the exception of the question on trial, was randomised. The eight perceptions items were combined to form a composite measure of cigarette perceptions. For smokers and non-smokers, the two dissuasive cigarettes (cigarette with warning, green cigarette) were rated significantly less favourably than the standard cigarette, and less likely to encourage trial. For cigarette perceptions no significant interaction was detected between cigarette style and smoking status or susceptibility to smoke among never smokers. A significant interaction was found for likelihood of trying the cigarettes, with dissuasive cigarettes having a greater impact with smokers than non-smokers. This study suggests that dissuasive cigarettes may help to reduce the desirability of cigarettes. The cigarette stick is the object of tobacco consumption, which is seen every time a cigarette is smoked. It is also an increasingly important promotional tool for tobacco companies. In this study, young adults rated two dissuasive cigarettes (a green coloured cigarette and a cigarette displaying a health warning) more negatively than a standard cigarette, and considered them less likely to encourage product trial. Our findings suggest that it may be possible to reduce the desirability of cigarette sticks by altering their design, e.g., with the addition of a warning or use of an unattractive colour. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cigarette Price-Minimization Strategies by U.S. Smokers

PubMed Central

Xu, Xin; Pesko, Michael F.; Tynan, Michael A.; Gerzoff, Robert B.; Malarcher, Ann M.; Pechacek, Terry F.

2015-01-01

Background Smokers may react to cigarette excise tax increases by engaging in price-minimization strategies (i.e., finding ways to reduce the cost of cigarette smoking) rather than by quitting or reducing their cigarette use, thereby reducing the public health benefits of such tax increases. Purpose To evaluate the state and national prevalence of five common cigarette price-minimization strategies and the size of price reductions obtained from these strategies. Methods Using data from the 2009–2010 National Adult Tobacco Survey, the prevalence of five common price-minimization strategies by type of strategy and by smoker’s cigarette consumption level were estimated. The price reductions associated with these price-minimization strategies also were evaluated. Analyses took place in November 2012. Results Approximately 55.4% of U.S. adult smokers used at least one of five price-minimization strategies in the previous year, with an average reduction of $1.27 per pack (22.0%). Results varied widely by state. Conclusions Cigarette price-minimization strategies are practiced widely among current smokers, and resulting price reductions are relatively large. Policies that decrease opportunities to effectively apply cigarette price-minimization strategies would increase the public health gains of cigarette excise tax increases. PMID:23597810

Differential responsiveness to cigarette price by education and income among adult urban Chinese smokers: findings from the ITC China Survey.

PubMed

Huang, Jidong; Zheng, Rong; Chaloupka, Frank J; Fong, Geoffrey T; Jiang, Yuan

2015-07-01

Few studies have examined the impact of tobacco tax and price policies in China. In addition, very little is known about the differential responses to tax and price increases based on socioeconomic status in China. To estimate the conditional cigarette consumption price elasticity among adult urban smokers in China and to examine the differential responses to cigarette price increases among groups with different income and/or educational levels. Multivariate analyses employing the general estimating equations method were conducted using the first three waves of the International Tobacco Control (ITC) China Survey. Analyses based on subsample by education and income were conducted. Conditional cigarette demand price elasticity ranges from -0.12 to -0.14. No differential responses to cigarette price increase were found across education levels. The price elasticity estimates do not differ between high-income smokers and medium-income smokers. Cigarette consumption among low-income smokers did not decrease after a price increase, at least among those who continued to smoke. Relative to other low-income and middle-income countries, cigarette consumption among Chinese adult smokers is not very sensitive to changes in cigarette prices. The total impact of cigarette price increase would be larger if its impact on smoking initiation and cessation, as well as the price-reducing behaviours such as brand switching and trading down, were taken into account. 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.

Opposite trends in the consumption of manufactured and roll-your-own cigarettes in Spain (1991-2020).

PubMed

Fu, Marcela; Martínez-Sánchez, Jose M; Clèries, Ramon; Villalbí, Joan R; Daynard, Richard A; Connolly, Gregory N; Fernández, Esteve

2014-12-10

The aim of this study is to describe trends in the consumption of manufactured and roll-your-own cigarettes between 1991 and 2012 in Spain, and to project these trends up to 2020. We estimated daily consumption per capita during 1991-2012 using data on sales of manufactured cigarettes (20-packs) and rolling tobacco (kg) from the Tobacco Market Commission, and using data of the Spanish adult population from the National Statistics Institute. We considered different weights (0.5, 0.8 and 1 g) to compute the number of rolled cigarettes per capita. We computed the annual per cent of change and assessed possible changes in trends using joinpoint regression, and projected the consumption up to 2020 using Bayesian methods. Daily consumption per capita of manufactured cigarettes decreased on average by 3.0% per year in 1991-2012, from 7.6 to 3.8 units, with three trend changes. However, daily consumption per capita of roll-your-own cigarettes increased on average by 14.1% per year, from 0.07 to 0.92 units of 0.5 g, with unchanged trends. Together, daily consumption per capita decreased between 2.9% and 2.5%, depending on the weight of the roll-your-own cigarettes. Projections up to 2020 indicate a decrease of manufactured cigarettes (1.75 units per capita) but an increase of roll-your-own cigarettes (1.25 units per capita). While the consumption per capita of manufactured cigarettes has decreased in the past years in Spain, the consumption of roll-your-own cigarettes has increased at an annual rate around 14% over the past years. Whereas a net decrease in cigarette consumption is expected in the future, use of roll-your-own cigarettes will continue to increase. 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.

Feasibility of Electronic Nicotine Delivery Systems in Surgical Patients

PubMed Central

Nolan, Margaret; Leischow, Scott; Croghan, Ivana; Kadimpati, Sandeep; Hanson, Andrew; Schroeder, Darrell

2016-01-01

Abstract Introduction: Cigarette smoking is a known risk factor for postoperative complications. Quitting or cutting down on cigarettes around the time of surgery may reduce these risks. This study aimed to determine the feasibility of using electronic nicotine delivery systems (ENDS) to help patients achieve this goal, regardless of their intent to attempt long-term abstinence. Methods: An open-label observational study was performed of cigarette smoking adults scheduled for elective surgery at Mayo Clinic Rochester and seen in the pre-operative evaluation clinic between December 2014 and June 2015. Subjects were given a supply of ENDS to use prior to and 2 weeks after surgery. They were encouraged to use them whenever they craved a cigarette. Daily use of ENDS was recorded, and patients were asked about smoking behavior and ENDS use at baseline, 14 days and 30 days. Results: Of the 105 patients approached, 80 (76%) agreed to participate; five of these were later excluded. Among the 75, 67 (87%) tried ENDS during the study period. At 30-day follow-up, 34 (51%) who had used ENDS planned to continue using them. Average cigarette consumption decreased from 15.6 per person/d to 7.6 over the study period ( P < .001). At 30 days, 11/67 (17%) reported abstinence from cigarettes. Conclusion: ENDS use is feasible in adult smokers scheduled for elective surgery and is associated with a reduction in perioperative cigarette consumption. These results support further exploration of ENDS as a means to help surgical patients reduce or eliminate their cigarette consumption around the time of surgery. Implications: Smoking in the perioperative period increases patients’ risk for surgical complications and healing difficulties, but new strategies are needed to help patients quit or cut down during this stressful time. These pilot data suggest that ENDS use is feasible and well-accepted in surgical patients, and worthy of exploration as a harm reduction strategy in these patients. PMID:26834051

Self-affirmation reduces smokers' defensiveness to graphic on-pack cigarette warning labels.

PubMed

Harris, Peter R; Mayle, Kathryn; Mabbott, Lucy; Napper, Lucy

2007-07-01

Little is known about how smokers respond to graphic images depicting the health consequences of smoking. The authors tested whether smokers respond defensively to such images and whether allowing them to self-affirm reduces their defensiveness. Young smokers (N = 87) were randomly allocated to self-affirm or perform a control task prior to viewing 4 images intended for future use on cigarette packs in the European Union. Measures were taken immediately postexposure and after 1 week. Participants rated each image for threat and personal relevance. Once all 4 images had been viewed, they completed measures of intentions, self-efficacy, and perceived behavioral control for reducing cigarette consumption, negative thoughts and feelings about smoking, personal vulnerability to 6 smoking-related diseases, desire to quit, and plans to quit. At the 1-week follow-up, measures of self-reported smoking and desire to reduce consumption were taken. Relative to controls, self-affirmed participants rated the images as more threatening and personally relevant, and they reported more negative thoughts and feelings and higher levels of control, self-efficacy, and intentions. Risk level moderated the effect of self-affirmation on relevance and intentions: Self-affirmation increased ratings on both measures among those who smoked more. In addition, self-affirmation moderated the threat-intention relationship, which was weaker in the self-affirmed group. At follow-up, motivation to reduce consumption remained higher in self-affirmed participants, but there were no differences in reported consumption. Self-affirmation can promote less defensive responding even to visual material about well-established health risks such as smoking. Copyright 2007 APA.

Lack of Substantial Post-Cessation Weight Increase in Electronic Cigarettes Users.

PubMed

Russo, Cristina; Cibella, Fabio; Mondati, Enrico; Caponnetto, Pasquale; Frazzetto, Evelise; Caruso, Massimo; Caci, Grazia; Polosa, Riccardo

2018-03-23

Minimization of post-cessation weight gain in quitters is important, but existing approaches (e.g., antismoking medications) shows only limited success. We investigated changes in body weight in smokers who quit or reduced substantially their cigarette consumption by switching to electronic cigarettes (ECs) use. Body weight and smoking/vaping history were extracted from medical records of smokers and ex-smokers to match three study groups: (1) regular EC users on at least two consecutive follow-up visits; (2) regular smokers (and not using ECs); (3) subjects who reported sustained smoking abstinence after completing a cessation program. Review of their medical records was conducted at two follow-up visits at 6- (F/U 6m) and 12-months (F/U 12m). A total of 86 EC users, 93 regular smokers, and 44 quitters were studied. In the EC users study group, cigarettes/day use decreased from 21.1 at baseline to 1.8 at F/U 12m ( p < 0.0001). Dual usage was reported by approximately 50% of EC users. Both within factor (time, p < 0.0001) and between factor (study groups, p < 0.0001) produced significant effect on weight (% change from baseline), with a significant 4.8% weight gain from baseline in the quitters study group at F/U 12m. For the EC users, weight gain at F/U 12m was only 1.5% of baseline. There was no evidence of post-cessation weight increase in those who reduced substantially cigarette consumption by switching to ECs (i.e., dual users) and only modest post-cessation weight increase was reported in exclusive EC users at F/U 12m. By reducing weight gain and tobacco consumption, EC-based interventions may promote an overall improvement in quality of life.

The impact of cigarette taxes and advertising on the demand for cigarettes in Ukraine.

PubMed

Peng, Limin; Ross, Hana

2009-06-01

Cigarette consumption in Ukraine is increasing while the cigarettes are becoming more affordable due to low taxes and raising income. The impact of cigarette prices and taxes on cigarette consumption is unclear due to the limited research evidence using the local data. This study estimates the sensitivity of Ukraine population to cigarette prices and the affordability of cigarettes using the macro level data in order to predict the effectiveness of cigarette tax policy. Monthly time-series data available from 1997 to 2006 in Ukraine were used to estimate the generalized least square model with an AR(1) process to investigate the impact of cigarette price/tax, household income, the affordability of cigarettes and the volume of tobacco advertising on Ukraine domestic cigarette sales while controlling for other factors. Our analyses demonstrate a strong positive association between cigarette sales and household income as well as a strong positive association between cigarette sales and tobacco advertising activity. The population is found to have relatively low sensitivity to cigarette prices and cigarette taxes, but the impact of cigarettes' affordability is statistically significant, even though also of low magnitude. We speculate that the lower sensitivity to cigarette prices among Ukraine population is caused by wide price variation allowing smokers to avoid a price increase by brand substitution as well as by low costs of cigarettes, high social acceptance of smoking and limited effort to control tobacco use in Ukraine. Narrowing the cigarette price choices and increasing cigarette prices above the level of inflation and income growth by adopting the appropriate tax policy would likely increase the effectiveness of this tool for controlling the smoking rate in Ukraine as well as yield additional budget revenue gains. In addition, imposing advertising restriction may further help reducing the smoking prevalence.

New Zealand's tobacco control programme 1985-1998

PubMed Central

Laugesen, M.; Swinburn, B.

2000-01-01

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


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

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

PubMed

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

2014-06-01

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

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/

Electronic cigarette: use and perceptions among French military nurses in 2013.

PubMed

Guillet, Sébastien; Sicard, Sébastien; Meynard, Jean-Baptiste; Mayet, Aurélie

2015-01-01

Paramedical personnel are exposed to tobacco smoking. Electronic cigarettes (e-cigarettes) may be considered as a lower-risk substitute for cigarettes. The aim of the study was to estimate the prevalence of e-cigarette use, the motives for use and the perceptions among French military nurses. A cross-sectional survey, using self-administered questionnaires, was conducted in 2013 among 300 students and instructors of the French school of military paramedical personnel. Prevalences of e-cigarette use among smokers and nonsmokers were compared using logistic regressions adjusted on age and gender. The prevalence of smoking was 40% among the 200 responders. E-cigarette current use prevalence was 25% (6% daily users), without significant difference according to gender and age. Tobacco smokers reported significantly more e-cigarette current use (51% vs7%). Motives for e-cigarette use reported by smokers were curiosity (48%), intention to reduce tobacco consumption (43%) or to quit smoking (8%). Among users of both tobacco and e-cigarettes, 48% reported a significant decrease in tobacco consumption following e-cigarette initiation (average decrease of 5-10 cigarettes smoked per day; p <0.001). Both tobacco smokers and nonsmokers (88%) estimated that e-cigarette use was potentially harmful for health, but it was perceived as less harmful than tobacco by 46%. E-cigarette use among military nurses follows the trends observed in the general population in terms of prevalence and motives. E-cigarettes, which are seen as an attractive alternative to cigarettes, may contribute to a reduction in tobacco use among healthcare workers.

The effect of Taiwan's tax-induced increases in cigarette prices on brand-switching and the consumption of cigarettes.

PubMed

Tsai, Yi-Wen; Yang, Chung-Lin; Chen, Chin-Shyan; Liu, Tsai-Ching; Chen, Pei-Fen

2005-06-01

The effect of raising cigarette taxes to reduce smoking has been the subject of several studies, which often treat the price of cigarettes as an exogenous factor given to smokers who respond to it by adjusting their smoking behavior. However, cigarette prices vary with brand and quality, and smokers can and do switch to lower-priced brands to reduce the impact of the tax on the cost of cigarettes as they try to consume the same number of cigarettes as they had before a tax hike. Using data from a two-year follow-up interview survey conducted before and after a new cigarette tax scheme was imposed in Taiwan in 2002, this study examines three behavioral changes smokers may make to respond to tax-induced cigarette price increase: brand-switching, amount consumed, and amount spent on smoking. These changes were studied in relation to smoker income, before-tax cigarette price, level of addiction, exposure to advertizing, and consumer loyalty. We found that smokers, depending upon exposure to advertizing, level of consumer loyalty and initial price of cigarettes, switched brands to maintain current smoking habits and control costs. We also found that the initial amount smoked and level of addiction, not price, at least not at the current levels in Taiwan, determined whether a smoker reduced the number of cigarettes he consumed. Copyright 2005 John Wiley & Sons, Ltd.

Estimates of price and income elasticity in Greece. Greek debt crisis transforming cigarettes into a luxury good: an econometric approach

PubMed Central

Tarantilis, Filippos; Athanasakis, Kostas; Zavras, Dimitris; Vozikis, Athanassios; Kyriopoulos, Ioannis

2015-01-01

Objective During the past decades, smoking prevalence in Greece was estimated to be near or over 40%. Following a sharp fall in cigarette consumption, as shown in current data, our objective is to assess smokers’ sensitivity to cigarette price and consumer income changes as well as to project health benefits of an additional tax increase. Methods Cigarette consumption was considered as the dependent variable, with Weighted Average Price as a proxy for cigarette price, gross domestic product as a proxy for consumers’ income and dummy variables reflecting smoking restrictions and antismoking campaigns. Values were computed to natural logarithms and regression was performed. Then, four scenarios of tax increase were distinguished in order to calculate potential health benefits. Results Short-run price elasticity is estimated at −0.441 and short-run income elasticity is estimated at 1.040. Antismoking campaigns were found to have a statistically significant impact on consumption. Results indicate that, depending on the level of tax increase, annual per capita consumption could fall by at least 209.83 cigarettes; tax revenue could rise by more than €0.74 billion, while smokers could be reduced by up to 530 568 and at least 465 smoking-related deaths could be averted. Conclusions Price elasticity estimates are similar to previous studies in Greece, while income elasticity estimates are far greater. With cigarettes regarded as a luxury good, a great opportunity is presented for decisionmakers to counter smoking. Increased taxation, along with focused antismoking campaigns, law reinforcement (to ensure compliance with smoking bans) and intensive control for smuggling could invoke a massive blow to the tobacco epidemic in Greece. PMID:25564137

The effects of higher cigarette prices on tar and nicotine consumption in a cohort of adult smokers.

PubMed

Farrelly, M C; Nimsch, C T; Hyland, A; Cummings, M

2004-01-01

The objective of this paper is to estimate the demand for tar and nicotine in cigarettes as a function of cigarette prices in a cohort of cigarette 11,966 smokers followed for 5 years. Data for the analysis come from a longitudinal telephone survey of 11,966 smokers who were interviewed in 1988 and 1993 as part of the Community Intervention Trial for Smoking Cessation (COMMIT). Separate models are estimated for three age groups to account for differences in levels of addiction and brand loyalty across age. We found that smokers respond to higher cigarette prices by reducing the number of cigarettes smoked per day but also by switching to cigarettes that are higher in tar and nicotine per cigarette. Copyright 2003 John Wiley & Sons, Ltd.

Lifetime risk of distinct upper aerodigestive tract cancers and consumption of alcohol, betel and cigarette.

PubMed

Hsu, Wan-Lun; Chien, Yin-Chu; Chiang, Chun-Ju; Yang, Hwai-I; Lou, Pei-Jen; Wang, Cheng-Ping; Yu, Kelly J; You, San-Lin; Wang, Li-Yu; Chen, Shu-Yuan; Yang, Czau-Siung; Chen, Chien-Jen

2014-09-15

The cancer of upper aerodigestive tract (UADT) is a common cancers in the world. However, its lifetime risk by consumption of alcohol, betel and cigarettes remain to be elucidated. This study aimed to estimate lifetime risk of distinct UADT cancers and assess their associations with alcohol, betel and cigarette consumption. Three cohorts of 25,611 men were enrolled in 1982-1992 in Taiwan. The history of alcohol, betel and cigarette consumption was enquired through questionnaire interview. Newly developed UADT cancers were ascertained through computerized linkage with national cancer registry profile. Lifetime (30-80 years old) risk and multivariate-adjusted hazard ratio (HRadj) of distinct UADT cancers by alcohol, betel and cigarette consumption were estimated. A total of 269 pathologically confirmed cases of UADT cancers were newly-diagnosed during 472,096 person-years of follow-up. The lifetime risk of UADT cancer was 9.42 and 1.65% for betel chewers and nonchewers, 3.22 and 1.21% for cigarette smokers and nonsmokers and 4.77 and 1.85% for alcohol drinkers and nondrinkers. The HRadj (95% confidence interval) of developing UADT cancer was 3.36 (2.51-4.49), 2.02 (1.43-2.84), 1.90 (1.46-2.49), respectively, for the consumption of betel, cigarette and alcohol. Alcohol, betel and cigarette had different effect on cancers at various anatomical sites of UADT. The cancer risk from the mouth, pharynx, esophagus to larynx increased for alcohol and cigarette consumption, but decreased for betel consumption. Alcohol, betel and cigarette consumption are independent risk predictors for distinct UADT cancers. © 2014 UICC.

The relationship among learning, health beliefs, alcohol consumption, and tobacco use of primigravidas.

PubMed

Strychar, I M; Griffith, W S; Conry, R F

1990-01-01

The purposes of this study were to identify how pregnant women learned about alcohol consumption and tobacco use, and to identify the relationship between learning, health beliefs and behaviours. Determining how pregnant women learned was based upon Tough's and Knowles' view of learning and consisted of identifying knowledge levels, resources utilized, advice given, time in learning, and initiators of learning episodes. The ex post facto research design involved one-hour interviews with 128 primigravidas at 8 hospitals in British Columbia, 75% of the sample consumed alcoholic beverages before becoming pregnant and these women reduced their intake by an average of 82%; 39% smoked cigarettes before becoming pregnant and these women reduced their cigarette smoking by an average of 52%. Drinkers were advised not to consume alcoholic beverages during pregnancy, whereas smokers were told by friends and family members that it was okay to smoke during pregnancy. Engagement in other-initiated learning episodes was found to be correlated with reduced alcohol intake (p less than or equal to .05); whereas, health beliefs were not correlated with reduced alcohol intake. Neither self-initiated nor other-initiated learning was associated with reduced cigarette smoking; however, perceived risk was associated with reduced cigarette smoking. Knowledge about smoking was associated with health beliefs, suggesting that learning may be indirectly related to smoking behaviours. This study should be replicated with a larger sample to determine the directionality of the association between learning, beliefs and behaviours.

Effect of the tobacco price support program on cigarette consumption in the United States: an updated model.

PubMed Central

Zhang, P; Husten, C; Giovino, G

2000-01-01

OBJECTIVES: This study evaluated the direct effect of the tobacco price support program on domestic cigarette consumption. METHODS: We developed an economic model of demand and supply of US tobacco to estimate how much the price support program increases the price of tobacco. We calculated the resultant increase in cigarette prices from the change in the tobacco price and the quantity of domestic tobacco contained in US cigarettes. We then assessed the reduction in cigarette consumption attributable to the price support program by applying the estimated increase in the cigarette price to assumed price elasticities of demand for cigarettes. RESULTS: We estimated that the tobacco price support program increased the price of tobacco leaf by $0.36 per pound. This higher tobacco price translates to a $0.01 increase in the price of a pack of cigarettes and an estimated 0.21% reduction in cigarette consumption. CONCLUSION: Because the tobacco price support program increases the price of cigarettes minimally, its potential health benefit is likely to be small. The adverse political effect of the tobacco program might substantially outweigh the potential direct benefit of the program on cigarette consumption. PMID:10800423

Coffee and Cigarette Consumption and Perceived Effects in Recovering Alcoholics Participating in Alcoholics Anonymous in Nashville, TN

PubMed Central

Reich, Michael S.; Dietrich, Mary S.; Finlayson, A.J. Reid; Fischer, Edward F.; Martin, Peter R.

2008-01-01

Background Alcoholics Anonymous (AA) members represent an important and relatively understudied population for improving our understanding of alcohol dependence recovery since over one million Americans participate in the program. Further insight into coffee and cigarette use by these individuals is necessary given AA members’ apparent widespread consumption and the recognized health consequences and psychopharmacological actions of these substances. Methods Volunteers were sought from all open-AA meetings in Nashville, TN during the summer of 2007 to complete a questionnaire (n=289, completion rate=94.1%) including timeline followback for coffee, cigarette, and alcohol consumption; the Alcoholics Anonymous Affiliation Scale; coffee consumption and effects questions; the Fagerstrom Test for Nicotine Dependence (FTND); and the Smoking Effects Questionnaire. Results Mean (±SD) age of onset of alcohol consumption was 15.4±4.2 years and mean lifetime alcohol consumption was 1026.0±772.8 kg ethanol. Median declared alcohol abstinence was 2.1 years (range: 0 days–41.1 years) and median lifetime AA attendance was 1000.0 meetings (range: 4–44209 meetings); average AA affiliation score was 7.6±1.5. Most (88.5%) individuals consumed coffee and approximately 33% of coffee consumers drank more than four cups per day (M=3.9±3.9). The most common self-reported reasons for coffee consumption and coffee-associated behavioral changes were related to stimulatory effects. More than half (56.9%) of individuals in AA smoked cigarettes. Of those who smoked, 78.7% consumed at least half a pack of cigarettes per day (M=21.8±12.3). Smokers’ FTND scores were 5.8±2.4; over 60% of smokers were highly or very highly dependent. Reduced negative affect was the most important subjective effect of smoking. Conclusions A greater proportion of AA participants drink coffee and smoke cigarettes in larger per capita amounts than observed in general US populations. The effects of these products as described by AA participants suggest significant stimulation and negative affect reduction. Fundamental knowledge of the quantitative and qualitative aspects of coffee and cigarette consumption among AA members will enable future research to discern their impact on alcohol abstinence and recovery. PMID:18657129

Price and cigarette consumption in Europe.

PubMed

Gallus, S; Schiaffino, A; La Vecchia, C; Townsend, J; Fernandez, E

2006-04-01

To analyse the variation in demand for tobacco according to price of cigarettes across the European region. Cross-sectional study. All the 52 countries of the European region. For each European country, data were collected on annual per adult cigarette consumption (2000), smoking prevalence (most recent), retail price of a pack of local and foreign brand cigarettes (around 2000), the gross domestic product adjusted by purchasing power parities, and the adult population (2000). Price elasticity of demand for cigarettes (that is, the change in cigarette consumption according to a change in tobacco price) across all the European countries, estimated by double-log multiple linear regression. Controlling for male to female prevalence ratio, price elasticities for consumption were -0.46 (95% confidence interval (CI) -0.74 to -0.17) and -0.74 (95% CI -1.13 to -0.35) for local and foreign brand, respectively. The inverse relation between cigarette price and consumption was stronger in countries not in the European Union (price elasticity for foreign brand cigarettes of -0.8) as compared to European Union countries (price elasticity of -0.4). The result that, on average, in Europe smoking consumption decreases 5-7% for a 10% increase in the real price of cigarettes strongly supports an inverse association between price and cigarette smoking.

Economics of tobacco control in Pakistan: estimating elasticities of cigarette demand.

PubMed

Mushtaq, Nasir; Mushtaq, Saghir; Beebe, Laura A

2011-11-01

Despite ongoing global efforts for tobacco control, low-income countries with struggling economies have challenges to effectively implement tobacco policies and programs. Due to the complexity of the tobacco control issue and lack of comprehensive policies, tobacco use is increasing in Pakistan. The aim of this study was to assess the effect of taxes on tobacco demand in Pakistan. Various surveillance indicators of tobacco use were assessed from 2001 to 2009. Price elasticities of cigarette demand in Pakistan were investigated. During 2003-2009, annual per capita cigarette consumption increased by 30%. Analysis of economic data indicated that a 10% increase in cigarette prices would lead to 4.8% decrease in cigarette consumption while controlling for per capita income in the short term. The long-term price elasticities of cigarette demand were estimated at -1.17. The estimations provided support for myopic addiction model for cigarette consumption in Pakistan. Increasing tobacco taxes would have a significant impact on tobacco consumption in Pakistan. Cigarette consumption could decrease by 11.7% in the long term if there was a 10% increase in its price. The results of this study should benefit policymakers as it provides information on the characteristics of the cigarette consumption and cigarette demand function that may help in planning tobacco control strategies in low-income and middle-income countries.

The Consequences of High Cigarette Excise Taxes for Low-Income Smokers

PubMed Central

Farrelly, Matthew C.; Nonnemaker, James M.; Watson, Kimberly A.

2012-01-01

Background To illustrate the burden of high cigarette excise taxes on low-income smokers. Methodology/Principal Findings Using data from the New York and national Adult Tobacco Surveys from 2010–2011, we estimated how smoking prevalence, daily cigarette consumption, and share of annual income spent on cigarettes vary by annual income (less than $30,000; $30,000–$59,999; and more than $60,000). The 2010–2011 sample includes 7,536 adults and 1,294 smokers from New York and 3,777 adults and 748 smokers nationally. Overall, smoking prevalence is lower in New York (16.1%) than nationally (22.2%) and is strongly associated with income in New York and nationally (P<.001). Smoking prevalence ranges from 12.2% to 33.7% nationally and from 10.1% to 24.3% from the highest to lowest income group. In 2010–2011, the lowest income group spent 23.6% of annual household income on cigarettes in New York (up from 11.6% in 2003–2004) and 14.2% nationally. Daily cigarette consumption is not related to income. Conclusions/Significance Although high cigarette taxes are an effective method for reducing cigarette smoking, they can impose a significant financial burden on low-income smokers. PMID:22984447

Blood carboxyhaemoglobin, plasma thiocyanate, and cigarette consumption: implications for epidemiological studies in smokers.

PubMed Central

Vesey, C J; Saloojee, Y; Cole, P V; Russell, M A

1982-01-01

Carboxyhaemoglobin and plasma thiocyanate concentrations were found to be significantly correlated with self-reported daily cigarette consumption in 360 smokers (r = 0.416 and 0.412 respectively; p less than 0.001). The extent to which inhalation patterns affected the intake of cigarette smoke constituents was determined from the partial correlation between carboxyhaemoglobin and plasma thiocyanate concentrations after the number of cigarettes smoke per day had been allowed for (r = 0.48). Thus 23% of the variation in carboxyhaemoglobin and thiocyanate concentrations was accounted for by the was a cigarette was smoked and a further 21% by the number smoked a day. Furthermore, the relation between carboxyhaemoglobin or plasma thiocyanate and daily cigarette consumption was not linear but reached an asymptote at consumption rates above 25 cigarettes a day. These results suggest that by itself daily cigarette consumption will not identify those smokers most at risk and will also underestimate and dose-response relationship between smoking and selected diseases. PMID:6805589

Anti-tobacco control industry strategies in Turkey.

PubMed

Keklik, Seda; Gultekin-Karakas, Derya

2018-02-26

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

Economic policies for tobacco control in developing countries.

PubMed

Ross, H; Chaloupka, F J

2006-01-01

Raising tobacco taxes can have an income distributional impact on the population. Since lower socio-economic groups usually smoke more, they also contribute more to total cigarette tax collection. Thus, those who can afford it least contribute the most in terms of tobacco taxes. This means that tobacco taxes are regressive. However, tobacco tax increases are likely to be progressive, decreasing the relative tax incidence on the poor, vis-à-vis the rich. This is based on the premise that the poor are likely to be more sensitive to price changes, and would thus reduce their cigarette consumption by a greater percentage than the rich in response to an excise tax-induced increase in cigarette prices. Recent empirical studies confirm this hypothesis by demonstrating that the price responsiveness of cigarette demand increases with income. Research in China confirmed that reducing cigarette expenditures could release household resources for spending on food, housing, and other goods that improve living standards. Therefore, in the long run, tobacco control measures will reduce social inequality.

Changes in cigarette prices, affordability, and brand-tier consumption after a tobacco tax increase in Thailand: Evidence from the Global Adult Tobacco Surveys, 2009 and 2011

PubMed Central

Husain, Muhammad Jami; Kostova, Deliana; Mbulo, Lazarous; Benjakul, Sarunya; Kengganpanich, Mondha; Andes, Linda

2017-01-01

Despite the 2009 implementation of a tobacco tax increase in Thailand, smoking rates remained unchanged between 2009 and 2011. Prior evidence has linked cigarette tax increases to compensatory behaviours aimed at lowering the cost of smoking, such as switching to lower-priced cigarette brands. Using data from 2009 and 2011 Global Adult Tobacco Surveys in Thailand, we estimated unadjusted changes in cigarette prices paid, cigarette affordability, and consumption of cigarettes in three price categories classified as upper-, middle-, and lower-priced brand tiers (or price tertiles). We used ordered logit regression to analyse the correlates of price-tier choice and to estimate the change in price-tier consumption adjusted for demographic and region characteristics. Between 2009 and 2011, real cigarette prices increased, but the affordability of cigarettes remained unchanged overall. There was a significant reduction in the consumption of cigarette brands in the top price-tier overall, accompanied by increases in the consumption of brands in the bottom and middle price-tiers, depending on the region. Adjusted estimates from the logit models indicate that, on average, the proportion of smokers selecting brands from upper- and middle price-tiers decreased while consumption of lower price-tier brands increased during the study period. The estimated shifts in consumption from more expensive to less expensive cigarette brands and the overall lack of change in cigarette affordability in Thailand between 2009 and 2011 are both factors that may have contributed to the observed lack of change in smoking rates after the 2009 tax increase. PMID:28579499

Does coffee consumption impact on heaviness of smoking?

PubMed Central

Ware, Jennifer J.; Tanner, Julie‐Anne; Taylor, Amy E.; Bin, Zhao; Haycock, Philip; Bowden, Jack; Rogers, Peter J.; Davey Smith, George; Tyndale, Rachel F.

2017-01-01

Abstract Background and Aims Coffee consumption and cigarette smoking are strongly associated, but whether this association is causal remains unclear. We sought to: (1) determine whether coffee consumption influences cigarette smoking causally, (2) estimate the magnitude of any association and (3) explore potential mechanisms. Design We used Mendelian randomization (MR) analyses of observational data, using publicly available summarized data from the Tobacco and Genetics (TAG) consortium, individual‐level data from the UK Biobank and in‐vitro experiments of candidate compounds. Setting The TAG consortium includes data from studies in several countries. The UK Biobank includes data from men and women recruited across England, Wales and Scotland. Participants The TAG consortium provided data on n ≤ 38 181 participants. The UK Biobank provided data on 8072 participants. Measurements In MR analyses, the exposure was coffee consumption (cups/day) and the outcome was heaviness of smoking (cigarettes/day). In our in‐vitro experiments we assessed the effect of caffeic acid, quercetin and p‐coumaric acid on the rate of nicotine metabolism in human liver microsomes and cDNA‐expressed human CYP2A6. Findings Two‐sample MR analyses of TAG consortium data indicated that heavier coffee consumption might lead to reduced heaviness of smoking [beta = −1.49, 95% confidence interval (CI) = −2.88 to −0.09]. However, in‐vitro experiments found that the compounds investigated are unlikely to inhibit significantly the rate of nicotine metabolism following coffee consumption. Further MR analyses in UK Biobank found no evidence of a causal relationship between coffee consumption and heaviness of smoking (beta = 0.20, 95% CI = –1.72 to 2.12). Conclusions Amount of coffee consumption is unlikely to have a major causal impact upon amount of cigarette smoking. If it does influence smoking, this is not likely to operate via effects of caffeic acid, quercetin or p‐coumaric acid on nicotine metabolism. The observational association between coffee consumption and cigarette smoking may be due to smoking impacting on coffee consumption or confounding. PMID:28556459

Does coffee consumption impact on heaviness of smoking?

PubMed

Ware, Jennifer J; Tanner, Julie-Anne; Taylor, Amy E; Bin, Zhao; Haycock, Philip; Bowden, Jack; Rogers, Peter J; Davey Smith, George; Tyndale, Rachel F; Munafò, Marcus R

2017-10-01

Coffee consumption and cigarette smoking are strongly associated, but whether this association is causal remains unclear. We sought to: (1) determine whether coffee consumption influences cigarette smoking causally, (2) estimate the magnitude of any association and (3) explore potential mechanisms. We used Mendelian randomization (MR) analyses of observational data, using publicly available summarized data from the Tobacco and Genetics (TAG) consortium, individual-level data from the UK Biobank and in-vitro experiments of candidate compounds. The TAG consortium includes data from studies in several countries. The UK Biobank includes data from men and women recruited across England, Wales and Scotland. The TAG consortium provided data on n ≤ 38 181 participants. The UK Biobank provided data on 8072 participants. In MR analyses, the exposure was coffee consumption (cups/day) and the outcome was heaviness of smoking (cigarettes/day). In our in-vitro experiments we assessed the effect of caffeic acid, quercetin and p-coumaric acid on the rate of nicotine metabolism in human liver microsomes and cDNA-expressed human CYP2A6. Two-sample MR analyses of TAG consortium data indicated that heavier coffee consumption might lead to reduced heaviness of smoking [beta = -1.49, 95% confidence interval (CI) = -2.88 to -0.09]. However, in-vitro experiments found that the compounds investigated are unlikely to inhibit significantly the rate of nicotine metabolism following coffee consumption. Further MR analyses in UK Biobank found no evidence of a causal relationship between coffee consumption and heaviness of smoking (beta = 0.20, 95% CI = -1.72 to 2.12). Amount of coffee consumption is unlikely to have a major causal impact upon amount of cigarette smoking. If it does influence smoking, this is not likely to operate via effects of caffeic acid, quercetin or p-coumaric acid on nicotine metabolism. The observational association between coffee consumption and cigarette smoking may be due to smoking impacting on coffee consumption or confounding. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Cigarette consumption among foreign tourists in Thailand.

PubMed

Termsirikulchai, Lakkhana; Kengganpanich, Mondha; Benjakul, Sarunya; Kengganpanich, Tharadol

2012-06-01

To explore the cigarette consumption among foreign tourists in Thailand. The data in this cross-sectional survey is collected by interviewing 655 foreign tourist smokers with questionnaires in congested areas including Suvarnabhum International Airport, Khao San Road, shopping centers and tourist attraction sites. The data was collected in October, 2010, analyzed by descriptive statistic and the crude magnitude of cigarette consumption was calculated. The findings indicated that 62.9% of tourists were male and 58.9% were from European countries and 22.7% were from Asian countries. 59.2% smoked cigarettes sold in Thailand and were taxed legally. In that amount, 55.7% smoked imported cigarettes and only 3.5% smoked Thai cigarettes. 40.8% had brought cigarettes from their countries or bought cigarettes from Duty Free shops with the amount allowed by Thai law. The top 2 popular brands were Marlboro and L&M. The main reason why they bought imported cigarettes in Thailand was that the price was cheaper or the same when compared with that in their countries. The cigarette consumption share crudely calculated was around 8.90 million packs. Foreign tourists smoked imported cigarettes distributed in Thailand and cigarettes brought from abroad. So, Free Trade Agreement in bilateral level or multilateral level need to be reviewed and should separate cigarettes from other goods. The tax barrier excise tax measure and permission law of carrying in 200 sticks should be reviewed in order to control cigarette consumption effectively.

Reduced nicotine content cigarette advertising: How false beliefs and subjective ratings affect smoking behavior

PubMed Central

Mercincavage, Melissa; Saddleson, Megan L.; Gup, Emily; Halstead, Angela; Mays, Darren; Strasser, Andrew A.

2017-01-01

Introduction Tobacco advertising can create false beliefs about health harms that are reinforced by product design features. Reduced nicotine content (RNC) cigarettes may reduce harm, but research has not addressed advertising influences. This study examined RNC cigarette advertising effects on false harm beliefs, and how these beliefs – along with initial subjective ratings of RNC cigarettes – affect subsequent smoking behaviors. We further explored whether subjective ratings moderate associations between false beliefs and behavior. Methods Seventy-seven daily, non-treatment-seeking smokers (66.2% male) participated in the first 15 days of a randomized, controlled, open-label RNC cigarette trial. Participants viewed an RNC cigarette advertisement at baseline before completing a 5-day period of preferred brand cigarette use, followed by a 10-day period of RNC cigarette use (0.6 mg nicotine yield). Participants provided pre- and post-advertisement beliefs, and subjective ratings and smoking behaviors for cigarettes smoked during laboratory visits. Results Viewing the advertisement increased beliefs that RNC cigarettes contain less nicotine and are healthier than regular cigarettes (p’s < 0.001 and 0.011), and decreased the belief that they are less likely to cause cancer (p = 0.046). Neither false beliefs nor subjective ratings directly affected smoking behaviors. Significant interactions of strength and taste ratings with beliefs (p’s < 0.001), however, indicated that among smokers with less negative initial subjective ratings, greater false beliefs were associated with greater RNC cigarette consumption. Conclusions Smokers may misconstrue RNC cigarettes as less harmful than regular cigarettes. These beliefs, in conjunction with favorable subjective ratings, may increase product use. PMID:28214392

Reduced nicotine content cigarette advertising: How false beliefs and subjective ratings affect smoking behavior.

PubMed

Mercincavage, Melissa; Saddleson, Megan L; Gup, Emily; Halstead, Angela; Mays, Darren; Strasser, Andrew A

2017-04-01

Tobacco advertising can create false beliefs about health harms that are reinforced by product design features. Reduced nicotine content (RNC) cigarettes may reduce harm, but research has not addressed advertising influences. This study examined RNC cigarette advertising effects on false harm beliefs, and how these beliefs - along with initial subjective ratings of RNC cigarettes - affect subsequent smoking behaviors. We further explored whether subjective ratings moderate associations between false beliefs and behavior. Seventy-seven daily, non-treatment-seeking smokers (66.2% male) participated in the first 15days of a randomized, controlled, open-label RNC cigarette trial. Participants viewed an RNC cigarette advertisement at baseline before completing a 5-day period of preferred brand cigarette use, followed by a 10-day period of RNC cigarette use (0.6mg nicotine yield). Participants provided pre- and post-advertisement beliefs, and subjective ratings and smoking behaviors for cigarettes smoked during laboratory visits. Viewing the advertisement increased beliefs that RNC cigarettes contain less nicotine and are healthier than regular cigarettes (p's<0.001 and 0.011), and decreased the belief that they are less likely to cause cancer (p=0.046). Neither false beliefs nor subjective ratings directly affected smoking behaviors. Significant interactions of strength and taste ratings with beliefs (p's<0.001), however, indicated that among smokers with less negative initial subjective ratings, greater false beliefs were associated with greater RNC cigarette consumption. Smokers may misconstrue RNC cigarettes as less harmful than regular cigarettes. These beliefs, in conjunction with favorable subjective ratings, may increase product use. Copyright © 2017 Elsevier B.V. All rights reserved.

Does acute tobacco smoking prevent cue-induced craving?

PubMed

Schlagintweit, Hera E; Barrett, Sean P

2016-05-01

Smoking cessation aids appear to be limited in their ability to prevent craving triggered by exposure to smoking-associated stimuli; however, the extent to which cue-induced cravings persist following denicotinized or nicotine-containing tobacco smoking is not known. Thirty (17 male) ⩾12-hour abstinent dependent smokers completed two sessions during which they smoked a nicotine-containing or denicotinized cigarette. Instructions regarding the nicotine content of the cigarette varied across sessions, and all participants were exposed to a neutral cue followed by a smoking cue after cigarette consumption. Craving was assessed before and after cigarette consumption and cue exposure. Reduced intentions to smoke were associated with both nicotine expectancy (p<0.05) and nicotine administration (p<0.01), while reduced withdrawal-related craving was uniquely associated with nicotine administration (p<0.05). Smoking-associated stimuli increased craving regardless of nicotine expectancy or administration (p-values<0.001). While both nicotine pharmacology and expectancy appear to contribute to craving reduction associated with acute tobacco smoking, neither smoking-related nicotine administration nor expectation prevents increases in craving following exposure to smoking-associated stimuli. These findings suggest that cue-induced craving may be resistant to various pharmacological and psychological interventions. © The Author(s) 2016.

The impact of tobacco control policies in Albania

PubMed Central

Ross, Hana; Levy, David T

2010-01-01

Objective To assess the impact of a tobacco control law adopted in Albania in 2007 and to estimate the share of illicit cigarettes on the market. Design Comparative analysis of two waves of a nationally representative household survey, one conducted before the new law went into effect and the other after 2 years. Official sales data were contrasted with the consumption estimate based on the survey. Main outcome measures Smoking prevalence, quit attempts, exposure to cigarette advertising, exposure to second-hand smoke, total cigarette consumption, share of illicit packs among packs possessed by smokers. Results Despite the adoption of strong smoke-free policies and adverting restrictions, smoking prevalence in Albania has risen. The increase in prevalence has been driven by higher smoking rates among females (18.9% in 2007 vs 29.3% in 2009) and young adults (23.2% in 2007 vs 38.5% in 2009 among 18–19 year olds). Self-reported exposure to second-hand smoke and cigarette advertising have been reduced since 2007. The majority of respondents are still exposed to second-hand smoke and more than half are exposed to tobacco advertising. Nevertheless, there are signs that the consumption of illicit cigarettes is declining. Conclusions The impacts of smoke-free policies and an advertising ban have been limited due to lack of enforcement and failure to adopt a comprehensive set of tobacco control measures. These measures should include sizeable and regular tobacco tax increases in excess of the general level of inflation and income growth. The decline in the share of illicit cigarettes should improve the effectiveness of the cigarette tax policy. PMID:20679417

Price elasticity estimates for tobacco products in India.

PubMed

John, Rijo M

2008-05-01

The tax base of tobacco in India is heavily dependent on about 14% of tobacco users, who smoke cigarettes. Non-cigarette tobacco products accounting for 85% of the tobacco consumption contributes only 15% of the total tobacco taxes. Though taxation is an important tool to regulate consumption of tobacco, there have been no estimates of price elasticities for different tobacco products in India to date, which can guide tax policy on tobacco. This paper, for the first time in India, examines the price elasticity of demand for bidis, cigarettes and leaf tobacco at the national level using a representative cross-section of households. This study found that own-price elasticity estimates of different tobacco products in India ranged between -0.4 to -0.9, with bidis (an indigenous hand-rolled smoked tobacco preparation in India) and leaf tobacco having elasticities close to unity. Cigarettes were the least price elastic of all. With some assumptions, it is shown that the tax on bidis can be increased to Rs. 100 per 1000 sticks compared with the current Rs. 14 and the tax on an average cigarette can be increased to Rs. 3.5 per stick without any fear of losing revenue. The paper argues that the current system of taxing cigarettes in India based on the presence of filters and the length of cigarettes has no justification on health grounds, and should be abolished, if reducing tobacco consumption and the consequent disease burden is one of the objectives of tobacco taxation policy. It also argues that attempts to regulate tobacco use without effecting significant tax increases on bidis may not produce desired results.

The impact of tobacco control policies in Albania.

PubMed

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

2010-12-01

To assess the impact of a tobacco control law adopted in Albania in 2007 and to estimate the share of illicit cigarettes on the market. Comparative analysis of two waves of a nationally representative household survey, one conducted before the new law went into effect and the other after 2 years. Official sales data were contrasted with the consumption estimate based on the survey. Smoking prevalence, quit attempts, exposure to cigarette advertising, exposure to second-hand smoke, total cigarette consumption, share of illicit packs among packs possessed by smokers. Despite the adoption of strong smoke-free policies and adverting restrictions, smoking prevalence in Albania has risen. The increase in prevalence has been driven by higher smoking rates among females (18.9% in 2007 vs 29.3% in 2009) and young adults (23.2% in 2007 vs 38.5% in 2009 among 18-19 year olds). Self-reported exposure to second-hand smoke and cigarette advertising have been reduced since 2007. The majority of respondents are still exposed to second-hand smoke and more than half are exposed to tobacco advertising. Nevertheless, there are signs that the consumption of illicit cigarettes is declining. The impacts of smoke-free policies and an advertising ban have been limited due to lack of enforcement and failure to adopt a comprehensive set of tobacco control measures. These measures should include sizeable and regular tobacco tax increases in excess of the general level of inflation and income growth. The decline in the share of illicit cigarettes should improve the effectiveness of the cigarette tax policy.

Perception of electronic cigarettes in the general population: does their usefulness outweigh their risks?

PubMed Central

Martínez-Sánchez, Jose M; Fu, Marcela; Martín-Sánchez, Juan Carlos; Ballbè, Montse; Saltó, Esteve; Fernández, Esteve

2015-01-01

Objective To describe and compare the perceptions of the general population about the harmful effects of electronic cigarettes (e-cigarettes) on users and on those passively exposed to e-cigarettes and the perceptions about e-cigarette usefulness for reducing or eliminating tobacco smoking. Design, setting, and participants We analysed cross-sectional data from a longitudinal study of a representative sample of the general adult (≥16 years) population of Barcelona, Spain (336 men and 400 women). The fieldwork was conducted between May 2013 and February 2014. We computed the percentages, adjusted OR and their corresponding 95% CI among participants with some awareness of e-cigarettes (79.2% of the sample). Primary and secondary outcome measures We assessed the perception about harmfulness for e-cigarette users and for passively exposed non-e-cigarette users, as well as the perception of usefulness for smokers of cigarette cessation and reduction. Results In this sample, 40.1% thought that e-cigarettes had a harmful effect on users, and 27.1% thought that e-cigarettes had a harmful effect on passively exposed bystanders (p<0.001). Particularly, more never-smokers perceived that e-cigarettes had harmful effects on passively exposed bystanders than current smokers (34.4% vs 20.6%; OR=1.93, 95% CI 1.02 to 3.63). More people perceived e-cigarettes as being useful for reducing smoking than for quitting (50.6% vs 29.9%, p<0.001), as well as for reducing smoking than as being harmful to users (50.6% vs 40.1%, p=0.044). Discussion The perception that e-cigarettes are useful for reducing tobacco consumption was more prevalent than the perception that e-cigarettes are harmful to users and to those passively exposed to e-cigarettes. Advertisements and messages about the use of e-cigarettes and their harmful effects should be regulated and based on scientific evidence to avoid creating erroneous ideas about their use. PMID:26534735

Empirical measurement of illicit tobacco trade in the Philippines

PubMed Central

Abola, Victor; Sy, Deborah; Denniston, Ryan; So, Anthony

2015-01-01

Cigarette smuggling reduces the price of cigarettes, thwarts youth access restrictions, reduces government revenue, and undercuts the ability of taxes to reduce consumption. The tobacco industry often opposes increases to tobacco taxes on the claim that greater taxes induce more smuggling. To date, little is known about the magnitude of smuggling in the Philippines. his information is necessary to effectively address illicit trade and to measure the impacts of tax changes and the introduction of secure tax markings on illicit trade. This study employs two gap discrepancy methods to estimate the magnitude of illicit trade in cigarettes for the Philippines between 1994 and 2009. First, domestic consumption is compared with tax-paid sales to measure the consumption of illicit cigarettes. Second, imports recorded by the Philippines are compared with exports to the Philippines by trade partners to measure smuggling. Domestic consumption fell short of tax-paid sales for all survey years. The magnitude of these differences and a comparison with a prevalence survey for 2009 suggest a high level of survey under-reporting of smoking. In the late 1990s and the mid 2000s, the Philippines experienced two sharp declines in trade discrepancies, from a high of $750 million in 1995 to a low of $133.7 million in 2008. Discrepancies composed more than one-third of the domestic market in 1995, but only 10 percent in 2009. Hong Kong, Singapore, and China together account for more than 80 percent of the cumulative discrepancies over the period and 74 percent of the discrepancy in 2009. The presence of large discrepancies supports the need to implement an effective tax marking and tobacco track and trace system to reduce illicit trade and support tax collection. The absence of a relation between tax changes and smuggling suggests that potential increases in the excise tax should not be discouraged by illicit trade. Finally, the identification of specific trade partners as primary sources for illicit trade may facilitate targeted efforts in cooperation with these governments to reduce illicit trade. PMID:26855640

Empirical measurement of illicit tobacco trade in the Philippines.

PubMed

Abola, Victor; Sy, Deborah; Denniston, Ryan; So, Anthony

2014-12-01

Cigarette smuggling reduces the price of cigarettes, thwarts youth access restrictions, reduces government revenue, and undercuts the ability of taxes to reduce consumption. The tobacco industry often opposes increases to tobacco taxes on the claim that greater taxes induce more smuggling. To date, little is known about the magnitude of smuggling in the Philippines. his information is necessary to effectively address illicit trade and to measure the impacts of tax changes and the introduction of secure tax markings on illicit trade. This study employs two gap discrepancy methods to estimate the magnitude of illicit trade in cigarettes for the Philippines between 1994 and 2009. First, domestic consumption is compared with tax-paid sales to measure the consumption of illicit cigarettes. Second, imports recorded by the Philippines are compared with exports to the Philippines by trade partners to measure smuggling. Domestic consumption fell short of tax-paid sales for all survey years. The magnitude of these differences and a comparison with a prevalence survey for 2009 suggest a high level of survey under-reporting of smoking. In the late 1990s and the mid 2000s, the Philippines experienced two sharp declines in trade discrepancies, from a high of $750 million in 1995 to a low of $133.7 million in 2008. Discrepancies composed more than one-third of the domestic market in 1995, but only 10 percent in 2009. Hong Kong, Singapore, and China together account for more than 80 percent of the cumulative discrepancies over the period and 74 percent of the discrepancy in 2009. The presence of large discrepancies supports the need to implement an effective tax marking and tobacco track and trace system to reduce illicit trade and support tax collection. The absence of a relation between tax changes and smuggling suggests that potential increases in the excise tax should not be discouraged by illicit trade. Finally, the identification of specific trade partners as primary sources for illicit trade may facilitate targeted efforts in cooperation with these governments to reduce illicit trade.

Feasibility of Electronic Nicotine Delivery Systems in Surgical Patients.

PubMed

Nolan, Margaret; Leischow, Scott; Croghan, Ivana; Kadimpati, Sandeep; Hanson, Andrew; Schroeder, Darrell; Warner, David O

2016-08-01

Cigarette smoking is a known risk factor for postoperative complications. Quitting or cutting down on cigarettes around the time of surgery may reduce these risks. This study aimed to determine the feasibility of using electronic nicotine delivery systems (ENDS) to help patients achieve this goal, regardless of their intent to attempt long-term abstinence. An open-label observational study was performed of cigarette smoking adults scheduled for elective surgery at Mayo Clinic Rochester and seen in the pre-operative evaluation clinic between December 2014 and June 2015. Subjects were given a supply of ENDS to use prior to and 2 weeks after surgery. They were encouraged to use them whenever they craved a cigarette. Daily use of ENDS was recorded, and patients were asked about smoking behavior and ENDS use at baseline, 14 days and 30 days. Of the 105 patients approached, 80 (76%) agreed to participate; five of these were later excluded. Among the 75, 67 (87%) tried ENDS during the study period. At 30-day follow-up, 34 (51%) who had used ENDS planned to continue using them. Average cigarette consumption decreased from 15.6 per person/d to 7.6 over the study period (P < .001). At 30 days, 11/67 (17%) reported abstinence from cigarettes. ENDS use is feasible in adult smokers scheduled for elective surgery and is associated with a reduction in perioperative cigarette consumption. These results support further exploration of ENDS as a means to help surgical patients reduce or eliminate their cigarette consumption around the time of surgery. Smoking in the perioperative period increases patients' risk for surgical complications and healing difficulties, but new strategies are needed to help patients quit or cut down during this stressful time. These pilot data suggest that ENDS use is feasible and well-accepted in surgical patients, and worthy of exploration as a harm reduction strategy in these patients. © 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.

Cross sectional survey on association between alcohol, betel- nut, cigarette consumption and health promoting behavior of industrial workers in Ghaziabad.

PubMed

Arora, Dimple; Marya, Charu Mohan; Menon, Ipseeta; Oberoi, Sukhvinder Singh; Dhingra, Chandan; Anand, Richa

2015-01-01

The work force in industries are at risk of developing unduly high rates of health and behaviour related problems including abuse of alcohol, betel nut and cigarette (alcohol, betel nut and cigarette consumption). This study describes the relationships between alcohol, betel nut and cigarette consumption and health promoting behaviour among industrial workers. A cross sectional survey was conducted on workers in various industries of Ghaziabad city with concerned authority permission. A sample size of 732 workers was calculated based on pilot study. Through Simple random sampling 732 workers in 20 to 50 years age group with informed consent were interviewed through structured, pretested, validated questionnaire in vernacular language by one calibrated investigator. Data on socio demography, alcohol, betel nut and cigarette consumption pattern and health behaviour were collected. The association between health promoting behaviour and alcohol, betel nut and cigarette consumption was analysed by Logistic regression and Chi-square test through SPSS 16 at p<0.05 and 95%CI as significant. Total prevalence of alcohol, betel nut and cigarette consumption in study population was 88%. The prevalence of individual alcohol, betel nut and cigarette consumption were 82%, 68% and 79% respectively. Combined alcohol, betel nut and cigarette prevalence in study population was 58%. Alcohol and cigarette users were significantly higher (p<0.001) in 30 to 40 years age group with lower level of education having poor attitude towards health promoting behaviour, poor oral hygiene practices and rare indulgence in regular physical exercise. This study stimulate further research on exploring methods to prevent initiation of health risk behaviour and promote healthy behaviour with cessation help for the current alcohol, betel nut and cigarette users.

Effectiveness of tobacco control television advertisements with different types of emotional content on tobacco use in England, 2004–2010

PubMed Central

Sims, M; Langley, T; Lewis, S; Richardson, S; Szatkowski, L; McNeill, A; Gilmore, A B

2016-01-01

Aim To examine the effects of tobacco control television advertisements with positive and negative emotional content on adult smoking prevalence and cigarette consumption. Design Analysis of monthly cross-sectional surveys using generalised additive models. Setting England. Participants 60 000 adults aged 18 years or over living in England and interviewed in the Opinions and Lifestyle Survey from 2004 to 2010. Measurements Current smoking status, daily cigarette consumption, tobacco control gross rating points (GRPs—a measure of per capita advertising exposure), cigarette costliness, concurrent tobacco control policies, sociodemographic variables. Results After adjusting for cigarette costliness, other tobacco control policies and individual characteristics, we found that a 400-point increase in positive emotive GRPs was associated with 7% lower odds of smoking (odds ratio (OR) 0.93, 95% CI 0.87 to 0.98) 1 month later and a similar increase in negative emotive GRPs was significantly associated with 4% lower odds of smoking (OR 0.96, 95% CI 0.92 to 0.999) 2 months later. An increase in negative emotive GRPs from 0 to 400 was also associated with a significant 3.3% (95% CI 1.1 to 5.6) decrease in average cigarette consumption. There was no evidence that the association between positive emotive GRPs and the outcomes differed depending on the intensity of negative emotive GRPs (and vice versa). Conclusions This is the first study to explore the effects of campaigns with different types of emotive content on adult smoking prevalence and consumption. It suggests that both types of campaign (positive and negative) are effective in reducing smoking prevalence, whereas consumption among smokers was only affected by campaigns evoking negative emotions. PMID:25037155

Estimating the size of illicit tobacco consumption in Brazil: findings from the global adult tobacco survey.

PubMed

Iglesias, Roberto Magno; Szklo, André Salem; Souza, Mirian Carvalho de; de Almeida, Liz Maria

2017-01-01

Brazil experienced a large decline in smoking prevalence between 2008 and 2013. Tax rate increases since 2007 and a new tobacco tax structure in 2012 may have played an important role in this decline. However, continuous tax rate increases pushed up cigarette prices over personal income growth and, therefore, some consumers, especially lower income individuals, may have migrated to cheaper illicit cigarettes. To use tobacco surveillance data to estimate the size of illicit tobacco consumption before and after excise tax increases. We defined a threshold price and compared it with purchasing prices obtained from two representative surveys conducted in 2008 and 2013 to estimate the proportion of illicit cigarette use among daily smokers. Generalised linear model was specified to understand whether the absolute difference in proportions over time differed by sociodemographic groups and consumption levels. Our findings were validated using an alternative method. Total proportion of illicit daily consumption increased from 16.6% to 31.1% between 2008 and 2013. We observed a pattern of unadjusted absolute decreases in cigarette smoking prevalence and increases in the proportion of illicit consumption, irrespective of gender, age, educational level, area of residence and amount of cigarettes consumed. The strategy of raising taxes has increased government revenues, reduced smoking prevalence and resulted in an increased illicit trade. Surveillance data can be used to provide information on illicit tobacco trade to help in the implementation of WHO Framework Convention on Tobacco Control (FCTC) article 15 and the FCTC Protocol to Eliminate Illicit Trade in 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/.

An international analysis of cigarette affordability

PubMed Central

Blecher, E; van Walbeek, C P

2004-01-01

Objective: To investigate how affordable cigarettes are in developed and developing countries, and to calculate by how much the affordability of cigarettes has changed between 1990 and 2001; and secondly, to investigate the relation between cigarette affordability and consumption. Design: Affordability was defined as the cost of cigarettes relative to per capita income. Trends in cigarette affordability, and affordability elasticities of demand, were estimated using regression techniques. Subjects: Seventy countries were investigated, of which 28 are categorised as high income developed countries, while 42 are categorised as developing countries. Cigarette prices were obtained for the main city/cities in the countries. Results: Despite the fact that cigarettes are more expensive in developed countries, the high levels of income make cigarettes more affordable in these countries vis-à-vis developing countries. Of the 28 developed countries, cigarettes became more affordable in 11 and less affordable in 17 countries during the 1990s. Of the 42 developing countries, cigarettes became more affordable in 24 and less affordable in 18 countries. Based on a cross sectional analysis, a 1% increase in the relative income price (the inverse of cigarette affordability) is expected to decrease cigarette consumption by between 0.49–0.57%. Conclusions: Cigarette affordability, more than just the price, determines cigarette consumption. While cigarettes have become more affordable in many developing countries, some developing countries (for example, South Africa, Poland, and Thailand) have implemented strong and effective tobacco control policies, and have been able to decrease cigarette consumption as a result. PMID:15564616

Smoking intensity among male factory workers in Kunming, China.

PubMed

Cheng, Kai-Wen; Tsoh, Janice Y; Cui, Wenlong; Li, Xiaoliang; Kohrman, Matthew

2015-03-01

This study investigated the intensity of cigarette consumption and its correlates in China among urban male factory workers, a cohort especially vulnerable to tobacco exposure, one that appears to have benefitted little from recent public health efforts to reduce smoking rates. Data were collected from men working in factories of Kunming city, Yunnan, China, who are current daily smokers (N = 490). A multinomial logistic regression was conducted to examine the factors in association with smoking intensity in light, moderate, and heavy levels. Light smoking correlated with social smoking, smoking the first cigarette later in the day, self-reported health condition, and quit intention. Heavy smoking was associated with purchase of lower priced cigarettes, difficulty refraining from smoking, and prehypertensive blood pressure. Even in regions where smoking is highly prevalent, even among cohorts who smoke heavily, variation exists in how cigarettes are consumed. Analyses of this consumption, with special consideration given to smoking intensity and its correlates, can help guide tobacco-control strategists in developing more effective interventions. © 2013 APJPH.

An empirical analysis of cigarette demand in Argentina

PubMed Central

Martinez, Eugenio; Mejia, Raul; Pérez-Stable, Eliseo J

2014-01-01

Objective To estimate the long-term and short-term effects on cigarette demand in Argentina based on changes in cigarette price and income per person >14 years old. Method Public data from the Ministry of Economics and Production were analysed based on monthly time series data between 1994 and 2010. The econometric analysis used cigarette consumption per person >14 years of age as the dependent variable and the real income per person >14 years old and the real average price of cigarettes as independent variables. Empirical analyses were done to verify the order of integration of the variables, to test for cointegration to capture the long-term effects and to capture the short-term dynamics of the variables. Results The demand for cigarettes in Argentina was affected by changes in real income and the real average price of cigarettes. The long-term income elasticity was equal to 0.43, while the own-price elasticity was equal to −0.31, indicating a 10% increase in the growth of real income led to an increase in cigarette consumption of 4.3% and a 10% increase in the price produced a fall of 3.1% in cigarette consumption. The vector error correction model estimated that the short-term income elasticity was 0.25 and the short-term own-price elasticity of cigarette demand was −0.15. A simulation exercise showed that increasing the price of cigarettes by 110% would maximise revenues and result in a potentially large decrease in total cigarette consumption. Conclusion Econometric analyses of cigarette consumption and their relationship with cigarette price and income can provide valuable information for developing cigarette price policy. PMID:23760657

An empirical analysis of cigarette demand in Argentina.

PubMed

Martinez, Eugenio; Mejia, Raul; Pérez-Stable, Eliseo J

2015-01-01

To estimate the long-term and short-term effects on cigarette demand in Argentina based on changes in cigarette price and income per person >14 years old. Public data from the Ministry of Economics and Production were analysed based on monthly time series data between 1994 and 2010. The econometric analysis used cigarette consumption per person >14 years of age as the dependent variable and the real income per person >14 years old and the real average price of cigarettes as independent variables. Empirical analyses were done to verify the order of integration of the variables, to test for cointegration to capture the long-term effects and to capture the short-term dynamics of the variables. The demand for cigarettes in Argentina was affected by changes in real income and the real average price of cigarettes. The long-term income elasticity was equal to 0.43, while the own-price elasticity was equal to -0.31, indicating a 10% increase in the growth of real income led to an increase in cigarette consumption of 4.3% and a 10% increase in the price produced a fall of 3.1% in cigarette consumption. The vector error correction model estimated that the short-term income elasticity was 0.25 and the short-term own-price elasticity of cigarette demand was -0.15. A simulation exercise showed that increasing the price of cigarettes by 110% would maximise revenues and result in a potentially large decrease in total cigarette consumption. Econometric analyses of cigarette consumption and their relationship with cigarette price and income can provide valuable information for developing cigarette price policy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

How do minimum cigarette price laws affect cigarette prices at the retail level?

PubMed Central

Feighery, E; Ribisl, K; Schleicher, N; Zellers, L; Wellington, N

2005-01-01

Objectives: Half of US states have minimum cigarette price laws that were originally passed to protect small independent retailers from unfair price competition with larger retailers. These laws prohibit cigarettes from being sold below a minimum price that is set by a formula. Many of these laws allow cigarette company promotional incentives offered to retailers, such as buydowns and master-type programmes, to be calculated into the formula. Allowing this provision has the potential to lower the allowable minimum price. This study assesses whether stores in states with minimum price laws have higher cigarette prices and lower rates of retailer participation in cigarette company promotional incentive programmes. Design: Retail cigarette prices and retailer participation in cigarette company incentive programmes in 2001 were compared in eight states with minimum price laws and seven states without them. New York State had the most stringent minimum price law at the time of the study because it excluded promotional incentive programmes in its price setting formula; cigarette prices in New York were compared to all other states included in the study. Results: Cigarette prices were not significantly different in our sample of US states with and without cigarette minimum price laws. Cigarette prices were significantly higher in New York stores than in the 14 other states combined. Conclusions: Most existing minimum cigarette price laws appear to have little impact on the retail price of cigarettes. This may be because they allow the use of promotional programmes, which are used by manufacturers to reduce cigarette prices. New York's strategy to disallow these types of incentive programmes may result in higher minimum cigarette prices, and should also be explored as a potential policy strategy to control cigarette company marketing practices in stores. Strict cigarette minimum price laws may have the potential to reduce cigarette consumption by decreasing demand through increased cigarette prices and reduced promotional activities at retail outlets. PMID:15791016

How do minimum cigarette price laws affect cigarette prices at the retail level?

PubMed

Feighery, E C; Ribisl, K M; Schleicher, N C; Zellers, L; Wellington, N

2005-04-01

Half of US states have minimum cigarette price laws that were originally passed to protect small independent retailers from unfair price competition with larger retailers. These laws prohibit cigarettes from being sold below a minimum price that is set by a formula. Many of these laws allow cigarette company promotional incentives offered to retailers, such as buydowns and master-type programmes, to be calculated into the formula. Allowing this provision has the potential to lower the allowable minimum price. This study assesses whether stores in states with minimum price laws have higher cigarette prices and lower rates of retailer participation in cigarette company promotional incentive programmes. Retail cigarette prices and retailer participation in cigarette company incentive programmes in 2001 were compared in eight states with minimum price laws and seven states without them. New York State had the most stringent minimum price law at the time of the study because it excluded promotional incentive programmes in its price setting formula; cigarette prices in New York were compared to all other states included in the study. Cigarette prices were not significantly different in our sample of US states with and without cigarette minimum price laws. Cigarette prices were significantly higher in New York stores than in the 14 other states combined. Most existing minimum cigarette price laws appear to have little impact on the retail price of cigarettes. This may be because they allow the use of promotional programmes, which are used by manufacturers to reduce cigarette prices. New York's strategy to disallow these types of incentive programmes may result in higher minimum cigarette prices, and should also be explored as a potential policy strategy to control cigarette company marketing practices in stores. Strict cigarette minimum price laws may have the potential to reduce cigarette consumption by decreasing demand through increased cigarette prices and reduced promotional activities at retail outlets.

Estimates of price and income elasticity in Greece. Greek debt crisis transforming cigarettes into a luxury good: an econometric approach.

PubMed

Tarantilis, Filippos; Athanasakis, Kostas; Zavras, Dimitris; Vozikis, Athanassios; Kyriopoulos, Ioannis

2015-01-05

During the past decades, smoking prevalence in Greece was estimated to be near or over 40%. Following a sharp fall in cigarette consumption, as shown in current data, our objective is to assess smokers' sensitivity to cigarette price and consumer income changes as well as to project health benefits of an additional tax increase. Cigarette consumption was considered as the dependent variable, with Weighted Average Price as a proxy for cigarette price, gross domestic product as a proxy for consumers' income and dummy variables reflecting smoking restrictions and antismoking campaigns. Values were computed to natural logarithms and regression was performed. Then, four scenarios of tax increase were distinguished in order to calculate potential health benefits. Short-run price elasticity is estimated at -0.441 and short-run income elasticity is estimated at 1.040. Antismoking campaigns were found to have a statistically significant impact on consumption. Results indicate that, depending on the level of tax increase, annual per capita consumption could fall by at least 209.83 cigarettes; tax revenue could rise by more than €0.74 billion, while smokers could be reduced by up to 530 568 and at least 465 smoking-related deaths could be averted. Price elasticity estimates are similar to previous studies in Greece, while income elasticity estimates are far greater. With cigarettes regarded as a luxury good, a great opportunity is presented for decisionmakers to counter smoking. Increased taxation, along with focused antismoking campaigns, law reinforcement (to ensure compliance with smoking bans) and intensive control for smuggling could invoke a massive blow to the tobacco epidemic in Greece. 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.

Cohort study of electronic cigarette use: effectiveness and safety at 24 months.

PubMed

Manzoli, Lamberto; Flacco, Maria Elena; Ferrante, Margherita; La Vecchia, Carlo; Siliquini, Roberta; Ricciardi, Walter; Marzuillo, Carolina; Villari, Paolo; Fiore, Maria

2017-05-01

To evaluate the safety and effectiveness of e-cigarettes, by comparing users of only e-cigarettes, smokers of only tobacco cigarettes and dual users. Prospective cohort study. We update previous 12-month findings and report the results of the 24-month follow-up. Direct contact and questionnaires by phone or via internet. Adults (30-75 years) were classified as: (1) tobacco smokers, if they smoked ≥1 tobacco cigarette/day, (2) e-cigarette users, if they inhaled ≥50 puffs/week of any type of e-cigarette and (3) dual users, if they smoked tobacco cigarettes and also used e-cigarettes. Carbon monoxide levels were tested in 50% of those declaring tobacco smoking abstinence. Hospital discharge data were used to validate possibly related serious adverse events in 46.0% of the sample. Sustained abstinence from tobacco cigarettes and/or e-cigarettes after 24 months, the difference in the number of tobacco cigarettes smoked daily between baseline and 24 months, possibly related serious adverse events. Data at 24 months were available for 229 e-cigarette users, 480 tobacco smokers and 223 dual users (overall response rate 68.8%). Of the e-cigarette users, 61.1% remained abstinent from tobacco (while 23.1% and 26.0% of tobacco-only smokers and dual users achieved tobacco abstinence). The rate (18.8%) of stopping use of either product (tobacco and/or e-cigarettes) was not higher for e-cigarette users compared with tobacco smokers or dual users. Self-rated health and adverse events were similar between all groups. Among those continuing to smoke, there were no differences in the proportion of participants reducing tobacco cigarette consumption by 50% or more, the average daily number of cigarettes and the average self-rated health by baseline group. Most dual users at baseline abandoned e-cigarettes and continued to smoke tobacco. Those who continued dual using or converted from tobacco smoking to dual use during follow-up experienced significant improvements in the 3 outcomes compared with those who continued or switched to only smoking tobacco (p<0.001). E-cigarette use alone might support tobacco quitters remaining abstinent from smoking. However, dual use did not improve the likelihood of quitting tobacco or e-cigarette use, but may be helpful to reduce tobacco consumption. Adverse event data were scarce and must be considered preliminary. NCT01785537. 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/.

Effects of Experimental Income on Demand for Potentially Real Cigarettes

PubMed Central

Wilson, Arlington George; Bickel, Warren K.

2015-01-01

Introduction: Cigarette demand, or the change in cigarette consumption as a function of price, is a measure of reinforcement that is associated with level of tobacco dependence and other clinically relevant measures, but the effects of experimentally controlled income on real-world cigarette consumption have not been examined. Methods: In this study, income available for cigarette purchases was manipulated to assess the effect on cigarette demand. Tobacco-dependent cigarette smokers (n = 15) who smoked 10–40 cigarettes per day completed a series of cigarette purchasing tasks under a variety of income conditions meant to mimic different weekly cigarette budgets: $280, approximately $127, $70, or approximately $32 per week. Prices of $0.12, $0.25, $0.50, and $1.00 per cigarette were assessed in each income condition. Participants were instructed to purchase as many cigarettes as they would like for the next week and to only consume cigarettes purchased in the context of the study. One price in 1 income condition was randomly chosen to be “real,” and the cigarettes and the excess money in the budget for that condition were given to the participant. Results: Results indicate that demand elasticity was negatively correlated with income. Demand intensity (consumption at low prices) was unrelated to income condition and remained high across incomes. Conclusions: These results indicate that the amount of income that is available for cigarette purchases has a large effect on cigarette consumption, but only at high prices. PMID:25168032

Turning off the tap: the real solution to cigarette smuggling.

PubMed

Joossens, L; Raw, M

2003-03-01

The tobacco industry has argued that tobacco smuggling is caused by market forces, i.e., by the price differences between countries, which create an incentive to smuggle cigarettes from 'cheaper' to 'more expensive' countries, and so urged governments to solve the problem by reducing taxes to remove this differential, which will also, they say, restore revenue. Although such market forces have some effect, smuggling is in fact more prevalent in 'cheaper' countries, and reducing tax is not the solution. Where taxes have been reduced tobacco consumption has risen and revenue has fallen, with disastrous consequences for public health. The key to understanding cigarette smuggling is understanding the role of the tobacco industry. At the heart of cigarette smuggling is large scale fraud: container loads of cigarettes are exported, legally and duty unpaid, to countries where they have no market, and where they disappear into the contraband market. They are often smuggled back into the country of origin, where they are sold at a third to half price. It is therefore profitable because duty has been illegally evaded. The key to controlling cigarette smuggling is not lowering taxes, it is controlling the tobacco manufacturing industry and its exporting practices.

Effects of the Opioid Receptor Antagonist Naltrexone on Smoking and Related Behaviors in Smokers Preparing to Quit: A Randomized Controlled Trial

PubMed Central

King, Andrea; Cao, Dingcai; Zhang, Lingjiao; Rueger, Sandra Yu

2013-01-01

Aims To determine if naltrexone affects smoking behaviours in smokers preparing to quit, and whether such pre-quit responses predict post-quit date outcomes. Design Double-blind, placebo-controlled, randomized study. Current study focused on smoking-related outcomes in the pre-quit phase, which was one week prior to the quit date, and these findings were linked with reductions in same outcomes demonstrated in the post-quit phase previously published for this RCT in mediation analyses. Setting Community sample of adult smokers desiring to quit in Chicago, Illinois USA. Participants Participants were 315 smokers randomized to naltrexone (n=161; mean age=42.6 years; 60% white) or placebo (n=154; mean age=41.3 years; 55% white). Measurements Difference from baseline in the number of cigarettes smoked during pre-quit phase interval was the primary outcome. Secondary pre-quit outcomes were assessed using Likert scales of subjective responses and consumption of cigarettes, alcohol, and food. Number of cigarettes smoked, alcoholic drinks consumed, and the Brief Questionnaire of Smoking Urges were assessed in the post-quit phase. Findings Relative to placebo, naltrexone decreased the number of cigarettes smoked (−4.21 vs. −2.93, p<.05), smoking urge (p=.02), and number of alcoholic drinks consumed (p=.04). Exploratory mediation analyses linking outcomes of the pre quit and post quit phases found that naltrexone’s effects on reducing smoking urge, cigarettes smoked and alcoholic drinks consumed in the pre-quit phase demonstrated full mediation of their respective effects during the post-quit phase. Conclusions Naltrexone taken in the week before a quit attempt appears to reduce cigarette consumption, urges to smoke and alcohol consumption relative to placebo. The size of the effect statistically mediates the size of similar effects after the quit date. PMID:23714324

Nicotine reduction as an increase in the unit price of cigarettes: A behavioral economics approach

PubMed Central

Smith, Tracy T.; Sved, Alan F.; Hatsukami, Dorothy K.; Donny, Eric C.

2015-01-01

Urgent action is needed to reduce the harm caused by smoking. Product standards that reduce the addictiveness of cigarettes are now possible both in the U.S. and in countries party to the Framework Convention on Tobacco Control. Specifically, standards that required substantially reduced nicotine content in cigarettes could enable cessation in smokers and prevent future smoking among current non-smokers. Behavioral economics uses principles from the field of microeconomics to characterize how consumption of a reinforcer changes as a function of the unit price of that reinforcer (unit price = cost / reinforcer magnitude). A nicotine reduction policy might be considered an increase in the unit price of nicotine because smokers are paying more per unit of nicotine. This perspective allows principles from behavioral economics to be applied to nicotine reduction research questions, including how nicotine consumption, smoking behavior, use of other tobacco products, and use of other drugs of abuse are likely to be affected. This paper reviews the utility of this approach and evaluates the notion that a reduction in nicotine content is equivalent to a reduction in the reinforcement value of smoking—an assumption made by the unit price approach. PMID:25025523

Nicotine reduction as an increase in the unit price of cigarettes: a behavioral economics approach.

PubMed

Smith, Tracy T; Sved, Alan F; Hatsukami, Dorothy K; Donny, Eric C

2014-11-01

Urgent action is needed to reduce the harm caused by smoking. Product standards that reduce the addictiveness of cigarettes are now possible both in the U.S. and in countries party to the Framework Convention on Tobacco Control. Specifically, standards that required substantially reduced nicotine content in cigarettes could enable cessation in smokers and prevent future smoking among current non-smokers. Behavioral economics uses principles from the field of microeconomics to characterize how consumption of a reinforcer changes as a function of the unit price of that reinforcer (unit price=cost/reinforcer magnitude). A nicotine reduction policy might be considered an increase in the unit price of nicotine because smokers are paying more per unit of nicotine. This perspective allows principles from behavioral economics to be applied to nicotine reduction research questions, including how nicotine consumption, smoking behavior, use of other tobacco products, and use of other drugs of abuse are likely to be affected. This paper reviews the utility of this approach and evaluates the notion that a reduction in nicotine content is equivalent to a reduction in the reinforcement value of smoking-an assumption made by the unit price approach. Copyright © 2014 Elsevier Inc. All rights reserved.

Smoking behaviour and associated factors of illicit cigarette consumption in a border province of southern Thailand.

PubMed

Ketchoo, Chittawet; Sangthong, Rassamee; Chongsuvivatwong, Virasakdi; Geater, Alan; McNeil, Edward

2013-07-01

Illicit cigarette consumption has increased worldwide. It is important to understand this problem thoroughly. To investigate behaviours and factors associated with illicit cigarette consumption in southern Thailand. A survey and qualitative study were conducted in a border province in southern Thailand next to Malaysia. A modified snowballing technique was used to recruit 300 illicit and 150 non-illicit cigarette smokers. A questionnaire was used to interview subjects. Illicit cigarette packs were obtained in order to identify their characteristics. Bivariate and multivariate logistic regression was used for data analysis. Smoking of illicit cigarettes has become accepted in the communities. They were available in supermarkets and vendor shops. Friends and other illicit smokers known by illicit cigarette smokers were an important source of information for access to illicit cigarette products. The main factors associated with smoking illicit cigarettes, compared with smoking non-illicit cigarettes, were younger age, higher education and higher average monthly expenditure on cigarettes (most illicit smokers smoked illicit cigarettes (average price per packet = 33 THB (US$1.1), while most non-illicit smokers smoked hand-rolled cigarettes (average price per packet = 7 THB (US$0.2)) and knowledge of other illicit cigarette smokers. The low price of illicit cigarettes was the main reason for their use. Selling strategies included sale of singles, sale in shops and direct sale through social networking. Illicit cigarette consumption has become more acceptable especially among young adult smokers. Age and extent of social networks are important factors associated with smoking illicit cigarettes.

Is there a role for e-cigarettes in smoking cessation?

PubMed

Leduc, Charlotte; Quoix, Elisabeth

2016-04-01

The use of e-cigarettes has dramatically increased over the past few years and their role in smoking cessation remains controversial. Several clinical studies have evaluated their efficacy in smoking cessation but most of them are prospective cohort studies. Only two randomized, controlled trials have compared e-cigarettes versus placebo or patches. A meta-analysis of these two randomized, controlled trials has been performed. Nicotine-containing e-cigarettes appear to help smokers unable to stop smoking altogether to reduce their cigarette consumption when compared with placebo. However, these results are rated 'low' by GRADE standards. Many cohort studies have been conducted, with contradictory results. For some, e-cigarettes could increase the risk of nonsmokers developing nicotine dependence and of current smokers maintaining their dependence. The debate remains open and more randomized trials are needed with long-term data about the efficacy and safety of e-cigarettes. © The Author(s), 2015.

Sales Trends in Price-Discounted Cigarettes, Large Cigars, Little Cigars, and Cigarillos-United States, 2011-2016.

PubMed

Wang, Teresa W; Falvey, Kyle; Gammon, Doris G; Loomis, Brett R; Kuiper, Nicole M; Rogers, Todd; King, Brian A

2017-12-15

Tobacco manufacturers continue to implement a range of pricing strategies to increase the affordability and consumption of tobacco products. To demonstrate the extent of retail- and brand-level price discounts at the point of sale, this study assessed national sales trends in price-discounted cigarettes, large cigars, little cigars, and cigarillos. Retail scanner data for tobacco product sales were obtained for convenience stores (C-store) and all-other-outlets-combined (AOC) from September 25, 2011, to January 9, 2016. The proportion of price-discounted sales, average nondiscounted unit price, and average discounted unit price were examined by product category and brand. JoinPoint regression was used to assess average monthly percentage change. Overall, price-discounted sales accounted for 11.3% of cigarette, 3.4% of large cigar, 4.1% of little cigar, and 3.9% of cigarillo sales. The average difference between nondiscounted and discounted prices was 25.5% (C-store) and 36.7% (AOC) for cigarettes; 11.0% (C-store) and 11.2% (AOC) for large cigars; 19.2% (C-store) and 9.6% (AOC) for little cigars; and 5.3% (C-store) and 14.7% (AOC) for cigarillos. Furthermore, price-discounted sales of top-selling tobacco brands comprised up to 36% of cigarette, 7.4% of large cigar, 7.7% of little cigar, and 4.2% of cigarillo unit sales. These findings highlight the use of price discounts by tobacco manufacturers to reduce the cost of cigarettes, large cigars, little cigars, and cigarillos to consumers. These sales patterns underscore the importance of sustained efforts to implement evidence-based strategies to increase prices and reduce availability and consumption of combustible tobacco in the United States. This study highlights the prevalence and provides a baseline of price-discounted cigarettes, large cigars, little cigars, and cigarillos. Surveillance of tobacco sales data, including state-level trends and additional product types, is critical for informing approaches to reduce tobacco consumption. These approaches include countering tobacco product price-discounting practices and raising and maintaining a high sales price for all tobacco products. The implementation of evidence-based population-level interventions, together with local, state, and federal regulation of tobacco products, could prevent tobacco initiation, increase tobacco cessation, and reduce overall tobacco use among US youth and adults. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Heavier smoking increases coffee consumption: findings from a Mendelian randomization analysis.

PubMed

Bjørngaard, Johan H; Nordestgaard, Ask Tybjærg; Taylor, Amy E; Treur, Jorien L; Gabrielsen, Maiken E; Munafò, Marcus R; Nordestgaard, Børge Grønne; Åsvold, Bjørn Olav; Romundstad, Pål; Davey Smith, George

2017-12-01

There is evidence for a positive relationship between cigarette and coffee consumption in smokers. Cigarette smoke increases metabolism of caffeine, so this may represent a causal effect of smoking on caffeine intake. We performed Mendelian randomization analyses in the UK Biobank (N = 114 029), the Norwegian HUNT study (N = 56 664) and the Copenhagen General Population Study (CGPS) (N = 78 650). We used the rs16969968 genetic variant as a proxy for smoking heaviness in all studies and rs4410790 and rs2472297 as proxies for coffee consumption in UK Biobank and CGPS. Analyses were conducted using linear regression and meta-analysed across studies. Each additional cigarette per day consumed by current smokers was associated with higher coffee consumption (0.10 cups per day, 95% CI: 0.03, 0.17). There was weak evidence for an increase in tea consumption per additional cigarette smoked per day (0.04 cups per day, 95% CI: -0.002, 0.07). There was strong evidence that each additional copy of the minor allele of rs16969968 (which increases daily cigarette consumption) in current smokers was associated with higher coffee consumption (0.16 cups per day, 95% CI: 0.11, 0.20), but only weak evidence for an association with tea consumption (0.04 cups per day, 95% CI: -0.01, 0.09). There was no clear evidence that rs16969968 was associated with coffee or tea consumption in never or former smokers or that the coffee-related variants were associated with cigarette consumption. Higher cigarette consumption causally increases coffee intake. This is consistent with faster metabolism of caffeine by smokers, but could also reflect a behavioural effect of smoking on coffee drinking. © The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association.

Heavier smoking increases coffee consumption: findings from a Mendelian randomization analysis

PubMed Central

Bjørngaard, Johan H; Nordestgaard, Ask Tybjærg; Taylor, Amy E; Treur, Jorien L; Gabrielsen, Maiken E; Munafò, Marcus R; Nordestgaard, Børge Grønne; Åsvold, Bjørn Olav; Romundstad, Pål; Davey Smith, George

2017-01-01

Abstract Background There is evidence for a positive relationship between cigarette and coffee consumption in smokers. Cigarette smoke increases metabolism of caffeine, so this may represent a causal effect of smoking on caffeine intake. Methods We performed Mendelian randomization analyses in the UK Biobank (N = 114 029), the Norwegian HUNT study (N = 56 664) and the Copenhagen General Population Study (CGPS) (N = 78 650). We used the rs16969968 genetic variant as a proxy for smoking heaviness in all studies and rs4410790 and rs2472297 as proxies for coffee consumption in UK Biobank and CGPS. Analyses were conducted using linear regression and meta-analysed across studies. Results Each additional cigarette per day consumed by current smokers was associated with higher coffee consumption (0.10 cups per day, 95% CI: 0.03, 0.17). There was weak evidence for an increase in tea consumption per additional cigarette smoked per day (0.04 cups per day, 95% CI: −0.002, 0.07). There was strong evidence that each additional copy of the minor allele of rs16969968 (which increases daily cigarette consumption) in current smokers was associated with higher coffee consumption (0.16 cups per day, 95% CI: 0.11, 0.20), but only weak evidence for an association with tea consumption (0.04 cups per day, 95% CI: -0.01, 0.09). There was no clear evidence that rs16969968 was associated with coffee or tea consumption in never or former smokers or that the coffee-related variants were associated with cigarette consumption. Conclusions Higher cigarette consumption causally increases coffee intake. This is consistent with faster metabolism of caffeine by smokers, but could also reflect a behavioural effect of smoking on coffee drinking. PMID:29025033

Price Elasticity Estimates for Tobacco Products in India

PubMed Central

John, Rijo M

2009-01-01

The tax base of tobacco in India is heavily dependent on about 14% of tobacco users, who smoke cigarettes. Non-cigarette tobacco products accounting for 85% of the tobacco consumption contributes only 15% of the total tobacco taxes. Though taxation is an important tool to regulate consumption of tobacco, there have been no estimates of price elasticities for different tobacco products in India to date, which can guide tax policy on tobacco. This paper, for the first time in India, examines the price elasticity of demand for bidis, cigarettes and leaf tobacco at the national level using a representative cross-section of households. This study found that own-price elasticity estimates of different tobacco products in India ranged between −0.4 to −0.9, with bidis (an indigenous hand-rolled smoked tobacco preparation in India) and leaf tobacco having elasticities close to unity. Cigarettes were the least price elastic of all. With some assumptions, it is shown that the tax on bidis can be increased to Rs. 100 per 1000 sticks compared with the current Rs. 14 and the tax on an average cigarette can be increased to Rs. 3.5 per stick without any fear of losing revenue. The paper argues that the current system of taxing cigarettes in India based on the presence of filters and the length of cigarettes has no justification on health grounds, and should be abolished, if reducing tobacco consumption and the consequent disease burden is one of the objectives of tobacco taxation policy. It also argues that attempts to regulate tobacco use without effecting significant tax increases on bidis may not produce desired results. PMID:18424474

Nicotine Dependence as a Mediator of Project EX’s Effects to Reduce Tobacco Use in Scholars

PubMed Central

Gonzálvez, María T.; Espada, José P.; Orgilés, Mireia; Morales, Alexandra; Sussman, Steve

2016-01-01

In Spain, 44% of 14–18-year-olds have smoked, and 12.5% have smoked cigarettes in the last 30 days. Nicotine is one of the most addictive substances, and can lead to serious addiction in adulthood with adverse consequences to one’s health. School plays a relevant role in health promotion and preventing risk behaviors such as tobacco consumption. Despite the fact that some school-based tobacco cessation and prevention interventions prove to be effective for their purposes, there is a lack of understanding as to why these programs succeed or fail. This longitudinal study aims to test the nicotine dependence (ND) as a mediator of Project EX’s effect – a tobacco-use cessation program developed for high school youth to reduce tobacco consumption in scholars. Six high schools located in the Mediterranean coast were randomized for the participation of the program (Spanish version of Project EX) or a waiting-list group with baseline, immediate-posttest, and 12-month follow-up assessments. At baseline, 1,546 adolescents aged 14–21 years old (mean age: 15.28; SD = 1.20; 46% were women) were evaluated by self-administered tests on tobacco consumption and ND. A biomarker of smoke inhalation – a measurement of exhaled carbon monoxide (ECM) – was used. Participants who were smokers (N = 501; 32%) were selected for this study. Mediation analyses were conducted using the PROCESS v2.12 macro for Windows. The significant criterion was p ≤ 0.05, and 5,000 samples were used for bias-corrected bootstrap confidence intervals. Results indicated that Project EX indirectly decreased the number of cigarettes smoked in the last month, the number of cigarettes smoked within the last 7 days, the number of daily cigarettes, and ECM level at 12-month follow up through decreasing the level of ND in the short-term. This is the first Spanish study that explores ND as a mediator of the long-term efficacy of Project EX to reduce tobacco consumption in adolescents. Results suggest that interventions that reduce ND at short-term are more likely to be successful to decrease tobacco use at long-term. PMID:27570514

State cigarette minimum price laws - United States, 2009.

PubMed

2010-04-09

Cigarette price increases reduce the demand for cigarettes and thereby reduce smoking prevalence, cigarette consumption, and youth initiation of smoking. Excise tax increases are the most effective government intervention to increase the price of cigarettes, but cigarette manufacturers use trade discounts, coupons, and other promotions to counteract the effects of these tax increases and appeal to price-sensitive smokers. State cigarette minimum price laws, initiated by states in the 1940s and 1950s to protect tobacco retailers from predatory business practices, typically require a minimum percentage markup to be added to the wholesale and/or retail price. If a statute prohibits trade discounts from the minimum price calculation, these laws have the potential to counteract discounting by cigarette manufacturers. To assess the status of cigarette minimum price laws in the United States, CDC surveyed state statutes and identified those states with minimum price laws in effect as of December 31, 2009. This report summarizes the results of that survey, which determined that 25 states had minimum price laws for cigarettes (median wholesale markup: 4.00%; median retail markup: 8.00%), and seven of those states also expressly prohibited the use of trade discounts in the minimum retail price calculation. Minimum price laws can help prevent trade discounting from eroding the positive effects of state excise tax increases and higher cigarette prices on public health.

Episodic future thinking reduces delay discounting and cigarette demand: an investigation of the good-subject effect.

PubMed

Stein, Jeffrey S; Tegge, Allison N; Turner, Jamie K; Bickel, Warren K

2018-04-01

Episodic future thinking (EFT), an intervention involving mental simulation of future events, has been shown to reduce both delay discounting and cigarette self-administration. In the present study, we extended these findings by showing that EFT in a web-based sample of smokers reduces delay discounting and intensity of demand for cigarettes (ad libitum consumption) in a hypothetical purchase task. No effect was observed on elasticity of demand (sensitivity to price) or cigarette craving. We also explored whether demand characteristics (specifically, the "good-subject" effect) might be responsible for observed effects. EFT participants were significantly better able than control participants to discern the experimental hypothesis. However, EFT participants were not better than controls at identifying whether they had been assigned to the experimental group and, likewise, showed no differences in attitudes about the experiment and experimenter. Importantly, effects of EFT on delay discounting and demand remained significant even when controlling for measures of demand characteristics, indicating that EFT's effects are independent of participants' perceptions about the experiment.

Effects of experimental income on demand for potentially real cigarettes.

PubMed

Koffarnus, Mikhail N; Wilson, Arlington George; Bickel, Warren K

2015-03-01

Cigarette demand, or the change in cigarette consumption as a function of price, is a measure of reinforcement that is associated with level of tobacco dependence and other clinically relevant measures, but the effects of experimentally controlled income on real-world cigarette consumption have not been examined. In this study, income available for cigarette purchases was manipulated to assess the effect on cigarette demand. Tobacco-dependent cigarette smokers (n = 15) who smoked 10-40 cigarettes per day completed a series of cigarette purchasing tasks under a variety of income conditions meant to mimic different weekly cigarette budgets: $280, approximately $127, $70, or approximately $32 per week. Prices of $0.12, $0.25, $0.50, and $1.00 per cigarette were assessed in each income condition. Participants were instructed to purchase as many cigarettes as they would like for the next week and to only consume cigarettes purchased in the context of the study. One price in 1 income condition was randomly chosen to be "real," and the cigarettes and the excess money in the budget for that condition were given to the participant. Results indicate that demand elasticity was negatively correlated with income. Demand intensity (consumption at low prices) was unrelated to income condition and remained high across incomes. These results indicate that the amount of income that is available for cigarette purchases has a large effect on cigarette consumption, but only at high prices. © 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.

Effect of cigarette tax increase in combination with mass media campaign on smoking behavior in Mauritius: Findings from the ITC Survey

PubMed Central

Azagba, Sunday; Burhoo, Premduth; Chaloupka, Frank J.; Fong, Geoffrey T

2015-01-01

Background Mauritius has made great strides in adopting evidence-based tobacco control measures, including an increase in its cigarette excise tax and anti-tobacco mass media (Sponge) campaign. The primary objective of this study is to examine the combined effect of these measures on smoking behavior. Methods This study used longitudinal data from the International Tobacco Control Mauritius Survey, 2009–2011. Waves 1 and 2 were conducted before the tax increase and wave 3 was conducted shortly after the Sponge campaign and six months after the cigarette excise tax increase. Generalized estimating equations were used to examine the effects of these two key tobacco control measures on smoking prevalence and the quantity of cigarettes smoked. Results The results showed that the combination of cigarette tax increase and the Sponge campaign had a significant negative effect on the prevalence of smoking in Mauritius and the number of cigarettes smoked among continuing smokers. Specifically, the measures significantly reduced the odds of being a smoker (AOR 0.88, 95% CI 0.81–0.97). For average daily cigarettes smoked, the measures had a significant reduction in cigarettes per day by about 6% (Incidence-rate ratios 0.94, 95% CI 0.89–0.99). Conclusions The combination of policy measures significantly reduced the consumption of cigarettes in Mauritius. While these results are encouraging, these efforts must be part of a sustained effort to further reduce the smoking prevalence in Mauritius. PMID:25701857

Cigarette consumption per adult of each sex in various countries.

PubMed Central

Todd, G F

1978-01-01

Estimates of cigarette consumption per adult male and female available from surveys in eight countries are examined and the figures of national consumption per adult implied by the surveys are compared with national averages obtained from government data and other sources. The errors likely to be found in the surveys are considered and corrected figures are calculated. Estimates are also made of cigarette consumption per woman of childbearing age. PMID:744820

Estimating price elasticities when there is smuggling: the sensitivity of smoking to price in Canada.

PubMed

Gruber, Jonathan; Sen, Anindya; Stabile, Mark

2003-09-01

A central parameter for evaluating tax policies is the price elasticity of demand for cigarettes. But in many countries this parameter is difficult to estimate reliably due to widespread smuggling, which significantly biases estimates using legal sales data. An excellent example is Canada, where widespread smuggling in the early 1990s, in response to large tax increases, biases upwards the response of legal cigarette sales to price. We surmount this problem through two approaches: excluding the provinces and years where smuggling was greatest; and using household level expenditure data on smoking. These two approaches yield a tightly estimated elasticity in the range of -0.45 to -0.47. We also show that the sensitivity of smoking to price is much larger among lower income Canadians. In the context of recent behavioral models of smoking, whereby higher taxes reduce unwanted smoking among price sensitive populations, this finding suggests that cigarette taxes may not be as regressive as previously suggested. Finally, we show that price increases on cigarettes do not increase, and may actually decrease, consumption of alcohol; as a result, smuggling of cigarettes may have raised consumption of alcohol as well.

Self-reported price of cigarettes, consumption and compensatory behaviours in a cohort of Mexican smokers before and after a cigarette tax increase.

PubMed

Saenz-de-Miera, Belen; Thrasher, James F; Chaloupka, Frank J; Waters, Hugh R; Hernandez-Avila, Mauricio; Fong, Geoffrey T

2010-12-01

To assess the impact of a 2007 cigarette tax increase from 110% to 140% of the price to the retailer on cigarette price and consumption among Mexican smokers, including efforts to offset price increases. Data were analysed from the 2006 and 2007 administrations of the International Tobacco Control (ITC) Policy Evaluation Survey in Mexico, which is a population-based cohort of adult smokers. Self-reported price of last cigarette purchase, place of last purchase, preferred brand, daily consumption and quit behaviour were assessed at baseline and follow-up. Self-reported cigarette prices increased by 12.7% after the tax increase, with prices for international brands increasing more than for national brands (13.5% vs 8.7%, respectively). Although the tax increases were not fully passed onto consumers particularly on national brands, no evidence was found for smokers changing behaviour to offset price increases. Consistent declines in consumption across groups defined by sociodemographic and smoking-related psychosocial variables suggest a relatively uniform impact of the tax increase across subpopulations. However, decreased consumption appeared limited to people who smoked relatively more cigarettes a day (>5 cigarettes/day). Average daily consumption among lighter smokers did not significantly decline. A total of 13% (n=98) of the sample reported being quit for a month or more at follow-up. In multivariate models, lighter smokers were more likely than heavier smokers to be quit. Results suggest that the 2007 tax increase was passed on to consumers, whose consumption generally declined. Since no other tobacco control policies or programmes were implemented during the period analysed, the tax increase appears likely to have decreased consumption.

Self-reported price of cigarettes, consumption and compensatory behaviours in a cohort of Mexican smokers before and after a cigarette tax increase

PubMed Central

Saenz-de-Miera, Belen; Chaloupka, Frank J; Waters, Hugh R; Hernandez-Avila, Mauricio; Fong, Geoffrey T

2010-01-01

Objective To assess the impact of a 2007 cigarette tax increase from 110% to 140% of the price to the retailer on cigarette price and consumption among Mexican smokers, including efforts to offset price increases. Methods Data were analysed from the 2006 and 2007 administrations of the International Tobacco Control (ITC) Policy Evaluation Survey in Mexico, which is a population-based cohort of adult smokers. Self-reported price of last cigarette purchase, place of last purchase, preferred brand, daily consumption and quit behaviour were assessed at baseline and follow-up. Results Self-reported cigarette prices increased by 12.7% after the tax increase, with prices for international brands increasing more than for national brands (13.5% vs 8.7%, respectively). Although the tax increases were not fully passed onto consumers particularly on national brands, no evidence was found for smokers changing behaviour to offset price increases. Consistent declines in consumption across groups defined by sociodemographic and smoking-related psychosocial variables suggest a relatively uniform impact of the tax increase across subpopulations. However, decreased consumption appeared limited to people who smoked relatively more cigarettes a day (>5 cigarettes/day). Average daily consumption among lighter smokers did not significantly decline. A total of 13% (n=98) of the sample reported being quit for a month or more at follow-up. In multivariate models, lighter smokers were more likely than heavier smokers to be quit. Conclusions Results suggest that the 2007 tax increase was passed on to consumers, whose consumption generally declined. Since no other tobacco control policies or programmes were implemented during the period analysed, the tax increase appears likely to have decreased consumption. PMID:20870740

A longitudinal study of smokers' exposure to cigarette smoke and the effects of spontaneous product switching.

PubMed

Cunningham, Anthony; Sommarström, Johan; Camacho, Oscar M; Sisodiya, Ajit S; Prasad, Krishna

2015-06-01

A challenge in investigating the effect of public health policies on cigarette consumption and exposure arises from variation in a smoker's exposure from cigarette to cigarette and the considerable differences between smokers. In addition, limited data are available on the effects of spontaneous product switching on a smoker's cigarette consumption and exposure to smoke constituents. Over 1000 adult smokers of the same commercial 10mg International Organization for Standardization (ISO) tar yield cigarette were recruited into the non-residential, longitudinal study across 10 cities in Germany. Cigarette consumption, mouth level exposure to tar and nicotine and biomarkers of exposure to nicotine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone were measured every 6months over a 3 and a half year period. Cigarette consumption remained stable through the study period and did not vary significantly when smokers spontaneously switched products. Mouth level exposure decreased for smokers (n=111) who switched to cigarettes of 7mg ISO tar yield or lower. In addition, downward trends in mouth level exposure estimates were observed for smokers who did not switch cigarettes. Data from this study illustrate some of the challenges in measuring smokers' long-term exposure to smoke constituents in their everyday environment. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

E-cigarette initiation and associated changes in smoking cessation and reduction: the Population Assessment of Tobacco and Health Study, 2013-2015.

PubMed

Berry, Kaitlyn M; Reynolds, Lindsay M; Collins, Jason M; Siegel, Michael B; Fetterman, Jessica L; Hamburg, Naomi M; Bhatnagar, Aruni; Benjamin, Emelia J; Stokes, Andrew

2018-03-24

The role of electronic cigarettes (e-cigarettes) in product transitions has been debated. We used nationally representative data from the Population Assessment of Tobacco and Health Study waves 1 (2013-2014) and 2 (2014-2015) to investigate the associations between e-cigarette initiation and cigarette cessation/reduction in the USA. We limited the sample to current cigarette smokers aged 25+ years who were not current e-cigarette users at wave 1. We modelled 30-day cigarette cessation and substantial reduction in cigarette consumption as a function of e-cigarette initiation between surveys using multivariable logistic regression. Between waves 1 and 2, 6.9% of cigarette smokers who were not current e-cigarette users transitioned to former smokers. After adjusting for covariates, cigarette smokers who initiated e-cigarette use between waves and reported they used e-cigarettes daily at wave 2 had 7.88 (95% CI 4.45 to 13.95) times the odds of 30-day cigarette cessation compared with non-users of e-cigarettes at wave 2. Cigarette smokers who began using e-cigarettes every day and did not achieve cessation had 5.70 (95% CI 3.47 to 9.35) times the odds of reducing their average daily cigarette use by at least 50% between waves 1 and 2 compared with e-cigarette non-users. Daily e-cigarette initiators were more likely to have quit smoking cigarettes or reduced use compared with non-users. However, less frequent e-cigarette use was not associated with cigarette cessation/reduction. These results suggest incorporating frequency of e-cigarette use is important for developing a more thorough understanding of the association between e-cigarette use and cigarette cessation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Smoking Status and Incidence of Cancer After Myocardial Infarction: A Follow-Up Study of over 20 Years.

PubMed

Lotan, Katrin; Goldbourt, Uri; Gerber, Yariv

2017-09-01

We evaluated long-term incidence of cancer after myocardial infarction among current, former, and never smokers, and assessed whether reducing cigarette consumption is associated with decreased cancer risk. Consecutive patients aged ≤65 years discharged from 8 hospitals in central Israel after first myocardial infarction in 1992-1993 were followed for cancer and death. Extensive data including smoking habits were obtained at the index hospitalization and 4 time points during follow-up. Survival methods were applied to assess the hazard ratios (HRs) for cancer associated with smoking categories. Included in the study were 1486 cancer-free participants (mean age, 54 years; 81% men), among whom 787 were current smokers at baseline (average daily cigarette consumption = 29). Smokers were younger than nonsmokers and more likely to be male and of lower socioeconomic status. Over a median follow-up of 21.4 years, 273 (18.4%) patients developed cancer. Baseline smoking was associated with a ∼40% excess adjusted risk of cancer; ∼25% after accounting for death as a competing event. Considering changes in smoking during follow-up, the excess risk was confined to persistent smokers (adjusted HR 1.75; 95% confidence interval [CI], 1.22-2.50), whereas post- (HR 1.14; 95% CI, 0.80-1.62) and pre-myocardial infarction quitters (HR 1.02; 95% CI, 0.71-1.47) were comparable with never smokers. Among persistent smokers, each reduction of 10 cigarettes relative to pre-myocardial infarction consumption was associated with a ∼10% reduced adjusted risk. Among young survivors of first myocardial infarction followed-up longitudinally, smoking cessation is associated with lower risk of cancer. Reducing consumption among smokers may also be beneficial. Copyright © 2017 Elsevier Inc. All rights reserved.

Do cigarette taxes affect children's body mass index? The effect of household environment on health.

PubMed

Mellor, Jennifer M

2011-04-01

Several recent studies demonstrate a positive effect of cigarette prices and taxes on obesity among adults, especially those who smoke. If higher cigarette costs affect smokers' weights by increasing calories consumed or increasing food expenditures, then cigarette taxes and prices may also affect obesity in children of smokers. This study examines the link between child body mass index (BMI) and obesity status and cigarette costs using data from the National Longitudinal Survey of Youth-79 (NLSY79). Controlling for various child, mother, and household characteristics as well as child-fixed effects, I find that cigarette taxes and prices increase BMI in the children of smoking mothers. Interestingly, and unlike previous research findings for adults, higher cigarette taxes do not increase the likelihood of obesity in children. These findings are consistent with a causal mechanism in which higher cigarette costs reduce smoking and increase food expenditures and consumption in the household. Copyright © 2010 John Wiley & Sons, Ltd.

Case studies in international tobacco surveillance: cigarette smuggling in Brazil.

PubMed

Shafey, O; Cokkinides, V; Cavalcante, T M; Teixeira, M; Vianna, C; Thun, M

2002-09-01

This article is the first in a series of international case studies developed by the American Cancer Society to illustrate use of publicly available surveillance data for regional tobacco control. A descriptive analysis of Brazil and Paraguay cigarette production and trade data from official sources. Per capita cigarette consumption for Brazil and its neighbour was calculated from 1970 to 1998 using data on production, imports, and exports from NATIONS, the National Tobacco Information Online System. A 63% decrease was observed in the estimate of per capita consumption of cigarettes in Brazil between 1986 and 1998 (from 1913 cigarettes per person in 1986 to 714 cigarettes per person in 1998) and a 16-fold increase in Paraguay was observed during the same period (from 678 cigarettes per person in 1986 to 10 929 cigarettes per person in 1998). Following Brazil's 1999 passage of a 150% cigarette export tax, cigarette exports fell 89% and Brazil's estimated per capita consumption rose to 1990 levels (based on preliminary data). Per capita consumption in Paraguay also fell to 1990 levels. These trends coincide with local evidence that large volumes of cigarettes manufactured in Brazil for export to Paraguay are smuggled back and consumed as tax-free contraband in Brazil. It is hoped that this case study will draw wider public attention to the problems that smuggling presents for tobacco control, help identify other countries confronting similar issues, and stimulate effective interventions.

[Smoking fewer cigarettes per day may determine a significant risk reduction in developing smoking attributable diseases? Is there a risk reduction for e-cigarette users?].

PubMed

Pieri, Luca; Chellini, Elisabetta; Gorini, Giuseppe

2014-01-01

Among Italian smokers--about 10 millions in 2013--about 600,000 began using electronic cigarettes (e-cigs) in last years. About 10% of e-cig users quitted smoking tobacco, whereas the 90% was dual users. Among them, about three out of four decreased the number of cigarettes smoked per day (cig/day), but did not quit. How many fewer cigarettes a smoker has to smoke to obtain significant health benefits? Is there a threshold? In order to observe a significant 27% reduction in the risk of developing lung cancer, a smoker must reduce the number of cig/day by at least 50%, while for the other smoking-related diseases (acute myocardial infarction - AMI, stroke, chronic obstructive pulmonary diseases), halving the number of cig/day did not drive to a significant risk reduction. Even smoking 5 cig/day increases the risk of AMI, whereas it significantly lowers the risk of lung cancer. Obviously, quitting smoking is the best choice to highly reduce risks for all smoking-related diseases. Therefore, in order to achieve significant risk reductions, e-cig users should quit smoking as first choice, or, if they feel it is impossible to them, reduce the consumption of traditional cigarettes to less than 5 cig/day.

The influence of estimated retail tobacco sale price increase on smokers' smoking habit in Jiangxi province, China: a cross-sectional study.

PubMed

Wang, Ruiping; Zhu, Liping; Yan, Wei; Zeng, Guang; Michael, Engelgau

2015-01-01

China is the biggest tobacco producer and consumer in the world. Raising cigarette taxes and increasing tobacco retail prices have been prove as effective strategies to reduce tobacco consumption and the prevalence of smoking in western countries. But in China, it is uncertain how an increase of cigarette retail price will influence the tobacco consumption. From April to July, 2012, we selected 4025 residents over 15 years by a three stage random sampling in four cities, Jiangxi Province, China. We conducted interviews of their current smoking habits and how they would change their smoking behavior if tobacco retail prices increase. Overall, the prevalence of smoking is 27 % (47 % for male, 3.1 % for female). 15 % of smokers have tried to quit smoking in the past but all relapsed (168/1088), and over 50 % of current smokers do not want to quit, The average cigarette price per pack is 1.1 USD (range = 0.25-5.0). If retail cigarette prices increases by 50 %, 45 % of smokers say they will smoke fewer cigarettes, 20 % will change to cheaper brands and 5 % will attempt to quit smoking. Smokers who have intention to quit smoking are more sensitive to retail cigarette price increase. With retail cigarette price increases, more smokers will attempt to quit smoking. Chinese smokers will change their smoking habits if tobacco retail prices increase. Consequently the Chinese government should enact tobacco laws which increase the retail cigarette price. The implementation of new tobacco laws could result in lowering the prevalence of smoking. Meanwhile, price increase measures need to apply to all cigarette brands to avoid smokers switching cigarettes to cheaper brands.

Effectiveness of tobacco control television advertisements with different types of emotional content on tobacco use in England, 2004-2010.

PubMed

Sims, M; Langley, T; Lewis, S; Richardson, S; Szatkowski, L; McNeill, A; Gilmore, A B

2016-01-01

To examine the effects of tobacco control television advertisements with positive and negative emotional content on adult smoking prevalence and cigarette consumption. Analysis of monthly cross-sectional surveys using generalised additive models. England. 60 000 adults aged 18 years or over living in England and interviewed in the Opinions and Lifestyle Survey from 2004 to 2010. Current smoking status, daily cigarette consumption, tobacco control gross rating points (GRPs-a measure of per capita advertising exposure), cigarette costliness, concurrent tobacco control policies, sociodemographic variables. After adjusting for cigarette costliness, other tobacco control policies and individual characteristics, we found that a 400-point increase in positive emotive GRPs was associated with 7% lower odds of smoking (odds ratio (OR) 0.93, 95% CI 0.87 to 0.98) 1 month later and a similar increase in negative emotive GRPs was significantly associated with 4% lower odds of smoking (OR 0.96, 95% CI 0.92 to 0.999) 2 months later. An increase in negative emotive GRPs from 0 to 400 was also associated with a significant 3.3% (95% CI 1.1 to 5.6) decrease in average cigarette consumption. There was no evidence that the association between positive emotive GRPs and the outcomes differed depending on the intensity of negative emotive GRPs (and vice versa). This is the first study to explore the effects of campaigns with different types of emotive content on adult smoking prevalence and consumption. It suggests that both types of campaign (positive and negative) are effective in reducing smoking prevalence, whereas consumption among smokers was only affected by campaigns evoking negative emotions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The impact of smoke-free workplaces on declining cigarette consumption in Australia and the United States.

PubMed Central

Chapman, S; Borland, R; Scollo, M; Brownson, R C; Dominello, A; Woodward, S

1999-01-01

OBJECTIVES: This study estimates the contribution of smoke-free workplaces to the recent national declines in cigarette consumption in Australia and the United States. METHODS: Nineteen studies of the impact of smoke-free workplaces on workday cigarette consumption were reviewed. The number and cost of cigarettes forgone were calculated and extrapolated to a scenario in which all indoor work areas were smoke-free. RESULTS: Of the 19 studies, 18 reported declines in daily smoking rates, and 17 reported declines in smoking prevalence. Smoke-free workplaces are currently responsible for an annual reduction of some 602 million cigarettes, or 1.8% of all cigarettes that might otherwise be consumed, in Australia, and an annual reduction of 9.7 billion cigarettes (2%) in the United States. Approximately 22.3% of the 2.7 billion decrease in cigarette consumption in Australia between 1988 and 1995 can be attributed to smoke-free workplaces, as can 12.7% of the 76.5 billion decrease in the United States between 1988 and 1994. CONCLUSIONS: If workplaces were universally smoke-free, the number of cigarettes forgone annually would increase to 1.14 billion (3.4%) in Australia and 20.9 billion (4.1%) in the United States. PMID:10394309

Cigarette Fires Involving Upholstered Furniture in Residences: The Role that Smokers, Smoker Behavior, and Fire Standard Compliant Cigarettes Play.

PubMed

Butry, David T; Thomas, Douglas S

2017-05-01

Residential structure fires pose a significant risk to life and property. A major source of these fires is the ignition of upholstered furniture by cigarettes. It has long been established that cigarettes and other lighted tobacco products could ignite upholstered furniture and were a leading cause of fire deaths in residences. In recent years, states have adopted fire standard compliant cigarettes ('FSC cigarettes') that are made with a wrapping paper that contains regularly spaced bands, which increases the likelihood of self-extinguishment. This paper measures the effectiveness of FSC cigarettes on the number of residential fires involving upholstered furniture, and the resulting fatalities, injuries, and extent of flame spread, while accounting for the under-reporting of fire incidents. In total, four models were estimated using fire department data from 2002 to 2011. The results provide evidence that FSC cigarettes, on average, reduced the number of residential fires by 45 %, reduced fatalities by 23 %, and extent of flame spread by 27 % in 2011. No effect on injuries was found. Within each state, effectiveness is moderated by the number of smokers and their consumption patterns. In general, FSC cigarettes are more effective in places with a large smoking population who engage in heavier smoking. There is a very limited effect on the lightest of smokers, suggesting behavioral differences between heavy and light smokers that influence fire risk.

The first decade of the Massachusetts Tobacco Control Program.

PubMed Central

Koh, Howard K.; Judge, Christine M.; Robbins, Harriet; Celebucki, Carolyn Cobb; Walker, Deborah K.; Connolly, Gregory N.

2005-01-01

This article provides a comprehensive overview of the first decade of the Massachusetts Tobacco Control Program (MTCP). Born after Massachusetts passed a 1992 ballot initiative raising cigarette excise taxes to fund the program, MTCP greatly reduced statewide cigarette consumption before being reduced to a skeletal state by funding cuts. The article describes the program's components and goals, details outcomes, presents a summary of policy accomplishments, and reviews the present status of MTCP in the current climate of national and state fiscal crises. The first decade of the MTCP offers many lessons learned for the future of tobacco control. PMID:16224981

The first decade of the Massachusetts Tobacco Control Program.

PubMed

Koh, Howard K; Judge, Christine M; Robbins, Harriet; Celebucki, Carolyn Cobb; Walker, Deborah K; Connolly, Gregory N

2005-01-01

This article provides a comprehensive overview of the first decade of the Massachusetts Tobacco Control Program (MTCP). Born after Massachusetts passed a 1992 ballot initiative raising cigarette excise taxes to fund the program, MTCP greatly reduced statewide cigarette consumption before being reduced to a skeletal state by funding cuts. The article describes the program's components and goals, details outcomes, presents a summary of policy accomplishments, and reviews the present status of MTCP in the current climate of national and state fiscal crises. The first decade of the MTCP offers many lessons learned for the future of tobacco control.

Does smoke cross the border? Cigarette tax avoidance in France.

PubMed

Ben Lakhdar, Christian; Vaillant, Nicolas Gérard; Wolff, François-Charles

2016-12-01

This paper examines the impact on cigarette sales of the successive increases in cigarette prices in France from 2002 to 2004. Since the price differential between France and neighboring countries increased over the period in question, cross-border purchases became more financially attractive for smokers living near borders. Results from difference-in-differences estimates indicate that the decrease in cigarette sales observed in French border departments was around 20 % higher from 2004 to 2007 compared to non-border departments. The loss of fiscal revenue due to cross-border shopping since the tax increase amounts to 2 billion euros over the period 2002-2007. Our findings highlight the need for improved coordination of policies aimed at reducing tobacco consumption across European Union countries.

Consumption of cigarettes and combustible tobacco--United States, 2000-2011.

PubMed

2012-08-03

Smoking cigarettes and other combustible tobacco products causes adverse health outcomes, particularly cancer and cardiovascular and pulmonary diseases. A priority of the U.S. Department of Health and Human Services is to develop innovative, rapid-response surveillance systems for assessing changes in tobacco use and related health outcomes. The two standard approaches for measuring smoking rates and behaviors are 1) surveying a representative sample of the public and asking questions about personal smoking behaviors and 2) estimating consumption based on tobacco excise tax data. Whereas CDC regularly publishes findings on national and state-specific smoking rates from public surveys, CDC has not reported consumption estimates. The U.S. Department of Agriculture (USDA), which previously provided such estimates, stopped reporting on consumption in 2007. To estimate consumption for the period 2000-2011, CDC examined excise tax data from the U.S. Department of Treasury's Alcohol and Tobacco Tax and Trade Bureau (TTB); consumption estimates were calculated for cigarettes, roll-your-own tobacco, pipe tobacco, and small and large cigars. From 2000 to 2011, total consumption of all combustible tobacco decreased from 450.7 billion cigarette equivalents to 326.6, a 27.5% decrease; per capita consumption of all combustible tobacco products declined from 2,148 to 1,374, a 36.0% decrease. However, while consumption of cigarettes decreased 32.8% from 2000 to 2011, consumption of loose tobacco and cigars increased 123.1% over the same period. As a result, the percentage of total combustible tobacco consumption composed of loose tobacco and cigars increased from 3.4% in 2000 to 10.4% in 2011. The data suggest that certain smokers have switched from cigarettes to other combustible tobacco products, most notably since a 2009 increase in the federal tobacco excise tax that created tax disparities between product types.

[The Impact of Prices and Taxes on the Use of Tobacco Products in Latin America and the Caribbean].

PubMed

Guindon, G Emmanuel; Paraje, Guillermo R; Chaloupka, Frank J

2016-10-01

We examined the impact of tobacco prices or taxes on tobacco use in Latin America and Caribbean countries. We searched MEDLINE, EconLit, LILACS, unpublished literature, 6 specialty journals, and reviewed references. We calculated pooled price elasticities using random-effects models. The 32 studies we examined found that cigarette prices have a negative and statistically significant effect on cigarette consumption. A change in price is associated with a less than proportional change in the quantity of cigarettes demanded. In most Latin American countries, own-price elasticity for cigarettes is likely below -0.5 (pooled elasticities, shortrun: -0.31; 95% confidence interval = -0.39, -0.24; longrun: -0.43; 95% CI = -0.51, -0.35). Tax increases effectively reduce cigarette use. Lack of studies using household- or individual-level data limits research's policy relevance.

From promotion to cessation: masculinity, race, and style in the consumption of cigarettes, 1962-1972.

PubMed

White, Cameron; Oliffe, John L; Bottorff, Joan L

2013-04-01

In the United States, analysis of survey data provided by projects such as the National Health Interview Survey and the Youth Tobacco Survey has revealed the extent to which cigarette consumption patterns are influenced by gender and race. Taking our lead from a broader field of research that analyzed the sociological characteristics of cigarette consumption, we analyzed these intersections between race and gender through a study of masculinity and style in Marlboro and Kool cigarette advertisements during the 1960s and 1970s. We focused on this period because it was then that the racial bifurcation of cigarette consumption practices first became apparent. We suggest that style provides both a theoretical framework and methodology for understanding how and why White American and African American male consumers learned to consume in different ways. We also argue that the analysis of tobacco consumption in terms of masculinity and style provides a useful method for approaching the design of antismoking interventions.

From Promotion to Cessation: Masculinity, Race, and Style in the Consumption of Cigarettes, 1962–1972

PubMed Central

Oliffe, John L.; Bottorff, Joan L.

2013-01-01

In the United States, analysis of survey data provided by projects such as the National Health Interview Survey and the Youth Tobacco Survey has revealed the extent to which cigarette consumption patterns are influenced by gender and race. Taking our lead from a broader field of research that analyzed the sociological characteristics of cigarette consumption, we analyzed these intersections between race and gender through a study of masculinity and style in Marlboro and Kool cigarette advertisements during the 1960s and 1970s. We focused on this period because it was then that the racial bifurcation of cigarette consumption practices first became apparent. We suggest that style provides both a theoretical framework and methodology for understanding how and why White American and African American male consumers learned to consume in different ways. We also argue that the analysis of tobacco consumption in terms of masculinity and style provides a useful method for approaching the design of antismoking interventions. PMID:23409887

Case studies in international tobacco surveillance: cigarette smuggling in Brazil

PubMed Central

Shafey, O; Cokkinides, V; Cavalcante, T; Teixeira, M; Vianna, C; Thun, M

2002-01-01

Objective: This article is the first in a series of international case studies developed by the American Cancer Society to illustrate use of publicly available surveillance data for regional tobacco control. Design: A descriptive analysis of Brazil and Paraguay cigarette production and trade data from official sources. Methods: Per capita cigarette consumption for Brazil and its neighbour was calculated from 1970 to 1998 using data on production, imports, and exports from NATIONS, the National Tobacco Information Online System. Results: A 63% decrease was observed in the estimate of per capita consumption of cigarettes in Brazil between 1986 and 1998 (from 1913 cigarettes per person in 1986 to 714 cigarettes per person in 1998) and a 16-fold increase in Paraguay was observed during the same period (from 678 cigarettes per person in 1986 to 10 929 cigarettes per person in 1998). Following Brazil's 1999 passage of a 150% cigarette export tax, cigarette exports fell 89% and Brazil's estimated per capita consumption rose to 1990 levels (based on preliminary data). Per capita consumption in Paraguay also fell to 1990 levels. Conclusions: These trends coincide with local evidence that large volumes of cigarettes manufactured in Brazil for export to Paraguay are smuggled back and consumed as tax-free contraband in Brazil. It is hoped that this case study will draw wider public attention to the problems that smuggling presents for tobacco control, help identify other countries confronting similar issues, and stimulate effective interventions. PMID:12198271

Think abstractly, smoke less: a brief construal-level intervention can promote self-control, leading to reduced cigarette consumption among current smokers.

PubMed

Chiou, Wen-Bin; Wu, Wen-Hsiung; Chang, Ming-Hsu

2013-05-01

Inadequate self-control has been linked to behavioural and impulse-control problems such as overeating, alcohol and drug abuse and smoking. Construal-level theory (CLT) suggests that a high-level construal (highlighting central goals associated with an event), relative to a low-level construal (highlighting means and resources), promotes self-control. Inspired by CLT, we examined whether smokers primed with a high-level (versus low-level) construal mind-set would show reductions in smoking that might be mediated by improved self-control. A single-factor (construal level: high, low, control) between-subjects design was employed. We used a widely employed why/how paradigm to induce high/low construal levels, whereby participants were asked to respond to questions about 'why' or 'how' they would maintain good physical health. Laboratory at Kaohsiung Medical University, Taiwan. A community sample consisting of 102 daily smokers participated in this experiment. The Stroop task measuring self-control was implemented after the construal-level manipulation. The dependent measure was actual cigarette consumption during an ostensible survey. Participants in a high-level construal mind-set smoked fewer cigarettes [mean = 1.3, 95% confidence interval (CI): 0.9, 1.7] than those in a low-level construal mind-set (mean = 2.6, 95% CI: 2.2, 3.0; P < 0.01). A bootstrapping analysis supported for the role of self-control (B = -1.14, 95% CI: -1.65, -0.74, P < 0.01) as a mechanism underlying this effect. Smokers primed with a high-level construal mind-set (i.e. cognitive abstraction) may induce greater self-control that leads to reduced cigarette consumption. Thus, reminding smokers to think abstractly about health may be an effective strategy that could help them to smoke fewer cigarettes. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Cigarette prices and smoking prevalence after a tobacco tax increase--Turkey, 2008 and 2012.

PubMed

Kostova, Deliana; Andes, Linda; Erguder, Toker; Yurekli, Ayda; Keskinkılıç, Bekir; Polat, Sertaç; Culha, Gönül; Kilinç, Evin Aras; Taştı, Enver; Erşahin, Yılmaz; Ozmen, Mehmet; San, Ramazan; Ozcebe, Hilal; Bilir, Nazmi; Asma, Samira

2014-05-30

Raising the price of tobacco products has been shown to reduce tobacco consumption in the United States and other high-income countries, and evidence of this impact has been growing for low- and middle-income countries as well. Turkey is a middle-income country surveyed by the Global Adult Tobacco Survey (GATS) twice in a 4-year period, in 2008 and 2012. During this time, the country introduced a policy raising its Special Consumption Tax on Tobacco and implemented a comprehensive tobacco control program banning smoking in public places, banning advertising, and introducing graphic health warnings. The higher tobacco tax took effect in early 2010, allowing sufficient time for subsequent changes in prices and smoking to be observed by the time of the 2012 GATS. This report uses data from GATS Turkey to examine how cigarette prices changed after the 2010 tax increase, describe the temporally associated changes in smoking prevalence, and learn whether this smoking prevalence changed more in some demographic groups than others. From 2008 to 2012, the average price paid for cigarettes increased by 42.1%, cigarettes became less affordable, and smoking prevalence decreased by 14.6%. The largest reduction in smoking was observed among persons with lower socioeconomic status (SES), highlighting the potential role of tax policy in reducing health disparities across socioeconomic groups.

Extreme testing of undiluted e-cigarette aerosol in vitro using an Ames air-agar-interface technique.

PubMed

Thorne, D; Hollings, M; Seymour, A; Adamson, J; Dalrymple, A; Ballantyne, M; Gaca, M

2018-04-01

There is a growing consensus that e-cigarettes hold the potential for reducing the harm associated with cigarette smoking. Recently published studies have reported in vitro testing of e-cigarettes, demonstrating reduced toxicological and biological effects. Few studies however have reported the use of e-cigarettes under extreme testing conditions. To assess the full mutagenic potential of a commercially available electronic-cigarette (Vype ePen), this study investigated the delivery of aerosol under extreme conditions, using a scaled-down 35 mm plate Ames bacterial reverse mutagenicity assay. S. typhimurium strains TA98, TA100, TA97, TA104 and E. coli WP2 uvrA pKM101 with or without metabolic activation (S9), were employed. Using a modified Vitrocell VC 10 exposure system 0, 180, 360, 540, 720 or 900 puffs of undiluted e-cigarette aerosol was generated and delivered to bacterial cultures aligned to reported human consumption data. The results demonstrate that no mutagenic activity was observed in any strain under any test condition even when exposed to 900 puffs of undiluted e-cigarette aerosols +/- S9. Positive control responses were observed in all strains +/- S9. Nicotine assessments demonstrated an increased and consistent aerosol delivery, with calculated maximum doses of ∼1 mg/mL delivery of nicotine. These data demonstrate the validity of this unique testing approach and adds further information to the growing weight of evidence that e-cigarettes offer substantially reduced exposure when compared to conventional cigarette smoke. For future in vitro assessments of next generation tobacco and nicotine products, the generation, delivery and testing of undiluted aerosols can now be considered. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Dose Response and Prediction Characteristics of a Methylation Sensitive Digital PCR Assay for Cigarette Consumption in Adults.

PubMed

Philibert, Robert; Dogan, Meesha; Noel, Amanda; Miller, Shelly; Krukow, Brianna; Papworth, Emma; Cowley, Joseph; Long, Jeffrey D; Beach, Steven R H; Black, Donald W

2018-01-01

The tobacco use disorders are the largest preventable cause of morbidity and mortality in the world. A substantial barrier to the development of better intervention and screening measures is the lack of clinically employable biomarkers to detect the existence and extent of tobacco consumption. In prior work, we and others have shown that array based assessment of DNA methylation status at cg05575921 is a sensitive and quantitative method for assessing cigarette consumption. Unfortunately, in general, arrays are not practical clinical tools. Herein, we detail the prediction performance metrics and dose dependency of a clinically implementable droplet digital PCR (ddPCR) assay for cigarette consumption in adults. First, we demonstrate that measurements of cg05575921 as determined by Illumina array and ddPCR are highly correlated ( R 2 = 0.98, n = 92). Second, using clinical data and biomaterial from 177 subjects ranging from 18 to 78 years of age, we show that the Receiver Operating Characteristic (ROC) area under the curve (AUC) for classifying smoking status using methylation status at cg05575921 is 0.99. Finally, we conduct modeling analyses of cigarette consumption over discrete time periods to show that methylation status is best correlated with mean cigarette consumption over the past year ( R 2 = 0.5) and that demethylation at cg05575921 is dose dependent with a demethylation (delta beta) of 1% being equivalent to 1.2 cigarettes per day. But we do not find a relationship between Fagerstrom score and DNA methylation. We conclude that ddPCR assessment of cg05575921 methylation is an accurate method for assessing the presence and extent of cigarette consumption in adult subjects. We suggest that skillful clinical implementation of this approach alone or in combination with other assessment methods could lead to substantial reduction of cigarette consumption related morbidity and mortality.

Dose Response and Prediction Characteristics of a Methylation Sensitive Digital PCR Assay for Cigarette Consumption in Adults

PubMed Central

Philibert, Robert; Dogan, Meesha; Noel, Amanda; Miller, Shelly; Krukow, Brianna; Papworth, Emma; Cowley, Joseph; Long, Jeffrey D.; Beach, Steven R. H.; Black, Donald W.

2018-01-01

The tobacco use disorders are the largest preventable cause of morbidity and mortality in the world. A substantial barrier to the development of better intervention and screening measures is the lack of clinically employable biomarkers to detect the existence and extent of tobacco consumption. In prior work, we and others have shown that array based assessment of DNA methylation status at cg05575921 is a sensitive and quantitative method for assessing cigarette consumption. Unfortunately, in general, arrays are not practical clinical tools. Herein, we detail the prediction performance metrics and dose dependency of a clinically implementable droplet digital PCR (ddPCR) assay for cigarette consumption in adults. First, we demonstrate that measurements of cg05575921 as determined by Illumina array and ddPCR are highly correlated (R2 = 0.98, n = 92). Second, using clinical data and biomaterial from 177 subjects ranging from 18 to 78 years of age, we show that the Receiver Operating Characteristic (ROC) area under the curve (AUC) for classifying smoking status using methylation status at cg05575921 is 0.99. Finally, we conduct modeling analyses of cigarette consumption over discrete time periods to show that methylation status is best correlated with mean cigarette consumption over the past year (R2 = 0.5) and that demethylation at cg05575921 is dose dependent with a demethylation (delta beta) of 1% being equivalent to 1.2 cigarettes per day. But we do not find a relationship between Fagerstrom score and DNA methylation. We conclude that ddPCR assessment of cg05575921 methylation is an accurate method for assessing the presence and extent of cigarette consumption in adult subjects. We suggest that skillful clinical implementation of this approach alone or in combination with other assessment methods could lead to substantial reduction of cigarette consumption related morbidity and mortality. PMID:29740475

Firm strategy and consumer behaviour under a complex tobacco tax system: implications for the effectiveness of taxation on tobacco control.

PubMed

Atuk, Oğuz; Özmen, M Utku

2017-05-01

The current tobacco taxation scheme in Turkey, a mix of high ad valorem tax and low specific tax, contains incentives for firms and consumers to change pricing and consumption patterns, respectively. The association between tax structure and price and tax revenue stability has not been studied in detail with micro data containing price segment information. In this study, we analyse whether incentives for firms and consumers undermine the effectiveness of tax policy in reducing consumption. We calculate alternative taxation scheme outcomes using differing ad valorem and specific tax rates through simulation analysis. We also estimate price elasticity of demand using detailed price and volume statistics between segments via regression analysis. A very high ad valorem rate provides strong incentives to firms to reduce prices. Therefore, this sort of tax strategy may induce even more consumption despite its initial aim of discouraging consumption. While higher prices dramatically reduce consumption of economy and medium price segment cigarettes, demand for premium segment cigarettes is found to be highly price-inelastic. The current tax scheme, based on both ad valorem and specific components, introduces various incentives to firms as well as to consumers which reduce the effectiveness of the tax policy. Therefore, on the basis of our theoretical predictions, an appropriate tax scheme should involve a balanced combination of ad valorem and specific rates, away from extreme ( ad valorem or specific dominant) cases to enhance the effectiveness of tax policy for curbing 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/.

Hurricane Katrina: Addictive Behavior Trends and Predictors

PubMed Central

Beaudoin, Christopher E.

2011-01-01

Objective Post-disaster trends in alcohol consumption and cigarette smoking, as well as their predictors, were identified. Methods Data from cross-sectional and panel surveys of African American adults in New Orleans, Louisiana, were used from before (2004: n=1,867; 2005: n=879) and after (2006a: n=500; 2006b: n=500) Hurricane Katrina. Results Alcohol consumption increased significantly from pre- to post-Hurricane Katrina, while cigarette smoking remained constant. In 2006, posttraumatic stress disorder (PTSD) was associated with cigarette smoking, whereas “news attention” and “provided social support” were inversely associated with cigarette smoking. “News attention” was also inversely associated with cigarette smoking frequency, while “neighborliness” was associated with alcohol consumption. In addition, the effects of PTSD on alcohol consumption were moderated by “neighborliness.” Conclusions In the wake of Hurricane Katrina, there were complex predictive processes of addictive behaviors involving PTSD, news information, and social capital-related measures. PMID:21553669

Hurricane Katrina: addictive behavior trends and predictors.

PubMed

Beaudoin, Christopher E

2011-01-01

Post-disaster trends in alcohol consumption and cigarette smoking, as well as their predictors, were identified. Methods. Data from cross-sectional and panel surveys of African American adults in New Orleans, Louisiana, were used from before (2004: n = 1,867; 2005: n = 879) and after (2006a: n = 500; 2006b: n = 500) Hurricane Katrina. Alcohol consumption increased significantly from pre- to post-Hurricane Katrina, while cigarette smoking remained constant. In 2006, posttraumatic stress disorder (PTSD) was associated with cigarette smoking, whereas "news attention" and "provided social support" were inversely associated with cigarette smoking. "News attention" was also inversely associated with cigarette smoking frequency, while "neighborliness" was associated with alcohol consumption. In addition, the effects of PTSD on alcohol consumption were moderated by "neighborliness." In the wake of Hurricane Katrina, there were complex predictive processes of addictive behaviors involving PTSD, news information, and social capital-related measures.

Tax Avoidance and Evasion: Cigarette Purchases From Indian Reservations Among US Adult Smokers, 2010-2011

PubMed Central

Xu, Xin; Tynan, Michael A.; Gerzoff, Robert B.; Caraballo, Ralph S.; Promoff, Gabbi R.

2017-01-01

Excise taxes are the primary public health strategy used to increase the price of cigarettes in the United States. Rather than quitting or reducing consumption of cigarettes, some price-sensitive smokers may avoid state and local excise taxes by purchasing cigarettes from Indian reservations. The objectives of this study were to (1) provide the most recent state-specific prevalence of purchases made on Indian reservations by non–American Indians/Alaska Natives (non-AI/ANs) and (2) assess the impact of these purchases on state tax revenues. We used data from a large national and state-representative survey, the 2010-2011 Tobacco Use Supplement to the Current Population Survey, which collects self-reported measures on cigarette use and purchases. Nationwide, 3.8% of non-AI/AN smokers reported purchasing cigarettes from Indian reservations. However, in Arizona, Nevada, New Mexico, New York, Oklahoma, and Washington State, about 15% to 30% of smokers reported making such purchases, resulting in annual tax revenue losses ranging from $3.5 million (Washington State) to $292 million (New York) during 2010-2011. Strategies to reduce the sale of non- or lower-taxed cigarettes to non-AI/ANs on Indian reservations have the potential to decrease smoking prevalence and recoup lost revenue from purchases made on reservations. PMID:28395142

Tax Avoidance and Evasion: Cigarette Purchases From Indian Reservations Among US Adult Smokers, 2010-2011.

PubMed

Wang, Xu; Xu, Xin; Tynan, Michael A; Gerzoff, Robert B; Caraballo, Ralph S; Promoff, Gabbi R

Excise taxes are the primary public health strategy used to increase the price of cigarettes in the United States. Rather than quitting or reducing consumption of cigarettes, some price-sensitive smokers may avoid state and local excise taxes by purchasing cigarettes from Indian reservations. The objectives of this study were to (1) provide the most recent state-specific prevalence of purchases made on Indian reservations by non-American Indians/Alaska Natives (non-AI/ANs) and (2) assess the impact of these purchases on state tax revenues. We used data from a large national and state-representative survey, the 2010-2011 Tobacco Use Supplement to the Current Population Survey, which collects self-reported measures on cigarette use and purchases. Nationwide, 3.8% of non-AI/AN smokers reported purchasing cigarettes from Indian reservations. However, in Arizona, Nevada, New Mexico, New York, Oklahoma, and Washington State, about 15% to 30% of smokers reported making such purchases, resulting in annual tax revenue losses ranging from $3.5 million (Washington State) to $292 million (New York) during 2010-2011. Strategies to reduce the sale of non- or lower-taxed cigarettes to non-AI/ANs on Indian reservations have the potential to decrease smoking prevalence and recoup lost revenue from purchases made on reservations.

EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as tobacco cigarettes substitute: a prospective 12-month randomized control design study.

PubMed

Caponnetto, Pasquale; Campagna, Davide; Cibella, Fabio; Morjaria, Jaymin B; Caruso, Massimo; Russo, Cristina; Polosa, Riccardo

2013-01-01

Electronic cigarettes (e-cigarettes) are becoming increasingly popular with smokers worldwide. Users report buying them to help quit smoking, to reduce cigarette consumption, to relieve tobacco withdrawal symptoms, and to continue having a 'smoking' experience, but with reduced health risks. Research on e-cigarettes is urgently needed in order to ensure that the decisions of regulators, healthcare providers and consumers are based on science. Methods ECLAT is a prospective 12-month randomized, controlled trial that evaluates smoking reduction/abstinence in 300 smokers not intending to quit experimenting two different nicotine strengths of a popular e-cigarette model ('Categoria'; Arbi Group Srl, Italy) compared to its non-nicotine choice. GroupA (n = 100) received 7.2 mg nicotine cartridges for 12 weeks; GroupB (n = 100), a 6-week 7.2 mg nicotine cartridges followed by a further 6-week 5.4 mg nicotine cartridges; GroupC (n = 100) received no-nicotine cartridges for 12 weeks. The study consisted of nine visits during which cig/day use and exhaled carbon monoxide (eCO) levels were measured. Smoking reduction and abstinence rates were calculated. Adverse events and product preferences were also reviewed. Declines in cig/day use and eCO levels were observed at each study visits in all three study groups (p<0.001 vs baseline), with no consistent differences among study groups. Smoking reduction was documented in 22.3% and 10.3% at week-12 and week-52 respectively. Complete abstinence from tobacco smoking was documented in 10.7% and 8.7% at week-12 and week-52 respectively. A substantial decrease in adverse events from baseline was observed and withdrawal symptoms were infrequently reported during the study. Participants' perception and acceptance of the product under investigation was satisfactory. In smokers not intending to quit, the use of e-cigarettes, with or without nicotine, decreased cigarette consumption and elicited enduring tobacco abstinence without causing significant side effects. ClinicalTrials.gov NCT01164072 NCT01164072.

Density of tobacco retail outlets near schools and smoking behaviour among secondary school students.

PubMed

Scully, Maree; McCarthy, Molly; Zacher, Meghan; Warne, Charles; Wakefield, Melanie; White, Victoria

2013-12-01

To investigate whether the density of tobacco retail outlets near schools in Victoria, Australia, is associated with adolescent smoking behaviour. Cross-sectional survey data of 2,044 secondary school students aged 12-17 years was combined with tobacco outlet audit data. Associations between students' self-reported tobacco use and the density of tobacco outlets near schools was examined using multilevel logistic and negative binomial regression models, with cigarette price at local milk bars and key socio-demographic and school-related variables included as covariates. Increased tobacco retail outlet density was associated with a significant increase in the number of cigarettes smoked in the previous seven days among students who smoked in the past month (IRR=1.13; 95% CI 1.02-1.26), but not the odds of smoking in the past month in the larger sample (OR=1.06; 95% CI 0.90-1.24), after controlling for local mean price of cigarettes and socio-demographic and school-related variables. This study suggests there is a positive association between tobacco retail outlet density and cigarette consumption among adolescent smokers, but not smoking prevalence, in the Australian context. There is value in considering policy measures that restrict the supply of tobacco retail outlets in school neighbourhoods as a means of reducing youth cigarette consumption.

A RANDOMIZED CONTROLLED TRIAL OF PROGRESSIVELY REDUCED NICOTINE CONTENT CIGARETTES ON SMOKING BEHAVIORS, BIOMARKERS OF EXPOSURE, AND SUBJECTIVE RATINGS

PubMed Central

Mercincavage, Melissa; Souprountchouk, Valentina; Tang, Kathy Z.; Dumont, Rachel L.; Wileyto, E. Paul; Carmella, Steven G.; Hecht, Stephen S.; Strasser, Andrew A.

2016-01-01

Background The U.S. FDA has the authority to reduce cigarette nicotine content if found to benefit public health. Reduced nicotine content (RNC) cigarette use does not appear to increase harm exposure, but studies have not rigorously assessed smoking behavior or utilized a comprehensive panel of biomarkers. This study examined the effects of progressively decreasing RNC cigarettes on smoking behaviors, biomarkers of exposure, and subjective ratings. Methods 158 daily, non-treatment-seeking smokers participated in a 35-day randomized, unblinded, parallel study. After a 5-day baseline period, participants were randomly assigned to an experimental group (n = 80) that smoked progressively decreasing RNC cigarettes during three 10-day periods, or control group (n =78) that smoked their own brand throughout the study. Results Daily cigarette consumption significantly increased for the intermediate RNCs (P’s < 0.001) but approached baseline rate for the lowest RNC (P = 0.686); in contrast, puffing behavior significantly decreased at intermediate levels and increased for the lowest RNC (P’s < 0.001). Cotinine and NNAL significantly decreased by RNC period (P’s ≤ 0.001–0.02), while CO boost initially increased (P’s = 0.001–0.005). 1-HOP did not change by period (P = 0.109). Conclusions Smoking behaviors changed by RNC period via CPD and puffing behavior. Biomarkers of exposure generally decreased with nicotine content. Impact Findings suggest that RNC use does not ubiquitously reduce smoking behaviors or biomarkers, yet the lowest RNC level tested may reduce harm exposure. This emphasizes the importance of utilizing multiple behavioral and biological measures to address the impact of RNC cigarette smoking. PMID:27197288

Cigarette Fires Involving Upholstered Furniture in Residences: The Role that Smokers, Smoker Behavior, and Fire Standard Compliant Cigarettes Play

PubMed Central

Butry, David T.; Thomas, Douglas S.

2017-01-01

Residential structure fires pose a significant risk to life and property. A major source of these fires is the ignition of upholstered furniture by cigarettes. It has long been established that cigarettes and other lighted tobacco products could ignite upholstered furniture and were a leading cause of fire deaths in residences. In recent years, states have adopted fire standard compliant cigarettes (‘FSC cigarettes’) that are made with a wrapping paper that contains regularly spaced bands, which increases the likelihood of self-extinguishment. This paper measures the effectiveness of FSC cigarettes on the number of residential fires involving upholstered furniture, and the resulting fatalities, injuries, and extent of flame spread, while accounting for the under-reporting of fire incidents. In total, four models were estimated using fire department data from 2002 to 2011. The results provide evidence that FSC cigarettes, on average, reduced the number of residential fires by 45 %, reduced fatalities by 23 %, and extent of flame spread by 27 % in 2011. No effect on injuries was found. Within each state, effectiveness is moderated by the number of smokers and their consumption patterns. In general, FSC cigarettes are more effective in places with a large smoking population who engage in heavier smoking. There is a very limited effect on the lightest of smokers, suggesting behavioral differences between heavy and light smokers that influence fire risk. PMID:28751788

Cigarette tax avoidance and evasion.

PubMed

Stehr, Mark

2005-03-01

Variation in state cigarette taxes provides incentives for tax avoidance through smuggling, legal border crossing to low tax jurisdictions, or Internet purchasing. When taxes rise, tax paid sales of cigarettes will decline both because consumption will decrease and because tax avoidance will increase. The key innovation of this paper is to compare cigarette sales data to cigarette consumption data from the Behavioral Risk Factor Surveillance System (BRFSS). I show that after subtracting percent changes in consumption, residual percent changes in sales are associated with state cigarette tax changes implying the existence of tax avoidance. I estimate that the tax avoidance response to tax changes is at least twice the consumption response and that tax avoidance accounted for up to 9.6% of sales between 1985 and 2001. Because of the increase in tax avoidance, tax paid sales data understate the level of smoking and overstate the drop in smoking. I also find that the level of legal border crossing was very low relative to other forms of tax avoidance. If states have strong preferences for smoking control, they must pair high cigarette taxes with effective policies to curb smuggling and other forms of tax avoidance or employ alternative policies such as counter-advertising and smoking restrictions.

Does e-cigarette consumption cause passive vaping?

PubMed

Schripp, T; Markewitz, D; Uhde, E; Salthammer, T

2013-02-01

Electronic cigarette consumption ('vaping') is marketed as an alternative to conventional tobacco smoking. Technically, a mixture of chemicals containing carrier liquids, flavors, and optionally nicotine is vaporized and inhaled. The present study aims at the determination of the release of volatile organic compounds (VOC) and (ultra)fine particles (FP/UFP) from an e-cigarette under near-to-real-use conditions in an 8-m(3) emission test chamber. Furthermore, the inhaled mixture is analyzed in small chambers. An increase in FP/UFP and VOC could be determined after the use of the e-cigarette. Prominent components in the gas-phase are 1,2-propanediol, 1,2,3-propanetriol, diacetin, flavorings, and traces of nicotine. As a consequence, 'passive vaping' must be expected from the consumption of e-cigarettes. Furthermore, the inhaled aerosol undergoes changes in the human lung that is assumed to be attributed to deposition and evaporation. The consumption of e-cigarettes marks a new source for chemical and aerosol exposure in the indoor environment. To evaluate the impact of e-cigarettes on indoor air quality and to estimate the possible effect of passive vaping, information about the chemical characteristics of the released vapor is needed. © 2012 John Wiley & Sons A/S.

Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports.

PubMed

Hackshaw, Allan; Morris, Joan K; Boniface, Sadie; Tang, Jin-Ling; Milenković, Dušan

2018-01-24

To use the relation between cigarette consumption and cardiovascular disease to quantify the risk of coronary heart disease and stroke for light smoking (one to five cigarettes/day). Systematic review and meta-analysis. Medline 1946 to May 2015, with manual searches of references. Prospective cohort studies with at least 50 events, reporting hazard ratios or relative risks (both hereafter referred to as relative risk) compared with never smokers or age specific incidence in relation to risk of coronary heart disease or stroke. MOOSE guidelines were followed. For each study, the relative risk was estimated for smoking one, five, or 20 cigarettes per day by using regression modelling between risk and cigarette consumption. Relative risks were adjusted for at least age and often additional confounders. The main measure was the excess relative risk for smoking one cigarette per day (RR 1_per_day -1) expressed as a proportion of that for smoking 20 cigarettes per day (RR 20_per_day -1), expected to be about 5% assuming a linear relation between risk and consumption (as seen with lung cancer). The relative risks for one, five, and 20 cigarettes per day were also pooled across all studies in a random effects meta-analysis. Separate analyses were done for each combination of sex and disorder. The meta-analysis included 55 publications containing 141 cohort studies. Among men, the pooled relative risk for coronary heart disease was 1.48 for smoking one cigarette per day and 2.04 for 20 cigarettes per day, using all studies, but 1.74 and 2.27 among studies in which the relative risk had been adjusted for multiple confounders. Among women, the pooled relative risks were 1.57 and 2.84 for one and 20 cigarettes per day (or 2.19 and 3.95 using relative risks adjusted for multiple factors). Men who smoked one cigarette per day had 46% of the excess relative risk for smoking 20 cigarettes per day (53% using relative risks adjusted for multiple factors), and women had 31% of the excess risk (38% using relative risks adjusted for multiple factors). For stroke, the pooled relative risks for men were 1.25 and 1.64 for smoking one or 20 cigarettes per day (1.30 and 1.56 using relative risks adjusted for multiple factors). In women, the pooled relative risks were 1.31 and 2.16 for smoking one or 20 cigarettes per day (1.46 and 2.42 using relative risks adjusted for multiple factors). The excess risk for stroke associated with one cigarette per day (in relation to 20 cigarettes per day) was 41% for men and 34% for women (or 64% and 36% using relative risks adjusted for multiple factors). Relative risks were generally higher among women than men. Smoking only about one cigarette per day carries a risk of developing coronary heart disease and stroke much greater than expected: around half that for people who smoke 20 per day. No safe level of smoking exists for cardiovascular disease. Smokers should aim to quit instead of cutting down to significantly reduce their risk of these two common major disorders. 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.

Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports

PubMed Central

Morris, Joan K; Boniface, Sadie; Tang, Jin-Ling; Milenković, Dušan

2018-01-01

Abstract Objective To use the relation between cigarette consumption and cardiovascular disease to quantify the risk of coronary heart disease and stroke for light smoking (one to five cigarettes/day). Design Systematic review and meta-analysis. Data sources Medline 1946 to May 2015, with manual searches of references. Eligibility criteria for selecting studies Prospective cohort studies with at least 50 events, reporting hazard ratios or relative risks (both hereafter referred to as relative risk) compared with never smokers or age specific incidence in relation to risk of coronary heart disease or stroke. Data extraction/synthesis MOOSE guidelines were followed. For each study, the relative risk was estimated for smoking one, five, or 20 cigarettes per day by using regression modelling between risk and cigarette consumption. Relative risks were adjusted for at least age and often additional confounders. The main measure was the excess relative risk for smoking one cigarette per day (RR1_per_day−1) expressed as a proportion of that for smoking 20 cigarettes per day (RR20_per_day−1), expected to be about 5% assuming a linear relation between risk and consumption (as seen with lung cancer). The relative risks for one, five, and 20 cigarettes per day were also pooled across all studies in a random effects meta-analysis. Separate analyses were done for each combination of sex and disorder. Results The meta-analysis included 55 publications containing 141 cohort studies. Among men, the pooled relative risk for coronary heart disease was 1.48 for smoking one cigarette per day and 2.04 for 20 cigarettes per day, using all studies, but 1.74 and 2.27 among studies in which the relative risk had been adjusted for multiple confounders. Among women, the pooled relative risks were 1.57 and 2.84 for one and 20 cigarettes per day (or 2.19 and 3.95 using relative risks adjusted for multiple factors). Men who smoked one cigarette per day had 46% of the excess relative risk for smoking 20 cigarettes per day (53% using relative risks adjusted for multiple factors), and women had 31% of the excess risk (38% using relative risks adjusted for multiple factors). For stroke, the pooled relative risks for men were 1.25 and 1.64 for smoking one or 20 cigarettes per day (1.30 and 1.56 using relative risks adjusted for multiple factors). In women, the pooled relative risks were 1.31 and 2.16 for smoking one or 20 cigarettes per day (1.46 and 2.42 using relative risks adjusted for multiple factors). The excess risk for stroke associated with one cigarette per day (in relation to 20 cigarettes per day) was 41% for men and 34% for women (or 64% and 36% using relative risks adjusted for multiple factors). Relative risks were generally higher among women than men. Conclusions Smoking only about one cigarette per day carries a risk of developing coronary heart disease and stroke much greater than expected: around half that for people who smoke 20 per day. No safe level of smoking exists for cardiovascular disease. Smokers should aim to quit instead of cutting down to significantly reduce their risk of these two common major disorders. PMID:29367388

Exploring the impact of foreign direct investment on tobacco consumption in the former Soviet Union

PubMed Central

Gilmore, A; McKee, M

2005-01-01

Background: Tobacco is the single largest cause of morbidity and mortality in the developed world; in the former socialist bloc tobacco kills twice as many men as in the west. Although evidence shows that liberalisation of the cigarette trade through the elimination of import barriers leads to significant increases in consumption, far less is known about the impact of foreign direct investment on cigarette consumption. This paper seeks to explore the impact that the substantial transnational tobacco company investments have had on patterns of tobacco trade and consumption in the former Soviet Union. Design: Routine data were used to explore trends in cigarette trade and consumption in the 15 countries of the former Soviet Union from the 1960s to the present day. Comparisons were made between trends in countries that have received substantial investment from the tobacco transnationals and countries that have not. Results: Between 1991 and 2000 cigarette production increased by 96% in countries receiving industry investment and by 11% in countries that did not. Over the same period cigarette consumption increased by 40%; the increase was concentrated in countries receiving investments. Despite these investments, cigarette imports still outweigh exports and no trade surplus has yet to result. Conclusions: The findings suggest that liberalisation of inward investment has a significant and positive impact on cigarette consumption and that without appropriate safeguards, market liberalisation may have long term negative impacts on health. Specific trade rules are needed to govern trade and investment in this uniquely harmful product. Implementation of effective tobacco control policies should precede tobacco industry privatisation. International financial organisations pressing for privatisation should ensure this occurs. PMID:15735295

Exploring the impact of foreign direct investment on tobacco consumption in the former Soviet Union.

PubMed

Gilmore, A B; McKee, M

2005-02-01

Tobacco is the single largest cause of morbidity and mortality in the developed world; in the former socialist bloc tobacco kills twice as many men as in the west. Although evidence shows that liberalisation of the cigarette trade through the elimination of import barriers leads to significant increases in consumption, far less is known about the impact of foreign direct investment on cigarette consumption. This paper seeks to explore the impact that the substantial transnational tobacco company investments have had on patterns of tobacco trade and consumption in the former Soviet Union. Routine data were used to explore trends in cigarette trade and consumption in the 15 countries of the former Soviet Union from the 1960s to the present day. Comparisons were made between trends in countries that have received substantial investment from the tobacco transnationals and countries that have not. Between 1991 and 2000 cigarette production increased by 96% in countries receiving industry investment and by 11% in countries that did not. Over the same period cigarette consumption increased by 40%; the increase was concentrated in countries receiving investments. Despite these investments, cigarette imports still outweigh exports and no trade surplus has yet to result. The findings suggest that liberalisation of inward investment has a significant and positive impact on cigarette consumption and that without appropriate safeguards, market liberalisation may have long term negative impacts on health. Specific trade rules are needed to govern trade and investment in this uniquely harmful product. Implementation of effective tobacco control policies should precede tobacco industry privatisation. International financial organisations pressing for privatisation should ensure this occurs.

The Impact of Prices and Taxes on the Use of Tobacco Products in Latin America and the Caribbean

PubMed Central

Paraje, Guillermo R.; Chaloupka, Frank J.

2015-01-01

We examined the impact of tobacco prices or taxes on tobacco use in Latin America and Caribbean countries. We searched MEDLINE, EconLit, LILACS, unpublished literature, 6 specialty journals, and reviewed references. We calculated pooled price elasticities using random-effects models. The 32 studies we examined found that cigarette prices have a negative and statistically significant effect on cigarette consumption. A change in price is associated with a less than proportional change in the quantity of cigarettes demanded. In most Latin American countries, own-price elasticity for cigarettes is likely below  −0.5  (pooled elasticities, short-run: −0.31; 95% confidence interval = −0.39, −0.24; long-run: −0.43; 95% CI = −0.51, −0.35). Tax increases effectively reduce cigarette use. Lack of studies using household- or individual-level data limits research’s policy relevance. PMID:25602902

Nicotine Intake in Pregnant Smokers and a General Population of Smokers.

PubMed

Berlin, Ivan; Jacob, Nelly; Heishman, Stephen J

2018-01-01

The purpose of this study was to assess whether pregnant smokers have the same nicotine intake from cigarettes as a general population of smokers and whether the known lower daily cigarette consumption among pregnant smokers is associated with higher nicotine intake among pregnant smokers. The study was a cross-sectional comparison of pregnant smokers and a general population of smokers in smoking cessation clinics. Participants were treatment-seeking pregnant (n = 476), nonpregnant female (n = 116), and male (n = 195) smokers who participated in two independent smoking cessation trials. Nicotine intake was measured as saliva cotinine/ cigarette/kg body weight ratio. The mean saliva cotinine (μg/L)/ cigarette/kg body weight (0.21, SD = 0.15) of pregnant smokers was similar to that of nonpregnant female smokers (0.24, SD = 0.14) and higher than that of male smokers (0.18, SD = 0.12, p = .002) despite a substantially lower number of cigarettes per day (pregnant smokers: 12, SD = 6; nonpregnant female smokers: 26.6, SD = 11.7; male smokers: 23.5, SD = 9.5, p < .001). Among pregnant smokers, saliva cotinine, as expected, increased in parallel with the number of cigarettes per day, but nicotine intake (cotinine/cigarette/kg body weight) was inversely associated with daily cigarette consumption (p < .001). No association between cigarettes per day and nicotine intake was observed in male and nonpregnant female smokers (p = .43). This secondary analysis showed that pregnant smokers' nicotine intake was similar to that of a general population of smokers despite a lower cigarette consumption rate. Among pregnant smokers, lower daily cigarette consumption was associated with higher nicotine intake from cigarettes, suggesting compensatory smoking.

Effect of cigarette tax increase in combination with mass media campaign on smoking behaviour in Mauritius: findings from the ITC Mauritius Survey.

PubMed

Azagba, Sunday; Burhoo, Premduth; Chaloupka, Frank J; Fong, Geoffrey T

2015-07-01

Mauritius has made great strides in adopting evidence-based tobacco control measures, including an increase in its cigarette excise tax and antitobacco mass media (Sponge) campaign. The primary objective of this study is to examine the combined effect of these measures on smoking behaviour. This study used longitudinal data from the International Tobacco Control Mauritius Survey, 2009-2011. Waves 1 and 2 were conducted before the tax increase and wave 3 was conducted shortly after the Sponge campaign and 6 months after the cigarette excise tax increase. Generalised estimating equations were used to examine the effects of these two key tobacco control measures on smoking prevalence and the quantity of cigarettes smoked. The results showed that the combination of cigarette tax increase and the Sponge campaign had a significantly negative effect on the prevalence of smoking in Mauritius and the number of cigarettes smoked among continuing smokers. Specifically, the measures significantly reduced the odds of being a smoker (adjusted OR 0.88, 95% CI 0.81 to 0.97). For average daily cigarettes smoked, the measures had a significant reduction in cigarettes per day by about 6% (incidence rate ratios 0.94, 95% CI 0.89 to 0.99). The combination of policy measures significantly reduced the consumption of cigarettes in Mauritius. While these results are encouraging, these efforts must be part of a sustained effort to further reduce the smoking prevalence in Mauritius. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The effects of the anti-smoking campaign on cigarette consumption.

PubMed Central

Warner, K E

1977-01-01

The impact of the anti-smoking campaign on the consumption of cigarettes is measured by fitting cigarette demand functions to pre-campaign dat, projecting "ahead" as if the campaign had not occurred, and then comparing these predictions with realized consumption. The analysis suggests that major "events" in the campaign (e.g., the Surgeon General's Report) caused immediate though transitory decreases of 4 to 5 per cent in annual per capita consumption. However, the cumulative effect of persistent publicity supported by other public policies, has been substantial: in the absence of the campaign, per capita consumption likely would have exceeded its actual 1975 value by 20 to 30 per cent. This is a conservative indication of the effectiveness of the campaign, for it ignores other potentially important and desirable behavior changes, such as the shift to low "tar" and nicotine cigarettes. PMID:879393

21 CFR 101.73 - Health claims: dietary lipids and cancer.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., cigarette smoking, alcohol consumption, overweight and obesity, ultraviolet or ionizing radiation, exposure... history of a specific type of cancer, cigarette smoking, alcohol consumption, overweight and obesity...

21 CFR 101.73 - Health claims: dietary lipids and cancer.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., cigarette smoking, alcohol consumption, overweight and obesity, ultraviolet or ionizing radiation, exposure... history of a specific type of cancer, cigarette smoking, alcohol consumption, overweight and obesity...

21 CFR 101.73 - Health claims: dietary lipids and cancer.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., cigarette smoking, alcohol consumption, overweight and obesity, ultraviolet or ionizing radiation, exposure... history of a specific type of cancer, cigarette smoking, alcohol consumption, overweight and obesity...

21 CFR 101.73 - Health claims: dietary lipids and cancer.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., cigarette smoking, alcohol consumption, overweight and obesity, ultraviolet or ionizing radiation, exposure... history of a specific type of cancer, cigarette smoking, alcohol consumption, overweight and obesity...

21 CFR 101.73 - Health claims: dietary lipids and cancer.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., cigarette smoking, alcohol consumption, overweight and obesity, ultraviolet or ionizing radiation, exposure... history of a specific type of cancer, cigarette smoking, alcohol consumption, overweight and obesity...

Latent factor structure of a behavioral economic cigarette demand curve in adolescent smokers

PubMed Central

Bidwell, L. Cinnamon; MacKillop, James; Murphy, James G.; Tidey, Jennifer W.; Colby, Suzanne M.

2012-01-01

Behavioral economic demand curves, or quantitative representations of drug consumption across a range of prices, have been used to assess motivation for a variety of drugs. Such curves generate multiple measures of drug demand that are associated with cigarette consumption and nicotine dependence. However, little is known about the relationships among these facets of demand. The aim of the study was to quantify these relationships in adolescent smokers by using exploratory factor analysis to examine the underlying structure of the facets of nicotine incentive value generated from a demand curve measure. Participants were 138 adolescent smokers who completed a hypothetical cigarette purchase task, which assessed estimated cigarette consumption at escalating levels of price/cigarette. Demand curves and five facets of demand were generated from the measure: Elasticity (i.e., 1/α or proportionate price sensitivity); Intensity (i.e., consumption at zero price); Omax (i.e., maximum financial expenditure on cigarettes); Pmax (i.e., price at which expenditure is maximized); and Breakpoint (i.e., the price that suppresses consumption to zero). Principal components analysis was used to examine the latent structure among the variables. The results revealed a two-factor solution, which were interpreted as “Persistence,” reflecting insensitivity to escalating price, and “Amplitude,” reflecting the absolute levels of consumption and price. These findings suggest a two factor structure of nicotine incentive value as measured via a demand curve. If supported, these findings have implications for understanding the relationships among individual demand indices in future behavioral economic studies and may further contribute to understanding of the nature of cigarette reinforcement. PMID:22727784

Behavioral economic analysis of withdrawal- and cue-elicited craving for tobacco: an initial investigation.

PubMed

MacKillop, James; Brown, Courtney L; Stojek, Monika K; Murphy, Cara M; Sweet, Lawrence; Niaura, Ray S

2012-12-01

The role of craving in nicotine dependence remains controversial and may be a function of measurement challenges. The current study used behavioral economic approach to test the hypotheses that subjective craving from acute withdrawal and exposure to tobacco cues dynamically increases the relative value of cigarettes. Using a 2 (1-hr/12-hr deprivation) × 2 (neutral/tobacco cues) within-subjects design, 33 nicotine dependent adults completed 2 laboratory sessions. Assessment included subjective craving and behavioral economic indices of cigarette demand, namely Intensity (i.e., cigarette consumption at zero cost), O(max) (i.e., maximum total expenditure), Breakpoint (i.e., highest acceptable price for cigarettes), P(max) (i.e., price at which consumption becomes sensitive to price), and elasticity (i.e., price sensitivity). Behavioral economic indices were generated using a Cigarette Purchase Task in which participants selected between cigarettes for a subsequent 2-hr self-administration period and money. Main effects of deprivation and tobacco cues were present for subjective craving and multiple behavioral economic indices of cigarette demand. Interestingly, deprivation significantly increased Breakpoint (p ≤ .01) and P(max) (p ≤ .05) and had trend-level effects on Intensity and O(max) (p ≤ .10); whereas cues significantly reduced elasticity (p ≤ .01), reflecting lower sensitivity to increasing prices. Heterogeneous associations were evident among the motivational variables but with aggregations suggesting variably overlapping motivational channels. These findings further support a behavioral economic approach to craving and a multidimensional conception of acute motivation for addictive drugs. Methodological considerations, including potential order effects, and the need for further refinement of these findings are discussed.

Pictorial health warning labels on cigarette packages: an investigation on opinions of male smokers.

PubMed

Shojaezadeh, Davoud; Peyman, Nooshin; Shakeri, Mohammad Taghi; Nedjat, Saharnaz; Mohaddes Hakkak, Abbas; Taghdisi, Mohammad Hossein; Mohaddes Hakkak, Hamid Reza; Shariati, Keivan; Taghipour, Ali

2014-03-01

Health warning labels on cigarette packages are among the most straightforward and important tools to communicate with smokers and various studies have illustrated their efficacy. The current study aimed to investigate the opinions of male smokers in Mashhad city about the efficacy of health warning labels printed on cigarette packages on the smoking status of smokers. This cross-sectional descriptive study was conducted in 2013 using a questionnaire. The research population included the male smokers of Mashhad. The participants were selected from the customers referring to the newsstands for cigarettes. The obtained data were analyzed employing SPSS software Version 16, and the statistical tests including Kruskal-Wallis, Spearman, and correlation coefficient of Pearson, Chi Square, Mann-Whitney, and Bonferroni correction were used in this regard. In this research, there were 500 participants with the average age of 25 years. The initiation age of smoking was eight years while the maximum age was reported as 45 years. Results of this research about the effect of these labels on decreasing cigarette consumption rate showed that almost half of the participants believed that these labels were ineffective for them (52.2%) and other smokers (53.8%).Furthermore, significant relationship was found between the age and opinion of the smokers about the influence of these labels on reducing their cigarette consumption (P < 0.001). To promote the effect of printed images on cigarette packages, it is recommended to consider the suitability of labels in the targeted culture. In addition, to be more effective consultation sites to quit smoking should be introduced under the images.

The impact of taxation on tobacco consumption in Mexico.

PubMed

Jiménez-Ruiz, J A; Sáenz de Miera, B; Reynales-Shigematsu, L M; Waters, H R; Hernández-Avila, M

2008-04-01

The price of cigarettes to consumers in Mexico, and Latin America in general, remains low in comparison with other regions of the world. In Mexico, taxes represented 59% of the total price of cigarettes in 2006, compared to 75% or more in many high-income countries. The feasibility of raising taxes on cigarettes in Mexico--to both discourage consumption and increase revenues--is an important policy question. Using household survey data, we undertake a pooled cross-sectional analysis of the demand for cigarettes in Mexico. We use a two-part model to estimate the price elasticity of cigarettes. This model controls for the selection effect that arises from the fact that the impact of price on the decision to smoke or not is estimated using all households in the dataset. The results indicate that price is a significant factor in household decisions concerning smoking and the number of cigarettes smoked. Holding other factors constant, our simulations show that a 10% increase in the cigarette tax in Mexico--calculated as a percentage of the price--yields a 12.4% increase in the price to the consumer, a 6.4% decrease in consumption of cigarettes and a 15.7% increase in the revenue yielded by the tax. In Mexico, there are strong arguments for increasing cigarette taxes. Revenue raised could be used to further prevent tobacco consumption and to finance current funding shortages for the treatment of diseases related to smoking.

The 2005 British Columbia Smoking Cessation Mass Media Campaign and short-term changes in smoking.

PubMed

Gagné, Lynda

2007-01-01

The objective of this study was to evaluate the impact of the 2005 British Columbia Ministry of Health Smoking Cessation Mass Media Campaign on short-term smoking behavior. National cross-sectional data are used with a quasi-experimental approach to test the impact of the campaign. Findings indicate that prevalence and average number of cigarettes smoked per day deviated upward from trend for the rest of Canada (P = .08; P = .01) but not for British Columbia. They also indicate that British Columbia smokers in lower risk groups reduced their average daily consumption of cigarettes over and above the 1999-2004 trend (-2.23; P = .10), whereas smokers in the rest of Canada did not, and that British Columbia smokers in high-risk groups did not increase their average daily consumption of cigarettes over and above the 1999-2004 trend, whereas smokers in the rest of Canada did (2.97; P = .01). The overall poorer performance of high-risk groups is attributed to high exposure to cigarette smoking, which reduces a smoker's chances of successful cessation. In particular, high-risk groups are by definition more likely to be exposed to smoking by peers, but are also less likely to work in workplaces with smoking bans, which are shown to have a substantial impact on prevalence. Results suggest that for mass media campaigns to be more effective with high-risk groups, they need to be combined with other incentives, and that more prolonged interventions should be considered.

Taxation, smuggling and demand for cigarettes in Canada: evidence from time-series data.

PubMed

Galbraith, J W; Kaiserman, M

1997-06-01

This study analyzes Canadian cigarette consumption and taxation between 1980 and 1994, a period in which there have been large price rises and declines, and a dramatic increase in the consumption of contraband tobacco products. We examine elasticities of legal cigarette sales and total sales (including contraband) with respect to the price of legal cigarettes and various other factors. The growth of the contraband market since 1987 appears to have created two classes of cigarette--taxed and untaxed--with responses to changes in the legal price that are respectively higher, and lower, than was previously the case. The sensitivity of total cigarette sales to the taxation instrument is much lower than it would appear from sales of taxed cigarettes alone.

Are marketing campaigns in Taiwan by foreign tobacco companies targeting young smokers?

PubMed Central

Wen, C; Chen, T; Tsai, Y; Tsai, S; Chung, W; Cheng, T; Levy, D; Hsu, C; Peterson, R; Liu, W

2005-01-01

Objective: To assess the impact of promotions on cigarette sales in Taiwan after the cigarette market opened to foreign companies, and to assess whether young smokers were targeted by these companies. Methods: Trends in cigarette sales, advertising expenditure, brand preference, and cigarette consumption were examined for the period following the 1987 opening of the cigarette market. Tobacco industry internal documents from Legacy Tobacco Documents Library of the University of California, San Francisco, were searched for corporate strategies on promoting youth consumption in Taiwan. Results: Between 1995 and 2000, the inflation adjusted advertising expenditures by all foreign firms increased fourfold. Much of the expenditure was spent on brand stretching the Mild Seven (Japan) and Davidoff (Germany) brands in television advertising. By 2000, the market share of foreign cigarettes exceeded domestics by three to one among young smokers and the leading brand preferred by this segment shifted from the most popular domestic brand (Long Life) to a foreign brand (Mild Seven). Furthermore, there was a sudden increase of 16.4% in smoking rates among young adults (from 36.1% to 42.0%) during the first five years after the market opened. This was also accompanied by increased per capita cigarette consumption and decreased age of smoking initiation. Industry documents confirmed the use of strategies targeted at the young. In particular, establishing new point of sale (POS) retail stores or promotional activities at POS were found to be more effective than advertising in magazines. Conclusions: This study provides evidence that advertising increased with increased competition following the market opening, which, in turn, spurred cigarette sales and consumption. Foreign tobacco companies have deliberately targeted youth in Taiwan and succeeded in gaining three quarters of their cigarette purchases within a decade. Expanding youth consumption will incur excessive future health care costs borne by society. Foreign tobacco companies should be obligated to reimburse these expenses through higher tariffs on cigarettes. PMID:15923447

Are marketing campaigns in Taiwan by foreign tobacco companies targeting young smokers?

PubMed

Wen, C P; Chen, T; Tsai, Y-Y; Tsai, S P; Chung, W S I; Cheng, T Y; Levy, D T; Hsu, C C; Peterson, R; Liu, W-Y

2005-06-01

To assess the impact of promotions on cigarette sales in Taiwan after the cigarette market opened to foreign companies, and to assess whether young smokers were targeted by these companies. Trends in cigarette sales, advertising expenditure, brand preference, and cigarette consumption were examined for the period following the 1987 opening of the cigarette market. Tobacco industry internal documents from Legacy Tobacco Documents Library of the University of California, San Francisco, were searched for corporate strategies on promoting youth consumption in Taiwan. Between 1995 and 2000, the inflation adjusted advertising expenditures by all foreign firms increased fourfold. Much of the expenditure was spent on brand stretching the Mild Seven (Japan) and Davidoff (Germany) brands in television advertising. By 2000, the market share of foreign cigarettes exceeded domestics by three to one among young smokers and the leading brand preferred by this segment shifted from the most popular domestic brand (Long Life) to a foreign brand (Mild Seven). Furthermore, there was a sudden increase of 16.4% in smoking rates among young adults (from 36.1% to 42.0%) during the first five years after the market opened. This was also accompanied by increased per capita cigarette consumption and decreased age of smoking initiation. Industry documents confirmed the use of strategies targeted at the young. In particular, establishing new point of sale (POS) retail stores or promotional activities at POS were found to be more effective than advertising in magazines. This study provides evidence that advertising increased with increased competition following the market opening, which, in turn, spurred cigarette sales and consumption. Foreign tobacco companies have deliberately targeted youth in Taiwan and succeeded in gaining three quarters of their cigarette purchases within a decade. Expanding youth consumption will incur excessive future health care costs borne by society. Foreign tobacco companies should be obligated to reimburse these expenses through higher tariffs on cigarettes.

The consumption of cigarettes, coffee and sweets in detoxified alcoholics and its association with relapse and a family history of alcoholism.

PubMed

Junghanns, Klaus; Backhaus, Jutta; Tietz, Ulrike; Lange, Wolfgang; Rink, Lothar; Wetterling, Tilman; Driessen, Martin

2005-08-01

Thirty male alcohol dependent inpatients without concurrent depressive disorder, 13 of them with a positive family history of alcohol dependence in a first degree relative (PFH), were questioned about their desire and consumption habits with respect to cigarettes, coffee, and sweets while on a three-week inpatient treatment after detoxification from alcohol. Six weeks after discharge from hospital, the patients were reassessed for relapse. Eleven patients (36.6%) had relapsed at follow-up. Relapsers were younger than abstainers. The days until relapse correlated negatively with intensity of desire to drink alcohol, desire to smoke cigarettes, and with a higher consumption of cigarettes. PFH patients did not relapse earlier but they had a stronger desire to drink coffee and eat sweets and had a higher coffee consumption.

Graphic warning labels and the demand for cigarettes.

PubMed

Starr, Martha A; Drake, Keith

2017-03-01

In 2010, the US Food and Drug Administration (FDA) proposed requiring tobacco companies to add graphic warning labels (GWLs) to cigarette packs. GWLs are large prominently placed warnings that use both text and photographic images to depict health risks of smoking. The companies challenged FDA's authority on First Amendment grounds; the courts accepted that FDA could compel companies to add GWLs, but argued that FDA had not established that GWLs would significantly reduce smoking. This paper adds new evidence on the question of whether GWLs would have reduced cigarette demand, by examining whether tobacco companies' share prices fell unusually after news indicating a higher likelihood of having GWLs, and rose on the opposite news. Such findings would be expected if investors viewed GWLs as likely to reduce cigarette demand. An event-study approach is used to determine whether the stock prices of US tobacco companies rose or fell unusually after news events in the period when GWLs were proposed, finalised, challenged and withdrawn. Tobacco companies' stock prices indeed realised significant abnormal returns after GWL news, consistent with expected negative effects on cigarette demand. Our estimates suggest investors expected GWLs to reduce the number of smokers by an extra 2.4-6.9 million in the 10 years after the rule took effect. These findings support the view that the GWLs proposed by FDA would have curbed cigarette consumption in the USA in an appreciable way. 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/.

Latent factor structure of a behavioral economic cigarette demand curve in adolescent smokers.

PubMed

Bidwell, L Cinnamon; MacKillop, James; Murphy, James G; Tidey, Jennifer W; Colby, Suzanne M

2012-11-01

Behavioral economic demand curves, or quantitative representations of drug consumption across a range of prices, have been used to assess motivation for a variety of drugs. Such curves generate multiple measures of drug demand that are associated with cigarette consumption and nicotine dependence. However, little is known about the relationships among these facets of demand. The aim of the study was to quantify these relationships in adolescent smokers by using exploratory factor analysis to examine the underlying structure of the facets of nicotine incentive value generated from a demand curve measure. Participants were 138 adolescent smokers who completed a hypothetical cigarette purchase task, which assessed estimated cigarette consumption at escalating levels of price/cigarette. Demand curves and five facets of demand were generated from the measure: Elasticity (i.e., 1/α or proportionate price sensitivity); Intensity (i.e., consumption at zero price); O(max) (i.e., maximum financial expenditure on cigarettes); P(max) (i.e., price at which expenditure is maximized); and Breakpoint (i.e., the price that suppresses consumption to zero). Principal components analysis was used to examine the latent structure among the variables. The results revealed a two-factor solution, which were interpreted as "Persistence," reflecting insensitivity to escalating price, and "Amplitude," reflecting the absolute levels of consumption and price. These findings suggest a two factor structure of nicotine incentive value as measured via a demand curve. If supported, these findings have implications for understanding the relationships among individual demand indices in future behavioral economic studies and may further contribute to understanding of the nature of cigarette reinforcement. Copyright © 2012 Elsevier Ltd. All rights reserved.

Respiratory infections and pneumonia: potential benefits of switching from smoking to vaping.

PubMed

Campagna, Davide; Amaradio, Maria Domenica; Sands, Mark F; Polosa, Riccardo

2016-01-01

Abstaining from tobacco smoking is likely to lower the risk of respiratory infections and pneumonia. Unfortunately, quitting smoking is not easy. Electronic cigarettes (ECs) are emerging as an attractive long-term alternative nicotine source to conventional cigarettes and are being adopted by smokers who wish to reduce or quit cigarette consumption. Also, given that the propylene glycol in EC aerosols is a potent bactericidal agent, switching from smoking to regular vaping is likely to produce additional lung health benefits. Here, we critically address some of the concerns arising from regular EC use in relation to lung health, including respiratory infections and pneumonia. In conclusion, smokers who quit by switching to regular ECs use can reduce risk and reverse harm from tobacco smoking. Innovation in the e-vapour category is likely not only to further minimise residual health risks, but also to maximise health benefits.

Estimating cross-price elasticity of e-cigarettes using a simulated demand procedure.

PubMed

Grace, Randolph C; Kivell, Bronwyn M; Laugesen, Murray

2015-05-01

Our goal was to measure the cross-price elasticity of electronic cigarettes (e-cigarettes) and simulated demand for tobacco cigarettes both in the presence and absence of e-cigarette availability. A sample of New Zealand smokers (N = 210) completed a Cigarette Purchase Task to indicate their demand for tobacco at a range of prices. They sampled an e-cigarette and rated it and their own-brand tobacco for favorability, and indicated how many e-cigarettes and regular cigarettes they would purchase at 0.5×, 1×, and 2× the current market price for regular cigarettes, assuming that the price of e-cigarettes remained constant. Cross-price elasticity for e-cigarettes was estimated as 0.16, and was significantly positive, indicating that e-cigarettes were partially substitutable for regular cigarettes. Simulated demand for regular cigarettes at current market prices decreased by 42.8% when e-cigarettes were available, and e-cigarettes were rated 81% as favorably as own-brand tobacco. However when cigarettes cost 2× the current market price, significantly more smokers said they would quit (50.2%) if e-cigarettes were not available than if they were available (30.0%). Results show that e-cigarettes are potentially substitutable for regular cigarettes and their availability will reduce tobacco consumption. However, e-cigarettes may discourage smokers from quitting entirely as cigarette price increases, so policy makers should consider maintaining a constant relative price differential between e-cigarettes and tobacco cigarettes. © 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.

Is youth smoking responsive to cigarette prices? Evidence from low- and middle-income countries.

PubMed

Kostova, Deliana; Ross, Hana; Blecher, Evan; Markowitz, Sara

2011-11-01

To estimate the price elasticity of cigarette demand among youth in low- and middle-income countries (LMIC). The Global Youth Tobacco Survey was used to obtain data on the smoking behaviour of 315,353 adolescents from 17 LMIC. Two-part model of cigarette demand with country fixed effects. The first part estimates the impact of prices on smoking participation while the second part estimates the impact of prices on the number of cigarettes smoked among current smokers. Besides controlling for individual characteristics such as Age, Gender, Parental Smoking and availability of Pocket Money, the authors control for confounding environmental factors such as anti-smoking sentiment, the prevalence of cigarette advertising and anti-tobacco media messAges, and ease of purchasing cigarettes. All countries in this study are represented with at least two observations over time, which allows us to control for unobserved country characteristics and/or policies that may influence smoking patterns within countries. Cigarette price is an important determinant of smoking. The estimated price elasticity of smoking participation is -0.74, and the estimated price elasticity of conditional cigarette demand is approximately -1.37. The total price elasticity of cigarette demand is -2.11, implying that an increase in price of 10% would reduce youth cigarette consumption by 21.1% at the mean.

Evaluating South Africa's tobacco control policy using a synthetic control method.

PubMed

Chelwa, Grieve; van Walbeek, Corné; Blecher, Evan

2016-09-01

South Africa has since 1994 consistently increased the excise tax on cigarettes to maintain a total tax burden of 50% (1997-2003) and 52% (after 2004) of the average retail selling price. Between 1994 and 2004, the real (inflation-adjusted) excise tax increased by 249%, and the average real retail price of cigarettes increased by 110%. In addition, advertising and smoking bans were implemented in 2001. These measures, which we collectively refer to as tax-led, coincided with a 46% decrease in per capita consumption of cigarettes. No evaluation of South Africa's tobacco control policies has created a counterfactual of what would have happened if the tax-led measures had not occurred. (1) To create a credible counterfactual of what would have happened to per capita cigarette consumption if the tax-led measures had not happened. (2) To use this counterfactual to estimate their impact on cigarette consumption in South Africa. We use a synthetic control method to create a synthetic South Africa, as a weighted average of countries (the 'donor pool') that are similar to South Africa, but that did not engage in large-scale tobacco control measures between 1990 and 2004. Per capita cigarette consumption would not have continued declining in the absence of the tax-led measures that began in 1994. By 2004, per capita cigarette consumption was 36% lower than it would have been in the absence of the tax-led measures. These results, which we mostly attribute to tax increases, are robust to different specifications of the 'donor pool'. Significant public health dividends can be obtained by consistently increasing the real tax on cigarettes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Qualitative assessment of a Context of Consumption Framework to inform regulation of cigarette pack design in the U.S.

PubMed

Lee, Joseph G L; Averett, Paige E; Blanchflower, Tiffany; Gregory, Kyle R

2018-02-01

Researchers and regulators need to know how changes to cigarette packages can influence population health. We sought to advance research on the role of cigarette packaging by assessing a theory-informed framework from the fields of design and consumer research. The selected Context of Consumption Framework posits cognitive, affective, and behavioral responses to visual design. To assess the Framework's potential for guiding research on the visual design of cigarette packaging in the U.S., this study seeks to understand to what extent the Context of Consumption Framework converges with how adult smokers think and talk about cigarette pack designs. Data for this qualitative study came from six telephone-based focus groups conducted in March 2017. Two groups consisted of lesbian, gay, and bisexual participants; two groups of participants with less than four years college education; one group of LGB and straight identity; and one group the general population. All groups were selected for regional, gender, and racial/ethnic diversity. Participants (n=33) represented all nine U.S. Census divisions. We conducted a deductive qualitative analysis. Cigarette package designs captured the participants' attention, suggested the characteristics of the product, and reflected (or could be leveraged to convey) multiple dimensions of consumer identity. Particular to the affective responses to design, our participants shared that cigarette packaging conveyed how the pack could be used to particular ends, created an emotional response to the designs, complied with normative expectations of a cigarette, elicited interest when designs change, and prompted fascination when unique design characteristics are used. Use of the Context of Consumption Framework for cigarette product packaging design can inform regulatory research on tobacco product packaging. Researchers and regulators should consider multiple cognitive, affective, and behavioral responses to cigarette pack design.

Prevalence of smuggled and foreign cigarette use in Tehran, 2009

PubMed Central

Heydari, Gholamreza; Tafti, Saeid Fallah; Telischi, Firouzeh; Joossens, Luk; Hosseini, Mostafa; Ghafari, Mostafa

2010-01-01

Background Iran is one of two main target markets for tobacco smuggling in the WHO's Eastern Mediterranean Region. The Iranian government has a local tobacco monopoly but there is high demand for international brands. Informal reports show about 20% of cigarette consumption is smuggled brands. This pack survey study is the first in Iran to gather validated information on use of smuggled cigarettes. Methods A randomized cross-sectional household survey in Tehran in 2008–2009 of 1540 smokers aged 16–90 (83% men) was performed, including interviewer checking of cigarette packs. Results In all, 20.9% of cigarettes and 6.7% of domestic branded cigarettes were smuggled. A total of 60.1% of smokers preferred foreign cigarettes. There was no significant difference between consumption of illegal cigarettes by sex. (Fisher exact test p=0.61) Use of smuggled cigarettes was higher among younger smokers (p=0.01) Conclusions Use of illegal cigarettes is high. Tobacco control laws outlawing their sale are not being enforced. PMID:20876076

Pictorial Health Warning Labels on Cigarette Packages: An Investigation on Opinions of Male Smokers

PubMed Central

Shojaezadeh, Davoud; Peyman, Nooshin; Shakeri, Mohammad Taghi; Nedjat, Saharnaz; Mohaddes Hakkak, Abbas; Taghdisi, Mohammad Hossein; Mohaddes Hakkak, Hamid Reza; Shariati, Keivan; Taghipour, Ali

2014-01-01

Background: Health warning labels on cigarette packages are among the most straightforward and important tools to communicate with smokers and various studies have illustrated their efficacy. Objectives: The current study aimed to investigate the opinions of male smokers in Mashhad city about the efficacy of health warning labels printed on cigarette packages on the smoking status of smokers. Patients and Methods: This cross-sectional descriptive study was conducted in 2013 using a questionnaire. The research population included the male smokers of Mashhad. The participants were selected from the customers referring to the newsstands for cigarettes. The obtained data were analyzed employing SPSS software Version 16, and the statistical tests including Kruskal-Wallis, Spearman, and correlation coefficient of Pearson, Chi Square, Mann-Whitney, and Bonferroni correction were used in this regard. Results: In this research, there were 500 participants with the average age of 25 years. The initiation age of smoking was eight years while the maximum age was reported as 45 years. Results of this research about the effect of these labels on decreasing cigarette consumption rate showed that almost half of the participants believed that these labels were ineffective for them (52.2%) and other smokers (53.8%).Furthermore, significant relationship was found between the age and opinion of the smokers about the influence of these labels on reducing their cigarette consumption (P < 0.001). Conclusions: To promote the effect of printed images on cigarette packages, it is recommended to consider the suitability of labels in the targeted culture. In addition, to be more effective consultation sites to quit smoking should be introduced under the images. PMID:24829777

A two-site, two-arm, 34-week, double-blind, parallel-group, randomized controlled trial of reduced nicotine cigarettes in smokers with mood and/or anxiety disorders: trial design and protocol.

PubMed

Allen, Sophia I; Foulds, Jonathan; Pachas, Gladys N; Veldheer, Susan; Cather, Corinne; Azzouz, Nour; Hrabovsky, Shari; Hameed, Ahmad; Yingst, Jessica; Hammett, Erin; Modesto, Jennifer; Krebs, Nicolle M; Zhu, Junjia; Liao, Jason; Muscat, Joshua E; Richie, John; Evins, A Eden

2017-01-19

The U.S. Food and Drug Administration can set standards for cigarettes that could include reducing their nicotine content. Such a standard should improve public health without causing unintended serious consequences for sub-populations. This study evaluates the effect of progressive nicotine reduction in cigarettes on smoking behavior, toxicant exposure, and psychiatric symptoms in smokers with comorbid mood and/or anxiety disorders using a two-site, two-arm, double-blind, parallel group, randomized controlled trial (RCT) in four phases over 34 weeks. Adult smokers (N = 200) of 5 or more cigarettes per day will be randomized across two sites (Penn State and Massachusetts General). Participants must have not had a quit attempt in the prior month, nor be planning to quit in the next 6 months, meet criteria for a current or lifetime unipolar mood and/or anxiety disorder based on the structured Mini-International Neuropsychiatric Interview, and must not have an unstable medical or psychiatric condition. After a week of smoking their own cigarettes, participants receive two weeks of Spectrum research cigarettes with usual nicotine content (11.6 mg). After this baseline period, participants will be randomly assigned to continue smoking Spectrum research cigarettes that contain either (a) Usual Nicotine Content (11.6 mg); or (b) Reduced Nicotine Content: the nicotine content per cigarette is progressively reduced from approximately 11.6 mg to 0.2 mg in five steps over 18 weeks. At the end of the randomization phase, participants will be offered the choice to either (a) quit smoking with assistance, (b) continue smoking free research cigarettes, or (c) return to purchasing their own cigarettes, for the final 12 weeks of the study. The primary outcome measure is blood cotinine; key secondary outcomes are: exhaled carbon monoxide, urinary total NNAL- 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and 1-hydroxypyrene, oxidative stress biomarkers including 8-isoprostanes, measures of psychiatric symptoms (e.g., depression, anxiety), smoking behavior and dependence (e.g., cigarette consumption, quit attempts), and health effects (e.g., blood pressure, respiratory symptoms). Results from this study will inform FDA on the potential effects of regulating the nicotine content of cigarettes and help determine whether smokers with mood and/or anxiety disorders can safely transition to significantly reduced nicotine content cigarettes. TRN: NCT01928758 , registered August 21, 2013.

Who purchases cigarettes from cheaper sources in China? Findings from the ITC China Survey

PubMed Central

Yao, Tingting; Huang, Jidong; Sung, Hai-Yen; Ong, Michael K.; Mao, Zhengzhong; Jiang, Yuan; Fong, Geoffrey T.; Max, Wendy

2014-01-01

Objective The availability of cigarettes from cheaper sources constitutes a major challenge to public health throughout the world, including China, because it may counteract price-based tobacco control policies. The goal of this study was to identify factors associated with purchasing cigarettes from cheaper sources among adult smokers in China. Methods Data were analyzed from Waves 1–3 of the International Tobacco Control China Survey, conducted in 2006–2009 among adult smokers in six cities in China (N=7,980). One survey question asked, “In the last six months, have you purchased cheaper cigarettes than you can get from local stores for economic reasons?” We examined whether sociodemographic factors and smoking intensity were associated with purchasing cigarettes from cheaper sources using the general estimating equations (GEE) model. Sociodemographic factors considered were gender, age, marital status, monthly household income, education, employment status, and city of residence. Results 15.6% of smokers reported purchasing cigarettes from cheaper sources. After controlling for other covariates, the associations of the behavior of purchasing cigarettes from cheaper sources with age (AOR=1.49, 95% CI=1.17–3.92 for age 18–24 compared to age 55+) and with income (AOR=2.93, 95%CI=2.27–3.79 for low income compared to high income) were statistically significant, but there was no statistically significant relationship with smoking intensity. Conclusions Our findings indicate that young and low income smokers are more likely than older and high income smokers to purchase cigarettes from cheaper sources in China. Tobacco control policies that reduce the availability of cigarettes from cheaper sources could have an impact on reducing cigarette consumption among young and low income smokers in China. PMID:24078076

Who purchases cigarettes from cheaper sources in China? Findings from the ITC China Survey.

PubMed

Yao, Tingting; Huang, Jidong; Sung, Hai-Yen; Ong, Michael K; Mao, Zhengzhong; Jiang, Yuan; Fong, Geoffrey T; Max, Wendy

2014-03-01

The availability of cigarettes from cheaper sources constitutes a major challenge to public health throughout the world, including China, because it may counteract price-based tobacco control policies. The goal of this study was to identify factors associated with purchasing cigarettes from cheaper sources among adult smokers in China. Data were analysed from Waves 1 to 3 of the International Tobacco Control China Survey conducted in 2006-2009 among adult smokers in six cities in China (N=7980). One survey question asked, "In the last 6 months, have you purchased cheaper cigarettes than you can get from local stores for economic reasons?" We examined whether sociodemographic factors and smoking intensity were associated with purchasing cigarettes from cheaper sources using the general estimating equations model. Sociodemographic factors considered were gender, age, marital status, monthly household income, education, employment status and city of residence. 15.6% of smokers reported purchasing cigarettes from cheaper sources. After controlling for other covariates, the associations of the behaviour of purchasing cigarettes from cheaper sources with age (adjusted OR (AOR)=1.49, 95% CI 1.17 to 3.92 for age 18-24 compared with age 55+) and with income (AOR=2.93, 95% CI 2.27 to 3.79 for low income compared with high income) were statistically significant, but there was no statistically significant relationship with smoking intensity. Our findings indicate that young and low-income smokers are more likely than older and high-income smokers to purchase cigarettes from cheaper sources in China. Tobacco control policies that reduce the availability of cigarettes from cheaper sources could have an impact on reducing cigarette consumption among young and low-income smokers in China.

Is Every Smoker Interested in Price Promotions? An Evaluation of Price-Related Discounts by Cigarette Brands

PubMed Central

Xu, Xin; Wang, Xu; Caraballo, Ralph S.

2015-01-01

Context Raising unit price is one of the most effective ways of reducing cigarette consumption. A large proportion of US adult smokers use generic brands or price discounts in response to higher prices, which may mitigate the public health impacts of raising unit price. Objective The main purpose of this study was to evaluate the retail price impact and the determinants of price-related discount use among US adult smokers by their most commonly used cigarette brand types. Methods Data from the 2009–2010 National Adult Tobacco Survey, a telephone survey of US adults 18 years or older, was used to assess price-related discount use by cigarette brands. Price-related discounts included coupons, rebates, buy 1 get 1 free, 2 for 1, or any other special promotions. Multivariate logistic regression was used to assess sociodemographic and tobacco use determinants of discount use by cigarette brands. Results Discount use was most common among premium brand users (22.1%), followed by generic (13.3%) and other brand (10.8%) users. Among premium brand users, those who smoked 10 to 20 cigarettes per day were more likely to use discounts, whereas elderly smokers, non-Hispanic blacks, those with greater annual household income, dual users of cigarettes and other combustible tobacco products, and those who had no quit intentions were less likely to do so. Among generic brand users, those who had no quit intentions and those who smoked first cigarette within 60 minutes after waking were more likely to use discounts. Conclusions Frequent use of discounts varies between smokers of premium and generic cigarette brands. Setting a high minimum price, together with limiting the use of coupons and promotions, may uphold the effect of cigarette excise taxes to reduce smoking prevalence. PMID:26598952

Is Every Smoker Interested in Price Promotions? An Evaluation of Price-Related Discounts by Cigarette Brands.

PubMed

Xu, Xin; Wang, Xu; Caraballo, Ralph S

2016-01-01

Raising unit price is one of the most effective ways of reducing cigarette consumption. A large proportion of US adult smokers use generic brands or price discounts in response to higher prices, which may mitigate the public health impacts of raising unit price. The main purpose of this study was to evaluate the retail price impact and the determinants of price-related discount use among US adult smokers by their most commonly used cigarette brand types. Data from the 2009-2010 National Adult Tobacco Survey, a telephone survey of US adults 18 years or older, was used to assess price-related discount use by cigarette brands. Price-related discounts included coupons, rebates, buy 1 get 1 free, 2 for 1, or any other special promotions. Multivariate logistic regression was used to assess sociodemographic and tobacco use determinants of discount use by cigarette brands. Discount use was most common among premium brand users (22.1%), followed by generic (13.3%) and other brand (10.8%) users. Among premium brand users, those who smoked 10 to 20 cigarettes per day were more likely to use discounts, whereas elderly smokers, non-Hispanic blacks, those with greater annual household income, dual users of cigarettes and other combustible tobacco products, and those who had no quit intentions were less likely to do so. Among generic brand users, those who had no quit intentions and those who smoked first cigarette within 60 minutes after waking were more likely to use discounts. Frequent use of discounts varies between smokers of premium and generic cigarette brands. Setting a high minimum price, together with limiting the use of coupons and promotions, may uphold the effect of cigarette excise taxes to reduce smoking prevalence.

Changes in Biomarkers of Exposure on Switching From a Conventional Cigarette to Tobacco Heating Products: A Randomized, Controlled Study in Healthy Japanese Subjects.

PubMed

Gale, Nathan; McEwan, Mike; Eldridge, Alison C; Fearon, Ian M; Sherwood, Neil; Bowen, Edward; McDermott, Simon; Holmes, Emma; Hedge, Andrew; Hossack, Stuart; Wakenshaw, Louise; Glew, James; Camacho, Oscar M; Errington, Graham; McAughey, John; Murphy, James; Liu, Chuan; Proctor, Christopher J

2018-06-15

Smoking is a leading cause of numerous human disorders including pulmonary disease, cardiovascular disease, and cancer. Disease development is primarily caused by exposure to cigarette smoke constituents, many of which are known toxicants. Switching smokers to modified risk tobacco products (MRTPs) has been suggested as a potential means to reduce the risks of tobacco use, by reducing such exposure. This randomized, controlled study investigated whether biomarkers of toxicant exposure (BoE) were reduced when smokers switched from smoking combustible cigarettes to using a novel (glo™/THP1.0) or in-market comparator (iQOS/THS) tobacco heating product (THP). One hundred eighty Japanese smokers smoked combustible cigarettes during a 2-day baseline period, followed by randomization to either continue smoking cigarettes, switch to using mentholated or non-mentholated variants of glo™, switch to using a non-mentholated variant of iQOS, or quit nicotine and tobacco product use completely for 5 days. Baseline and post-randomization 24-h urine samples were collected for BoE analysis. Carbon monoxide was measured daily in exhaled breath (eCO). On day 5 after switching, urinary BoE (excluding for nicotine) and eCO levels were significantly (p < .05) reduced by medians between 20.9% and 92.1% compared with baseline in all groups either using glo™ or iQOS or quitting tobacco use. Between-group comparisons revealed that the reductions in the glo™ groups were similar (p > .05) to quitting in many cases. glo™ or iQOS use for 5 days reduced exposure to smoke toxicants in a manner comparable to quitting tobacco use. THPs are reduced exposure tobacco products with the potential to be MRTPs. This clinical study demonstrates that when smokers switched from smoking combustible cigarettes to using tobacco heating products their exposure to smoke toxicants was significantly decreased. In many cases, this was to the same extent as that seen when they quit smoking completely. This may indicate that these products have the potential to be reduced exposure and/or reduced risk tobacco products when used by smokers whose cigarette consumption is displaced completely. ISRCTN14301360 and UMIN000024988.

Higher cigarette prices influence cigarette purchase patterns.

PubMed

Hyland, A; Bauer, J E; Li, Q; Abrams, S M; Higbee, C; Peppone, L; Cummings, K M

2005-04-01

To examine cigarette purchasing patterns of current smokers and to determine the effects of cigarette price on use of cheaper sources, discount/generic cigarettes, and coupons. Higher cigarette prices result in decreased cigarette consumption, but price sensitive smokers may seek lower priced or tax-free cigarette sources, especially if they are readily available. This price avoidance behaviour costs states excise tax money and dampens the health impact of higher cigarette prices. Telephone survey data from 3602 US smokers who were originally in the COMMIT (community intervention trial for smoking cessation) study were analysed to assess cigarette purchase patterns, use of discount/generic cigarettes, and use of coupons. 59% reported engaging in a high price avoidance strategy, including 34% who regularly purchase from a low or untaxed venue, 28% who smoke a discount/generic cigarette brand, and 18% who report using cigarette coupons more frequently that they did five years ago. The report of engaging in a price avoidance strategy was associated with living within 40 miles of a state or Indian reservation with lower cigarette excise taxes, higher average cigarette consumption, white, non-Hispanic race/ethnicity, and female sex. Data from this study indicate that most smokers are price sensitive and seek out measures to purchase less expensive cigarettes, which may decrease future cessation efforts.

[Price elasticity of demand for cigarettes and alcohol in Ecuador, based on household data].

PubMed

Chávez, Ricardo

2016-10-01

Estimate price elasticity of demand for cigarettes and alcohol in Ecuador using cross-sectional data from the National Survey of Urban and Rural Household Income and Expenditures (ENIGHUR is the acronym in Spanish) 2011-2012. ENIGHUR 2011-2012 data were used with Deaton's (1, 2) methodology to estimate price elasticity of demand for cigarettes and alcohol with expenditure and quantity information. Household socioeconomic variables were also included. Price elasticity of demand for cigarettes is -0.87, meaning that a 10% price increase could lead to an 8.7% decrease in consumption. Results for cross-price elasticities of alcohol on cigarette demand are negative, as expected, indicating that they are complementary goods; however, the results are not statistically significant. Furthermore, it was found that price elasticity of demand for alcohol is -0.44, meaning that a 10% increase in the price of alcohol would produce a 4.4% decrease in consumption. A policy of price increases, for example, with a tax increase, applied to both cigarettes and alcohol, could have a positive effect on public health through reductions in consumption of both goods. However, this measure would not be sufficient to bridge gaps in prevalence measures and health outcomes between sex and other population groups, given the observed difference in the sensitivity of consumption to price variations.

Tobacco Product Waste: An Environmental Approach to Reduce Tobacco Consumption.

PubMed

Novotny, Thomas E; Slaughter, Elli

2014-01-01

Cigarette butts and other tobacco product wastes (TPW) are the most common items picked up in urban and beach cleanups worldwide. TPW contains all the toxins, nicotine, and carcinogens found in tobacco products, along with the plastic nonbiodegradable filter attached to almost all cigarettes sold in the United States and in most countries worldwide. Toxicity studies suggest that compounds leached from cigarette butts in salt and fresh water are toxic to aquatic micro-organisms and test fish. Toxic chemicals have also been identified in roadside TPW. With as much as two-thirds of all smoked cigarettes (numbering in the trillions globally) being discarded into the environment each year, it is critical to consider the potential toxicity and remediation of these waste products. This article reviews reports on the toxicity of TPW and recommends several policy approaches to mitigation of this ubiquitous environmental blight.

Has Underreporting of Cigarette Consumption Changed Over Time? Estimates Derived From US National Health Surveillance Systems Between 1965 and 2015.

PubMed

Liber, Alex C; Warner, Kenneth E

2018-01-01

According to survey data, the prevalence of Americans' self-reported cigarette smoking is dropping steadily. However, the accuracy of national surveys has been questioned because of declining response rates and the increasing stigmatization of smoking. We used data from 2 repeated, cross-sectional, nationally representative health surveys (National Survey on Drug Use and Health (NSDUH), 1979-2014; and National Health Interview Survey (NHIS), 1965-2015) to determine whether self-reported cigarette consumption has changed over time as a proportion of federally taxed cigarette sales. From each survey, we calculated national equivalents of annual cigarette consumption. From 1979 to 1997, the amount of cigarettes that NSDUH and NHIS respondents reported corresponded to an average of 59.5% (standard deviation (SD), 2.3%) and 65.6% (SD, 3.2%), respectively, of taxed cigarette sales. After 1997, respondents' reported smoking data corresponded to the equivalent of an average of 64.2% (SD, 5.9%) and 63.3% (SD, 2.5%), respectively, of taxed cigarette sales. NHIS figures remained steady throughout the latter period, with a decline during 2013-2015 from 65.9% to 61.1%. NSDUH figures increased steadily, exceeding those of the NHIS after 2002. Given the consistent underreporting of cigarette consumption over time, these surveys are likely not less accurate than they were previously. The recent decrease in NHIS accuracy, however, gives pause about the magnitude of the reported decline in smoking prevalence in 2014 and 2015. Improvement in the accuracy of NSDUH data is encouraging. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Does e-cigarette use predict cigarette escalation? A longitudinal study of young adult non-daily smokers.

PubMed

Doran, Neal; Brikmanis, Kristin; Petersen, Angela; Delucchi, Kevin; Al-Delaimy, Wael K; Luczak, Susan; Myers, Mark; Strong, David

2017-07-01

Recent studies suggest that e-cigarette use among youth may be associated with increased risk of cigarette initiation. The goal of this study was to test the hypothesis that use of e-cigarettes among young adult non-daily cigarette smokers would be associated with increased cigarette consumption. Participants (n=391; 52% male) were 18-24year-old non-daily cigarette smokers recruited from across California. Cigarette and e-cigarette use were assessed online or via mobile phone every three months for one year between March 2015 and December 2016. Longitudinal negative binomial regression models showed that, adjusted for propensity for baseline e-cigarette use, non-daily smokers who reported more frequent use of e-cigarettes upon study entry reported greater quantity and frequency of cigarette smoking at baseline and greater increases in cigarette quantity over 12months than non-daily cigarette only smokers (ps<0.01). During the 12months of assessment, more consistent consumption of e-cigarettes was associated with greater quantity and frequency of cigarette use (ps<0.01); these effects did not vary over time. Findings suggest that among non-daily smokers, young adults who use e-cigarettes tend to smoke more cigarettes and to do so more frequently. Such individuals may be at greater risk for chronic tobacco use and dependence. Copyright © 2017 Elsevier Inc. All rights reserved.

The Intergenerational Transmission of Smoking Across Three Cohabitant Generations: A Count Data Approach.

PubMed

Escario, José-Julián; Wilkinson, Anna V

2015-10-01

This paper examines the extent to which parent and grandparent smoking influences adolescent smoking and its quantitative implications for tobacco control. It extends similar prior studies by investigating the effects on the probability of becoming a smoker and on the number of cigarettes smoked. Count regressions were used to assess the intergenerational transmission of smoking across three cohabitant generations, simultaneously, using data from the 2010 survey "Encuesta Estatal Sobre Uso De Drogas en Estudiantes de Enseñanzas Secundarias". This survey, of 32,234 students, constitutes a representative sample of Spanish students between 14 and 18 years of age. Living with a mother who smokes, a father who smokes, or a grandparent who smokes reduces the odds of being a non-smoker by 36.1% (OR 0.639), 26.1% (OR 0.739) and 20.3% (OR 0.797), respectively. Parental smoking increases cigarette consumption levels among adolescents. Having a cohabitant mother who smokes increases the number of cigarettes smoked by children by around 18.7% (IRR 1.187), while having a cohabitant father who smokes increases the number by around 12.1% (IRR 1.121). Estimates support the hypothesis that visibility of smoking among parents and grandparents is a strong predictor of smoking among adolescents. Accordingly, quitting smoking by parents and grandparents before children become adolescents appears to be a powerful means to both reduce smoking rates among adolescents and the number of cigarettes smoked by smokers; such decisions appear to exert a stronger influence on the prevalence of smoking and consumption levels than exposure to smoking prevention campaigns at school.

The effect of cigarette price increases on cigarette consumption, tax revenue, and smoking-related death in Africa from 1999 to 2013.

PubMed

Ho, Li-Ming; Schafferer, Christian; Lee, Jie-Min; Yeh, Chun-Yuan; Hsieh, Chi-Jung

2017-11-01

This study investigates the effects of price hikes on cigarette consumption, tobacco tax revenues, and reduction in smoking-caused mortality in 36 African countries. Using panel data from the 1999-2013 Euromonitor International, the World Bank and the World Health Organization, we applied fixed-effects and random-effects regression models of panel data to estimate the elasticity of cigarette prices and simulate the effect of price fluctuations. Cigarette price elasticity was the highest for low-income countries and considerably lower for other African economies. The administered simulation shows that with an average annual cigarette price increase of 7.38%, the average annual cigarette consumption would decrease by 3.84%, and the average annual tobacco tax revenue would increase by 19.39%. By 2050, the number of averted smoking-attributable deaths (SADs) will be the highest in South Africa, followed by the Democratic Republic of Congo, Madagascar, and Ethiopia. Excise tax increases have a significant effect on the reduction of smoking prevalence and the number of averted smoking-attributable deaths, Low-income countries are most affected by high taxation policies.

Tobacco excise and declining tobacco consumption: the case of Papua New Guinea.

PubMed Central

Chapman, S; Richardson, J

1990-01-01

Excise elasticities of demand for non-cigarette tobacco and cigarettes were calculated for Papua New Guinea for the 14 years 1973-86. Respectively, these were -0.50 and -0.71. This means that 10 percent increases in cigarette and non-cigarette tobacco excise are associated with an estimated 7.1 percent fall in demand for cigarettes and a 5 percent decrease in the demand for tobacco. As tax (excise) elasticities would normally be significantly smaller than price elasticities, these results imply that the consumption of cigarettes and tobacco in Papua New Guinea are more responsive to prices than in the United States and other Western countries. The level of excise is therefore an important and practical instrument for the control of consumption. These elasticities appear to be the first reported for a developing country. It is suggested that if they are indicative of consumer behavior in lower income countries then increasing tobacco and cigarette excise should be considered as an important strategy for the control of smoking in these countries which, because of their large populations, are huge markets for tobacco products and thus major targets for tobacco control measures. PMID:2327528

Impact of cigarette minimum price laws on the retail price of cigarettes in the USA.

PubMed

Tynan, Michael A; Ribisl, Kurt M; Loomis, Brett R

2013-05-01

Cigarette price increases prevent youth initiation, reduce cigarette consumption and increase the number of smokers who quit. Cigarette minimum price laws (MPLs), which typically require cigarette wholesalers and retailers to charge a minimum percentage mark-up for cigarette sales, have been identified as an intervention that can potentially increase cigarette prices. 24 states and the District of Columbia have cigarette MPLs. Using data extracted from SCANTRACK retail scanner data from the Nielsen company, average cigarette prices were calculated for designated market areas in states with and without MPLs in three retail channels: grocery stores, drug stores and convenience stores. Regression models were estimated using the average cigarette pack price in each designated market area and calendar quarter in 2009 as the outcome variable. The average difference in cigarette pack prices are 46 cents in the grocery channel, 29 cents in the drug channel and 13 cents in the convenience channel, with prices being lower in states with MPLs for all three channels. The findings that MPLs do not raise cigarette prices could be the result of a lack of compliance and enforcement by the state or could be attributed to the minimum state mark-up being lower than the free-market mark-up for cigarettes. Rather than require a minimum mark-up, which can be nullified by promotional incentives and discounts, states and countries could strengthen MPLs by setting a simple 'floor price' that is the true minimum price for all cigarettes or could prohibit discounts to consumers and retailers.

Particulate metals and organic compounds from electronic and tobacco-containing cigarettes: comparison of emission rates and secondhand exposure.

PubMed

Saffari, Arian; Daher, Nancy; Ruprecht, Ario; De Marco, Cinzia; Pozzi, Paolo; Boffi, Roberto; Hamad, Samera H; Shafer, Martin M; Schauer, James J; Westerdahl, Dane; Sioutas, Constantinos

2014-01-01

In recent years, electronic cigarettes have gained increasing popularity as alternatives to normal (tobacco-containing) cigarettes. In the present study, particles generated by e-cigarettes and normal cigarettes have been analyzed and the degree of exposure to different chemical agents and their emission rates were quantified. Despite the 10-fold decrease in the total exposure to particulate elements in e-cigarettes compared to normal cigarettes, specific metals (e.g. Ni and Ag) still displayed a higher emission rate from e-cigarettes. Further analysis indicated that the contribution of e-liquid to the emission of these metals is rather minimal, implying that they likely originate from other components of the e-cigarette device or other indoor sources. Organic species had lower emission rates during e-cigarette consumption compared to normal cigarettes. Of particular note was the non-detectable emission of polycyclic aromatic hydrocarbons (PAHs) from e-cigarettes, while substantial emission of these species was observed from normal cigarettes. Overall, with the exception of Ni, Zn, and Ag, the consumption of e-cigarettes resulted in a remarkable decrease in secondhand exposure to all metals and organic compounds. Implementing quality control protocols on the manufacture of e-cigarettes would further minimize the emission of metals from these devices and improve their safety and associated health effects.

Global Adult Tobacco Survey (GATS): a case for change in definition, analysis and interpretation of "cigarettes" and "cigarettes per day" in completed and future surveys.

PubMed

Jena, Pratap Kumar; Kishore, Jugal; Sarkar, Bidyut K

2013-01-01

The Global Adult Tobacco Survey has 15 key indicators, cigarettes smoked per day (CPD) among daily smokers being one of them. The first wave of GATS in 14 countries indicated that mean CPD use is higher in women than men in India only, which is contrary to the current understanding of tobacco use globally. This study was undertaken to understand the unusual findings for mean CPD use in the GATS-India survey. Items B06a and B06b of the GATS India survey questionnaire that collected information on daily consumption of manufactured and rolled cigarettes were analyzed using SPSS software. Exclusive users were identified from these items after excluding the concurrent users of other tobacco products. Cigarette type, exclusive use and gender stratified analyses were made. Consumption of different types of cigarettes among the mixed users of manufactured and rolled cigarettes were correlated. Higher mean number of CPD use among male daily-smokers was observed than their female counterparts in product specific analysis. Mean CPD as per GATS cigarette definition was higher in males than females for exclusive users but a reverse trend was observed in case of non-exclusive users. Use of manufactured cigarettes increased with increase in use of rolled cigarette among the mixed users and around half of these users reported equal CPD frequency for the both types of cigarettes. The anomaly in mean CPD estimate in GATS-India data was due to inclusion of two heterogeneous products to define cigarettes, variation in cigarette product specific user proportions contributing to the average and non-exclusive concurrent use of other tobacco products. The consumption pattern of cigarettes among the mixed users highlights bias in CPD reporting. Definition, analysis and interpretation of 'cigarettes per day' in the GATS India survey need to be improved by redefining cigarettes and making product specific analyses.

Adolescent consumption of sports and energy drinks: linkages to higher physical activity, unhealthy beverage patterns, cigarette smoking, and screen media use.

PubMed

Larson, Nicole; Dewolfe, Jessica; Story, Mary; Neumark-Sztainer, Dianne

2014-01-01

To examine patterns of adolescent sports and energy drink (SED) consumption and identify behavioral correlates. Data were drawn from Eating and Activity in Teens, a population-based study. Adolescents from 20 middle and high schools in Minneapolis/St Paul, MN completed classroom-administered surveys. A total of 2,793 adolescents (53.2% girls) in grades 6-12. Beverage patterns; breakfast frequency; moderate to vigorous physical activity (MVPA); media use; sleep; and cigarette smoking. Linear and logistic regression models were used to estimate associations between health behaviors and SED consumption, adjusting for demographics. Over a third of adolescents consumed sports drinks and 14.7% consumed energy drinks at least once a week. Among boys and girls, both sports and energy drink consumption were related to higher video game use; sugar-sweetened beverage and fruit juice intake; and smoking (P < .05). Sports drink consumption was also significantly related to higher MVPA and organized sport participation for both genders (P < .01). Although sports drink consumption was associated with higher MVPA, adolescents should be reminded of recommendations to consume these beverages only after vigorous, prolonged activity. There is also a need for future interventions designed to reduce SED consumption, to address the clustering of unhealthy behaviors. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Adolescent Consumption of Sports and Energy Drinks: Linkages to Higher Physical Activity, Unhealthy Beverage Patterns, Cigarette Smoking, and Screen Media Use

PubMed Central

Larson, Nicole; DeWolfe, Jessica; Story, Mary; Neumark-Sztainer, Dianne

2014-01-01

Objective To examine patterns of adolescent sports and energy drink (SED) consumption and identify behavioral correlates. Design Data were drawn from EAT 2010 (Eating and Activity in Teens), a population-based study. Setting Adolescents from 20 middle and high schools in Minneapolis/St. Paul, Minnesota completed classroom-administered surveys. Participants 2,793 adolescents (53.2% girls) in grades 6–12. Variables Measured Beverage patterns; breakfast frequency; moderate-to-vigorous physical activity (MVPA); media use; sleep; and cigarette smoking. Analysis Linear and logistic regression models were used to estimate associations between health behaviors and SED consumption, adjusting for demographics. Results Over a third of adolescents consumed sports drinks and 14.7% consumed energy drinks at least once a week. Among boys and girls, both sports and energy drink consumption were related to higher video game use; sugar-sweetened beverage and fruit juice intake; and smoking (P<0.05). Sports drink consumption was also significantly related to higher MVPA and organized sport participation for both genders (P<0.01). Conclusions and Implications Although sports drink consumption was associated with higher MVPA, adolescents should be reminded of recommendations to consume these beverages only following vigorous, prolonged activity. There is also a need for future interventions designed to reduce SED consumption to address the clustering of unhealthy behaviors. PMID:24809865

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

PubMed

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

2015-01-01

Tobacco consumption rates in Lebanon are among the highest worldwide. The country ratified the Framework Convention on Tobacco Control in 2005. A law was passed in 2011 which regulates smoking in closed public spaces, bans advertising, and stipulates larger warnings. Despite international evidence confirming that increasing taxation on tobacco products lowers tobacco consumption, no such policy has yet been adopted: a cigarette pack costs on average US$1.50. To date no studies in Lebanon have addressed the welfare and public finance effects of increasing taxes on tobacco products. Using the 2005 national survey of household living conditions, we estimate an almost ideal demand system to generate price elasticities of demand for tobacco. Using estimated elasticities and a conservative scenario for expected smuggling, we simulate the consumption and tax revenue effects of a change in the price of tobacco under various tax schemes. Increasing taxes on all tobacco products so as to double the price of imported cigarettes would lower their consumption by 7% and consumption of domestically produced cigarettes by over 90%. Young adults (ages 15-30) are more sensitive: consumption would drop by 9% for imported cigarettes and by 100% for domestic cigarettes. Government revenues would increase by approximately 52%. The estimated elasticities indicate that an increase in taxes on all tobacco products would lead to a reduction in consumption and an increase in government revenue. Evidence from Lebanon on the effectiveness of increased taxation may help initiate national debate on the need to raise taxes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

PubMed

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

2014-01-01

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

Cigarette pack warning labels in Russia: how graphic should they be?

PubMed

Wade, Benjamin; Merrill, Ray M; Lindsay, Gordon B

2011-06-01

Tobacco warning labels on cigarette packs have been shown to reduce cigarette consumption. The current study measures the Russian population's acceptance and preference of graphic (picture + text) tobacco warning labels. Nationally representative data were collected from 1778 participants in the Russian Federation in October 2009. A cross-sectional survey was conducted through person-to-person household interviews with respondents aged ≥ 14 years. Survey questions included standard demographic queries and three study-specific questions. Participants rated the strength of 13 cigarette warning labels according to their effectiveness to deter from smoking. Smoking status and the population's acceptance of similar warning labels was also measured. A dose-response pattern is apparent between the degree of graphic content of cigarette warning labels and the public's perception regarding the warning label's ability to discourage smoking. Approximately 87% of all respondents thought Russian authorities should require tobacco manufacturers to place graphic warning labels on cigarette packs, while 80% of current smokers wanted their government to enact such enforcement. The Russian population would strongly support government policy that would require graphic warning labels to be placed on cigarette packs in their country. In order to best deter from smoking, future cigarette warning labels in Russia should be as graphic as possible.

Electronic cigarettes, quit attempts and smoking cessation: a 6-month follow-up.

PubMed

Pasquereau, Anne; Guignard, Romain; Andler, Raphaël; Nguyen-Thanh, Viêt

2017-09-01

There is conflicting evidence that use of e-cigarettes promotes cessation in regular smokers, but contrasting findings may be due to differing definitions of vaping. The aim was to assess whether regular use of e-cigarettes while smoking is associated with subsequent smoking cessation. Baseline internet survey with outcomes measured at 6-month follow-up. All French metropolitan territory. A total of 2057 smokers aged 15-85 years were recruited through an access panel and responded to a 6-month follow-up: 1805 exclusive tobacco smokers and 252 dual users (tobacco plus regular e-cigarette users) at baseline. The three outcomes assessed at 6 months were: a minimum 50% reduction in the number of cigarettes smoked per day, quit attempts of at least 7 days and smoking cessation of at least 7 days at the time of follow-up. Logistic regressions were performed to model the three outcomes according to regular e-cigarette use at baseline, adjusted for socio-economic variables and smoking behaviours. Baseline dual users were more likely than baseline exclusive tobacco smokers to have halved cigarette consumption [25.9 versus 11.2%, P < 0.001, adjusted odds ratio (aOR) = 2.6, confidence interval (CI) = 1.8-3.8]. Dual users at baseline were also more likely to have made a quit attempt of at least 7 days (22.8 versus 10.9%, P < 0.001, aOR = 1.8, CI = 1.2-2.6). No significant difference was found for 7-day cessation rates at 6 months (12.5 versus 9.5%, P = 0.18, aOR = 1.2, CI = 0.8-1.9). Among people who smoke, those also using an e-cigarette regularly are more likely to try to quit smoking and reduce their cigarette consumption during the next 6 months. It remains unclear whether regular e-cigarette users are also more likely to stop smoking. © 2017 Society for the Study of Addiction.

Qualitative assessment of a Context of Consumption Framework to inform regulation of cigarette pack design in the U.S

PubMed Central

Lee, Joseph G. L.; Averett, Paige E.; Blanchflower, Tiffany; Gregory, Kyle R.

2018-01-01

INTRODUCTION Researchers and regulators need to know how changes to cigarette packages can influence population health. We sought to advance research on the role of cigarette packaging by assessing a theory-informed framework from the fields of design and consumer research. The selected Context of Consumption Framework posits cognitive, affective, and behavioral responses to visual design. To assess the Framework’s potential for guiding research on the visual design of cigarette packaging in the U.S., this study seeks to understand to what extent the Context of Consumption Framework converges with how adult smokers think and talk about cigarette pack designs. METHODS Data for this qualitative study came from six telephone-based focus groups conducted in March 2017. Two groups consisted of lesbian, gay, and bisexual participants; two groups of participants with less than four years college education; one group of LGB and straight identity; and one group the general population. All groups were selected for regional, gender, and racial/ethnic diversity. Participants (n=33) represented all nine U.S. Census divisions. We conducted a deductive qualitative analysis. RESULTS Cigarette package designs captured the participants’ attention, suggested the characteristics of the product, and reflected (or could be leveraged to convey) multiple dimensions of consumer identity. Particular to the affective responses to design, our participants shared that cigarette packaging conveyed how the pack could be used to particular ends, created an emotional response to the designs, complied with normative expectations of a cigarette, elicited interest when designs change, and prompted fascination when unique design characteristics are used. CONCLUSIONS Use of the Context of Consumption Framework for cigarette product packaging design can inform regulatory research on tobacco product packaging. Researchers and regulators should consider multiple cognitive, affective, and behavioral responses to cigarette pack design. PMID:29593883

Selected aspects of tobacco control in Croatia.

PubMed

Loubeau, Patricia R

2009-03-01

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

The relation between cigarette taxes and older adult smoking in Zhejiang and Gansu: what happened following the 2009 Chinese Tax adjustments?

PubMed

Wang, Qing

2017-04-04

In May 2009, the Chinese government raised cigarette excise tax rates and adjusted standards for Grade A cigarettes and Grade B cigarettes. The present study aimed to examine the effects of the tax adjustments in 2009 on smoking behaviors and health outcomes among smokers aged above 45. Data from the 2008 and 2012 China Health and Retirement Longitudinal Study of Zhejiang and Gansu provinces were used to estimate the influence of tax increase on the number of cigarettes smoked daily and health capital. The sample included 706 smokers who were 45 years old and older at the time of data collection in 2008. The sample group was surveyed again in 2012. The final sample size was 1366. Logit model was applied. Cigarette tax adjustment in 2009 resulted in the decrease in the likelihood of smoking 0-10 cigarettes per day by 1.06%; the increase in the likelihood of those smoking 11-20 cigarettes per day by 0.44%; and, those smoking 20 cigarettes or more by 0.63%; the decrease in the likelihood of good health by 0.47%; the increase in the prevalence of chronic disease by 1.34%. The smoke tax adjustment in 2009 worsened individual unhealthy smoking behaviors and health outcomes. The proposed cigarette tax levied at the retail level can reduce the State Tobacco Monopoly Administration's control overall and each price and increase the influence of the market on cigarette consumption in China.

Socio-economic variations in tobacco consumption, intention to quit and self-efficacy to quit among male smokers in Thailand and Malaysia: results from the International Tobacco Control-South-East Asia (ITC-SEA) survey.

PubMed

Siahpush, Mohammad; Borland, Ron; Yong, Hua-Hie; Kin, Foong; Sirirassamee, Buppha

2008-03-01

Aim To examine the association of socio-economic position (education, income and employment status) with cigarette consumption, intention to quit and self-efficacy to quit among male smokers in Thailand and Malaysia. Design and setting The data were based on a survey of adult smokers conducted in early 2005 in Thailand and Malaysia as part of the International Tobacco Control-South-East Asia (ITC-SEA) project. Participants A total of 1846 men in Thailand and 1906 men in Malaysia. Measurement Participants were asked questions on daily cigarette consumption, intention to quit and self-efficacy to quit in face-to-face interviews. Findings Analyses were based on multivariate regression models that adjusted for all three socio-economic indicators. In Thailand, higher level of education was associated strongly with not having self-efficacy, associated weakly with having an intention to quit and was not associated with cigarette consumption. Higher income was associated strongly with having self-efficacy, associated weakly with high cigarette consumption and was not associated with having an intention to quit. Being employed was associated strongly with having an intention to quit and was not associated with cigarette consumption or self-efficacy. In Malaysia, higher level of education was not associated with any of the outcomes. Higher income was associated strongly with having self-efficacy, and was not associated with the other outcomes. Being employed was associated moderately with higher cigarette consumption and was not associated with the other outcomes. Conclusion Socio-economic and cultural conditions, as well as tobacco control policies and tobacco industry activities, shape the determinants of smoking behaviour and beliefs. Existing knowledge from high-income countries about disparities in smoking should not be generalized readily to other countries.

Predicting Alcohol, Cigarette, and Marijuana Use from Preferential Music Consumption

ERIC Educational Resources Information Center

Oberle, Crystal D.; Garcia, Javier A.

2015-01-01

This study investigated whether use of alcohol, cigarettes, and marijuana may be predicted from preferential consumption of particular music genres. Undergraduates (257 women and 78 men) completed a questionnaire assessing these variables. Partial correlation analyses, controlling for sensation-seeking tendencies and behaviors, revealed that…

[Adolescent daily smoking, negative mood-states and the role of family communication].

PubMed

Martínez-Hernáez, Ángel; Marí-Klose, Marga; Julià, Albert; Escapa, Sandra; Marí-Klose, Pau; DiGiacomo, Susan

2012-01-01

To determine whether negative mood states constitute a risk factor for daily smoking during adolescence, and to specify the role of familial factors in the association between the two variables. Cross-sectional study of a representative sample (second wave, Panel of Families and Childhood) of Catalan adolescents between 14 and 18 years of age. Six logistic regression models were used for girls (n = 1,442) and six for boys (n =1,100) in order to determine whether negative mood states constitute a risk factor for daily cigarette consumption, and to what extent this effect is attributable to familial factors. The prevalence of daily smoking at ages 17-18 is 3.8% for girls and 3.6 for boys. Feelings of sadness constitute a risk factor for daily cigarette consumption (odds ratio [OR] = 1.633), and communication with the father cancels out this effect. Parental pressure is a risk factor for daily smoking in both sexes (girls, OR = 2.064; boys, OR = 1.784). When parental communication is controlled for, this effect is reduced but not canceled out. Living in a reconstituted family is a risk factor for daily cigarette consumption among boys (OR = 2.988). Intergenerational communication decreases the risk of daily tobacco use among adolescents independently of their mood state. Anti-smoking interventions designed in accordance with these findings may be more effective. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

Are smokers rational addicts? Empirical evidence from the Indonesian Family Life Survey

PubMed Central

2011-01-01

Background Indonesia is one of the largest consumers of tobacco in the world, however there has been little work done on the economics addiction of tobacco. This study provides an empirical test of a rational addiction (henceforth RA) hypothesis of cigarette demand in Indonesia. Methods Four estimators (OLS, 2SLS, GMM, and System-GMM) were explored to test the RA hypothesis. The author adopted several diagnostics tests to select the best estimator to overcome econometric problems faced in presence of the past and future cigarette consumption (suspected endogenous variables). A short-run and long-run price elasticities of cigarettes demand was then calculated. The model was applied to individuals pooled data derived from three-waves a panel of the Indonesian Family Life Survey spanning the period 1993-2000. Results The past cigarette consumption coefficients turned out to be a positive with a p-value < 1%, implying that cigarettes indeed an addictive goods. The rational addiction hypothesis was rejected in favour of myopic ones. The short-run cigarette price elasticity for male and female was estimated to be-0.38 and -0.57, respectively, and the long-run one was -0.4 and -3.85, respectively. Conclusions Health policymakers should redesign current public health campaign against cigarette smoking in the country. Given the demand for cigarettes to be more prices sensitive for the long run (and female) than the short run (and male), an increase in the price of cigarettes could lead to a significant fall in cigarette consumption in the long run rather than as a constant source of government revenue. PMID:21345229

Are smokers rational addicts? Empirical evidence from the Indonesian Family Life Survey.

PubMed

Hidayat, Budi; Thabrany, Hasbullah

2011-02-23

Indonesia is one of the largest consumers of tobacco in the world, however there has been little work done on the economics addiction of tobacco. This study provides an empirical test of a rational addiction (henceforth RA) hypothesis of cigarette demand in Indonesia. Four estimators (OLS, 2SLS, GMM, and System-GMM) were explored to test the RA hypothesis. The author adopted several diagnostics tests to select the best estimator to overcome econometric problems faced in presence of the past and future cigarette consumption (suspected endogenous variables). A short-run and long-run price elasticities of cigarettes demand was then calculated. The model was applied to individuals pooled data derived from three-waves a panel of the Indonesian Family Life Survey spanning the period 1993-2000. The past cigarette consumption coefficients turned out to be a positive with a p-value < 1%, implying that cigarettes indeed an addictive goods. The rational addiction hypothesis was rejected in favour of myopic ones. The short-run cigarette price elasticity for male and female was estimated to be-0.38 and -0.57, respectively, and the long-run one was -0.4 and -3.85, respectively. Health policymakers should redesign current public health campaign against cigarette smoking in the country. Given the demand for cigarettes to be more prices sensitive for the long run (and female) than the short run (and male), an increase in the price of cigarettes could lead to a significant fall in cigarette consumption in the long run rather than as a constant source of government revenue.

Examining the relationships between posttraumatic stress disorder symptoms, positive smoking outcome expectancies, and cigarette smoking in people with substance use disorders: a multiple mediator model.

PubMed

Hruska, Bryce; Bernier, Jennifer; Kenner, Frank; Kenne, Deric R; Boros, Alec P; Richardson, Christopher J; Delahanty, Douglas L

2014-01-01

Cigarette smoking is highly prevalent in people with substance use disorders (SUDs) and is associated with significant physical health problems. Posttraumatic stress disorder (PTSD) is also highly associated with both SUDs and cigarette smoking and may serve as a barrier to smoking cessation efforts. In addition, people with PTSD are more likely to hold positive smoking outcome expectancies (i.e., beliefs that smoking cigarettes results in positive outcomes); these beliefs may contribute to cigarette smoking in people with SUDs experiencing PTSD symptoms. The present study examined the relationship between PTSD symptoms and typical daily cigarette smoking/cigarette dependence symptoms in a sample of 227 trauma-exposed current smokers with SUDs (59.9% male, 89.4% Caucasian) seeking detoxification treatment services. Additionally, the indirect effects of multiple types of positive smoking outcome expectancies on these relationships were examined. Participants completed questionnaires assessing PTSD symptoms, positive smoking outcome expectancies, cigarette consumption, and cigarette dependence symptoms. Results indicated that PTSD symptoms were not directly related to cigarette consumption or cigarette dependence symptoms. However, negative affect reduction outcome expectancies were shown to have a significant indirect effect between PTSD symptoms and cigarette consumption, while negative affect reduction, boredom reduction, and taste-sensorimotor manipulation outcome expectancies were all found to have significant indirect effects between PTSD symptoms and cigarette dependence symptoms. The indirect effect involving negative affect reduction outcome expectancies was statistically larger than that of taste sensorimotor manipulation outcome expectancies, while negative affect reduction and boredom reduction outcome expectancies were comparable in magnitude. These results suggest that expectancies that smoking can manage negative affective experiences are related to cigarette smoking in people with SUDs experiencing PTSD symptoms and suggest that effective smoking cessation treatments should take into account these expectancies. © 2013.

[Cigarette consumer price and affordability in China: results from 2015 China adult survey].

PubMed

Wang, L L; Yang, Y; Nan, Y; Tu, M W; Wang, J J; Jiang, Y

2017-01-10

Objective: To analyze the change of cigarette consumption price, and understand the cigarette affordability in China. Methods: A total of 16 800 households were selected through multi-stage stratified cluster sampling. Then IPAQ was used to randomly select one family member to conduct the survey. Questionnaire from Global Tobacco Surveillance System with added country-specific questions was used. Results: Up to 50 % of current smokers would buy 20 cigarettes with price of 9.9 yuan (RMB) or less, and 25 % of current smokers would not buy 20 cigarettes with price exceed 5.5 yuan (RMB). Only 10 % would buy 20 cigarettes with price over 19.9 yuan (RMB). The calculated median monthly expenditure for cigarettes was 181.4 yuan (RMB). From 2010 to 2015, the proportion of annual expenditure for cigarettes in disposable income per capita declined from 10.5 % to 8.8 % in urban area and from 21.1 % to 17.3 % in rural area. Conclusion: During 2010-2015, the purchasing power of Chinese smokers increased in both urban area and rural area due to the decrease of cigarette consumption price.

Is the use of electronic cigarettes while smoking associated with smoking cessation attempts, cessation and reduced cigarette consumption? A survey with a 1‐year follow‐up

PubMed Central

Hitchman, Sara C.; Brown, Jamie; West, Robert; McNeill, Ann

2015-01-01

Abstract Aims To use a unique longitudinal data set to assess the association between e‐cigarette use while smoking with smoking cessation attempts, cessation and substantial reduction, taking into account frequency of use and key potential confounders. Design Web‐based survey, baseline November/December 2012, 1‐year follow‐up in December 2013. Setting Great Britain. Participants National general population sample of 4064 adult smokers, with 1759 (43%) followed‐up. Measurements Main outcome measures were cessation attempt, cessation and substantial reduction (≥50% from baseline to follow‐up) of cigarettes per day (CPD). In logistic regression models, cessation attempt in the last year (analysis n = 1473) and smoking status (n = 1656) at follow‐up were regressed on to baseline e‐cigarette use (none, non‐daily, daily) while adjusting for baseline socio‐demographics, dependence and nicotine replacement (NRT) use. Substantial reduction (n = 1042) was regressed on to follow‐up e‐cigarette use while adjusting for baseline socio‐demographics and dependence and follow‐up NRT use. Findings Compared with non‐use, daily e‐cigarette use at baseline was associated with increased cessation attempts [odds ratio (OR) = 2.11, 95% confidence interval (CI) = 1.24–3.58, P = 0.006], but not with cessation at follow‐up (OR = 0.62, 95% CI = 0.28–1.37, P = 0.24). Non‐daily use was not associated with cessation attempts or cessation. Daily e‐cigarette use at follow‐up was associated with increased odds of substantial reduction (OR = 2.49, 95% CI = 1.14–5.45, P = 0.02), non‐daily use was not. Conclusions Daily use of e‐cigarettes while smoking appears to be associated with subsequent increases in rates of attempting to stop smoking and reducing smoking, but not with smoking cessation. Non‐daily use of e‐cigarettes while smoking does not appear to be associated with cessation attempts, cessation or reduced smoking. PMID:25900312

Is the use of electronic cigarettes while smoking associated with smoking cessation attempts, cessation and reduced cigarette consumption? A survey with a 1-year follow-up.

PubMed

Brose, Leonie S; Hitchman, Sara C; Brown, Jamie; West, Robert; McNeill, Ann

2015-07-01

To use a unique longitudinal data set to assess the association between e-cigarette use while smoking with smoking cessation attempts, cessation and substantial reduction, taking into account frequency of use and key potential confounders. Web-based survey, baseline November/December 2012, 1-year follow-up in December 2013. Great Britain. National general population sample of 4064 adult smokers, with 1759 (43%) followed-up. Main outcome measures were cessation attempt, cessation and substantial reduction (≥50% from baseline to follow-up) of cigarettes per day (CPD). In logistic regression models, cessation attempt in the last year (analysis n = 1473) and smoking status (n = 1656) at follow-up were regressed on to baseline e-cigarette use (none, non-daily, daily) while adjusting for baseline socio-demographics, dependence and nicotine replacement (NRT) use. Substantial reduction (n = 1042) was regressed on to follow-up e-cigarette use while adjusting for baseline socio-demographics and dependence and follow-up NRT use. Compared with non-use, daily e-cigarette use at baseline was associated with increased cessation attempts [odds ratio (OR) = 2.11, 95% confidence interval (CI) = 1.24-3.58, P = 0.006], but not with cessation at follow-up (OR = 0.62, 95% CI = 0.28-1.37, P = 0.24). Non-daily use was not associated with cessation attempts or cessation. Daily e-cigarette use at follow-up was associated with increased odds of substantial reduction (OR = 2.49, 95% CI = 1.14-5.45, P = 0.02), non-daily use was not. Daily use of e-cigarettes while smoking appears to be associated with subsequent increases in rates of attempting to stop smoking and reducing smoking, but not with smoking cessation. Non-daily use of e-cigarettes while smoking does not appear to be associated with cessation attempts, cessation or reduced smoking. © 2015 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Slowing Menthol's Progress: Differential Impact of a Tobacco Tax Increase on Cigarette Sales.

PubMed

Amato, Michael S; D'Silva, Joanne; Boyle, Raymond G

2016-05-01

The proportion of smokers who use menthol cigarettes has increased nationally since 2004, while use of non-menthol cigarettes is declining, suggesting that menthol may be undermining the effectiveness of population level tobacco control efforts. In 2013 Minnesota passed a $1.75 cigarette tax increase. We investigated whether sales of menthol and non-menthol cigarettes were differentially affected by the price increase. Cigarette sales data from convenience stores in the Minneapolis, Minnesota, metro area from January 2012, through May 2015, were obtained. Proportion of sales accounted for by menthol cigarettes was analyzed with segmented regression. Before the price increase, menthol cigarettes gained 2.21% (1.17, 3.12) of market share annually. Following the price increase, the trend slowed to 0.26% (-0.78, 1.56) annually. The slope before the price increase was significantly positive; the slope following the price increase did not significantly differ from zero. Sales of menthol cigarettes declined less rapidly than non-menthol cigarettes before the price increase. Sales of menthol and non-menthol cigarettes declined at more comparable rates after the price increase. Increasing the price of tobacco may help ensure declines in consumption are more evenly distributed across menthol and non-menthol cigarettes. Using sales data, we found that a trend of increasing market share for menthol cigarettes was significantly reduced by a $1.75 cigarette price increase. These results suggest that cigarette price increases, a core tobacco control policy, may have a greater effect on menthol smokers than non-menthol smokers. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A novel approach to estimating the prevalence of untaxed cigarettes in the USA: findings from the 2009 and 2010 international tobacco control surveys.

PubMed

Fix, Brian V; Hyland, Andrew; O'Connor, Richard J; Cummings, K Michael; Fong, Geoffrey T; Chaloupka, Frank J; Licht, Andrea S

2014-03-01

Increases in tobacco taxes are effective in reducing tobacco consumption, but because of the addictive nature of cigarettes, smokers often seek out less expensive sources of cigarettes. The objective of this study is to estimate the prevalence of cigarette packs that are untaxed by the state in which the participant resides in a sample of US smokers at two time points. Data for this study were taken from the 2009 and 2010 waves of the International Tobacco Control United States Survey. Members of this nationally representative cohort of smokers were invited to send us an unopened pack of their usual brand of cigarettes. In 2009, 318 packs were received from 401 eligible participants (79%). In 2010, 366 packs were received from 491 eligible participants (75%). In total, 20% of the packs in 2009 and 21% in 2010 were classified as untaxed by the participant's state of residence. The prevalence of untaxed cigarettes was higher in states with higher-excise taxes. Smokers who do not have a plan to quit were significantly more likely to have sent back a pack that was classified as untaxed by the participant's state of residence. One in five packs were untaxed with rates higher in states with higher-excise taxes. It is unclear whether these estimates differ from the actual prevalence of cigarettes that are untaxed by a smoker's state of residence. Harmonisation of excise tax rates across all 50 US states might be one method of reducing or eliminating the incentive to avoid or evade these taxes.

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

PubMed

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

2015-06-01

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

Cigarette, Water-pipe, and Medwakh Smoking Prevalence Among Applicants to Abu Dhabi's Pre-marital Screening Program, 2011

PubMed Central

Aden, Bashir; Karrar, Sara; Shafey, Omar; Al Hosni, Farida

2013-01-01

Background: This study assesses self-reported tobacco use prevalence (cigarette, water-pipe, and medwakh) among applicants to Abu Dhabi's Premarital Screening program during 2011. Methods: Premarital Screening data reported to the Health Authority – Abu Dhabi from April to December 2011 were utilized to estimate tobacco use prevalence among applicants. Smoking prevalence was examined by nationality, age group and gender. Results: Overall, 24.7% of Premarital Screening Program applicants were current smokers; 11.5% smoked cigarettes, 5.9% smoked medwakh (hand-held pipe), 4.8% smoked water-pipe and 2.5% smoked a combination (more than one type). Men (19.2%) were more likely than women (3.5%) to be current cigarette smokers. Women were much less likely to smoke medwakh (0.1%) than men (11.5%), with male UAE Nationals having the highest medwakh smoking prevalence (16.1%). The overall prevalence of water-pipe smoking was 6.8% among men and 2.8% for women with the highest water-pipe smoking prevalence (10.2%) among Arab expatriate men. Conclusions: Variations in tobacco use prevalence among Premarital Screening Program applicants reflect preferences for different modes of tobacco consumption by nationality, age group and gender. Enforcement of tobacco control laws, including implementation of clean indoor air laws and tobacco tax increases, and targeted health education programs are required to reduce tobacco consumption and concomitant tobacco-related morbidity and mortality. PMID:24404364

Vulnerability and self-perceived health status among light and heavy smokers: the relationship to short-term fear appeal tobacco control messages.

PubMed

Szklo, André Salem; Coutinho, Evandro Silva Freire

2009-07-01

It is important to stimulate smokers to acquire some level of risk perception associated with their current behavior in order to motivate smoking cessation. The present article attempts to understand how the content of short-term fear appeal government tobacco messages may interact with different levels of daily cigarette consumption in order to affect smokers' vulnerabilities, expressed by self-perceived health status. A Poisson model was used to estimate the prevalence ratio of fair or poor self-perceived health status (FPHS) according to daily cigarette consumption. We also calculated the proportions of smokers who stated that selected health warning pictures on cigarette packets encourage people to quit smoking, stratified by self-perceived health status and daily cigarette consumption. The proportion of smokers with FPHS was 25% higher among those who smoked > 20 cigarettes/day (p = 0.01). Among smokers with FPHS, heavy smokers showed the highest proportions of responses in favor of selected warning pictures most closely related to losses in ordinary daily living, such as shortness of breath and being bothered by cigarette addiction. Short-term loss-framed tobacco control messages seem to have raised awareness of vulnerability among heavier smokers.

Quit and Smoking Reduction Rates in Vape Shop Consumers: A Prospective 12-Month Survey

PubMed Central

Polosa, Riccardo; Caponnetto, Pasquale; Cibella, Fabio; Le-Houezec, Jacques

2015-01-01

Aims: Here, we present results from a prospective pilot study that was aimed at surveying changes in daily cigarette consumption in smokers making their first purchase at vape shops. Modifications in products purchase were also noted. Design: Participants were instructed how to charge, fill, activate and use their e-cigarettes (e-cigs). Participants were encouraged to use these products in the anticipation of reducing the number of cig/day smoked. Settings: Staff from LIAF contacted 10 vape shops in the province of the city of Catania (Italy) that acted as sponsors to the 2013 No Tobacco Day. Participants: 71 adult smokers (≥18 years old) making their first purchase at local participating vape shops were asked by professional retail staff to complete a form. Measurements: Their cigarette consumption was followed-up prospectively at 6 and 12 months. Details of products purchase (i.e., e-cigs hardware, e-liquid nicotine strengths and flavours) were also noted. Findings: Retention rate was elevated, with 69% of participants attending their final follow-up visit. At 12 month, 40.8% subjects could be classified as quitters, 25.4% as reducers and 33.8% as failures. Switching from standard refillables (initial choice) to more advanced devices (MODs) was observed in this study (from 8.5% at baseline to 18.4% at 12 month) as well as a trend in decreasing the e-liquid nicotine strength, with more participants adopting low nicotine strength (from 49.3% at baseline to 57.1% at 12 month). Conclusions: We have found that smokers purchasing e-cigarettes from vape shops with professional advice and support can achieve high success rates. PMID:25811767

Socioeconomic and country variations in cross-border cigarette purchasing as tobacco tax avoidance strategy. Findings from the ITC Europe Surveys.

PubMed

Nagelhout, Gera E; van den Putte, Bas; Allwright, Shane; Mons, Ute; McNeill, Ann; Guignard, Romain; Beck, François; Siahpush, Mohammad; Joossens, Luk; Fong, Geoffrey T; de Vries, Hein; Willemsen, Marc C

2014-03-01

Legal tobacco tax avoidance strategies such as cross-border cigarette purchasing may attenuate the impact of tax increases on tobacco consumption. Little is known about socioeconomic and country variations in cross-border purchasing. To describe socioeconomic and country variations in cross-border cigarette purchasing in six European countries. Cross-sectional data from adult smokers (n=7873) from the International Tobacco Control (ITC) Surveys in France (2006/2007), Germany (2007), Ireland (2006), The Netherlands (2008), Scotland (2006) and the rest of the UK (2007/2008) were used. Respondents were asked whether they had bought cigarettes outside their country in the last 6 months and how often. In French and German provinces/states bordering countries with lower cigarette prices, 24% and 13% of smokers, respectively, reported purchasing cigarettes frequently outside their country. In non-border regions of France and Germany, and in Ireland, Scotland, the rest of the UK and The Netherlands, frequent purchasing of cigarettes outside the country was reported by 2-7% of smokers. Smokers with higher levels of education or income, younger smokers, daily smokers, heavier smokers and smokers not planning to quit smoking were more likely to purchase cigarettes outside their country. Cross-border cigarette purchasing is more common in European regions bordering countries with lower cigarette prices and is more often reported by smokers with higher education and income. Increasing taxes in countries with lower cigarette prices, and reducing the number of cigarettes that can be legally imported across borders could help to avoid cross-border purchasing.

Effects of cigarette tax on cigarette consumption and the Chinese economy

PubMed Central

Hu, T; Mao, Z

2002-01-01

Objectives: To analyse a policy dilemma in China on public health versus the tobacco economy through additional cigarette tax. Methods: Using published statistics from 1980 through 1997 to estimate the impact of tobacco production and consumption on government revenue and the entire economy. These estimates relied on the results of estimated price elasticities of the demand for cigarettes in China. Results: Given the estimated price elasticities (-0.54), by introducing an additional 10% increase in cigarette tax per pack (from the current 40% to 50% tax rate), the central government tax revenue would twice exceed total losses in industry revenue, tobacco farmers' income, and local tax revenue. In addition, between 1.44 and 2.16 million lives would be saved by this tax increase. Conclusions: Additional taxation on cigarettes in China would be a desirable public policy for the Chinese government to consider. PMID:12035000

The effect of a major cigarette price change on smoking behavior in california: a zero-inflated negative binomial model.

PubMed

Sheu, Mei-Ling; Hu, Teh-Wei; Keeler, Theodore E; Ong, Michael; Sung, Hai-Yen

2004-08-01

The objective of this paper is to determine the price sensitivity of smokers in their consumption of cigarettes, using evidence from a major increase in California cigarette prices due to Proposition 10 and the Tobacco Settlement. The study sample consists of individual survey data from Behavioral Risk Factor Survey (BRFS) and price data from the Bureau of Labor Statistics between 1996 and 1999. A zero-inflated negative binomial (ZINB) regression model was applied for the statistical analysis. The statistical model showed that price did not have an effect on reducing the estimated prevalence of smoking. However, it indicated that among smokers the price elasticity was at the level of -0.46 and statistically significant. Since smoking prevalence is significantly lower than it was a decade ago, price increases are becoming less effective as an inducement for hard-core smokers to quit, although they may respond by decreasing consumption. For those who only smoke occasionally (many of them being young adults) price increases alone may not be an effective inducement to quit smoking. Additional underlying behavioral factors need to be identified so that more effective anti-smoking strategies can be developed.

Trends in cigarette smoking among refinery and petrochemical plant employees with a discussion of the potential impact on lung cancer.

PubMed

Tsai, S P; Wendt, J K; Hunter, R B

2001-09-01

To examine trends in cigarette smoking prevalence and intensity among petroleum industry employees over a 22-year period, from 1976 to 1997, and to evaluate the hypothesis that the (about 20%) lower lung cancer mortality, when compared with the general population, among these workers is due to lower average cigarette consumption. Self-reported smoking prevalence and intensity (number of cigarettes smoked per day) data were available from the Shell Health Surveillance System for approximately 5,400 employees in the 1970s, 11,000 in the 1980s, and 8,300 in the 1990s. Data were analyzed by gender, time period, and work status (production vs. staff). During the 22-year study period, smoking prevalence dropped significantly in this working population. When compared with the general US population, smoking prevalence trends were very similar. For the entire employee population, smoking prevalence was highest for women working in production (hourly) jobs. While smoking prevalence was higher among production employees than among staff employees, daily cigarette consumption was slightly lower. Cigarette consumption among Shell employees was similar to that in the US in the 1970s, but lower in the 1980s and 1990s. By applying smoking consumption data from the 1970s, the ratio of weighted lung cancer relative risks for Shell employees and the US general population was 0.98. In other words, the lung cancer mortality rate of refinery and petrochemical employees would be adjusted upward by 2% if one were to remove the influence of smoking consumption by Shell employees. Based on our data, it is unlikely that differences in smoking prevalence and intensity between refinery/petrochemical workers and the general population could account for the lower risk of lung cancer mortality reported in the literature.

Can we measure daily tobacco consumption in remote indigenous communities? Comparing self-reported tobacco consumption with community-level estimates in an Arnhem Land study.

PubMed

Clough, Alan R; MacLaren, David J; Robertson, Jan A; Ivers, Rowena G; Conigrave, Katherine M

2011-03-01

In remote Indigenous Australian communities measuring individual tobacco use can be confounded by cultural expectations, including sharing. We compared self-reported tobacco consumption with community-level estimates in Arnhem Land (Northern Territory). In a cross-sectional survey in three communities (population 2319 Indigenous residents, aged ≥16 years), 400 Indigenous residents were interviewed (206 men, 194 women). Eight community stores provided information about tobacco sold during the survey. To gauge the impact of 255 non-Indigenous residents on tobacco turnover, 10 were interviewed (five men, five women). Breath carbon monoxide levels confirmed self-reported smoking. Self-reported number of cigarettes smoked per day was compared with daily tobacco consumption per user estimated using amounts of tobacco sold during 12 months before the survey (2007-2008). 'Lighter smokers' (<10 cigarettes per day) and 'heavier smokers' (≥10 cigarettes per day) in men and women were compared. Of 400 Indigenous study participants, 305 (76%) used tobacco; four chewed tobacco. Of 301 Indigenous smokers, 177 (58%) provided self-reported consumption information; a median of 11-11.5 cigarettes per day in men and 5.5-10 cigarettes per day in women. Men were three times (odds ratio=2.9) more likely to be 'heavier smokers'. Store turnover data indicated that Indigenous tobacco users consumed the equivalent of 9.2-13.1 cigarettes per day; very similar to self-reported levels. Sixty per cent (=6/10) of non-Indigenous residents interviewed were smokers, but with little impact on tobacco turnover overall (2-6%). Smoking levels reported by Indigenous Australians in this study, when sharing tobacco was considered, closely reflected quantities of tobacco sold in community stores. © 2010 Australasian Professional Society on Alcohol and other Drugs.

History of Bhutan's prohibition of cigarettes: implications for neo-prohibitionists and their critics.

PubMed

Givel, Michael S

2011-07-01

Recently, cigarette neo-prohibitionists have argued that a cigarette ban can be obtained from a de-facto phase-out of cigarettes based on a combination of effective anti-tobacco regulations and high taxes in conjunction with aggressive application of nicotine replacement therapies. The purpose of this study was to ascertain whether these claims were valid in Bhutan, which enacted a national cigarette sales prohibition law in 2004. Did Bhutan from 2004 to 2009 eliminate or nearly eliminate cigarette consumption and avoid a significant cigarette black market and smuggling? This study is a historical, qualitative, descriptive statistical, and archival content overview from 2004 to 2009 of smoking prevalence rates and smuggling and black market trends subsequent to the enactment of the Bhutan Penal Code Act of 2004. For adults in Bhutan, tobacco prevalence rates are fairly low compared with other nations but in 2008 remained a serious health issue for those who consumed cigarettes. For minors, tobacco consumption and second hand smoke exposure in 2008 was a significant health issue. In addition, the best available evidence indicates that illegal tobacco smuggling including black market sales due to the sales ban in Bhutan remains robust. So far, in Bhutan, cigarette neo-prohibitionist arguments that stringent anti-tobacco tax and regulatory approaches including a sales prohibition will induce tobacco consumption to cease or nearly cease has not occurred. In addition, the best scientific evidence indicates that a harm reduction-oriented nicotine replacement therapy approach will not be entirely effective. The results of this study provide an important lesson learned for health practitioners and advocates considering or advocating, albeit a gradual, but total cigarette ban as public policy. Copyright © 2011 Elsevier B.V. All rights reserved.

The Effects of Maternal Alcohol Consumption and Cigarette Smoking during Pregnancy on Acoustic Cry Analysis.

ERIC Educational Resources Information Center

Nugent, J. Kevin; And Others

1996-01-01

Measured the neurobehavioral integrity of Irish infants and maternal alcohol consumption and cigarette smoking. Subjects were 127 primiparous mothers. Results demonstrated significant cry effects on infants of heavily drinking mothers, supporting the conclusion that newborn infants show functional disturbances in the nervous system resulting from…

Physical Activity, Body Mass Index, Alcohol Consumption and Cigarette Smoking among East Asian College Students

ERIC Educational Resources Information Center

Seo, Dong-Chul; Torabi, Mohammad R.; Chin, Ming-Kai; Lee, Chung Gun; Kim, Nayoung; Huang, Sen-Fang; Chen, Chee Keong; Mok, Magdalena Mo Ching; Wong, Patricia; Chia, Michael; Park, Bock-Hee

2014-01-01

Objective: To identify levels of moderate-intensity physical activity (MPA) and vigorous-intensity physical activity (VPA) in a representative sample of college students in six East Asian economies and examine their relationship with weight, alcohol consumption and cigarette smoking. Design: Cross-sectional survey. Setting: College students…

Measuring changes in the illicit cigarette market using government revenue data: the example of South Africa

PubMed Central

van Walbeek, Corné

2014-01-01

Background The tobacco industry claims that illicit trade in cigarettes has increased sharply since the 1990s and that government has lost substantial tax revenue. Objectives (1) To determine whether cigarette excise tax revenue has been below budget in recent years, compared with previous decades. (2) To determine trends in the size of the illicit market since 1995. Methods For (1), mean percentage errors and root mean square percentage errors were calculated for budget revenue deviation for three products (cigarettes, beer and spirits), for various subperiods. For (2), predicted changes in total consumption, using actual cigarette price and GDP changes and previously published price and income elasticity estimates, were calculated and compared with changes in tax-paid consumption. Results Cigarette excise revenues were 0.7% below budget for 2000–2012 on average, compared with 3.0% below budget for beer and 4.7% below budget for spirits. There is no evidence that illicit trade in cigarettes in South Africa increased between 2002 and 2009. There is a substantial increase in illicit trade in 2010, probably peaking in 2011. In 2012 tax-paid consumption of cigarettes increased 2.6%, implying that the illicit market share decreased an estimated 0.6 percentage points. Conclusions Other than in 2010, there is no evidence that illicit trade is significantly undermining government revenue. Claims that illicit trade has consistently increased over the past 15 years, and has continued its sharp increase since 2010, are not supported. PMID:24431121

Exploring the relationship between cigarette prices and smoking among adults: a cross-country study of low- and middle-income nations.

PubMed

Kostova, Deliana; Tesche, Jean; Perucic, Anne-Marie; Yurekli, Ayda; Asma, Samira

2014-01-01

Evidence on the relationship between cigarette prices and adult smoking in low- and middle-income countries (LMICs) is relatively limited. This study offers new descriptive evidence on this relationship using data from a set of 13 LMICs. We use Global Adult Tobacco Survey (GATS) cross-country data from approximately 200,000 participants aged 15 and older. Estimates on the relationship between prices and adult smoking were obtained from logit models of smoking participation and ordinary least squares models of conditional cigarette demand. Higher prices were associated with lower demand across countries, in terms of both smoking prevalence and daily number of cigarettes smoked among smokers. Our estimates suggest that the total price elasticity of cigarette demand in LMICs is approximately -0.53. We find that higher socioeconomic status (SES), represented through wealth and education effects is associated with lower chance of smoking overall, but among existing smokers, it may be associated with a larger number of cigarettes smoked. After controlling for a set of individual demographic and country characteristics, cigarette prices retain a significant role in shaping cigarette demand across LMICs. Because higher SES is associated with a reduced chance of smoking overall but also with increased daily consumption among current smokers, optimal tobacco tax policies in LMICs may face an added need to accommodate to shifting SES structures within the populations of these countries.

Cigarette Excise Taxes in Context: Cautionary Lessons from the U.S. Experience.

PubMed

Campbell, Richard B; Balbach, Edith D

2015-01-01

Cigarette excise taxes are an important tool in the World Health Organization Framework Convention on Tobacco Control strategy for reducing global tobacco consumption. However, contemporary tobacco control efforts also coincide with the proliferation of neoliberal economic programs calling for the withdrawal of state activity from the economy to facilitate trade. In this environment, cigarette excise taxes may be seen less as an instrument of tobacco control than a feature of an economic program that is punitive to lower-income people. This article reviews collaboration between progressive organizations in the United States and the tobacco industry in the 1980s and 1990s, documenting potential sources of unanticipated resistance to excise taxes and highlighting the tobacco industry's capacity to engage in policy issues through third-party surrogates. It is important for those implementing cigarette excise tax increases to distance tobacco control objectives from larger economic policy measures and for tobacco control advocates to build alliances with organizations working for economic fairness in order to address mutual concerns. © SAGE Publications 2015.

First Nations Communities and Tobacco Taxation: A Commentary

ERIC Educational Resources Information Center

Samji, Hasina; Wardman, Dennis

2009-01-01

Taxation of tobacco is a widely used strategy that promotes smoking cessation among adults and reduces cigarette consumption among continuing smokers. First Nations (FN) populations' tobacco use is estimated to be 2-3 times that of other Canadians and, in part, a reflection that tobacco products purchased on reserve by FN people are tax exempt.…

Smoking bans, cigarette prices and life satisfaction.

PubMed

Odermatt, Reto; Stutzer, Alois

2015-12-01

The consequences of tobacco control policies for individual welfare are difficult to assess, even more so when related consumption choices challenge people's willpower. We therefore evaluate the impact of smoking bans and cigarette prices on subjective well-being by analyzing data for 40 European countries and regions between 1990 and 2011. We exploit the staggered introduction of bans and apply an imputation strategy to study the effect of anti-smoking policies on people with different propensities to smoke. We find that higher cigarette prices reduce the life satisfaction of likely smokers. Overall, smoking bans are barely related to subjective well-being, but increase the life satisfaction of smokers who would like to quit smoking. The latter finding is consistent with cue-triggered models of addiction and the idea of bans as self-control devices. Copyright © 2015 Elsevier B.V. All rights reserved.

[Cigarette smuggling: a wide scope phenomenon only there to serve the interests of big tobacco manufacturers].

PubMed

Gauvin, Louis

2005-01-01

"Cigarette smuggling: a wide scope phenomenon only there to serve the interests of big tobacco manuafacturers" uses industry officials' quotes and documents to describe how tobacco manufacturers are involved in the organisation of smuggling and how manufacturers use smuggling in two ways: on one hand, to flood markets with cheap cigarettes and defeat governements' efforts to reduce tobacco consumption by adopting one of the most efficient public health measures (ie: high taxation of tobacco products) and on the other hand, by using the false threat of increased contraband to scare politicians and prevent them from adopting strong fiscal policies. The Framework Convention on Tobacco Control (FCTC) with a protocol on smuggling and the collaboration between international agencies is a means to counter and defeat the tobacco industry attemps at sabotaging efficient public health measures.

Adolescent dual-product users: Acquisition and situational use of cigarettes and cigars.

PubMed

Trapl, Erika S; Koopman Gonzalez, Sarah J; Fryer, Craig S

2018-05-16

Little is known about how adolescents who smoke both cigarettes and cigar products obtain and use these products. This study sought to explore cigarette and cigar acquisition and situational use among high school smokers. Data are drawn from the 2011 Cuyahoga County Youth Risk Behavior Survey. Analysis was limited to youth who smoke cigarettes as well as cigars, cigarillos, and little cigars (CCLC) in the past month (N = 649). Consumption of both products was calculated and used to create four subtypes of users based on high or low use of each product (Dual High, Dual Low, High CCLC/Low Cigarette, and Low CCLC/High Cigarette users). Current users were asked to identify situations in which they use cigarettes and CCLCs and ways in which they obtain these products. Data were analyzed overall and by user subtype. Youth reported acquiring cigarettes and CCLC in similar ways, although youth were more likely to take cigarettes from family members than CCLC (11.1% vs. 4.8%). Several differences were observed between cigarettes and CCLC for situational use. While both products are frequently used in social situations (e.g., with friends), cigarettes were more likely to be used in solitary situations (e.g., before bed). Further, significant differences were observed among the four user subtypes. Study results highlight important, nuanced differences regarding how young multi-tobacco users obtain and the situational use of such products. Importantly, these findings vary by user subtype, informing future interventions to prevent and reduce smoking among the most vulnerable subgroups of youth. Copyright © 2018 Elsevier B.V. All rights reserved.

Do e-cigarettes have the potential to compete with conventional cigarettes?: a survey of conventional cigarette smokers' experiences with e-cigarettes.

PubMed

Kralikova, Eva; Novak, Jan; West, Oliver; Kmetova, Alexandra; Hajek, Peter

2013-11-01

Electronic cigarettes (ECs) are becoming increasingly popular globally. If they were to replace conventional cigarettes, it could have a substantial impact on public health. To evaluate EC's potential for competing with conventional cigarettes as a consumer product, we report the first data, to our knowledge, on the proportion of smokers who try ECs and become regular users. A total of 2,012 people seen smoking or buying cigarettes in the Czech Republic were approached to answer questions about smoking, with no mention made of ECs to avoid the common bias in surveys of EC users. During the interview, the volunteers' experience with ECs was then discussed. A total of 1,738 smokers (86%) participated. One-half reported trying ECs at least once. Among those who tried ECs, 18.3% (95% CI, 0.15.7%-20.9%) reported using them regularly, and 14% (95% CI, 11.6%-16.2%) used them daily. On average, regular users used ECs daily for 7.1 months. The most common reason for using ECs was to reduce consumption of conventional cigarettes; 60% of regular EC users reported that ECs helped them to achieve this. Being older and having a more favorable initial experience with ECs explained 19% of the variance in progressing to regular EC use. Almost one-fifth of smokers who try ECs once go on to become regular users. ECs may develop into a genuine competitor to conventional cigarettes. Government agencies preparing to regulate ECs need to ensure that such moves do not create a market monopoly for conventional cigarettes.

Changes in cigarette expenditure minimising strategies before and after a cigarette tax increase.

PubMed

Choi, Kelvin; Boyle, Raymond G

2018-01-01

Smokers use cigarette expenditure minimising strategies (CEMS) to alleviate the effect of tax increases on their cigarette expenses. We examined changes in smokers' CEMS use before and after a 2013 Minnesota $1.75 cigarette tax increase. Data were from representative samples of smokers who participated in the Minnesota Adult Tobacco Survey 2010 (n=948) and 2014 (n=1229). Participants indicated CEMS used in the past year from a list. Weighted multiple logistic regressions were used to examine changes in prevalence of each CEMS use over time adjusting for demographics and cigarette consumption. Characteristics associated with CEMS use in 2014 were examined. Between 2010 and 2014, more smokers tried to save money on cigarettes by rolling their own cigarettes (from 19% to 29%), using other tobacco products (from 13% to 25%), and buying cigarettes from cheaper places (from 48% to 55%). Yet, fewer smokers used coupons/promotions (from 63% to 50%) and bought cigarettes by the carton (from 39% to 32%). These changes varied somewhat by race/ethnicity and education, for example, more smokers with

Reductions in biomarkers of exposure (BoE) to harmful or potentially harmful constituents (HPHCs) following partial or complete substitution of cigarettes with electronic cigarettes in adult smokers

PubMed Central

O’Connell, Grant; Graff, Donald W.; D’Ruiz, Carl D.

2016-01-01

Abstract Changes in fifteen urine, blood and exhaled breath BoEs of HPHCs representing classes of compounds reported by FDA to be significant contributors to smoking-associated disease risks were measured in 105 clinical-confined subjects following randomization and a five-day forced-switch from usual brand conventional combustible cigarettes to: (i) exclusive commercial e-cigarette use; (ii) dual-use of commercial e-cigarettes and the subject’s usual cigarette brand; or (iii) discontinued use of all tobacco or nicotine products. Levels of urinary biomarkers in subjects that completely substituted their usual cigarette with e-cigarettes were significantly lower (29–95%) after 5 days. Percent reductions in eight of nine urinary BoEs were indistinguishable to smokers who had quit smoking, except for nicotine equivalents, which declined by 25–40%. Dual users who halved self-reported daily cigarette consumption with e-cigarettes exhibited reductions (7–38%) in eight of nine urinary biomarkers, but had increase (1–20%) in nicotine equivalents. Reductions were broadly proportional to the reduced numbers of cigarettes smoked. Dual user urinary nicotine equivalents were slightly higher, but not statistically significant. After 5 days, blood nicotine biomarker levels were lower in the cessation (75–96%) and exclusive use groups (11–83%); with dual users experiencing no significant reductions. All subjects experienced significant decreases in exhaled CO. Decreases in the cessation and exclusive groups ranged from 88–89% and 27–32% in dual users. Exhaled NO increased in the cessation and exclusive groups (46–63% respectively), whereas the dual users experienced minimal changes. Overall, smokers who completely or partially substituted conventional cigarettes with e-cigarettes over five days, experienced reductions in HPHCs. PMID:27401591

Reductions in biomarkers of exposure (BoE) to harmful or potentially harmful constituents (HPHCs) following partial or complete substitution of cigarettes with electronic cigarettes in adult smokers.

PubMed

O'Connell, Grant; Graff, Donald W; D'Ruiz, Carl D

2016-07-01

Changes in fifteen urine, blood and exhaled breath BoEs of HPHCs representing classes of compounds reported by FDA to be significant contributors to smoking-associated disease risks were measured in 105 clinical-confined subjects following randomization and a five-day forced-switch from usual brand conventional combustible cigarettes to: (i) exclusive commercial e-cigarette use; (ii) dual-use of commercial e-cigarettes and the subject's usual cigarette brand; or (iii) discontinued use of all tobacco or nicotine products. Levels of urinary biomarkers in subjects that completely substituted their usual cigarette with e-cigarettes were significantly lower (29-95%) after 5 days. Percent reductions in eight of nine urinary BoEs were indistinguishable to smokers who had quit smoking, except for nicotine equivalents, which declined by 25-40%. Dual users who halved self-reported daily cigarette consumption with e-cigarettes exhibited reductions (7-38%) in eight of nine urinary biomarkers, but had increase (1-20%) in nicotine equivalents. Reductions were broadly proportional to the reduced numbers of cigarettes smoked. Dual user urinary nicotine equivalents were slightly higher, but not statistically significant. After 5 days, blood nicotine biomarker levels were lower in the cessation (75-96%) and exclusive use groups (11-83%); with dual users experiencing no significant reductions. All subjects experienced significant decreases in exhaled CO. Decreases in the cessation and exclusive groups ranged from 88-89% and 27-32% in dual users. Exhaled NO increased in the cessation and exclusive groups (46-63% respectively), whereas the dual users experienced minimal changes. Overall, smokers who completely or partially substituted conventional cigarettes with e-cigarettes over five days, experienced reductions in HPHCs.

Price elasticity of demand of non-cigarette tobacco products: a systematic review and meta-analysis.

PubMed

Jawad, Mohammed; Lee, John Tayu; Glantz, Stanton; Millett, Christopher

2018-01-23

To systematically review the price elasticity of demand of non-cigarette tobacco products. Medline, Embase, EconLit and the Web of Science without language or time restrictions. Two reviewers screened title and abstracts, then full texts, independently and in duplicate. We based eligibility criteria on study design (interventional or observational), population (individuals or communities without geographic restrictions), intervention (price change) and outcome (change in demand). We abstracted data on study features, outcome measures, statistical approach, and single best own- and cross-price elasticity estimates with respect to cigarettes. We conducted a random effects meta-analysis for estimates of similar product, outcome and country income level. For other studies we reported median elasticities by product and country income level. We analysed 36 studies from 15 countries yielding 125 elasticity estimates. A 10% price increase would reduce demand by: 8.3% for cigars (95% CI 2.9 to 13.8), 6.4% for roll your owns (95% CI 4.3 to 8.4), 5.7% for bidis (95% CI 4.3 to 7.1) and 2.1% for smokeless tobacco (95% CI -0.6 to 4.8). Median price elasticities for all ten products were also negative. Results from few studies that examined cross-price elasticity suggested a positive substitution effect between cigarette and non-cigarette tobacco products. There is sufficient evidence in support of the effectiveness of price increases to reduce consumption of non-cigarette tobacco products as it is for cigarettes. Positive substitutability between cigarette and non-cigarette tobacco products suggest that tax and price increases need to be simultaneous and comparable across all tobacco products. © 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.

Trends and affordability of cigarette prices: ample room for tax increases and related health gains

PubMed Central

Guindon, G; Tobin, S; Yach, D

2002-01-01

Objectives: To compare cigarette price data from more than 80 countries using varying methods, examine trends in prices and affordability during the 1990s, and explore various policy implications pertaining to tobacco prices. Design: March 2001 cigarette price data from the Economist Intelligence Unit are used to compare cigarette prices across countries. To facilitate comparison and to assess affordability, prices are presented in US dollars, purchasing power parity (PPP) units using the Big Mac index as an indicator of PPP and in terms of minutes of labour required to purchase a pack of cigarettes. Annual real percentage changes in cigarette prices between 1990 and 2000 and annual changes in the minutes of labour required to buy cigarettes between 1991 and 2000 are also calculated to examine trends. Results: Cigarette prices tend to be higher in wealthier countries and in countries that have strong tobacco control programmes. On the other hand, minutes of labour required to purchase cigarettes vary vastly between countries. Trends between 1990 and 2000 in real prices and minutes of labour indicate, with some exceptions, that cigarettes have become more expensive in most developed countries but more affordable in many developing countries. However, in the UK, despite recent increases in price, cigarettes are still more affordable than they were in the 1960s. Conclusions: The results suggest that there is ample room to increase tobacco prices through taxation. In too many countries, cigarette prices have failed to keep up with increases in the general price level of goods and services, rendering them more affordable in 2000 than they were at the beginning of the decade. Opportunities to increase government revenue and improve health through reduced consumption brought about by higher prices have been overlooked in many countries. PMID:11891366

Socioeconomic and country variations in cross-border cigarette purchasing as tobacco tax avoidance strategy. Findings from the ITC Europe Surveys

PubMed Central

Nagelhout, Gera E.; van den Putte, Bas; Allwright, Shane; Mons, Ute; McNeill, Ann; Guignard, Romain; Beck, François; Siahpush, Mohammad; Joossens, Luk; Fong, Geoffrey T.; de Vries, Hein; Willemsen, Marc C.

2014-01-01

Background Legal tobacco tax avoidance strategies such as cross-border cigarette purchasing may attenuate the impact of tax increases on tobacco consumption. Little is known about socioeconomic and country variations in cross-border purchasing. Objective To describe socioeconomic and country variations in cross-border cigarette purchasing in six European countries. Methods Cross-sectional data from adult smokers (n = 7,873) from the International Tobacco Control (ITC) Surveys in France (2006/7), Germany (2007), Ireland (2006), the Netherlands (2008), Scotland (2006), and the rest of the United Kingdom (2007/8) were used. Respondents were asked whether they had bought cigarettes outside their country in the last six months and how often. Findings In French and German provinces/states bordering countries with lower cigarette prices, 24% and 13% of smokers respectively reported purchasing cigarettes frequently outside their country. In non-border regions of France and Germany and in Ireland, Scotland, the rest of the United Kingdom, and the Netherlands, frequent purchasing of cigarettes outside the country was reported by 2% to 7% of smokers. Smokers with higher levels of education or income, younger smokers, daily smokers, heavier smokers, and smokers not planning to quit smoking were more likely to purchase cigarettes outside their country. Conclusion Cross-border cigarette purchasing is more common in European regions bordering countries with lower cigarette prices and is more often reported by smokers with higher education and income. Increasing taxes in countries with lower cigarette prices and reducing the number of cigarettes that can be legally imported across borders could help to avoid cross-border purchasing. PMID:23644287

A novel approach to estimating the prevalence of untaxed cigarettes in the USA: findings from the 2009 and 2010 international tobacco control surveys

PubMed Central

Fix, Brian V; Hyland, Andrew; O’Connor, Richard J; Cummings, K Michael; Fong, Geoffrey T; Chaloupka, Frank J; Licht, Andrea S

2014-01-01

Background Increases in tobacco taxes are effective in reducing tobacco consumption, but because of the addictive nature of cigarettes, smokers often seek out less expensive sources of cigarettes. The objective of this study is to estimate the prevalence of cigarette packs that are untaxed by the state in which the participant resides in a sample of US smokers at two time points. Methods Data for this study were taken from the 2009 and 2010 waves of the International Tobacco Control United States Survey. Members of this nationally representative cohort of smokers were invited to send us an unopened pack of their usual brand of cigarettes. Results In 2009, 318 packs were received from 401 eligible participants (79%). In 2010, 366 packs were received from 491 eligible participants (75%). In total, 20% of the packs in 2009 and 21% in 2010 were classified as untaxed by the participant’s state of residence. The prevalence of untaxed cigarettes was higher in states with higher-excise taxes. Smokers who do not have a plan to quit were significantly more likely to have sent back a pack that was classified as untaxed by the participant’s state of residence. Conclusions One in five packs were untaxed with rates higher in states with higher-excise taxes. It is unclear whether these estimates differ from the actual prevalence of cigarettes that are untaxed by a smoker’s state of residence. Harmonisation of excise tax rates across all 50 US states might be one method of reducing or eliminating the incentive to avoid or evade these taxes. PMID:23970794

Differences between Dual Users and Switchers Center around Vaping Behavior and Its Experiences Rather than Beliefs and Attitudes

PubMed Central

2017-01-01

(1) Background: Many smokers completely switch to vaping (switchers), whereas others use e-cigarettes (e-cigs) alongside tobacco cigarettes (dual users). To the extent that dual users substantially lower the number of cigarettes, they will reduce health risks from smoking. However, from a medical point of view, exclusive vaping is preferable to dual use; (2) Methods: Using an online questionnaire we assessed behavioral, cognitive and attitudinal aspects of e-cig use in smoking and ex-smoking vapers; (3) Results: Our sample consisted of 19% dual users and 81% switchers. Before e-cig initiation, both groups smoked on average 22 cigarettes per day (CPD). After e-cig initiation, dual users decreased tobacco consumption by 82% and were low-to-moderately cigarette dependent. Both groups had been vaping for on average 22 months, were highly e-cig dependent, used state-of-the-art e-cigs, nicotine concentrations of 4–8 mg/mL and often flavors other than tobacco. Dual users used substantially less e-liquid per week than switchers but reported a similar number of puffs/day, experienced less e-cig efficacy, more practical problems, more negative and less positive consequences, and endorsed smoking reduction (rather than quitting) as a more important reason to start vaping. For both groups, e-cig risk perception was low and little stigmatization was experienced. Dual users preferred tobacco cigarettes in stressful situations and when rapid nicotine uptake is required. E-cigs were preferred where cigarettes are prohibited and to reduce second-hand smoke; (4) Conclusions: Differences between dual users and switchers center around variables proximal to the vaping behavior and its experienced effects rather than hinging on more general vaping-related beliefs and attitudes. PMID:29295483

Differences between Dual Users and Switchers Center around Vaping Behavior and Its Experiences Rather than Beliefs and Attitudes.

PubMed

Adriaens, Karolien; Van Gucht, Dinska; Baeyens, Frank

2017-12-23

(1) Background: Many smokers completely switch to vaping (switchers), whereas others use e-cigarettes (e-cigs) alongside tobacco cigarettes (dual users). To the extent that dual users substantially lower the number of cigarettes, they will reduce health risks from smoking. However, from a medical point of view, exclusive vaping is preferable to dual use; (2) Methods: Using an online questionnaire we assessed behavioral, cognitive and attitudinal aspects of e-cig use in smoking and ex-smoking vapers; (3) Results: Our sample consisted of 19% dual users and 81% switchers. Before e-cig initiation, both groups smoked on average 22 cigarettes per day (CPD). After e-cig initiation, dual users decreased tobacco consumption by 82% and were low-to-moderately cigarette dependent. Both groups had been vaping for on average 22 months, were highly e-cig dependent, used state-of-the-art e-cigs, nicotine concentrations of 4-8 mg/mL and often flavors other than tobacco. Dual users used substantially less e-liquid per week than switchers but reported a similar number of puffs/day, experienced less e-cig efficacy, more practical problems, more negative and less positive consequences, and endorsed smoking reduction (rather than quitting) as a more important reason to start vaping. For both groups, e-cig risk perception was low and little stigmatization was experienced. Dual users preferred tobacco cigarettes in stressful situations and when rapid nicotine uptake is required. E-cigs were preferred where cigarettes are prohibited and to reduce second-hand smoke; (4) Conclusions: Differences between dual users and switchers center around variables proximal to the vaping behavior and its experienced effects rather than hinging on more general vaping-related beliefs and attitudes.

Cigarette smoking in young adults: the influence of the HTR2A T102C polymorphism and punishment sensitivity.

PubMed

White, Melanie J; Young, Ross McD; Morris, C Phillip; Lawford, Bruce R

2011-04-01

The C allele of a common polymorphism of the serotonin 2A receptor (HTR2A) gene, T102C, results in reduced synthesis of 5-HT2A receptors and has been associated with current smoking status in adults. The -1438A/G polymorphism, located in the regulatory region of this gene, is in linkage disequilibrium with T102C, and the A allele is associated with increased promoter activity and with smoking in adult males. We investigated the contributions of the HTR2A gene, chronic psychological stress, and impulsivity to the prediction of cigarette smoking status and dependence in young adults. T102C and -1438A/G genotyping was conducted on 132 healthy Caucasian young adults (47 smokers) who completed self-report measures of chronic stress, depressive symptoms, impulsive personality and cigarette use. A logistic regression analysis of current cigarette smoker user status, after adjusting for gender, depressive symptom severity and chronic stress, indicated that the T102C TT genotype relative to the CC genotype (OR=7.53), and lower punishment sensitivity (OR=0.91) were each significant predictive risk factors. However, for number of cigarettes smoked, only lower punishment sensitivity was a significant predictor (OR=0.81). These data indicate the importance of the T102C polymorphism to tobacco use but not number of cigarettes smoked for Caucasian young adults. Future studies should examine whether this is explained by effects of nicotine on the serotonin system. Lower punishment sensitivity increased risk of both smoking and of greater consumption, perhaps via a reduced sensitivity to cigarette health warnings and negative physiological effects. Crown Copyright © 2010. Published by Elsevier Ireland Ltd. All rights reserved.

Cigarette smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity.

PubMed

Townsend, J; Roderick, P; Cooper, J

1994-10-08

To assess effects of price, income, and health publicity on cigarette smoking by age, sex, and socioeconomic group. Econometric multiple regression analysis of data on cigarette smoking from the British general household survey. Random sample of adult population in Britain interviewed for biennial general household surveys 1972-90. Changes in cigarette consumption and prevalence of smoking. Price elasticities of demand for cigarettes (percentage change in cigarette consumption for a 1% change in price) were significant at -0.5 (95% confidence interval -0.8 to -0.1) for men and -0.6 (-0.9 to -0.3) for women, were highest in socioeconomic group V (-1.0 for men and -0.9 for women), and lowest (not significantly different from zero) in socioeconomic groups I and II. The gradient in price elasticities by socioeconomic group was significant for men (F = 5.6, P = 0.02) and for women (F = 6.1, P = 0.02). Price was a significant factor in cigarette consumption by age for women in every age group and for men aged 25-34. Cigarette consumption by young men aged 16-34 increased with income. There was a significant decrease in smoking over time by women in socioeconomic groups I and II and by men in all age and social groups except socioeconomic group V attributable to health publicity. Price significantly affected smoking prevalence in socioeconomic group V (-0.6 for men and -0.5 for women) and for all women (-0.2). Men and women in lower socioeconomic groups are more responsive than are those in higher socioeconomic groups to changes in the price of cigarettes and less to health publicity. Women of all ages, including teenagers, appear to have been less responsive to health publicity than have men but more responsive to price. Response to health publicity decreased linearly with age. Real price increases in cigarettes could narrow differences between socioeconomic groups in smoking and the related inequalities in health, but specific measures would be necessary to ameliorate effects on the most deprived families that may include members who continue to smoke. The use of a policy to steadily increase cigarette tax is likely to help achieve the government's targets for smoking and smoking related diseases.

The Empirical Analysis of Cigarette Tax Avoidance and Illicit Trade in Vietnam, 1998-2010

PubMed Central

Nguyen, Minh Thac; Denniston, Ryan; Nguyen, Hien Thi Thu; Hoang, Tuan Anh; Ross, Hana; So, Anthony D.

2014-01-01

Illicit trade carries the potential to magnify existing tobacco-related health care costs through increased availability of untaxed and inexpensive cigarettes. What is known with respect to the magnitude of illicit trade for Vietnam is produced primarily by the industry, and methodologies are typically opaque. Independent assessment of the illicit cigarette trade in Vietnam is vital to tobacco control policy. This paper measures the magnitude of illicit cigarette trade for Vietnam between 1998 and 2010 using two methods, discrepancies between legitimate domestic cigarette sales and domestic tobacco consumption estimated from surveys, and trade discrepancies as recorded by Vietnam and trade partners. The results indicate that Vietnam likely experienced net smuggling in during the period studied. With the inclusion of adjustments for survey respondent under-reporting, inward illicit trade likely occurred in three of the four years for which surveys were available. Discrepancies in trade records indicate that the value of smuggled cigarettes into Vietnam ranges from $100 million to $300 million between 2000 and 2010 and that these cigarettes primarily originate in Singapore, Hong Kong, Macao, Malaysia, and Australia. Notable differences in trends over time exist between the two methods, but by comparison, the industry estimates consistently place the magnitude of illicit trade at the upper bounds of what this study shows. The unavailability of annual, survey-based estimates of consumption may obscure the true, annual trend over time. Second, as surveys changed over time, estimates relying on them may be inconsistent with one another. Finally, these two methods measure different components of illicit trade, specifically consumption of illicit cigarettes regardless of origin and smuggling of cigarettes into a particular market. However, absent a gold standard, comparisons of different approaches to illicit trade measurement serve efforts to refine and improve measurement approaches and estimates. PMID:24489886

The empirical analysis of cigarette tax avoidance and illicit trade in Vietnam, 1998-2010.

PubMed

Nguyen, Minh Thac; Denniston, Ryan; Nguyen, Hien Thi Thu; Hoang, Tuan Anh; Ross, Hana; So, Anthony D

2014-01-01

Illicit trade carries the potential to magnify existing tobacco-related health care costs through increased availability of untaxed and inexpensive cigarettes. What is known with respect to the magnitude of illicit trade for Vietnam is produced primarily by the industry, and methodologies are typically opaque. Independent assessment of the illicit cigarette trade in Vietnam is vital to tobacco control policy. This paper measures the magnitude of illicit cigarette trade for Vietnam between 1998 and 2010 using two methods, discrepancies between legitimate domestic cigarette sales and domestic tobacco consumption estimated from surveys, and trade discrepancies as recorded by Vietnam and trade partners. The results indicate that Vietnam likely experienced net smuggling in during the period studied. With the inclusion of adjustments for survey respondent under-reporting, inward illicit trade likely occurred in three of the four years for which surveys were available. Discrepancies in trade records indicate that the value of smuggled cigarettes into Vietnam ranges from $100 million to $300 million between 2000 and 2010 and that these cigarettes primarily originate in Singapore, Hong Kong, Macao, Malaysia, and Australia. Notable differences in trends over time exist between the two methods, but by comparison, the industry estimates consistently place the magnitude of illicit trade at the upper bounds of what this study shows. The unavailability of annual, survey-based estimates of consumption may obscure the true, annual trend over time. Second, as surveys changed over time, estimates relying on them may be inconsistent with one another. Finally, these two methods measure different components of illicit trade, specifically consumption of illicit cigarettes regardless of origin and smuggling of cigarettes into a particular market. However, absent a gold standard, comparisons of different approaches to illicit trade measurement serve efforts to refine and improve measurement approaches and estimates.

[Demand for cigarettes and tax increases in El Salvador].

PubMed

Ramos-Carbajales, Alejandro; González-Rozada, Martín; Vallarino, Hugo

2016-10-01

Analyze short- and long-term elasticities of demand for cigarettes in El Salvador as a tool for supporting recommendations on tax increases to reduce prevalence and consumption through price increases. Demand for cigarettes in El Salvador was analyzed through an econometric time-series model using a database from El Salvador's General Directorate of Internal Taxes (DGII) and the General Directorate of Statistics and Census (DIGESTYC). The analysis period was quarterly: 2000Q1-2012Q4. The usual tests were done to prevent a spurious econometric estimation. It was found that the variables volume sales, actual sale prices, and actual per capita income exhibited first-order cointegration; this result makes it possible to use an error correction model with short- and long-term elasticity estimates. Only long-term elasticities were found to be statistically significant to 5%. Results show long-term price elasticity (5 quarters) of -0.9287 and income price elasticity of 0.9978. Absolute price elasticity is somewhat high, although it is within the levels estimated in other studies in low per-capita income countries. A tax increase from a base amount of US$1.04 per pack of 20 cigarettes to US$1.66 within three years would reduce demand by 20% to 31% and would increase tax revenues by 9% to 22%.

Minnesota smokers' perceived helpfulness of 2009 federal tobacco tax increase in assisting smoking cessation: a prospective cohort study.

PubMed

Choi, Kelvin; Boyle, Raymond G

2013-10-18

The cost of cigarettes has been cited as a motivating factor for smokers to quit smoking, and a cigarette tax increase is an effective way to increase the cost of cigarettes. Scholars have suggested that smokers may see cigarette tax increases as commitment devices to help them quit smoking. Little is known about whether smokers actually think cigarette tax increases help them quit, and whether this perception predicts subsequent smoking cessation behaviors. We used data from the Minnesota Adult Tobacco Survey Cohort Study collected after the 2009 federal tobacco tax increase to answer these questions. In 2009, 727 smokers were asked whether they thought the federal tobacco tax increase helped them to: (1) think about quitting, (2) cut down on cigarettes, and (3) make a quit attempt. We also collected data on demographics, number of cigarette price-minimizing strategies used, and cigarette consumption. In 2010, we assessed if these smokers had made a quit attempt, had cut down on their cigarette consumption, and had stopped smoking. Logistic regression models were used to assess the characteristics associated with the perceptions that the tax increase was helpful in assisting smoking cessation, and the association between these perceptions in 2009 and cessation behaviors in 2010. Overall, 65% of the sample thought that the 2009 tax increase helped them think about quitting, 47% thought it helped them cut down on cigarettes, and 29% thought it helped them make a quit attempt. Lower education, lower income, lower cigarette consumption, and using more cigarette price-minimizing strategies were associated with the perceptions that the tax increase was helpful in assisting smoking cessation (p < 0.05). Smokers who perceived the tax increase as helpful in assisting smoking cessation were more likely than those who did not perceive the tax increase as helpful to report making a quit attempt in 2010 (p < 0.05). A significant proportion of smokers in our sample thought the 2009 federal tobacco tax increase was helpful in assisting smoking cessation, particularly among smokers of lower socio-economic status. Health communication interventions to promote cigarette tax increases as an opportunity for smoking cessation may further assist quit attempts.

Effect of the California Tobacco Control Program on Personal Health Care Expenditures

PubMed Central

Lightwood, James M; Dinno, Alexis; Glantz, Stanton A

2008-01-01

Background Large state tobacco control programs have been shown to reduce smoking and would be expected to affect health care costs. We investigate the effect of California's large-scale tobacco control program on aggregate personal health care expenditures in the state. Methods and Findings Cointegrating regressions were used to predict (1) the difference in per capita cigarette consumption between California and 38 control states as a function of the difference in cumulative expenditures of the California and control state tobacco control programs, and (2) the relationship between the difference in cigarette consumption and the difference in per capita personal health expenditures between the control states and California between 1980 and 2004. Between 1989 (when it started) and 2004, the California program was associated with $86 billion (2004 US dollars) (95% confidence interval [CI] $28 billion to $151 billion) lower health care expenditures than would have been expected without the program. This reduction grew over time, reaching 7.3% (95% CI 2.7%–12.1%) of total health care expenditures in 2004. Conclusions A strong tobacco control program is not only associated with reduced smoking, but also with reductions in health care expenditures. PMID:18752344

Varenicline, low dose naltrexone, and their combination for heavy-drinking smokers: human laboratory findings.

PubMed

Ray, Lara A; Courtney, Kelly E; Ghahremani, Dara G; Miotto, Karen; Brody, Arthur; London, Edythe D

2014-10-01

Heavy-drinking smokers constitute a sizeable and hard-to-treat subgroup of smokers, for whom tailored smoking cessation therapies are not yet available. The present study used a double-blind, randomized, 2 × 2 medication design, testing varenicline alone (VAR; 1 mg twice daily), low dose naltrexone alone (L-NTX; 25 mg once daily), varenicline plus naltrexone, and placebo for effects on cigarette craving and subjective response to alcohol and cigarettes in a sample (n = 130) of heavy-drinking daily smokers (≥10 cigarettes/day). All participants were tested after a 9-day titration period designed to reach a steady state on the target medication. Testing was completed at 12 h of nicotine abstinence, after consuming a standard dose of alcohol (target breath alcohol concentration = 0.06 g/dl) and after smoking the first cigarette of the day. The combination of VAR + L-NTX was superior to placebo, and at times superior to monotherapy, in attenuating cigarette craving, cigarette and alcohol "high," and in reducing ad-lib consumption of both cigarettes and alcohol during the 9-day medication titration period. These preliminary findings indicate that clinical studies of the combination of VAR + L-NTX for heavy drinkers trying to quit smoking are warranted and may ultimately improve clinical care for this sizeable and treatment-resistant subgroup of smokers.

Assessing contraband tobacco in two jurisdictions: a direct collection of cigarette butts.

PubMed

Stratton, Julie; Shiplo, Samantha; Ward, Megan; Babayan, Alexey; Stevens, Adam; Edwards, Sarah

2016-07-22

The sale of contraband tobacco allows for tobacco tax evasion, which can undermine the effectiveness of tobacco tax policies in reducing the number of smokers. Estimates of the proportion of contraband vary widely as do the methods used to measure the proportion of contraband being smoked. The purpose of this study is to determine the proportion of contraband use in two different jurisdictions. A cross-sectional direct collection of cigarette butts was conducted in Peel and Brantford, Ontario, Canada in 2013 and 2014, respectively. Cigarette butts were collected from a variety of locations within both regions. Cigarette butts were assessed and classified into one of the following categories: contraband, legal Canadian, legal Native, International, unknown, and discards. The overall proportion of contraband cigarettes in Peel was 5.3 %, ranging from 2.8 to 8.6 % by location. In Brantford, the proportion of contraband was 33.0 %, with a range from 32.8 to 33.1 % by location. The direct collection of cigarette butts was determined to be a feasible method for a local public health unit in determining the proportion of contraband cigarettes. This approach showed that Brantford has a higher proportion of contraband consumption compared to Peel, which may be due to geographic location and proximity to the United States (US)-Canada border and Native Reserves. More research is needed to confirm this geographic association with other jurisdictions.

The Use of E-Cigarettes.

PubMed

Eichler, Martin; Blettner, Maria; Singer, Susanne

2016-12-16

Electronic cigarettes (e-cigarettes) are a consumer product whose benefits and risks are currently debated. Advocates of the "tobacco harm reduction" strategy emphasize their potential as an aid to smoking cessation, while advocates of the precautionary principle emphasize their risks instead. There have been only a few studies to date on the prevalence of e-cigarette use in Germany. In May 2016, in collaboration with Forsa, an opinion research firm, we carried out a survey among 4002 randomly chosen persons aged 14 and older, asking them about their consumption of e-cigarettes with and without nicotine, reasons for using e-cigarettes, plans for future use, estimation of danger compared to that of tobacco products, smoking behavior, and sociodemographic features. 1.4% of the respondents used e-cigarettes regularly, and a further 2.2% had used them regularly in the past. 11.8% had at least tried them, including 32.7% of smokers and 2.3% of persons who had never smoked. 24.5% of ex-smokers who had quit smoking after 2010 had used e-cigarettes at least once. 20.7% of the respondents considered electronic cigarettes less dangerous than conventional cigarettes, 46.3% equally dangerous, and 16.1% more dangerous. An extrapolation of these data to the general population suggests that about one million persons in Germany use e-cigarettes regularly and another 1.55 million have done so in the past. The consumption of electronic cigarettes in Germany is not very widespread, but it is not negligible either. Nearly 1 in 8 Germans has tried e-cigarettes at least once. Regular consumers of e-cigarettes are almost exclusively smokers and ex-smokers.

Maternal Fish Consumption and Infant Birth Size and Gestation: New York State Angler Cohort Study

PubMed Central

Buck, Germaine M; Tee, Grace P; Fitzgerald, Edward F; Vena, John E; Weiner, John M; Swanson, Mya; Msall, Michael E

2003-01-01

Background The scientific literature poses a perplexing dilemma for pregnant women with respect to the consumption of fish from natural bodies of water. On one hand, fish is a good source of protein, low in fat and a rich source of other nutrients all of which have presumably beneficial effects on developing embryos and fetuses. On the other hand, consumption of fish contaminated with environmental toxicants such as polychlorinated biphenyls (PCBs) has been associated with decrements in gestation and birth size. Methods 2,716 infants born between 1986–1991 to participants of the New York State Angler Cohort Study were studied with respect to duration of maternal consumption of contaminated fish from Lake Ontario and its tributaries and gestation and birth size. Hospital delivery records (maternal and newborn) were obtained for 92% of infants for the ascertainment of gestation (weeks), birth size (weight, length, chest, and head circumference) and other known determinants of fetal growth (i.e., maternal parity, history of placental infarction, uterine bleeding, pregnancy loss or cigarette smoking and infant's race, sex and presence of birth defect). Duration of maternal fish consumption prior to the index infant's birth was categorized as: none; 1–2, 3–7, 8+ years, while birth weight (in grams), birth length (in centimeters), and head and chest circumference (in centimeters) were left as continuous variables in multiple linear regression models. Birth size percentiles, ponderal indices and head to chest circumference ratios were computed to further assess proportionality and birth size in relation to gestational age. Results Analysis of variance failed to identify significant mean differences in gestation or any measure of birth size in relation to duration of maternal lifetime fish consumption. Multiple linear regressions identified gestational age, male sex, number of daily cigarettes, parity and placental infarction, as significant determinants of birth size. Conclusions The results support the absence of an adverse relation between Lake Ontario fish consumption and reduced birth size as measured by weight, length and head circumference. Biological determinants and maternal cigarette smoking during pregnancy remain important determinants of birth size. PMID:12826023

Cigarette smokers' classification of tobacco products.

PubMed

Casseus, M; Garmon, J; Hrywna, M; Delnevo, C D

2016-11-01

Cigarette consumption has declined in the USA. However, cigar consumption has increased. This may be due in part to some cigarette smokers switching to filtered cigars as a less expensive substitute for cigarettes. Additionally, some cigarette smokers may perceive and consume little filtered cigars as cigarettes. The purpose of this study was to determine how cigarette smokers classify tobacco products when presented with photographs of those products. An online survey was conducted with a sample of 344 self-identified cigarette smokers. Respondents were presented with pictures of various types of tobacco products, both with and without packaging, and then asked to categorise them as either a cigarette, little cigar, cigarillo, cigar or machine-injected roll-your-own cigarette (RYO). Respondents were also asked about their tobacco use and purchasing behaviour. Overall, respondents had difficulty distinguishing between cigarettes, little cigars, cigarillos and RYO. When presented with images of the products without packaging, 93% of respondents identified RYO as a cigarette, while 42% identified a little cigar as a cigarette. Additionally, respondents stated that they would consider purchasing little cigars as substitutes for cigarettes because of the price advantage. The results of this survey suggest that when presented with photographs of tobacco products, large proportions of current smokers were unable to differentiate between cigarettes, little cigars, cigarillos, RYO and cigars. Findings have implications for existing public health efforts targeting cigarette smokers, and underscore the need to review current definitions of tobacco products and federal excise taxes on such 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/.

Reductions in biomarkers of exposure, impacts on smoking urge and assessment of product use and tolerability in adult smokers following partial or complete substitution of cigarettes with electronic cigarettes.

PubMed

D'Ruiz, Carl D; Graff, Donald W; Robinson, Edward

2016-07-11

Electronic cigarettes (e-cigarettes) are popular alternatives to conventional cigarettes among adult smokers wishing to reduce their exposure to harmful smoke constituents. However, little information exists on the relative internal exposures resulting from the exclusive or dual use of e-cigarettes. Measurements of product use; adverse events; changes in smoking urge; and blood, urine and exhaled breath biomarkers of exposure (BoE) representing toxicants believed to contribute to smoking related diseases were made at baseline and after five days of product use in 105 clinically-confined smokers randomized into groups that partially or completely substituted their usual brand combustible cigarette with commercial e-cigarettes, or discontinued all nicotine and tobacco products. Subjects switching to e-cigarettes had significantly lower levels (29 %-95 %) of urinary BoEs after 5 days. Nicotine equivalents declined by 25 %-40 %. Dual users who substituted half of their self-reported daily cigarette consumption with e-cigarettes experienced 7 %-38 % reductions, but had increases (1 %-20 %) in nicotine equivalents. Blood nicotine biomarker levels were lower in the cessation (75 %-96 %) and e-cigarette use groups (11 %-83 %); dual users had no significant reductions. All groups experienced significant decreases in exhaled CO (27 %-89 %). Exhaled NO increases (46 %-63 %) were observed in the cessation and e-cigarette use groups; dual users had minimal changes. By Day 5, all groups had greater reductions in smoking urge compared to cessation. However, reductions were larger in the dual use group. No serious adverse events were observed. Exposures to harmful smoke toxicants were observed to be lower in smokers who completely or partially replaced their cigarettes with e-cigarettes over five days.

Addictive behaviors, social and psychosocial factors, and electronic cigarette use among adolescents: a population-based study.

PubMed

Lindström, M; Rosvall, M

2018-02-01

The aim was to investigate associations between e-cigarette use and social and psychosocial factors and cigarette smoking, alcohol consumption, and narcotics use among adolescents attending 9th grade in primary school and 2nd grade in secondary school. Cross-sectional study. The public health survey among adolescents in Scania in 2016 includes pupils in grades 9 and 2. The associations between e-cigarette use and lifestyle, social and psychosocial factors, and trust were investigated with logistic regressions. In 9th grade, 32% of male pupils and 27% of female pupils had ever used e-cigarettes, and in 2nd grade, 43% of males and 31% of females had ever used e-cigarettes. E-cigarette use was significantly associated with current smoking, snus (a moist powder tobacco product originating in Sweden) use, water pipe use, intensive alcohol consumption, and narcotics and also with psychosocial conditions related to home and parents, peers, and school. The prevalence of ever e-cigarette use was high among adolescents attending both grades. E-cigarette use was most strongly associated with health-related lifestyles. It was also associated with psychosocial factors such as study difficulties, school stress, problems talking with parents, and generalized trust. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Gifting and sharing cigarettes in a rural Chinese village: a cross-sectional study.

PubMed

Rich, Zachary C; Hu, Mi; Xiao, Shuiyuan

2014-11-01

Quantitative measurement of the prevalence of cigarette sharing and gifting in a town in rural China and evaluation of the impact of these practices on individual smoking habits and family expenditures. An interview-based cross-sectional study of 105 households in rural Hunan, China tabulated household cigarette gifting and expenditures. Individual smoking and cigarette sharing activities were also recorded among 198 household members aged >15 years who were resident for at least 6 months. With regard to sharing cigarettes, 92% of men and 19% of women reported being offered a cigarette within the past week. Among previous and current smokers who had attempted to quit smoking, 90% reported that their friends had tried to dissuade them from quitting by tempting them with cigarettes. Concerning gifting cigarettes, 74% of households reported sending packaged cigarettes as gifts during the Chinese New Year Festival at an average expense of 2.8% of household annual income. Although households received an average of 12.4% of their annual cigarette consumption in the form of gifts during the Chinese New Year Festival, no association was found between the amount of cigarettes received by a household and the annual cigarette consumption for that household. Both gifting and sharing cigarettes are common in rural China. Gifting of cigarettes during the New Year Festival is a significant expenditure affecting both smoking and non-smoking households and may be an opportunity for additional mass media marketing. Among current and former smokers, sharing cigarettes in China is a major impediment to smoking cessation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The prevalence of illicit cigarette consumption and related factors in Turkey.

PubMed

Kaplan, Bekir; Navas-Acien, Ana; Cohen, Joanna E

2018-07-01

The tobacco industry claims that high cigarette taxes drive illicit trade and that governments should therefore not increase tobacco tax because it will increase the level of illicit trade. This study examines illicit cigarette consumption in Turkey after a tobacco tax increase and its related factors. This national cross-sectional survey was conducted in March-June 2013 and 9717 people aged ≥18 years participated in the interviewer-administered survey. Smokers were asked to show their last used cigarette pack to the interviewers and price paid for their cigarettes. Factors associated with smoking cigarettes with a tobacco tax stamp and paying ≥5 TL (Turkish lira) for a pack of cigarettes were analysed with logistic regression. Among the observed cigarette packs, 12.1% did not have the Turkish tax stamp. More illicit cigarettes were observed in the East region than in other regions (p<0.001). The reported average amount paid for a pack of cigarettes was €2.12 (€2.15 for men and €1.97 for women, p<0.001). The amount paid for cigarettes with a tax stamp (€2.15) was higher than the amount paid for cigarettes without tax stamp (€1.08) (per cigarette pack) (p<0.001). Just over 1 in 10 smokers (12%) had an illicit cigarette pack about 5 months after the final tax increase; this was most common in the East region of Turkey. Estimates are comparable to those in previous studies and do not indicate that an increase occurred in the prevalence of illicit cigarette use compared with before the tobacco tax increase. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The impact of the cigarette market opening in Taiwan

PubMed Central

Wen, C; Cheng, T; Eriksen, M; Tsai, S; Hsu, C

2005-01-01

Objective: To assess the effect of the opening of the Taiwanese cigarette market on cigarette consumption, changes in market share, and the effects on tobacco control efforts. Methods: With the use of key word "Taiwan", the Legacy Tobacco Documents Library of the University of California, San Francisco, was searched for internal documents related to smuggling activities, promotion of light cigarettes, and market share analyses in Taiwan. Age adjusted smoking rates and cigarette and betel quid consumption before and after market opening were compared. Results: By 2000, the market share of imported cigarettes increased from less than 2% in 1986 to nearly 50%, and per capita cigarette consumption increased 15% following market opening. Because of the sharp increase in smuggling, with contraband cigarettes being as popular as legal imports, and the rapid proliferation of retail outlets, such as betel quid stalls, the market penetration by foreign tobacco companies was greater in Taiwan than among the other Super 301 Asian countries. Aggressive cigarette marketing strategies were associated with a 6% increase in adult male smoking prevalence, and with a 13% increase in the youth rate, within three years after market opening. The market opening also had an incidental effect on increasing the popularity of betel quid. Betel quid chewing has since become a major public health problem in Taiwan. Conclusion: The opening of the cigarette market in 1987 had a long lasting impact on Taiwan. It increased smoking prevalence and the market has become dominated by foreign companies. The seriousness of smuggling and its associated loss of revenue by the government, the extent of increased youth smoking and its associated future health care costs, and the increased use of betel quid and the associated doubling of oral cancer mortality rates each pose significant problems to Taiwan. However, the market opening galvanised anti-smoking sentiment and forced the government to initiate and intensify a series of tobacco control efforts. PMID:15923448

The impact of the cigarette market opening in Taiwan.

PubMed

Wen, C P; Cheng, T Y; Eriksen, M P; Tsai, S P; Hsu, C C

2005-06-01

To assess the effect of the opening of the Taiwanese cigarette market on cigarette consumption, changes in market share, and the effects on tobacco control efforts. With the use of key word "Taiwan", the Legacy Tobacco Documents Library of the University of California, San Francisco, was searched for internal documents related to smuggling activities, promotion of light cigarettes, and market share analyses in Taiwan. Age adjusted smoking rates and cigarette and betel quid consumption before and after market opening were compared. By 2000, the market share of imported cigarettes increased from less than 2% in 1986 to nearly 50%, and per capita cigarette consumption increased 15% following market opening. Because of the sharp increase in smuggling, with contraband cigarettes being as popular as legal imports, and the rapid proliferation of retail outlets, such as betel quid stalls, the market penetration by foreign tobacco companies was greater in Taiwan than among the other Super 301 Asian countries. Aggressive cigarette marketing strategies were associated with a 6% increase in adult male smoking prevalence, and with a 13% increase in the youth rate, within three years after market opening. The market opening also had an incidental effect on increasing the popularity of betel quid. Betel quid chewing has since become a major public health problem in Taiwan. The opening of the cigarette market in 1987 had a long lasting impact on Taiwan. It increased smoking prevalence and the market has become dominated by foreign companies. The seriousness of smuggling and its associated loss of revenue by the government, the extent of increased youth smoking and its associated future health care costs, and the increased use of betel quid and the associated doubling of oral cancer mortality rates each pose significant problems to Taiwan. However, the market opening galvanised anti-smoking sentiment and forced the government to initiate and intensify a series of tobacco control efforts.

Partner smoking influences whether mothers quit smoking during pregnancy: a prospective cohort study.

PubMed

Román-Gálvez, R M; Amezcua-Prieto, C; Olmedo-Requena, R; Lewis-Mikhael Saad, A M; Martínez-Galiano, J M; Bueno-Cavanillas, A

2017-10-20

To analyse the prevalence and intensity of smoking among pregnant women and their partners, and factors associated with quitting smoking among pregnant women. A prospective cohort study, starting in 2013. Andalusia, the south of Spain. A cohort of 486 healthy pregnant women followed-up on three occasions during pregnancy. Estimation of the proportions of women and partners who quit smoking at each trimester. To determine factors associated in a multivariable model, considering sociodemographic, obstetric, anthropometric, lifestyle variables, and the smoking habits of their partners. A high proportion of women quit smoking during pregnancy (61.08%; 95% confidence interval, 95% CI 53.61-68.55%). The smoking rate amongst mothers decreased from 36.06% (n = 167) before pregnancy to 14.08% (n = 65), 12.39% (n = 54), and 11.92% (n = 51) during the three pregnancy trimesters (P < 0.001), and consumption decreased from 8.71 cigarettes/day in the first trimester to 5.51 cigarettes/day in the second trimester (P < 0.001) and 5.96 cigarettes/day in third trimester (P = 0.0002 first versus third trimester). There was only a minimal decrease in the frequency of smoking among the partners, however: 38.44% (n = 178) before pregnancy, and 36.07% (n = 167), 32.72% (n = 143), and 31.85% (n = 136) during the three trimesters of pregnancy. The consumption of cigarettes did not decrease among partners: 11.75, 11.67, and 12.09 cigarettes/day (P = 0.4299 first versus second trimester; P = 0.654 first versus third trimester). Women whose partner smoked were less likely to quit (adjusted odds ratio, aOR 0.26; 95% CI 0.12-0.55). About one in ten pregnant women smoked and one in four was a passive smoker. Strategies to reduce tobacco exposure in pregnancy should include a focus on partner smoking. Pregnant women quit smoking cigarettes in pregnancy. What about their partners? © 2017 Royal College of Obstetricians and Gynaecologists.

CHRNA3 rs6495308 genotype as an effect modifier of the association between daily cigarette consumption and hypertension in Chinese male smokers.

PubMed

Wu, Xiao-Ying; Zhou, Shan-Yu; Niu, Zhong-Zheng; Liu, Tao; Xie, Chuan-Bo; Chen, Wei-Qing

2015-04-14

Cigarette smoking is an important risk factor for hypertension. However, the effects on hypertension of the interaction between smoking and the genotype of the nicotinic acetylcholine receptor gene are unclear. The purpose of this study is to determine whether the CHRNA3 rs6495308 genotype affects the association between daily cigarette consumption and hypertension. We recruited 947 male smokers in southern China and used a questionnaire administered in face to face interviews to obtain information on their socio-demographic characteristics and smoking behavior. Blood samples were collected to test for CHRNA3 rs6495308 genotype variations. Three blood-pressure measurements were taken for each participant, and the average values recorded. We found that, compared with light smoking (<15 cigarettes per day), heavy smoking (≥15 cigarettes per day) yielded a greater risk of hypertension. We also observed that the interaction between daily cigarette consumption and the CHRNA3 rs6495308 genotype may affect hypertension. Heavy smokers with the homozygous mutant CHRNA3 rs6495308 genotype exhibited a significantly greater risk of hypertension than light smokers with wild-type CHRNA3 rs6495308 genotypes. The positive interaction between heavy smoking and the homozygous mutant CHRNA3 rs6495308 genotype was found to affect the likelihood of hypertension in Chinese male smokers.

Levels and trends in cigarette contraband in Canada

PubMed Central

Guindon, G Emmanuel; Burkhalter, Robin; Brown, K Stephen

2017-01-01

Background There is overwhelming evidence that increases in tobacco taxes reduce tobacco use, save lives and increase government tax revenue. High taxes, however, create an incentive to devise ways to avoid or evade tobacco taxes through contraband tobacco. The associated consequences are significant and call for an accurate measurement of contraband's magnitude. However, its illegal nature makes the levels and trends in contraband intrinsically difficult to measure accurately. Objective To examine levels and trends in cigarette contraband in Canada. Methods We employed 2 approaches: first, we contrasted estimates of tax-paid cigarettes sales with consumption estimates based on survey data; second, we used data from several individual-level surveys that examined smokers' purchasing and use behaviours. We placed a particular emphasis on the provinces of Québec and Ontario because existing research suggests that cigarette contraband levels are far higher than in any other province. Results The estimates presented show a clear upward trend from the early 2000s in cigarette contraband in Québec and Ontario followed by, on the whole, a decreasing trend from about 2007 to 2009. None of the data presented provide support to the narrative that cigarette contraband has been increasing in recent years. Of note are Québec estimates which suggest relatively low levels of cigarette contraband since 2010, at levels no higher than in the early 2000s. Conclusions The data presented suggest that policies to tackle cigarette contraband introduced from the mid-2000s to late 2000s, at both federal and provincial levels, may have dampened the demand for contraband cigarettes. PMID:27601454

E-cigarette awareness, use, and harm perceptions in Italy: a national representative survey.

PubMed

Gallus, Silvano; Lugo, Alessandra; Pacifici, Roberta; Pichini, Simona; Colombo, Paolo; Garattini, Silvio; La Vecchia, Carlo

2014-12-01

Only a few studies have provided information on awareness, use, and harm perceptions of e-cigarettes in Europe. We fill the knowledge gap in Italy. We used data from a face-to-face survey conducted in 2013 of a sample of 3,000 individuals, representative of the Italian population aged ≥15 years (51.1 million inhabitants). Awareness of e-cigarettes was 91.1%; it was lowest among women (87.8%), the elderly (78.4%), those with less education (84.1%), and never-smokers (89.0%). Ever e-cigarette use was 6.8% overall and was inversely related to age, whereas no significant difference was observed according to sex. With regard to smoking status, 2.6% of never-smokers, 7.0% of ex-smokers, and 20.4% of current smokers tried the e-cigarette at least once. Regular e-cigarette use was 1.2% overall, 1.5% among men, and 0.9% among women, and it was highest among young (2.4%) and current smokers (3.7%). Among 36 e-cigarette regular users, 22.0% did not change their smoking habit, 67.7% reduced traditional cigarette consumption, and 10.4% quit smoking. After fewer than 3 years from the opening of the first Italian e-cigarette shop, more than 45 million Italians have heard about e-cigarettes, 3.5 million have tried e-cigaretts, and more than 600,000 Italians regularly use e-cigarettes. Three out of 4 e-cigarette users reported to have favorably modified their smoking habit; however, 90% of users did not quit smoking as a consequence of starting vaping e-cigarettes. Almost 900,000 Italian never-smokers, particularly young never-smokers, have tried this new and potentially addictive product at least once. © 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.

Temporal changes of under-reporting of cigarette consumption in population-based studies.

PubMed

Gallus, Silvano; Tramacere, Irene; Boffetta, Paolo; Fernandez, Esteve; Rossi, Silvia; Zuccaro, Piergiorgio; Colombo, Paolo; La Vecchia, Carlo

2011-01-01

To monitor trends in under-reporting of smoking in Italy over the last two decades. A total of 9 representative population-based surveys on smoking conducted in Italy in 1990 and annually between 2001 and 2008, covering 26,397 individuals, were studied. The number of cigarettes per day per person aged 15 years or over, obtained from these interview-based surveys, was compared with official data from legal sales. Over the last two decades, self-reported smoking prevalence progressively decreased from 32% in 1990 to 22% in 2008. Self-reported daily per capita consumption of cigarettes also showed a reduction between 1990 and 2008, notably so over the last few years (from 5.2 in 1990 to 4.0 in 2004 to 3.2 in 2008). According to data from legal sales, number of cigarettes per day per person decreased from 5.3 in 1990 to 5.0 in 1992, levelled off from 1992 to 1997, subsequently increased from 5.0 in 1997 to 5.8 in 2002 (likely due to control of smuggling), and decreased over the last 6 years (to 4.9 in 2008). These figures correspond to an under-reporting of approximately 1% in 1990, 25% in 2001 and up to 35% in 2008. The difference in cigarette consumption between legal sale and self-reported data has substantially increased over the last two decades in Italy, reflecting increasing under-reporting of cigarette consumption mainly due to a decreasing social acceptability of smoking. Comparisons between interview-based and legal sale data are complicated by factors such as smuggling control and changes in the population (eg, increased proportion of immigrants); however these are able to justify only a small proportion of the gap found in Italy.

Cigarettes with different nicotine levels affect sensory perception and levels of biomarkers of exposure in adult smokers.

PubMed

McKinney, Diana L; Frost-Pineda, Kimberly; Oldham, Michael J; Fisher, Michael T; Wang, Jingzhu; Gogova, Maria; Kobal, Gerd

2014-07-01

Few clinical studies involving cigarettes have provided a comprehensive picture of smoke exposure, test article characterization, and insights into sensory properties combined. The purpose of these pilot studies was to determine whether cigarettes with different levels of nicotine but similar tar levels would affect sensory experience or smoking behavior so as to significantly alter levels of selected biomarkers of exposure (BOE). In 2 confined, double-blind studies, 120 adult smokers switched from Marlboro Gold cigarettes at baseline to either 1 of 2 lower nicotine cigarettes or 1 of 2 higher nicotine cigarettes and then to the other cigarette after 5 days. Urinary excretion of exposure biomarkers (nicotine equivalents [NE], total and free 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol [NNAL], 1-hydroxypyrene, and 3-hydroxypropyl mercapturic acid) as well as carboxyhemoglobin and plasma cotinine were measured at baseline, Day 5, and Day 10. Daily cigarette consumption was monitored and sensory characteristics were rated for each cigarette. With higher nicotine yield, urine NE, urine total NNAL, and plasma cotinine increased while nonnicotine BOE decreased without changes in cigarette consumption. In contrast, with lower nicotine yield, urine NE, urine total NNAL, and plasma cotinine dropped while nonnicotine BOE and cigarettes per day increased. Higher nicotine cigarettes were rated harsher and stronger than at baseline while lower nicotine cigarettes were less strong. All 4 test cigarettes were highly disliked. These studies demonstrate that abrupt increases or decreases in nicotine and the resulting sensory changes impact BOE through changes in intensity or frequency of smoking. © 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.

Who pays the most cigarette tax in Turkey.

PubMed

Önder, Zeynep; Yürekli, Ayda A

2016-01-01

Although higher taxation of tobacco products is considered the most cost-effective tobacco control policy, its negative impact on low-income groups is one of the arguments used against it. To investigate the impact of current excise taxes and the increases of excise taxes on tobacco and household expenditures by expenditure tertiles, and examine who pays excise taxes in general. Impacts of excise taxes on cigarettes are examined with a budgetary approach. We first estimate the price elasticity of cigarettes by expenditure tertiles using data from the 2003 Turkish Household Expenditure Survey, the most recent data set covering detailed tobacco product information relevant to our analysis. We then conduct a number of simulation analyses by increasing the excise taxes per pack of cigarettes and examine the impacts of these increases on household expenditures. Finally, as excise tax increases, we predict the total excise tax paid by households in different expenditure tertiles and compare the concentration curve of excise tax spending with the Lorenz curve showing the cumulative share of total household expenditures by expenditure tertiles. We estimate the progressivity coefficient that measures the area between the Lorenz and concentration curves. The low-income group is found to be the most sensitive to tax and price increases. It spends a relatively higher share of the household expenditure on cigarettes compared with higher income groups. However, the results suggest a different outcome as excise tax increases; the share of household expenditures spent on cigarettes declines for all household tertiles but a significant reduction occurs on the lowest expenditure tertile, suggesting that increases in excise taxes are progressive. Furthermore, the highest expenditure tertile pays the highest excise tax among expenditure tertiles, and their share in total excise revenue increases as the excise tax per pack of cigarettes increases. The poor smoking households benefit the most from increases in excise taxes; from a budgetary perspective, as they reduce their smoking consumption significantly, the share of their excise payment in total household expenditures declines. From a health perspective, they are likely to have more health benefits as their consumption reduces. Government revenues are also predicted to increase with increased excise taxes, and the government can allocate a part of these revenue increases on implementing and enforcing other tobacco control measures including cessation support and smoke-free environments. 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/

Reduced Exposure to Harmful and Potentially Harmful Smoke Constituents With the Tobacco Heating System 2.1

PubMed Central

Baker, Gizelle; Magnette, John; Picavet, Patrick; Weitkunat, Rolf

2017-01-01

Introduction: Heating rather than burning tobacco reduces levels of harmful and potentially harmful constituents, and consumer products using this approach aim to reduce exposure to tobacco toxicants. The Tobacco Heating System (THS) version 2.1 has been enhanced from earlier prototypes with an improved heat control and sensorial experience and thereby user acceptance. Exposure measurements are required to determine whether it may be possible to reduce the individual health risk compared to smoking combustible cigarettes (CCs). Methods: This controlled clinical study randomly assigned 40 smokers to either a group continuing to use of their own CC brand (n = 20) or a group switching to THS 2.1 (n = 20) for 5 days. Biomarkers of exposure were measured at baseline and on day 1 through day 5. Product consumption, Human Puffing Topography, the occurrence of adverse events, and an assessment of subjective effects, such as smoking satisfaction and enjoyment of respiratory tract sensations, were also determined. Results: The group of smokers who switched to THS 2.1 adapted their puffing behavior initially through longer puff duration and more puffs. During the duration of the study, total puff volume returned to baseline levels and the mean daily product consumption increased but with similar nicotine exposure compared to baseline CC use. Biomarkers of exposure to tobacco smoke toxicants which inform product risk assessment were significantly reduced with THS use compared to the CC group. THS 2.1 users experienced less reinforcing effects with THS 2.1 than with their own cigarette brand. Conclusions: THS 2.1 is a promising alternative to smoking CCs. Notwithstanding possible use adaption through consumption or puffing behavior, the exposure to harmful smoke constituents was markedly reduced with the new heated tobacco platform. Implications: Exposure markers to harmful and potentially harmful smoke constituents were lowered with the THS 2.1. Heating tobacco instead of burning can offer a potentially lower risk of delivering nicotine compared to CCs. PMID:27613951

Geospatial Analysis on the Distributions of Tobacco Smoking and Alcohol Drinking in India

PubMed Central

Fu, Sze Hang; Jha, Prabhat; Gupta, Prakash C.; Kumar, Rajesh; Dikshit, Rajesh; Sinha, Dhirendra

2014-01-01

Background Tobacco smoking and binge alcohol drinking are two of the leading risk factors for premature mortality worldwide. In India, studies have examined the geographic distributions of tobacco smoking and alcohol drinking only at the state-level; sub-state variations and the spatial association between the two consumptions are poorly understood. Methodology We used data from the Special Fertility and Mortality Survey conducted in 1998 to examine the geographic distributions of tobacco smoking and alcohol drinking at the district and postal code levels. We used kriging interpolation to generate smoking and drinking distributions at the postal code level. We also examined spatial autocorrelations and identified spatial clusters of high and low prevalence of smoking and drinking. Finally, we used bivariate analyses to examine the spatial correlations between smoking and drinking, and between cigarette and bidi smoking. Results There was a high prevalence of any smoking in the central and northeastern states, and a high prevalence of any drinking in Himachal Pradesh, Arunachal Pradesh, and eastern Madhya Pradesh. Spatial clusters of early smoking (started smoking before age 20) were identified in the central states. Cigarette and bidi smoking showed distinctly different geographic patterns, with high levels of cigarette smoking in the northeastern states and high levels of bidi smoking in the central states. The geographic pattern of bidi smoking was similar to early smoking. Cigarette smoking was spatially associated with any drinking. Smoking prevalences in 1998 were correlated with prevalences in 2004 at the district level and 2010 at the state level. Conclusion These results along with earlier evidence on the complementarities between tobacco smoking and alcohol drinking suggest that local public health action on smoking might also help to reduce alcohol consumption, and vice versa. Surveys that properly represent tobacco and alcohol consumptions at the district level are recommended. PMID:25025379

A Prospective Cohort Study of Cigarette Prices and Smoking Cessation in Older Smokers.

PubMed

Stevens, Victoria L; Diver, W Ryan; Stoklosa, Michal; Flanders, W Dana; Westmaas, J Lee; Jemal, Ahmedin; Drope, Jeffrey M; Gapstur, Susan M; Jacobs, Eric J

2017-07-01

Background: Cigarette price increases effectively prevent smoking initiation and reduce cigarette consumption among young smokers. However, the impact of cigarette prices on smoking cessation among older smokers is less clear, particularly for those aged 65 years and older, a group that is at highest risk of smoking-related disease and will almost double in the United States between 2012 and 2050. Methods: Biennial questionnaires administered between 1997 and 2013 assessed smoking status for 9,446 Cancer Prevention Study-II Nutrition Cohort participants who were ≥50 years old and lived in Washington, DC, and 48 states. For each interval between biennial questionnaires, change in price per pack and average price level per pack were calculated. The separate associations between these price variables and smoking cessation during the same time interval were determined. Results: In multivariable-adjusted models, each $1.00 price increase was associated with a 9% higher rate of quitting [rate ratio (RR) = 1.09; 95% confidence interval (CI), 1.04-1.14). Each $1.00 increase in average price was associated with a 6% higher rate of quitting (RR = 1.06; 95% CI, 1.02-1.10). The association with average price was strongest among smokers aged 65 years and older (RR = 1.07; 95% CI, 1.04-1.11) and, for price change, for smokers with no major prevalent disease (RR = 1.13; 95% CI, 1.07-1.19). Conclusions: These results suggest that increasing cigarette prices will promote quitting even among smokers aged 65 years and older. Impact: Increasing cigarette prices through higher taxes could reduce smoking rates among older adults and decrease risk of smoking-related cancers and diseases in this high-risk group. Cancer Epidemiol Biomarkers Prev; 26(7); 1071-7. ©2017 AACR . ©2017 American Association for Cancer Research.

Change in smoking, diet, and walking for exercise in Blacks.

PubMed

Berg, Carla J; Thomas, Janet L; An, Lawrence C; Guo, Hongfei; Collins, Tracie; Okuyemi, Kolawole S; Ahluwalia, Jasjit S

2012-04-01

Positive changes in one health behavior may be accompanied by other constructive health behavior changes. Thus, the authors investigated the association of smoking reduction and cessation to changes in fruit and vegetable (FV) intake and engaging in walking for exercise. This study included 539 Black light smokers (≤10 cigarettes per day ≥25 days/month) enrolled in a 2 × 2 factorial study (placebo vs. nicotine gum, health education vs. motivational interviewing). Reducing cigarette consumption (p = .02) and quitting smoking (p < .01), as well as receiving the nicotine gum (p = .04), was associated with increased FV intake, after controlling for baseline FV intake. Compared with those who did not reduce their smoking, both reducers (p < .001) and quitters (p < .001) were more likely to walk for exercise at follow-up, after controlling for baseline walking status (p = .01). Thus, addressing one health risk behavior may prompt other positive health behaviors, which may argue for developing interventions targeting multiple health risk behaviors.

Change in Smoking, Diet, and Walking for Exercise in Blacks

PubMed Central

Berg, Carla J.; Thomas, Janet L.; An, Lawrence C.; Guo, Hongfei; Collins, Tracie; Okuyemi, Kolawole S.; Ahluwalia, Jasjit S.

2013-01-01

Positive changes in one health behavior may be accompanied by other constructive health behavior changes. Thus, the authors investigated the association of smoking reduction and cessation to changes in fruit and vegetable (FV) intake and engaging in walking for exercise. This study included 539 Black light smokers (≤10 cigarettes per day ≥25 days/month) enrolled in a 2 × 2 factorial study (placebo vs. nicotine gum, health education vs. motivational interviewing). Reducing cigarette consumption (p = .02) and quitting smoking (p < .01), as well as receiving the nicotine gum (p = .04), was associated with increased FV intake, after controlling for baseline FV intake. Compared with those who did not reduce their smoking, both reducers (p < .001) and quitters (p < .001) were more likely to walk for exercise at follow-up, after controlling for baseline walking status (p = .01). Thus, addressing one health risk behavior may prompt other positive health behaviors, which may argue for developing interventions targeting multiple health risk behaviors. PMID:22330092

Energy drink consumption among young Australian adults: associations with alcohol and illicit drug use.

PubMed

Trapp, Georgina S A; Allen, Karina L; O'Sullivan, Therese; Robinson, Monique; Jacoby, Peter; Oddy, Wendy H

2014-01-01

Energy drinks are becoming increasingly popular among young people. The purpose of this study was to determine the prevalence of energy drink consumption and its associations with socio-demographic characteristics, alcohol, cigarette and illicit drug use in a population-based sample of young adults participating in the Western Australian Pregnancy Cohort (Raine) Study. We used self-administered questionnaires to assess energy drink consumption patterns, alcohol intake, cigarette and illicit drug use at the 20-year cohort follow-up. Data was also collected on socio-demographics, physical activity, body mass index (BMI) and dietary intake. Our sample included 1234 participants (47% male, mean age 20 ± 0.5 years). We considered energy-drink consumption as a categorical (users versus non-users) variable. Overall, 48% of participants consumed energy drinks at least once per month, with an average intake of 1.31 ± 0.75 cans per day amongst energy drink users. The most significant correlates of energy drink use were being in part-time or full-time employment, being male, being a cigarette smoker, having heavier alcoholic spirit consumption patterns and being an ecstasy user (all p<0.05). No significant associations were observed with BMI or dietary intake. Australian energy drink users tend to have heavier alcohol consumption patterns be a cigarette smoker and use illicit drugs relative to non-users. More research is needed regarding the health risks associated with energy drink use in young adults, including their possible role in the development of substance abuse problems. Copyright © 2013. Published by Elsevier Ireland Ltd.

Effects of bupropion on simulated demand for cigarettes and the subjective effects of smoking.

PubMed

Madden, Gregory J; Kalman, David

2010-04-01

The biobehavioral mechanism(s) mediating bupropion's efficacy are not well understood. Behavioral economic measures such as demand curves have proven useful in investigations of the reinforcing effects of drugs of abuse. Behavioral economic measures may also be used to measure the effect of pharmacotherapies on the reinforcing effects of drugs of abuse. The effects of bupropion on simulated demand for cigarettes were investigated in a placebo-controlled double-blind clinical trial. Participants reported the number of cigarettes they would purchase and consume in a single day at a range of prices. The effects of medication on the subjective effects of smoking were also explored. Demand for cigarettes was well described by an exponential demand equation. Bupropion did not significantly decrease the maximum number of cigarettes that participants said they would smoke in a single day nor did it significantly alter the relation between price per cigarette and demand. Baseline demand elasticity did not predict smoking cessation, but changes in elasticity following 1 week of treatment did. Medication group had no effect on any subjective effects of smoking. Bupropion had no significant effects on demand for cigarettes. The exponential demand equation, recently introduced in behavioral economics, proved amenable to human simulated demand and might be usefully employed in other pharmacotherapy studies as it provides a potentially useful measure of changes in the essential value of the drug as a reinforcer. Such changes may be useful in predicting the efficacy of medications designed to reduce drug consumption.

Public support in England for raising the price of cigarettes to fund tobacco control activities.

PubMed

Gardner, Benjamin; West, Robert

2010-08-01

Increasing the price of cigarettes reduces consumption, with a global price elasticity of approximately -0.4. In the UK where the cost of cigarettes is already relatively high, there is an issue surrounding public acceptance of further price rises ahead of the inflation rate. Previous research suggests that price increases may be supported where funds are dedicated to tobacco control. This study assessed public support in England for such a policy. A cross-sectional household survey was conducted in England between August 2008 and January 2009. A representative sample of 8736 respondents aged 16+, of whom 1900 (22%) were cigarette smokers at the time of the survey, was recruited. The primary outcome measure was support for a 20p (4%) price increase on a pack of cigarettes with proceeds going to fund tobacco control activities. 6216 participants (71%), including half (47%) of current cigarette smokers, indicated that they would support a 20p price increase if funds were dedicated to tobacco control activities. Levels of support among smokers were similar across the social gradient and gender. Younger smokers were more likely to support the increase. Smokers who smoked 0-10 cigarettes per day were more supportive of the increase than heavier smokers. There is broad public support for raising the cost of cigarettes with funds being used for tobacco control activities. The absence of a social gradient among smokers concurs with other research showing that more disadvantaged smokers are as engaged with tobacco control objectives as more affluent smokers.

SMOKING INCLINED GROUPS ACCORDING TO THE PHENOTYPE OF THE PTC GENE.

PubMed

Khukhunaishvili, R; Tskvitinidze, S; Koridze, M; Nagervadze, M; Chelidze, N

2016-09-01

The ability to sense phenylthiocarbamide (PTC) bitterness represents a well-known and convenient genetic marker for human populations and biomedical studies. Two basic phenotypes can be dichotomized by PTC sensitivity: PTC-sensitive or "tester" and PTC-insensitive or "non-tester". The majority of the population (approximately 70%) belong to the PTC-sensitive phenotype, while the remaining 30% are PTC-insensitive. The distribution of PTC sensitivities varies by consumption of alcohol, bitter coffee and cigarettes. This study was conducted among randomly selected 90 cigarette smokers living in the Ajara Region of Georgia. Our results indicate that PTC-insensitive phenotypes are correlated with cigarette consumption and should be considered as an important genetic proxy for cigarette use. This marker may prove very useful for identifying adolescents who might benefit from a focused smoking prevention intervention.

A public health strategy for e-cigarettes.

PubMed

Schneider, Sven; Diehl, Katharina

2015-07-01

The e-cigarette may present a new and significant Public Health problem: Studies published so far do not seem to indicate that e-cigarette use is just a passing trend. If e-cigarette use is less harmless than it is portrayed in many advertisements, Public Health would do well to start a serious discussion about a suitable prevention policy as soon as possible.The aim of this short paper is to discuss a range of measures designed to prevent e-cigarette consumption.Concretely, we suggest to monitor e-cigarette use, the e-cigarette industry and prevention policies, to implement a vapor-free policy, to develop help to quit e-cigarette use, to inform about the health risks of e-cigarette use, to establish regulations on e-cigarette advertising, promotion and sponsorship, and to introduce taxes on e-cigarettes.

Associations between e-cigarette access and smoking and drinking behaviours in teenagers.

PubMed

Hughes, Karen; Bellis, Mark A; Hardcastle, Katherine A; McHale, Philip; Bennett, Andrew; Ireland, Robin; Pike, Kate

2015-03-31

Public health concerns regarding e-cigarettes and debate on appropriate regulatory responses are focusing on the need to prevent child access to these devices. However, little is currently known about the characteristics of those young people that are accessing e-cigarettes. Using a cross-sectional survey of 14-17 year old school students in North West England (n = 16,193) we examined associations between e-cigarette access and demographics, conventional smoking behaviours, alcohol consumption, and methods of accessing cigarettes and alcohol. Access to e-cigarettes was identified through a question asking students if they had ever tried or purchased e-cigarettes. One in five participants reported having accessed e-cigarettes (19.2%). Prevalence was highest among smokers (rising to 75.8% in those smoking >5 per day), although 15.8% of teenagers that had accessed e-cigarettes had never smoked conventional cigarettes (v.13.6% being ex-smokers). E-cigarette access was independently associated with male gender, having parents/guardians that smoke and students' alcohol use. Compared with non-drinkers, teenagers that drank alcohol at least weekly and binge drank were more likely to have accessed e-cigarettes (adjusted odds ratio [AOR] 1.89, P < 0.001), with this association particularly strong among never-smokers (AOR 4.59, P < 0.001). Among drinkers, e-cigarette access was related to: drinking to get drunk, alcohol-related violence, consumption of spirits; self-purchase of alcohol from shops or supermarkets; and accessing alcohol by recruiting adult proxy purchasers outside shops. There is an urgent need for controls on the promotion and sale of e-cigarettes to children. Findings suggest that e-cigarettes are being accessed by teenagers more for experimentation than smoking cessation. Those most likely to access e-cigarettes may already be familiar with illicit methods of accessing age-restricted substances.

Validity of a demand curve measure of nicotine reinforcement with adolescent smokers.

PubMed

Murphy, James G; MacKillop, James; Tidey, Jennifer W; Brazil, Linda A; Colby, Suzanne M

2011-01-15

High or inelastic demand for drugs is central to many laboratory and theoretical models of drug abuse, but it has not been widely measured with human substance abusers. The authors used a simulated cigarette purchase task to generate a demand curve measure of nicotine reinforcement in a sample of 138 adolescent smokers. Participants reported the number of cigarettes they would purchase and smoke in a hypothetical day across a range of prices, and their responses were well-described by a regression equation that has been used to construct demand curves in drug self-administration studies. Several demand curve measures were generated, including breakpoint, intensity, elasticity, P(max), and O(max). Although simulated cigarette smoking was price sensitive, smoking levels were high (8+ cigarettes/day) at prices up to 50¢ per cigarette, and the majority of the sample reported that they would purchase at least 1 cigarette at prices as high as $2.50 per cigarette. Higher scores on the demand indices O(max) (maximum cigarette purchase expenditure), intensity (reported smoking level when cigarettes were free), and breakpoint (the first price to completely suppress consumption), and lower elasticity (sensitivity of cigarette consumption to increases in cost), were associated with greater levels of naturalistic smoking and nicotine dependence. Greater demand intensity was associated with lower motivation to change smoking. These results provide initial support for the validity of a self-report cigarette purchase task as a measure of economic demand for nicotine with adolescent smokers. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Validation of survey information on smoking and alcohol consumption against import statistics, Greenland 1993-2010.

PubMed

Bjerregaard, Peter; Becker, Ulrik

2013-01-01

Questionnaires are widely used to obtain information on health-related behaviour, and they are more often than not the only method that can be used to assess the distribution of behaviour in subgroups of the population. No validation studies of reported consumption of tobacco or alcohol have been published from circumpolar indigenous communities. The purpose of the study is to compare information on the consumption of tobacco and alcohol obtained from 3 population surveys in Greenland with import statistics. Estimates of consumption of cigarettes and alcohol using several different survey instruments in cross-sectional population studies from 1993-1994, 1999-2001 and 2005-2010 were compared with import statistics from the same years. For cigarettes, survey results accounted for virtually the total import. Alcohol consumption was significantly under-reported with reporting completeness ranging from 40% to 51% for different estimates of habitual weekly consumption in the 3 study periods. Including an estimate of binge drinking increased the estimated total consumption to 78% of the import. Compared with import statistics, questionnaire-based population surveys capture the consumption of cigarettes well in Greenland. Consumption of alcohol is under-reported, but asking about binge episodes in addition to the usual intake considerably increased the reported intake in this population and made it more in agreement with import statistics. It is unknown to what extent these findings at the population level can be inferred to population subgroups.

The effect of excise tax increases on cigarette prices in South Africa

PubMed Central

Linegar, Daniel J; van Walbeek, Corne

2018-01-01

Introduction The effectiveness of excise tax increases as a tool for reducing tobacco consumption depends largely on how the tax increases impact the retail price. We estimate this relationship in South Africa for 2001–2015. Data Statistics South Africa provided disaggregated cigarette price data, used in the calculation of the Consumers’ Price Index. Data on the excise tax per cigarette were obtained from Budget Reviews prepared by the National Treasury of South Africa. Methods Regression equations were estimated for each month. The month-on-month change in cigarette prices in February through April was regressed against March’s excise tax change to estimate the pass-through coefficient. For the other 9 months, the month-on-month change in cigarette price was regressed against monthly dummy variables to determine the size of the non-tax-related price increase in each of these months. The analysis was performed in both nominal and real (inflation-adjusted) terms. Findings Expressed in real terms, the excise tax was undershifted. A R1.00 (one rand) increase in the excise tax is associated with an increase in the retail price of cigarettes of R0.90 in the pre-2010 period, and R0.49 in the post-2010 period. In the pre-2010 period, the tobacco industry increased the retail price of cigarettes in July/August, independent of the excise tax increase. The discretionary July/August price increases largely disappeared after 2010, primarily because the market became more competitive. Conclusion The degree of excise tax pass-through, and the magnitude of discretionary increases in cigarette prices, is significantly determined by the competitive environment in the cigarette market. PMID:28341767

Unintended consequences of cigarette price changes for alcohol drinking behaviors across age groups: evidence from pooled cross sections

PubMed Central

2012-01-01

Background Raising prices through taxation on tobacco and alcohol products is a common strategy to raise revenues and reduce consumption. However, taxation policies are product specific, focusing either on alcohol or tobacco products. Several studies document interactions between the price of cigarettes and general alcohol use and it is important to know whether increased cigarette prices are associated with varying alcohol drinking patterns among different population groups. To inform policymaking, this study investigates the association of state cigarette prices with smoking, and current, binge, and heavy drinking by age group. Methods The 2001-2006 Behavioral Risk Factor Surveillance System surveys (n = 1,323,758) were pooled and analyzed using multiple regression equations to estimate changes in smoking and drinking pattern response to an increase in cigarette price, among adults aged 18 and older. For each outcome, a multiple linear probability model was estimated which incorporated terms interacting state cigarette price with age group. State and year fixed effects were included to control for potential unobserved state-level characteristics that might influence smoking and drinking. Results Increases in state cigarette prices were associated with increases in current drinking among persons aged 65 and older, and binge and heavy drinking among persons aged 21-29. Reductions in smoking were found among persons aged 30-64, drinking among those aged 18-20, and binge drinking among those aged 65 and older. Conclusions Increases in state cigarette prices may increase or decrease smoking and harmful drinking behaviors differentially by age. Adults aged 21-29 and 65 and older are more prone to increased drinking as a result of increased cigarette prices. Researchers, practitioners, advocates, and policymakers should work together to understand and prepare for these unintended consequences of tobacco taxation policy. PMID:22784412

Levels and trends in cigarette contraband in Canada.

PubMed

Guindon, G Emmanuel; Burkhalter, Robin; Brown, K Stephen

2016-09-01

There is overwhelming evidence that increases in tobacco taxes reduce tobacco use, save lives and increase government tax revenue. High taxes, however, create an incentive to devise ways to avoid or evade tobacco taxes through contraband tobacco. The associated consequences are significant and call for an accurate measurement of contraband's magnitude. However, its illegal nature makes the levels and trends in contraband intrinsically difficult to measure accurately. To examine levels and trends in cigarette contraband in Canada. We employed 2 approaches: first, we contrasted estimates of tax-paid cigarettes sales with consumption estimates based on survey data; second, we used data from several individual-level surveys that examined smokers' purchasing and use behaviours. We placed a particular emphasis on the provinces of Québec and Ontario because existing research suggests that cigarette contraband levels are far higher than in any other province. The estimates presented show a clear upward trend from the early 2000s in cigarette contraband in Québec and Ontario followed by, on the whole, a decreasing trend from about 2007 to 2009. None of the data presented provide support to the narrative that cigarette contraband has been increasing in recent years. Of note are Québec estimates which suggest relatively low levels of cigarette contraband since 2010, at levels no higher than in the early 2000s. The data presented suggest that policies to tackle cigarette contraband introduced from the mid-2000s to late 2000s, at both federal and provincial levels, may have dampened the demand for contraband cigarettes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Cigarette smoking before and after an excise tax increase and an antismoking campaign--Massachusetts, 1990-1996.

PubMed

1996-11-08

In November 1992, residents of Massachusetts approved a ballot petition (Question 1) that increased the tax on each pack of cigarettes from $.26 to $.51 beginning January 1, 1993, and requested that the legislature spend the proceeds on tobacco control and health education. The Massachusetts Tobacco Control Program (MTCP), administered by the Massachusetts Department of Public Health (MDPH), was established in response to the approval of the petition. In October 1993, MTCP initiated a statewide mass-media antismoking campaign. In early 1994, the program began funding local boards of health and school health and other youth programs to promote policies to reduce public exposure to environmental tobacco smoke and to restrict youth access to cigarettes. Efforts also included support to health education programs, primary-care providers, and other services to help smokers quit. Through June 1996, MTCP expenditures totaled $116 million, including $43 million for the mass-media campaign. To assess the effects of the excise tax increase and the antismoking campaign on cigarette smoking in Massachusetts, CDC and MDPH analyzed data about the number of packs of cigarettes taxed per capita and the prevalence of cigarette smoking during the period preceding (1990-1992) and following (1993-1996) implementation of the ballot petition. This report summarizes the findings of the assessment and compares trends in cigarette consumption (i.e., purchases) in Massachusetts, in California (where a voter-mandated cigarette tax increase in January 1989 funded a statewide antismoking campaign that began in April 1990, and in the 48 remaining states and the District of Columbia combined. The findings suggest that the number of packs of cigarettes taxed per capita declined substantially in Massachusetts after implementation of the ballot petition.

Unintended consequences of cigarette price changes for alcohol drinking behaviors across age groups: evidence from pooled cross sections.

PubMed

McLellan, Deborah L; Hodgkin, Dominic; Fagan, Pebbles; Reif, Sharon; Horgan, Constance M

2012-07-11

Raising prices through taxation on tobacco and alcohol products is a common strategy to raise revenues and reduce consumption. However, taxation policies are product specific, focusing either on alcohol or tobacco products. Several studies document interactions between the price of cigarettes and general alcohol use and it is important to know whether increased cigarette prices are associated with varying alcohol drinking patterns among different population groups. To inform policymaking, this study investigates the association of state cigarette prices with smoking, and current, binge, and heavy drinking by age group. The 2001-2006 Behavioral Risk Factor Surveillance System surveys (n = 1,323,758) were pooled and analyzed using multiple regression equations to estimate changes in smoking and drinking pattern response to an increase in cigarette price, among adults aged 18 and older. For each outcome, a multiple linear probability model was estimated which incorporated terms interacting state cigarette price with age group. State and year fixed effects were included to control for potential unobserved state-level characteristics that might influence smoking and drinking. Increases in state cigarette prices were associated with increases in current drinking among persons aged 65 and older, and binge and heavy drinking among persons aged 21-29. Reductions in smoking were found among persons aged 30-64, drinking among those aged 18-20, and binge drinking among those aged 65 and older. Increases in state cigarette prices may increase or decrease smoking and harmful drinking behaviors differentially by age. Adults aged 21-29 and 65 and older are more prone to increased drinking as a result of increased cigarette prices. Researchers, practitioners, advocates, and policymakers should work together to understand and prepare for these unintended consequences of tobacco taxation policy.

The effect of excise tax increases on cigarette prices in South Africa.

PubMed

Linegar, Daniel J; van Walbeek, Corne

2018-01-01

The effectiveness of excise tax increases as a tool for reducing tobacco consumption depends largely on how the tax increases impact the retail price. We estimate this relationship in South Africa for 2001-2015. Statistics South Africa provided disaggregated cigarette price data, used in the calculation of the Consumers' Price Index. Data on the excise tax per cigarette were obtained from Budget Reviews prepared by the National Treasury of South Africa. Regression equations were estimated for each month. The month-on-month change in cigarette prices in February through April was regressed against March's excise tax change to estimate the pass-through coefficient. For the other 9 months, the month-on-month change in cigarette price was regressed against monthly dummy variables to determine the size of the non-tax-related price increase in each of these months. The analysis was performed in both nominal and real (inflation-adjusted) terms. Expressed in real terms, the excise tax was undershifted. A R1.00 (one rand) increase in the excise tax is associated with an increase in the retail price of cigarettes of R0.90 in the pre-2010 period, and R0.49 in the post-2010 period. In the pre-2010 period, the tobacco industry increased the retail price of cigarettes in July/August, independent of the excise tax increase. The discretionary July/August price increases largely disappeared after 2010, primarily because the market became more competitive. The degree of excise tax pass-through, and the magnitude of discretionary increases in cigarette prices, is significantly determined by the competitive environment in the cigarette market. © 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.

Estimating the Smoking Ban Effects on Smoking Prevalence, Quitting and Cigarette Consumption in a Population Study of Apprentices in Italy.

PubMed

Pieroni, Luca; Muzi, Giacomo; Quercia, Augusto; Lanari, Donatella; Rundo, Carmen; Minelli, Liliana; Salmasi, Luca; dell'Omo, Marco

2015-08-13

We evaluated the effects of the Italian 2005 smoking ban in public places on the prevalence of smoking, quitting and cigarette consumption of young workers. The dataset was obtained from non-computerized registers of medical examinations for a population of workers with apprenticeship contracts residing in the province of Viterbo, Italy, in the period 1996-2007. To estimate the effects of the ban, a segmented regression approach was used, exploiting the discontinuity introduced by the application of the law on apprentices' smoking behavior. It is estimated that the Italian smoking ban generally had no effect on smoking prevalence, quitting ratio, or cigarette consumption of apprentices. However, when the estimates were applied to subpopulations, significant effects were found: -1% in smoking prevalence, +2% in quitting, and -3% in smoking intensity of apprentices with at least a diploma.

Estimating the Smoking Ban Effects on Smoking Prevalence, Quitting and Cigarette Consumption in a Population Study of Apprentices in Italy

PubMed Central

Pieroni, Luca; Muzi, Giacomo; Quercia, Augusto; Lanari, Donatella; Rundo, Carmen; Minelli, Liliana; Salmasi, Luca; dell’Omo, Marco

2015-01-01

Objectives: We evaluated the effects of the Italian 2005 smoking ban in public places on the prevalence of smoking, quitting and cigarette consumption of young workers. Data and Methods: The dataset was obtained from non-computerized registers of medical examinations for a population of workers with apprenticeship contracts residing in the province of Viterbo, Italy, in the period 1996–2007. To estimate the effects of the ban, a segmented regression approach was used, exploiting the discontinuity introduced by the application of the law on apprentices’ smoking behavior. Results: It is estimated that the Italian smoking ban generally had no effect on smoking prevalence, quitting ratio, or cigarette consumption of apprentices. However, when the estimates were applied to subpopulations, significant effects were found: −1% in smoking prevalence, +2% in quitting, and −3% in smoking intensity of apprentices with at least a diploma. PMID:26287220

Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex reduces resting-state insula activity and modulates functional connectivity of the orbitofrontal cortex in cigarette smokers.

PubMed

Li, Xingbao; Du, Lian; Sahlem, Gregory L; Badran, Bashar W; Henderson, Scott; George, Mark S

2017-05-01

Previous studies reported that repetitive transcranial magnetic stimulation (rTMS) can reduce cue-elicited craving and decrease cigarette consumption in smokers. The mechanism of this effect however, remains unclear. We used resting-state functional magnetic resonance imaging (rsfMRI) to test the effect of rTMS in non-treatment seeking smokers. We used a single blinded, sham-controlled, randomized counterbalanced crossover design where participants underwent two visits separated by at least 1 week. Participants received active rTMS over the left dorsolateral prefrontal cortex (DLPFC) during one of their visits, and sham rTMS during their other visit. They had two rsFMRI scans before and after each rTMS session. We used the same rTMS stimulation parameters as in a previous study (10Hz, 5s-on, 10s-off, 100% resting motor threshold, 3000 pulses). Ten non-treatment-seeking, nicotine-dependent, cigarette smokers (6 women, an average age of 39.72 and an average cigarette per day of 17.30) finished the study. rsFMRI results demonstrate that as compared to a single session of sham rTMS, a single session of active rTMS inhibits brain activity in the right insula and thalamus in fractional amplitude of low frequency fluctuation (fALFF). For intrinsic brain connectivity comparisons, active TMS resulted in significantly decreased connectivity from the site of rTMS to the left orbitomedial prefrontal cortex. This data suggests that one session of rTMS can reduce activity in the right insula and right thalamus as measured by fALFF. The data also demonstrates that rTMS can reduce rsFC between the left DLPFC and the medial orbitofrontal cortex. Copyright © 2017 Elsevier B.V. All rights reserved.

Policy and health implications of using the U.S. Food and Drug Administration product design approach in reducing tobacco product risk.

PubMed

Givel, Michael

2008-06-01

Purported risk or harm reduction through product design change of cigarettes has occurred in three phases in the U.S. The first phase from the 1940s to the early 1960s included a gradual rise in filtered cigarettes. The second phase, which began in the early 1960s in response to the landmark 1964 U.S. Surgeon General's report that linked smoking with lung cancer and other diseases, included the introduction of purportedly low tar and nicotine cigarettes. Subsequent research found that both filters and low tar and nicotine cigarettes were ineffective approaches to reducing health risks associated with smoking. Despite this, these product design changes were used in tobacco industry marketing campaigns to allay consumer health concerns and stabilize tobacco markets and sales. Since 2004, a new risk or harm reduction phase has occurred with the backing by Philip Morris as well as major U.S. health groups of U.S. Food and Drug Administration legislation that would require disclosure of tobacco ingredients, ban misleading health claims, prohibit or reduce harmful ingredients, and require prior approval of tobacco design, performance changes, and modified risk tobacco products. However, current scientific literature indicates that there is no scientific consensus and little evidence on what tobacco ingredients are linked to particular morbidities and mortalities and at what levels. This will allow the tobacco industry to implicitly or explicitly claim their products are "safer." Instead, health advocates should advocate for scientifically proven policy measures such as smoke free public places or higher tobacco taxes that control and reduce tobacco markets and consumption.

Measuring illicit cigarette trade in Colombia.

PubMed

Maldonado, Norman; Llorente, Blanca Amalia; Iglesias, Roberto Magno; Escobar, Diego

2018-03-14

By 2016, tobacco industry provided the only illicit trade estimates in Colombia and used these to discourage tax increases since the 1990s. To establish the viability of a threefold hike in the excise tax, policy makers needed unbiased estimates of the illicit cigarette. To estimate the size of illicit cigarette trade in five Colombian cities (63% of the market), analyse characteristics of smokers of illicit cigarettes and compare market share results with one industry-funded survey. Street cross-sectional survey with smokers' self-report on consumption pattern, last purchase information and direct observation of smoker's packs. Sampling frame: smokers, men and women, 12 years old or older, all income levels, resident in five Colombian cities (Bogotá, Medellín, Cali, Cartagena and Cúcuta) with 1 733 316 smokers in 2013. Sample size 1697, simple random sample by city, sampling weights based on age groups and cities. Confidence level 95%, margin of error 3.5% for Bogotá and Medellín and 5% for the other three cities. Data collection period: 24 August-14 September 2016. Illicit cigarettes represent 3.5% of consumption in the five cities, a much lower estimate than the industry data. There are significant differences across cities, with Bogotá at the bottom (1.5%) and Cúcuta at the top (22.8%). The low overall penetration of illicit cigarettes in Colombia indicates that the industry's warnings against tax increases are not justified. The limited importance of tax levels as determinant of consumption of illicit cigarettes is also suggested by the differences across cities, all of them with the same tax regime. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Smoking behaviour and sensations during the pre-quit period of an exercise-aided smoking cessation intervention.

PubMed

De Jesus, Stefanie; Prapavessis, Harry

2018-06-01

Previous research has shown reductions in cigarette consumption during the pre-quit period of exercise-aided smoking cessation interventions. Smoking topography and sensation patterns during this period is unknown and may provide valuable insight into compensation and cessation readiness. Female smokers (N = 236, M age = 43, M cigarettes/day = 17.0) enrolled in an exercise-aided smoking cessation intervention self-reported daily cigarette use and cigarette sensory experiences. Breath carbon monoxide and smoking topography data were collected during the period leading up to the targeted quit date (i.e., baseline, week 1, and week 3), which was set for week 4. Repeated measures ANOVAs revealed that cigarette consumption (p < 0.001, eta = 0.32), carbon monoxide (p < 0.001, eta = 0.14), puff duration (p = 0.01, eta = 0.05), smoking satisfaction (p < 0.001, eta = 0.34), psychological reward (p < 0.001, eta = 0.43), enjoyment of respiratory tract sensations (p < 0.001, eta = 0.29), and craving (p < 0.001, eta = 0.39) decreased, whereas average puff flow (p = 0.01, eta = 0.05) increased. This is the first study to establish that regular exercise during the pre-quit period served as a conduit for facilitating behavioral and sensory harm reduction with cigarettes. Furthermore, the pattern of change observed between cigarette consumption and smoking topography does not support compensation. These findings imply that female smokers who exercise prior to a quit attempt are in a favourable state to achieve cessation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Investigating Male Tobacco Use and Expenditure Patterns across Socio-Economic Groups in Nigeria

PubMed Central

Uguru, Nkoli P.; Mbachu, Chinyere; Ibe, Ogochukwu P.; Uguru, Chibuzo C.; Odukoya, Oluwakemi; Okwuosa, Chinenye; Onwujekwe, Obinna

2015-01-01

The magnitude of variation in economic costs of tobacco consumption among socio-economic status (SES) groups in Nigeria is unclear. Understanding the factors that influence tobacco use and expenditure among different socio-economic groups would inform decisions on interventions for tobacco control in Nigeria. Secondary data was obtained from the 2008 National demographic and health survey. Information on tobacco use and expenditure in households and individual males were extracted from the database. A total of 34,070 households and 15,846 individual males were sampled. Analysis was done using descriptive statistics and binary logistic regression analysis. Information on wealth index obtained were categorized into socio-economic quintile groups (Q1 to Q5), representing poorest to richest socio-economic groups. To estimate expenditure on cigarettes, the average cost of a stick of cigarette was obtained and multiplied with the number of sticks smoked per day. The proportion of households that use tobacco in Nigeria is 5.25% with a greater percentage (89.6%) residing in the rural areas. Prevalence of cigarette smoking in individual males is 8.59%, and the poorer SES group smoked more cigarettes (20.9%) and spent more (0.60–1.19USD) than the richest SES group. Low education level, traditional beliefs, literacy levels, SES and employment status all influence cigarette smoking in adult males. Although poor people smoked more and spent more of their income on cigarettes, other factors like educational level and traditional beliefs were found to influence practice of cigarette smoking in men. This implies that tobacco control legislation through increased taxes alone may not effectively reduce the use of tobacco and its products in Nigeria. A consolidated approach that includes behavioral change procedures, enforcing bans on tobacco advertisement and the use of strong graphic anti-tobacco messages targeted at both the poor and rich as well as the educated and uneducated need to be effected to reduce tobacco use. PMID:25856074

[Changes in tobacco consumption: boom of roll-your-own cigarettes and emergence of e-cigarettes].

PubMed

Tarrazo, Marina; Pérez-Ríos, Mónica; Santiago-Pérez, María I; Malvar, Alberto; Suanzes, Jorge; Hervada, Xurxo

To assess changes in smoking prevalence and study roll-your-own (RYO) tobacco and e-cigarette use in the Galician population between 2007 and 2015. Data were obtained from five independent, cross-sectional studies carried out in Galicia (Spain) between 2007-2015 in the population aged 16 and over (n=8,000/year). Prevalence of use was estimated, with 95% confidence intervals, overall, according to sex and by age group, area of residence and level of education. Smoking prevalence decreased from 25.4% in 2007 to 21.8% in 2015. In 2007, 1.8% of current smokers declared that they had smoked RYO tobacco, compared to 18.6% in 2015. Among smokers, RYO tobacco consumption increased across all demographic groups. In both 2014 and 2015, ever use of e-cigarettes was 0.7%. E-cigarette use was more frequent in urban settings. Smoking prevalence decreased in Galicia between 2007 and 2015, and there has been rapid growth in the prevalence of RYO tobacco use. Although smokers are more likely to use e-cigarettes, both former and never smokers declared their use. The boom of RYO cigarettes and the emergence of e-cigarettes highlight the importance of having continuous surveillance systems to identify smoking behavioural changes. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Are Statewide Restaurant and Bar Smoking Bans Associated With Reduced Cigarette Smoking Among Those With Mental Illness?

PubMed Central

2014-01-01

Background: Smoke-free air laws have effectively reduced cigarette consumption at the population level; however, the influence of these policies on smoking among those with mental illness is unclear. We examined whether associations between statewide restaurant/bar smoking bans and cigarette smoking varied by psychiatric diagnoses and gender. Methods: We analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, Wave 1: 2001–2002; Wave 2: 2004–2005; n = 7,317 smokers). All analyses were stratified by gender. We examined whether tobacco cessation was associated with the interaction between ban implementation and Wave 1 psychiatric diagnoses (alcohol use disorder [AUD], anxiety disorder [AD], or mood disorder), adjusting for relevant covariates. Among those who continued to use tobacco at Wave 2, we examined associations between Wave 2 cigarettes per day (CPD) and the diagnoses × ban interactions, controlling for Wave 1 CPD and other relevant covariates. Results: Among men with an AUD and women with an AD, ban implementation was associated with 6% and 10% greater probability of tobacco cessation at Wave 2, respectively. Among men in the overall sample, ban implementation was associated with smoking 0.8 fewer CPD at Wave 2. Associations with CPD were nonsignificant among women. Interactions between ban implementation and psychiatric diagnoses were also nonsignificant when examining CPD, suggesting consistent reductions in CPD among men but not among women. Conclusions: This study provided the first evidence that statewide restaurant/bar smoking bans may be associated with reduced smoking among those with select psychiatric conditions. PMID:24566280

Impact of the economic crisis on health-related behaviors in Italy.

PubMed

Mattei, Giorgio; De Vogli, Roberto; Ferrari, Silvia; Pingani, Luca; Rigatelli, Marco; Galeazzi, Gian Maria

2017-11-01

Evidence exists supporting the impact of the Great Recession on health-related behaviors internationally, though few studies are available concerning the Italian population. To assess the impact of the late 2000s economic crisis on health-related behaviors linked to population mental health in Italy. Descriptive study. Health indicators came from the Italian Institute of Statistics database (years 2000-2015). Statistics performed by means of linear regression models. Increased smokers (β = 1.68, p = .03), heavy smokers, that is, people smoking 11-20 cigarettes per day (β = 2.18, p = .04) or more than 20 cigarettes per day (β = 1.04, p < .01) and mean number of smoked cigarettes per day (β = 0.56, p = .02) were noticeable. Also, prevalence of overweight increased (β = 0.91, p = .04), while the Italian families' expenditure for alcoholic beverages decreased (β = -812.80, p = .01). Alcohol consumption decreased (β = -0.60, p < .01), especially in men (β = -0.95, p < .01); binge drinking increased in years 2009-2010. No change was noticeable in the diet indicators collected. The economic crisis may have increased smoking, overweight and binge drinking in Italy (though data on the latter phenomenon are not conclusive), and reduced overall alcohol consumption.

Estimating demand for alternatives to cigarettes with online purchase tasks.

PubMed

O'Connor, Richard J; June, Kristie M; Bansal-Travers, Maansi; Rousu, Matthew C; Thrasher, James F; Hyland, Andrew; Cummings, K Michael

2014-01-01

To explore how advertising affects demand for cigarettes and potential substitutes, including snus, dissolvable tobacco, and medicinal nicotine. A Web-based experiment randomized 1062 smokers to see advertisements for alternative nicotine products or soft drinks, then complete a series of purchase tasks, which were used to estimate demand elasticity, peak consumption, and cross-price elasticity (CPE) for tobacco products. Lower demand elasticity and greater peak consumption were seen for cigarettes compared to all alternative products (p < .05). CPE did not differ across the alternative products (p ≤ .03). Seeing relevant advertisements was not significantly related to demand. These findings suggest significantly lower demand for alternative nicotine sources among smokers than previously revealed.

Smoking intensity before and after introduction of the public place smoking ban in Scotland.

PubMed

Ashley, Madeleine; Saunders, Pam; Mullard, Gavin; Prasad, Krishna; Mariner, Derek; Williamson, Justine; Richter, Audrey

2011-12-01

A study was performed to determine whether cigarettes were smoked more intensely outside of public venues in Scotland, compared to indoors, after introduction of the public place smoking (PPS) ban. It was conducted in three waves: before the ban, immediately after and 6 months after introduction. The study included 322 regular smokers of four cigarette brand variants. Filter analysis measurements were used to estimate the human-smoked yields of tar and nicotine from cigarettes smoked predominantly inside (before the ban) or outside (after the ban) public venues. Self-reported cigarette consumption data were also collected. Numbers of cigarettes smoked indoors in public places fell dramatically after the ban. There was a corresponding rise in smoking incidence in outdoor public locations. The ban did not significantly affect the total number of cigarettes smoked by the subjects over the weekends investigated. Human-smoked yields of tar and nicotine decreased slightly after the introduction of the ban and some reductions were significant. Therefore, smoking outdoors at public venues, following the PPS ban, did not increase smoking intensity. Any changes in smoking behaviour that may have occurred had little effect on mainstream smoke exposure or cigarette consumption for those that continued to smoke. Copyright © 2010 Elsevier Inc. All rights reserved.

Smoking in Africa: the coming epidemic.

PubMed

Taha, A; Ball, K

1982-01-01

This discussion describes the development of tobacco smoking in Africa, the increase in consumption, and how tobacco use is promoted. It also presents evidence to show that smoking-related diseases similar to those seen in Western nations may be emerging. Tobacco was first introduced into Africa in the 16th century by the Turks who brought it into Egypt. The smoking habits of today's Africans are governed by local custom and economic status. Cigarette smoking is replacing the traditional pipe (hookah), although the latter is still used, particularly in rural areas. The prevalence of smoking is higher in urban than rural areas. Traditionally, only men smoked, but the proportion of women smokers is now rising. Smoking is also increasing among African children and adolescents. Cigarette consumption was examined in the 6 African countries from which statistics were available. In all of them, it rose steeply between 1967-76 and actually doubled in Libya and Ethiopia. In Egypt domestic cigarette sales increased by 23% between 1976-78, but sales of imported cigarettes rose by 25% in 1 year alone. Consumption of imported cigarettes is rising in many African countries. Between 1965-76 the volume of tobacco imports almost doubled. Cigarette smuggling is common in some African countries and may account for about 1/3 of total cigarette consumption in the Sudan. Some African countries are expanding tobacco agriculture so that they can supply their own needs. Nigeria has increased tobacco cultivation by about 10% a year to meet local dmeands. Zaire's imports of tobacco increased by about 30% between 1969-73 but now expects to become self sufficient in tobacco production. Tanzania's tobacco output incrased 7-fold between 1962-74 and will continue to grow through the help of the International Development Association. Cigarettes are heavily promoted in Africa. The advertisements present smoking as socially desirable by showing young, happy people and by relating it to manliness and success. Smoking-related diseases have already made their appearance in Africa. The 2 most common types of cancer in the Natal Bantu are lung and esophageal tumors. Lung cancer in Natal men has increased 6-fold and in women about 5-fold over the past 11 years. Other studies from southern Africa show much higher smoking rates in patients with lung cancer than in controls. The incidence of esophageal cancer in blacks in Durban, South Africa, and Zimbabwe is among the highest in the world. Other suggestive associations with cigarette smoking in African subjects are bladder cancer, myocardial infarction, and chronic bronchitis. Many Western governments and health authorities now try to persuade people not to smoke, and in some developed countries consumption has already begun to fall. As a result, tobacco companies have started to diversify and intensify promotion of cigarettes and the growth of tobacco in the 3rd world.

Does participation in prenatal courses lead to heavier babies?

PubMed Central

Robitaille, Y; Kramer, M S

1985-01-01

In a prospective epidemiologic survey of 1,676 primiparous women delivering in four Montreal hospitals during an eight-month period, we studied the impact of prenatal courses on birthweight, maternal weight gain, and cigarette smoking. Women who participated in prenatal courses were older and of higher socioeconomic status and were less likely to be smokers than non-participants. After adjustment for these differences, newborns of course participants had similar mean birthweights compared to those of non-participants (3286 grams vs 3271 grams), and the difference for maternal weight gain was substantially reduced. Most of the reduction in cigarette consumption occurred during the first three months of pregnancy, even among later participants, suggesting that something other than prenatal courses influenced cigarette smoking reduction in course participants. We conclude that as far as the birthweight objective is concerned, the format and content of prenatal courses (as currently constituted in the Montreal region) require re-examination, and new ideas and interventions need to be developed and tested. PMID:4037161

Blood harmane concentrations in 497 individuals relative to coffee, cigarettes, and food consumption on the morning of testing.

PubMed

Louis, Elan D; Factor-Litvak, Pam; Gerbin, Marina; Jiang, Wendy; Zheng, Wei

2011-01-01

Harmane, a potent neurotoxin linked with several neurological disorders, is present in many foods, coffee, and cigarettes. We assessed whether morning food/coffee consumption and smoking were reflected in blood harmane concentrations (BHCs) we obtained in an epidemiologic sample (n = 497). Participants who smoked on the morning of phlebotomy had similar logBHCs to those who had not smoked (P = .57); there was no correlation between logBHCs and number of cigarettes (P = .59). Among the coffee drinkers, there was no correlation between number of cups and logBHCs (P = .98). Participants who had eaten on the morning of phlebotomy had similar logBHCs to those who had not (P = .49); logBHCs did not correlate with the time latency between last food consumption and phlebotomy (P = .74). BHCs in this sample of ~500 individuals did not covary with recent smoking, coffee, or food consumption, suggesting that our inability to withhold these exposures on the morning of phlebotomy was not reflected in the BHCs we measured.

Blood Harmane Concentrations in 497 Individuals Relative to Coffee, Cigarettes, and Food Consumption on the Morning of Testing

PubMed Central

Louis, Elan D.; Factor-Litvak, Pam; Gerbin, Marina; Jiang, Wendy; Zheng, Wei

2011-01-01

Harmane, a potent neurotoxin linked with several neurological disorders, is present in many foods, coffee, and cigarettes. We assessed whether morning food/coffee consumption and smoking were reflected in blood harmane concentrations (BHCs) we obtained in an epidemiologic sample (n = 497). Participants who smoked on the morning of phlebotomy had similar logBHCs to those who had not smoked (P = .57); there was no correlation between logBHCs and number of cigarettes (P = .59). Among the coffee drinkers, there was no correlation between number of cups and logBHCs (P = .98). Participants who had eaten on the morning of phlebotomy had similar logBHCs to those who had not (P = .49); logBHCs did not correlate with the time latency between last food consumption and phlebotomy (P = .74). BHCs in this sample of ~500 individuals did not covary with recent smoking, coffee, or food consumption, suggesting that our inability to withhold these exposures on the morning of phlebotomy was not reflected in the BHCs we measured. PMID:21776263

Cigarette Smoking Practice and Attitudes, and Proposed Effective Smoking Cessation Measures among College Student Smokers in China

ERIC Educational Resources Information Center

Cui, Yanping; Ying, Mao; Fan, Hongqi

2012-01-01

Purpose: This paper aims to investigate the average daily consumption of cigarettes and its correlates, attitudes toward smoking, and suggestions for anti-smoking measures in a sample of Chinese college student smokers. Design/methodology/approach: A sample of 150 college student cigarette smokers in Baoding, a city near Beijing, filled out a…

Variation in CYP2A6 and tobacco dependence throughout adolescence and in young adult smokers

PubMed Central

Chenoweth, Meghan J.; Sylvestre, Marie-Pierre; Contreras, Gisele; Novalen, Maria; O’Loughlin, Jennifer; Tyndale, Rachel F.

2015-01-01

Background Smoking is influenced by genetic factors including variation in CYP2A6 and CYP2B6, which encode nicotine-metabolizing enzymes. In early adolescence, CYP2A6 slow nicotine metabolism was associated with higher dependence acquisition, but reduced cigarette consumption. Here we extend this work by examining associations of CYP2A6 and CYP2B6 with tobacco dependence acquisition in a larger sample of smokers followed throughout adolescence. Methods White participants from the Nicotine Dependence in Teens cohort that had ever inhaled (n=421) were followed frequently from age 12–18 years. Cox’s proportional hazards models compared the risk of ICD-10 tobacco dependence acquisition (score 3+) for CYP2A6 and CYP2B6 metabolism groups. Early smoking experiences, as well as amount smoked at end of follow-up, was also computed. At age 24 (N=162), we assessed concordance between self-reported cigarette consumption and salivary cotinine. Results In those who initiated inhalation during follow-up, CYP2A6 slow (vs. normal) metabolizers were at greater risk of dependence (hazards ratio (HR)=2.3; 95% CI=1.1, 4.8); CYP2B6 slow (vs. normal) metabolizers had non-significantly greater risk (HR=1.5; 95% CI=0.8, 2.6). Variation in CYP2A6 or CYP2B6 was not significantly associated with early smoking symptoms or cigarette consumption at end of follow-up. At age 24, neither gene was significantly associated with dependence status. Self-reported consumption was associated with salivary cotinine, a biomarker of tobacco exposure, acquired at age 24 (B=0.37; P<0.001). Conclusions Our findings extend previous work indicating that slow nicotine metabolism mediated by CYP2A6, and perhaps CYP2B6, increases risk for tobacco dependence throughout adolescence. PMID:26644138

Electronic Cigarettes Efficacy and Safety at 12 Months: Cohort Study

PubMed Central

Fiore, Maria; La Vecchia, Carlo; Marzuillo, Carolina; Gualano, Maria Rosaria; Liguori, Giorgio; Cicolini, Giancarlo; Capasso, Lorenzo; D'Amario, Claudio; Boccia, Stefania; Siliquini, Roberta; Ricciardi, Walter; Villari, Paolo

2015-01-01

Objective To evaluate the safety and efficacy as a tool of smoking cessation of electronic cigarettes (e-cigarettes), directly comparing users of e-cigarettes only, smokers of tobacco cigarettes only, and smokers of both. Design Prospective cohort study. Final results are expected in 2019, but given the urgency of data to support policies on electronic smoking, we report the results of the 12-month follow-up. Data Sources Direct contact and structured questionnaires by phone or via internet. Methods Adults (30–75 years) were included if they were smokers of ≥1 tobacco cigarette/day (tobacco smokers), users of any type of e-cigarettes, inhaling ≥50 puffs weekly (e-smokers), or smokers of both tobacco and e-cigarettes (dual smokers). Carbon monoxide levels were tested in a sample of those declaring tobacco smoking abstinence. Main Outcome Measures Sustained smoking abstinence from tobacco smoking at 12 months, reduction in the number of tobacco cigarettes smoked daily. Data Synthesis We used linear and logistic regression, with region as cluster unit. Results Follow-up data were available for 236 e-smokers, 491 tobacco smokers, and 232 dual smokers (overall response rate 70.8%). All e-smokers were tobacco ex-smokers. At 12 months, 61.9% of the e-smokers were still abstinent from tobacco smoking; 20.6% of the tobacco smokers and 22.0% of the dual smokers achieved tobacco abstinence. Adjusting for potential confounders, tobacco smoking abstinence or cessation remained significantly more likely among e-smokers (adjusted OR 5.19; 95% CI: 3.35–8.02), whereas adding e-cigarettes to tobacco smoking did not enhance the likelihood of quitting tobacco and did not reduce tobacco cigarette consumption. E-smokers showed a minimal but significantly higher increase in self-rated health than other smokers. Non significant differences were found in self-reported serious adverse events (eleven overall). Conclusions Adding e-cigarettes to tobacco smoking did not facilitate smoking cessation or reduction. If e-cigarette safety will be confirmed, however, the use of e-cigarettes alone may facilitate quitters remaining so. Registration Number NCT01785537. PMID:26061661

Drug Metabolizing Enzyme and Transporter Gene Variation, Nicotine Metabolism, Prospective Abstinence, and Cigarette Consumption.

PubMed

Bergen, Andrew W; Michel, Martha; Nishita, Denise; Krasnow, Ruth; Javitz, Harold S; Conneely, Karen N; Lessov-Schlaggar, Christina N; Hops, Hyman; Zhu, Andy Z X; Baurley, James W; McClure, Jennifer B; Hall, Sharon M; Baker, Timothy B; Conti, David V; Benowitz, Neal L; Lerman, Caryn; Tyndale, Rachel F; Swan, Gary E

2015-01-01

The Nicotine Metabolite Ratio (NMR, ratio of trans-3'-hydroxycotinine and cotinine), has previously been associated with CYP2A6 activity, response to smoking cessation treatments, and cigarette consumption. We searched for drug metabolizing enzyme and transporter (DMET) gene variation associated with the NMR and prospective abstinence in 2,946 participants of laboratory studies of nicotine metabolism and of clinical trials of smoking cessation therapies. Stage I was a meta-analysis of the association of 507 common single nucleotide polymorphisms (SNPs) at 173 DMET genes with the NMR in 449 participants of two laboratory studies. Nominally significant associations were identified in ten genes after adjustment for intragenic SNPs; CYP2A6 and two CYP2A6 SNPs attained experiment-wide significance adjusted for correlated SNPs (CYP2A6 PACT=4.1E-7, rs4803381 PACT=4.5E-5, rs1137115, PACT=1.2E-3). Stage II was mega-regression analyses of 10 DMET SNPs with pretreatment NMR and prospective abstinence in up to 2,497 participants from eight trials. rs4803381 and rs1137115 SNPs were associated with pretreatment NMR at genome-wide significance. In post-hoc analyses of CYP2A6 SNPs, we observed nominally significant association with: abstinence in one pharmacotherapy arm; cigarette consumption among all trial participants; and lung cancer in four case:control studies. CYP2A6 minor alleles were associated with reduced NMR, CPD, and lung cancer risk. We confirmed the major role that CYP2A6 plays in nicotine metabolism, and made novel findings with respect to genome-wide significance and associations with CPD, abstinence and lung cancer risk. Additional multivariate analyses with patient variables and genetic modeling will improve prediction of nicotine metabolism, disease risk and smoking cessation treatment prognosis.

[Genotoxicity from exposure to cigarettes in young smokers in Colombia].

PubMed

Arboleda-Moreno, Yexania; Hoyos, Luz Stella; Carvajal, Silvio; Sierra-Torres, Carlos H

2004-06-01

To evaluate the frequency of chromosome aberrations (CAs) in the peripheral blood lymphocytes of young cigarette smokers in the city of Popayán, Colombia. In this cytogenetic case-control study there were 32 young cigarette smokers and 32 nonsmokers. All of them were between 19 and 29 years old and none used psychoactive drugs, suffered from chronic or infectious diseases, or had been exposed to chemotherapy or radiation therapy or to chemical agents in their work. A survey was used to obtain demographic information, occupational information (type of employment, type of and length of exposure to chemical agents), lifestyle information (consumption of alcoholic beverages and psychoactive drugs), and information on smoking (current or former smoker, number of cigarettes smoked daily, length of time smoking, and type of cigarettes smoked). The cases were matched with the controls by age (+/- 5 years) and sex. The microscopic study of the CAs using lymphocyte cultures was carried out under the light microscope with 100X magnification. For each study participant, 100 complete metaphase cells (2n = 46 chromosomes) were analyzed, counting the structural CAs (chromatid breaks and chromosome breaks) and numerical CAs (change in the number of chromosomes). The frequency of CAs was adjusted for alcohol consumption, using a univariate linear model. The frequency of total CAs was significantly greater in the young cigarettes smokers (6.02 +/- 0.52) than in the nonsmokers (3.04 +/- 0.50), and the greatest number of CAs (7.77 +/- 0.88) was found in those who had a pack-year value of more than 3.0. In addition, there was a dose-effect relationship, shown by the increase in the frequency of CAs with an increase in the pack-years of consumption (coefficient of determination = 0.2257). We confirmed the association between cigarette consumption and CAs in young people who smoked relatively little. These results should be taken into account in order to formulate national smoking prevention policies and to evaluate their outcomes, from both the social, economic, and environmental standpoint and the standpoint of the health of future generations.

Marijuana and tobacco cigarettes: Estimating their behavioral economic relationship using purchasing tasks.

PubMed

Peters, Erica N; Rosenberry, Zachary R; Schauer, Gillian L; O'Grady, Kevin E; Johnson, Patrick S

2017-06-01

Although marijuana and tobacco are commonly coused, the nature of their relationship has not been fully elucidated. Behavioral economics has characterized the relationship between concurrently available commodities but has not been applied to marijuana and tobacco couse. U.S. adults ≥18 years who coused marijuana and tobacco cigarettes were recruited via Mechanical Turk, a crowdsourcing service by Amazon. Participants (N = 82) completed online purchasing tasks assessing hypothetical marijuana or tobacco cigarette puff consumption across a range of per-puff prices; 2 single-commodity tasks assessed these when only 1 commodity was available, and 2 cross-commodity tasks assessed these in the presence of a concurrently available fixed-price commodity. Purchasing tasks generated measures of demand elasticity, that is, sensitivity of consumption to prices. In single-commodity tasks, consumption of tobacco cigarette puffs (elasticity of demand: α = 0.0075; 95% confidence interval [0.0066, 0.0085], R² = 0.72) and of marijuana puffs (α = .0044; 95% confidence interval [0.0038, 0.0049], R² = 0.71) declined significantly with increases in price per puff. In cross-commodity tasks when both tobacco cigarette puffs and marijuana puffs were available, demand for 1 commodity was independent of price increases in the other commodity (ps > .05). Results revealed that, in this small sample, marijuana and tobacco cigarettes did not substitute for each other and did not complement each other; instead, they were independent of each other. These preliminary results can inform future studies assessing the economic relationship between tobacco and marijuana in the quickly changing policy climate in the United States. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

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.

Paradoxical increase in cigarette smuggling after the market opening in Taiwan

PubMed Central

Wen, C P; Peterson, R A; Cheng, T Y D; Tsai, S P; Eriksen, M P; Chen, T

2006-01-01

Objectives To assess the magnitude of cigarette smuggling after the market opened in Taiwan. Methods Review of tobacco industry documents for references to smuggling activities related to Taiwan and government statistics on seizure of smuggled cigarettes. Results The market opening in 1987 led to an increase in smuggling. Contraband cigarettes became as available as legal ones, with only a small fraction (8%) being seized. Being specifically excluded from the market‐opening, Japan entered the Taiwan market by setting up a Swiss plant as a legal cover for smuggling 10–20 times its legal quota of exports to Taiwan. Smuggling in Taiwan contributed to increased consumption of foreign brands, particularly by the young. Taiwan, not a member of the World Health Organization, was excluded from the East Asian 16‐member “Project Crocodile”, a regional anti‐smuggling collaborative effort to implement the Framework Convention on Tobacco Control. Conclusions Taiwan showed a sharp increase in smuggling after market liberalisation. Being excluded from the international community, Taiwan faces an uphill battle to fight smuggling alone. If Taiwan remained as its weakest link, global efforts to reduce tobacco use will be undermined, particularly for countries in the East Asian region. PMID:16728745

Paradoxical increase in cigarette smuggling after the market opening in Taiwan.

PubMed

Wen, C P; Peterson, R A; Cheng, T Y D; Tsai, S P; Eriksen, M P; Chen, T

2006-06-01

To assess the magnitude of cigarette smuggling after the market opened in Taiwan. Review of tobacco industry documents for references to smuggling activities related to Taiwan and government statistics on seizure of smuggled cigarettes. The market opening in 1987 led to an increase in smuggling. Contraband cigarettes became as available as legal ones, with only a small fraction (8%) being seized. Being specifically excluded from the market-opening, Japan entered the Taiwan market by setting up a Swiss plant as a legal cover for smuggling 10-20 times its legal quota of exports to Taiwan. Smuggling in Taiwan contributed to increased consumption of foreign brands, particularly by the young. Taiwan, not a member of the World Health Organization, was excluded from the East Asian 16-member "Project Crocodile", a regional anti-smuggling collaborative effort to implement the Framework Convention on Tobacco Control. Taiwan showed a sharp increase in smuggling after market liberalisation. Being excluded from the international community, Taiwan faces an uphill battle to fight smuggling alone. If Taiwan remained as its weakest link, global efforts to reduce tobacco use will be undermined, particularly for countries in the East Asian region.

19 CFR 144.42 - Combined entry for rewarehouse and withdrawal for consumption.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., and shall contain all of the statistical information as provided in § 141.61(e) of this chapter, one... be presented for each entry of cigars, cigarettes, or cigarette papers or tubes, when the release...

19 CFR 144.42 - Combined entry for rewarehouse and withdrawal for consumption.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., and shall contain all of the statistical information as provided in § 141.61(e) of this chapter, one... be presented for each entry of cigars, cigarettes, or cigarette papers or tubes, when the release...

19 CFR 144.42 - Combined entry for rewarehouse and withdrawal for consumption.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., and shall contain all of the statistical information as provided in § 141.61(e) of this chapter, one... be presented for each entry of cigars, cigarettes, or cigarette papers or tubes, when the release...

19 CFR 144.42 - Combined entry for rewarehouse and withdrawal for consumption.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., and shall contain all of the statistical information as provided in § 141.61(e) of this chapter, one... be presented for each entry of cigars, cigarettes, or cigarette papers or tubes, when the release...

19 CFR 144.42 - Combined entry for rewarehouse and withdrawal for consumption.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., and shall contain all of the statistical information as provided in § 141.61(e) of this chapter, one... be presented for each entry of cigars, cigarettes, or cigarette papers or tubes, when the release...

Prevalence and factors associated with smoking among adolescents.

PubMed

Urrutia-Pereira, Marilyn; Oliano, Vinicius J; Aranda, Carolina S; Mallol, Javier; Solé, Dirceu

Despite anti-smoking prevention programs, many adolescents start smoking at school age. The main objectives of this study were to determine the prevalence and risk factors associated with smoking in adolescents living in Uruguaiana, RS, Brazil. A prospective study was conducted in adolescents (12-19 years), enrolled in municipal schools, who answered a self-administered questionnaire on smoking. 798 adolescents were enrolled in the study, with equal distribution between genders. The tobacco experimentation frequency (ever tried a cigarette, even one or two puffs) was 29.3%; 14.5% started smoking before 12 years of age and 13.0% reported smoking at least one cigarette/day last month. Having a smoking friend (OR: 5.67, 95% CI: 2.06-7.09), having cigarettes offered by friends (OR: 4.21, 95% CI: 2.46-5.76) and having easy access to cigarettes (OR: 3.82, 95% CI: 1.22-5.41) was identified as factors associated with smoking. Having parental guidance on smoking (OR: 0.67, 95% CI: 0.45-0.77), having no contact with cigarettes at home in the last week (OR: 0.51, 95% CI: 0.11-0.79) and knowing about the dangers of electronic cigarettes (OR: 0.88, 95% CI: 0.21-0.92) were identified as protection factors. The prevalence of smoking among adolescents in Uruguaiana is high. The implementation of measures to reduce/stop tobacco use and its new forms of consumption, such as electronic cigarettes and hookah, are urgent and imperative in schools. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

The relation between cigarette price and hand-rolling tobacco consumption in the UK: an ecological study.

PubMed

Rothwell, Lucas; Britton, John; Bogdanovica, Ilze

2015-06-15

Cigarette price increases reduce smoking prevalence but as a tobacco control policy are undermined by the availability of lower cost alternatives such as hand-rolling tobacco. The aim of this descriptive study is to explore time trends in the price of manufactured cigarettes and hand-rolling tobacco, and in the numbers of people who smoke these products, over recent years in the UK. UK. Trends in the most popular price category (MPPC) data for cigarettes and hand-rolling tobacco from 1983 to 2012 adjusted for inflation using the Retail Price Index, and trends in smoking prevalence and the proportion of smokers using hand-rolling tobacco from 1974 to 2010. After adjustment for inflation, there was an increase in prices of manufactured cigarettes and hand-rolling tobacco between 1983 and 2012. Between 1974 and 2010, the prevalence of smoking fell from 45% to 20%, and the estimated total number of smokers from 25.3 to 12.4 million. However the number of people smoking hand-rolling tobacco increased from 1.4 to 3.2 million, and MPPC cigarette price was strongly correlated with number of people smoking hand-rolling tobacco. Although the ecological study design precludes conclusions on causality, the association between increases in manufactured cigarette price and the number of people smoking hand-rolling tobacco suggests that the lower cost of smoking hand-rolling tobacco encourages downtrading when cigarette prices rise. The magnitude of this association indicates that the lower cost of hand-rolling tobacco seriously undermines the use of price as a tobacco control measure. 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.

Use of Interrupted Time-Series Method to Evaluate the Impact of Cigarette Excise Tax Increases in Pennsylvania, 2000–2009

PubMed Central

Kuller, Lewis H.; Fisher, Monica A.; Ostroff, Stephen M.

2013-01-01

Introduction Scientific evidence shows that cigarette price increases can significantly reduce smoking prevalence and smoking initiation among adolescents and young adults. However, data are lacking regarding the effectiveness of increasing Pennsylvania’s cigarette tax to reduce smoking and/or adverse health effects of smoking. The objective of our study was to assess the impact of cigarette tax increases and resulting price increases on smoking prevalence, acute myocardial infarction (AMI) and asthma hospitalization rates, and sudden cardiac death (SCD) rates in Pennsylvania. Methods We used segmented regression analyses of interrupted time series to evaluate the level and trend changes in Pennsylvania adults’ current smoking prevalence, age-adjusted AMI and asthma hospitalization rates, age-specific asthma hospitalization rates, and age-adjusted SCD rates following 2 cigarette excise tax increases. Results After the first excise tax increase, no beneficial effects were noted on the outcomes of interest. The second tax increase was associated with significant declines in smoking prevalence for people aged 18 to 39, age-adjusted AMI hospitalization rates for men, age-adjusted asthma hospitalizations rates, and SCD rates among men. Overall smoking prevalence declined by 5.2% (P = .01), with a quarterly decrease of 1.4% (P = .01) for people aged 18 to 39 years. The age-adjusted AMI hospitalization rate for men showed a decline of 3.87/100,000 population (P = .04). The rate of age-adjusted asthma hospitalizations decreased by 10.05/100,000 population (P < .001), and the quarterly trend decreased by 3.21/100,000 population (P < .001). Quarterly SCD rates for men decreased by 1.34/100,000 population (P < .001). Conclusion An increase in the price of cigarettes to more than $4 per 20-cigarette pack was associated with a significant decrease in smoking among younger people (aged 18–39). Decreases were also seen in asthma hospitalizations and men’s age-adjusted AMI hospitalization and SCD rates. Further research and policy development regarding the effect of cigarette taxes on tobacco consumption should be cognizant of the psychological tipping points at which overall price affects smoking patterns. PMID:24135393

Government paralysis? Stable tobacco prices mean preventable deaths and disease persist, along with health inequalities in New Zealand.

PubMed

Thomson, George; O'Dea, Des; Wilson, Nick; Edwards, Richard

2010-01-23

Tobacco affordability, prices and tobacco tax rates have considerable effects on smoking uptake, consumption, and quitting. We examined the trends in New Zealand per capita tobacco consumption and real cigarette prices from 1975-2008. Since 1984, there has been a close inverse relationship between real price and per capita tobacco consumption. Thus price increases drive consumption falls. However, in the periods of 1992-1997 and 2002-2008, both price and consumption were largely stable. The stability since 2002 means other tobacco control interventions have been undercut by increased tobacco affordability (due to increased average real incomes). Furthermore, the lack of tobacco tax increases (to be used to fund better tobacco control) is against majority surveyed New Zealand public opinion, and may be contrary to even smokers' views. The great majority of smokers, who want to quit, could be assisted by more extensive programmes funded by the extra revenue from tobacco tax increases. These could include more prime-time mass media campaigns and greater Quitline capacity. Tobacco tax increases are a highly evidence-based policy that could help reduce harm to the health of New Zealanders and reduce health inequalities.

Aldehyde levels in e-cigarette aerosol: Findings from a replication study and from use of a new-generation device.

PubMed

Farsalinos, Konstantinos E; Kistler, Kurt A; Pennington, Alexander; Spyrou, Alketa; Kouretas, Dimitris; Gillman, Gene

2018-01-01

A recent study identified high aldehyde emissions from e-cigarettes (ECs), that when converted to reasonable daily human EC liquid consumption, 5 g/day, gave formaldehyde exposure equivalent to 604-3257 tobacco cigarettes. We replicated this study and also tested a new-generation atomizer under verified realistic (no dry puff) conditions. CE4v2 atomizers were tested at 3.8 V and 4.8 V, and a Nautilus Mini atomizer was tested at 9.0 W and 13.5 W. All measurements were performed in a laboratory ISO-accredited for EC aerosol collection and aldehyde measurements. CE4v2 generated dry puffs at both voltage settings. Formaldehyde levels were >10-fold lower, acetaldehyde 6-9-fold lower and acrolein 16-26-fold lower than reported in the previous study. Nautilus Mini did not generate dry puffs, and minimal aldehydes were emitted despite >100% higher aerosol production per puff compared to CE4v2 (formaldehyde: 16.7 and 16.5 μg/g; acetaldehyde: 9.6 and 10.3 μg/g; acrolein: 8.6 and 11.7 μg/g at 9.0 W and 13.5 W, respectively). EC liquid consumption of 5 g/day reduces aldehyde exposure by 94.4-99.8% compared to smoking 20 tobacco cigarettes. Checking for dry puffs is essential for EC emission testing. Under realistic conditions, new-generation ECs emit minimal aldehydes/g liquid at both low and high power. Validated methods should be used when analyzing EC aerosol. Copyright © 2017 Elsevier Ltd. All rights reserved.

The global smoking epidemic: a history and status report.

PubMed

Proctor, Robert N

2004-05-01

The World Health Organization estimates that tobacco causes approximately 5 million deaths annually worldwide, a number expected to double by 2025. Cigarette consumption grew from only a few billion per year in 1900 to present values of approximately 5.5 trillion worldwide. Historical causes for the rise of smoking include the invention of flue curing, safety matches, and cigarette rolling machines, but also the distribution of cigarettes to soldiers during World War I, mass marketing, the failure of governments to limit consumption, and the duplicitous denial of hazards by manufacturers. Cancers of the lip, throat, and tongue were linked to tobacco as early as the 18th century, but a lung cancer hazard from smoking was not suspected until the first decade of the 20th century. Epidemiologic evidence began to emerge in the 1920s, and by the 1950s, the causal link with cigarette smoking was well established. Epidemiologic studies, animal experiments, and studies demonstrating pathologic changes in lung tissues at autopsy were 3 pivotal sources of evidence. However, the tobacco industry refused to concede the reality of tobacco hazards until the late 1990s. Instead, the industry sought to target physicians and others with its message of "no proof," using subtle techniques of deception, including the funding of spurious research, duplicitous press releases, propaganda efforts directed at physicians, and the employment of historians to construct exculpatory narratives. The World Health Organization's Framework Convention on Tobacco Control promises to standardize global tobacco control measures, including policies to limit smuggling. Effective means of reducing tobacco use include counter-advertising, increased taxation, smoke-free workplace legislation, and litigation against the industry.

The impact of the Malaysian minimum cigarette price law: findings from the ITC Malaysia Survey.

PubMed

Liber, Alex C; Ross, Hana; Omar, Maizurah; Chaloupka, Frank J

2015-07-01

Study the effects of the 2011 Malaysian minimum price law (MPL) on prices of licit and illicit cigarette brands. Identify barriers to the MPL achieving positive public health effects. The International Tobacco Control Project's Southeast Asia survey collected information on Malaysian smokers' cigarette purchases (n=7520) in five survey waves between 2005 and 2012. Consumption-weighted comparisons of proportions tests and adjusted Wald tests were used to evaluate changes over time in violation rates of the inflation-adjusted MPL, the proportion of illicit cigarette purchases and mean prices. After the passage of the MPL, the proportion of licit brand cigarette purchases that were below the inflation-adjusted 2011 minimum price level fell substantially (before 3.9%, after 1.8%, p=0.002), while violation of the MPL for illicit brand cigarette purchases was unchanged (before 89.8%, after 91.9%, p=0.496). At the same time, the mean real price of licit cigarettes rose (p=0.006), while the mean real price of illicit cigarettes remained unchanged (p=0.134). The proportion of illicit cigarette purchases rose as well (before 13.4%, after 16.5%, p=0.041). The MPL appears not to have meaningfully changed cigarette prices in Malaysia, as licit brand prices remained well above and illicit brand prices remained well below the minimum price level before and after MPL's implementation. The increasing proportion of illicit cigarettes on the market may have undermined any positive health effects of the Malaysian MPL. The illicit cigarette trade must be addressed before a full evaluation of the Malaysian MPL's impact on public health can take place. The authors encourage the continued use of specific excise tax increases to reliably increase the price and decrease the consumption of cigarettes in Malaysia and elsewhere. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Impact of the Malaysian Minimum Cigarette Price Law: Findings from the ITC Malaysia Survey

PubMed Central

Liber, Alex C.; Ross, Hana; Omar, Maizurah; Chaloupka, Frank J.

2015-01-01

Objectives Study the effects of the 2011 Malaysian minimum price law (MPL) on prices of licit and illicit cigarette brands. Identify barriers to the MPL achieving positive public health effects. Methods The International Tobacco Control Project's Southeast Asia survey collected information on Malaysian smokers' cigarette purchases (n=7,520) in five survey waves between 2005 and 2012. Consumption-weighted comparisons of proportions tests and adjusted Wald tests were used to evaluate changes over time in violation rates of the inflation-adjusted MPL, the proportion of illicit cigarette purchases, and mean prices. Results After the passage of the MPL, the proportion of licit brand cigarette purchases that were below the inflation-adjusted 2011 minimum price level fell substantially (before 3.9%, after 1.8%, p=0.002), while violation of the MPL for illicit brand cigarette purchases was unchanged (before 89.8%, after 91.9%, p=0.496). At the same time, the mean real price of licit cigarettes rose (p=0.006) while the mean real price of illicit cigarettes remained unchanged (p=0.134). The proportion of illicit cigarette purchases rose as well (before 13.4%, after 16.5%, p=0.041). Discussion The MPL appears not to have meaningfully changed cigarette prices in Malaysia, as licit brand prices remained well above and illicit brand prices remained well below the minimum price level before and after MPL's implementation. The increasing proportion of illicit cigarettes on the market may have undermined any positive health effects of the Malaysian MPL. The illicit cigarette trade must be addressed before a full evaluation of the Malaysian MPL's impact on public health can take place. The authors encourage the continued use of specific excise tax increases to reliably increase the price and decrease the consumption of cigarettes in Malaysia and elsewhere. PMID:25808666

Surveillance for selected tobacco-use behaviors--United States, 1900-1994.

PubMed

Giovino, G A; Schooley, M W; Zhu, B P; Chrismon, J H; Tomar, S L; Peddicord, J P; Merritt, R K; Husten, C G; Eriksen, M P

1994-11-18

Surveillance of tobacco use is an essential component of any tobacco-control program. The information gathered can be used to guide research initiatives, intervention programs, and policy decisions. REPORTING PERIODS: This report covers the period 1900-1994 for per capita cigarette consumption; 1965-1991 for trends in cigarette smoking prevalence and cessation; 1974-1991 for trends in the number of cigarettes smoked daily by current smokers; 1987-1991 for recent patterns of tobacco use; 1970, 1987, and 1991 for trends in cigar/pipe smoking and snuff/chewing tobacco use; 1984-1992 for trends in state-specific prevalences of regular cigarette smoking; 1987-1992 for state-specific estimates of smokeless-tobacco use; and 1976-1993 for trends in cigarette smoking among U.S. high school seniors. Estimates of cigarette consumption are reported by the U.S. Department of Agriculture, which uses data from the U.S. Department of the Treasury, the U.S. Department of Commerce, the Tobacco Institute, and other sources. The National Health Interview Survey uses household interviews to provide nationally representative estimates (for the civilian, noninstitutionalized population) of cigarette smoking and other behaviors related to tobacco use. The Behavioral Risk Factor surveillance System uses telephone surveys of civilian, noninstitutionalized adults (> or = 18 years of age) to provide state-specific estimates of current cigarette smoking and use of smokeless tobacco. The University of Michigan's Institute for Social Research uses school-based, self-administered questionnaires to gather data on cigarette smoking from a representative sample of U.S. high school seniors. During the period 1900-1963, per capita cigarette consumption increased; after 1964, consumption declined. During the years 1965-1991, current cigarette smoking prevalence among persons ages > or = 18 years declined overall and in every sociodemographic category examined. Decrease in current smoking prevalence was slow in some groups (e.g., among persons with fewer years of formal education). Both the prevalence of never smoking and the prevalence of cessation increased from 1965 through 1991. The prevalence of current cigarette smoking, any tobacco smoking, and any tobacco use was highest among American Indians/Alaska Natives and non-Hispanic blacks and lowest among Asians/Pacific Islanders. The prevalence of cigar smoking and pipe smoking has declined substantially since 1970. The prevalence of smokeless-tobacco use among white males ages 18-34 years was higher in 1987 and 1991 than in 1970; among persons > or = 45 years of age, the use of smokeless tobacco was more common among blacks than whites in 1970 and 1987. Cigarette smoking prevalence has decreased in most states. The prevalence of smokeless tobacco use was especially high among men in West Virginia, Montana, and several southern states. From 1984-1993, prevalence of cigarette smoking remained constant among U.S. high school seniors. However, prevalence increased slightly for male seniors and white seniors, decreased slightly for female high school seniors, and decreased sharply for black high school seniors. With the exceptions of increases in cigarette smoking among white and male high school seniors and in the use of smokeless tobacco among white males ages 18-34 years, reductions in tobacco use occurred in every subgroup examined. This decrease must continue if the national health objectives for the year 2000 are to be reached. Surveillance of tobacco use is ongoing. Effective interventions that discourage initiation and encourage cessation are being disseminated throughout the United States.

Does tobacco industry marketing of 'light' cigarettes give smokers a rationale for postponing quitting?

PubMed

Gilpin, Elizabeth A; Emery, Sherry; White, Martha M; Pierce, John P

2002-01-01

The objective of this analysis was to examine further whether tobacco industry marketing using the labels light and ultra-light is perceived by smokers as a health claim. Smokers might view low tar/nicotine brands of cigarettes as a means to reduce the harm to their health from smoking and postpone quitting. Data were from smokers responding to a large, population-based survey of Californians' smoking behavior, conducted in 1996 (8,582 current smokers). Sixty percent of smokers thought the labels light and ultra-light referred to low tar/nicotine cigarettes, or otherwise implied a health claim. This percentage was higher for smokers of low tar/nicotine brands. Among smokers of regular brands, the more highly addicted, those who were trying unsuccessfully to quit, those who had cut consumption or thought about it, and those with health concerns were more likely to have considered switching. While some of these characteristics also were associated with smokers of low tar/nicotine brands, the associations were not as numerous or as strong. We conclude that some smokers appear to view low tar/nicotine brands as one short-term strategy to reduce the harm to their health from smoking without quitting. By implying reduced tar or nicotine exposure, tobacco industry marketing using the labels light and ultra-light is misleading smokers. The use of such labels should be regulated.

High-resolution Behavioral Economic Analysis of Cigarette Demand to Inform Tax Policy

PubMed Central

MacKillop, James; Few, Lauren R.; Murphy, James G.; Wier, Lauren M.; Acker, John; Murphy, Cara; Stojek, Monika; Carrigan, Maureen; Chaloupka, Frank

2012-01-01

Aims Novel methods in behavioral economics permit the systematic assessment of the relationship between cigarette consumption and price. Toward informing tax policy, the goals of this study were to conduct a high-resolution analysis of cigarette demand in a large sample of adult smokers and to use the data to estimate the effects of tax increases in ten U.S. States. Design In-person descriptive survey assessment. Setting Academic departments at three universities. Participants Adult daily smokers (i.e., 5+ cigarettes/day; 18+ years old; ≥8th grade education); N = 1056. Measurements Estimated cigarette demand, demographics, expired carbon monoxide. Findings The cigarette demand curve exhibited highly variable levels of price sensitivity, especially in the form of ‘left-digit effects’ (i.e., very high price sensitivity as pack prices transitioned from one whole number to the next; e.g., $5.80-$6/pack). A $1 tax increase in the ten states was projected to reduce the economic burden of smoking by an average of $531M (range: $93.6M-$976.5M) and increase gross tax revenue by an average of 162% (range: 114%- 247%). Conclusions Tobacco price sensitivity is nonlinear across the demand curve and in particular for pack-level left-digit price transitions. Tax increases in U.S. states with similar price and tax rates to the sample are projected to result in substantial decreases in smoking-related costs and substantial increases in tax revenues. PMID:22845784

High-resolution behavioral economic analysis of cigarette demand to inform tax policy.

PubMed

MacKillop, James; Few, Lauren R; Murphy, James G; Wier, Lauren M; Acker, John; Murphy, Cara; Stojek, Monika; Carrigan, Maureen; Chaloupka, Frank

2012-12-01

Novel methods in behavioral economics permit the systematic assessment of the relationship between cigarette consumption and price. Towards informing tax policy, the goals of this study were to conduct a high-resolution analysis of cigarette demand in a large sample of adult smokers and to use the data to estimate the effects of tax increases in 10 US States. In-person descriptive survey assessment. Academic departments at three universities. Adult daily smokers (i.e. more than five cigarettes/day; 18+ years old; ≥8th grade education); n = 1056. Estimated cigarette demand, demographics, expired carbon monoxide. The cigarette demand curve exhibited highly variable levels of price sensitivity, especially in the form of 'left-digit effects' (i.e. very high price sensitivity as pack prices transitioned from one whole number to the next; e.g. $5.80-6/pack). A $1 tax increase in the 10 states was projected to reduce the economic burden of smoking by an average of $530.6 million (range: $93.6-976.5 million) and increase gross tax revenue by an average of 162% (range: 114-247%). Tobacco price sensitivity is non-linear across the demand curve and in particular for pack-level left-digit price transitions. Tax increases in US states with similar price and tax rates to the sample are projected to result in substantial decreases in smoking-related costs and substantial increases in tax revenues. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Low Nicotine Content Descriptors Reduce Perceived Health Risks and Positive Cigarette Ratings in Participants Using Very Low Nicotine Content Cigarettes.

PubMed

Denlinger-Apte, Rachel L; Joel, Danielle L; Strasser, Andrew A; Donny, Eric C

2017-10-01

Understanding how smokers perceive reduced nicotine content cigarettes will be important if the FDA and global regulatory agencies implement reduced nicotine product standards for cigarettes. Prior research has shown that some smokers incorrectly believe "light" cigarettes are less harmful than regular cigarettes. Similar misunderstandings of health risk could also apply to reduced nicotine cigarettes. To date, most studies of reduced nicotine cigarettes have blinded subjects to the nicotine content. Therefore, little is known about how smokers experience reduced nicotine content cigarettes when they are aware of the reduced content, and how use may be impacted. The present study was a within-subjects experiment with 68 adult daily smokers who smoked two identical very low nicotine content Quest 3 (0.05 mg nicotine yield) cigarettes. Subjects were told that one cigarette contained "average" nicotine content, and the other contained "very low" nicotine content. After smoking each cigarette, subjects completed subjective measures about their smoking experience. Subjects rated the "very low" nicotine cigarette as less harmful to their health overall compared to the "average" nicotine cigarette; this effect held true for specific smoking-related diseases. Additionally, they rated the "very low" nicotine cigarette as having less desirable subjective effects than the "average" nicotine cigarette and predicted having greater interest in quitting smoking in the future if only the "very low" nicotine cigarette was available. Explicit knowledge of very low nicotine content changes smokers' perceptions of very low nicotine content cigarettes, resulting in reduced predicted harm, subjective ratings and predicted future use. Before a reduced nicotine product standard for cigarettes can be implemented, it is important to understand how product information impacts how smokers think about and experience very low nicotine content cigarettes. Prior research has shown that smokers incorrectly believed light cigarettes were less harmful products. As such, smokers may also misunderstand the health risks associated with smoking very low nicotine content cigarettes. This study highlights the importance of smokers' perceptions of nicotine content in cigarettes on the perceived health risks and the subjective effects of smoking very low nicotine content cigarettes. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The quarter that changed the world.

PubMed

Roeseler, April; Burns, David

2010-04-01

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

The quarter that changed the world

PubMed Central

Burns, David

2010-01-01

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

Estimating Demand for Alternatives to Cigarettes With Online Purchase Tasks

PubMed Central

O’Connor, Richard J.; June, Kristie M.; Bansal-Travers, Maansi; Rousu, Matthew C.; Thrasher, James F.; Hyland, Andrew; Cummings, K. Michael

2013-01-01

Objectives This study explored how advertising affects demand for cigarettes and potential substitutes, including snus, dissolvable tobacco, and medicinal nicotine. Methods A web-based experiment randomized 1062 smokers to see advertisements for alternative nicotine products or soft drinks, then complete a series of purchase tasks, which were used to estimate demand elasticity, peak consumption, and cross-price elasticity (CPE) for tobacco products. Results Lower demand elasticity and greater peak consumption were seen for cigarettes compared to all alternative products (p < .05). CPE did not differ across the alternative products (p ≤ .03). Seeing relevant advertisements was not significantly related to demand. Conclusions These findings suggest significantly lower demand for alternative nicotine sources among smokers than previously revealed. PMID:24034685

Predicting Alcohol, Cigarette, and Marijuana Use From Preferential Music Consumption.

PubMed

Oberle, Crystal D; Garcia, Javier A

2015-01-01

This study investigated whether use of alcohol, cigarettes, and marijuana may be predicted from preferential consumption of particular music genres. Undergraduates (257 women and 78 men) completed a questionnaire assessing these variables. Partial correlation analyses, controlling for sensation-seeking tendencies and behaviors, revealed that listening to conventional music (pop, country, and religious genres) was negatively correlated with cigarette smoking (p=.001) and marijuana use (p<.001). Additionally, listening to energetic music (rap or hip-hop and soul or funk genres) was positively correlated with marijuana use (p=.004). The only significant predictor of alcohol use was country music, with which it was positively correlated (p=.04). This research suggests an especially harmful influence of energetic music on marijuana use. © The Author(s) 2015.

Sustainable funding of health initiatives in Wonju, Republic of Korea via a tobacco consumption tax.

PubMed

Nam, Eun Woo; De Leeuw, Evelyne; Moon, Ji Young; Ikeda, Nayu; Dorjsuren, Bayarsaikhan; Park, Myung Bae

2011-12-01

Wonju is the first municipality in the Republic of Korea to fund the Healthy City project through municipal revenues from the local tobacco consumption tax. We investigated the process of the local tobacco consumption tax being approved as the main source of financing for the local Healthy City project. We also examined the sustainability and sufficiency of the funding by looking at the pricing policies instituted for cigarettes, smoking prevalence, cigarette consumption and revenues from local tobacco consumption as well as the budgetary allocations among programs in the city. The strong initiative of the mayor of Wonju was one of the factors that enabled the earmarking of the local tobacco consumption tax for the Healthy City Wonju project. He consulted academic counselors and persuaded the municipal government and the City Council to approve the bill. Despite the increasing price of cigarettes in Korea, adequate funding can be sustained to cover the short-term and mid-term programs in Wonju for at least 5 years of the mayor's term, because the smoking rate is persistently high. Analyzing the effects of strong leadership on the part of local authorities and the balance between revenues from the tobacco tax and the prevalence of smoking in the face of anti-smoking policies would be helpful for other countries and communities interested in developing sustainable Healthy Cities projects.

Impact of tobacco regulation on animal research: new perspectives and opportunities.

PubMed

Donny, Eric C; Taylor, Tracy G; LeSage, Mark G; Levin, Melissa; Buffalari, Deanne M; Joel, Danielle; Sved, Alan F

2012-11-01

The Family Smoking Prevention and Tobacco Control Act in the United States and the World Health Organization Framework Convention on Tobacco or Health ratified by over 170 countries render scientific investigations into the abuse liability, harm, and effects of tobacco more critical than ever. A key area to explore relates to the potential regulation of nicotine content in cigarettes. Determining the nicotine content per cigarette below which smokers reliably reduce their consumption of and dependence on cigarettes, an idea proposed almost 20 years ago (Benowitz & Henningfield, 1994), could be a powerful approach to reduce the abuse liability and consequent harm from cigarettes. However, this approach is laden with potentially complex issues. Many of these complications can be studied using animal models, but they require a particular perspective. Herein, we review several challenges for animal researchers interested in nicotine reduction as examples of how this perspective dictates new approaches to animal research. These include defining the threshold nicotine dose for maintaining self-administration, evaluating the differential impact of various implementation strategies, assessing the factors that could interact with nicotine to alter the reinforcement threshold, describing the role of cues in maintaining low dose nicotine self-administration, and examining individual differences in response to nicotine reduction. Researchers who study tobacco using animal models have the opportunity to play a central role in the regulatory science of tobacco and conduct studies that directly inform policy decisions that could impact the lives of millions.

Status of lipids and the frequency diseases of cardiovascular origin in smokers according to the length period of smoking and a number of cigarettes smoked daily

PubMed Central

Bišanović, Senaida; Mehić, Bakir; Sivić, Suad

2011-01-01

Cigarette smoking affects all phases of atherosclerosis from endothelial dysfunction to acute occlusive clinical events. The problem is, whether the length of the period of cigarette smoking has a more reflection to the status of lipids and illnesses of cardiovascular system or the bigger number of smoked cigarettes in a shorter time-period? The observed sample has constituted of two groups of smokers, both gender, age 25-64 years old. The first group consisted of 210 examinees divided in 7 subgroups according to a number of years they have been smoking. The second group consisted of 150 examinees, which was divided in 5 subgroups, according to average number of cigarettes smoked daily. The average values of serum cholesterol (6.98 vs. 6.13 mmol/L), triglycerides (3.15 vs. 3.13 mmol/L) and LDL-cholesterol (3.80 vs. 3.64 mmol/L) were always higher in a group of smokers according to a number of daily smoked cigarettes. Average value of smoking consumption period was higher in a group of smokers according to the length of smoking consumption period than in a group of smokers according to a number of cigarettes smoked daily (20.34 y vs. 13.55 y.). Hypertension (72% vs. 30.9%), angina pectoris (44.6% vs. 20.4%), CHD (30.6% vs. 22.8%) and myocardial infarction (16% vs. 11.4%) appeared much more in the group of smokers according to a number of cigarettes smoked daily. More reflection to the status of lipids and illnesses of cardiovascular system has the bigger number of smoked cigarettes daily than the length of the period of cigarette smoking. PMID:21342142

Cigarette smuggling in Europe: who really benefits?

PubMed

Joossens, L; Raw, M

1998-01-01

Cigarette smuggling, now on the increase, is so widespread and well organised that it poses a serious threat to public health. This threat comes from two principal directions. First, smuggling makes cigarettes available cheaply, thereby increasing consumption. A third of annual global exports go to the contraband market, representing an enormous impact on consumption, and thus causing an increase in the burden of disease, especially in poorer countries. It is also costing government treasuries thousands of millions of dollars in lost tax revenue. Second, the tobacco industry uses smuggling politically, lobbying governments to lower tax, arguing that smuggling is caused by price differences. This paper shows that the claimed correlation between high prices and high levels of smuggling does not exist in western Europe. In fact, countries such as Norway and Sweden, with expensive cigarettes, do not have a large smuggling problem, whereas countries in the south of Europe do. Cigarette smuggling is not caused principally by "market forces". It is mainly caused by fraud, by the illegal evasion of import duty. The cigarettes involved are not the cheap brands from southern European countries, for which there is no international market. It is the well-known international brands such as Marlboro and Winston. We propose much tighter regulation of cigarette trade, including an international transport convention, and a total ban on transit trade-sale by the manufacturers to dealers, who sell on to smugglers.

Cigarette smuggling in Europe: who really benefits?

PubMed Central

Joossens, L.; Raw, M.

1998-01-01

Cigarette smuggling, now on the increase, is so widespread and well organised that it poses a serious threat to public health. This threat comes from two principal directions. First, smuggling makes cigarettes available cheaply, thereby increasing consumption. A third of annual global exports go to the contraband market, representing an enormous impact on consumption, and thus causing an increase in the burden of disease, especially in poorer countries. It is also costing government treasuries thousands of millions of dollars in lost tax revenue. Second, the tobacco industry uses smuggling politically, lobbying governments to lower tax, arguing that smuggling is caused by price differences. This paper shows that the claimed correlation between high prices and high levels of smuggling does not exist in western Europe. In fact, countries such as Norway and Sweden, with expensive cigarettes, do not have a large smuggling problem, whereas countries in the south of Europe do. Cigarette smuggling is not caused principally by "market forces". It is mainly caused by fraud, by the illegal evasion of import duty. The cigarettes involved are not the cheap brands from southern European countries, for which there is no international market. It is the well-known international brands such as Marlboro and Winston. We propose much tighter regulation of cigarette trade, including an international transport convention, and a total ban on transit trade—sale by the manufacturers to dealers, who sell on to smugglers.

 PMID:9706757

No sisyphean task: how the FDA can regulate electronic cigarettes.

PubMed

Paradise, Jordan

2013-01-01

The adverse effects of smoking have fostered a natural market for smoking cessation and smoking reduction products. Smokers attempting to quit or reduce consumption have tried everything: "low" or "light" cigarettes; nicotine-infused chewing gum, lozenges, and lollipops; dermal patches; and even hypnosis. The latest craze in the quest to find a safer source of nicotine is the electronic cigarette. Electronic cigarettes (e-cigarettes) have swept the market, reaching a rapidly expanding international consumer base. Boasting nicotine delivery and the tactile feel of a traditional cigarette without the dozens of other chemical constituents that contribute to carcinogenicity, e-cigarettes are often portrayed as less risky, as a smoking reduction or even a complete smoking cessation product, and perhaps most troubling for its appeal to youth, as a flavorful, trendy, and convenient accessory. The sensationalism associated with e-cigarettes has spurred outcry from health and medical professional groups, as well as the Food and Drug Administration (FDA), because of the unknown effects on public health. Inhabiting a realm of products deemed "tobacco products" under recent 2009 legislation, e-cigarettes pose new challenges to FDA regulation because of their novel method of nicotine delivery, various mechanical and electrical parts, and nearly nonexistent safety data. Consumer use, marketing and promotional claims, and technological characteristics of e-cigarettes have also raised decades old questions of when the FDA can assert authority over products as drugs or medical devices. Recent case law restricting FDA enforcement efforts against e-cigarettes further confounds the distinction among drugs and medical devices, emerging e-cigarette products, and traditional tobacco products such as cigarettes, cigars, and smokeless tobacco. This Article investigates the e-cigarette phenomenon in the wake of the recently enacted Family Smoking Prevention and Tobacco Control Act of 2009 (TCA). It examines the tumultuous history of attempts at tobacco regulation by reflecting on the history of Congressional activity to regulate tobacco sales and promotion. Furthermore, this Article suggests a feasible approach to strengthening regulation of e-cigarettes under the existing statutory framework. This approach includes increased scrutiny of manufacturer and distributor claims that trigger drug and medical device provisions, utilization of new tobacco product and modified risk tobacco product provisions, and promulgation of new FDA regulations and guidance specifically directed at e-cigarettes.

21 CFR 101.78 - Health claims: fruits and vegetables and cancer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... smoking, alcohol consumption, overweight and obesity, ultraviolet or ionizing radiation, exposure to... specific type of cancer, cigarette smoking, alcohol consumption, overweight and obesity, ultraviolet or...

21 CFR 101.78 - Health claims: fruits and vegetables and cancer.

Code of Federal Regulations, 2012 CFR

2012-04-01

... smoking, alcohol consumption, overweight and obesity, ultraviolet or ionizing radiation, exposure to... specific type of cancer, cigarette smoking, alcohol consumption, overweight and obesity, ultraviolet or...

21 CFR 101.78 - Health claims: fruits and vegetables and cancer.

Code of Federal Regulations, 2013 CFR

2013-04-01

... smoking, alcohol consumption, overweight and obesity, ultraviolet or ionizing radiation, exposure to... specific type of cancer, cigarette smoking, alcohol consumption, overweight and obesity, ultraviolet or...

21 CFR 101.78 - Health claims: fruits and vegetables and cancer.

Code of Federal Regulations, 2014 CFR

2014-04-01

... smoking, alcohol consumption, overweight and obesity, ultraviolet or ionizing radiation, exposure to... specific type of cancer, cigarette smoking, alcohol consumption, overweight and obesity, ultraviolet or...

21 CFR 101.78 - Health claims: fruits and vegetables and cancer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... smoking, alcohol consumption, overweight and obesity, ultraviolet or ionizing radiation, exposure to... specific type of cancer, cigarette smoking, alcohol consumption, overweight and obesity, ultraviolet or...

Impact of an electronic cigarette on smoking reduction and cessation in schizophrenic smokers: a prospective 12-month pilot study.

PubMed

Caponnetto, Pasquale; Auditore, Roberta; Russo, Cristina; Cappello, Giorgio Carlo; Polosa, Riccardo

2013-01-28

Cigarette smoking is a tough addiction to break. This dependence is the most common dual diagnosis for individuals with schizophrenia. Currently three effective drugs are approved for smoking cessation: nicotine replacement therapy (NRT), varenicline and bupropion. However, some serious side effects of varenicline have been reported, including depression, suicidal thoughts, and suicide. The use of bupropion also has side effects. It should not be used by people who have epilepsy or any condition that lowers the seizure threshold, nor by people who take a specific class of drugs called monoamine oxidase inhibitors. Hence, there are pharmacodynamic reason to believe they could precipitate or exacerbate psychosis. For its capacity to deliver nicotine and provide a coping mechanism for conditioned smoking cues by replacing some of the rituals associated with smoking gestures, electronic-cigarettes may reduce nicotine withdrawal symptoms without serious side effects. Our recent work with ECs in healthy smokers not intending to quit consistently show surprisingly high success rates. We hypothesised that these positive findings could be replicated in difficult patients with schizophrenia This tool may help smokers with schizophrenia remain abstinent during their quitting attempts or to reduce cigarette consumption. Efficacy and safety of these devices in long-term smoking cessation and/or smoking reduction studies have never been investigated for this special population. In this study we monitored possible modifications in smoking habits of 14 smokers (not intending to quit) with schizophrenia experimenting with the "Categoria" e-Cigarette with a focus on smoking reduction and smoking abstinence. Study participants were invited to attend six study visits: at baseline, week-4, week-8, week-12 week-24 and week 52. Product use, number of cigarettes smoked, carbon monoxide in exhaled breath (eCO) and positive and negative symptoms of schizophrenia levels were measured at each visit. Smoking reduction and abstinence rates were calculated. Adverse events were also reviewed. Sustained 50% reduction in the number of cig/day at week-52 was shown in 7/14 (50%) participants; their median of 30 cig/day decreasing significantly to 15 cig/day (p = 0.018). Sustained smoking abstinence at week-52 was observed in 2/14 (14.3%) participants. Combined sustained 50% reduction and smoking abstinence was shown in 9/14 (64.3%) participants. Nausea was observed in 2/14 (14.4%) of participants, throat irritation in 2/14 (14.4%) of participants, headache in 2/14 (14.4%) of participants , and dry cough in 4/14 (28.6%) of participants. However, these adverse events diminished substantially by week-24. Overall, one to two cartridges/day were used throughout the study. Positive and negative symptoms of schizophrenia are not increased after smoking reduction/cessation in patients using e-cigarettes. We have shown for the first time that the use of e-cigarette substantially decreased cigarette consumption without causing significant side effects in chronic schizophrenic patients who smoke not intending to quit. This was achieved without negative impacts on the symptoms of schizophrenia as assessed by SAPS and SANS symptoms scales.

Understanding the relationship between sales of legal cigarettes and deaths: A case-study in Brazil.

PubMed

Szklo, André Salem; Iglesias, Roberto Magno; de Souza, Mirian Carvalho; Szklo, Moysés; Cavalcante, Tânia Maria; de Almeida, Liz Maria

2017-01-01

Brazil has experienced a large decline in cigarette consumption in the last 25years. However, the most recent annual reports from the tobacco industry market leader in Brazil did not show a decrease in its gross profits. This is particularly important because tobacco industry donations/sponsorships come directly from the industry's reported gross-profits and are used to subvert health policies. The aim of the present study was to estimate (i) tobacco industry's gross-profit from legal cigarettes sales, and (ii) all-cause smoking-attributable deaths (SADs) among current Brazilian smokers who consumed legal cigarettes in 2013. We collected information on prevalence of legal cigarette use, cigarette consumption, price per cigarette pack among individuals aged ≥35years from the Global Adult Tobacco Survey, legal cigarettes sales (e.g., average costs and total volume of sales) provided by the Federal Secretariat of Revenues, and population mortality from the available vital statistics. With a gross-profit of US$1.378 billion (1.307-1.434) from sales of 54.6 billion sticks of cigarettes (53.4-55.5) to 8,424,510 smokers aged 35years and older in Brazil in 2013, cumulative SADs were estimated at 96,012 (85,647-107,654) (around 34% of cumulative SADs also including current smoking of illegal cigarettes and past smoking), i.e., one SAD was equivalent to a gross-profit of US$14,352 (12,140-16,743). Our results revealed the association between sales of cigarettes, gross-profits, and deaths in Brazil. As tobacco industry donations/sponsorships originate from industry's gross profits, which, in turn, depend on cigarette sales, our findings may be useful for increasing "moral pressure" on individuals and institutions and help countries in stopping tobacco industry interference in health policies. Copyright © 2016 Elsevier Inc. All rights reserved.

Using E-Cigarettes in the Home to Reduce Smoking and Secondhand Smoke: Disadvantaged Parents' Accounts

ERIC Educational Resources Information Center

Rowa-Dewar, Neneh; Rooke, Catriona; Amos, Amanda

2017-01-01

Electronic cigarettes (e-cigarettes) are subject to considerable public health debate. Most public health experts agree that for smokers who find it particularly challenging to quit, e-cigarettes may reduce harm. E-cigarette use in the home may also reduce children's secondhand smoke (SHS) exposure, although e-cigarette vapour may pose risks. This…

Reducing tobacco consumption in California. Development of a statewide anti-tobacco use campaign.

PubMed

Bal, D G; Kizer, K W; Felten, P G; Mozar, H N; Niemeyer, D

1990-09-26

Cigarette smoking continues to be the leading preventable cause of death in California and the United States. Although substantial progress has been made over the past 25 years, there is growing recognition of the need for large-scale efforts to reduce tobacco use. Given their central roles in implementing public health programs and their ability to reach many of the groups most at risk of tobacco use uptake and tobacco-related disease, state health agencies have an important challenge before them. This article describes the development and operation of a statewide, publicly funded anti-tobacco use campaign currently undertaken by the California Department of Health Services under the auspices of the state's Tobacco Tax and Health Promotion Act of 1988 (Proposition 99), which increased excise taxes on cigarettes by 25 cents per pack sold in the state. A discussion of problems in implementation and operation being incurred may be relevant to the planning of similar campaigns elsewhere.

Behavioral economic analysis of cue-elicited craving for tobacco: a virtual reality study.

PubMed

Acker, John; MacKillop, James

2013-08-01

Subjective craving is a prominent construct in the study of tobacco motivation; yet, the precise measurement of tobacco craving poses several difficulties. A behavioral economic approach to understanding drug motivation imports concepts and methods from economics to improve the assessment of craving. Using an immersive virtual reality (VR) cue reactivity paradigm, this study tested the hypothesis that, compared with neutral cues, tobacco cues would result in significant increases in subjective craving and diverse aspects of demand for tobacco in a community sample of 47 regular smokers. In addition, the study examined these motivational indices in relation to a dual-component delay and cigarette consumption self-administration paradigm. In response to the VR tobacco cues, significant increases were observed for tobacco craving and the demand indices of Omax (i.e., maximum total expenditure toward cigarettes) and Breakpoint (i.e., price at which consumption is completely suppressed), whereas a significant decrease was observed for Elasticity (i.e., lower cigarette price sensitivity). Continuous analyses revealed trend-level inverse associations between Omax and Intensity in relation to delay duration and significant positive associations between subjective craving, Omax, and Elasticity in relation to the number of cigarettes purchased. The results from this study provide further evidence for the utility of behavioral economic concepts and methods in understanding smoking motivation. These data also reveal the incremental contribution of behavioral economic indices beyond subjective craving in predicting in vivo cigarette consumption. Relationships to previous studies and methodological considerations are discussed.

Behavioral Economic Analysis of Cue-Elicited Craving for Tobacco: A Virtual Reality Study

PubMed Central

2013-01-01

Introduction: Subjective craving is a prominent construct in the study of tobacco motivation; yet, the precise measurement of tobacco craving poses several difficulties. A behavioral economic approach to understanding drug motivation imports concepts and methods from economics to improve the assessment of craving. Methods: Using an immersive virtual reality (VR) cue reactivity paradigm, this study tested the hypothesis that, compared with neutral cues, tobacco cues would result in significant increases in subjective craving and diverse aspects of demand for tobacco in a community sample of 47 regular smokers. In addition, the study examined these motivational indices in relation to a dual-component delay and cigarette consumption self-administration paradigm. Results: In response to the VR tobacco cues, significant increases were observed for tobacco craving and the demand indices of Omax (i.e., maximum total expenditure toward cigarettes) and Breakpoint (i.e., price at which consumption is completely suppressed), whereas a significant decrease was observed for Elasticity (i.e., lower cigarette price sensitivity). Continuous analyses revealed trend-level inverse associations between Omax and Intensity in relation to delay duration and significant positive associations between subjective craving, Omax, and Elasticity in relation to the number of cigarettes purchased. Conclusions: The results from this study provide further evidence for the utility of behavioral economic concepts and methods in understanding smoking motivation. These data also reveal the incremental contribution of behavioral economic indices beyond subjective craving in predicting in vivo cigarette consumption. Relationships to previous studies and methodological considerations are discussed. PMID:23322768

Reduced Exposure to Harmful and Potentially Harmful Smoke Constituents With the Tobacco Heating System 2.1.

PubMed

Lüdicke, Frank; Baker, Gizelle; Magnette, John; Picavet, Patrick; Weitkunat, Rolf

2017-02-01

Heating rather than burning tobacco reduces levels of harmful and potentially harmful constituents, and consumer products using this approach aim to reduce exposure to tobacco toxicants. The Tobacco Heating System (THS) version 2.1 has been enhanced from earlier prototypes with an improved heat control and sensorial experience and thereby user acceptance. Exposure measurements are required to determine whether it may be possible to reduce the individual health risk compared to smoking combustible cigarettes (CCs). This controlled clinical study randomly assigned 40 smokers to either a group continuing to use of their own CC brand (n = 20) or a group switching to THS 2.1 (n = 20) for 5 days. Biomarkers of exposure were measured at baseline and on day 1 through day 5. Product consumption, Human Puffing Topography, the occurrence of adverse events, and an assessment of subjective effects, such as smoking satisfaction and enjoyment of respiratory tract sensations, were also determined. The group of smokers who switched to THS 2.1 adapted their puffing behavior initially through longer puff duration and more puffs. During the duration of the study, total puff volume returned to baseline levels and the mean daily product consumption increased but with similar nicotine exposure compared to baseline CC use. Biomarkers of exposure to tobacco smoke toxicants which inform product risk assessment were significantly reduced with THS use compared to the CC group. THS 2.1 users experienced less reinforcing effects with THS 2.1 than with their own cigarette brand. THS 2.1 is a promising alternative to smoking CCs. Notwithstanding possible use adaption through consumption or puffing behavior, the exposure to harmful smoke constituents was markedly reduced with the new heated tobacco platform. Exposure markers to harmful and potentially harmful smoke constituents were lowered with the THS 2.1. Heating tobacco instead of burning can offer a potentially lower risk of delivering nicotine compared to CCs. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

Tobacco Use by Male Prisoners Under an Indoor Smoking Ban

PubMed Central

Ferketich, Amy K.; Murray, David M.; Bellair, Paul E.; Wewers, Mary Ellen

2011-01-01

Introduction: Most correctional facilities have implemented tobacco restrictions in an effort to reduce costs and improve prisoner health, but little has been done to evaluate the impact of these policy changes. Patterns of tobacco use among prisoners were explored to determine the impact of incarceration in a facility with an indoor smoking ban on tobacco use behaviors. Methods: Recently incarcerated male inmates (n = 200) were surveyed about their tobacco use prior to and during incarceration. Results: Tobacco use was prevalent prior to arrest (77.5%) and increased during incarceration (81.0%). Though the number of cigarette smokers increased during imprisonment, per-capita cigarette consumption declined by 7.1 cigarettes/day (p < .001). Despite widespread tobacco use, most participants recognized that smoking is a cause of lung cancer (96.0%) and heart disease (75.4%) and that it can be addicting (97.5%). Most tobacco users (70.0%) reported a desire to quit, with 63.0% saying they intended to try quitting in the next year. Conclusions: Indoor smoking bans do not promote cessation in prisons but may reduce the amount of tobacco consumed. Though smoking is commonplace in prisons, most prisoners recognize the risks involved and wish to quit. This creates an ideal setting for intervention. Evidence-based cessation assistance should be made freely available to all incarcerated smokers. PMID:21447838

Tobacco Consumption and Toxicant Exposure of Cigarette Smokers Using Electronic Cigarettes.

PubMed

Pulvers, Kim; Emami, Ashley S; Nollen, Nicole L; Romero, Devan R; Strong, David R; Benowitz, Neal L; Ahluwalia, Jasjit S

2018-01-05

There is considerable debate about the benefits and risks of electronic cigarettes (ECs). To better understand the risk-benefit ratio of ECs, more information is needed about net nicotine consumption and toxicant exposure of cigarette smokers switching to ECs. Forty cigarette smokers (≥1 year of smoking) interested in switching to ECs but not necessarily quitting smoking were enrolled in a 4-week observational study and provided an e-Go C non-variable battery and refillable atomizers and choice of eight flavors in 12 or 24 mg nicotine dosage. Measurement of urinary cotinine (metabolite of nicotine), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL; a pulmonary carcinogen), and eight volatile organic compounds (VOCs) that are toxic tobacco smoke constituents was conducted at baseline and week 4. All participants with follow-up data (92.5%) reported using the study EC. Of the 40 smokers, 16 reported no cigarettes at week 2 (40%) and six continued to report no cigarettes at week 4 (15%). Change in nicotine intake over the 4 weeks was non-significant (p = .90). Carbon monoxide (p < .001), NNAL (p < .01) and metabolites of benzene (p < .01) and acrylonitrile (p = .001) were significantly decreased in the study sample. Smokers switching exclusively to ECs for at least half of the study period demonstrated significant reductions in metabolites of ethylene oxide (p = .03) and acrylamide (p < .01). Smokers using ECs over 4 weeks maintained cotinine levels and experienced significant reductions in carbon monoxide, NNAL, and two out of eight measured VOC metabolites. Those who switched exclusively to ECs for at least half of the study period significantly reduced two additional VOCs. This study extends current literature by measuring change in smoking dependence and disease-associated biomarkers, NNAL and a panel of eight common VOCs that are toxic tobacco smoke constituents in smokers who switch to ECs. The findings support the idea of harm reduction, however some levels of toxicant exposure are still of clinical concern, particularly for dual users. Extrapolation of these results must be careful to separate the different toxic exposure results for exclusive switchers versus dual cigarette + EC users, and not to equate harm reduction with the idea that using ECs is harmless. © The Author(s) 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.

Cigarette smoking, physical activity, and alcohol consumption: relationship to blood lipids and lipoproteins in premenopausal females.

PubMed

Stamford, B A; Matter, S; Fell, R D; Sady, S; Cresanta, M K; Papanek, P

1984-07-01

A total of 164 premenopausal female subjects were randomly selected for evaluation from a much larger pool of volunteers. The relationships between blood lipid and lipoprotein levels as dependent variables and cigarette smoking, physical activity, and alcohol consumption were determined from partial regression coefficients. A lower HDL-C level (10.1 mg/dL) was seen in smokers v nonsmokers. For each ounce of alcohol consumed, HDL-C level was higher by 2.8 mg/dL, and greater physical activity was associated with a higher HDL-C level of 8.6 mg/dL. An analysis of covariance with covariance adjustments for age and body fat revealed that smokers who regularly exercise or consume alcohol had significantly lower HDL-C levels than nonsmokers with similar habits. Subjects who both exercise and consume alcohol demonstrated higher HDL-C levels than those who indulge in one or the other separately. Results suggest that cigarette smoking may attenuate the effects of chronic exercise or alcohol consumption, or of both, to raise HDL-C levels. Also, chronic exercise and alcohol consumption may exert an additive effect, raising HDL-C level.

Association between smoking and alcohol‐related behaviours: a time–series analysis of population trends in England

PubMed Central

West, Robert; Michie, Susan; Brown, Jamie

2017-01-01

Abstract Aims This paper estimates how far monthly changes in prevalence of cigarette smoking, motivation to quit and attempts to stop smoking have been associated with changes in prevalence of high‐risk drinking, and motivation and attempts to reduce alcohol consumption in England. Design Data were used from the Alcohol and Smoking Toolkit Studies between April 2014 and June 2016. These involve monthly household face‐to‐face surveys of representative samples of ~1700 adults in England. Measurements Autoregressive Integrated Moving Average with Exogeneous Input (ARIMAX) modelling was used to assess the association over time between monthly prevalence of (a) smoking and high‐risk drinking; (b) high motivation to quit smoking and high motivation to reduce alcohol consumption; and (c) attempts to quit smoking and attempts to reduce alcohol consumption. Findings Mean smoking prevalence over the study period was 18.6% and high‐risk drinking prevalence was 13.0%. A decrease of 1% of the series mean smoking prevalence was associated with a reduction of 0.185% of the mean prevalence of high‐risk drinking 2 months later [95% confidence interval (CI) = 0.033 to 0.337, P = 0.017]. A statistically significant association was not found between prevalence of high motivation to quit smoking and high motivation to reduce alcohol consumption (β = 0.324, 95% CI = –0.371 to 1.019, P = 0.360) or prevalence of attempts to quit smoking and attempts to reduce alcohol consumption (β = −0.026, 95% CI = –1.348 to 1.296, P = 0.969). Conclusion Between 2014 and 2016, monthly changes in prevalence of smoking in England were associated positively with prevalence of high‐risk drinking. There was no significant association between motivation to stop and motivation to reduce alcohol consumption, or attempts to quit smoking and attempts to reduce alcohol consumption. PMID:28556467

Electronic-cigarette use by individuals in treatment for substance abuse: A survey of 24 treatment centers in the United States.

PubMed

Gubner, Noah R; Andrews, K Blakely; Mohammad-Zadeh, Ana; Lisha, Nadra E; Guydish, Joseph

2016-12-01

Prevalence and reasons for using electronic cigarettes (e-cigarettes) was examined among patients enrolled in 24 substance abuse treatment centers in the United States (N=1113). Prevalence of e-cigarette use was assessed for the full sample. Bivariate analyses and multivariate logistic regression were used to identify characteristics associated with e-cigarette use among current cigarette smokers (the majority of e-cigarette users). Overall 55.5% of the sample reported lifetime use of e-cigarettes, and 30.5% reported using e-cigarettes in the past 30days (current users). The main reasons for using e-cigarettes were (a) at times/places when smoking was prohibited (53.5%), and (b) as a way to quit/reduce cigarette smoking (50.3%). Daily vs non-daily e-cigarette users were more likely to use e-cigarettes both as a way to reduce health risks, and as a way to quit/reduce cigarette smoking. A majority of e-cigarette users (87.1%) reported dual use of e-cigarettes and tobacco cigarettes during the past month. Among current cigarette smokers, those that also used e-cigarettes smoked more cigarettes per day, were more likely to have made a past year cigarette quit attempt, and to have tried nicotine replacement therapy compared to cigarette only smokers. There was a high rate of dual e-cigarette and cigarette use by persons enrolled in addiction treatment. E-cigarette users may be heavier cigarette smokers trying to quit or reduce their cigarette smoking. However, e-cigarettes were also used at times when individuals could not smoke cigarettes. Substance abuse treatment centers developing tobacco policies need to consider these potentially conflicting reasons for using e-cigarettes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Social-cognitive beliefs, alcohol, and tobacco use: a prospective community study of change following a ban on smoking in public places.

PubMed

Orbell, Sheina; Lidierth, Patrick; Henderson, Caroline J; Geeraert, Nicolas; Uller, Claudia; Uskul, Ayse K; Kyriakaki, Maria

2009-11-01

To examine social-cognitive change associated with behavior change after the introduction of a smoke-free public places policy. Adults (N = 583) who use public houses licensed to sell alcohol (pubs) completed questionnaires assessing alcohol and tobacco consumption and social-cognitive beliefs 2 months prior to the introduction of the smoking ban in England on July 1, 2007. Longitudinal follow-up (N = 272) was 3 months after the introduction of the ban. Social-cognitive beliefs, daily cigarette consumption, and weekly alcohol consumption. Smokers consumed considerably more alcohol than did nonsmokers at both time points. However, a significant interaction of Smoking Status x Time showed that while smokers had consumed fewer units of alcohol after the ban, nonsmokers showed an increase over the same period. There was a significant reduction in number of cigarettes consumed after the ban. Subjective norms concerning not smoking, and perceived severity of smoking-related illness increased across time. Negative outcomes associated with not smoking were reduced among former smokers and increased across time among smokers. Regression analyses showed that changes in subjective norm and negative outcome expectancies accounted for significant variance in change in smoking across time. Results suggest that the smoking ban may have positive health benefits that are supported by social-cognitive change. PsycINFO Database Record (c) 2009 APA, all rights reserved.

Illicit Cigarette Trade in Five South American Countries: A Gap Analysis for Argentina, Brazil, Chile, Colombia and Peru.

PubMed

Paraje, Guillermo

2018-05-15

Due to its nature, it is very hard to measure tobacco illicit trade in any product. In the case of Latin American countries, there is scant information on the magnitude and characteristics of this trade in the case of cigarettes. The goal of this article is to provide estimates on the evolution of the illicit cigarette trade in five South American countries: Argentina, Brazil, Chile, Colombia and Peru. Gap analysis estimates for cigarette tax evasion/avoidance (a comparison on the evolution of the difference between registered cigarette sales and measured population consumption) is developed for Argentina, Brazil, Chile, Colombia and Peru. Nationally representative surveys, conducted regularly, are used to measure population consumption. Confidence intervals constructed by bootstrapping sample estimates are generated in order to statistically evaluate the evolution of the gap. Cigarette illicit trade has increased as a percentage of total sales in Brazil in recent years. In the case of Argentina, after a relative decrease between 2005 and 2009 it seems to have stabilized. There is no statistical evidence to argue that there has been an increase of cigarette illicit trade in Chile, Colombia and Peru, despite substantial price increases in Chile and tax increase in both Colombia and Peru. Using simple statistical methods, it is possible to assess the trend in tobacco illicit trend over time to better inform policy-makers. Getting reliable and regular population consumption surveys can also help to track tobacco illicit trade. Claims by tobacco industry of a positive association between price/tax changes and illicit trade are unsubstantiated. Evolution of cigarette illicit trade in five Latin American countries show different trajectories, not in line with tobacco industry estimates, which highlight the importance of producing solid, independent estimates. There are inexpensive methodologies that can provide estimates of the evolution of the relative importance of illicit trade and can be used to inform policy-makers. Claims by tobacco industry of a positive association between price/tax changes and illicit trade are unsubstantiated.

Socioeconomic inequalities and changes in oral health behaviors among Brazilian adolescents from 2009 to 2012

PubMed Central

Freire, Maria do Carmo Matias; Jordão, Lidia Moraes Ribeiro; Malta, Deborah Carvalho; Andrade, Silvânia Suely Caribé de Araújo; Peres, Marco Aurelio

2015-01-01

OBJECTIVE To analyze oral health behaviors changes over time in Brazilian adolescents concerning maternal educational inequalities. METHODS Data from the Pesquisa Nacional de Saúde do Escolar (Brazilian National School Health Survey) were analyzed. The sample was composed of 60,973 and 61,145 students from 26 Brazilian state capitals and the Federal District in 2009 and 2012, respectively. The analyzed factors were oral health behaviors (toothbrushing frequency, sweets consumption, soft drink consumption, and cigarette experimentation) and sociodemographics (age, sex, race, type of school and maternal schooling). Oral health behaviors and sociodemographic factors in the two years were compared (Rao-Scott test) and relative and absolute measures of socioeconomic inequalities in health were estimated (slope index of inequality and relative concentration index), using maternal education as a socioeconomic indicator, expressed in number of years of study (> 11; 9-11; ≤ 8). RESULTS Results from 2012, when compared with those from 2009, for all maternal education categories, showed that the proportion of people with low toothbrushing frequency increased, and that consumption of sweets and soft drinks and cigarette experimentation decreased. In private schools, positive slope index of inequality and relative concentration index indicated higher soft drink consumption in 2012 and higher cigarette experimentation in both years among students who reported greater maternal schooling, with no significant change in inequalities. In public schools, negative slope index of inequality and relative concentration index indicated higher soft drink consumption among students who reported lower maternal schooling in both years, with no significant change overtime. The positive relative concentration index indicated inequality in 2009 for cigarette experimentation, with a higher prevalence among students who reported greater maternal schooling. There were no inequalities for toothbrushing frequency or sweets consumption. CONCLUSIONS There were changes in the prevalences of oral health behaviors during the analyzed period; however, these changes were not related to maternal education inequalities. PMID:26270015

Impact on smoking of England's 2012 partial tobacco point of sale display ban: a repeated cross-sectional national study.

PubMed

Kuipers, Mirte A G; Beard, Emma; Hitchman, Sara C; Brown, Jamie; Stronks, Karien; Kunst, Anton E; McNeill, Ann; West, Robert

2017-03-01

A partial tobacco point of sale (PoS) display ban was introduced in large shops (>280 m 2 floor area) in England on 6 April 2012. The aim of this study was to assess the medium-term effects of the partial tobacco PoS display ban on smoking in England. Data were used from 129 957 respondents participating in monthly, cross-sectional household surveys of representative samples of the English adult population aged 18+ years from January 2009 to February 2015. Interrupted-time series regression models assessed step changes in the level of current smoking and cigarette consumption in smokers and changes in the trends postban compared with preban. Models were adjusted for sociodemographic variables and e-cigarette use, seasonality and autocorrelation. Potential confounding by cigarette price was accounted for by time, as price was almost perfectly correlated with time. Following the display ban, there was no immediate step level change in smoking (-3.69% change, 95% CI -7.94 to 0.75, p=0.102) or in cigarette consumption (β -0.183, 95% CI -0.602 to 0.236). There was a significantly steeper decline in smoking post display ban (-0.46% change, 95% CI -0.72 to -0.20, p=0.001). This effect was demonstrated by respondents in manual occupations (-0.62% change, 95% CI -0.72 to -0.20, p=0.001), but not for those in non-manual occupations (-0.42, 95% CI -0.90 to 0.06, p=0.084). Cigarette consumption declined preban period (β -0.486, 95% CI -0.633 to -0.339, p<0.001), but no significant change in cigarette consumption trend was observed (β 0.019, 95% CI -0.006 to 0.042, p=0.131). The partial tobacco PoS display ban introduced in England in April 2012 did not lead to an immediate decline in smoking, but was followed by a decline in the trend of smoking prevalence that could not be accounted for by seasonal factors, e-cigarette use or price changes. 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/.

How smokers may react to cigarette taxes and price increases in Brazil: data from a national survey.

PubMed

Gigliotti, Analice; Figueiredo, Valeska C; Madruga, Clarice S; Marques, Ana C P R; Pinsky, Ilana; Caetano, Raul; da Costa e Silva, Vera Luiza; Raw, Martin; Laranjeira, Ronaldo

2014-04-08

Despite being the third largest tobacco producer in the world, Brazil has developed a comprehensive tobacco control policy that includes a broad restriction on both advertising and smoking in indoor public places, compulsory pictorial warning labels, and a menthol cigarette ban. However, tax and pricing policies have been developed slowly and only very recently were stronger measures implemented. This study investigated the expected responses of smokers to hypothetical price increases in Brazil. We analyzed smokers' responses to hypothetical future price increases according to sociodemographic characteristics and smoking conditions in a multistage sample of Brazilian current cigarette smokers aged≥14 years (n=500). Logistic regression analysis was used to examine the relationship between possible responses and different predictors. In most subgroups investigated, smokers most frequently said they would react to a hypothetical price increase by taking up alternatives that might have a positive impact on health, i.e., they would "try to stop smoking" (52.3%) or "smoke fewer cigarettes" (46.8%). However, a considerable percentage responded that they would use alternatives that would reduce the effect of price increases, such as the same brand with lower cost (48.1%). After controlling for sex age group (14-19, 20-39, 40-59, and ≥60 years), schooling level (≥9 versus ≤9 years), number of cigarettes per day (>20 versus ≤20), and stage of change for smoking cessation (precontemplation, contemplation, and preparation), lower levels of dependence were positively associated with the response "I would try to stop smoking" (odds ratio [OR], 2.19). Young age was associated with "I would decrease the number of cigarettes" (OR, 3.44). A low schooling level was strongly associated with all responses. Taxes and prices increases have great potential to stimulate cessation or reduction of cigarette consumption further among two important vulnerable populations of smokers in Brazil: young smokers and those of low educational level. The results from the present study also suggest that seeking illegal products may reduce the impact of increased taxes, but does not eliminate it.

Bans on electronic cigarette sales to minors and smoking among high school students.

PubMed

Abouk, Rahi; Adams, Scott

2017-07-01

Many states have banned electronic cigarette sales to minors under the rationale that using e-cigarettes leads to smoking traditional combustion cigarettes. Such sales bans would be counterproductive, however, if e-cigarettes and traditional cigarettes are substitutes, as bans might push teenagers back to smoking the more dangerous combustion cigarettes. We provide evidence that these sales bans reduce the incidence of smoking conventional cigarettes among high school seniors. Moreover, we provide evidence suggesting that sales bans reduced e-cigarette usage as well. This evidence suggests that not only are e-cigarettes and smoking regular cigarettes positively related and not substitutes for young people, banning retail sales to minors is an effective policy tool in reducing tobacco use. Copyright © 2017 Elsevier B.V. All rights reserved.

The Association between Tax Structure and Cigarette Price Variability: Findings from the International Tobacco Control Policy Evaluation (ITC) Project

PubMed Central

Shang, Ce; Chaloupka, Frank J.; Fong, Geoffrey T; Thompson, Mary; O’Connor, Richard J

2015-01-01

Background Recent studies have shown that more opportunities exist for tax avoidance when cigarette excise tax structure departs from a uniform specific structure. However, the association between tax structure and cigarette price variability has not been thoroughly studied in the existing literature. Objective To examine how cigarette tax structure is associated with price variability. The variability of self-reported prices is measured using the ratios of differences between higher and lower prices to the median price such as the IQR-to-median ratio. Methods We used survey data taken from the International Tobacco Control Policy Evaluation (ITC) Project in 17 countries to conduct the analysis. Cigarette prices were derived using individual purchase information and aggregated to price variability measures for each surveyed country and wave. The effect of tax structures on price variability was estimated using Generalised Estimating Equations after adjusting for year and country attributes. Findings Our study provides empirical evidence of a relationship between tax structure and cigarette price variability. We find that, compared to the specific uniform tax structure, mixed uniform and tiered (specific, ad valorem or mixed) structures are associated with greater price variability (p≤0.01). Moreover, while a greater share of the specific component in total excise taxes is associated with lower price variability (p≤0.05), a tiered tax structure is associated with greater price variability (p≤0.01). The results suggest that a uniform and specific tax structure is the most effective tax structure for reducing tobacco consumption and prevalence by limiting price variability and decreasing opportunities for tax avoidance. PMID:25855641

Persistence and amplitude of cigarette demand in relation to quit intentions and attempts

PubMed Central

O’Connor, Richard J.; Heckman, Bryan W.; Adkison, Sarah E.; Rees, Vaughan W.; Hatsukami, Dorothy K.; Bickel, Warren K.; Cummings, K. Michael

2016-01-01

INTRODUCTION The cigarette purchase task (CPT) is a method that can be used to assess relative value of cigarettes. Based on cigarettes purchased across a price range, five derived metrics (Omax, Pmax, breakpoint, intensity, elasticity) can assess cigarette demand. A study with adolescent smokers found that these could be reduced to two latent factors: Persistence (price insensitivity) and Amplitude (volumetric consumption). We sought to replicate this structure with adult smokers, and examine how these variables relate to cessation efforts. METHOD Web-based survey conducted in 2014 among adult (18+) current daily cigarette smokers (N=1194). Participants completed the CPT, Fagerstrom Test for Nicotine Dependence (FTND), reported past-year quit attempts, and future quit intentions. We included published scales assessing perceived prevalence of smoking, social reactivity, smoker identity, and risk perception. RESULTS Our analysis supported two latent variables, Persistence and Amplitude, which correlated positively with FTND. Persistence correlated with several psychosocial factors, and was higher among those intending to quit very soon, but did not vary by number of past-year quit attempts. Amplitude differed across quit attempts and intention (p’s <.001), and in multivariable models was significantly associated with lower 30-day quit intention [OR=0.76, p=.001]. CONCLUSIONS Persistence and Amplitude factors characterized CPT data in adults, discriminated known groups (e.g., smokers by intentions to quit), and were positively associated with nicotine dependence. Factor scores also appear to relate to certain psychosocial factors, such as smoker identity and perceptions of risk. Future research should examine the predictive validity of these constructs. PMID:27048156

Persistence and amplitude of cigarette demand in relation to quit intentions and attempts.

PubMed

O'Connor, Richard J; Heckman, Bryan W; Adkison, Sarah E; Rees, Vaughan W; Hatsukami, Dorothy K; Bickel, Warren K; Cummings, K Michael

2016-06-01

The cigarette purchase task (CPT) is a method that can be used to assess the relative value of cigarettes. Based on cigarettes purchased across a price range, five derived metrics (Omax, Pmax, breakpoint, intensity, and elasticity) can assess cigarette demand. A study with adolescent smokers found that these could be reduced to two latent factors: persistence (price insensitivity) and amplitude (volumetric consumption). We sought to replicate this structure with adult smokers and examine how these variables relate to cessation efforts. Web-based survey conducted in 2014 among adult (18 years and above) current daily cigarette smokers (N = 1194). Participants completed the CPT, Fagerstrom Test for Nicotine Dependence (FTND), reported past-year quit attempts, and future quit intentions. We included published scales assessing perceived prevalence of smoking, social reactivity, smoker identity, and risk perception. Our analysis supported two latent variables, persistence and amplitude, which correlated positively with FTND. Persistence was correlated with several psychosocial factors and was higher among those intending to quit very soon, but did not vary by number of past-year quit attempts. Amplitude differed across quit attempts and intention (p < 0.001) and, in multivariable models, was significantly associated with lower 30-day quit intention (OR = 0.76, p = 0.001). Persistence and amplitude factors characterized CPT data in adults, discriminated known groups (e.g., smokers by intentions to quit), and were positively associated with nicotine dependence. Factor scores also appear to relate to certain psychosocial factors, such as smoker identity and perceptions of risk. Future research should examine the predictive validity of these constructs.

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

Evaluation of antismoking advertising campaigns.

PubMed

Goldman, L K; Glantz, S A

1998-03-11

Active and passive smoking are the first and third leading preventable causes of death. Many states are running or initiating antitobacco media campaigns. To review research on the effectiveness of different antismoking messages and published evidence of the effectiveness of paid antismoking advertising. Focus group studies conducted by professional advertising agencies that contract with California, Massachusetts, and Michigan to run their antismoking advertising campaigns, the Centers for Disease Control and Prevention's Media Campaign Resource Book, and copies of the advertisements. In total, we reviewed the results of 186 focus groups involving more than 1500 children and adults dealing with 118 advertisements that had actually been aired and additional concept advertisements that were not produced. Published literature was located using MEDLINE and standard bibliographic sources on the effectiveness of large, paid antitobacco media campaigns. We also reviewed reports and studies conducted by, or for, the California and Massachusetts health departments on program effectiveness, and conducted our own comparison of California vs Massachusetts using cigarette consumption data from the Tobacco Institute. All available studies. Eight advertising strategies to prevent people from starting to smoke and persuading them to stop were reviewed: industry manipulation, secondhand smoke, addiction, cessation, youth access, short-term effects, long-term health effects, and romantic rejection. These focus groups identified strategies that would be expected to be effective and ineffective. Regression analysis was used to compare the cost-effectiveness of the California and Massachusetts programs. Focus group participants indicated that industry manipulation and secondhand smoke are the most effective strategies for denormalizing smoking and reducing cigarette consumption. Addiction and cessation can be effective when used in conjunction with the industry manipulation and secondhand smoke strategies. Youth access, short-term effects, long-term health effects, and romantic rejection are not effective strategies. More aggressive advertising strategies appear to be more effective at reducing tobacco consumption.

Cigarette smoking and poverty in China.

PubMed

Liu, Yuanli; Rao, Keqin; Hu, Teh-Wei; Sun, Qi; Mao, Zhenzhong

2006-12-01

Drawing on the 1998 China national health services survey data, this study estimated the poverty impact of two smoking-related expenses: excessive medical spending attributable to smoking and direct spending on cigarettes. The excessive medical spending attributable to smoking is estimated using a regression model of medical expenditure with smoking status (current smoker, former smoker, never smoker) as part of the explanatory variables, controlling for people's demographic and socioeconomic characteristics. The poverty impact is measured by the changes in the poverty head count, after smoking-related expenses are subtracted from income. We found that the excessive medical spending attributable to smoking may have caused the poverty rate to increase by 1.5% for the urban population and by 0.7% for the rural population. To a greater magnitude, the poverty headcount in urban and rural areas increased by 6.4% and 1.9%, respectively, due to the direct household spending on cigarettes. Combined, the excessive medical spending attributable to smoking and consumption spending on cigarettes are estimated to be responsible for impoverishing 30.5 million urban residents and 23.7 million rural residents in China. Smoking related expenses pushed a significant proportion of low-income families into poverty in China. Therefore, reducing the smoking rate appears to be not only a public health strategy, but also a poverty reduction strategy.

Cigarette smoking, alcohol intake, and risk of glioma in the NIH-AARP Diet and Health Study.

PubMed

Braganza, M Z; Rajaraman, P; Park, Y; Inskip, P D; Freedman, N D; Hollenbeck, A R; de González, A Berrington; Kitahara, C M

2014-01-07

Although cigarette smoking and alcohol drinking increase the risk of several cancers and certain components of cigarette smoke and alcohol can penetrate the blood-brain barrier, it remains unclear whether these exposures influence the risk of glioma. We examined the associations between cigarette smoking, alcohol intake, and risk of glioma in the National Institutes of Health-AARP Diet and Health Study, a prospective study of 477,095 US men and women ages 50-71 years at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using models with age as the time metric and adjusted for sex, race/ethnicity, education, and marital status. During a median 10.5 person-years of follow-up, 492 men and 212 women were diagnosed with first primary glioma. Among men, current, heavier smoking was associated with a reduced risk of glioma compared with never smoking, but this was based on only nine cases. No associations were observed between smoking behaviours and glioma risk in women. Greater alcohol consumption was associated with a decreased risk of glioma, particularly among men (>2 drinks per day vs <1 drink per week: HR=0.67, 95% CI=0.51-0.90). Smoking and alcohol drinking do not appear to increase the risk of glioma.

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.

Cytologic analysis of alterations induced by Smoking and by alcohol consumption.

PubMed

Pavanello, Marcella Batista; Prado, Fernanda Almeida; Balducci, Ivan; Brandão, Adriana Aigotti Haberbeck; Almeida, Janete Dias

2006-01-01

To analyze cytologically the buccal mucosa of smoking and nonsmoking volunteers to determine what cellular changes are induced by cigarettes and alcohol consumption. In order to evaluate cellular changes induced by smoking and alcohol consumption, exfoliative cytology was used for the analysis of mucosal smears obtained from the buccal mucosa of 25 smokers and 25 nonsmokers. The number of cigarettes consumed, duration of smoking, presence or absence of alcohol ingestion, ingested alcohol dose and frequency of consumption, and most frequently used type of alcoholic beverage were determined using a questionnaire. Three smears from each individual stained by the Papanicolaou method were analyzed quantitatively and qualitatively under a light microscope by 2 experienced examiners in terms of inflammatory and dysplastic alterations and of the degree of epithelial maturation. Although numerous alterations were observed in smokers they corresponded up to only Papanicolaou class II and were not significantly different from nonsmokers (Mann-Whitney and chi2 tests, p < 0.05). A higher proportion of inflammatory cells (polymorphonuclear and mononuclear cells) were obtained from smokers as compared to nonsmokers, while the proportion of bacteria was similar in the 2 groups. The findings indicate that even after a short period of cigarette use and alcohol consumption, inflammatory alterations were detectable on exfoliative cytology of the buccal mucosa in a young group, demonstrating the usefulness of cytology for early detection in smokers.

Dual use of electronic and tobacco cigarettes among adolescents: a cross-sectional study in Poland.

PubMed

Goniewicz, Maciej L; Leigh, Noel J; Gawron, Michal; Nadolska, Justyna; Balwicki, Lukasz; McGuire, Connor; Sobczak, Andrzej

2016-03-01

Electronic cigarettes (e-cigarettes) are gaining in popularity among youth. While these products may be beneficial in adult smokers, the effect on young users of electronic and tobacco cigarettes (dual users) is unknown. The objective of this study was to assess the frequency of dual use among adolescents and to compare tobacco cigarette consumption among dual and exclusive tobacco cigarette users. A cross-sectional survey of a sample of 2213 Polish students aged 16-18 conducted between December 2013 and February 2014. Overall, 21.8 % of students were dual users. Dual users were more likely to smoke tobacco cigarettes on a daily basis [adjusted odds ratio, AOR 3.54 (95 % CI 2.34-5.36) and less likely to smoke fewer cigarettes per day (AOR 0.27 (95 % CI 0.12-0.57)] than exclusive tobacco cigarette users. The frequency of dual use was higher than exclusive use of a single product among Polish adolescents. Young dual users do not smoke a lower number of tobacco cigarettes per day than exclusive tobacco cigarette users.

Economic interventions to discourage the illegal sale of cigarettes to minors in New York State.

PubMed

Cummings, K M; Pechacek, T; Sciandra, E

1992-12-01

In New York State it is illegal to sell tobacco products to persons under the age of 18 years. In most communities, compliance with this law is poor. This study provides estimates of teenage cigarette smoking and the illegal sale of cigarettes to minors in 1990 in each of New York's 57 counties and in New York City. Results show that in New York State, approximately 135,700 teens between the ages of 12 and 17 years are regular cigarette smokers. Data available on the cigarette consumption and purchasing habits of teenage smokers reveal that nearly 21.9 million packs of cigarettes were sold illegally to minors in 1991 in New York State. This finding underscores the fact that cigarette sales to underage youth in New York is big business, representing $39.5 million in sales annually. Government officials should consider levying an illegal drug profit tax on the cigarette industry to recover the millions in profits derived annually from the illegal sale of cigarettes to children.

19 CFR 144.38 - Withdrawal for consumption.

Code of Federal Regulations, 2010 CFR

2010-04-01

... provided in § 141.61(e) of this chapter. (b) Withdrawal for exportation to Canada or Mexico. A withdrawal... withdrawal of cigars, cigarettes, or cigarette papers or tubes subject to internal revenue tax, the statement... will be finally due upon liquidation. (e) Permit for release of merchandise. When the duties and other...

19 CFR 144.38 - Withdrawal for consumption.

Code of Federal Regulations, 2014 CFR

2014-04-01

... provided in § 141.61(e) of this chapter. (b) Withdrawal for exportation to Canada or Mexico. A withdrawal... withdrawal of cigars, cigarettes, or cigarette papers or tubes subject to internal revenue tax, the statement... will be finally due upon liquidation. (e) Permit for release of merchandise. When the duties and other...

19 CFR 144.38 - Withdrawal for consumption.

Code of Federal Regulations, 2011 CFR

2011-04-01

... provided in § 141.61(e) of this chapter. (b) Withdrawal for exportation to Canada or Mexico. A withdrawal... withdrawal of cigars, cigarettes, or cigarette papers or tubes subject to internal revenue tax, the statement... will be finally due upon liquidation. (e) Permit for release of merchandise. When the duties and other...

19 CFR 144.38 - Withdrawal for consumption.

Code of Federal Regulations, 2013 CFR

2013-04-01

... provided in § 141.61(e) of this chapter. (b) Withdrawal for exportation to Canada or Mexico. A withdrawal... withdrawal of cigars, cigarettes, or cigarette papers or tubes subject to internal revenue tax, the statement... will be finally due upon liquidation. (e) Permit for release of merchandise. When the duties and other...

19 CFR 144.38 - Withdrawal for consumption.

Code of Federal Regulations, 2012 CFR

2012-04-01

... provided in § 141.61(e) of this chapter. (b) Withdrawal for exportation to Canada or Mexico. A withdrawal... withdrawal of cigars, cigarettes, or cigarette papers or tubes subject to internal revenue tax, the statement... will be finally due upon liquidation. (e) Permit for release of merchandise. When the duties and other...

Using e-cigarettes in the home to reduce smoking and secondhand smoke: disadvantaged parents' accounts.

PubMed

Rowa-Dewar, Neneh; Rooke, Catriona; Amos, Amanda

2017-02-01

Electronic cigarettes (e-cigarettes) are subject to considerable public health debate. Most public health experts agree that for smokers who find it particularly challenging to quit, e-cigarettes may reduce harm. E-cigarette use in the home may also reduce children's secondhand smoke (SHS) exposure, although e-cigarette vapour may pose risks. This is the first qualitative study to explore disadvantaged parents' views and experiences of e-cigarettes in relation to reducing SHS exposure in the home. Interviews with 25 disadvantaged parents from Edinburgh who smoked and had children aged 1-3 were conducted in 2013, with 17 re-interviewed in 2014. Accounts of e-cigarette perceptions and use were analysed thematically. E-cigarettes were seen by some as potentially valuable in helping quitting or reducing smoking in difficult circumstances, and protecting children from SHS when smoking outside is constrained. However, parents raised concerns about safety issues and continuing their nicotine addiction. In relation to children, concerns included possible health effects of the vapour, children playing with them and role-modelling e-cigarette use. While significant concerns remain about e-cigarettes, for some parents who find it challenging to quit or safely leave their children to smoke outside, e-cigarettes may offer potential for reducing the harm to them and their children. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-08-26

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

Do increases in cigarette prices lead to increases in sales of cigarettes with high tar and nicotine yields?

PubMed

Farrelly, Matthew C; Loomis, Brett R; Mann, Nathan H

2007-10-01

We used scanner data on cigarette prices and sales collected from supermarkets across the United States from 1994 to 2004 to test the hypothesis that cigarette prices are positively correlated with sales of cigarettes with higher tar and nicotine content. During this period the average inflation-adjusted price for menthol cigarettes increased 55.8%. Price elasticities from multivariate regression models suggest that this price increase led to an increase of 1.73% in sales-weighted average tar yields and a 1.28% increase in sales-weighted average nicotine yields for menthol cigarettes. The 50.5% price increase of nonmenthol varieties over the same period yielded an estimated increase of 1% in tar per cigarette but no statistically significant increase in nicotine yields. An ordered probit model of the impact of cigarette prices on cigarette strength (ultra-light, light, full flavor, unfiltered) offers an explanation: As cigarette prices increase, the probability that stronger cigarette types will be sold increases. This effect is larger for menthol than for nonmenthol cigarettes. Our results are consistent with earlier population-based cross-sectional and longitudinal studies showing that higher cigarette prices and taxes are associated with increasing consumption of higher-yield cigarettes by smokers.

Impact of flavour variability on electronic cigarette use experience: an internet survey.

PubMed

Farsalinos, Konstantinos E; Romagna, Giorgio; Tsiapras, Dimitris; Kyrzopoulos, Stamatis; Spyrou, Alketa; Voudris, Vassilis

2013-12-17

A major characteristic of the electronic cigarette (EC) market is the availability of a large number of different flavours. This has been criticised by the public health authorities, some of whom believe that diverse flavours will attract young users and that ECs are a gateway to smoking. At the same time, several reports in the news media mention that the main purpose of flavour marketing is to attract youngsters. The importance of flavourings and their patterns of use by EC consumers have not been adequately evaluated, therefore, the purpose of this survey was to examine and understand the impact of flavourings in the EC experience of dedicated users. A questionnaire was prepared and uploaded in an online survey tool. EC users were asked to participate irrespective of their current smoking status. Participants were divided according to their smoking status at the time of participation in two subgroups: former smokers and current smokers. In total, 4,618 participants were included in the analysis, with 4,515 reporting current smoking status. The vast majority (91.1%) were former smokers, while current smokers had reduced smoking consumption from 20 to 4 cigarettes per day. Both subgroups had a median smoking history of 22 years and had been using ECs for 12 months. On average they were using three different types of liquid flavours on a regular basis, with former smokers switching between flavours more frequently compared to current smokers; 69.2% of the former subgroup reported doing so on a daily basis or within the day. Fruit flavours were more popular at the time of participation, while tobacco flavours were more popular at initiation of EC use. On a scale from 1 (not at all important) to 5 (extremely important) participants answered that variability of flavours was "very important" (score = 4) in their effort to reduce or quit smoking. The majority reported that restricting variability will make ECs less enjoyable and more boring, while 48.5% mentioned that it would increase craving for cigarettes and 39.7% said that it would have been less likely for them to reduce or quit smoking. The number of flavours used was independently associated with smoking cessation. The results of this survey of dedicated users indicate that flavours are marketed in order to satisfy vapers' demand. They appear to contribute to both perceived pleasure and the effort to reduce cigarette consumption or quit smoking. Due to the fact that adoption of ECs by youngsters is currently minimal, it seems that implementing regulatory restrictions to flavours could cause harm to current vapers while no public health benefits would be observed in youngsters. Therefore, flavours variability should be maintained; any potential future risk for youngsters being attracted to ECs can be sufficiently minimized by strictly prohibiting EC sales in this population group.

Approach bias modification training and consumption: A review of the literature.

PubMed

Kakoschke, Naomi; Kemps, Eva; Tiggemann, Marika

2017-01-01

Recent theoretical perspectives and empirical evidence have suggested that biased cognitive processing is an important contributor to unhealthy behaviour. Approach bias modification is a novel intervention in which approach biases for appetitive cues are modified. The current review of the literature aimed to evaluate the effectiveness of modifying approach bias for harmful consumption behaviours, including alcohol use, cigarette smoking, and unhealthy eating. Relevant publications were identified through a search of four electronic databases (PsycINFO, Google Scholar, ScienceDirect and Scopus) that were conducted between October and December 2015. Eligibility criteria included the use of a human adult sample, at least one session of avoidance training, and an outcome measure related to the behaviour of interest. The fifteen identified publications (comprising 18 individual studies) were coded on a number of characteristics, including consumption behaviour, participants, task, training and control conditions, number of training sessions and trials, outcome measure, and results. The results generally showed positive effects of approach-avoidance training, including reduced consumption behaviour in the laboratory, lower relapse rates, and improvements in self-reported measures of behaviour. Importantly, all studies (with one exception) that reported favourable consumption outcomes also demonstrated successful reduction of the approach bias for appetitive cues. Thus, the current review concluded that approach bias modification is effective for reducing both approach bias and unhealthy consumption behaviour. Copyright © 2016 Elsevier Ltd. All rights reserved.

Relationships between nicotine and cotinine concentrations in maternal milk and saliva.

PubMed

Jacob, Nelly; Golmard, Jean-Louis; Berlin, Ivan

2015-08-01

Breastfeeding may be impaired due to nicotine excreted into the milk of smoking mothers. We investigated the relationships between nicotine and cotinine concentrations in maternal milk and saliva among breastfeeding smokers. The 41 mothers reported their cigarette consumption between waking up and milk and saliva sampling. The median sampling time took place four days after delivery. Nicotine and cotinine concentrations were determined by liquid chromatography and UV detection, after a single-step saliva or three-step milk liquid-to-liquid extraction. The median (interquartile range) concentrations in milk and saliva were 7 (6-22) and 27 (4-207) μg/L for nicotine and 24 (5-111) and 22 (4-120) μg/L for cotinine, respectively. Milk cotinine was positively associated with saliva cotinine (p < 0.0001) and cigarette consumption (p = 0.039) and inversely associated with the time since the last cigarette (p = 0.0004, model R(2) = 0.90). Milk nicotine was associated with saliva nicotine concentration (p = 0.0017) and cigarette consumption (p = 0.0023, model R(2) = 0.63). Saliva nicotine concentration was not a very good estimate of milk nicotine concentration in breastfeeding mothers. Saliva cotinine concentration may be used instead of milk cotinine concentration to estimate tobacco or nicotine exposure among breastfed neonates or infants. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Association of socioeconomic status with consumption of cigarettes, illicit drugs, and alcohol.

PubMed

Marzban, Maryam; Hadji, Maryam; Gholipour, Mahin; Rashidian, Hamideh; Rezaianzadeh, Abbas; Hasanzadeh, Jafar; Haghdoost, Ali Akbar; Rahimi-Movaghar, Afarin; Ghiasvand, Reza; Moradi, Abdolvahab; Khavari-Daneshvar, Hossein; Weiderpass, Elisabete; Kamangar, Farin; Zendehdel, Kazem

2017-08-18

Socioeconomic Status (SES) is considered as one of the important factors associated with use of various drugs. The present study aimed to investigate the effect of SES on cigarette smoking, alcohol use, drug use, and passive exposure to opium and cigarette smoke. In this study, which is part of a multicenter case-control study, the research hypothesis was checked among controls who had referred to hospitals. Data were collected through a questionnaire and laboratory tests to determine the actual consumers of opium and other illicit drugs. Then, the data were analyzed using STATA 13. This study was performed on 364 individuals within the age range of 30 to 75 years. More than 55% of the participants had a history of life-time consumption of cigarettes and hookah as well as alcohol and drugs. The results revealed an inverse relationship between SES and life-time consumption of hookah and alcohol. Furthermore, individuals with higher SES were more likely to deny their drug use. The results revealed little robust evidence supporting the assumption that SES level can have an important effect on illicit drug use. On the other hand, the participants' characteristics could have a prominent effect on precise evaluation of the relationship between SES and drug use. Further multicenter studies are needed with samples diversified in terms of age and ethnicity to identify these confounding relationships.

76 FR 4935 - In the Matter of Certain Reduced Ignition Proclivity Cigarette Paper Wrappers and Products...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-27

... Proclivity Cigarette Paper Wrappers and Products Containing Same; Notice of Investigation AGENCY: U.S... importation of certain reduced ignition proclivity cigarette paper wrappers and products containing same by... reduced ignition proclivity cigarette paper wrappers and products containing same that infringe one or...

Can you refuse these discounts? An evaluation of the use and price discount impact of price-related promotions among US adult smokers by cigarette manufacturers

PubMed Central

Caraballo, Ralph S; Wang, Xu; Xu, Xin

2014-01-01

Objectives The raising unit price of cigarette has been shown to be one of the most effective ways of reducing cigarette consumption and increasing rates of successful quitting. However, researchers have shown that price-sensitive smokers have used a variety of strategies to mitigate the effect of the rising price of cigarettes on their smoking habits. In particular, 23–34% of adult smokers in the US use cheaper brands, and 18–55% use coupons or promotions. Little is known about the discount use by type of brands. As such, the main purpose of this analysis is to evaluate the uses and price discount effects of these price-related discounts by manufacturers and major brands. Setting An analysis based on the cross-sectional 2009–2010 National Adult Tobacco Survey (NATS). Participants 11 766 current smokers aged 18 or above in the USA. Primary outcome measures Price-related discount was defined as smokers who used coupons, rebates, buy-one-get-one-free, two-for-one or any other special promotions for their last cigarettes purchase. Results The use of price-related discounts and associated price impact vary widely by cigarette manufacturer and brand. Approximately one of three Camel, one of four Marlboro and one of eight Newport smokers used price-related discounts on their latest cigarette purchases. The average price reductions of discounts offered by Philip Morris (PM) or R.J. Reynolds (RJR) were around 29 cents per pack while that of Lorillard (Newport only) was 24 cents per pack. Cigarette brands that provided significant per pack price reductions include: PM Marlboro (28 cents), RJR brand Camel (41 cents), Doral (50 cents), Kool (73 cents) and Salem (80 cents), and Lorillard Newport (24 cents). Conclusions Policies that decrease price-minimisation strategies will benefit public health. PMID:24898086

Can you refuse these discounts? An evaluation of the use and price discount impact of price-related promotions among US adult smokers by cigarette manufacturers.

PubMed

Caraballo, Ralph S; Wang, Xu; Xu, Xin

2014-06-04

The raising unit price of cigarette has been shown to be one of the most effective ways of reducing cigarette consumption and increasing rates of successful quitting. However, researchers have shown that price-sensitive smokers have used a variety of strategies to mitigate the effect of the rising price of cigarettes on their smoking habits. In particular, 23-34% of adult smokers in the US use cheaper brands, and 18-55% use coupons or promotions. Little is known about the discount use by type of brands. As such, the main purpose of this analysis is to evaluate the uses and price discount effects of these price-related discounts by manufacturers and major brands. An analysis based on the cross-sectional 2009-2010 National Adult Tobacco Survey (NATS). 11 766 current smokers aged 18 or above in the USA. Price-related discount was defined as smokers who used coupons, rebates, buy-one-get-one-free, two-for-one or any other special promotions for their last cigarettes purchase. The use of price-related discounts and associated price impact vary widely by cigarette manufacturer and brand. Approximately one of three Camel, one of four Marlboro and one of eight Newport smokers used price-related discounts on their latest cigarette purchases. The average price reductions of discounts offered by Philip Morris (PM) or R.J. Reynolds (RJR) were around 29 cents per pack while that of Lorillard (Newport only) was 24 cents per pack. Cigarette brands that provided significant per pack price reductions include: PM Marlboro (28 cents), RJR brand Camel (41 cents), Doral (50 cents), Kool (73 cents) and Salem (80 cents), and Lorillard Newport (24 cents). Policies that decrease price-minimisation strategies will benefit public health. 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.

Integrating chemical, toxicological and clinical research to assess the potential of reducing health risks associated with cigarette smoking through reducing toxicant emissions.

PubMed

McAdam, Kevin; Murphy, James; Eldridge, Alison; Meredith, Clive; Proctor, Christopher

2018-06-01

The concept of a risk continuum for tobacco and nicotine products has been proposed, which differentiates products according to their propensity to reduce toxicant exposure and risk. Cigarettes are deemed the most risky and medicinal nicotine the least. We assessed whether a Reduced-Toxicant Prototype (RTP) cigarette could sufficiently reduce exposure to toxicants versus conventional cigarettes to be considered a distinct category in the risk continuum. We present findings from both pre-clinical and clinical studies in order to examine the potential for reduced smoke toxicant emissions to lower health risks associated with cigarette smoking. We conclude that current toxicant reducing technologies are unable to reduce toxicant emissions sufficiently to manifest beneficial disease-relevant changes in smokers. These findings point to a minimum toxicant exposure standard that future potentially reduced risk products would need to meet to be considered for full biological assessment. The RTP met WHO TobReg proposed limits on cigarette toxicant emissions, however the absence of beneficial disease relevant changes in smokers after six months reduced toxicant cigarette use, does not provide evidence that these regulatory proposals will positively impact risks of smoking related diseases. Greater toxicant reductions, such as those that can be achieved in next generation products e.g. tobacco heating products and electronic cigarettes are likely to be necessary to clearly reduce risks compared with conventional cigarettes. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Effects of 6-Week Use of Reduced-Nicotine Content Cigarettes in Smokers With and Without Elevated Depressive Symptoms.

PubMed

Tidey, Jennifer W; Pacek, Lauren R; Koopmeiners, Joseph S; Vandrey, Ryan; Nardone, Natalie; Drobes, David J; Benowitz, Neal L; Dermody, Sarah S; Lemieux, Andrine; Denlinger, Rachel L; Cassidy, Rachel; al'Absi, Mustafa; Hatsukami, Dorothy K; Donny, Eric C

2017-01-01

The FDA recently acquired regulatory authority over tobacco products, leading to renewed interest in whether reducing the nicotine content of cigarettes would reduce tobacco dependence in the United States. Given the association between depressive symptoms and cigarette smoking, it is important to consider whether smokers with elevated depressive symptoms experience unique benefits or negative consequences of nicotine reduction. In this secondary analysis of a randomized clinical trial that examined the effects of cigarettes varying in nicotine content over a 6-week period in non-treatment-seeking smokers, we used linear regression to examine whether baseline depressive symptom severity (scores on the Center for Epidemiologic Studies Depression Scale [CES-D]) moderated the effects of reduced-nicotine content (RNC) cigarettes, relative to normal-nicotine content (NNC) cigarettes, on smoking rates, depressive symptom severity, and related subjective and physiological measures. Of the 717 participants included in this analysis, 109 (15.2%) had CES-D scores ≥ 16, indicative of possible clinical depression. Relative to NNC cigarettes, RNC cigarettes reduced smoking rates, nicotine dependence, and cigarette craving, and these effects were not significantly moderated by baseline CES-D score. A significant interaction between baseline CES-D score and cigarette condition on week 6 CES-D score was observed (p < .05); among those with CES-D scores ≥ 16 at baseline, those assigned to RNC cigarettes had lower week 6 CES-D scores than those assigned to NNC cigarettes. Among those in the lowest nicotine content conditions, biochemically confirmed compliance with the RNC cigarettes was associated with an increase in CES-D score for those with baseline CES-D scores < 16 and no change in CES-D score for those with baseline CES-D scores ≥ 16. These findings provide initial evidence that a reduced-nicotine standard for cigarettes may reduce smoking, without worsening depressive symptoms, among smokers with elevated depressive symptoms. This secondary analysis of a recent clinical trial examined whether depressive symptom severity moderated the effects of reduced-nicotine cigarettes on smoking and depressive symptoms. Results indicate that, regardless of baseline depressive symptoms, participants randomized to reduced-nicotine cigarettes had lower smoking rates, nicotine intake, nicotine dependence, and craving at week 6 post-randomization than those assigned to normal-nicotine cigarettes. In participants with higher baseline depressive symptoms, those assigned to reduced-nicotine cigarettes had lower week 6 depressive symptoms than those assigned to normal-nicotine cigarettes. These results suggest that a nicotine reduction policy could have beneficial effects for smokers, regardless of depressive symptom severity. © 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.

Work stress and health risk behavior.

PubMed

Siegrist, Johannes; Rödel, Andreas

2006-12-01

This contribution discusses current knowledge of associations between psychosocial stress at work and health risk behavior, in particular cigarette smoking, alcohol consumption and overweight, by reviewing findings from major studies in the field published between 1989 and 2006. Psychosocial stress at work is measured by the demand-control model and the effort-reward imbalance model. Health risk behavior was analyzed in the broader context of a health-related Western lifestyle with socially and economically patterned practices of consumption. Overall, the review, based on 46 studies, only modestly supports the hypothesis of a consistent association between work stress and health risk behavior. The relatively strongest relationships have been found with regard to heavy alcohol consumption among men, overweight, and the co-manifestation of several risks. Suggestions for further research are given, and the need to reduce stressful experience in the framework of worksite health promotion programs is emphasized.

Sports Promotion and Teen Smoking and Drinking: An Exploratory Study.

ERIC Educational Resources Information Center

Bloom, Paul N.; And Others

1997-01-01

Surveys of adolescents examined the link between sports promotion and advertising of alcohol and tobacco and teen smoking and drinking behaviors. Data analysis found an association between exposure to sporting events and cigarette use and beer consumption. Watching stock car racing was related to cigarette use; football and basketball to beer use.…

Comparison of Hypnotherapy with Systematic Relaxation in the Treatment of Cigarette Habituation.

ERIC Educational Resources Information Center

Schubert, Donald K.

1983-01-01

Studied the effectiveness of hypnosis in the treatment of cigarette habituation. Volunteers (N=87) were randomly assigned to hypnosis, relaxation, or waiting list control groups. Hypnosis was found to be superior to relaxation only for subjects high in hypnotic susceptibility. Those who quit smoking increased food consumption. (Author/JAC)

[Knowledge of electronic cigarettes and their perceived harmfulness among the adult population in Barcelona (Spain)].

PubMed

Martínez-Sánchez, José M; Fu, Marcela; Ballbè, Montse; Martín-Sánchez, Juan Carlos; Saltó, Esteve; Fernández, Esteve

2015-01-01

To describe knowledge of electronic cigarettes (e-cigarettes) and their perceived harmfulness in the population of Barcelona in 2013-2014. We used participants from a longitudinal study of a representative sample of the adult population in the city of Barcelona (n=736). The field work was conducted between May 2013 and February 2014. Awareness of e-cigarette was 79.2%. The average level of knowledge was 4.4 points out of 10; there were statistically significant differences according to age, educational level, tobacco consumption, and nicotine dependence. Most participants had learned about e-cigarettes through traditional media (57.8%). Nearly half (47.2%) of the participants believed that e-cigarettes are less harmful than conventional cigarettes. Advertising of e-cigarettes in the media should be regulated because there is still scarce scientific evidence about the usefulness and harmful effects of these devices. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Drug Metabolizing Enzyme and Transporter Gene Variation, Nicotine Metabolism, Prospective Abstinence, and Cigarette Consumption

PubMed Central

Bergen, Andrew W.; Michel, Martha; Nishita, Denise; Krasnow, Ruth; Javitz, Harold S.; Conneely, Karen N.; Lessov-Schlaggar, Christina N.; Hops, Hyman; Zhu, Andy Z. X.; Baurley, James W.; McClure, Jennifer B.; Hall, Sharon M.; Baker, Timothy B.; Conti, David V.; Benowitz, Neal L.; Lerman, Caryn; Tyndale, Rachel F.; Swan, Gary E.

2015-01-01

The Nicotine Metabolite Ratio (NMR, ratio of trans-3’-hydroxycotinine and cotinine), has previously been associated with CYP2A6 activity, response to smoking cessation treatments, and cigarette consumption. We searched for drug metabolizing enzyme and transporter (DMET) gene variation associated with the NMR and prospective abstinence in 2,946 participants of laboratory studies of nicotine metabolism and of clinical trials of smoking cessation therapies. Stage I was a meta-analysis of the association of 507 common single nucleotide polymorphisms (SNPs) at 173 DMET genes with the NMR in 449 participants of two laboratory studies. Nominally significant associations were identified in ten genes after adjustment for intragenic SNPs; CYP2A6 and two CYP2A6 SNPs attained experiment-wide significance adjusted for correlated SNPs (CYP2A6 P ACT=4.1E-7, rs4803381 P ACT=4.5E-5, rs1137115, P ACT=1.2E-3). Stage II was mega-regression analyses of 10 DMET SNPs with pretreatment NMR and prospective abstinence in up to 2,497 participants from eight trials. rs4803381 and rs1137115 SNPs were associated with pretreatment NMR at genome-wide significance. In post-hoc analyses of CYP2A6 SNPs, we observed nominally significant association with: abstinence in one pharmacotherapy arm; cigarette consumption among all trial participants; and lung cancer in four case:control studies. CYP2A6 minor alleles were associated with reduced NMR, CPD, and lung cancer risk. We confirmed the major role that CYP2A6 plays in nicotine metabolism, and made novel findings with respect to genome-wide significance and associations with CPD, abstinence and lung cancer risk. Additional multivariate analyses with patient variables and genetic modeling will improve prediction of nicotine metabolism, disease risk and smoking cessation treatment prognosis. PMID:26132489

Advertising bans as a means of tobacco control policy: a systematic literature review of time-series analyses.

PubMed

Quentin, Wilm; Neubauer, Simone; Leidl, Reiner; König, Hans-Helmut

2007-01-01

This paper reviews the international literature that employed time-series analysis to evaluate the effects of advertising bans on aggregate consumption of cigarettes or tobacco. A systematic search of the literature was conducted. Three groups of studies representing analyses of advertising bans in the U.S.A., in other countries and in 22 OECD countries were defined. The estimated effects of advertising bans and their significance were analysed. 24 studies were identified. They used a wide array of explanatory variables, models, estimating methods and data sources. 18 studies found a negative effect of an advertising ban on aggregate consumption, but only ten of these studies found a significant effect. Two studies using data from 22 OECD countries suggested that partial bans would have little or no influence on aggregate consumption, whereas complete bans would significantly reduce consumption. The results imply that advertising bans have a negative but sometimes only narrow impact on consumption. Complete bans let expect a higher effectiveness. Because of methodological restrictions of analysing advertising bans' effects by time series approaches, also different approaches should be used in the future.

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

PubMed

Gultekin-Karakas, Derya

2015-01-01

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

Quasi-experimental evidence on tobacco tax regressivity.

PubMed

Koch, Steven F

2018-01-01

Tobacco taxes are known to reduce tobacco consumption and to be regressive, such that tobacco control policy may have the perverse effect of further harming the poor. However, if tobacco consumption falls faster amongst the poor than the rich, tobacco control policy can actually be progressive. We take advantage of persistent and committed tobacco control activities in South Africa to examine the household tobacco expenditure burden. For the analysis, we make use of two South African Income and Expenditure Surveys (2005/06 and 2010/11) that span a series of such tax increases and have been matched across the years, yielding 7806 matched pairs of tobacco consuming households and 4909 matched pairs of cigarette consuming households. By matching households across the surveys, we are able to examine both the regressivity of the household tobacco burden, and any change in that regressivity, and since tobacco taxes have been a consistent component of tobacco prices, our results also relate to the regressivity of tobacco taxes. Like previous research into cigarette and tobacco expenditures, we find that the tobacco burden is regressive; thus, so are tobacco taxes. However, we find that over the five-year period considered, the tobacco burden has decreased, and, most importantly, falls less heavily on the poor. Thus, the tobacco burden and the tobacco tax is less regressive in 2010/11 than in 2005/06. Thus, increased tobacco taxes can, in at least some circumstances, reduce the financial burden that tobacco places on households. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effects of father involvement during pregnancy on receipt of prenatal care and maternal smoking.

PubMed

Martin, Laurie T; McNamara, Michelle J; Milot, Alyssa S; Halle, Tamara; Hair, Elizabeth C

2007-11-01

To examine whether women whose partners are involved in their pregnancy are more likely to receive early prenatal care and reduce cigarette consumption over the course of the pregnancy. This study also examines sociodemographic predictors of father involvement during pregnancy. Data on 5,404 women and their partners from the first wave of the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) were used to examine the association between father involvement during pregnancy and maternal behaviors during pregnancy. Multivariate linear and logistic regression analyses were used and data were weighted to account for the complex survey design of the ECLS-B. Women whose partners were involved in their pregnancy were 1.5 times more likely to receive prenatal care in the first trimester and, among those who smoked at conception, to reduce their cigarette consumption 36% more than women whose partners were not involved in the pregnancy (p = .09). Fathers with less than a high school education were significantly less likely to be involved in their partner's pregnancy, while first-time fathers and fathers who reported wanting the pregnancy were significantly more likely to be involved. The positive benefits of father involvement often reported in the literature on child health and development can be extended into the prenatal period. Father involvement is an important, but understudied, predictor of maternal behaviors during the prenatal period, and improving father involvement may have important consequences for the health of his partner, her pregnancy, and their child.

Separate and Combined Effects of Very Low Nicotine Cigarettes and Nicotine Replacement in Smokers with Schizophrenia and Controls

PubMed Central

Rohsenow, Damaris J.; Kaplan, Gary B.; Swift, Robert M.; AhnAllen, Christopher G.

2013-01-01

Introduction: The prevalence of smoking among people with schizophrenia in the United States is about 3 times that of the general population. Novel approaches are needed to reduce rates of smoking-related morbidity and mortality among these smokers. Methods: This study used a within-subjects design to investigate the separate and combined effects of sensorimotor replacement for smoking (very low nicotine content [VLNC] cigarettes vs. no cigarettes) and transdermal nicotine replacement (42 mg nicotine [NIC] vs. placebo [PLA] patches) in smokers with schizophrenia (SS; n = 30) and control smokers without psychiatric illness (CS; n = 26). Each session contained a 5-hr controlled administration period in which participants underwent the following conditions, in counterbalanced order: VLNC + NIC, VLNC + PLA, no cigarettes + NIC, no cigarettes + PLA, usual-brand cigarettes + no patches. Next, participants completed measures of cigarette craving, nicotine withdrawal, smoking habit withdrawal, and cigarette subjective effects, followed by a 90-min period of ad libitum usual-brand smoking. Results: Smoking VLNC cigarettes during the controlled administration periods reduced cigarette craving, nicotine withdrawal symptoms, habit withdrawal symptoms, and usual-brand smoking in SS and CS relative to the no cigarette conditions. VLNC cigarettes were well accepted by both groups and did not affect psychiatric symptom levels in SS. Transdermal nicotine significantly reduced cigarette craving but did not affect usual-brand smoking. Conclusions: These findings suggest that reducing the nicotine content of cigarettes to nonaddictive levels may be a promising approach for reducing nicotine dependence among people with schizophrenia. PMID:22517190

Cigarette Nicotine Content as a Moderator of the Relationship Between Negative Affect and Smoking.

PubMed

Robinson, Jason D; Kypriotakis, George; Karam-Hage, Maher; Green, Charles E; Hatsukami, Dorothy K; Cinciripini, Paul M; Donny, Eric C

2017-09-01

Research suggests a strong association between negative affect (NA) and smoking. However, little is known about the association between NA and smoking among individuals who switch to reduced-nicotine cigarettes. The goal of this study was to examine the extent to which cigarette nicotine content moderates the relationship between NA and smoking over time. Seven hundred and seventeen participants, 237 in the normal nicotine content (NNC; 15.8 mg/g and usual brand) cigarette group and 480 in the very low nicotine content (VLNC; 2.4 mg/g nicotine or less) cigarette group, participated in a randomized trial that examined the effects of cigarette nicotine content on smoking behavior over 6 weeks. We used parallel process latent growth curve modeling to estimate the relationship between changes in NA and changes in the numbers of cigarettes smoked per day (CPD), from baseline to 6 weeks, as a function of cigarette nicotine content. The relationship between NA and investigational CPD reduced over time for those in the VLNC group, but not for those in the NNC group. There was no significant relationship between change in PA and CPD over time for either cigarette group. Smoking VLNC cigarettes disrupts the relationship between smoking and negative affect, which may help reduce nicotine dependence. This study suggests that the association between NA and smoking behavior is reduced over time among those that smoked reduced-nicotine content cigarettes. This provides additional evidence that smoking reduced-nicotine content cigarettes may help reduce nicotine dependence. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

Tobacco branding, plain packaging, pictorial warnings, and symbolic consumption.

PubMed

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

2012-05-01

We use brand association and symbolic consumption theory to explore how plain cigarette packaging would influence the identities young adults cocreate with tobacco products. Group discussions and in-depth interviews with 86 young adult smokers and nonsmokers investigated how participants perceive tobacco branding and plain cigarette packaging with larger health warnings. We examined the transcript data using thematic analysis and explored how removing tobacco branding and replacing this with larger warnings would affect the symbolic status of tobacco brands and their social connotations. Smokers used tobacco brand imagery to define their social attributes and standing, and their connection with specific groups. Plain cigarette packaging usurped this process by undermining aspirational connotations and exposing tobacco products as toxic. Replacing tobacco branding with larger health warnings diminishes the cachet brand insignia creates, weakens the social benefits brands confer on users, and represents a potentially powerful policy measure.

Drug Resistance and Substance Use Among Male and Female Adolescents in Alternative Secondary Schools in Guanajuato, Mexico

PubMed Central

Kulis, Stephen; Marsiglia, Flavio F.; Ayers, Stephanie L.; Booth, Jaime; Nuño-Gutiérrez, Bertha L.

2012-01-01

Objective: Research is limited on the strategies that Mexican adolescents use to resist use of alcohol, cigarettes, and other drugs. Cultural norms and gender socialization patterns concerning the acceptability of use of various substances by women and men influence Mexican youths in their responses to offers of substances. This study explored the drug-resistance strategies used by youth in the central Mexican state of Guanajuato, how their use predicted patterns of substance use, and how these associations differed by gender. Method: The analysis used cross-sectional survey data from 702 (60% male) students enrolled in eight alternative secondary education school sites in 2007. Participants reported the drug-resistance behaviors they used to deal with offers of alcohol, cigarettes, and marijuana. Past-12-month use of the four drug-resistance strategies employed most often by U.S. youth—refuse, explain, avoid, and leave (R.E.A.L.)—and any other strategies were measured. Composite measures of lifetime and recent use of alcohol, cigarettes, and marijuana were predicted in multivariate ordinary least squares regression analyses. Models were tested with and without controls for the frequency that respondents were offered substances and introduced gender interaction effects. Results: Controlling for substance use offers, more frequent use of a wide repertoire of R.E.A.L. strategies predicted less consumption of alcohol and cigarettes, and using non-R.E.A.L. strategies predicted less marijuana consumption. All of these relationships were either stronger for males than for females or significant for males only. Conclusions: Gender differences exist in the impact of R.E.A.L. strategies on substance use among youth in Mexico. Despite a narrowing gender gap in substance use in Mexico, large exposure to and susceptibility of substance use remains. Developing effective prevention programs in Mexico based on teaching appropriate drug-resistance strategies and enhancing communication skills could aid in reducing substance use among Mexican adolescents. PMID:22152668

Tobacco use, occupation, coffee, various nutrients, and bladder cancer.

PubMed

Howe, G R; Burch, J D; Miller, A B; Cook, G M; Esteve, J; Morrison, B; Gordon, P; Chambers, L W; Fodor, G; Winsor, G M

1980-04-01

In a Canadian population-based case-control study of 480 males and 152 female case-control pairs, the relative risk for development of bladder cancer for ever used versus never used cigarettes was 3.9 for males and 2.4 for females, with a dose-response relationship in both sexes. A reduced risk was associated with the use of filter cigarettes compared to nonfilter cigarettes. After control for cigarette usage, a significant risk was noted for male pipe smokers. For male ex-smokers the risk after 15 years of no smoking was less than one-half that of current male smokers. Bladder cancer risk was found for workers in the chemical, rubber, photographic, petroleum, medical, and food processing industries among males and for workers occupationally exposed to dust or fumes among both sexes. Bladder cancer risk was elevated for males consuming all types of coffee, regular coffee, and instant coffee and for females consuming instant coffee, but no dose-response relationship was found. Risk was found for males consuming water from nonpublic supples but not for females. No risk was observed in males or females consuming nitrate-containing foods, beverages other than coffee, or fiddlehead greens. Hair dye usage in females and phenacetin usage in males and females carried no risk. Divergent findings by area for aspirin suggested that an overall association was not causal. Reevaluation of the data on artificial sweeteners confirmed a significant bladder cancer risk in males and a dose-response relationship. The cumulated population attributable risk for bladder cancer was 90% for males from cigarette smoking, industrial exposure, and exposure to nonpublic water supplies and 29% for females from cigarette smoking, industrial exposure, and instant coffee consumption.

The association between tax structure and cigarette price variability: findings from the ITC Project.

PubMed

Shang, Ce; Chaloupka, Frank J; Fong, Geoffrey T; Thompson, Mary; O'Connor, Richard J

2015-07-01

Recent studies have shown that more opportunities exist for tax avoidance when cigarette excise tax structure departs from a uniform specific structure. However, the association between tax structure and cigarette price variability has not been thoroughly studied in the existing literature. To examine how cigarette tax structure is associated with price variability. The variability of self-reported prices is measured using the ratios of differences between higher and lower prices to the median price such as the IQR-to-median ratio. We used survey data taken from the International Tobacco Control Policy Evaluation (ITC) Project in 17 countries to conduct the analysis. Cigarette prices were derived using individual purchase information and aggregated to price variability measures for each surveyed country and wave. The effect of tax structures on price variability was estimated using Generalised Estimating Equations after adjusting for year and country attributes. Our study provides empirical evidence of a relationship between tax structure and cigarette price variability. We find that, compared to the specific uniform tax structure, mixed uniform and tiered (specific, ad valorem or mixed) structures are associated with greater price variability (p≤0.01). Moreover, while a greater share of the specific component in total excise taxes is associated with lower price variability (p≤0.05), a tiered tax structure is associated with greater price variability (p≤0.01). The results suggest that a uniform and specific tax structure is the most effective tax structure for reducing tobacco consumption and prevalence by limiting price variability and decreasing opportunities for tax avoidance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The choice of discount brand cigarettes: a comparative analysis of International Tobacco Control surveys in Canada and the USA (2002-2005).

PubMed

Nargis, Nigar; Fong, Geoffrey T; Chaloupka, Frank J; Li, Qiang

2014-03-01

Increasing tobacco taxes to increase price is a proven tobacco control measure. This article investigates how smokers respond to tax and price increases in their choice of discount brand cigarettes versus premium brands. To estimate how increase in the tax rate can affect smokers' choice of discount brands versus premium brands. Using data from International Tobacco Control surveys in Canada and the USA, a logit model was constructed to estimate the probability of choosing discount brand cigarettes in response to its price changes relative to premium brands, controlling for individual-specific demographic and socioeconomic characteristics and regional effects. The self-reported price of an individual smoker is used in a random-effects regression model to impute price and to construct the price ratio for discount and premium brands for each smoker, which is used in the logit model. An increase in the ratio of price of discount brand cigarettes to the price of premium brands by 0.1 is associated with a decrease in the probability of choosing discount brands by 0.08 in Canada. No significant effect is observed in case of the USA. The results of the model explain two phenomena: (1) the widened price differential between premium and discount brand cigarettes contributed to the increased share of discount brand cigarettes in Canada in contrast to a relatively steady share in the USA during 2002-2005 and (2) increasing the price ratio of discount brands to premium brands-which occurs with an increase in specific excise tax-may lead to upward shifting from discount to premium brands rather than to downward shifting. These results underscore the significance of studying the effectiveness of tax increases in reducing overall tobacco consumption, particularly for specific excise taxes.

Behavioral economic substitution between conventional cigarettes and e-cigarettes differs as a function of the frequency of e-cigarette use.

PubMed

Snider, Sarah E; Cummings, K Michael; Bickel, Warren K

2017-08-01

Models measuring the interactions between consumption of conventional cigarettes and electronic cigarettes (e-cigarettes) in the marketplace are becoming vital forecast tools as the popularity of e-cigarettes increases and policy on tobacco products changes. Behavioral economics, which involves the integration of psychology and consumer demand, can be used to measure individuals' purchase behavior under different marketplace conditions. Our goal was to measure hypothetical conventional cigarette and e-cigarette purchasing among smokers with varying e-cigarette use patterns. Daily cigarette smokers were recruited using Amazon Mechanical Turk, an online crowdsourcing tool. Participants were asked about their frequency of e-cigarette use and to complete hypothetical single and cross-commodity purchase tasks. Frequency of e-cigarette use differentially affected how individuals consumed both conventional and e- cigarettes in different hypothetical marketplace conditions. The present study demonstrates four main findings: 1) the demand for conventional cigarettes was the lowest in those with greater frequency of e-cigarette use, 2) the demand for e-cigarettes was the highest in those with greater frequency of e-cigarette use, 3) when both products were available together, daily e-cigarette users purchased more e-cigarettes, but e-cigarettes served as a substitute for cigarettes in all groups regardless of frequency of use, and 4) the demand for conventional cigarette demand was lower in frequent e-cigarette users when e-cigarettes were concurrently available. Together, these data suggest that price and marketplace conditions will impact purchasing behavior of conventional and e-cigarettes users heterogeneously. Therefore, frequency of use patterns should be considered when implementing novel policies and/or marketplace changes. Copyright © 2017 Elsevier B.V. All rights reserved.

Advertising, price, income and publicity effects on weekly cigarette sales in New Zealand supermarkets.

PubMed

Laugesen, M; Meads, C

1991-01-01

Total cigarettes (all brands) sold weekly by a panel of 60 New Zealand supermarkets were monitored electronically for 42 weeks, a period when cigarette advertisements were in plain format with strong, varied disease warnings. Real cigarette price, newspaper advertising of old, regular and upmarket brands, and the number of newspaper news items on smoking issues were inversely associated with cigarette sales. Tending to increase total sales (all brands) were: more non-shopping days in the current week, and in the week following; volume of grocery items purchased, to indicate income and store traffic; and real advertising expenditure in newspapers for new downmarket cigarette brands, particularly one heavily-advertised brand (Peter Jackson) which was in late 1989 smoked by 4% of teenage smokers. All factors when interacting, explained 93% of changes in weekly cigarette sales. Most of the change occurred in the same week, and was 90% in place after a further 3 weeks. Newspapers, by doubling news coverage of smoking issues or by banning cigarette advertisements, can lower cigarette consumption as much as can a 10% price increase.

Randomized Trial of Reduced-Nicotine Standards for Cigarettes.

PubMed

Donny, Eric C; Denlinger, Rachel L; Tidey, Jennifer W; Koopmeiners, Joseph S; Benowitz, Neal L; Vandrey, Ryan G; al'Absi, Mustafa; Carmella, Steven G; Cinciripini, Paul M; Dermody, Sarah S; Drobes, David J; Hecht, Stephen S; Jensen, Joni; Lane, Tonya; Le, Chap T; McClernon, F Joseph; Montoya, Ivan D; Murphy, Sharon E; Robinson, Jason D; Stitzer, Maxine L; Strasser, Andrew A; Tindle, Hilary; Hatsukami, Dorothy K

2015-10-01

The Food and Drug Administration can set standards that reduce the nicotine content of cigarettes. We conducted a double-blind, parallel, randomized clinical trial between June 2013 and July 2014 at 10 sites. Eligibility criteria included an age of 18 years or older, smoking of five or more cigarettes per day, and no current interest in quitting smoking. Participants were randomly assigned to smoke for 6 weeks either their usual brand of cigarettes or one of six types of investigational cigarettes, provided free. The investigational cigarettes had nicotine content ranging from 15.8 mg per gram of tobacco (typical of commercial brands) to 0.4 mg per gram. The primary outcome was the number of cigarettes smoked per day during week 6. A total of 840 participants underwent randomization, and 780 completed the 6-week study. During week 6, the average number of cigarettes smoked per day was lower for participants randomly assigned to cigarettes containing 2.4, 1.3, or 0.4 mg of nicotine per gram of tobacco (16.5, 16.3, and 14.9 cigarettes, respectively) than for participants randomly assigned to their usual brand or to cigarettes containing 15.8 mg per gram (22.2 and 21.3 cigarettes, respectively; P<0.001). Participants assigned to cigarettes with 5.2 mg per gram smoked an average of 20.8 cigarettes per day, which did not differ significantly from the average number among those who smoked control cigarettes. Cigarettes with lower nicotine content, as compared with control cigarettes, reduced exposure to and dependence on nicotine, as well as craving during abstinence from smoking, without significantly increasing the expired carbon monoxide level or total puff volume, suggesting minimal compensation. Adverse events were generally mild and similar among groups. In this 6-week study, reduced-nicotine cigarettes versus standard-nicotine cigarettes reduced nicotine exposure and dependence and the number of cigarettes smoked. (Funded by the National Institute on Drug Abuse and the Food and Drug Administration Center for Tobacco Products; ClinicalTrials.gov number, NCT01681875.).

Association between Parkinson’s Disease and Cigarette Smoking, Rural Living, Well-Water Consumption, Farming and Pesticide Use: Systematic Review and Meta-Analysis

PubMed Central

Breckenridge, Charles B.; Berry, Colin; Chang, Ellen T.; Sielken, Robert L.; Mandel, Jack S.

2016-01-01

Objective Bradford Hill’s viewpoints were used to conduct a weight-of-the-evidence assessment of the association between Parkinson’s disease (PD) and rural living, farming and pesticide use. The results were compared with an assessment based upon meta-analysis. For comparison, we also evaluated the association between PD and cigarette smoking as a “positive control” because a strong inverse association has been described consistently in the literature. Methods PubMed was searched systematically to identify all published epidemiological studies that evaluated associations between Parkinson’s disease (PD) and cigarette smoking, rural living, well-water consumption, farming and the use of pesticides, herbicides, insecticides, fungicides or paraquat. Studies were categorized into two study quality groups (Tier 1 or Tier 2); data were abstracted and a forest plot of relative risks (RRs) was developed for each risk factor. In addition, when available, RRs were tabulated for more highly exposed individuals compared with the unexposed. Summary RRs for each risk factor were calculated by meta-analysis of Tier 1, Tier 2 and all studies combined, with sensitivity analyses stratified by other study characteristics. Indices of between-study heterogeneity and evidence of reporting bias were assessed. Bradford Hill’s viewpoints were used to determine if a causal relationship between PD and each risk factor was supported by the weight of the evidence. Findings There was a consistent inverse (negative) association between current cigarette smoking and PD risk. In contrast, associations between PD and rural living, well-water consumption, farming and the use of pesticides, herbicides, insecticides, fungicides or paraquat were less consistent when assessed quantitatively or qualitatively. Conclusion The weight of the evidence and meta-analysis support the conclusion that there is a causal relationship between PD risk and cigarette smoking, or some unknown factor correlated with cigarette smoking. There may be risk factors associated with rural living, farming, pesticide use or well-water consumption that are causally related to PD, but the studies to date have not identified such factors. To overcome the limitations of research in this area, future studies will have to better characterize the onset of PD and its relationship to rural living, farming and exposure to pesticides. PMID:27055126

Associations of cigarette smoking, betel quid chewing and alcohol consumption with high-sensitivity C-reactive protein in early radiographic knee osteoarthritis: a cross-sectional study.

PubMed

Zhang, Yi; Zeng, Chao; Wei, Jie; Li, Hui; Yang, Tuo; Yang, Ye; Deng, Zhen-han; Ding, Xiang; Lei, Guanghua

2016-03-11

High-sensitivity C-reactive protein (hsCRP) is possibly related to osteoarthritis (OA) progression and a variety of OA-related symptoms. This study aimed to examine associations between cigarette smoking, betel quid chewing and alcohol consumption and hsCRP in early radiographic knee OA. Cross-sectional health examination survey. This primary study was conducted in a health examination centre in China. 936 (656 men and 280 women) patients with early radiographic knee OA were included in this cross-sectional study. Smoking status was classified into four levels based on daily smoking habit: 0/day, 1-10/day, 11-20/day and >20/day. Betel quid chewing and alcohol consumption status was divided into 'Yes' or 'No'. Early radiographic knee OA was defined as Kellgren Lawrence (K-L) grade 1 or 2 in at least one leg, and elevated hsCRP was assessed as ≥ 3.0 mg/L. After adjustment for a number of potential confounding factors, a significant positive association between cigarette smoking and hsCRP was observed in the multivariable model. The multivariable-adjusted ORs (95% CI) of elevated hsCRP (≥ 3.0 mg/L) in the second (1-10/day, n=133), third (11-20/day, n=59) and highest (>20/day, n=104) cigarette smoking categories were 1.54 (95% CI 0.91 to 2.61), 1.27 (95% CI 0.57 to 2.79) and 2.09 (95% CI 1.20 to 3.64), respectively, compared with the non-smoker category (n=640). In addition, there was a positive dose-response relationship between cigarette smoking and elevated hsCRP (p for trend=0.01). No significant associations between betel quid chewing and alcohol consumption and hsCRP were observed in the multivariable model. This study indicated that cigarette smoking was positively associated with serum hsCRP level in patients with early radiographic knee OA. However, in view of the nature of cross-sectional designs, the results need to be confirmed by further prospective studies. 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/

[Impact of the Tobacco Law on the workplace: a follow up study of a cohort of workers in Spain 2005-2007].

PubMed

Bauzà-Amengual, M de Lluc; Blasco-González, Manuel; Sánchez-Vazquez, Elena; Pereiró-Berenguer, Inmaculada; Ruiz-Varea, Nidia; Pericás-Beltran, Jordi

2010-06-01

The aim of this study is to describe the changes caused by the Law on Tobacco and its consumption in workers who are active smokers. A post-intervention follow up study of a cohort of users. Health Centres in Valencia and Majorca. Users who attended health centres. The field work consisted of each patient filling in a case report form with the requested information. The variables collected were, sex, place of work, education level, number of workers in the company, number of cigarettes smoked. They were told that on the following day they had to count the cigarettes smoked throughout the day, noting whether they had been smoked during or outside working hours. If they smoked during working hours, they reported whether it was inside or outside the workplace. On the following day they were telephoned to let us know the number of cigarettes smoked. This telephone call was repeated at six months and eighteen months. Smoking prevalence and the number of cigarettes smoked in the workplace has been reduced by 9% per month. The variables associated with compliance with the law were education level, the sex of the worker, and the size of the company. The coming into force of the Tobacco Law has been effective. Copyright 2009 Elsevier España, S.L. All rights reserved.

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

PubMed

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

2014-03-01

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

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

PubMed Central

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

2014-01-01

Background Recent tax increases in Mexico differed in structure and provide an opportunity to better understand tobacco industry pricing strategies, as well as smokers’ responses to any resulting price changes. Objectives To assess if taxes were passed onto consumers of different cigarette brands, the extent of brand switching, and predictors of preference for cheaper national brands. Methods Using data from three waves of the Mexican administration of the ITC Survey, we analyzed self-reported brand and price paid at last cigarette purchase. Generalized estimating equations were used to determine predictors of price and preference for national brands. Results The average price of premium/international brands increased each year from 2008–2011; however, the price for discount/national brands increased only from 2010 to 2011. The percentage of smokers who smoked national brands remained stable between 2008 and 2010 but dropped in 2011. Factors related to smoking national as opposed to international brands included being male and having relatively older age, lower education, lower income, and higher consumption. Conclusions Tobacco industry pricing strategies in the wake of ad valorem taxes implemented in Mexico prior to 2011 had the impact of segmenting the market into discount national brands and premium international brands. The specific tax increase implemented in 2011 reduced the price gap between these two segments, by raising the price of the national brands relative to the international brands. Evidence for trading up was found after the 2011 tax increase. These results provide further evidence for the relevance of tax policy as a tobacco control strategy; in particular, they illustrate the importance of how specific rather than ad valorem taxes can reduce the potential for downward brand switching in the face of decreasing cigarette affordability. PMID:24114563

Recruiting women smokers: the engineering of consent.

PubMed

Brandt, A M

1996-01-01

A range of social forces contributed to the effective recruitment of women to cigarette smoking in the crucial period between 1900 and 1940. Cigarette advertisers and public relations experts recognized the significance of women's changing roles and the rising culture of consumption, and worked to create specific meanings for the cigarette to make it appeal to women. The cigarette was a flexible symbol, with a remarkably elastic set of meanings; for women, it represented rebellious independence, glamour, seduction, and sexual allure, and served as a symbol for both feminists and flappers. The industry, with the help of advertisers and public relations experts, effectively engineered consent for women as smokers. The "engineering of consent" has a role to play in smoking cessation, since negative meanings for the cigarette can be engineered as well.

Smoking Topography Characteristics of Very Low Nicotine Content Cigarettes, With and Without Nicotine Replacement, in Smokers With Schizophrenia and Controls

PubMed Central

Cassidy, Rachel N.; Miller, Mollie E.

2016-01-01

Introduction: Reducing the nicotine content of cigarettes to a minimally addictive level has been proposed as a regulatory strategy for reducing tobacco dependence. However, smokers with schizophrenia (SS) may be prone to changing their smoking topography in efforts to compensate for the reduction in nicotine content. The aims of this study were to compare smoking topography characteristics of usual-brand and very low nicotine content (VLNC) cigarettes in SS and control smokers without psychiatric illness (CS), and to determine whether nicotine replacement reversed any changes in topography produced by VLNC cigarettes. Methods: Using a within-subjects, counter-balanced design, SS (n = 27) and CS (n = 23) smoked usual brand cigarettes, VLNC cigarettes while wearing placebo patches (VLNC + PLA), or VLNC cigarettes while wearing transdermal nicotine patches totaling 42mg (VLNC + NIC) during 5-hour ad libitum smoking sessions. Cigarettes were smoked through topography measurement devices. Results: Across conditions, SS smoked more puffs per session and per cigarette, had higher cigarette volumes, and had shorter inter-puff intervals than CS (Ps < .01). During VLNC cigarette sessions, puff duration increased and time between puffs decreased, but participants smoked fewer puffs, resulting in a net decrease in cigarette and total session volume (Ps < .001). There were no significant interactions between group and condition. Conclusions: These findings indicate that acute use of VLNC cigarettes does not increase intensity of smoking in SS, and support the feasibility of a nicotine reduction policy. Implications: Reducing the nicotine in cigarettes to a minimally addictive level has been proposed as a means of reducing tobacco dependence. However, smokers, particularly those with schizophrenia (SS) may alter their puffing in an attempt to extract more nicotine from VLNC cigarettes. This study compared smoking topography of usual brand versus VLNC cigarettes, combined with placebo or transdermal nicotine patches, in SS and controls. Although some changes in topography were indicative of compensatory smoking, total puffs and total cigarette volume were reduced with VLNC cigarettes, indicating that acute VLNC cigarette use does not increase smoking in SS. PMID:26995794

Have combustible cigarettes met their match? The nicotine delivery profiles and harmful constituent exposures of second-generation and third-generation electronic cigarette users

PubMed Central

Wagener, Theodore L; Floyd, Evan L; Stepanov, Irina; Driskill, Leslie M; Frank, Summer G; Meier, Ellen; Leavens, Eleanor L; Tackett, Alayna P; Molina, Neil; Queimado, Lurdes

2017-01-01

Introduction Electronic cigarettes’ (e-cigarettes) viability as a public health strategy to end smoking will likely be determined by their ability to mimic the pharmacokinetic profile of a cigarette while also exposing users to significantly lower levels of harmful/potentially harmful constituents (HPHCs). The present study examined the nicotine delivery profile of third- (G3) versus second-generation (G2) e-cigarette devices and their users’ exposure to nicotine and select HPHCs compared with cigarette smokers. Methods 30 participants (10 smokers, 9 G2 and 11 G3 users) completed baseline questionnaires and provided exhaled carbon monoxide (eCO), saliva and urine samples. Following a 12-hour nicotine abstinence, G2 and G3 users completed a 2-hour vaping session (ie, 5 min, 10-puff bout followed by ad libitum puffing for 115 min). Blood samples, subjective effects, device characteristics and e-liquid consumption were assessed. Results Smokers, G2 and G3 users had similar baseline levels of cotinine, but smokers had 4 and 7 times higher levels of eCO (p<0.0001) and total 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol (i.e., NNAL, p<0.01), respectively, than G2 or G3 users. Compared with G2s, G3 devices delivered significantly higher power to the atomiser, but G3 users vaped e-cigarette liquids with significantly lower nicotine concentrations. During the vaping session, G3 users achieved significantly higher plasma nicotine concentrations than G2 users following the first 10 puffs (17.5 vs 7.3 ng/mL, respectively) and at 25 and 40 min of ad libitum use. G3 users consumed significantly more e-liquid than G2 users. Vaping urges/withdrawal were reduced following 10 puffs, with no significant differences between device groups. Discussion Under normal use conditions, both G2 and G3 devices deliver cigarette-like amounts of nicotine, but G3 devices matched the amount and speed of nicotine delivery of a conventional cigarette. Compared with cigarettes, G2 and G3 e-cigarettes resulted in significantly lower levels of exposure to a potent lung carcinogen and cardiovascular toxicant. These findings have significant implications for understanding the addiction potential of these devices and their viability/suitability as aids to smoking cessation. PMID:27729564

Use of E-Cigarettes Among Current Smokers: Associations Among Reasons for Use, Quit Intentions, and Current Tobacco Use

PubMed Central

Blake, Kelly D.; Agunwamba, Amenah A.; Grana, Rachel A.; Wilson, Patrick M.; Ebbert, Jon O.; Okamoto, Janet; Leischow, Scott J.

2015-01-01

Introduction: Research has documented growing availability and use of e-cigarettes in the United States over the last decade. Methods: We conducted a national panel survey of current adult cigarette smokers to assess attitudes, beliefs, and behaviors relating to e-cigarette use in the United States (N = 2,254). Results: Among current cigarette smokers, 20.4% reported current use of e-cigarettes on some days and 3.7% reported daily use. Reported reasons for e-cigarette use included: quit smoking (58.4%), reduce smoking (57.9%), and reduce health risks (51.9%). No significant differences in sociodemographic characteristics between e-cigarette users and nonusers were observed. Prior quit attempts were reported more frequently among e-cigarette users (82.8%) than nonusers (74.0%). Intention to quit was reported more frequently among e-cigarette users (64.7%) than nonusers (46.8%). Smokers intending to quit were more likely to be e-cigarette users than those not intending to quit (odds ratio [OR] = 1.90, CI =1.36–2.65). Those who used e-cigarettes to try to quit smoking (OR = 2.25, CI = 1.25–4.05), reduce stress (OR = 3.66, CI = 1.11–12.09), or because they cost less (OR = 3.42, CI = 1.64–7.13) were more likely to report decreases in cigarette smoking than those who did not indicate these reasons. Smokers who reported using e-cigarettes to quit smoking (OR = 16.25, CI = 8.32–31.74) or reduce stress (OR = 4.30, CI = 1.32–14.09) were significantly more likely to report an intention to quit than those who did not indicate those reasons for using e-cigarettes. Conclusions: Nearly a quarter of smokers in our study reported e-cigarettes use, primarily motivated by intentions to quit or reduce smoking. These findings identify a clinical and public health opportunity to re-engage smokers in cessation efforts. PMID:25589678

Smoking ban policies in Italy and the potential impact of the so-called Sirchia Law: state of the art after eight years.

PubMed

Gualano, Maria Rosaria; Bert, Fabrizio; Scaioli, Giacomo; Passi, Stefano; La Torre, Giuseppe; Siliquini, Roberta

2014-01-01

The aim of the present work is to describe the state of the art of tobacco habits in Italy, eight years after the law was introduced. Time series analyses, based on estimates of smoking prevalence/consumption derived from the openly available data of national surveys performed during the 2001-2013 period, were performed. Data have been expressed in percentage of smokers and daily cigarettes consumption. Time changes are expressed as expected annual percentage change (EAPC). Over time, the percentage of Italian smokers shows a constant and statistically significant decrease (from 28.9% in 2001 to 20.6% in 2013, EAPC = -2.6%, and P < 0.001). Regarding data stratified by gender, we found a stronger reduction among men (EAPC = -2.9%, P < 0.001) than in women (EAPC = -2.5%, P < 0.001). Similarly, the consumption of tobacco smoking, measured as the number of daily cigarettes smoked, registered a downward trend (P < 0.001). No join point (time point when a significant trend change is detected) resulted from the trend analysis. Data show a constant decrease of tobacco consumption in Italy, with no join point related to the introduction of the banning law. These findings require to reflect on the priorities of the smoking banning policies that may be focused on other intervention activities such as to increase the price of cigarettes.

Relationship between the rs1414334 C/G polymorphism in the HTR2C gene and smoking in patients treated with atypical antipsychotics.

PubMed

Rico-Gomis, José María; Palazón-Bru, Antonio; Triano-García, Irene; Mahecha-García, Luis Fabián; García-Monsalve, Ana; Navarro-Ruiz, Andrés; Villagordo-Peñalver, Berta; Martínez-Hortelano, Alicia; Gil-Guillén, Vicente Francisco

2018-04-15

An association has been found between the C allele of the rs1414334 polymorphism in the HTR2C gene and the metabolic syndrome in psychiatric patients. However, no study has yet evaluated whether this allele is associated with smoking. To assess this issue, therefore, we performed a cross-sectional study with a sample of 166 adult patients treated with atypical antipsychotics in 2012-2013 in a region of Spain. The primary variable was the presence of the C allele of the rs1414334 polymorphism in the HTR2C gene. Secondary variables were the number of pack-years (number of cigarettes per day x number of smoking years ÷ 20), age, gender, schizophrenia, years since diagnosis, metabolic syndrome criteria and SCORE. A stepwise binary logistic regression model was constructed to determine associations between primary and secondary variables and their area under the ROC curve (AUC) was calculated. Of the total sample, 33 patients (19.9%) had the C allele of the polymorphism analyzed. Mean cigarette consumption was 11.6 pack-years. The multivariate analysis showed the following factors as associated with the polymorphism: higher cigarette consumption, being a woman, and not having abdominal obesity. The AUC was 0.706. An association was found between increased cigarette consumption over the years and the presence of the C allele of the rs1414334 polymorphism in the HTR2C gene.

The effect of the market opening on trends in smoking rates in Taiwan.

PubMed

Hsu, Chih Cheng; Levy, David Theodore; Wen, Chi Pang; Cheng, Ting Yuan; Tsai, Shan Pou; Chen, Ted; Eriksen, Michael P; Shu, Chen Chun

2005-09-28

To examine smoking rates before and after the opening of the market to foreign imports. Consumer surveys of Monopoly Bureau, National Health Interview Survey and official tobacco consumption, production and import data were used to calculate smoking rates, cigarette consumption, and the market share of imports. Age-adjusted smoking rates were used to compare trends before and after the market opening. The market share of the imports reached half in 2001 from 2% before opening. Compared to projected rates, smoking rates in 2001 for all and younger males, and all and younger females were increased by 12, 6, 202, and 249%, respectively, over and above the projected trends. The ratio of smoking rates between younger and older adults became larger, from 0.62 to 0.74 in males and from 0.32 to 0.98 in females. Per capita consumption increased after the market opening, particularly when large increases in smuggled cigarettes were considered. The finding that the market opening triggered an increase in smoking rates is contrary to the assertion by U.S. cigarette producers that importation would only make smokers switch brands. Younger adults and females were more affected, reflecting their higher sensitivity to the appeal from foreign cigarettes. Because of the marketing strategy of imports, more young people smoked, at an earlier age. Experience from Taiwan revealed that after the initial increase in smoking rates, the opening had galvanized the anti-smoking sentiments, legitimized and strengthened tobacco control policies and tempered the severity of the adverse impact.

Cardiac Development in Zebrafish and Human Embryonic Stem Cells Is Inhibited by Exposure to Tobacco Cigarettes and E-Cigarettes

PubMed Central

Palpant, Nathan J.; Hofsteen, Peter; Pabon, Lil; Reinecke, Hans; Murry, Charles E.

2015-01-01

Background Maternal smoking is a risk factor for low birth weight and other adverse developmental outcomes. Objective We sought to determine the impact of standard tobacco cigarettes and e-cigarettes on heart development in vitro and in vivo. Methods Zebrafish (Danio rerio) were used to assess developmental effects in vivo and cardiac differentiation of human embryonic stem cells (hESCs) was used as a model for in vitro cardiac development. Results In zebrafish, exposure to both types of cigarettes results in broad, dose-dependent developmental defects coupled with severe heart malformation, pericardial edema and reduced heart function. Tobacco cigarettes are more toxic than e-cigarettes at comparable nicotine concentrations. During cardiac differentiation of hESCs, tobacco smoke exposure results in a delayed transition through mesoderm. Both types of cigarettes decrease expression of cardiac transcription factors in cardiac progenitor cells, suggesting a persistent delay in differentiation. In definitive human cardiomyocytes, both e-cigarette- and tobacco cigarette-treated samples showed reduced expression of sarcomeric genes such as MLC2v and MYL6. Furthermore, tobacco cigarette-treated samples had delayed onset of beating and showed low levels and aberrant localization of N-cadherin, reduced myofilament content with significantly reduced sarcomere length, and increased expression of the immature cardiac marker smooth muscle alpha-actin. Conclusion These data indicate a negative effect of both tobacco cigarettes and e-cigarettes on heart development in vitro and in vivo. Tobacco cigarettes are more toxic than E-cigarettes and exhibit a broader spectrum of cardiac developmental defects. PMID:25978043

Cessation and reduction in smoking behavior: impact of creating a smoke-free home on smokers.

PubMed

Haardörfer, R; Kreuter, M; Berg, C J; Escoffery, C; Bundy, L T; Hovell, M; Mullen, P D; Williams, R; Kegler, M C

2018-06-01

The aim of this study was to assess the effect of a creating a smoke-free home (SFH) on cessation and reduction of cigarette smoking on low-income smokers. This secondary data analysis uses data from study participants who were originally recruited through 2-1-1 information and referral call centers in Atlanta (Georgia, 2013), North Carolina (2014) and the Texas Gulf Coast (2015) across three randomized controlled trials testing an intervention aimed at creating SFHs, pooling data from 941 smokers. Participants who reported adopting a SFH were more likely to report quitting smoking than those who did not adopt a SFH. This was true at 3-month follow-up and even more pronounced at 6-month follow-up and persisted when considering only those who consistently reported no smoking at 3 and 6 months. Among those who did not stop smoking, the number of cigarettes per day declined significantly more and quit attempts were more frequent for those who created a SFH compared with those who did not. Findings suggest that creating a SFH facilitates cessation, reduces cigarette consumption and increases quit attempts. Future studies should assess the long-term impact of SFHs on sustaining cessation.

Knowledge Gaps of the Health Benefits of Beans among Low-Income Women.

PubMed

Palmer, Shelly M; Winham, Donna M; Hradek, Christine

2018-01-01

We determined knowledge of the health benefits of consuming beans, and assessed if awareness varied by acculturation status among Hispanic and non-Hispanic low-income women. We used a self-administered survey with Iowa women aged 18-65 years who were eligible to receive income-based services through 2 healthcare clinics, a WIC clinic, and Extension Outreach. Chi-square and ANOVA were used to compare bean health benefit knowledge, demographics, health-risk factors, nutrition information seeking, and self-efficacy by acculturation categories. Of the 158 women who completed the survey, 58% were Hispanic, with a mean age of 36 years. In terms of acculturation, 24% were Hispanic-dominant, 30% bicultural, and 46% English dominant. Over 50% of all respondents did not know bean consumption lowered cholesterol, aided blood glucose control, or reduced some cancer risks. Responses for 5 of 7 knowledge statements differed significantly by acculturation. Hispanic-dominant and bicultural women reported significantly better health, higher bean consumption, and less cigarette smoking than English-dominant women. Bicultural and English-dominant women were more likely to use the Internet for nutrition information. There are knowledge gaps about the health benefits of bean consumption among low-income women. Nutrition education to improve their knowledge may lead to increased bean consumption, reducing health disparities and improving nutrition.

An evaluation of fruit and vegetable consumption and cigarette smoking among youth.

PubMed

Haibach, Jeffrey P; Homish, Gregory G; Collins, R Lorraine; Ambrosone, Christine B; Giovino, Gary A

2015-06-01

Research across the past 4 decades has supported a cross-sectional association between adult cigarette smoking and lower fruit and vegetable consumption (FVC), and emerging research suggests higher FVC may predict cessation. Among youth, findings are limited to a few cross-sectional studies with somewhat mixed results. Here we evaluated the FVC-smoking association among youth both cross-sectionally and longitudinally. We analyzed data from a subsample of the National Longitudinal Survey of Youth 1979: Child and Young Adult. The subsample included adolescents aged 14-18 years at baseline in the year 2004. Multivariable cross-sectional analyses assessed whether baseline FVC was associated with smoking frequency among ever-smokers (n = 578). Longitudinally, the study assessed whether baseline FVC predicted smoking progression among baseline never-smokers who tried a cigarette by 4-year follow-up (n = 388). Multivariable regression models adjusted for age, gender, race/ethnicity, parental education, and health behavior orientation. Cross-sectionally, youth who consumed fruit ≥2 times per day were 53% less likely (RR = 0.47; p < .05) than those who typically did not consume fruit to be in a higher smoking frequency category. Longitudinally, the fruit consumption and smoking association was not significant (RR = 0.61; p = .282). There were no significant associations observed between vegetable consumption and smoking. Fruit consumption, but not vegetable consumption, was inversely associated with smoking frequency cross-sectionally but not longitudinally. Further research is needed to provide information on the consistency of the FVC-smoking relationship among youth and may help to elucidate possible explanatory mechanisms. © 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.

Personal Network Correlates of Alcohol, Cigarette, and Marijuana Use Among Homeless Youth

PubMed Central

Wenzel, Suzanne L.; Tucker, Joan S.; Golinelli, Daniela; Green, Harold D.; Zhou, Annie

2013-01-01

Background Youth who are homeless and on their own are among the most marginalized individuals in the United States and face multiple risks, including use of substances. This study investigates how the use of alcohol, cigarettes, and marijuana among homeless youth may be influenced by characteristics of their social networks. Methods Homeless youth aged 13–24 were randomly sampled from 41 service and street sites in Los Angeles County (N = 419). Predictors of substance use were examined using linear regression analysis (for average number of drinks and average number of cigarettes per day) and negative binomal regression analysis (for frequency of past month marijuana use). Results Youth with more substance users in their networks reported greater alcohol, cigarette, and marijuana consumption regardless of whether these network members provided tangible or emotional support. Marijuana use was more frequent for youth who met more network members through homeless settings, but less frequent among those who met more network members through treatment or AA/NA. Greater alcohol use occurred among youth who met more network members through substance use-related activities. Youth having more adults in positions of responsibility in their networks consumed less alcohol, and those with more school attendees in their networks consumed less alcohol and cigarettes. Conclusions Findings highlight the importance of social context in understanding substance use among homeless youth. Results also support the relevance of network-based interventions to change social context for substance using youth, in terms of both enhancing pro-social influences and reducing exposure to substance use. PMID:20656423

Personal network correlates of alcohol, cigarette, and marijuana use among homeless youth.

PubMed

Wenzel, Suzanne L; Tucker, Joan S; Golinelli, Daniela; Green, Harold D; Zhou, Annie

2010-11-01

Youth who are homeless and on their own are among the most marginalized individuals in the United States and face multiple risks, including use of substances. This study investigates how the use of alcohol, cigarettes, and marijuana among homeless youth may be influenced by characteristics of their social networks. Homeless youth aged 13-24 were randomly sampled from 41 service and street sites in Los Angeles County (N=419). Predictors of substance use were examined using linear regression analysis (for average number of drinks and average number of cigarettes per day) and negative binomial regression analysis (for frequency of past month marijuana use). Youth with more substance users in their networks reported greater alcohol, cigarette, and marijuana consumption regardless of whether these network members provided tangible or emotional support. Marijuana use was more frequent for youth who met more network members through homeless settings, but less frequent among those who met more network members through treatment or AA/NA. Greater alcohol use occurred among youth who met more network members through substance use-related activities. Youth having more adults in positions of responsibility in their networks consumed less alcohol, and those with more school attendees in their networks consumed less alcohol and cigarettes. Findings highlight the importance of social context in understanding substance use among homeless youth. Results also support the relevance of network-based interventions to change social context for substance-using youth, in terms of both enhancing pro-social influences and reducing exposure to substance use. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Taxes, Cigarette Consumption, and Smoking Intensity.

PubMed

Adda, Jérôme; Cornaglia, Francesca

2006-09-01

This paper analyses the compensatory behavior of smokers. Exploiting data on cotinine concentration--a metabolite of nicotine--measured in a large population of smokers over time, we show that smokers compensate for tax hikes by extracting more nicotine per cigarette. Our study makes two important contributions. First, as smoking a given cigarette more intensively is detrimental to health, our results question the usefulness of tax increases. Second, we develop a model of rational addiction where agents can also adjust their intensity of smoking, and we show that the previous empirical results suffer from estimation biases.

Tobacco sales to minors in Italy.

PubMed

Gallus, Silvano; Tramacere, Irene; Zuccaro, Piergiorgio; Colombo, Paolo; La Vecchia, Carlo

2009-01-01

One of the strategies to control tobacco is to limit purchase of cigarettes to minors. To understand the attitudes of Italian adults towards regulations to prevent minors from purchasing tobacco products, we added specific questions to the annual survey on smoking in Italy. During March-April 2007, we conducted a survey on smoking on 3,057 subjects representative of the Italian population aged > or = 15 years. Two specific questions were included, one investigating the attitudes towards the proposed legislation prohibiting purchase of tobacco to individuals under 18 years of age (instead of 16 years) as a policy to reduce smoking prevalence and consumption. The second question asked whether the current tobacco sales-to-minors law was observed. Overall, 78% of Italians believed that a restriction of the current tobacco sales-to-minors law could be moderately to extremely effective as a strategy to decrease smoking prevalence and consumption. More than 90% of Italians reported that they had never seen in their lifetime a retailer refusing to sell cigarettes to an adolescent or requesting the minor's identification or age. A restriction of the legislation, increasing to 18 years the minimum age for purchasing tobacco, would limit access to tobacco products by minors, only if adopted together with systematic and effective enforcement measures.

[Tobacco and advertising. Systematic review of the articles published between 2000 and 2008].

PubMed

March Cerdá, Joan Carles; Suess, Astrid; Danet, Alina; Prieto Rodríguez, María Angeles; Romero Vallecillos, Manuel

2010-04-01

To evaluate the influence of tobacco advertising on consumer habits. Systematic review. PubMed, Ovid, Scielo, Mediclatina, Elsevier-Doyma, Isooc (CSIC) (January 2000-September 2008) A total of 44 national and international articles, linking the consumption of tobacco with any promotional or advertising practice. Articles not focused on the impact of advertising and promotion of cigarettes and research on prevention, intervention, plans and laws were removed. Advertising influences tobacco consumption. Publicity leads to starting smoking (5 articles) and maintaining the habit (3 articles). It uses the relationship between advertising and smoker's image and concept (5 articles) and different advertising strategies (22 articles). The advertising developed by the tobacco industry uses different strategies of influence on the consumption of cigarettes in the population. Copyright 2009 Elsevier España, S.L. All rights reserved.

The distribution of cigarette prices under different tax structures: findings from the International Tobacco Control Policy Evaluation (ITC) Project

PubMed Central

Shang, Ce; Chaloupka, Frank J; Zahra, Nahleen; Fong, Geoffrey T

2013-01-01

Background The distribution of cigarette prices has rarely been studied and compared under different tax structures. Descriptive evidence on price distributions by countries can shed light on opportunities for tax avoidance and brand switching under different tobacco tax structures, which could impact the effectiveness of increased taxation in reducing smoking. Objective This paper aims to describe the distribution of cigarette prices by countries and to compare these distributions based on the tobacco tax structure in these countries. Methods We employed data for 16 countries taken from the International Tobacco Control Policy Evaluation Project to construct survey-derived cigarette prices for each country. Self-reported prices were weighted by cigarette consumption and described using a comprehensive set of statistics. We then compared these statistics for cigarette prices under different tax structures. In particular, countries of similar income levels and countries that impose similar total excise taxes using different tax structures were paired and compared in mean and variance using a two-sample comparison test. Findings Our investigation illustrates that, compared with specific uniform taxation, other tax structures, such as ad valorem uniform taxation, mixed (a tax system using ad valorem and specific taxes) uniform taxation, and tiered tax structures of specific, ad valorem and mixed taxation tend to have price distributions with greater variability. Countries that rely heavily on ad valorem and tiered taxes also tend to have greater price variability around the median. Among mixed taxation systems, countries that rely more heavily on the ad valorem component tend to have greater price variability than countries that rely more heavily on the specific component. In countries with tiered tax systems, cigarette prices are skewed more towards lower prices than are prices under uniform tax systems. The analyses presented here demonstrate that more opportunities exist for tax avoidance and brand switching when the tax structure departs from a uniform specific tax. PMID:23792324

The distribution of cigarette prices under different tax structures: findings from the International Tobacco Control Policy Evaluation (ITC) Project.

PubMed

Shang, Ce; Chaloupka, Frank J; Zahra, Nahleen; Fong, Geoffrey T

2014-03-01

The distribution of cigarette prices has rarely been studied and compared under different tax structures. Descriptive evidence on price distributions by countries can shed light on opportunities for tax avoidance and brand switching under different tobacco tax structures, which could impact the effectiveness of increased taxation in reducing smoking. This paper aims to describe the distribution of cigarette prices by countries and to compare these distributions based on the tobacco tax structure in these countries. We employed data for 16 countries taken from the International Tobacco Control Policy Evaluation Project to construct survey-derived cigarette prices for each country. Self-reported prices were weighted by cigarette consumption and described using a comprehensive set of statistics. We then compared these statistics for cigarette prices under different tax structures. In particular, countries of similar income levels and countries that impose similar total excise taxes using different tax structures were paired and compared in mean and variance using a two-sample comparison test. Our investigation illustrates that, compared with specific uniform taxation, other tax structures, such as ad valorem uniform taxation, mixed (a tax system using ad valorem and specific taxes) uniform taxation, and tiered tax structures of specific, ad valorem and mixed taxation tend to have price distributions with greater variability. Countries that rely heavily on ad valorem and tiered taxes also tend to have greater price variability around the median. Among mixed taxation systems, countries that rely more heavily on the ad valorem component tend to have greater price variability than countries that rely more heavily on the specific component. In countries with tiered tax systems, cigarette prices are skewed more towards lower prices than are prices under uniform tax systems. The analyses presented here demonstrate that more opportunities exist for tax avoidance and brand switching when the tax structure departs from a uniform specific tax.

The protective effect of habitual tea consumption on hypertension.

PubMed

Yang, Yi-Ching; Lu, Feng-Hwa; Wu, Jin-Shang; Wu, Chih-Hsing; Chang, Chih-Jen

2004-07-26

Tea has long been believed to possess hypotensive effects in popular Chinese medicine. However, conflicting results have been shown among human trials and animal studies on the relation between tea consumption and blood pressure. Epidemiological evidence about the long-term effect of tea on hypertensive risk is also inconsistent. We examined the effect of tea drinking, measured in detail for the past decades, on the risk of newly diagnosed hypertension in 1507 subjects (711 men and 796 women), 20 years or older, who did not have a hypertensive history during 1996 in Taiwan. Six hundred subjects (39.8%) were habitual tea drinkers, defined by tea consumption of 120 mL/d or more for at least 1 year. Compared with nonhabitual tea drinkers, the risk of developing hypertension decreased by 46% for those who drank 120 to 599 mL/d and was further reduced by 65% for those who drank 600 mL/d or more after carefully adjusting for age, sex, socioeconomic status, family history of hypertension, body mass index, waist-hip ratio, lifestyle factors (total physical activity, high sodium intake, cigarette smoking, alcohol consumption, and coffee drinking), and dietary factors (vegetable, fruit, unrefined grain, fish, milk, visible-fat food, and deep fried food intake). However, tea consumption for more than 1 year was not associated with a further reduction of hypertension risk. Habitual moderate strength green or oolong tea consumption, 120 mL/d or more for 1 year, significantly reduces the risk of developing hypertension in the Chinese population.

Susceptibility to cigarette smoking among middle and high school e-cigarette users in Canada.

PubMed

Azagba, Sunday; Baskerville, Neill Bruce; Foley, Kristie

2017-10-01

There is a growing concern that the historic reductions in tobacco consumption witnessed in the past decades may be undermined by the rapid increase in e-cigarette use. This study examined the association between e-cigarette use and future intention to smoke cigarettes among middle and high school students who had never smoked cigarettes. Data were drawn from the 2014-2015 Canadian Student Tobacco, Alcohol and Drugs Survey (n=25,637). A multivariable logistic regression model was used to examine the association between e-cigarette use and susceptibility to cigarette smoking. In addition, an inverse probability of treatment weighted regression adjustment method (doubly robust estimator), which models both the susceptibility to smoking and the probability of e-cigarette use, was conducted. About 10% of the students had ever tried an e-cigarette. There were higher rates of ever e-cigarette use among students in grades 10-12 (12.5%) than those in grades 7-9 (7.3%). Students who had ever tried an e-cigarette had higher odds of susceptibility to cigarette smoking (adjusted odds ratio=2.16, 95% confidence interval=1.80-2.58) compared to those that had never tried an e-cigarette. Current use of an e-cigarette was associated with higher odds of smoking susceptibility (adjusted odds ratio=2.02, 95% confidence interval=1.43-2.84). Similar results were obtained from the doubly robust estimation. Among students who had never smoked cigarettes, e-cigarette use was associated with a higher susceptibility to cigarette smoking. Copyright © 2017 Elsevier Inc. All rights reserved.

Differential effects of cigarette price changes on adult smoking behaviours.

PubMed

Cavazos-Rehg, Patricia A; Krauss, Melissa J; Spitznagel, Edward L; Chaloupka, Frank J; Luke, Douglas A; Waterman, Brian; Grucza, Richard A; Bierut, Laura Jean

2014-03-01

Raising cigarette prices through taxation is an important policy approach to reduce smoking. Yet, cigarette price increases may not be equally effective in all subpopulations of smokers. To examine differing effects of state cigarette price changes with individual changes in smoking among smokers of different intensity levels. Data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of US adults originally interviewed in 2001-2002 (Wave 1) and re-interviewed in 2004-2005 (Wave 2): 34 653 were re-interviewed in Wave 2, and 7068 smokers defined at Wave 1 were included in our study. Mixed effects linear regression models were used to assess whether the effects of changes in state cigarette prices on changes in daily smoking behaviour differed by level of daily smoking. In the multivariable model, there was a significant interaction between change in price per pack of cigarettes from Wave 1 to Wave 2 and the number of cigarettes smoked per day (p=0.044). The more cigarettes smoked per day at baseline, the more responsive the smokers were to increases in price per pack of cigarettes (ie, number of cigarettes smoked per day was reduced in response to price increases). Our findings that heavier smokers successfully and substantially reduced their cigarette smoking behaviours in response to state cigarette price increases provide fresh insight to the evidence on the effectiveness of higher cigarette prices in reducing smoking.

[Children and adolescents' alcohol and tobacco consumption in Tunja, Colombia, 2009].

PubMed

Manrique-Abril, Fred G; Ospina, Juan M; Garcia-Ubaque, Juan C

2011-02-01

Characterising tobacco and alcohol consumption, the linked psychosocial risk factors and protection factors in a sample of secondary / technical students in Tunja during 2009. A prevalence study was carried out, assessing consumption prevalence and determinants in a sample of 1,515 schoolchildren aged 13 to 18 who were studying in grades 8 to 11. Mean age was 15.2 years (SD=1.42), 50.2% were female; life prevalence: 73.5 % alcohol and 50.6 % cigarette consumption, 51.7 % drunkenness. Main consumption determinants were having a dysfunctional family, peer pressure and influence from partners, academic difficulties and conflicts with parents or guardians. Mean age at onset: transitional period between 12 and 13 years. Complete freedom of access to alcoholic beverages and cigarettes was reported. It was found that alcohol and tobacco consumption frequency was quite high in this age group. Related factors were also determinant as they are subject to educational intervention and should be considered as a priority, particularly those related to the family environment and peer group, given the enormous influence exerted by friends and members of recreational or sports team groups on adolescents at this age.

Building the evidence base for global tobacco control.

PubMed Central

Corrao, M. A.; Guindon, G. E.; Cokkinides, V.; Sharma, N.

2000-01-01

The tobacco control movement needs a global information system permitting routine monitoring of the tobacco trade, tobacco farming, the tobacco industry, the prevalence of tobacco use, associated mortality, and national resources for combating tobacco. The Tobacco Control Country Profiles database, a data collection initiative led by the American Cancer Society in collaboration with WHO and the Centers for Disease Control and Prevention, represents the first step in the development of such a system. Baseline data on several indicators of tobacco use were obtained from 191 Member States of WHO, two Associate Members, Hong Kong Special Administrative Region of China (Hong Kong SAR), China (Province of Taiwan) and the West Bank and Gaza Strip. The methods used to compile the data are described in the present paper. Selected indicators from the database were analysed in order to demonstrate the potential utility and value of data derived from an information system devoted to tobacco control. The analyses covered gender-specific smoking prevalence by WHO Region, per capita cigarette consumption by Human Development Index (HDI) category, and average real annual percentage changes in cigarette prices between 1990 and 1999 for selected countries in each category. In 1998, men were almost four times more likely than women to be smokers. The prevalence of smoking among men was highest in the Western Pacific Region. The differential in gender-specific smoking prevalence was narrowest in the Region of the Americas and the European Region. It was wider in the South-East Asia Region and the Western Pacific Region. The lowest and highest per capita consumption of manufactured cigarettes occurred in the lowest and highest HDI categories respectively. In the medium HDI category, China's growing cigarette consumption after 1975 had a major bearing on the rise in per capita consumption. Cigarette price trends suggest that there is considerable scope for increasing taxes on tobacco products, particularly in low or medium HDI countries. The implications of the findings for future tobacco control efforts are discussed, as are issues surrounding the quality of available data, priorities for future data collection and the need to maintain and improve the information system in order to support such efforts. PMID:10994261

An Epidemiological Study of ADHD Symptoms among Young Persons and the Relationship with Cigarette Smoking, Alcohol Consumption and Illicit Drug Use

ERIC Educational Resources Information Center

Gudjonsson, Gisli H.; Sigurdsson, Jon Fridrik; Sigfusdottir, Inga Dora; Young, Susan

2012-01-01

Background: This study investigates the relationship between attention deficit hyperactivity disorder (ADHD) symptoms and cigarette smoking, alcohol use and illicit drug use. Method: The participants were 10,987 pupils in the final three years of their compulsory education in Iceland (ages 14-16 years). The participants completed questionnaires in…

The natural history of light smokers: a population-based cohort study.

PubMed

Levy, Douglas E; Biener, Lois; Rigotti, Nancy A

2009-02-01

Among cigarette smokers, lower levels of consumption, defined as smoking fewer cigarettes per day (CPD) or not smoking daily, are becoming more common. The relationship between cigarette consumption and smoking frequency (daily or nondaily) is not well characterized, and the natural history of light smoking (defined here as smoking < or =10 CPD) is poorly understood. We assessed changes in CPD and smoking frequency over time among light smokers (< or =10 CPD) and very light smokers (< or =5 CPD), using a population-based longitudinal survey of 3,083 adult smokers in Massachusetts who were interviewed three times over a 4-year follow-up period (in 2000-2001, 2002-2003, and 2005-2006). We used logistic regression to identify factors associated with light smokers' progression to heavier smoking or smoking reduction/quitting. Seventy percent of very light smokers were nondaily smokers. Very light nondaily smokers differed from very light daily smokers by younger age, higher socioeconomic status, a social smoking pattern, later smoking initiation, less evidence of nicotine addiction, and more recent and planned cessation efforts. Very light nondaily smokers and smokers consuming 6-10 CPD were more likely to remain in the same smoking category and were less likely to increase consumption than were very light daily smokers. Factors independently associated with increasing consumption among very light smokers were smoking daily, nicotine dependence, White ethnicity, social smoking, and having more friends who smoked; among smokers consuming 6-10 CPD, male gender and lack of quitting self-efficacy were associated with increasing consumption. Our findings indicate that most light smoking is not a gateway to heavier smoking.

Adolescent smokers' response to reducing the nicotine content of cigarettes: Acute effects on withdrawal symptoms and subjective evaluations.

PubMed

Cassidy, Rachel N; Colby, Suzanne M; Tidey, Jennifer W; Jackson, Kristina M; Cioe, Patricia A; Krishnan-Sarin, Suchitra; Hatsukami, Dorothy

2018-05-15

Mandating a reduction in the nicotine content of cigarettes to a minimally addictive level could dramatically reduce smoking rates in the US. However, little is known about the effects of reduced nicotine content cigarettes in adolescents. Following overnight abstinence, adolescent daily smokers (ages 15-19, n = 50) reported on their craving, withdrawal, and positive and negative affect pre- and post- ad lib smoking of one cigarette containing varying nicotine content (15.8, 5.2, 1.3 and 0.4 mg/g of tobacco) in the laboratory and reported their subjective evaluations of each cigarette. Carbon monoxide (CO) boost from pre- to post-cigarette was calculated to determine if lower-nicotine cigarettes led to differential acute changes in toxicant exposure. All four nicotine cigarette types significantly reduced abstinence-induced craving, withdrawal, and negative affect (all p's < .05). Mixed models evaluating the effect of nicotine content, with nicotine dependence level and gender included as covariates, revealed a significant effect of nicotine content on craving and subjective evaluations: higher nicotine content resulted in greater reductions in craving and increases in both positive and negative subjective evaluations. There were no significant effects of nicotine dose on withdrawal symptoms, negative affect, or CO boost. These results suggest that lower nicotine cigarettes might result in reduced abuse liability compared to higher nicotine content cigarettes due to reduced positive subjective effects, while still reducing withdrawal, in adolescents. These results highlight the potential feasibility of this policy approach and support continued research on how a nicotine reduction policy may affect adolescent smoking patterns. Copyright © 2018 Elsevier B.V. All rights reserved.

Perceptions of plain packaging among young adult roll-your-own smokers in France: a naturalistic approach.

PubMed

Gallopel-Morvan, Karine; Moodie, Crawford; Eker, Figen; Beguinot, Emmanuelle; Martinet, Yves

2015-03-01

We explored, for the first time, young adult roll-your-own smokers' response to using plain packaging in real-world settings. Naturalistic research was employed, where 133 French young adult smokers (18-25 years of age) used plain roll-your-own packs for 10 days; the plain packs they were provided with contained their usual brand of rolling tobacco and displayed the name of their usual brand. Participants were recruited in five cities in France (Paris, Marseille, Metz, Nantes, Toulouse) and completed two questionnaires to measure their response to their own branded packs and the plain packs. Both questionnaires assessed pack perceptions, brand attachment, product perceptions (eg, taste, quality, natural), feelings about smoking (satisfying, pleasurable), feelings when using the pack in front of others (embarrassment, image), warning response (credibility, awareness of risks) and smoking-related behaviour (eg, consumption, quitting). Compared to their own fully branded packs, plain packs were associated with less positive pack and product perceptions, lower brand attachment and less positive feelings about smoking and feelings when using the pack in front of others. Participants were also more likely to report feeling like reducing consumption and quitting when using the plain packs, and more likely to feel like missing out on rolling a cigarette. No significant differences between the two pack types (plain and branded) were found in terms of credibility of warnings and perceptions of level of tar. The study suggests that the impacts of plain packaging for roll-your-own cigarette smokers are the same as for smokers of factory-made cigarettes. 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.

Exposure to advertising and perception, interest, and use of e-cigarettes among adolescents: findings from the US National Youth Tobacco Survey.

PubMed

Pu, Jia; Zhang, Xiao

2017-11-01

US adolescents are exposed to high levels of advertisements for electronic cigarettes (e-cigarettes). This study aimed to examine the associations between exposure to e-cigarette advertisements and perception, interest, and use of e-cigarettes among US middle school and high school students. Data from the 2014 cross-sectional National Youth Tobacco Survey were used. Logistic regressions were conducted to model four outcomes, including perception of reduced harmfulness compared to regular cigarettes, perception of reduced addictiveness, intention to use, and current use of e-cigarettes. Main predictors were exposure to e-cigarette advertisements via four sources, including Internet, newspaper/magazines, retail stores, and TV. When all the four sources of e-cigarette advertisements exposure were evaluated jointly, exposure via the Internet was associated with elevated likelihood of reporting all four outcomes related to e-cigarettes, while exposure via retail stores was associated with higher likelihood of current e-cigarette use and perception of reduced harmfulness of e-cigarettes compared to regular cigarettes ( p < .05). However, exposure via newspaper/magazines and TV was associated with lower likelihood of perceiving e-cigarettes to be less harmful or addictive ( p < .05). Exposure to e-cigarette advertisements via the Internet and retail stores may play a significant role in adolescents' use and perception of e-cigarettes. The results call for more research on the influence of different sources of advertising exposure on e-cigarette use to help public health programmes curtail the fast growing use of e-cigarette products among youth.

77 FR 20844 - Certain Reduced Ignition Proclivity Cigarette Paper Wrappers and Products Containing Same...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-06

... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-756] Certain Reduced Ignition Proclivity Cigarette Paper Wrappers and Products Containing Same Determination to Partially Review the Final Initial... reduced ignition proclivity cigarette paper wrappers and products containing same by reason of...

Expectancies for Cigarettes, E-Cigarettes, and Nicotine Replacement Therapies Among E-Cigarette Users (aka Vapers)

PubMed Central

Marquinez, Nicole S.; Correa, John B.; Meltzer, Lauren R.; Unrod, Marina; Sutton, Steven K.; Simmons, Vani N.; Brandon, Thomas H.

2015-01-01

Introduction: Use of e-cigarettes has been increasing exponentially, with the primary motivation reported as smoking cessation. To understand why smokers choose e-cigarettes as an alternative to cigarettes, as well as to US Food and Drug Administration (FDA)–approved nicotine replacement therapies (NRT), we compared outcome expectancies (beliefs about the results of drug use) for the three nicotine delivery systems among vapers, i.e., e-cigarette users, who were former smokers. Methods: Vapers (N = 1,434) completed an online survey assessing 14 expectancy domains as well as perceived cost and convenience. We focused on comparisons between e-cigarettes and cigarettes to determine the attraction of e-cigarettes as a smoking alternative and between e-cigarettes and NRT to determine perceived advantages of e-cigarettes over FDA-approved pharmacotherapy. Results: Participants believed that e-cigarettes, in comparison to conventional cigarettes, had fewer health risks; caused less craving, withdrawal, addiction, and negative physical feelings; tasted better; and were more satisfying. In contrast, conventional cigarettes were perceived as better than e-cigarettes for reducing negative affect, controlling weight, providing stimulation, and reducing stress. E-cigarettes, compared to NRT, were perceived to be less risky, cost less, cause fewer negative physical feelings, taste better, provide more satisfaction, and be better at reducing craving, negative affect, and stress. Moderator analyses indicated history with ad libitum forms of NRT was associated with less positive NRT expectancies. Conclusions: The degree to which expectancies for e-cigarettes differed from expectancies for either tobacco cigarettes or NRT offers insight into the motivation of e-cigarette users and provides guidance for public health and clinical interventions to encourage smoking-related behavior change. PMID:25168035

Smoking Topography Characteristics of Very Low Nicotine Content Cigarettes, With and Without Nicotine Replacement, in Smokers With Schizophrenia and Controls.

PubMed

Tidey, Jennifer W; Cassidy, Rachel N; Miller, Mollie E

2016-09-01

Reducing the nicotine content of cigarettes to a minimally addictive level has been proposed as a regulatory strategy for reducing tobacco dependence. However, smokers with schizophrenia (SS) may be prone to changing their smoking topography in efforts to compensate for the reduction in nicotine content. The aims of this study were to compare smoking topography characteristics of usual-brand and very low nicotine content (VLNC) cigarettes in SS and control smokers without psychiatric illness (CS), and to determine whether nicotine replacement reversed any changes in topography produced by VLNC cigarettes. Using a within-subjects, counter-balanced design, SS (n = 27) and CS (n = 23) smoked usual brand cigarettes, VLNC cigarettes while wearing placebo patches (VLNC + PLA), or VLNC cigarettes while wearing transdermal nicotine patches totaling 42mg (VLNC + NIC) during 5-hour ad libitum smoking sessions. Cigarettes were smoked through topography measurement devices. Across conditions, SS smoked more puffs per session and per cigarette, had higher cigarette volumes, and had shorter inter-puff intervals than CS (Ps < .01). During VLNC cigarette sessions, puff duration increased and time between puffs decreased, but participants smoked fewer puffs, resulting in a net decrease in cigarette and total session volume (Ps < .001). There were no significant interactions between group and condition. These findings indicate that acute use of VLNC cigarettes does not increase intensity of smoking in SS, and support the feasibility of a nicotine reduction policy. Reducing the nicotine in cigarettes to a minimally addictive level has been proposed as a means of reducing tobacco dependence. However, smokers, particularly those with schizophrenia (SS) may alter their puffing in an attempt to extract more nicotine from VLNC cigarettes. This study compared smoking topography of usual brand versus VLNC cigarettes, combined with placebo or transdermal nicotine patches, in SS and controls. Although some changes in topography were indicative of compensatory smoking, total puffs and total cigarette volume were reduced with VLNC cigarettes, indicating that acute VLNC cigarette use does not increase smoking in SS. © 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.

The Experimental Tobacco Marketplace II: Substitutability and sex effects in dual electronic cigarette and conventional cigarette users

PubMed Central

Quisenberry, Amanda J.; Koffarnus, Mikhail N.; Epstein, Leonard H.; Bickel, Warren K.

2017-01-01

Aim The aim of the current study was to evaluate tobacco product purchasing in the Experimental Tobacco Marketplace (ETM) among male and female smokers who also use e-cigarettes. We hypothesized a high substitution profile for e-cigarettes and that males would purchase more Snus than females. Methods The ETM is an online market used in clinical abuse liability research to mimic real-world purchasing patterns. Tobacco products, including each participant’s usual choice of conventional and e-cigarettes, were presented along with a price and description of nicotine content. Participants were endowed with an account balance based on the number of cigarettes and e-cigarettes consumed per week. Each participant was exposed to four ETM sessions in random order during which the price of conventional cigarettes was manipulated. Results Cigarette consumption decreased as price increased. A mixed factor three-way ANOVA revealed a significant main effect of price (i.e., more alternative products were purchased at higher cigarette prices), product (i.e., more e-cigarettes were purchased than gum, lozenges, and Snus), and sex (i.e., males purchased more than females). A significant three-way interaction indicated that males purchased more e-cigarettes, Snus, and dip than females at higher cigarette prices. Conclusion This study suggests that the user profile of cigarette smokers is associated with behavioral economic measures of alternative product substitution and indicates that the evaluation of nicotine replacement products should be considered for both males and females separately. PMID:28732318

The Experimental Tobacco Marketplace II: Substitutability and sex effects in dual electronic cigarette and conventional cigarette users.

PubMed

Quisenberry, Amanda J; Koffarnus, Mikhail N; Epstein, Leonard H; Bickel, Warren K

2017-09-01

The aim of the current study was to evaluate tobacco product purchasing in the Experimental: Tobacco Marketplace (ETM) among male and female smokers who also use e-cigarettes. We hypothesized a high substitution profile for e-cigarettes and that males would purchase more Snus than females. The ETM is an online market used in clinical abuse liability research to mimic real-world purchasing patterns. Tobacco products, including each participant's usual choice of conventional and e-cigarettes, were presented along with a price and description of nicotine content. Participants were endowed with an account balance based on the number of cigarettes and e-cigarettes consumed per week. Each participant was exposed to four ETM sessions in random order during which the price of conventional cigarettes was manipulated. Cigarette consumption decreased as price increased. A mixed factor three-way ANOVA revealed a significant main effect of price (i.e., more alternative products were purchased at higher cigarette prices), product (i.e., more e-cigarettes were purchased than gum, lozenges, and Snus), and sex (i.e., males purchased more than females). A significant three-way interaction indicated that males purchased more e-cigarettes, Snus, and dip than females at higher cigarette prices. This study suggests that the user profile of cigarette smokers is associated with behavioral economic measures of alternative product substitution and indicates that the evaluation of nicotine replacement products should be considered for both males and females separately. Copyright © 2017 Elsevier B.V. All rights reserved.

Have combustible cigarettes met their match? The nicotine delivery profiles and harmful constituent exposures of second-generation and third-generation electronic cigarette users.

PubMed

Wagener, Theodore L; Floyd, Evan L; Stepanov, Irina; Driskill, Leslie M; Frank, Summer G; Meier, Ellen; Leavens, Eleanor L; Tackett, Alayna P; Molina, Neil; Queimado, Lurdes

2017-03-01

Electronic cigarettes' (e-cigarettes) viability as a public health strategy to end smoking will likely be determined by their ability to mimic the pharmacokinetic profile of a cigarette while also exposing users to significantly lower levels of harmful/potentially harmful constituents (HPHCs). The present study examined the nicotine delivery profile of third- (G3) versus second-generation (G2) e-cigarette devices and their users' exposure to nicotine and select HPHCs compared with cigarette smokers. 30 participants (10 smokers, 9 G2 and 11 G3 users) completed baseline questionnaires and provided exhaled carbon monoxide (eCO), saliva and urine samples. Following a 12-hour nicotine abstinence, G2 and G3 users completed a 2-hour vaping session (ie, 5 min, 10-puff bout followed by ad libitum puffing for 115 min). Blood samples, subjective effects, device characteristics and e-liquid consumption were assessed. Smokers, G2 and G3 users had similar baseline levels of cotinine, but smokers had 4 and 7 times higher levels of eCO (p<0.0001) and total 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol (i.e., NNAL, p<0.01), respectively, than G2 or G3 users. Compared with G2s, G3 devices delivered significantly higher power to the atomiser, but G3 users vaped e-cigarette liquids with significantly lower nicotine concentrations. During the vaping session, G3 users achieved significantly higher plasma nicotine concentrations than G2 users following the first 10 puffs (17.5 vs 7.3 ng/mL, respectively) and at 25 and 40 min of ad libitum use. G3 users consumed significantly more e-liquid than G2 users. Vaping urges/withdrawal were reduced following 10 puffs, with no significant differences between device groups. Under normal use conditions, both G2 and G3 devices deliver cigarette-like amounts of nicotine, but G3 devices matched the amount and speed of nicotine delivery of a conventional cigarette. Compared with cigarettes, G2 and G3 e-cigarettes resulted in significantly lower levels of exposure to a potent lung carcinogen and cardiovascular toxicant. These findings have significant implications for understanding the addiction potential of these devices and their viability/suitability as aids to smoking cessation. 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/.

Use of E-Cigarettes Among Current Smokers: Associations Among Reasons for Use, Quit Intentions, and Current Tobacco Use.

PubMed

Rutten, Lila J Finney; Blake, Kelly D; Agunwamba, Amenah A; Grana, Rachel A; Wilson, Patrick M; Ebbert, Jon O; Okamoto, Janet; Leischow, Scott J

2015-10-01

Research has documented growing availability and use of e-cigarettes in the United States over the last decade. We conducted a national panel survey of current adult cigarette smokers to assess attitudes, beliefs, and behaviors relating to e-cigarette use in the United States (N = 2,254). Among current cigarette smokers, 20.4% reported current use of e-cigarettes on some days and 3.7% reported daily use. Reported reasons for e-cigarette use included: quit smoking (58.4%), reduce smoking (57.9%), and reduce health risks (51.9%). No significant differences in sociodemographic characteristics between e-cigarette users and nonusers were observed. Prior quit attempts were reported more frequently among e-cigarette users (82.8%) than nonusers (74.0%). Intention to quit was reported more frequently among e-cigarette users (64.7%) than nonusers (46.8%). Smokers intending to quit were more likely to be e-cigarette users than those not intending to quit (odds ratio [OR] = 1.90, CI =1.36-2.65). Those who used e-cigarettes to try to quit smoking (OR = 2.25, CI = 1.25-4.05), reduce stress (OR = 3.66, CI = 1.11-12.09), or because they cost less (OR = 3.42, CI = 1.64-7.13) were more likely to report decreases in cigarette smoking than those who did not indicate these reasons. Smokers who reported using e-cigarettes to quit smoking (OR = 16.25, CI = 8.32-31.74) or reduce stress (OR = 4.30, CI = 1.32-14.09) were significantly more likely to report an intention to quit than those who did not indicate those reasons for using e-cigarettes. Nearly a quarter of smokers in our study reported e-cigarettes use, primarily motivated by intentions to quit or reduce smoking. These findings identify a clinical and public health opportunity to re-engage smokers in cessation efforts. © 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.

Young adult smokers' perceptions of plain packaging: a pilot naturalistic study.

PubMed

Moodie, Crawford; Mackintosh, Anne Marie; Hastings, Gerard; Ford, Allison

2011-09-01

To explore the impact, if any, that using plain (non-branded) cigarette packs in real-life settings has on young adult smokers. Naturalistic-type research was employed, where smokers used brown 'plain' packs for 2 weeks and their regular packs for 2 weeks, in real-life settings. Participants were recruited in Glasgow, Scotland. Of the 140 smokers aged 18-35 years who participated in the naturalistic study, 48 correctly completed and returned all questionnaires. Over the 4-week study period, participants completed a questionnaire twice a week assessing pack perceptions and feelings, feelings about smoking, salience of health warnings and smoking-related behaviours. A subsample of 18 participated in a post-study interview, which employed a semistructured topic guide to assess perceptions and experiences of using plain packs. Trends in the data show that in comparison with branded packaging, plain packaging increased negative perceptions and feelings about the pack and about smoking. Plain packaging also increased avoidant behaviour (hiding the pack, covering the pack), certain smoking cessation behaviours, such as smoking less around others and forgoing cigarettes, and thinking about quitting. Almost half (n=8) of those in the post-study interview, predominantly women (n=6), reported that the use of plain packs had either increased avoidant behaviour or reduced consumption. This pilot naturalistic study suggests that plain packaging could potentially help reduce tobacco consumption among some young adult smokers, and women in particular. Employing an innovative research methodology, the findings of this study are consistent with, and indeed support, past plain packaging research.

Active enforcement of cigarette control laws in the prevention of cigarette sales to minors.

PubMed

Jason, L A; Ji, P Y; Anes, M D; Birkhead, S H

1991-12-11

To assess the effect that cigarette legislation would have on reducing merchant sales rates of cigarettes to minors and the affect on adolescent smoking behavior. Observational survey of merchant selling behaviors and adolescent smoking habits before and after passage of legislation. The setting for the merchant survey was Woodridge, Ill (population 25,200), a suburban community of Chicago. The surveys were distributed to adolescents in the local junior high school. Convenience sample of both merchants and adolescent students. Passage of community antismoking legislation. Percentage of stores selling cigarettes to minors in Woodridge and percentage of students who had experimented with cigarettes or were regular smokers. Merchant sales rates in Woodridge decreased from a baseline of 70% before legislation to less than 5% in 1.5 years of compliance checking after legislation. Student surveys showed that the rates of cigarette experimentation and regular use of cigarettes by adolescents were reduced by over 50%. Cigarette control laws can be effective in significantly reducing the rate of cigarettes sold by merchants and rates of cigarette use by adolescents. Key elements of successful legislation implementation are consistent compliance checking and heightened community awareness of the problems and prevalence of adolescent smoking.

Differences in preconceptional and prenatal behaviors in women with intended and unintended pregnancies.

PubMed Central

Hellerstedt, W L; Pirie, P L; Lando, H A; Curry, S J; McBride, C M; Grothaus, L C; Nelson, J C

1998-01-01

OBJECTIVES: This study examined whether pregnancy intention was associated with cigarette smoking, alcohol drinking, use of vitamins, and consumption of caffeinated drinks prior to pregnancy and in early pregnancy. METHODS: Data from a telephone survey of 7174 pregnant women were analyzed. RESULTS: In comparison with women whose pregnancies were intended, women with unintended pregnancies were more likely to report cigarette smoking and less likely to report daily vitamin use. Women with unintended pregnancies were also less likely to decrease consumption of caffeinated beverages or increase daily vitamin use. CONCLUSIONS: Pregnancy intention was associated with health behaviors, prior to pregnancy and in early pregnancy, that may influence pregnancy course and birth outcomes. PMID:9551015