Artificial intelligence in tobacco control: A systematic scoping review of applications, challenges, and ethical implications.

E-cigarette regulation: Is it time for a new Framework Convention on Tobacco Control?

The power of a treaty

Diverse e-cigarette regulations in the Asia Pacific: A health economic perspective.

Background and context: The Framework Convention on Tobacco Control (FCTC) is the world's first public health treaty enacted under the World Health Organization (WHO). It is the biggest global initiative in tobacco control. India is a signatory to this treaty since 2004. India is home to 275 million tobacco users and is the second largest producer and user of tobacco products after China. The country is also known for widespread production and consumption of many smokeless forms of tobacco. India's progress in complying with the Framework Convention treaty had been inconsistent. While few states (provinces) are making significant progress, larger parts of the country struggles with gaps in the law, weak regulatory surveillance and overall noncompliance. The protobacco lobbies in India argue against the legislation by forecasting that banning tobacco production would lead to huge loss of employment and significant negative impact on the economy. These issues act as big deterrents to the country's tobacco control initiatives. Aim: There are very few published policy analyses on compliance with the FCTC treaty and identifying gaps in Indian tobacco control laws. This paper looks at India's tobacco use behavior, the national tobacco control laws, and its gaps and barriers. Strategy/Tactics: Using a policy triangle framework developed by Walt and Gilson (1994), it analyzes the national tobacco control policies and laws against the current scenario to identify areas of improvement and policy reform. Program/Policy process: The Indian tobacco control regulations and the National Tobacco Control Plan is evaluated in light of the WHO FCTC treaty to identify gaps and barriers to its implementation using published evidence. Outcomes: The analysis revels significant gaps and legal complexities that are currently being exploited by the tobacco industry as they continue to promote tobacco products and increase production capacity. There are also important ethical issues related to the use of child labor in tobacco trade in India. What was learned: This paper recommends to amend the Indian tobacco control law to address the gaps and implement a more stringent legislation commensurate to the tobacco use patterns and existing barriers. This also recognizes the political-economic aspects and reflects on the contextual variables and stakeholders that play a significant role in deciding the fate of tobacco production, use and control in India.

Background: Globally, tobacco can be attributed to more than 7 million deaths each year. To address this potentially avoidable mortality, The University of Texas MD Anderson Cancer Center has engaged its Global Academic Program´s (GAP) sister institutions (SI) by conducting an inaugural tobacco control assessment survey. A similar survey was done with our University of Texas academic and health science center affiliates that led to improved adoption of tobacco control policies as well as prevention and cessation services on all campuses. The baseline data collected will serve as a mechanism to develop a tobacco prevention and control strategy within a global cancer center network. Aim: To assess SI laws and policies regarding tobacco use, existing screening and cessation services. Strategy/Tactics: Qualtrics was used to administer a 27-item survey to our GAP SI from April-October 2017. Survey questions focused on key areas of tobacco prevention and control: policy, tobacco use screening, and cessation services. A survey link was emailed to 34 institutions in 23 countries. Program/Policy process: Survey GAP SI to determine current tobacco prevention and control measures being implemented. Convene GAP SI in May 2018 to share tobacco control best practices across the network and identify resources and supports to strengthen tobacco control efforts at each institution. Build collaborations aimed at progressive actions in tobacco control policies, educational programs and cessation services culturally appropriate to the needs and resources of the GAP network. Outcomes: Of the 34 GAP SI, 26 responded to the survey (76% response rate). Key findings among the 26 responding institutions: policy - 96% are located in cities with laws regulating the sale and/or use of tobacco products by minors and 77% of the cities have laws regulating the use of tobacco in the workplace; 42% of the campuses have designated smoking areas; tobacco use screening - 65% screen for and document patients´ tobacco status, however only 27% screen “all the time”; cessation services - 19% offer telephone counseling as a cessation service; 38% offer cessation services to the community; 46% offer cessation services to employees. What was learned: The baseline assessment identified areas of institutional needs: cessation services and campus policies. Further discussion with the SI will help engage them in further efforts to address gaps in tobacco control. Collectively, we aim to develop action steps to collaborate and enhance existing services by creating a global platform in which tobacco control best practices and resources can be shared.

The Tobacco Endgame-Eradicating a Worsening Epidemic: A Joint Opinion From the American Heart Association, World Heart Federation, American College of Cardiology, and the European Society of Cardiology.

Purpose The purpose of this paper is to review the barriers in the dissemination of effective smoking cessation treatments and services globally. Offering tobacco users help to stop using tobacco is a key demand reduction measure outlined under Article 14 of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC). Implementing Article 14 can reap great dividends for the billion plus tobacco users around the world and their families, friends and societies. Design/methodology/approach A review of the status of the global implementation of Article 14 using available literature on smoking cessation products, services and national guidelines. Discussing innovative approaches being currently explored in South Asia that can lead to faster adoption and implementation of Article 14 globally. Findings Major gaps remain in cessation products’ availability and resource allocation for cessation services globally. Current licensed products are falling short on delivering and sustaining smoking cessation. Innovation in cessation products and services needs to build on learnings in nicotine pharmacokinetics, behavioural insights from consumer research and tap into 21st century tools such as mobile based apps. National implementation of FCTC’s Article 14 needs to follow guidelines that encourage integration into existing health programmes and health-care practitioners’ (HCPs) upskilling. Originality/value Smoking cessation is a desirable health outcome and nicotine replacement products are a means of achieving cessation through tobacco harm reduction. E-cigarettes are sophisticated nicotine replacement products. Innovation is urgently needed to fill the gaps in smoking cessation products and services, and for converting global policy into local practice. In low- and middle-income countries (LMICs), HCPs’ knowledge, attitudes and practice regarding tobacco use and cessation may hold the key to rapidly scaling up cessation support and delivery to achieve FCTC objectives sooner. Additionally, HCPs can play an important role in offering smoking cessation support in existing national health programmes for TB, cancer screening and maternal and child health. Also, widely prevalent smartphone devices may deliver smoking cessation through telemedicine in LMICs sooner, leapfrogging the hurdles of the existing health-care infrastructure.

Background: Tobacco is the single largest cause of preventable death globally. An emerging body of evidence shows that tobacco is 1 of the identified causes of cancer contributing to 50% of cancers in men and 20% in women and the same is estimated to kill 10 million people by 2030. The epicenter of this epidemic is the low and middle income countries with 80% of the 1 billion smokers in the world coming from there. India is home to 275 million tobacco users and is the second largest producer and user of tobacco products after China. Many of the users demonstrate a very early smoking debut and a significant proportion of India's population falls in this group. Prevention of early tobacco debut and use of tobacco in youth is 1 of the critical ways of reducing the burden of noncommunicable diseases in the world. There is very limited information on how today's youth perceive using tobacco products, and what they think of the anti-tobacco campaigns and legislative measures. Aim: The qualitative arm aims to bridge some of the knowledge gaps related to tobacco use in today's urban youth; to understand the perceptions of the youth about tobacco. The policy piece evaluates relevant tobacco control legislations in India using a prevalidated policy analysis framework. It critically analyses the gaps of the national tobacco control mechanisms responsible for impacting the tobacco use in the youth. Methods: A qualitative grounded theory approach was followed. In a university in India, 30 young undergraduate students were recruited. Data were collected through in-depth interviews, focus groups and participant observations. The policy section critically analyzed relevant parts of the India's tobacco control law taking its lead from the qualitative data, compared it with the WHO Framework Convention of Tobacco Control (FCTC), and identifies barriers and gaps to understand how its impacting the use of tobacco in youth. Results: Peer influence and social desirability emerged as major influencers for tobacco debut. Stress, exams, depression, family problems and symptoms of stress for example headache, sleeplessness etc. were other influencers for debut. The other major theme was the perceptions and concepts on tobacco addiction and quitting. Knowledge among youth on available quitting or cessation support was very little. Most of the study participants believed that the current tobacco control measures are not effective. The policy analysis of national tobacco control measures revealed significant gaps that are currently being exploited by the tobacco industry as they continue to promote tobacco products and increase production capacity. Conclusion: This study recommends amending the Indian tobacco control law to address the gaps and implement a more stringent legislation commensurate to the tobacco use patterns and existing barriers.

Using the Past to Understand the Future of U.S. and Global Smoking Disparities: A Birth Cohort Perspective

E‐cigarettes and the future of tobacco control

High International Electronic Cigarette Use Among Never Smoker Adolescents

BackgroundThe World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) was developed to assist nations in reducing the demand and supply of tobacco. As of 2020, 182 nations joined the FCTC, agreeing to implement the recommended tobacco control measures. The Gulf Cooperation Council (GCC) countries, including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates (UAE) ratified the WHO FCTC by August 2006. Given the unique political, cultural, and religious context – and known tobacco industry efforts to influence tobacco use- in these nations, a careful examination of the translation of FCTC measures into policy is needed. This study aimed to assess the implementation of FCTC tobacco control measures at the national level within the six GCC countries.MethodWe collected and coded the FCTC measures that were implemented in the GCC countries. We examined trends and variations of the implementation between 2008 and 2020.ResultsGCC countries implemented most FCTC measures targeting the demand for and supply of tobacco, with some variation among countries. Bahrain and Qatar were more comprehensively implementing FCTC measures while Kuwait and Oman implemented the least number of the FCTC measures. Implementing measures related to tobacco prices and eliminating the illicit tobacco trade has slowly progressed in GCC countries. All GCC countries entirely banned smoking in workplaces while three countries implemented a partial ban in restaurants. Only Oman has restrictions on tobacco ads shown in media. There is progress in implementing FCTC measures related to tobacco packaging, cessation, and sale to minors in most GCC countries.ConclusionsGiven the influence of the tobacco industry in the Gulf region, the findings suggest a need for ongoing surveillance to monitor the proliferation of tobacco control measures and evaluate their effectiveness. Efforts required to address tobacco use should correspond to the unique political and cultural background of the GCC countries.

Artificial intelligence (AI) is revolutionizing nursing by enhancing decision-making, patient monitoring, and efficiency. Machine learning, natural language processing (NLP), and predictive analytics claim to improve safety and automate tasks. However, a structured analysis of AI applications is necessary to ensure their effective implementation in nursing practice. This umbrella review aimed to synthesize existing systematic reviews on AI applications in nursing care, providing a comprehensive analysis of its benefits, challenges, and ethical implications. By consolidating findings from multiple sources, this review seeks to offer evidence-based insights to guide the effective and responsible integration of AI in nursing practice. A systematic umbrella review approach was employed following PRISMA guidelines. Multiple databases, including PubMed, CINAHL, Scopus, Web of Science, and IEEE Xplore, were searched for review articles published between 2015 and 2024. Findings were synthesized thematically to identify key trends, benefits, limitations, and research gaps. This review synthesized 13 studies, emphasizing AI's impact on clinical decision support, patient monitoring, nursing education, and workflow optimization. AI enhances early disease detection, minimizes diagnostic errors, and automates documentation, improving efficiency. However, data privacy risks, biases, ethical concerns, and limited AI literacy hinder integration. AI presents significant opportunities for improving nursing care, yet its successful implementation requires addressing ethical, legal, and practical challenges. Adequate AI training, robust data governance frameworks, and policies ensuring responsible AI use are essential for its integration into nursing practice. Future research should explore long-term AI impact, training models for nurses, and strategies to balance AI-driven efficiency with human-centered care.

In an era where technology facilitates both the generation of information and misinformation, it is crucial to equip students with critical thinking skills. This study aims to systematically review the role of artificial intelligence (AI) in fostering critical thinking, exploring its effectiveness, methodologies, and implications in educational contexts. A systematic literature review was conducted following PRISMA guidelines. Relevant peer-reviewed articles published in the last decade were sourced from databases such as Scopus, Web of Science, and IEEE Xplore. The inclusion criteria focused on studies that analyze AI-driven tools, techniques, and interventions designed to enhance critical thinking in students. The findings indicate that AI-based approaches, including machine learning algorithms, natural language processing, and intelligent tutoring systems, can support the development of critical thinking by providing personalized feedback, facilitating argument analysis, and detecting misinformation. However, challenges such as ethical concerns, biases in AI models, and accessibility issues remain significant barriers. The study provides insights for educators, policymakers, and AI developers on how to effectively integrate AI-driven tools into educational curricula. It also highlights the need for interdisciplinary collaboration to ensure that AI fosters rather than hinders critical thinking development. AI has the potential to enhance critical thinking skills in educational settings, but its implementation must be carefully designed to address ethical and technical challenges. Further research is needed to assess long-term impacts and to develop more inclusive and unbiased AI-based educational frameworks.

A HALF-CENTURY AFTER THE FEDERAL GOVERNMENT recognized the dangers of tobacco, substantial progress has been made in controlling its use in the United States. The prevalence of smoking has been halved from its peak and the majority of Americans work and live in smoke-free environments. Progress has also been made elsewhere, but in many lowand middleincome countries, prevalence of tobacco use continues to increase. Despite progress, much is unfinished in tobacco control worldwide. Now is a notable moment in tobacco control. The findings on disease causation by active and passive smoking are unassailable, and substantial evidence and experience define best practices for tobacco control. In the United States, the majority of states have some form of smoke-free legislation, and for the first time, Congress has given the US Food and Drug Administration (FDA) authority to regulate tobacco. Most countries have ratified the World Health Organization’s (WHO’s) Framework Convention on Tobacco Control (FCTC), a global public health treaty that obligates ratifying nations to implement comprehensive tobacco control. Moreover, funding for global tobacco control has increased significantly with a $500 million commitment from the Bloomberg Philanthropies and the Bill and Melinda Gates Foundation. Some unfinished business in the United States requires rapid completion. Taxes on cigarettes enhance revenues and benefit public health by increasing cessation and reducing initiation and should be raised further. Despite the recent increase in the federal tax, cigarettes in the United States remain among the most affordable in the world. At least the amount of tax revenues recommended by the Centers for Disease Control and Prevention should be used for tobacco control, and states should not reallocate to other initiatives funds received under the Master Settlement Agreement and originally dedicated to tobacco control. Smokefree public place regulations also need to be extended. The 39 states not mandating completely smoke-free restaurants and bars need to pass comprehensive legislation; there are now abundant models and ample evidence that revenues do not diminish. Smoke-free regulations cannot cover homes, a principal place of exposure for children, and vigorous efforts are needed to make homes smoke-free, including media campaigns and engagement of health care professionals to work with patients and families on this issue. Removing glamorous images of smoking in movies and on television has potential benefits globally, especially for youth and young adults. Smoking cessation is critical for reducing the tragic and predictable burden of disease caused by smoking. Despite decades of research and experience, long-term success rates using available smoking cessation therapies remain around 10%. While available therapies are cost-effective and benefit public health, they remain mostly uncovered by insurance, are as costly as cigarettes, and are not sold accessibly or in convenient and affordably sized units. Enhanced financial support for smoking cessation is needed, along with its full integration into the health care system and a continued search for better cessation methods. One transformative change in domestic business is the Family Smoking Prevention and Tobacco Control Act, federal legislation that was recently signed into law giving the FDA authority to regulate the tobacco industry and its products. The act’s provisions include strengthening advertising restrictions, requiring new and more prominent warning labels, compelling companies to disclose all ingredients in tobacco products, and authorizing the FDA to restrict harmful additives and monitor and reduce nicotine yields. There are potential complexities involved in implementing the act, including developing protocols for assessing the toxicity and addictive potential of tobacco products. Markers of tobacco toxicity can be measured in blood and other biological materials, and WHO has proposed a suite of markers of exposure as well as regulation of levels of tobaccospecific nitrosamines. However, the selected markers, although representative of toxins in tobacco smoke, lack prospective validation for predicting disease. While the mechanisms by which tobacco smoking causes disease have been extensively studied, the resulting evidence is incomplete as to how overall disease risks depend on specific components of tobacco or tobacco smoke. The FDA will be chal-