Anti-smoking Messages Research Articles

Anti-industry beliefs and attitudes mediate the effect of culturally tailored anti-smoking messages on quit intentions among sexual minority women.

We conducted a longitudinal randomized controlled experiment between September 2021 and May 2022 to evaluate whether anti-tobacco industry beliefs and attitudes mediate the effect of culturally tailored anti-smoking messages on quit intentions among US young adult sexual minority women (SMW) ages 18-30 who smoke. Participants were randomized to view up to a total of 20 tailored versus non-tailored messages over one month. Outcomes were assessed at baseline and one-month follow-up. We fit a structural equation model testing the effect of LGBTQ + community-tailored, anti-smoking messages on quit intentions and mediating roles of anti-industry attitudes and beliefs (n = 966). Anti-industry beliefs (indirect effect size = 0.024, 95% confidence interval [CI] = [0.040, 0.056]) and attitudes (indirect effect size = 0.034, 95% CI = [0.006, 0.077]) significantly mediated the effect of the tailored condition on quit intentions. These findings suggest that LGBTQ + -tailored cues in anti-smoking messaging may promote quit intentions indirectly through influencing young adult SMW's beliefs and attitudes about the tobacco industry. Future campaigns to promote quitting among young adult SMW who smoke should consider incorporating themes to change their beliefs and attitudes about the tobacco industry.Trial registration This study was registered in ClinicalTrials.gov (NCT04812795) on 24/03/2021.

Digital interventions to prevent smoking habit among children. Is there evidence?

Abstract Smoking remains one of the foremost preventable causes of death and disease on a global scale, with its roots often traced back to early childhood. The habit typically begins at a young age, setting a pattern that becomes increasingly difficult to break over time. This enduring issue highlights the critical need for effective preventive measures. Traditional approaches to curbing smoking among the youth-such as public health campaigns, school-based education, and legislative measures like age restrictions on tobacco purchases-have had limited success. In this context, digital interventions (DIs) have begun to emerge as a promising new frontier for tobacco prevention. Leveraging the pervasive influence of technology in young people’s lives, these interventions include gamified educational programs, which transform learning about the dangers of smoking into interactive and engaging activities; social media campaigns, which can spread powerful anti-smoking messages quickly and broadly; and virtual reality experiences, which immerse users in scenarios that vividly illustrate the impact of smoking on health. These digital strategies not only offer fresh avenues for conveying important health information but also engage young audiences in a medium they find relatable and compelling. In this context, the presentation will discuss results of a systematic review aims to assess the efficacy of DI in preventing smoking, and improving knowledge and awareness about smoking damages, among children. This review is part of the PRIN project, titled: “Leo&Giulia standing for public health”, whose goal is to evaluate the effectiveness of a DI aimed at school-aged children, intended to increase knowledge about the negative effects of smoking and prevent its use. Grasping the impact of DI in smoking prevention can greatly benefit public health by offering practical alternatives.

Resistance to anti-smoking messages related to the higher smoking stigma of Korean female smokers.

The degree of perceived smoking stigma can differ, based on various factors such as gender; this may influence the effect of smoking cessation interventions, including denormalization. This study investigates the gender differences in smoking stigma recognized by Korean smokers and explores the effect of these differences on the success of smoking cessation messages that aim to initiate an identity crisis among smokers. It aims to contribute to effective smoking cessation intervention strategies for female smokers. The smoker-gender Implicit Association Test (IAT) was used to measure gender-based smoking stigma; the test comprised photos of people smoking, with positive and negative descriptors. Participants were 120 smokers aged 19-35 years (60 males and 60 females). Participants' cognitive attitudes toward smoking and cessation intentions were assessed at baseline. To investigate the effect of social stigmatization on smokers, participants were asked to watch anti-smoking campaigns that stigmatized either smoking behavior or smokers' self-identity. Cognitive attitudes and cessations intention were used to show differences in gender and message conditions. The IAT D-score showed that female smokers perceived other female smokers significantly more negatively than they did male smokers, suggesting a higher level of smoking stigma. Female smokers in the socially stigmatizing condition reduced their negativity toward smoking less than those who were not stigmatized. Moreover, cessation intentions did not improve when female smokers received identity-threatening messages, indicating that female smokers tended to resist stigmatizing messages. These findings provide empirical evidence that the gender of Korean smokers is significantly related to differences in smoking stigma. The negative perception and resistance responses of female smokers shown in this study are consistent with the findings of previous studies on the stigma of substance use disorders and addiction. High smoking stigma can also be a risk factor in anti-smoking interventions, including health communication; therefore, these findings should be interpreted with caution.

A Descriptive Content Analysis of Anti-Smoking Messages among Indonesians on Instagram

A Descriptive Content Analysis of Anti-Smoking Messages among Indonesians on Instagram

금연공익광고 ‘노담’시리즈에 대한 텍스트 언어학적 연구 -2020년 광고를 중심으로-

This study analyzes the linguistic characteristics of the 2020 anti-smoking public service advertisement series 'Nodam'. The 2020 Nodam advertisements consist of three stories. The first story comprises three independent texts in an interview format, but they are unified into a single text through a repeated ‘question-answer' structure and recurring slogans. The second story is a single text woven from the relay-style narratives of five individuals, with independent subtexts bound together by cohesive devices. The third story has a single text structure consisting of one main text and a slogan. In terms of meaning construction, the first and second stories expand the advertisement's meaning and reinforce its purpose by linking subtexts through the same message and cohesive devices. The third story addresses e-cigarettes and smoking students, broadening the target and scope of the anti-smoking message. Additionally, as the advertisements target teenagers, they use abbreviations, neologisms, trendy expressions, and loanwords to capture teenagers' interest and elicit their empathy and participation.

ANTI-SMOKING MESSAGES VERSUS PRO-SMOKING MESSAGES AMONG INDONESIAN ADOLESCENT SMOKERS

Background: Anti-smoking messages (ASM) is a program designed to educate the public about the dangers of tobacco use, aiming to prevent adolescents and young people from smoking cigarettes in any form and to assist smokers in giving up their smoking habit. On the contrary, pro-smoking messages (PSM) is a marketing technique to promote tobacco products. Aims: This study was conducted to describe the exposure to ASM and PSM among Indonesian adolescent smokers (IAS). Methods: This study analyzed secondary data from the 2019 Global Youth Tobacco Survey (GYTS) Indonesia. The outcome variable was the respondent's smoking intensity in the last 30 days. The independent variables were the exposure to ASM and PSM in the various below-the-line media. Results: Most IAS were male (93.4%), mostly in secondary school (60.3%) and spent more than IDR 11,000 per week (71.1%). Adolescent smokers were exposed to ASM at a rate of 92.4%. Furthermore, ASM exposure happened to 60.5% of the low-intensity youth smoker group and 39.5% of the high-intensity youth smoker group. Meanwhile, 93% of adolescent smokers were exposed to PSM, with 40.8% in the high-intensity youth smoker group and 59.2% in the low-intensity youth smoker group. Conclusion: The exposure to ASM and PSM in the adolescent smoker group was relatively the same. Keywords: ASM, PSM, prevention, public health, tobacco control, youth

Maximizing the Effectiveness of Anti-Smoking Campaigns With Targeted Framing Strategies: Evidence From Behavioral and Neurological Studies

Background The global prevalence of smoking remains a significant public health concern, necessitating the development of effective anti-smoking campaigns to promote smoking cessation and discourage smoking initiation. Understanding the factors that influence individual responses to anti-smoking messages is critical for tailoring campaigns to different populations. Focus of the Article This study substantially exhibits the concepts of audience segmentation and targeting, informed by theory and formative research, and monitoring and evaluation research in the context of anti-smoking campaigns. Research Question The article aims to answer how smoking behavior and message framing influence individuals’ counterarguing responses to anti-smoking advertisements and the implications for ad effectiveness. Approach The research investigates the role of smoking behavior (smokers vs. non-smokers) and message framing (positive vs. negative) in shaping individuals’ counterarguing responses to anti-smoking advertisements, using two studies involving behavioral and neuroscientific methods. Methods Study 1 employed an online video task with 1920 participants, examining the effects of smoking behavior and message framing on ad effectiveness. Study 2 used electroencephalography (EEG) to record brain activity from 31 participants while they viewed anti-smoking video advertisements, focusing on the neural correlates of counterarguing and their effect on anti-smoking ad effectiveness. Results Study 1 found that smokers report lower ad effectiveness compared to non-smokers, and observed an interaction between smoking behavior and message framing. Study 2 found that smoking behavior significantly influenced brain activity in the dorsolateral prefrontal cortex (dlPFC), ventrolateral prefrontal cortex (VLPFC), and anterior cingulate cortex (ACC) regions in response to anti-smoking ads. Additionally, a significant interaction was observed between smoking behavior and ad framing on brain activity in all three regions. Recommendations for Research or Practice The findings suggest that anti-smoking campaigns should be tailored to the specific needs and attitudes of smokers and non-smokers, with separate campaigns for each group. Future research could explore the role of other individual differences in shaping counterarguing responses, the long-term effects of exposure to different types of anti-smoking messages on smoking behavior, and using more advanced neuroimaging techniques to investigate the neural processes that underlie counterarguing responses to anti-smoking messages for better flow.

Male Youth Tobacco Usage Pattern in Banned Smoking Area in Comparison With Non-banned Smoking Area: A Cross-Sectional Study.

This study aimed to assess the impact of smoking bans in schools on smoking prevalence and behavior among Saudi male youth aged 13-15 years. A cross-sectional comparative study was conducted involving students from two intermediate schools in Jeddah - one with a smoking ban and the other without. Data collection utilized the Global Youth Tobacco Survey questionnaire, and statistical analysis was performed using SPSS version 21.0. The study had a 93.9% response rate, with 659 students participating. Notably, a lower percentage of ever-smoking was observed in the banned area compared to the non-banned area (39.6% vs. 50.9%; p=0.002). Current smoking rates were also lower in the banned area (14.2% vs. 23.8%; p=0.014). Family and peer influences on smoking were reduced in the banned area, and more students discussed the harmful effects of smoking with family (72.8% vs. 59.8%; p=0.003). Students in the non-banned area found it easier to access cigarettes. A significantly higher percentage of students in the banned area were resolute in not smoking if offered a cigarette by their best friend (65.0% vs. 59.2%; p=0.006). Students in the non-banned area reported higher exposure to cigarette smoke at homeand in other places compared to those in the banned area (15.8% vs. 10.8%; p=0.008), respectively. A higher percentage of smokers in the banned area expressed a desire to quit smoking, though the difference was not statistically significant. More anti-smoking media messages were reported in the banned area (35.6% vs. 33.6%; p=0.004). Fewer respondents in the banned area had items with cigarette brand logos (13.6% vs. 19.9%; p=0.03). The findings underscore the effectiveness of smoking bans in schools in reducing smoking prevalence among students. This suggests a broader societal shift in attitudes towardsmoking, highlighting the need for comprehensive bans as part of public health strategies. However, there remains a need for targeted interventions to address the complexities of smoking behavior in both banned and non-bannedareas.

Exposure to anti- and pro-smoking messages among adults in China: Results from the Global Adult Tobacco Survey, 2018.

For decades, tobacco advertisements and promotions have been common in mass media and public places in China. In 2015, China amended the Advertising Law to prohibit the distribution of tobacco advertising, while also initiating waves of tobacco control media campaigns. This study investigates the associations between exposure to anti- and pro-smoking messages, smoking status, and people's smoking-related beliefs and willingness to support tobacco control policies. A secondary data analysis was performed with the 2018 Global Adult Tobacco Survey of 19,376 adults aged ≥15 years in China. Anti- and pro-smoking message exposures were measured as the sum of sources (media or places) where respondents have seen the messages. Multivariable logistic regression analyses were conducted to examine the relationships among smoking status, message exposure, and the outcome variables (health harm beliefs, support for increasing tax on cigarettes, support for using part of the increased tax on tobacco control) controlling for smoking status and demographic differences. Overall, 63.3% of the respondents reported being exposed to anti-smoking messages from at least 1 source, while 18.1% were exposed to pro-smoking messages from at least 1 source. Adults who currently, formerly, and never smoked differed in their beliefs about smoking and willingness to support tobacco control policies. Greater reported exposure to anti-smoking messages was positively associated with belief that smoking is harmful, support for increased cigarette tax, and support for using increased tax revenue for tobacco control measures. Meanwhile, greater reported exposure to pro-smoking messages was negatively related to willingness to support cigarette tax increases. While national and local tobacco control campaigns in China have reached a large proportion of the adult population, there is still room for improvement. China might consider expanding anti-tobacco campaigns, as reported exposure to these messages is associated with increased public awareness of the health hazards of smoking and support for increasing cigarette taxes.

Culturally Tailored Anti-Smoking Messages: A Randomized Trial With U.S. Sexual Minority Young Women

IntroductionThis study evaluated effects of exposure to culturally tailored anti-smoking ads versus control ads on quitting intentions, cigarette purchase intentions, and tobacco industry perceptions among young adult, cisgender and transgender, sexual minority women (SMW). Study designAn online randomized controlled experiment with 1-month longitudinal follow-up was conducted. Setting and participants2,214 U.S. SMW ages 18-30 were recruited via online survey panels (The PRIDE Study and Prolific), social media ads and posts, and HER dating app ads. Data were collected in 2021-2022. InterventionParticipants were randomly assigned to receive up to 20 tailored ads containing LGBTQ+ branding versus 20 control ads without LGBTQ+ branding over 4 weeks. Both conditions used identical anti-smoking statements and photographs (including several photographs of individuals who self-identified as SMW). Main outcome measures1-month follow-up intention to purchase cigarettes, intention to quit, marketing receptivity, pro-industry attitudes, and pro-industry beliefs were measured. Analyses were conducted in 2022-2023. Linear regression models predicted outcomes at 1-month follow-up with the randomized arm, adjusted for baseline measures of each outcome and stratified by smoking status (those who currently smoked and those who did not smoke). ResultsAmong those who smoked, follow-up intention to quit increased and intention to purchase cigarettes, marketing receptivity, pro-industry attitudes, and pro-industry beliefs decreased versus baseline in both arms. Follow-up pro-industry beliefs were significantly lower (B=-0.331, 95% CI -0.652, -0.010, p=0.043) in the tailored versus control arm, adjusted for baseline beliefs. Among those who did not smoke, marketing receptivity, pro-industry attitudes, and pro-industry beliefs decreased versus baseline in both arms. Follow-up outcomes did not differ significantly between arms. ConclusionsThese findings can inform future anti-smoking campaign development to reduce cigarette smoking-related disparities among young adult, cisgender and transgender, sexual minority women and serve as the basis for developing similar ads for other LGBTQ+ audiences. Trial RegistrationThis study was registered in ClinicalTrials.gov (NCT04812795) .

DO ANTI-SMOKING ADVERTISEMENTS INFLUENCE STUDENTS TO QUIT SMOKING?

Background: The prevalence of adolescent smoking in Indonesia increased from 2013 to 2018. Aims: This study examines the influence of pro and anti-cigarette advertising on students' smoking cessation. Methods: The study uses the Global Youth Tobacco Survey Indonesia 2019 data. The sample was students aged 13-15 years who had smoked. The dependent variable is quitting smoking, and the independent variables are pro-cigarette and anti-smoking ads: chi-square and logistic regression tests with a 95% confidence interval and a p-value of 0.05. Results: The total sample was 1023 students, and 79.32% wanted to quit smoking. In the anti-smoking ads variables: anti-smoking messages in various media (OR=1.63, 95% CI=1.14-2.34); pictorial health warnings (PHW) on cigarette packs (OR=3.46, 95% CI=2.40-4.97); feeling afraid when seeing health warnings on packaged cigarettes (OR=3.03, 95% CI=2.16-4.26); education about harmful of cigarette consumption (OR=1.40, 95% CI=1.00 – 1.96) had a significant association to quit smoking. The most dominant factor in multivariate analysis was pictorial health warnings on cigarette packs (OR=2.53, 95% CI=1.67-3.81). Conclusion: Most student smokers express a desire to quit smoking. Pictorial health warnings are significantly associated with quitting smoking among students. Keywords: cigarette ads, GYTS, pictorial health warning, students

Effects of Moral Frames Within Vaping Prevention Messages on Current smokers’ Support for Electronic Cigarette Regulations

Given the rise of communication campaigns to prevent and reduce the use of electronic nicotine delivery systems among minors nationwide, it is important to examine whether certain preventive messages will spill over to affect current adult smokers’ support for and compliance with vaping regulations. Drawing upon the Moral Foundations Theory, the current study experimentally examined the effects of moral frames on current adult smokers’ support for vape-free policies and marketing restrictions. An online sample of current smokers (N = 630) was randomly assigned to a 3 (moral frames in vaping prevention : care, purity, non-moral control) × 2 (priming of anti-smoking messages: yes or no) between-subject survey experiment. Compared with non-moral framed messages, smokers exposed to both care and purity framed messages were more likely to support vape-free policies in public places. Such effects were stronger for smokers with higher pre-treatment endorsement of the purity value, driven less by anger or disgust but more by smokers’ updating of both self-oriented and secondhand harm perceptions. Moral frames, especially those appealing to care and purity moral values, are thus promising messaging strategies for vaping prevention communication campaigns in terms of increasing current smokers’ support for vape-free policies. The results also help improve our understanding of the moral roots of health policy opinions and the potential of deploying moral framing to improve message design for health campaigns.

The influence of anti-smoking messages to Indonesian youth smoking behavior: the Indonesian 2019 Global Youth Tobacco Survey (GYTS)

IntroductionVarious anti-tobacco promotions have emerged in order to reduce the detrimental impacts of tobacco advertising on adolescents. The objective of this study is to explore the relationship between the exposure to anti-smoking messages and Indonesian youth smoking behavior.MethodWe used secondary data from the Indonesian 2019 Global Youth Tobacco Survey (GYTS). The participants were students from grades seven to twelve. We used multiple logistic regression to assess the relationship of anti-smoking messages exposure on the smoking behavior variable. We used complex samples process logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) and controlling for relevant covariables.ResultsThe percentage of the exposure to anti-smoking messages in all types were not more than 25% in each outcome variables. The results also showed that in the current smoker variables, adolescent who exposed to the two variables of anti-smoking messages increased the odds to become current smoker. The variables were anti smoking messages in media (AOR 1.41; 95% CI 1.15–1.73) and in school (AOR 1.26; 95% CI 1.06–1.50). On the other hand, in the smoking susceptibility variables, there were no variables of anti-smoking messages that had relation with it.ConclusionsThe study concluded that there were only two variables of the anti-smoking messages that had relation with the Indonesian youth smoking behavior, which were current smokers. Unfortunately those variables increased the odds of the respondents to become current smokers. Indonesia government should develop media following international best practices to convey the anti-smoking messages.

Tobacco Usage and Its Association With Mental Health Status of School-Going Adolescents Near Patna, Bihar: A Community-Based Cross-Sectional Study in Eastern India.

Background Of all the adolescents in India, 7.3% are suffering from some form of mental disorder. They frequently use tobacco to cope with these problems, but get stuck in a vicious cycle of deteriorating mental health. Our study aimed to determine the effect of tobacco on the mental health status of adolescents studying in the 9th to 12th standards in 10 high schools in urban and rural areas near Patna, Bihar. Methodology An analytical cross-sectional study was conducted among 360 school-going adolescents recruited using stratified random sampling. Selected adolescents were given the Indian Adolescent Health Questionnaire. The mental health status was calculated from the Strengths and Difficulties Questionnaire (SDQ) score. Information on sociodemographic characteristics and tobacco use was also obtained. Independent t-test, analysis of variance, and multiple linear regression analysis were used for predicting the significant factors. Significance was set at p-values <0.05. Results In this study, 40 (11.1%) adolescents had abnormal whereas 55 (15.3%) had borderline overall SDQ scores. The majority of those affected had peer problems (40%) and conduct problems (24.7%). All SDQ components of conduct (F = 2.94, p = 0.013), hyperactivity (F = 2.90, p = 0.014), emotional problems (F = 1.14, p = 0.001), and peer pressure (F = 3.06, p = 0.010), as well as the overall SDQ score (F = 5.74, p < 0.001), were significantly associated with increasing age. The adolescents attending rural schools (13.28 ± 5.22, p = 0.047) had significantly higher SDQ scores than those attending urban schools (12.08 ± 5.60). Hyperactivity scores were significantly higher in those studying in class 10 compared to other classes and in those attending rural rather than urban schools. Emotional problems score was significantly higher in 16-17-year-old students than in 14-15-year-old students, in females than in males, and in class 10 than in class 9 students. Only 24 (6.7%) adolescents had a history of tobacco consumption at least once which was significantly associated with the SDQ score (17.71 ± 5.69; t = 4.95, df = 358, p < 0.001). Around 79.4% of adolescents were exposed to passive smoking from close friends which deteriorated their overall mental health status (14.50 ± 5.99; F = 6.29, df = 2,357, p = 0.002). Those who had smoked for more than 10 days had significantly greater conduct problems and lesser pro-social behavior. Overall, 96.1% agreed that tobacco is harmful to health, and 76.1% had seen anti-smoking messages in the media. Female gender, increasing class and age, and history of smoking or chewing tobacco at least once also led to a significant increase in emotional problems. Age, area of the school, history of tobacco consumption, and exposure to cigarette smoke by either a close friend or male guardian had a significant impact on the conduct, hyperactivity, peer problems, and overall mental health status of school-going adolescents. Conclusions Predicting risk factors such as age, area of the school, and the history of tobacco consumption by self or by close friends is important for decision-making by school administration regarding counseling for mental health and preventing tobacco use.

Ethnic differences in smoking behaviour: The situation of Roma in Eastern Europe

Aim: To investigate ethnic differences in smoking between Roma and non-Roma and their determinants, including how discrimination faced by Roma may influence smoking decisions. Methods: We analysed data from the Roma Regional Survey 2011 implemented in twelve countries of Central and South-East Europe with random samples of approximately 750 households in Roma settlements and 350 households in nearby non-Roma communities in each country. The overall sample comprises 11,373 individuals (8,234 Roma) with a proportion of women of 57% and an average age of 36 years. Statistical methods include marginal effects from Probit and zero-truncated negative binomial estimates to explain cigarette consumption. Results: We found that Roma have a higher probability of smoking and are heavier smokers compared to otherwise comparable non-Roma. These differences in smoking behaviour cannot purely be explained by the lower socio-economic situation of Roma since the ethnic gap remains substantial once individual characteristics are controlled for. The probability of smoking is positively correlated with the degree of ethnic discrimination experienced by Roma, especially when it is related to private or public health services. Conclusions: By providing evidence on smoking behaviour between Roma and non-Roma in a large number of countries, our findings support the need to understand smoking behaviour of Roma from a comparative perspective, and may ultimately contribute to more effective anti-smoking messages for Roma. However, if the health disadvantage faced by Roma is to be addressed adequately, this group must be involved more effectively in the policy and public health process.

Tobacco advertising, promotion, and sponsorship (TAPS) in Ethiopia: a scoping review and narrative synthesis

Background Tobacco advertising, promotion and sponsorship (TAPS) has been shown to increase tobacco use in both adults and young people. In Ethiopia, TAPS is recognised as a top priority for the government, and all tobacco advertising, promotion, and sponsorship forms are prohibited. There is recognition that there are gaps in the evidence needed to inform policy and practice on TAPS, but the extent and nature of these gaps have not been explored. This review was aimed at understanding the extent and nature of the evidence gaps on TAPS in Ethiopia and identifying primary research priorities to inform future research direction. Methods Systematic searches were conducted in February 2022 in the following research databases: Medline, EMBASE, and PsycInfo. Two reviewers independently screened the study reports for eligibility and extracted data from the eligible studies. The extracted data was collated and summarised descriptively and policy, practice, and research recommendations were drawn. Research topics on TAPS in Ethiopia that stakeholders perceived to be priorities for primary research were identified through a consultation workshop. Results 579 research reports were identified, and only six studies were included in the scoping review. The included studies explored the following topics: the use of tobacco imagery in movies/films (two studies); the association between mass media exposure or home internet access and tobacco use (two studies), watching of televised football and tobacco smoking in adolescents (one study), exposure to point-of-sale advertising of tobacco products and daily occurrence of smoking or second-hand smoke exposure in the home among women (one study), and exposure to anti-smoking messages through mass media and disparities in risk perceptions across socio-economic and urban-rural subgroups (one study). None of the included studies investigated tobacco-related sponsorship. The top research priority topics identified by stakeholders in Ethiopia were: 1) barriers and facilitators to TAPS policy implementation, enforcement, and compliance monitoring; and 2) developing and testing effective, low-cost, and scalable strategies for TAPS enforcement and compliance monitoring. Conclusions There is a need for research evidence to inform policy and practice on TAPS in Ethiopia, particularly on barriers and facilitators to TAPS policy implementation, enforcement, compliance monitoring, and effective, low-cost, and scalable strategies for TAPS enforcement and compliance monitoring.

Cigarette Gifting Among Nonsmokers in China: Findings From the International Tobacco Control China Survey.

Cigarette gifting is commonly practiced in China and has contributed to the social acceptability and high prevalence of cigarette smoking in the country. As a result, nonsmokers in China are particularly susceptible to smoking. While previous studies have examined cigarette gifting behaviors among smokers, little is known about cigarette gifting among nonsmokers. This study aimed to examine the percentage and correlates of giving and receiving cigarettes as gifts among adult nonsmokers in China. We analyzed nonsmokers (N = 1813) aged ≥18 years using data from the International Tobacco Control China Wave 5 Survey. Descriptive statistics summarized the characteristics of those who gave and received cigarettes as gifts. Multivariable logistic regression models were used to identify factors associated with the two behaviors. Among nonsmokers, 9.9% reported giving cigarettes as gifts to family or friends in the last 6 months. A higher level of knowledge about smoking harms was associated with lower adjusted odds of gifting cigarettes. Nonsmokers aged 25-39 years, with middle income, positive attitude toward cigarette gifts, exposure to anti-smoking information, and exposure to smoking promotion, and those who reported receiving cigarettes as gifts from family or friends were more likely to give cigarettes as gifts. A total of 6.6% of nonsmokers reported receiving cigarettes as gifts in the last 6 months. High education, neutral or positive attitude toward cigarette gifts, exposure to anti-smoking information, exposure to smoking promotion, and having smoking friends were associated with receiving cigarettes as gifts. It is concerning that Chinese cultural norms that support cigarette gifting have extended to giving nonsmokers cigarettes as gifts. Effective anti-smoking messages are needed. Changing the norms around cigarette gifting and increasing knowledge about smoking harms should help reduce cigarette gifting among nonsmokers. Easy access to cigarettes received as gifts, along with the wide acceptance of smoking in China, places Chinese nonsmokers in a risky position. More educational campaigns targeting nonsmokers to proactively prevent them from smoking are called for. The ineffectiveness of existing anti-smoking information highlights the need for more effective anti-smoking messages. That attitude toward cigarette gifts is the strongest predictor of giving cigarettes as gifts suggests the need for interventions to reverse the positive attitude about cigarette gifting to decrease the popularity of this activity.

The effect of exposure to tobacco smoking-related media messages on youths' smoking behavior in Jordan: A longitudinal, school-based study

Only a few studies investigated the link between tobacco smoking-related media and youth smoking in the Eastern Mediterranean Region (EMR). This study aimed to assess the influence of both promotional and control messages on cigarette smoking behavior among young Jordanian students. Generalized Linear Mixed Models were analyzed using data from the Irbid Longitudinal Smoking Study that followed a random sample of 2174 students (2008-2011). We examined the associations of media messaging with smoking behavior, as well as intention-to-quit smoking, and intention-to-start smoking, among young adolescents. At baseline, 12.2% and 43.7% of students were exposed to only pro-smoking or only anti-smoking messages, while 41.8% were equally exposed to both. Exposure to anti-smoking messages was associated with lower odds of ever smoking at baseline among girls (AOR = 0.4; 95% CI: 0.2, 0.8). Boys who were exposed to anti-smoking messages were more likely to report an intention to quit, with borderline significance (AOR = 2.0; 95% CI: 0.9, 4.1). The cumulative exposure to anti-smoking messages over time was associated with lower odds of intention to smoke among girls (AOR = 0.5; 95% CI: 0.3, 0.9) but with higher odds among boys (AOR = 1.8; 95% CI: 1.0, 3.1). In both sexes, media messaging was not associated with progression of the smoking habit. In conclusion, this comprehensive analysis of both pro- and anti-smoking messages advances our understanding of their role in influencing youths' smoking behaviors, and could guide the development of evidence-based interventions to address adolescent tobacco smoking in Jordan and the EMR.

Effect of combining fear and anger in anti-smoking messages to discourage young smokers

ObjectivesPrevious studies have reported mixed results in reducing the prevalence of tobacco use among young people. The present study investigates the influence of a combined emotions (fear and anger) approach to strengthen the persuasive impact of anti-smoking messages aimed at young smokers. Study designThe study adopts a between-subject design experiment. MethodsParticipants were exposed to either a fear appeal or a fear and anger appeal message, after which they answered questions about their emotions, perceived message effectiveness, and intention to reduce cigarette consumption and to quit smoking. An original measure of the co-occurrence of emotions felt by the participants (minimum [MIN] score) was used and mediation analyses were conducted to test the relationship between the emotional content of the message and behavioral intentions through the co-occurrence of fear and anger and perceived message effectiveness. ResultsThe findings show that the co-occurrence of fear and anger felt by individuals and perceived message effectiveness serially mediate the positive influence of a fear and anger appeal message compared to a fear alone appeal on changes in intention behavior (intention to reduce cigarette consumption, indirect effect = 0.152, 95% confidence interval (CI) [0.014, 0.340], and intention to quit smoking, indirect effect = 0.236, 95% CI [0.096, 0.413]). ConclusionsThe study shows the interest of combining negative emotions in prevention messages and offers guidance for government agencies responsible for tobacco control policies to help them improve the effectiveness of anti-smoking messages.

Second-Hand Tobacco Smoke Exposure and Smoke-Free Environments in Ethiopia: A Scoping Review and Narrative Synthesis

Ethiopia passed a law prohibiting tobacco smoking in all public places in 2019. We conducted a scoping review to identify gaps in the existing literature on second-hand smoke (SHS) exposure and smoke-free environments in Ethiopia that need to be prioritised for future research to support policy and practice. We conducted systematic searches in January 2022 in the following databases: Medline, EMBASE, and PsycInfo. Two reviewers independently screened the identified study reports for eligibility and extracted data from the eligible studies. The extracted data was descriptively analysed, and research recommendations were drawn. A stakeholder consultation workshop was held to identify research topics on SHS exposure and smoke-free environments in Ethiopia that they perceived to be priorities for primary research. Of the 388 research reports identified, only nine were included in the scoping review. The topics explored includes prevalence of SHS exposure (six studies); knowledge on SHS exposure (three studies); compliance to smoke-free environments legislation (two studies); and exposure to anti-smoking messages (one study). The stakeholders prioritised further research addressing compliance monitoring and enforcement of the smoke free laws in Ethiopia. There is a need for studies that test new methods for compliance monitoring and enforcement, evaluate strategies to increase knowledge on the harms of SHS exposure and the smoke-free legislation, and evaluate the current smoke-free legislation in Ethiopia.