Cigarette Packs Research Articles

Effects of aerosols from heated tobacco products with flavors on the discoloration of bovine tooth enamel.

This in vitro study assessed the potential of tooth discoloration by aerosols generated from three heated tobacco products (HTPs) with different specifications: in-direct heating tobacco system platform 1.0a(IT1.0a), in-direct heating tobacco system platform 2.0a(IT2.0a), and direct heating tobacco system platform 3.0a(DT3.0a). In addition, three flavor types (regular, menthol, and berry menthol) were selected for each HTP to characterize the effect of flavor types on tooth discoloration. Six bovine tooth samples were exposed directly to aerosols generated from one pack of each HTP: 350 puffs for IT1.0a, 325 puffs for IT2.0a, and 220 puffs for DT3.0a. Six bovine tooth samples were also exposed to air (350 puffs) and smoke generated from one pack of cigarettes (160 puffs) as negative and positive controls, respectively. The color of each tooth sample was measured before and after exposure. The overall color changes were assessed using overall color differences (ΔE) calculated according to the Commission International de I'Eclairage color system. A one-way analysis of variancefollowed by Tukey's post hoc test was used to compare ΔE among bovine tooth samples exposed to air, cigarette smoke, and aerosols generated from each HTP. ΔE values for tooth samples exposed to air and aerosols generated from the three HTPs (IT1.0a, IT2.0a, and DT3.0a) were significantly lower than ΔE value for tooth samples exposed to cigarette smoke. ΔE values obtained with DT3.0a were significantly higher than those obtained with air-exposed control samples. However, ΔE values obtained with IT1.0a and IT2.0a were not significantly different from that obtained with air-exposed control samples. No HTPs showed significant differences in ΔE values among the three flavor types. This study showed that HTP aerosols reduce tooth discoloration potential compared with cigarette smoke, regardless of flavor types, and the tooth discoloration potential of the product may depend on product specifications.

Effects of cigarette price and packaging on hypothetical quit-smoking behaviour: a discrete choice experiment among Vietnamese adults who smoke

IntroductionRaising cigarette prices, increasing graphic health warning label (HWL) coverage and requiring plain packaging could reduce cigarette smoking in Vietnam. This discrete choice experiment estimates the potential impact of these...

Perceptions of Health Warning Labels on Cigarette Packages: A Study of Bangladesh Smokers

Perceptions of Health Warning Labels on Cigarette Packages: A Study of Bangladesh Smokers

Investigation of the Relationship Between the Levels of Cigarette Addiction and Depression Levels of University Students

Purpose: The study was conducted to be cross-sectional in order to determine the relationship levels between smoking and depression and to define the sociodemographic characteristics that make a significant difference.
 Methods: The study was conducted with 280 students who agreed to participate in the study and stated that they smoke. The research data were conducted with university students who met the sampling inclusion criteria, and students with medium and high cigarette addiction levels who agreed to participate in the study. In the study, the "Psychological Addiction Assessment Test" and "BURNS Depression Scale" were used to evaluate the personal and addiction-related characteristics of cigarette addicts.
 Results: The participants of 66.3% are between the ages of 19 and 22 and 64.2% are women. Findings of the answers given to the questions directed to the smoking variable; 29.8% started smoking before the age of 17, 70.2% after the age of 18, 23.8% smoked for more than 4 years, 37.6% used 1 pack of cigarettes a day, 51.1% of them stated that they had never tried to quit smoking before, 33.3% of their mothers and 75.2% of them their fathers were smoking A statistically high positive correlation was obtained between the BDI total score and the SBBT scale score (p

Smoking prevention that increases tax revenue: tobacco taxes in the Czech Republic 2004-2020.

Increasing tobacco excise tax is one of the most effective smoking-prevention tools. The aim of the study is to assess the use of this tool in the Czech Republic (CR) by studying trends in cigarette taxes, prices, tax revenue, and the affordability of cigarettes in the CR. Data on cigarette consumption, their tax rates, price, and tax revenue in the CR for 2004-2020 come from multiple sources. We used the consumer price index to convert nominal values to real values. Given an average daily consumption of 12.7 cigarettes per smoker, the affordability of cigarettes was measured as a percentage of the average monthly wage needed to buy 19 cigarette packs. Despite recent increases in excise taxes, cigarettes in the CR are becoming more affordable. We found that the affordability of cigarettes was greater in 2020 than in 2008. The values of both the specific and the minimum excise taxes are currently being eroded by inflation. Cigarette consumption has declined from 2015 to 2020, and the government still received a bit more excise tax revenue due to its earlier tax policy. However, if taxes are not increased further, the revenue will start to decline. Despite the trend of increasing tobacco taxes in the CR, both the affordability of cigarettes and their use are still high in the country. This means that the CR is not using tax policy effectively enough to reduce smoking prevalence. It needs a substantial and sudden tax increase, in addition to the currently planned tax increases, to reduce smoking prevalence and lower the burden of tobacco use in the economy. Such a move would not only improve public health in the CR, but also increase government revenue.

Support for pictorial health warning labels on cigarette packages in the United States among adults who currently smoke or quit smoking: Findings from the ITC US Smoking and Vaping Surveys.

In March 2020, the US Food and Drug Administration (FDA) finalized new pictorial health warnings (PHWs), covering 50% of the front and back of the pack; however, legal challenges from cigarette manufacturers have prevented the new warnings from being implemented. About 70% of adults in the general US population support PHWs. This study assessed support for PHWs in 2016, 2018 and 2020 among US adults (aged ≥18 years) who currently smoke or formerly smoked cigarettes. We also assessed factors related to support. Respondents included adults who currently or formerly smoked cigarettes and participated in at least one wave of the US ITC Smoking and Vaping Surveys: Wave 1 (2016, n=2557); Wave 2 (2018, n=2685); and Wave 3 (2020, n=1112). We assessed changes in support for PHWs between 2016 and 2020, and assessed factors related to support (support vs oppose/don't know). Analyses were conducted on weighted data. Overall, 38.0% of respondents supported PHWs in 2016, with a significant increase to 44.7% in 2018 (p<0.001), and leveling off to 45.0% in 2020 (2018 vs 2020, p=0.91). Support was highest among former smokers and lowest among daily smokers in all three survey years. Support for PHWs at all survey years was significantly higher among those who formerly smoked, were younger (aged 18-39 vs ≥40 years), those who identified as Black (vs White), and planned to quit smoking (vs not planning to quit). There were no differences by income level, education level, or sex. Nearly half of US adults who smoke cigarettes or quit smoking supported PHWs in 2020, with support being higher among younger adults, ethnic minorities, and those who formerly smoked. Support increased between 2016 and 2018, but not between 2018 and 2020. Similar to other studies, fewer current and former smokers supported PHWs compared to the US adult general population.

Analysis on the Development of Cigarette Packaging in the Era of Intelligence

China is a big country in cigarette production and sales, how to improve the quality and efficiency of cigarette production is a key concern of practitioners. Cigarette packaging is an important part of cigarette production. In the era of intellig B ence, cigarette packaging presents a new development trend. Therefore, it is necessary to strengthen research on related issues to improve the quality of cigarette packaging. This article summarizes the development process of cigarette packaging in our country, introduces the development of printing technology in the era of intelligence, summarizes the application of printing technology in cigarette packaging, analyzes and explores the development trend of cigarette packaging in the era of intelligence, and hopes to provide reference for practitioners.

Changes in Pack Features Among Top-Selling Cigarettes in the U.S., 2018 and 2021

Cigarette packaging is designed to increase consumer appeal and remains a primary promotional tool in many countries, including the U.S. This study documented changes in the prevalence of pack characteristics among the top-selling cigarette products in the U.S. in 2018 and 2021. The 50 cigarette packs with the highest national unit sales in U.S. convenience stores in 2018 and 2021 were identified using Nielsen's Scantrack data and subsequently purchased. Packs were coded for features such as dominant color(s), descriptive text, and promotional language. Descriptive analyses conducted in 2022 weighted by total annual unit sales compared the prevalence of pack characteristics between years. Three brands-Marlboro, Newport, and Camel-constituted over 80% of pack sales among the top-selling products. Packs with red as a dominant color grew less popular between years (33.3% vs 29.5%), whereas those with green became more prevalent (25.2% vs 28.9%), consistent with a rise in the proportion of menthol sales. The prevalence of descriptors such as flavor and fresh decreased from 46.0% to 39.4% and 9.7% to 5.2%, respectively. Meanwhile, the prevalence of promotional language (e.g., rewards programs) increased from 60.9% to 69.0%. The use of visual and named colors remains common, which can implicitly communicate sensory or health-related attributes. Moreover, promotions may help recruit and retain consumers in the context of more restrictive tobacco control policies and price increases. Given the strong influence that cigarette packaging exerts on consumers, packaging-focused policies, such as plain packaging laws, may reduce appeal and accelerate declines in cigarette use.

National income and macro-economic correlates of the double burden of malnutrition: an ecological study of adult populations in 188 countries over 42 years

The double burden of malnutrition (DBM) represents a growing global challenge with adverse health and economic consequences. We aimed to investigate the associative roles of national income (gross domestic product per capita [GDPPC]) and macro-environmental factors on the DBM trends among national adult populations. In this ecological study we assembled extensive historical data on GDPPC from the World Bank World Development Indicators database and population-level DBM data of adults (aged ≥18 years) from the WHO Global Health Observatory database in 188 countries over 42 years (1975-2016). In our analysis, a country was considered to have the DBM in a year when adult overweight (BMI ≥25·0 kg/m2) and underweight (BMI <18·5 kg/m2) prevalence was each 10% or more in that year. We used a Type 2 Tobit model to estimate the association of GDPPC and selected macro-environmental factors (globalisation index, adult literacy rate, female share in the labour force, share of agriculture in the national gross domestic product [GDP], prevalence of undernourishment, and percentage of principal display area mandated to be covered by health warnings on cigarette packaging) with DBM in 122 countries. We find a negative association between GDPPC and the likelihood of a country having the DBM. However, conditional on its presence, DBM level exhibits an inverted-U shaped association with GDPPC. We found an upward shift in DBM levels from 1975 to 2016 across countries at the same level of GDPPC. Among the macro-environmental variables, share of females in the labour force and share of agriculture in the national GDP are negatively associated with DBM presence in a country, whereas the prevalence of undernourishment in the population is positively associated. Further, globalisation index, adult literacy rate, share of females in the labour force, and health warnings on cigarette packaging are negatively associated with DBM levels in countries. DBM level in national adult populations rises with GDPPC until US$11 113 (in 2021 constant dollar terms) and then starts declining. Given their current GDPPC levels, most low-income and middle-income countries are thus unlikely to have a decline in the DBM levels in the near future, ceteris paribus. Those countries will also be expected to experience a higher DBM level at similar levels of national income than were historically experienced by the current high-income countries. Our findings point to a further intensification of the DBM challenge in the near future for the low-income and middle-income countries as they continue to have income growth. None.

Estimating the Effectiveness of Health Warnings on Cigarette Packaging in Nigeria: A Modeling Study.

Tobacco consumption is associated with nearly 30 000 deaths annually in Nigeria alongside other adverse health and economic effects. Our objective was to estimate the health and economic implications of the current cigarette labeling policies (text-only HWs); new health warnings policies in the country (adding graphic health warnings with up to 60% coverage), and plain packaging policy as recommended by the World Health Organization. We used a probabilistic state-transition individual microsimulation model, considering natural history, healthcare costs, and quality-of-life losses associated with main tobacco-attributable diseases; and the potential effects of packaging and labeling policies. We used three scenarios: (1) text-only health warnings (HWs) covering 50% of the pack, (2) introduction of graphic HWs of 50% (and later increasing to 80%) of the pack, and (3) plain packaging with HWs covering 80% of the pack. A total of 748 deaths are averted in the current situation; 7478 and 14 208 deaths can be averted with the new policy and with plain packaging, respectively. The number of cardiac, cerebrovascular, and cancer events that could be averted by adopting text and graphic HWs are 3093, 5093, and 1346, respectively; increasing to 5876, 9676, and 2557, respectively, with plain packaging. Up to 251 794 years were lost because of early deaths and disability, and ₦144.6 billion (USD 469 million) in health costs could be saved with HWs covering 50% to 80% of the pack over 10 years. With plain packaging and graphic HWs covering 80% of the package 478,408 years and ₦274.7 billion (USD 895 million) would be saved. The new cigarette labeling policy in Nigeria may yield significant health and economic benefits over 10 years. Moving the current policy to plain packaging can significantly improve these benefits. The new cigarette labeling policy that Nigeria is implementing should aim to achieve 100% compliance with its current regulation and the logical next step: Plain packaging with large warnings. The present study adds evidence of the potential health effects and cost savings of these levels of implementation, which is valuable for local policymakers.

The problematic use of cultural symbols on Chinese cigarette packs.

China is the world's largest tobacco-consuming nation. With minimal packaging regulations, the Chinese tobacco industry can use many appeals to promote their products, including calling upon traditions and culture to make positive connections between consumers and harmful products. We analyzed the nature and extent of cultural appeals on Chinese cigarette packs. A total of 610 unique cigarette packs were collected in 2017 from five major Chinese cities (Beijing, Guangzhou, Shanghai, Kunming, and Chengdu) following a systematic protocol. Two trained independent coders knowledgeable about Chinese culture and language coded the packs in accordance with a specially developed codebook encompassing important Chinese cultural symbols. The prevalence of identified elements was determined and interpreted. Overall, 60.7% (n=370) of the analyzed Chinese cigarette packs in our sample contained at least one culturally specific appeal. The most common cultural appeals included written arts (n=131; 21.5%), celebratory red as the primary pack color (n=119; 19.5%), visual arts (n=70; 11.4%), and special occasions (n=60; 9.9%). There was a diverse range of cultural appeals present on the packs. Cultural appeals are common on Chinese tobacco packaging, with over 60% of all analyzed packs containing at least one culturally specific element. With China's packaging policies requiring health warning labels to occupy only 35% of the pack, the tobacco industry is allowed plenty of package space to incorporate cultural elements among other appeals. A plain and standardized packaging policy would eliminate the ability for Chinese tobacco companies to use cultural appeals on their cigarette packs.

Cigarette health warning label compliance in Nigeria: A multi-city observational study.

Tobacco remains the world's leading preventable cause of death, with the majority of tobacco-caused deaths occurring in low- and middle-income countries. The first global health treaty, the Framework Convention on Tobacco Control (FCTC), outlines a set of policy initiatives that have been demonstrated as effective in reducing tobacco use. Article 11 of the FCTC focuses on using the tobacco package to communicate tobacco-caused harms; it also seeks to restrict the delivery of misleading information on the pack about the product.The objective of his study is to establish a surveillance system for tobacco packs in Nigeria to assess pack compliance with in-country health warning label requirements. The Tobacco Pack Surveillance System (TPackSS) monitors whether required health warnings on tobacco packages are being implemented as intended and identifies pack designs that might violate the communication of harm-related information and undermine the impact of the country's tobacco packaging laws. Tobacco cigarette packs were collected in three cities in 2019-2020. The intention was, to the extent possible, to construct a census of 'unique' pack presentations available for purchase in Nigeria. We implemented the TPackSS standardized Protocol for acquiring packs from 36 diverse neighborhoods across three cities. At the time of purchase, data on the price and place of acquisition of each pack were recorded. We photographed packs, coded, and archived them. Each pack was coded for compliance according to the current health warning label laws. Each pack was coded by two independent coders consistently. We routinely measured intercoder reliability and only retained variables for which a good level of reliability was achieved. Across the three cities in Nigeria, the team collected 90 tobacco packs. Overall, 77% of packs evaluated for HWL compliance complied with all the relevant common indicators of HWL compliance. There was a 92% compliance with the location of the HWL (e.g. top or bottom of pack, front or back panel) with in-country requirements. Of the four compliance indicators, the size of the HWL (the minimum required coverage) showed the lowest compliance (31%) (i.e. the HWL was too small on most of the packs). Label elements (such as color contrast or content of warnings) showed 85% compliance overall. The analysis of the packs showed various levels of compliance with Health Warning Label provisions for Nigeria. Periodic evaluations are required to ensure that minimum requirements are met.

Effects of Smoking on Pattern Visual Evoked Potentials

Aim: The aim of the study is to get a better understanding of the side effects of smoking by evaluating the effect of recently elevated smoking rate on Visual Evoked Potentials (VEP) and to determine whether it is necessary to use different normals when evaluating the VEP measurements of smoking patients. Material and Methods: The patients who have applied to our ophthalmology and neurology outpatient clinics during 2021-2022 are included to the study. Detailed ophthalmologic examination of the patients as well as their VEP test is completed followed by a dilated fundus examination assessment. The patients with normal results are included to the study. The smoking rate is calculated on pack/year basis. Pattern VEP (PVEP) recording is performed based on Keypoint (Dantec, Denmark) and International Society for Clinical Electrophysiology of Vision (ISCEV) criteria. Data obtained through the study are analyzed by SPSS 21.0 version software. Countable variables with normal distribution between two independent groups are analyzed with Independent Sample T test whereas variables without normal distribution are analyzed with Mann Whitney U test. Chi-square test is used for comparing categorical variables. Results: 71 patients were included to the study where 33 of them were placed in smoking group and 38 in non-smoking group (control group). Smoking group had a yearly cigarette package consumption of 5.20±8.93 (0.2-40). VEP latency and amplitude changes were compared and according to the obtained results; there was P100 latency prolongation in between left and right eye of the patients in the control group and smoking group but it did not have any statistical significance (p=0.910 and p=0.697 respectively). There was no statistically significant difference in either left nor right eye in terms of smoking and P100 and N70 latencies (p=0.707, p=0.838, p=0.717 and p=0.621 respectively). Similarly, there was no significant correlation between yearly package consumption and P100 and N70 latencies and amplitudes of left and right eyes (p=0.503, p=0.410, p=0.776 and p=0.940 respectively). Conclusion: No significant effect of smoking is found on VEP values thus leading us to believe that the same normal intervals can be used in the evaluation of VEP results of both smoking and non-smoking patients.

La vie sans histoire de James Castle par Luc Vezin

Reviewed by: La vie sans histoire de James Castle par Luc Vezin William Cloonan Vezin, Luc. La vie sans histoire de James Castle. Arléa, 2022. ISBN 978-2-36308-311-1. Pp. 260. Toward the end of Vezin's novel, the author cites his subject's tombstone inscription, "C. James Castle, September 25, 1900–October 27, 1977," and then remarks: "Sa postérité s'ouvrit sur une double erreur" (203). The errors here are slight. The real name was James C. Castle and he was born in 1899, but these minor mistakes point to a larger misapprehension concerning Castle's life and achievements, and it is partially for this reason that the novel was written. James Castle was born deaf in a little town in Idaho. He could only make guttural noises and laugh, sounds that usually unsettled people in his vicinity. He was uncouth, often dirty and in adulthood a chain smoker. He drew on scraps of paper (empty cigarette packs, labels of various sorts) using soot he moistened with spit. His subjects were his home, his region, and occasionally himself. Yet through a series of unlikely circumstances, toward the end of his life Castle was recognized as an important American artist whose work was sought by major museums and collectors. Vezin describes him at one gallery opening, smiling like a child and pointing to his drawings. A life like this is ripe for legends and sentimentality, most of which Vezin debunks. Castle did not have a particularly unhappy childhood, although he was occasionally the butt of mockery by kids who made fun of the "Dummy." He was not sent home from a school for the deaf and dumb with a note saying he was uneducable. He had in fact his family's support if not always understanding, and it was a nephew who spearheaded the effort to get recognition for "Uncle Jim." The nephew's initially timid, but consistent attempts to attract attention to his uncle's work, slowly paid off. Castle began to appear in galleries, at times with success and at other moments to indifference, but his drawings and small mud sculptures began to catch on and even sell. Without realizing it, Castle became famous. Vezin deftly describes the comportment and motives of the artist's admirers and detractors, but he avoids, probably correctly, trying to enter into Castle's mind and imagine what the artist thought. James Castle was a phenomenon, an American original; Vezin respects his achievements, but allows the mystery of his creative process to remain just that, a mystery. This novel tells an amazing story without sensationalism or bathos. It is unfortunate, but probably due to financial exigency, that examples of his work could not be included in the text. Based on the untitled figure on the book's cover, Castle's creations would seem to fall into the category of art brut, best associated in France with Jean DuBuffet (1901–1985). Vezin is a professional art historian; he might have chosen to write a scholarly monograph, but by opting for fiction, he has retained the basic facts while deepening the perplexity surrounding the origins and impetus of James Castle's art. [End Page 252] William Cloonan Florida State University, emeritus Copyright © 2023 American Association of Teachers of French

Does the Graphic Health Warning on Tobacco Products Have an Influence on Tobacco Consumers in India? A Scoping Review.

It is now a legal requirement in India that all tobacco products carry graphic health warnings on their packaging. The Government of India has taken steps to reduce the number of people using tobacco products by introducing the Cigarettes and Other Tobacco Products Act. This law states that all tobacco products must display health warnings on their packaging. Despite this, many people in India still use tobacco products. Graphic health warnings on tobacco packaging and labeling can be an effective way to spread awareness about the risks associated with smoking. Pictures or pictograms should be included on all products, as this can be particularly helpful for those with limited literacy skills. This way, everyone can understand the dangers of tobacco use, even if they cannot read. This review examines the effectiveness of pictures on cigarette and other tobacco product packages as health warnings in India. To assess the impact of these graphic warnings, research from India was reviewed, along with information from the Ministry of Health and Family Welfare websites and the World Health Organization. The results indicate that the images on packages have some positive effects. However, they need to be made more visible and easier to comprehend to have a more significant influence on discouraging people from taking up smoking.

Perceptions of novel warnings compared with current warning on tobacco packs, and warnings on cigarette sticks: A cross-sectional survey of college students in Southern India.

In India there is insufficient knowledge of the risks associated with tobacco use. Increasing awareness of these risks is critical, with pictorial warnings on tobacco packs a cost-effective way to communicate this information. We explored perceptions of the current warning, 'Tobacco causes cancer', displayed on packs in India and four novel warnings about other potential impacts of tobacco use including social, financial, and environmental, but also complications with diabetes. As loose cigarette sales are common in India, we also explored perceptions of warnings on cigarette sticks. A cross-sectional survey of college students aged ≥18 years in Karnataka, India, was conducted between January 2019 and February 2020. Participants were asked about salience, believability, and cognitive processing of warnings currently on packs. They were then shown an image of one current and four novel warnings and asked about their perceived effectiveness in preventing uptake and reducing and stopping tobacco use. They were then asked about warnings on cigarette sticks. Most participants (70.2%) recalled warnings on packs and considered them believable (55.7%), but only 12.0% read and 12.4% thought about them often. Warnings about the health impacts of tobacco use were viewed as most effective in preventing uptake, and reducing and stopping tobacco use. Nevertheless, at least a third of participants rated warnings pertaining to financial, social, and environmental impacts effective in preventing uptake, and reducing and stopping tobacco use. Approximately one-fifth (22.0%) thought that warnings on cigarette sticks would deter initiation. Our results suggest that health warnings are perceived as most effective in discouraging tobacco use among college students in Karnataka. While viewed as less effective than health warnings, novel non-health related messages were viewed as effective in preventing uptake, and reducing and stopping tobacco use by at least one in three participants. Warnings on cigarette sticks may help complement warnings on cigarette packs.

Perceptions of plain packaging and health warnings among university students in Turkey: a survey-based experiment

BackgroundCigarette pack design plays a crucial role in attracting customers, especially when other marketing methods are limited by policy. University students who engage in casual smoking take the risk of developing an addiction. The objective of this study was to assess the effects of plain packaging (PP) and graphic health warnings (GHWs) on cigarette packages on three outcome variables (negative affect, avoidant responses, and intentions to quit) among ever-smoker university students in Ankara, Turkey, where youth smoking prevalence is high.MethodsAn online survey-based experiment was used to collect data. The respondents were randomly assigned to one of the five conditions that contained images of cigarette packs with specific design elements. Regression analyses (n = 623) were used to compare across conditions and to estimate the effects of combined warnings (versus text-only warnings), stronger GHWs (versus old GHWs), and PP (versus branded packages) on the outcome variables, accounting for potential confounders.ResultsStronger GHWs generated more negative affect (0.31 points out of 5, p = 0.010) and avoidant responses (0.42 points out of 5, p = 0.002) than old warnings (when brand logos were visible). Plain packages generated more negative affect (0.48 points out of 5, p < 0.001) and avoidant responses (0.46 points out of 5, p = 0.001) than branded packages (with old warnings). Disentangling the effects of PP and new GHWs revealed that neither had individual differential effect on intentions to quit within 6 months.ConclusionsAlthough no differential effect of PP or harsher GHWs was found on intentions to quit when respondents were exposed to images on screen, both design elements were found to be effective in generating negative affect and avoidant responses. More work is needed to design effective tobacco control measures among youth during critical years of tertiary education.

Response to health warnings on cigarette packs as a predictor of future smoking among current tobacco smokers

The United States (US) Food and Drug Administration (FDA) requires health warning labels on all cigarette packages as part of a campaign to reduce tobacco smoking. Prior research has revealed the mixed effectiveness of these health warning labels. The present study used nationally representative, longitudinal data from the Population Study of Tobacco and Health (PATH) Study to assess whether reported reactions to health warning labels on cigarette packs predict smoking frequency and smoking cessation two years later. We hypothesized that individuals who reported strong reactions to health warnings at Wave 1 of the PATH Study would engage in less frequent smoking behavior and would be more likely to have completely quit cigarette smoking two years later (Wave 3), compared with individuals who did not report strong reactions. Multinomial and binary logistic regressions were used to estimate the associations between attitudes toward health warning labels and later smoking frequency and smoking cessation. Our hypotheses were partially supported; results indicated that several attitudes toward health warnings predict later smoking behaviors. These findings indicate general effectiveness of health warning labels and support the FDA’s initiative to require more attention-grabbing health warning labels on cigarette packs.

Association between cumulative smoking exposure and cognitive decline in non-demented older adults: NEDICES study

Whether cumulative smoking exposure is associated with cognitive decline among older adults remains unresolved. To address this question, we used data from the Neurological Disorders in Central Spain (NEDICES) cohort study, in which 2624 older adults were evaluated at two-time points separated by three years. A 37-item version of the Mini-Mental State Examination (MMSE-37) was administered at two visits to assess cognitive change. Regarding smoking exposure, we calculated an individual baseline score based on pack-years (i.e., packs of cigarettes smoked per day multiplied by years of smoking) in current and former smokers. Thus, smoking exposure was categorized into tertiles (low: < 19.0, medium: 19.0–47.0, and high: > 47.0). We used multivariable generalized estimating equation models to assess associations between pack-years and smoking status with 37-MMSE total score change from baseline to follow-up. The MMSE-37 total score had a decline of 1.05 points (confidence interval [CI] 95% 0.62 to 1.48) in the lower tertile of pack-years, 1.16 (CI 95% 0.70 to 1.62) in the middle tertile and 1.17 (CI 95% 0.70 to 1.65) in the higher tertile compared to never smokers, after adjusting for several demographic and clinical variables. The same occurred with smoking status, i.e., a decline of 1.33 (CI 95% 0.87 to 1.79) in current smokers and 1.01 (CI 95% 0.63 to 1.40) in former smokers. Our study provides evidence of the cumulative effect of smoking on cognition in older adults. Using a prospective population-based design, we demonstrated that cumulative smoking exposure was associated with cognitive decline in non-demented older adults. More population-based evidence is required to elucidate this association in older adults without dementia.

Impacts of Tax and Flavor Tobacco Policies on San Francisco Bay Area Tobacco Prices.

California Proposition 56 increased the state tobacco tax by $2 per cigarette pack effective April 1, 2017. Between 2015-2020 San Francisco (SF) and some cities in Alameda County enacted local flavored tobacco sales restrictions. SF also increased its Cigarette Litter Abatement Fee, from $0.20/pack in 2015 to $1.00 in 2020. Compare the change in tobacco prices before (2015) and after (2019/20) the implementation of a $2 increase in tobacco excise tax and local flavored tobacco policies in SF and Alameda Counties. Descriptive study of the pre-to-post policy analysis design. We drew a proportional random sample of retailers (N=463) in SF and Alameda Counties, by city. Using multivariable, single- and multiple-level linear regressions, we compared inflation-adjusted average tobacco prices in 2015 vs. 2019/20 by county and by flavor policy, accounting for socio-demographics. Change in inflation-adjusted average tobacco prices in 2015 vs. 2019/20 by county and flavor policy, accounting for socio-demographics. Between 2015-2019/20, the increase in cigarette prices was higher than the $2 tax increase, and higher in SF than Alameda County (+$4.6 vs +$2.5). SF retailers stopped selling Newport menthol cigarettes and Blu brand menthol e-cigarettes in 2019/20. Adjusted average cigarette prices increased significantly more in SF and Alameda County cities with comprehensive or partial flavor policies versus cities without flavor policies (by $3.23 and $2.11). Local flavor policies affected menthol product availability and may have had positive spillover effects and indirectly increased pack prices.