Current Tobacco Control Research Articles

Tobacco control in the Russian Federation--a policy analysis.

BackgroundThe Russian Federation (Russia) has one of the highest smoking rates in the world. The purpose of this study is to analyze past and current trends of the tobacco epidemic in the Russian Federation, review current tobacco control policy responses, and identify areas of opportunity for policy priorities.MethodsWe used a policy triangle as analytical framework to examine content, context, and processes of Russian tobacco control policy. The analysis was based on secondary data on supply and demand sides of the Russian tobacco epidemic, tobacco-related economic and health effects during Russia’s economic transition, and compliance of Russian tobacco policy with international standards and regulations.ResultsTobacco-promoting strategies have specifically targeted women and youth. Russia’s approval of a “National Tobacco Control Concept” and draft for a comprehensive tobacco control bill increasingly align national legislature with the WHO Framework Convention on Tobacco Control (FCTC). However, several structural and cultural factors represent substantial barriers to the policy process. The influence of transnational tobacco companies on policy processes in Russia has so far impeded a full implementation of the FCTC mandates.ConclusionsSeveral strategies have been identified as having the potential to reduce the prevalence of tobacco use in Russia and decrease tobacco-related national health and economic burden: adjusting national tobacco policy by raising tobacco tax from the current lowest level in Europe to at least 70%; consequent enforcement of a complete smoking ban in public places; marketing restrictions; and smoking cessation interventions integrated into primary care. Russia’s tobacco control efforts need to target women and youths specifically to efficiently counter industry efforts.

An examination of different smoking patterns among Canadian youth: New insight for tobacco control programming

Patterns of smoking can vary among youth smokers. The purpose of this study was to examine three different patterns of smoking among youth (daily smoking, smoking sporadically on weekdays and weekends, and smoking during weekdays only), and to examine the sociodemographic characteristics that are associated with each smoking pattern in a representative sample of Canadian youth smokers. Data were collected as part of the 2010/2011 Youth Smoking Survey (YSS) from 31,396 students in grades 9 to 12 from secondary schools in 9 Canadian provinces. Data from the YSS were used to assess smoking behaviors and sociodemographic factors that are associated with smoking patterns among youth. We used logistic regression models to examine factors associated with week day only and some day smoking patterns relative to daily smoking patterns. Results indicate that among current youth smokers, the majority are daily smokers (62.0%), followed by some day (23.5%) and week day only (13.5%) smokers. Students who smoke some days were more likely than daily smokers to share cigarettes with others; however, they were less likely than daily smokers to have a parent, step-parent or guardian who smokes cigarettes and less likely to have close friends who smoke cigarettes. Conversely, students who smoke week days only were less likely than daily smokers to have a sibling who smokes cigarettes. These data suggest that the school environment continues to play an important role in reducing youth smoking rates in Canada, especially among youth who only smoke week days. The high percentage of week day only smokers suggests that current school-level tobacco control initiatives may be insufficient for preventing youth smoking onset.

US Health Policy Related to Hookah Tobacco Smoking

Although US cigarette smoking is decreasing, hookah tobacco smoking (HTS) is an emerging trend associated with substantial toxicant exposure. We assessed how a representative sample of US tobacco control policies may apply to HTS. We examined municipal, county, and state legal texts applying to the 100 largest US cities. We developed a summary policy variable that distinguished among cities on the basis of how current tobacco control policies may apply to HTS and used multinomial logistic regression to determine associations between community-level sociodemographic variables and the policy outcome variable. Although 73 of the 100 largest US cities have laws that disallow cigarette smoking in bars, 69 of these cities have exemptions that allow HTS; 4 of the 69 have passed legislation specifically exempting HTS, and 65 may permit HTS via generic tobacco retail establishment exemptions. Cities in which HTS may be exempted had denser populations than cities without clean air legislation. Although three fourths of the largest US cities disallow cigarette smoking in bars, nearly 90% of these cities may permit HTS via exemptions. Closing this gap in clean air regulation may significantly reduce exposure to HTS.

The effects of smoking-related television advertising on smoking and intentions to quit among adults in the United States: 1999-2007.

We investigated whether state-sponsored antitobacco advertisements are associated with reduced adult smoking, and interactions between smoking-related advertising types. We measured mean exposure to smoking-related advertisements with television ratings for the top-75 US media markets from 1999 to 2007. We combined these data with individual-level Current Population Surveys Tobacco Use Supplement data and state tobacco control policy data. Higher exposure to state-sponsored, Legacy, and pharmaceutical advertisements was associated with less smoking; higher exposure to tobacco industry advertisements was associated with more smoking. Higher exposure to state- and Legacy-sponsored advertisements was positively associated with intentions to quit and having made a past-year quit attempt; higher exposure to ads for pharmaceutical cessation aids was negatively associated with having made a quit attempt. There was a significant negative interaction between state- and Legacy-sponsored advertisements. Exposure to state-sponsored advertisements was far below Centers for Disease Control and Prevention-recommended best practices. The significant negative relationships between antismoking advertising and adult smoking provide strong evidence that tobacco-control media campaigns help reduce adult smoking. The significant negative interaction between state- and Legacy-sponsored advertising suggests that the campaigns reinforce one another.

1. U.S. Health Policy Related to Hookah Tobacco Smoking

Objectives. Although US cigarette smoking is decreasing, hookah tobacco smoking (HTS) is an emerging trend associated with substantial toxicant exposure. We assessed how a representative sample of US tobacco control policies may apply to HTS.Methods. We examined municipal, county, and state legal texts applying to the 100 largest US cities. We developed a summary policy variable that distinguished among cities on the basis of how current tobacco control policies may apply to HTS and used multinomial logistic regression to determine associations between community-level sociodemographic variables and the policy outcome variable.Results. Although 73 of the 100 largest US cities have laws that disallow cigarette smoking in bars, 69 of these cities have exemptions that allow HTS; 4 of the 69 have passed legislation specifically exempting HTS, and 65 may permit HTS via generic tobacco retail establishment exemptions. Cities in which HTS may be exempted had denser populations than cities without clean air legisl...

A Decade of Tobacco Control Efforts in New Zealand (1996-2006): Impacts on Inequalities in Census-Derived Smoking Prevalence

Smoking prevalence in New Zealand is highly related to socioeconomic disadvantage and ethnicity, with particularly high smoking prevalence among the Māori population. In the 10-year period from 1996 to 2006, a range of tobacco control activities were implemented in New Zealand. Uniquely in New Zealand, the national census has regularly included questions on smoking status. The purpose of this paper is to inform policy by examining the relationships between smoking prevalence and age, sex, socioeconomic position, and ethnicity, comparing data from the 1996 and 2006 national censuses. Socioeconomic deprivation was measured using the year-specific NZDep index of socioeconomic deprivation for small areas, based on 9 variables from the relevant census. Ethnicity (Māori, Pacific, and European & Other) was assessed using self-definition. Smoking information from each census is stratified by age group, sex, NZDep, and ethnicity. The strong relationship between small-area socioeconomic deprivation and smoking prevalence remained unchanged in New Zealand over the decade 1996-2006. Smoking prevalence continued to be associated with Māori ethnicity independently of small-area socioeconomic deprivation. Smoking prevalence reduced modestly between 1996 and 2006 but increased in some age/sex/ethnic/deprivation groups. The findings of this analysis provide information to support the design and implementation of tobacco control policies in New Zealand over the next 10 years and suggest that current tobacco control policies need to be strengthened and additional, more carefully targeted, measures implemented.

Tobacco smoking in China: Prevalence, disease burden, challenges and future strategies

About one-third of the world's tobacco is produced and consumed in China. Despite existing tobacco control policies and activities, the prevalence of smoking in China remains high with 350 million smokers and 740 million passive smokers. Furthermore, smoking rates in the young population and in females are increasing. The number of deaths attributed to tobacco use has reached 1.2 million per year, whereas the death toll is expected to rise to 2 million annually by 2025. Sociocultural factors favouring smoking initiation, lack of awareness among the public about the hazards of smoking, weak support from the government and strong resistance from the tobacco industry are major reasons for the lack of effectiveness of current tobacco control measures. Effective intervention efforts are urgently required. Commitments from the government are crucial in tobacco control. Firm action should be taken on tobacco control issues at multiple levels including a reduction in tobacco supply, increased tobacco taxation, increased education, tobacco advertising limitations, decreased second-hand smoke exposure and smoking cessation support. The health-care community should also play a leading role in anti-tobacco campaigns and take a more active role in smoking cessation programmes.

Avanços e Desafios no Controle do Tabagismo: um Paralelo entre o Mundo e o Brasil

The aim of this opinion session is to contextualize the Brazilian program within the current international tobacco control efforts, and highlight its successful outcomes that have clearly resulted in a smoking prevalence reduction over the last 20 years. It also explores the new country challenges, highlighting the importance of tobacco control in the national and global development agenda.

Tobacco as a social currency: cigarette gifting and sharing in China.

China produces and consumes more tobacco than any other country in the world and as such is at the forefront of the world tobacco epidemic. Many studies have recently emerged that directly or indirectly reference the acts of giving and sharing cigarettes as a major contributor to China's high tobacco usage. The goal of this report is to review relevant literature relating to sharing and gifting cigarettes as well as provide useful historic and cultural contexts. Important differences between the act of giving individual cigarettes and the gifting of packaged cigarettes are explored as well as explanations for how both these practices have influenced current tobacco control efforts. Available Chinese and English sources on gifting and sharing cigarettes in China published between 1991 and 2011 were reviewed and discussed with a cultural and historical background. The practices of gifting and sharing cigarettes strongly contribute to smoking initiation as well as failure to quit smoking among Chinese males. Historical and cultural roots have reinforced these practices and hampered efforts to reduce tobacco use in China. Traditional tobacco control efforts should be combined with culture-specific approaches to reduce tobacco usage in China. The regular exchange of cigarettes normalizes smoking across society and promotes tobacco's acceptability. Great efforts should be taken not only to minimize these practices among males but also to discourage their adoption by females.

Knowledge and attitude about antismoking legislation in Morocco according to smoking status

Despite tobacco control legislation enacted in Morocco in 1996, the Moroccan population appears to have little interest in or awareness of tobacco control measures. This household survey aimed to assess sectional study was conducted on a random sample of 9195 Moroccans. Only 33.3% knew about the antismoking legislation: 38.7% of smokers versus 32.3% of non-smokers. Among the 3050 people who knew about the law, 60.1% knew about the ban on smoking in public areas and 22.4% knew there was an obligatory health warning on tobacco packaging. The attitude questions showed that 27.2% agreed that the price of tobacco products should increase sharply and 45.0% that antismoking legislation should prohibit tobacco sales to children. These data demonstrate low levels of information among Moroccans concerning current tobacco control legislation.

The case for OFSMOKE: how tobacco price regulation is needed to promote the health of markets, government revenue and the public

Mainstream economic theory outlines four main causes of market failure and it is already well established that two of these (information failure and externalities) exist in a tobacco market. A...

Results of Global Youth Tobacco Surveys in Public Schools in Bogotá, Colombia

The purpose of this paper is to use data from the Global Youth Tobacco Survey (GYTS) conducted in Bogotá, Colombia, in 2001 and 2007 to examine changes in tobacco use among youth 13-15 years of age. The current tobacco control effort in Bogotá will be accessed relative to Colombia ratifying the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in 2008. GYTS was implemented in public schools in Bogotá, Colombia, by the Colombian National Cancer Institute. Data were collected from students in classrooms using self-administered procedures. Between 2001 and 2007, ever having smoked cigarettes decreased along with exposure to secondhand smoke (SHS) at home, having an object with a tobacco logo on it, and having been offered free cigarettes by a tobacco company representative. Prevalence of current cigarette smoking did not change from 2001 to 2007 (32.9% and 29.9%). Exposure to pro-tobacco advertising increased, reaching 71.4%, and 73.4% respectively, in 2007. Having been taught about the harmful effects of tobacco use did not change over time. The government of Colombia ratified the WHO FCTC in 2008. However, Colombia has one of the highest levels of cigarette smoking among 13-15 year olds in the Region of the Americas. The tobacco control effort in Colombia has much work to do, including recognition that the levels of smoking among adolescents are already as high as those of adults. Future declines in tobacco use among adolescents in Bogotá will likely depend on development of a comprehensive tobacco control program.

A qualitative analysis of the tobacco control climate in the U.S. military

Rates of tobacco use in the U.S. military have traditionally been higher than in the general U.S. population. While the military has experienced decreases in tobacco use over the past two decades, recent surveys suggest a trend of increased use. Given the negative impact of tobacco on both the readiness and the long-term health of military members, it is important to understand what factors may be related to the increased use rates. It has been suggested that there is a culture that supports tobacco use in the military. We examined perceptions about the climate of tobacco control among military installation Tobacco Control Managers and Service Policy Leaders from all four branches of the military (n = 52) using semistructured interviews. The primary strength of the military's tobacco control program, according to the participants, was mandating the provision of treatment services on every military installation. Any military member can receive both counseling and pharmacotherapy for tobacco. Opinions vary on the most promising new strategies for tobacco control. Many have pushed for a completely tobacco-free Department of Defense, including requiring troops to be tobacco-free and banning tobacco sales on military installations. However, a number of tobacco control experts within the military worry about unintended consequences of a complete ban. While several benefits of the current tobacco control program were identified, opportunities for improvement were identified at both the installation and service level.

How big is support for smoking prohibition in public places in Kyrgyzstan among mining employees?

Summary Background In Kyrgyz Republic, some, but not all, workplaces and public places have been designated smoke-free, but the extent of support for this is unknown. The aim of this study was to determine how big if any this support is. Methods A cross-sectional sample of employees at the biggest mining company in Kyrgyzstan was interviewed during their annual medical examination. A self-administered questionnaire on attitudes towards a full smoking ban at the workplace along with questions on knowledge and attitudes regarding the current legislation was used on 1881 employees, who lived mostly in Bishek and the Issyk-Kul area. Logistic regression was used to determine the predictive role of smoking, sex, and place of residence. Results Participants were mostly men (87.1%), aged 38.6±9.4 years. In general, the employees supported a stricter tobacco control policy in their company (59.2%), and 58.2% supported a full smoking ban at workplaces and 61.5% in dwelling rooms at the mining site. The current tobacco control Law was familiar to 63% of employees (49% women). Of 668 participants, 85% indicated full support for the smoking ban in public places, and 77% supported full prohibition of smoking in places where smoking was currently partially banned. Smokers were less likely to support a full smoking ban in places with a current partial ban (OR 0.52; 0.35–0.75). Conclusions The level of awareness of the tobacco control legislation was very low among Kyrgyzstan mining employees. They supported the full smoking ban in places where smoking was already prohibited and a full smoking ban in places where smoking was currently only restricted.

Tobacco Control Policy Initiatives and UK Resident Bangladeshi Male Smokers: Community-Based, Qualitative Study

Objective. To reflect on recent proposed tobacco control initiatives in the socio-cultural context of the smoking behaviours of UK resident Bangladeshi men. Design. Cross-sectional study using focus groups and one-to-one interviews conducted in English and Sylheti. Eighty-one men, aged 18–64 years, were recruited from the Bangladeshi community of Tower Hamlets, London, during 2002. Participants were purposively selected to reflect their age, place of birth and tobacco-use status. The discussions were tape-recorded and subsequently transcribed. The transcripts were analysed using ‘framework’ principles. Three of the current themes for tobacco control—smoke-free workplace environments, access to alternative sources of tobacco, and use and availability of nicotine replacement therapy—were used to organise the data. Results. Smoking initiation and use was confirmed as linked to gender, age, religion and tradition. Continued smoking was supported by anxieties about harassment in younger respondents, the migration experience of older respondents, and the unskilled employment opportunities available in the restaurant trade. These employment opportunities, whilst providing social support, did not support smoking regulations, in contrast to the practices observed in the general employment market. Levels of knowledge about the health risks of smoking varied by age. Three cheaper alternative tobacco types were readily accessible for use: contraband, roll-ups and traditional chewing tobacco in paan (chewing tobacco mixed with areca nut rolled in a betel leaf). Despite the latter's associations with use by women, younger respondents described the transition to chewing tobacco in paan as a smoking cessation aid instead of nicotine replacement therapy. There was confusion about the purpose, availability and efficacy of nicotine replacement therapy. Respondents reported isolation and marginalisation from current tobacco control initiatives, including much NHS Stop Smoking Service provision. Conclusion. The socio-cultural context of the smoking behaviours of this group of Bangladeshi men was linked to a reported isolation and exclusion from current tobacco control initiatives. These initiatives should be inclusive and address the reported needs of this community. The findings have implications for service development. Addressing these findings will help to inform the implementation of relevant public health policy initiatives for tobacco control to meet the needs of this community.

Current tobacco control policy trends in the United States

This article takes a snap-shot view of current tobacco control laws and where the nation is headed. Smoke-free workplace laws are highlighted, and the New York campaign experience is explained briefly. The article also creates a view into current trends in tobacco excise taxes; youth access laws, US Food and Drug Administration regulations of tobacco, tobacco control program funding, and other regulatory efforts in municipalities, individual states, and the nation as a whole.

Newspaper Coverage of Youth and Tobacco: Implications for Public Health

The presentation of smoking as a "youth" issue is a powerful component of current tobacco-control efforts. Agenda setting theory demonstrates that the media serve as a potent forum in which the consideration and presentation of perspectives of social problems take place. This analysis of 643 U.S. youth-focused newspaper articles examines the messages being conveyed to the public and policymakers through coverage of tobacco issues focused on youth. Data illustrate that the issue of youth tobacco use is newsworthy but also suggest that youth-focused issues garner little commentary coverage. Rather, straightforward reports of "feel good" stories dominate the coverage, and youth-focused articles tend to conceptualize the problem of tobacco as being one of a need for greater individual-level education rather than structural or policy changes.

Tobacco Use Among Students Aged 13-15 Years—Philippines, 2000 and 2003

Tobacco use is one of the major preventable causes of premature death and disease in the world. A disproportionate share of the global tobacco burden falls on developing countries, where an estimated 84% of the world's 1.3 billion current smokers live. The Global Youth Tobacco Survey (GYTS), part of the Global Tobacco Surveillance System (GTSS) initiated by the World Health Organization (WHO) and CDC, was developed to monitor youth tobacco use, attitudes about tobacco, and exposure to tobacco smoke, and has been completed by approximately 1.4 million students in 133 countries. A key goal of GTSS is for countries to conduct the GYTS every 4 years. This report presents findings from the GYTS conducted in the Philippines in 2000 and 2003, which revealed substantial declines in the proportions of students aged 13-15 years who currently smoked cigarettes, currently used other tobacco products, were likely to start smoking in the next year, or were exposed to secondhand smoke in public places. The findings also indicated an increase in the proportion of students who supported bans on smoking in public places, had learned about the dangers of tobacco use in school, and had seen antitobacco messages in media and advertising. Public health authorities in the Philippines should evaluate their current tobacco-control programs and enhance or expand them to further reduce youth smoking.

Youth tobacco control research and activities in the United States: the current national landscape.

This paper highlights the increasing level of collaboration, resource sharing, and consensus building in youth tobacco control taking place in the United States. Better knowledge of current research, activities, and collaborations in this area will help in the planning of activities and the rational allocation of funds for tobacco control programs, research, advocacy, and the counter-advertising activities. We defined three general classifications for organizations that had national youth tobacco control activities: Government centers and institutes, government organizations, and bridging organizations. We asked national experts in our own organization and all other included organizations to suggest additional groups for inclusion. After gathering available public information on each organization from Web sites and printed materials, we than solicited additional information by personal communication with individuals in leadership positions for youth tobacco control within each group. We developed a uniform framework to present a clear picture of each group in the areas of institutional conception, general goals, youth tobacco control research, and youth tobacco control activities. The tables provide a helpful reference guide presenting the institutional conception, goals, funding for research, activities, and Web sites for the institutions and organizations discussed here. Many groups have current youth tobacco control priorities in the United States. This synthesis of current research, funding sources, programmatic activities, and collaborations in the United States will be a valuable resource for clinicians, tobacco control advocates, researchers, and program planners.

Responses to tobacco control policies among youth

Objective: Explore adolescents' response to current and potential tobacco control policy issues. Design: The 13 site Tobacco Control Network (TCN), sponsored by the Centers for Disease Control and Prevention, conducted...