Discourage Tobacco Use Research Articles

Tobacco use and risk of acute stroke in 32 countries in the INTERSTROKE study: a case–control study

Smoking is a major risk factor for the global burden of stroke. We have previously reported a global population attributable risk (PAR) of stroke of 12.4% associated with current smoking. In this study we aimed to explore the association of current tobacco use with different types of tobacco exposure and environmental tobacco smoke (ETS) exposure on the risk of stroke and stroke subtypes, and by regions and country income levels. The INTERSTROKE study is a case-control study of acute first stroke and was undertaken with 13,462 stroke cases and 13,488 controls recruited between January 11, 2007 and August 8, 2015 in 32 countries worldwide. Association of risk of tobacco use and ETS exposure were analysed with overall stroke, ischemic and intracerebral hemorrhage (ICH), and with TOAST etiological stroke subtypes (large vessel, small vessel, cardioembolism, and undetermined). Current smoking was associated with an increased risk of all stroke (odds ratio [OR] 1.64, 95% CI 1.46-1.84), and had a stronger association with ischemic stroke (OR 1.85, 95% CI 1.61-2.11) than ICH (OR 1.19 95% CI 1.00-1.41). The OR and PAR of stroke among current smokers varied significantly between regions and income levels with high income countries (HIC) having the highest odds (OR 3.02 95% CI 2.24-4.10) and PAR (18.6%, 15.1-22.8%). Among etiological subtypes of ischemic stroke, the strongest association of current smoking was seen for large vessel stroke (OR 2.16, 95% CI 1.63-2.87) and undetermined cause (OR 1.97, 95% CI 1.55-2.50). Both filtered (OR 1.73, 95% CI 1.50-1.99) and non-filtered (OR 2.59, 95% CI 1.79-3.77) cigarettes were associated with stroke risk. ETS exposure increased the risk of stroke in a dose-dependent manner, exposure for more than 10h per week increased risk for all stroke (OR 1.95, 95% CI 1.69-2.27), ischemic stroke (OR 1.89, 95% CI 1.59-2.24) and ICH (OR 2.00, 95% CI 1.60-2.50). There are significant variations in the magnitude of risk and PAR of stroke according to the types of tobacco used, active and ETS exposure, and countries with different income levels. Specific strategies to discourage tobacco use by any form and to build a smoke free environment should be implemented to ease the global burden of stroke. The Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, Canadian Stroke Network, Swedish Research Council, Swedish Heart and Lung Foundation, The Health & Medical Care Committee of the Regional Executive Board, Region Västra Götaland, and through unrestricted grants from several pharmaceutical companies with major contributions from Astra Zeneca, Boehringer Ingelheim (Canada), Pfizer (Canada), MERCK, Sharp and Dohme, Swedish Heart and Lung Foundation, UK Chest, and UK Heart and Stroke.

Tobacco Packaging Design in China, Thailand, and New Zealand: A Comparative Study

Packaging design has received much interest from the academic and industrial worlds. Numerous studies have shown that packaging significantly impacts purchase intent, product satisfaction, and repeat purchases. However, to some extent, tobacco packaging is not used to fulfil its consumer target’s demands or increase the repeat purchase rate. By contrast, it has the official duty to discourage tobacco use, as it is a highly regulated business. Nevertheless, tobacco manufacturers do their best to find the last opportunity to advertise on tobacco boxes because the packet is their final or only marketing or advertising tool in many countries. Thus, tobacco packaging design could be the most challenging advertising practice in many nations because two contradicting advertising contents (persuasion and dissuasion) emerge in one medium simultaneously. In this paper, I comparatively content-analysed 65 popular cigarette brands from China, Thailand, and New Zealand to find out how tobacco companies use cigarette packaging to communicate with their customers. The results suggested that Chinese tobacco packaging is highly market-oriented and emphasises the use of traditional Chinese cultural elements. Conversely, tobacco packaging in Thailand and New Zealand focuses on health communication. But warning labels in the two countries are platitudes. The results also indicate that although policy factors have had a positive impact on tobacco packaging in terms of its discouraging function and contributing to tobacco control over the past decades, there is a need for policies to be tailored to the socio-cultural context. Efforts should focus on improving tobacco packaging from the perspective of smokers’ psychology. This adjustment is deemed necessary due to the declining effectiveness of current tobacco packaging control policies in reducing smoking rates in recent years.

Early trajectories of cigarette and ENDS use among young adult recent Latino immigrants to U.S.

Background: Recent Latino immigrants (RLIs) to the U.S. have shown high smoking rates during their first year since arrival, raising concern about future escalation of tobacco use. Objective: To examine trajectories of cigarette and Electronic nicotine delivery systems (ENDS) use among RLIs from pre-immigration (T0) through their first (T1) and second (T2) year in the U.S. Methods: Data originated from a longitudinal study of 540 (50% females) RLIs aged 18-34. Inclusion criteria was residing in Miami/Dade County (MDC), and having immigrated from a Latin American country within the past year. Trajectories were identified by using the Proc Traj procedure (SAS©, v 9.4). Results: Rates of cigarette use per month declined from 11.8 days/month in T0 to 4.9 d/m in T2. Rates for ENDS use however, increased from T0 (1.1 d/m) to T1 (1.8 d/m) and then lowered back to 0.9 d/m in T2. Four separate cigarette and e-cigarette use trajectories were identified. Only one of them showed increase in cigarette (10.6% of RLIs), and ENDS use (4.5% of RLIs). Being male, and not completing high school were significant factors in explaining smoking trajectories. Being younger than 30 years old was largely associated with ENDS use. No evidence of a substitution effect between cigarette and ENDS use was found. Discussion/Conclusions: Interventions to discourage tobacco use among Latino immigrants should begin early in the immigration process, aimed to preserve initial reductions and dissuade those at risk of increased tobacco use overtime.

Smoking Prevalence, Attitude, and Cessation Training among Nursing Students in Bhubaneswar, India—A Cross-sectional Study

Abstract Introduction The smoking habit of health professionals including nursing students may prevent them from providing cessation advice and counseling to their patients as one cannot persuade others to quit if he/she is smoking himself/herself. Objective The study aimed to assess the smoking prevalence, attitude, and tobacco cessation training among nursing students. Materials and Methods During January to April 2019, we conducted a cross-sectional study among 432 third-year nursing students of eight graduate nursing colleges of Bhubaneswar using the Global Health Professional Student Survey (GHPSS) questionnaire. Results Overall, 38 (8.8%) were current smokers. Majority of participants agreed that health professionals should receive specific training on smoking cessation techniques (91%), serve as role models for their patients and the public (94%), advise their patients to quit tobacco (96.1%). Current smokers were more likely to be males (adjusted OR [aOR]: 6.53, 95% confidence interval or CI: 2.61–16.36), those not supporting a smoking ban in discos/bars/pubs (aOR: 2.82, 95% CI: 1.13–7.05), those lacking knowledge about dangers of smoking (aOR: 2.48, 95% CI: 1.10–5.60), and those not discussing the reasons of smoking (aOR: 2.49, 95% CI: 1.05–5.93). Conclusion Sincere efforts must be undertaken in the nursing colleges to design and implement strategies to discourage tobacco use among nursing students and adequately train them on tobacco cessation techniques.

Tobacco Use and Its Associated Factors among Undergraduate Public Health Students in Kathmandu Valley, Nepal.

Background Despite the crucial role of public health students in tobacco control, there is a paucity of information regarding tobacco use among this population in Nepal. This study aims to assess the prevalence of tobacco use among undergraduate public health students in Kathmandu valley, Nepal. Methods A web-based survey was conducted among 386 undergraduate public health students in Kathmandu valley, Nepal, using the Global Health Professions Student Survey (GHPSS) questionnaire. Associated factors were examined using multivariate logistic regression analyses at the level of significance of 0.05. Results A total of 16.8% of students were current cigarette smokers, 39.9% had ever smoked cigarettes, and 62.2% had smoked their first cigarettes during adolescence. Among the participants, 11.7% currently used other tobacco products. Male students (aOR: 15.4; 95% CI: 4.9–47.8), students with higher age (aOR: 2.4; 95% CI: 1.0–5.4), students belonging to non-Brahmin/Chhetri ethnic group (aOR: 2.3; 95% CI: 1.2–4.4), and those staying without family (aOR: 2.0; 95% CI: 1.1–5.0) had higher odds of being current smoker. Similarly, students with a parental history of tobacco use (aOR: 2.4; 95% CI: 1.3–5.0) and friends with smoking habits (aOR: 7.9; 95% CI: 2.3–27.0) were more likely to be a current smoker. Conclusion There is a notable prevalence of tobacco use among public health students in Kathmandu valley, Nepal. Concerned stakeholders should work jointly to implement a cessation program to discourage tobacco use among these populations who have a potential role in educating communities about the hazards of tobacco smoking, tobacco use prevention, and control.

Prevalence of tobacco use, exposure to secondhand smoke and knowledge on smoking cessation among students of health professions in Central Greece: a cross-sectional study

ObjectivesThe aim of this study was to assess the prevalence of tobacco use and exposure to secondhand smoke among students of health professions (SHPs) and determine possible risk factors for...

Tobacco smoking and COVID-19 infection

Tobacco smoking and COVID-19 infection

Evaluating the short-term impact of a tobacco-free policy in an inpatient addiction treatment setting

PurposeTobacco use is highly prevalent within addiction treatment settings, despite the potential benefits that cessation may provide to patients' psychosocial functioning and overall sobriety. Moreover, tobacco cessation is often insufficiently addressed in addiction treatment programs, although evidence suggests that tobacco control policies, such as access to evidence-based treatment or tobacco-free policies, may be effective. The objective of our study was to evaluate the impact of the implementation of these two tobacco control policies in an inpatient addiction treatment centre. MethodsUsing a 3-group quasi-experimental design, we examined how the implementation of the Ottawa Model for Smoking Cessation (OMSC) and a subsequent campus-wide tobacco ban influenced patients' overall smoking status, frequency, amount used per day, and quit attempts during treatment, compared to usual care. Participants (N = 397) responded to a comprehensive questionnaire upon admission and discharge from an addiction treatment program. We used generalized linear mixed modelling to measure changes over time while accounting for relevant sociodemographic covariates. ResultsPatients exposed to a more comprehensive tobacco control environment (i.e., the OMSC, plus complete tobacco ban) were over 80% less likely to report having used tobacco during treatment, compared to patients exposed to usual care (AOR = 0.17, 95% CI [0.05–0.63]). Receiving treatment in this setting also contributed to a 35% decrease in the average number of days patients used tobacco compared to usual care (AOR = 0.65, 95% CI [0.53–0.98]), and a 27% decrease in the average number of cigarettes used per day compared to usual care (AOR = 0.73, 95% CI [0.58–0.93]). ConclusionComprehensive tobacco control policy interventions within inpatient addiction treatment hospitals promote tobacco cessation. Such interventions should include a combination of evidence-based treatment for patients and environmental restrictions to discourage tobacco use. The results of our study suggest that, within inpatient addiction treatment settings, use of the OMSC in combination with a campus-wide tobacco ban may be more effective than usual care or the OMSC alone.

Prevalence of tobacco use and perceptions of student health professionals about cessation training: results from Global Health Professions Students Survey

IntroductionHealth professionals play an important role in providing advice to their patients about tobacco prevention and cessation. Health professionals who use tobacco may be deterred from providing cessation advice and...

Cigarette Taxes and Illicit Trade in Europe

Cigarettes are highly taxed in Europe to discourage tobacco use and to fund public-health measures to mitigate the harms from tobacco consumption. At higher prices (more precisely, at higher differentials between licit and black-market prices) consumers substitute more toward illicit cigarettes. Illicit retail trade in cigarettes (IRTC) includes counterfeiting and smuggling — either of legally purchased products, from lower-tax to higher-tax jurisdictions, or of entirely non-tax-paid cigarettes. The existing literature includes claims that taxes are not an important factor determining the scale of IRTC. We investigate these claims with data from 1999-2013 in the European Union. We find that while the simple correlation between licit cigarette prices and the market share of illicit cigarettes in consumption is negative, raising prices in any one country would, on average, lead to substantial increases in the expected illicit market share and volume in that country. A one euro increase in tax per pack in a country is expected to increase illicit market share by 5 to 12 percentage points and increase illicit cigarette sales by 25% to 120% of the average consumption. We also find that the role of prices in stimulating IRTC is, empirically, far more important than the role of corruption. The results are robust to a host of alternative specifications and sources of data.

Building a Comprehensive Tobacco Control Program at a Community Health System

Strategies to discourage tobacco use on many fronts from taxation to hard-hitting awareness campaigns have made an impact on reducing tobacco use and promoting tobacco avoidance. In order to further advance tobacco control efforts, future efforts require expanded awareness campaigns; additional training for health professions in tobacco treatment; continued policy shifts; and further integration of tobacco treatment at all health care visits. Anne Arundel Health System’s Cancer Prevention/Nicotine Dependence Program is using several evidence-based tobacco control strategies to eliminate one of the most potent causes of death and disease. These broad efforts have been designed to engage wherever the health system can interact with the public: inpatients, outpatients, community health clinics, public housing, public schools, health system employee policy and public health policy at the state level. Community Cancer Centers can and should play a leading role in anti-tobacco efforts. Incorporating several elements of tobacco control within our organization and in the community allows us to further advance tobacco control efforts and enhance the health of the people we serve.

Cigarette and waterpipe smoking associated knowledge and behaviour among medical students in Lebanon

As future physicians capable of controlling tobacco dependence in the population, medical students are considered a main target for tobacco control interventions. This cross-sectional study reported on the prevalence of tobacco use (cigarettes and waterpipes) and associated knowledge and behaviour among 6th-year medical students in 2009-2010 from 6 medical schools in Lebanon. The self-administered questionnaire based on the Global Health Professional Survey (GHPSS) core questions also enquired about training in tobacco cessation approaches. All enrolled students were asked to participate; the response rate was 191/354 (54.3%). The prevalence of tobacco use was 26.3% for cigarettes and 29.5% for waterpipes. Smoking waterpipes was the only significant predictor for cigarette smoking and there was no difference by sex and socioeconomic status. A minority reported ever receiving any formal training in treatment approaches for tobacco dependence. Medical schools should include tobacco dependence treatment training programmes in their curriculum and discourage tobacco use.

Cross-sectional survey: smoking among medical, pharmacy, dental and nursing students, University of Health Sciences, Lao PDR

ObjectivesTo investigate the prevalence of and attitudes to smoking among third year medical, pharmacy, dentistry and nursing students in Lao People’s Democratic Republic (PDR).DesignA cross-sectional survey conducted among third year...

Tobacco Use and Cessation Counseling Among Pharmacy Students

ABSTRACT Background: In 2003, the International Pharmaceutical Federation (FIP) adopted a policy stating pharmacists have an important role to play in tobacco control. In 2005, the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) developed the Global Health Professions Student Survey (GHPSS) to collect information on student tobacco use and training received on patient cessation counseling while in school. This study includes data from GHPSS conducted among 3rd year pharmacy students in 44 countries and the Gaza Strip/West Bank. Methods: A two-stage sample design was used to select schools and students for participation in the GHPSS. Self-administered data collection followed for 3rd year students in selected schools and classes. Results: Twenty-eight of the 40 sites with data for males reported rates greater than 20%; with only 4 sites reporting rates less than 5%. Thirteen of the 44 sites with data for females reported rates greater than 20%; with 21 sites reporting rates less than 5%. The majority of students recognized that they are role models in society, believed they should receive training on counseling patients to quit using tobacco, but few reported receiving formal training. Conclusions: Following FIP recommendations, pharmaceutical organizations must discourage tobacco use among pharmacists and universities teaching pharmacy must implement programs that train pharmacists in effective patient tobacco cessation-counseling techniques.

Exploring vector space: overcoming resistance to direct control of the tobacco industry

Within the epidemiological framework that describes the relationship of smokers (host), cigarettes (agent), tobacco companies (vector) and environment,1 both the agent and the vector are man-made and, in theory, controllable....

Prevalence of tobacco use among dental patients and their knowledge of its health effects

The objective of this study was to determine the prevalence of tobacco use in dental patients, to compare the knowledge of the effects of tobacco in tobacco users and nonuser, to determine their source of information, and to obtain their opinion on strategies that may be used to reduce or stop tobacco consumption. A descriptive cross-sectional survey of 400 patients attending the University of Benin Teaching Hospital dental clinic for treatment was carried out using a self-administered questionnaire. The result revealed that the prevalence of tobacco use is 4.25% and that tobacco was consumed in the form of cigarette in 94% of cases. Only a small percentage of the respondents (0.3%) had a poor knowledge of both the tobacco effect on general and oral health. Although 26.5% claimed to have multiple source of information on the effect of tobacco on health but the media was the highest single source (23.5%). Banning of sales of tobacco products was suggested by 30.5% of the respondents, 19.8% suggested that doctor should educate patients on the health effect of tobacco, and 17.8% feel that to discourage tobacco use, multiple strategies should be used. There is a need for health workers to lay more emphasis on the rare complications of tobacco use. The use of multiple regulatory strategies should be employed to reduce the overall adverse health impact of tobacco and the media can play a great role.

Tobacco Use, Exposure to Secondhand Smoke, and Cessation Counseling Training of Dental Students Around the World

The Global Health Professions Student Survey (GHPSS) has been conducted among third-year dental students in schools in forty-four countries, the Gaza Strip/West Bank, and three cities (Baghdad, Rio de Janeiro, and Havana) (all called "sites" in this article). In more than half the sites, over 20 percent of the students currently smoked cigarettes, with males having higher rates than females in thirty sites. Over 60 percent of students reported having been exposed to secondhand smoke in public places in thirty-seven of forty-eight sites. The majority of students recognized that they are role models in society and believed they should receive training on counseling patients to quit using tobacco, but few reported receiving formal training. Tobacco control efforts must discourage tobacco use among dentists, promote smoke-free workplaces, and implement programs that train dentists in effective cessation-counseling techniques.

The Lived Experiences of Tobacco Use, Dependence, and Cessation: Insights and Perspectives of People with Mental Illness

Even as the rate of smoking in the U.S. population overall has decreased dramatically during the last four decades, people with mental illness continue to use tobacco at alarmingly high rates. In the last two years, national initiatives have developed to address smoking within this population, yet there has not been an attempt to understand the perspectives of people with mental illness themselves regarding the role tobacco plays in their lives. This grounded theory study, based on focus group interviews with 26 individuals with various smoking statuses receiving outpatient mental health services, attempted to develop a theory to understand this high prevalence from the perspectives of people with mental illness. The article explores the experiences ofpeople with mental illness related to never smoking, smoking, and quitting; the role of tobacco use for people with mental illness; the other forces that promote or discourage tobacco use; and the tensions and complexities in understanding the "problem" of tobacco use in this population. It concludes by highlighting directions for future research, policy considerations, and the important role social workers can play in addressing this significant cause of health disparities.

Tobacco use, exposure to secondhand smoke, and cessation counseling among medical students: cross-country data from the Global Health Professions Student Survey (GHPSS), 2005-2008

BackgroundGHPSS is a school-based survey that collects self-administered data from students in regular classroom settings. GHPSS produces representative data at the national or city level in each country. This study aims to investigate the prevalence of tobacco use, exposure to secondhand smoke, and cessation counseling among medical students using the GHPSS data.MethodsThe Global Health Professions Student Survey (GHPSS) was conducted among 3rd year medical students in 47 countries and the Gaza Strip/West Bank from 2005-2008 to determine the prevalence of tobacco use and amount of formal training in cessation counseling.ResultsIn 26 of the 48 sites, over 20% of the students currently smoked cigarettes, with males having higher rates than females in 37 sites. Over 70% of students reported having been exposed to secondhand smoke in public places in 29 of 48 sites. The majority of students recognized that they are role models in society (over 80% in 42 of 48 sites), believed they should receive training on counseling patients to quit using tobacco (over 80% in 41 of 48 sites), but few reported receiving formal training (less than 40% in 46 of 48 sites).ConclusionTobacco control efforts must discourage tobacco use among health professionals, promote smoke free workplaces, and implement programs that train medical students in effective cessation-counseling techniques.

Influences on tobacco use among urban Hispanic young adults in Baltimore: findings from a qualitative study.

Among Hispanics, lung cancer is the leading cause of cancer-related death for men and the second leading cause of cancer death for women in the United States. Despite recent growth in Baltimore City's Hispanic population, few data exist on tobacco use behaviors in this group. The present research sought to explore the social and environmental influences and norms that encourage or discourage tobacco use among Hispanic young adults in Baltimore. In collaboration with several community stakeholders, we conducted focus groups with Hispanic young adults 18 to 24 years old. Participants were recruited from a community-based service organization and invited to take part in one of four focus groups segregated by gender. A total of 13 young men and 11 young women participated. Data from these focus groups indicate that cultural identity and gender norms leverage substantial influence in young adults' decision about whether, where, and with whom to smoke. The data also suggest multiple social and familial influences on their smoking and nonsmoking behaviors. Participants identified smoking practices and clear brand preferences that they feel distinguish Hispanics from other racial and ethnic groups. Despite acknowledging the high price of cigarettes, cost was not mentioned as a factor influential in their smoking decisions. These results provide essential guidance for the development of appropriate tobacco prevention and cessation intervention strategies and policy recommendations to eliminate tobacco use among Hispanic young adults in Baltimore.