Field Of Tobacco Control Research Articles

Smoking cessation patterns by socioeconomic status in Alaska.

The ongoing disparity in smoking prevalence across levels of socioeconomic status (SES) is a significant concern in the tobacco control field, and surveillance of cessation-related activity is key to understanding progress. Historically, lower SES smokers have had much lower quit ratios but this measure can be insensitive to recent quit-related behavior. It is therefore important to examine recent quit-related behavior to assess progress toward addressing this disparity, especially in states with tobacco control programs that focus on this priority population.We compared recent quit attempts and successes among non-Native lower SES Alaska smokers to those of higher SES using data from the 2012–2013 Alaska Behavioral Risk Factor Surveillance System (BRFSS). We assessed quit ratios, one-year and five-year quit rates, and six-month abstinence between the two groups.Cessation-related measures restricted to those who smoked in the previous one year did not significantly vary by SES. However, five year quit rates were significantly lower for persons of lower SES vs. higher SES (14% vs. 32% respectively, p < .001). Results were consistent after adjustment for age, sex, and other factors.Results showed that in the previous year, smokers of lower SES in Alaska were trying to quit and succeeding at similar rates as their higher SES counterparts. However, the equivalent pattern of quit success was not reflected in the five-year time frame. Tobacco control programs should monitor cessation trends using both recent and longer-term time frames for this population. More research is needed on reasons for fewer long-term quits among lower SES smokers.

Factors Influencing Trust in Agencies That Disseminate Tobacco Prevention Information.

Several health-related agencies administer national and targeted public education campaigns to provide health information and change health-related behaviors. The trust the public has in these agencies as the source of the message impacts the effectiveness of their communication campaigns. In this study, we explore the perceived trust of agencies that communicate health messages in the tobacco control field. As part of a larger tobacco regulatory science study, we conducted six 90-min focus groups comprising 41 participants. Five main themes emerged pertinent to the agency: (1) its integrity, (2) its competence, (3) its motives, (4) how it is portrayed in the media, and (5) skepticism and mistrust about it. Given the significant resources spent on health messaging to the public and potential benefits offered by this communication, an understanding of public trust in the agencies as the source of health messages is important. Findings suggest health information may be ignored or discounted when there is mistrust in the agency sending those messages.

Does capacity building on tobacco control change perception and knowledge among public health professionals? A case study from Puducherry, India

Background: The medical and public health personnel, especially in low- and middle-income countries, are not adequately equipped with the necessary knowledge and skills required to curb the menace of tobacco epidemic. Therefore, this study aims to assess the effectiveness of a tobacco control workshop conducted for doctors, postgraduate medical and master of public health students with a view to possibly integrate tobacco course in medical and public health curricula.Methodology: The contents of the workshop were finalized after an extensive review by a panel of experts in the field of tobacco control in India. The participants of the workshop were provided training in a learner-centered mode by an expert panel of facilitators from varied backgrounds with ample of experience and expertise in the field of tobacco control. At the end of 5-day long workshop, the participant's knowledge, attitude, practice with respect to tobacco control, and contents and comfort of the workshop were assessed using a retro-pre questionnaire.Results: There was statistically significant improvement in the knowledge, attitude, and practice domains related to tobacco control. Around 40%–55% participants were able to appreciate that health-care personnel have a definite role in curbing the menace of tobacco epidemic. Around one-third of the participants felt that they would be able to enquire about tobacco use as part of history taking, counsel using 5A's strategy, and advice to quit tobacco. Nearly 80% participants appreciated the appropriateness of the contents of the workshop and almost all were satisfied with faculty–participants interaction and methods of delivering various concepts for tobacco control.Conclusion: Use of hands-on training with practical sessions, backed by structured modules can help in improving knowledge, attitude, and skills of the health professionals toward tobacco control.

Setting research priorities in tobacco control: a stakeholder engagement project.

Background and AimsThe Cochrane Tobacco Addiction Group (TAG) conducts systematic reviews of the evidence for tobacco cessation and prevention interventions. In 2016 TAG conducted a priority‐setting, stakeholder engagement project to identify where further research is needed in the areas of tobacco control and smoking cessation.DesignThe project comprised two surveys and a workshop. A range of stakeholders participated, including members of the public (smokers and ex‐smokers), clinicians, researchers, research funders, health‐care commissioners and public health organizations. The first survey phase identified unanswered research questions in the field of tobacco control. The second phase asked participants to rank these, with overall rankings calculated by combining scores across participants. The workshop allowed attendees to discuss prioritization of topics and questions in more depth. Workshop discussions were transcribed and analysed thematically, and a final voting activity at the close of the workshop allowed participants to choose topics to prioritize and to de‐prioritize.FindingsA total of 304 stakeholders (researchers, health professionals, smokers and ex‐smokers, guideline developers, research funders and policymakers, representing 28 countries) identified 183 unanswered research questions. These were categorized into 15 research categories. A total of 175 participants prioritized categories and questions in the second survey phase, with ‘electronic cigarettes’; ‘addressing inequalities’; and ‘mental health and other substance abuse’ prioritized as the top three categories. Forty‐three stakeholders attended the workshop and discussed reasons for and against category prioritization. Prioritized research categories largely mirrored those in the survey stage, although ‘treatment delivery’ also emerged as a key category. Five cross‐cutting themes emerged: efficacy; relative efficacy; cost effectiveness; addressing inequalities; and different types of evidence.ConclusionsThere are many unanswered questions in the field of tobacco control. Stakeholders highlighted electronic cigarettes, addressing inequalities and mental health and other substance abuse as key areas for further research, and efficacy, relative efficacy, cost‐effectiveness and use of non‐randomized studies as important themes cutting across research areas. Future prioritization work would benefit from targeting non‐US and non‐UK stakeholders explicitly and from examining where priorities may differ based on stakeholder group.

PA04.01 A Realistic Goal? Achieving a Tobacco Free Ireland by 2025

Ireland has a proud record of leadership in the field of tobacco control. It was the first country in the world to introduce a Workplace Smoking Ban in 2013 and the first country in Europe to announce its intention to introduce plain packaging for cigarettes. In 2013 Ireland set a target date to achieve a tobacco free society with a targeted adult tobacco use prevalence of under 5%. Other countries to formally adopt a target for tobacco free societies include Finland 2040, New Zealand 2025, and Scotland 2034. Tobacco Free Ireland1 is a new tobacco policy for Ireland coming more than a decade after the publication of the previous national policy Towards a Tobacco Free Society.2 It is a timely successor because of the emerging non-communicable disease burden which is caused by risk factors that can be prevented. Tobacco is well known as a major contributor to ill-health and premature mortality. It is responsible for more than a third of all cancers. For the first time, we have a target date for Ireland to be tobacco free of 2025. The question is whether this target is in any way realistic. Tobacco Free Ireland addresses a range of tobacco control issues and initiatives and contains over 60 recommendations. A high level action plan, was drawn up in consultation with those who will lead out on the recommendations which outlines the responsibilities, actions necessary and timelines for the implementation of the recommendations. The recommendations to support Ireland becoming a tobacco free Society are categorized under:•Protection of children and denormalization of tobacco use•Legislative compliance and regulating the retail environment•Protect people from tobacco use•Offer help to quit tobacco use•Warn about the dangers of tobacco•Enforcement of bans on tobacco advertising, promotion and sponsorship•Raising taxation on tobacco products•National and International Partnerships For the first time in policy we see a commitment to substantially address supply side issues through introduction of levies such as an environmental waste levy and an industry profitability levy ring fencing income to address health promotion, cessation supports and illegal trade initiatives. The document fails to substantially address the inequality inherent in smoking patterns. In Ireland the bottom decile, at 35% prevalence, is more than twice as likely to smoke as the top decile at 16%. Specific deprived population targeted programs such as the Irish Cancer Societies ‘We Can Quit’ program, which challenges intergenerational smoking, have been successful and need to be funded and enhanced if a Tobacco Free Society is to be achieved. Current adult smoking rates of 19.5%3 suggest Ireland has some significant way to go towards achieving its target. Recent youth smoking rates of 13%4 for 15-17 year olds and 8%5 for 10-17 year olds suggests significant progress in reducing the uptake of smoking. Major investment is required to support increased quit attempts and increased success from quit attempts if the target of a Tobacco Free Ireland by 2025 is to be achieved.

PUB080 Different Methods for Tobacco Hazards Awareness

In the FCTC & MPOWER policy of WHO -W stands to Warn about hazards of Tobacco, specially the health hazards. Tobacco control is complex problem requires attention of all FCTC parties and NGO. Electronic media-specially TV media has the highest visibility, but, non aired mass media methods for creating awareness, has its own importance and many a times it is much cheaper and gets free coverage & easily available in different languages. Electronic media-specially TV media has the highest visibility, but, non aired mass media methods for creating awareness, has its own importance and many a times it is much cheaper and gets free coverage & easily available in different languages. Cancer Society of M.P. has been working in the field of Tobacco control for many years, using a combination of these different methodologies. Some of the activities conducted by us for Tobacco control and creating awareness about its health hazards are:- Posters: We have prepared, published and distributed various posters for tobacco control and self examination of oral cavity. Our posters have won international awards and have also been presented in many national & international conferences. The release of poster by eminent personalities, politicians gives us free media coverage on the topic too. One of our posters was also tested by Americans for its impact in Egypt. Hoardings/Bill boards are a cheaper long term display media, strategically placed, it has a high visibility also.Pamphlets:- We have distributed nearly 100 thousand pamphlets in the holy Sinhastha Mela (fair) where nearly 10 million people participated. Hoardings/Bill Boards:- Installed at strategic points they are a source of constant reminder to th health hazards of tobacco. Lectures/symposiums:- We regularly give lectures on different aspects of tobacco control & its health hazards. Exhibitions:- Participation & display of banners,posters etc in various exhibitions, where many people come & see them. Public Rally:- Rally taken out through the city draws attention of public as well as gets free media coverage. Involvement of Priests:-lectures given in various temples & holy places to involve priests into tobacco control. Lectures/symposiums/workshops- we have done more then 100 such activities, mainly targeting schools, colleges, social clubs, police, media, lawyers etc. Car Stickers, pasting of small banners behind rickshaws, slogan contests & involvement of local service clubs in the activities helps us reach a larger population. All media are helpful in Tobacco Control. Although TV is an important awareness media, others are also important.

Environmental Tobacco Smoke and Children's Health.

Children are the most ETS-sensitive population due to their smaller bronchial tubes and less-developed immune systems; they also breathe faster and take in more harmful chemicals per kg of body weight than do adults (1, 6). In addition, children spend more time in indoor environments, and have more contact with surfaces, such as carpet or upholstery, that are exposed to ETS. ETS begins to threaten a child’s health before birth. Smoking during pregnancy increases the risk of pregnancy complications, premature delivery, and low birth weight, which are leading causes of infant death and stillbirth. ETS-exposed infants are also approximately three times more likely to die from sudden infant death syndrome (SIDS) (7). Children exposed to ETS are more frequently affected by middle ear infections, reduced lung function, respiratory diseases such as pneumonia and bronchitis, and more severe asthma (5). In addition, SHS exposure threatens the mental health of children. In particular, exposure during pregnancy is related to more behavioral problems, especially hyperactivity/inattention and conduct problems (8). According to data from 192 countries in 2004, it was estimated that 40% of children worldwide were exposed to SHS and 28% of pediatric deaths were attributable to this exposure (9). Although some of the pollutants in SHS can be removed by ventilation, a significant fraction adheres to the clothing and hair of smokers, and to surfaces, furnishings, and dust in indoor environments, persisting for a longer time; this is considered THS (10). THS constituents are re-emitted into the gas phase, or react with oxidants and other compounds in the environment to form secondary pollutants (10). General cleaning methods, such as vacuuming and wiping, are not effective at removing the nicotine that is adsorbed into indoor surfaces, furniture, clothes, and dust (10). THS exposure occurs via inhalation, ingestion, and dermal routes (2). Thirdhand smoke is a new concept in the field of tobacco control, and there are insufficient data on its greater effects on children compared to adults. Attention must be drawn to this situation and further scientific research is needed, as well as improved awareness by families and the general public.

Tobacco Control Policies in Vietnam: Review on MPOWER Implementation Progress and Challenges.

In Vietnam, the WHO Framework Convention on Tobacco Control (WHO FCTC) took effect in March 2005 while MPOWER has been implemented since 2008. This paper describes the progress and challenges of implementation of the MPOWER package in Vietnam. We can report that, in term of monitoring, Vietnam is very active in the Global Tobacco Surveillance System, completing two rounds of the Global Adult Tobacco Survey (GATS) and three rounds of the Global Youth Tobacco Survey (GYTS). To protect people from tobacco smoke, Vietnam has issued and enforced a law requiring comprehensive smoking bans at workplaces and public places since 2013. Tobacco advertising and promotion are also prohibited with the exception of points of sale displays of tobacco products. Violations come in the form of promotion girls, corporate social responsibility activities from tobacco manufacturers and packages displayed by retail vendors. Vietnam is one of the 77 countries that require pictorial health warnings to be printed on cigarette packages to warn about the danger of tobacco and the warnings have been implemented effectively. Cigarette tax is 70% of factory price which is equal to less than 45% of retail price and much lower than the recommendation of WHO. However, Vietnam is one of the very few countries that require manufacturers and importers to make "compulsory contributions" at 1-2% of the factory price of cigarettes sold in Vietnam for the establishment of a Tobacco Control Fund (TCF). The TCF is being operated well. In 2015, 67 units of 63 provinces/cities, 22 ministries and political-social organizations and 6 hospitals received funding from TCF to implement a wide range of tobacco control activities. Cessation services have been starting with a a toll-free quit-line but need to be further strengthened. In conclusion, Vietnam has constantly put efforts into the tobacco control field with high commitment from the government, scientists and activists. Though several remarkable achievements have been gained, many challenges remain. To overcome those challenges, implementation strategies that take into account the contextual factors and social determinants of tobacco use in Vietnam are needed.

English

In November 2015, negotiations of the Trans-Pacific Partnership Agreement came to a close with the release of the final text. It included an optional carve-out (exclusion) for tobacco control measures from the TPP's investor-state dispute settlement mechanism. Despite the apparent 'win' for the field of tobacco control, the limited scope of the carve-out provides only partial protection for public health regulatory measures.

Third-hand smoke exposure and health hazards in children

Smoking still represents a huge public health problem. Millions of children suffer the detrimental effects of passive smoking. An increasing number of countries have recently issued laws to regulate smoking in public places. Instead, homes remain a site where children are dangerously exposed to environmental tobacco smoke (ETS). The combination of tobacco smoke pollutants which remain in an indoor environment, the so-called 'third-hand smoke' (THS), represent a new concept in the field of tobacco control. THS consists of pollutants that remain on surfaces and in dust after tobacco has been smoked, are re-emitted into the gas-phase, or react with other compounds in the environment to form secondary pollutants. Indoor surfaces can represent a hidden reservoir of THS constituents that could be re-emitted long after the cessation of active smoking. Human exposure to THS pollutants has not yet been thoroughly studied. Infants and children are more prone to the risks related to THS exposure than adults because they typically spend more time indoors and have age-specific behaviours that may expose them to potential health hazards from THS. Further investigations are warranted to study the health effects of THS relevant to different exposure pathways and profiles. It would also be very important to evaluate how THS may affect the lung development through the in utero exposure during the pre-natal life. We aimed at reviewing recent findings published about THS, with special reference to the effects on children's health.

Intragroup Variance in Lesbian, Gay, and Bisexual Tobacco Use Behaviors: Evidence That Subgroups Matter, Notably Bisexual Women.

Emerging evidence suggests bisexual populations are at increased risk for a variety of negative health outcomes, including tobacco use. Lesbian, gay, and bisexual (LGB) populations are at increased risk for cigarette smoking, but research on LGB subpopulations' use of tobacco products beyond cigarettes and tobacco use differences across LGB subgroups is in its infancy. This study explores differences in use of tobacco products across LGB subgroups, including gender differences among bisexuals. This study reports results from a 2013 nationally-representative cross-sectional online survey of US adults (N = 17 087). Weighted tobacco use prevalence and adjusted logistic regression results are reported. LGB populations reported higher current use of any tobacco product (35.7%) and current use of cigarettes (32.0%), e-cigarettes (8.9%), regular (5.5%) and small cigars (11.6%), compared with non-LGB. Bisexual (odds ratio [OR] = 2.6, 95% confidence interval [CI]: 1.7-3.9) and lesbian (OR = 1.7, 95% CI: 1.0-2.7) women have higher odds of any tobacco use than heterosexual women; including greater odds of regular (OR = 2.9, 95% CI: 1.2-7.0 and OR = 2.2, 95% CI: 1.3-3.9; respectively) and small cigar use (OR = 2.4, 95% CI: 1.4-4.1 and OR = 3.2, 95% CI: 2.0-5.1; respectively). Gay men had lower odds of cigar use (OR = 0.4, 95% CI: 0.2-0.8) than heterosexual men. This is the first US adult population study to assess differences in use of various tobacco products across adult LGB subpopulations and by gender, confirming their increased risk of use and illuminating differences by subgroup and gender. Exploring LGB as a unified population appears inadequate to accurately characterize LGB tobacco use risk. Tobacco-related LGB health inequities, particularly among bisexual and lesbian women, may be greater than previously indicated. This manuscript provides important contributions to the field of tobacco control and prevention, and more specifically to LGB tobacco-related health disparities research. This is among the first population level studies to explore various tobacco use across LGB populations and across genders, comparing results to non-LGB populations in a national study. We provide novel evidence that bisexual women in particular, have a higher risk for use of various tobacco products, compared with other LGB subpopulations. In order to address this disparity, tobacco control professionals need to be made aware of these important differences in tobacco use behavior.

Asthma and air pollution

During the last decades research all over the world has highlighted the deleterious effects of pollution on respiratory health of adults and children. Nevertheless, air pollution still represents a significant threat to health. Children are more sensitive than adults to pollutants for several factors: increased respiration relative to body size; physiologic immaturity of respiratory and immunologic systems; low metabolic capacity; longer life expectancy. Several studies demonstrated an association between exposure to outdoor pollutants and respiratory diseases in childhood. Outdoor pollutants, such as nitrogen oxides (NOx), particulate (PM), carbon monoxide (CO), carbon dioxide (CO2), ozone (O3), sulfur dioxide (SO2), may provoke cytotoxic and functional damages in the airways through oxidative stress and inflammation. During the last decades the amount of pollutants from vehicular traffic has significantly increased, especially in urban areas. Recent epidemiological studies have shown that vehicular traffic represents the main source of outdoor pollutants and that it may increase the risk of respiratory outcomes (cough, phlegm, wheeze, asthma) in children through short-term and long-term effects on airways, lung function and allergic sensitization [1]. Indoor pollution is also particularly dangerous, mainly for children and adolescents, that typically spend most of the time in confined spaces (home, school and public spaces). Indoor pollutants concentration depends on external environmental pollutants filtered inside buildings, pollutants generated inside buildings (domestic work) and pollutants generated by personal activities. Combustion products (tobacco smoke and wood burning), CO, CO2, volatile organic compounds (VOC), microbial agents (fungi and bacterial endotoxins), organic products (pet derived and mite allergens, dampness, mold derived components) are the most important indoor pollutants. There is growing epidemiological evidence that indoor allergen exposure may contribute to the development of allergic respiratory symptoms, such wheezing, coughing and asthma in children [2]. Tobacco smoke is one of the environmental pollutants influencing morbidity and death rate in childhood as it is responsible for adverse health effects in both prenatal and postnatal life. Homes remain a site where children are dangerously exposed to environmental tobacco smoke (ETS). The combination of tobacco smoke pollutants which remain in an indoor environment, the so-called ‘third-hand smoke’ (THS), represents a new concept in the field of tobacco control [3]. Children still need to be protected with strict air quality standards, in order to improve their respiratory health. Therefore, policies that ensure better air quality are strongly desirable all over the world.

Cameras for Public Health Surveillance: A Methods Protocol for Crowdsourced Annotation of Point-of-Sale Photographs

BackgroundPhotographs are an effective way to collect detailed and objective information about the environment, particularly for public health surveillance. However, accurately and reliably annotating (ie, extracting information from) photographs remains difficult, a critical bottleneck inhibiting the use of photographs for systematic surveillance. The advent of distributed human computation (ie, crowdsourcing) platforms represents a veritable breakthrough, making it possible for the first time to accurately, quickly, and repeatedly annotate photos at relatively low cost.ObjectiveThis paper describes a methods protocol, using photographs from point-of-sale surveillance studies in the field of tobacco control to demonstrate the development and testing of custom-built tools that can greatly enhance the quality of crowdsourced annotation.MethodsEnhancing the quality of crowdsourced photo annotation requires a number of approaches and tools. The crowdsourced photo annotation process is greatly simplified by decomposing the overall process into smaller tasks, which improves accuracy and speed and enables adaptive processing, in which irrelevant data is filtered out and more difficult targets receive increased scrutiny. Additionally, zoom tools enable users to see details within photographs and crop tools highlight where within an image a specific object of interest is found, generating a set of photographs that answer specific questions. Beyond such tools, optimizing the number of raters (ie, crowd size) for accuracy and reliability is an important facet of crowdsourced photo annotation. This can be determined in a systematic manner based on the difficulty of the task and the desired level of accuracy, using receiver operating characteristic (ROC) analyses. Usability tests of the zoom and crop tool suggest that these tools significantly improve annotation accuracy. The tests asked raters to extract data from photographs, not for the purposes of assessing the quality of that data, but rather to assess the usefulness of the tool. The proportion of individuals accurately identifying the presence of a specific advertisement was higher when provided with pictures of the product’s logo and an example of the ad, and even higher when also provided the zoom tool (χ2 2=155.7, P<.001). Similarly, when provided cropped images, a significantly greater proportion of respondents accurately identified the presence of cigarette product ads (χ2 1=75.14, P<.001), as well as reported being able to read prices (χ2 2=227.6, P<.001). Comparing the results of crowdsourced photo-only assessments to traditional field survey data, an excellent level of correspondence was found, with area under the ROC curves produced by sensitivity analyses averaging over 0.95, requiring on average 10 to 15 crowdsourced raters to achieve values of over 0.90.ResultsFurther testing and improvement of these tools and processes is currently underway. This includes conducting systematic evaluations that crowdsource photograph annotation and methodically assess the quality of raters’ work.ConclusionsOverall, the combination of crowdsourcing technologies with tiered data flow and tools that enhance annotation quality represents a breakthrough solution to the problem of photograph annotation, vastly expanding opportunities for the use of photographs rich in public health and other data on a scale previously unimaginable.

Youth Advocacy as a Tool for Environmental and Policy Changes That Support Physical Activity and Nutrition: An Evaluation Study in San Diego County

BackgroundAs evidence grows about the benefits of policy and environmental changes to support active living and healthy eating, effective tools for implementing change must be developed. Youth advocacy, a successful strategy in the field of tobacco control, should be evaluated for its potential in the field of obesity prevention.Community ContextSan Diego State University collaborated with the San Diego County Childhood Obesity Initiative to evaluate Youth Engagement and Action for Health! (YEAH!), a youth advocacy project to engage youth and adult mentors in advocating for neighborhood improvements in physical activity and healthy eating opportunities. Study objectives included documenting group process and success of groups in engaging in community advocacy with decision makers.MethodsIn 2011 and 2012, YEAH! group leaders were recruited from the San Diego County Childhood Obesity Initiative’s half-day train-the-trainer seminars for adult leaders. Evaluators collected baseline and postproject survey data from youth participants and adult group leaders and interviewed decision makers.OutcomesOf the 21 groups formed, 20 completed the evaluation, conducted community assessments, and advocated with decision makers. Various types of decision makers were engaged, including school principals, food service personnel, city council members, and parks and recreation officials. Eleven groups reported change(s) implemented as a result of their advocacy, 4 groups reported changes pending, and 5 groups reported no change as a result of their efforts.InterpretationEven a brief training session, paired with a practical manual, technical assistance, and commitment of adult leaders and youth may successfully engage decision makers and, ultimately, bring about change.

The use and perception of electronic cigarettes and snus among the U.S. population.

BackgroundE-cigarettes have generated controversy in the tobacco control field similar to that of Swedish snus, which came to the U.S. market six years earlier. Some argue that e-cigarettes have great potential to help smokers quit regular cigarettes while others contend they should be banned for lack of safety and efficacy data. This study examined population data from the U.S.MethodsA U.S. population survey with a national probability sample (N=10,041) was conducted (February 24 to March 8, 2012, before any major paid advertisement of e-cigarettes appeared on television). Survey respondents were asked if they had heard about e-cigarettes, where they had heard about them, whether they had used e-cigarettes or snus, how often they used them, and why they used them. Responses were weighted to represent the entire U.S. population.FindingsA high proportion, 75.4%, reported having heard about e-cigarettes. Television ranked as the number one source of information, followed by “in-person conversation” and “Internet.” About 8.1% had tried e-cigarettes, and 1.4% were current users. These rates were twice those of snus (4.3% and 0.8%, respectively). Among current smokers, 32.2% had tried e-cigarettes, and 6.3% were current users. Over 80% of current e-cigarette users were non-daily users. Women were significantly more likely to have tried e-cigarettes than men. Those who had tried e-cigarettes were more likely than those who tried snus to report their products being safer than regular cigarettes (49.9% vs. 10.8%). Almost half (49.5%) of current smokers were susceptible to using e-cigarettes in the future.ConclusionsThat e-cigarettes have surpassed snus in adoption rate, even before any promotion by major tobacco companies, suggests that the former have tapped into smokers’ intuitive preference for potentially harm-reducing products, probably due to the product design. E-cigarette use is likely to increase in the next few years.

Conceptual challenges in the translation of research into practice: it's not just a matter of "communication".

This paper identifies key barriers to the translation of science into practice and policy and makes recommendations for addressing them. It focuses on the challenges of translation within the field of tobacco control, but we argue that the insights are widely generalisable. Actor-Network Theory is used to frame an analysis, supplemented by focussed discussions with international tobacco control practitioners (service delivery and advocacy) and researchers. The central challenge to translation is that researchers and practitioners have different "practical ontologies". Researchers use findings from specific contexts to generalise to universal principles, while practitioners try to use these generalisations to inform their work in what are typically a somewhat different set of specific contexts. Neglecting the need to translate back from the general to the particular means research syntheses are not framed to meet practitioners' needs. Traditional knowledge broking roles need to be extended to better align the needs of researchers and practitioners. This may be facilitated by more creative use of "social computing" to enable real-time input into research syntheses from all interested parties, including input to the questions that research addresses. To do this systematically requires that we construct "generalisation gradients" to help practitioners apply general research conclusions to their particular situation and researchers to identify the relevance of their work. Disadvantaged communities in particular need help, since there is typically less research directly applicable to their contexts; thus, they need to generalise more.

Rigour and Feasibility in Tobacco Control Evaluation: Toward a Successful Reconciliation

Abstract: The challenge of reconciling scientific rigour with feasibility is central to the goals of policy and program evaluation for tobacco control. Evaluations conducted in various settings are held to high standards of performance, and must also be considered feasible by program authorities and stakeholders. This article describes three recent examples from the field of tobacco control. Issues of context, relevance, and stakeholder participation in planning evaluation designs are central to successful reconciliation. To affect tobacco control evaluation positively, reconciliation between the goals of rigour and feasibility needs to occur on two levels: between evaluator and stakeholders, and within the evaluation plan.

Nurses’ Use of Qualitative Research Approaches to Investigate Tobacco Use and Control

Qualitative research methods are increasingly used by nurse scientists to explore a wide variety of topics relevant to practice and/or health policy issues. The purpose of this chapter is to review the contributions of nurse scientists to the field of tobacco control through the use of qualitative research methods. A systematic literature search strategy was used to identify 51 articles published between 1980 and 2008. The majority (84%) of reviewed articles were authored by North American nurse scientists. Cessation was the most commonly (85%) studied aspect of tobacco control. Six qualitative research approaches were used: qualitative descriptive (55%), narrative analysis (8%), phenomenology (6%), grounded theory (14%), ethnography (12%), and case study (6%). Qualitative descriptive methods were primarily one-off studies to address practical problems or issues encountered in practice, and often validated current understandings related to tobacco. Researchers who used other types of qualitative methods and who conducted qualitative studies as part of programs of research were more likely to make more substantive contributions to the evolving field of tobacco control. These contributions related to how smoking intertwines with personal and social identities, the influence of social context on tobacco use, and nurses' involvement in tobacco control (both of their own tobacco use and in assisting others). Nurse scientists interested in exploring tobacco-related issues are encouraged to consider the full range of qualitative research approaches. Qualitative research methods contribute to our understanding of tobacco use arising from nursing practice, health care and policy, along with the field of tobacco control in general.

Tobacco Control: Visualisation of Research Activity Using Density-Equalizing Mapping and Scientometric Benchmarking Procedures

Background:Tobacco smoking continues to be a major preventable cause of death and disease and therefore tobacco control research is extremely important. However, research in this area is often hampered by a lack in funding and there is a need for scientometric techniques to display research efforts.Methods:The present study combines classical bibliometric tools with novel scientometric and visualizing techniques in order to analyse and categorise research in the field of tobacco control.Results:All studies related to tobacco control and listed in the ISI database since 1900 were identified by the use of defined search terms. Using bibliometric approaches, a continuous increase in qualitative markers such as collaboration numbers or citations were found for tobacco control research. The combination with density equalizing mapping revealed a distinct global pattern of research productivity and citation activity. Radar chart techniques were used to visualize bi- and multilateral research cooperation and institutional cooperation.Conclusions:The present study supplies a first scientometric approach that visualises research activity in the field of tobacco control. It provides data that can be used for funding policy and the identification of research clusters.

A letter from Nigel Gray

2008 is the fortieth anniversary of my entry into the field of tobacco control and I thank the editor for allowing me to indicate by this letter that I intend...