Reduce Cigarette Consumption Research Articles

Extended cost–benefit analysis of tobacco taxation in Brazil

BackgroundBrazil has experienced a persistent and substantial reduction in the prevalence of smoking in the population since 2006 due to increased taxes on tobacco and other tobacco control policies. Despite...

Smoking cessation interventions for pregnant women attending treatment for substance use disorders: A systematic review.

Background and aimsUp to 95% of pregnant women seeking treatment for alcohol and other drug (AOD) use smoke tobacco. Previous reviews indicate few effective smoking cessation treatments for this group. This updated review aimed to identify and measure the efficacy of smoking cessation interventions trialled among pregnant women in AOD treatment settings who smoke tobacco.MethodsA narrative synthesis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. Studies involving psychological, behavioural or pharmacological interventions used to treat tobacco use, including electronic nicotine delivery systems, for pregnant women of any age, who smoked tobacco and were seeking/receiving treatment, or in post‐treatment recovery for AOD concerns, were reviewed. MEDLINE, PsycINFO, CINAHL, EMBASE and ProQuest databases, grey literature and reference lists were searched, and field experts were contacted for unpublished study data. The Effective Public Health Practice Project tool assessed study quality. The review was pre‐registered with PROSPERO no. CRD42018108777.ResultsSeven interventions (two randomised controlled trials, two single‐arm pilot studies, two program evaluations and one causal comparative study) treating 875 women were identified. All were United States (US)‐based and targeted women with drug dependence, but not alcohol dependence. Three interventions used contingency management, five provided behavioural counselling, and one offered nicotine replacement therapy. All reported reductions in cigarette consumption; one contingency management‐based study demonstrated higher abstinence rates compared with controls at treatment‐end that were not maintained at follow‐up. Four of six studies were rated as methodologically weak and one unpublished study was not rated.ConclusionsConclusions about the efficacy of smoking interventions for pregnant women with alcohol and other drug concerns who also smoke tobacco are hindered by the paucity of available data and poor methodological quality of included studies.

The effect of price on cigarette consumption, distribution, and sale in Tehran: a qualitative study

BackgroundAppropriate increases in tobacco taxes and prices are an essential component of comprehensive tobacco control strategies. This study investigates factors related to the use, sale, and distribution of cigarettes in Iran, focusing on the relationship between cigarette price and its consumption.MethodsThis interview-based qualitative study was conducted among 20 participants, including cigarette smokers, retail shop owners, large-scale distributors, and an expert in tobacco control research.ResultsSeven themes were extracted from participant interviews, including the type and price of cigarette, the best time to sell cigarettes, profits from the sale of cigarette, affordability, rise in cigarette price and smokers’ reaction to it, lobbying and black-market sales of cigarettes, and the sale and distribution of cigarettes across the country. Although the price of cigarettes in Iran has shown some increases in the past decade, the timing of these increases are not predictable and the limited amount of these increases has not reduced the use of cigarettes. Following a price increase, consumers are more likely to switch from buying packets to single cigarettes, or buy a less expensive brand, then to quit. Moreover, increases in prices may encourage smokers and sellers to buy a large number of cigarettes and store them for a rainy day. Another adverse effect may be increased smuggling of illicit cigarettes to balance the pressure caused by rising prices.ConclusionsOur findings highlight two important aspects concerning cigarette pricing in Iran. First is the change in the type of purchase from the whole box of cigarettes to the single stick cigarette or swapping to less expensive cigarettes. Second, increase in cigarette price (either through taxing or regular increases) could be offset by flooding smuggled cigarettes into the market. Therefore, in addition to raising cigarette prices, reducing cigarette consumption rates in Iran requires the development and effective implementation of regulatory policies to control cigarette smuggling, reduce purchasing, and subsequently curb the use of this leading cause of premature morbidity and mortality.

Effects of the Brazilian tax reform plans on the tobacco market

BackgroundThere has been an intense debate in the Brazilian National Congress on how to reform the country’s tax system on consumption. This paper investigates the effects of the tax reform...

Repetitive transcranial magnetic stimulation for smoking cessation: apivotal multicenter double-blind randomized controlled trial.

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation method increasingly used to treat psychiatric disorders, primarily depression. Initial studies suggest that rTMS may help to treat addictions, but evaluation in multicenter randomized controlled trials (RCTs) is needed. We conducted a multicenter double-blind RCT in 262 chronic smokers meeting DSM-5 criteria for tobacco use disorder, who had made at least one prior failed attempt to quit, with 68% having made at least three failed attempts. They received three weeks of dailybilat-eral active or sham rTMS to the lateral prefrontal and insular cortices, followed by once weekly rTMS for three weeks. Each rTMS session was administered following a cue-induced craving procedure, and participants were monitored for a total of six weeks. Those in abstinence were monitored for additional 12 weeks. The primary outcome measure was the four-week continuous quit rate (CQR) until Week 18 in the intent-to-treat efficacy set, as determined by daily smoking diaries and verified by urine cotinine measures. The trial was registered at ClinicalTrials.gov (NCT02126124). In the intent-to-treat analysis set (N=234), the CQR until Week 18 was 19.4% following active and 8.7% following sham rTMS (X2 =5.655, p=0.017). Among completers (N=169), the CQR until Week 18 was 28.0% and 11.7%, respectively (X2 =7.219, p=0.007). The reduction in cigarette consumption and craving was significantly greater in the active than the sham group as early as two weeks into treatment. This study establishes a safe treatment protocol that promotes smoking cessation by stimulating relevant brain circuits. It represents the first large multicenter RCT of brain stimulation in addiction medicine, and has led to the first clearance by the US Food and Drug Administration for rTMS as an aid insmok-ing cessation for adults.

Cigarette pack size and consumption: an adaptive randomised controlled trial

BackgroundObservational evidence suggests that cigarette pack size – the number of cigarettes in a single pack – is associated with consumption but experimental evidence of a causal relationship is lacking. The tobacco industry is introducing increasingly large packs, in the absence of maximum cigarette pack size regulation. In Australia, the minimum pack size is 20 but packs of up to 50 cigarettes are available. We aimed to estimate the impact on smoking of reducing cigarette pack sizes from ≥25 to 20 cigarettes per pack.MethodA two-stage adaptive parallel group RCT in which Australian smokers who usually purchase packs containing ≥25 cigarettes were randomised to use only packs containing either 20 (intervention) or their usual packs (control) for four weeks. The primary outcome, the average number of cigarettes smoked per day, was measured through collecting all finished cigarette packs, labelled with the number of cigarettes participants smoked. An interim sample size re-estimation was used to evaluate the possibility of detecting a meaningful difference in the primary outcome.ResultsThe interim analysis, conducted when 124 participants had been randomised, suggested 1122 additional participants needed to be randomised for sufficient power to detect a meaningful effect. This exceeded pre-specified criteria for feasible recruitment, and data collection was terminated accordingly. Analysis of complete data (n = 79) indicated that the mean cigarettes smoked per day was 15.9 (SD = 8.5) in the intervention arm and 16.8 (SD = 6.7) among controls (difference − 0.9: 95%CI = − 4.3, 2.6).ConclusionIt remains unclear whether reducing cigarette pack sizes from ≥25 to 20 cigarettes reduces cigarette consumption. Importantly, the results of this study provide no evidence that capping cigarette pack sizes would be ineffective at reducing smoking. The limitations identified in this study can inform a more efficient RCT, which is urgently required to address the dearth of experimental evidence on the impact of large cigarette pack sizes on smoking.Trial registrationhttps://doi.org/10.1186/ISRCTN34202533

The influence of perceived stress and self-control on efficacy of repeated transcranial direct current stimulation in non-treatment-seeking smokers

IntroductionTranscranial direct current stimulation (tDCS) has recently been raising interest in its therapeutic impact on tobacco use disorder. This study investigates the effects of repeated frontal tDCS (anode: F3, cathode: F4) on cigarette consumption, craving and executive functions. Material and methodsIn a randomized sham-controlled trial, 24 individuals received active (2.0 mA) and 20 individuals received sham stimulation (0.3 mA) for 20 min on five consecutive days. The participants indicated their tobacco cravings, answered questionnaires and completed neuropsychological tasks at various time points throughout the study. Carbon monoxide (CO) levels and the daily numbers of consumed cigarettes were recorded. ResultsBoth intervention groups experienced a significant decrease in the daily number of smoked cigarettes, CO levels, and craving after the stimulation, however, there were no improvements in executive functions. These results did not differ significantly between both intervention groups. Additionally, in the active group, a higher level of perceived stress and a lower level of self-control were linked to a lower cigarette consumption, respectively a higher reduction of the level of CO. ConclusionThis study does not support the hypotheses that tDCS reduces cigarette consumption, attenuates substance craving, or improves executive functions beyond the placebo effect. Our subgroup analysis suggests that high levels of perceived stress and low self-control may be predictors for a successful reduction in cigarette consumption. Furthermore, the placebo effect might be rather high for light smokers, whereas heavy smokers seem to benefit more from the specific effects of tDCS.Clinical trial registration number: NCT03691805

Changes in Biomarkers of Cigarette Smoke Exposure After 6 Days of Switching Exclusively or Partially to Use of the JUUL System with Two Nicotine Concentrations: A Randomized Controlled Confinement Study in Adult Smokers.

IntroductionEvidence suggests that cigarette smokers who switch to electronic nicotine delivery systems (ENDS) reduce their exposure to harmful toxicants and carcinogens. It is unclear if dual-use is associated with decreases in exposure to toxicants.MethodsThis parallel-group confinement study assessed changes in biomarkers of exposure (BOEs) over six days among healthy adult smokers who were randomized into 1 of 11 study groups: eight JUUL-brand System (JUUL) groups (4 JUUL flavors [Virginia Tobacco, Menthol, Mint, Mango] × 2 nicotine concentrations [5.0% or 3.0% by weight]); Dual-Use group used preferred JUUL flavor (5.0% nicotine) and ≤50% usual brand (UB) cigarettes/day; UB Cigarette group and one group abstained from all tobacco/nicotine product use (Abstinence group). Urine and blood analysis assessed changes in primary BOE endpoints (NNAL, 3-HPMA, MHBMA, S-PMA COHb) and secondary BOE endpoints (NNN, HMPMA, CEMA, 1-OHP, O-toluidine, 2-NA, 4-ABP) among 279 adult smokers.ResultsIn JUUL groups, median percent reductions in primary BOEs (Day 6–Baseline) were 90%–≥100% of Abstinence; there were no significant differences between JUUL groups and Abstinence. All reductions in JUUL groups were substantially and statistically significantly greater than reductions in the UB Cigarette group (ps < 0.025). Median reductions in primary BOEs in the Dual-Use group were 43%–55% of Abstinence. Similar results were observed for secondary BOEs.ConclusionThis study suggests that the use of JUUL as a complete or partial substitute (i.e., dual-use with ≥50% reduction in cigarette consumption) for combustible cigarettes can substantially reduce exposure to multiple toxins associated with cigarette smoking.ImplicationsThis study adds to the growing body of evidence supporting the utility of ENDS products as potentially reduced-harm alternatives to cigarettes for adult smokers. Adult smokers who switched completely from cigarette smoking to use of the JUUL System (“JUUL”) in two nicotine concentrations (5.0% and 3.0%) and four flavors significantly reduced their exposure to multiple classes of cigarette-related toxicants. Additionally, smokers who used JUUL and continued smoking but reduced their daily cigarette consumption by ≥50% (dual users) also significantly reduced their toxicant exposure compared to cigarette smoking.

Identification characteristics of non-smoking tobacco products

Modern trends in the reduction of cigarette consumption have led to the spread of smokeless tobacco and non-tobacco nicotine-containing products [1]; their variety creates certain problems with the identification of products in this segment. Sucking tobacco (snus) has been banned in the Russian Federation for wholesale and retail trade since 2015, but it is a product similar to chew- ing tobacco in packaging, ingredient composition and physiological effects. Therefore, establishing the identification characteristics of chewing tobacco is an urgent task. The attitude towards chewing tobacco is controversial. The absence of the smoldering / burning process characteristic of cigarettes indicates a decrease in the harmful effect on the human body. At the same time, the physiological ef- fect on the consumer is based on the effect of nicotine extracted from tobacco through the oral mucosa. Consumer indicators of samples of smokeless tobacco / non-tobacco nicotine-containing products have been investigated: moisture content, fractional composition and nicotine content. The moisture content of samples of non-smoking products ranges from 19,0 % to 36,5 %. The nicotine content in the investigated tobacco / non-tobacco products is 0,3–2,4 % / 1,0–8,8 % respectively. To establish the identification signs of smokeless tobacco products the following methods have been used: product fractionation, optical microscopy, spectrophotometry, and liquid chromatography / tandem mass spectrometry (LCMS / MS). The main feature of the difference between smokeless tobacco products and non-tobacco nicotine-containing products has been determined – the presence of tobacco in the ingredient composition, confirmed by the structure of the product and the content of specific tobacco nitrosamines. As a result of the research, experimental data were obtained on the quantitative determination of the content of tobacco specific nitrosamines by the LCMS / MS method in smokeless tobacco products. The main identification feature of chewing tobacco has been established: the presence of raw tobacco in the ingredient composition with a coarse fraction content is at least 15 %.

Dual Use of Cigarettes and JUUL: Trajectory and Cigarette Consumption

Objectives: Many smokers who start using ENDS engage in dual use of cigarettes and ENDS. This paper examines time trends in dual use after a JUUL Starter Kit purchase, and changes in cigarette consumption among those remaining dual users. Methods: In the ADJUSST study, a cohort of adult smokers who purchased a JUUL Starter Kit were followed naturalistically 6 times over 12 months. Trends in dual use and reported complete switching away from cigarettes (ie, no past 30-day smoking), and changes in daily average cigarettes per day from baseline at 6 and 12 months were examined. Results: Dual use declined over time as complete switching increased. By 12 months, 43.2% reported dual using, and 51.2% reported switching away from cigarettes. Among dual users, approximately 60% reduced their cigarette consumption substantially (by ≥ 50%); average reductions in cigarette consumption were > 80%. Only a small minority (3%-10%) substantially increased cigarette consumption. Conclusions: Dual use of smoking and JUUL declines over time as switching away from smoking increases. This suggests that, for most smokers, dual use is a transitional state leading to switching completely away from cigarettes. Furthermore, dual use is often marked by substantial reductions in cigarette consumption.

Effect of an electronic nicotine delivery system with 0, 8, or 36 mg/mL liquid nicotine versus a cigarette substitute on tobacco-related toxicant exposure: a four-arm, parallel-group, randomised, controlled trial

Electronic nicotine delivery systems (ENDSs) are used by some smokers to reduce cigarette consumption, but their effectiveness is uncertain. We aimed to examine the extent to which ENDSs or a non-nicotine cigarette substitute influence tobacco-related toxicant exposure and cigarette consumption in smokers interested in smoking reduction. We did a four-arm, parallel-group, randomised controlled trial at two sites in the USA (Penn State University, Hershey, PA, and Virginia Commonwealth University, Richmond, VA). We enrolled adults aged 21-65 years who smoked more than nine cigarettes per day (for at least the past year), with exhaled CO of more than 9 parts per million at screening, who were not currently using an ENDS, and who were interested in reducing smoking but not quitting. Participants were randomised (site-specific with allocation concealment; 1:1:1:1) to receive either a cartomiser-based, pen-style ENDS (eGo-style) paired with 0, 8, or 36 mg/mL liquid nicotine (participants and researchers masked to concentration) or a non-ENDS cigarette-shaped plastic tube that delivered no nicotine or aerosol (cigarette substitute; unmasked) for 24 weeks. Conditions were chosen to reflect a range of nicotine delivery including none (cigarette substitute and 0 mg/mL ENDS), low (8 mg/mL), and cigarette-like (36 mg/mL), and all conditions were paired with smoking reduction instructions. The primary outcome was concentration of the tobacco-specific carcinogen metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL; urinary total) collected at randomisation and at 4, 12, and 24 weeks. Multiple imputation with and without covariate adjustment was used in addition to sensitivity analyses. This trial is registered with ClinicalTrials.gov, NCT02342795. Between July 22, 2015, and Nov 16, 2017, 684 individuals were screened and 520 (76%) were enrolled and randomised. 188 (36%) of 520 participants were lost to follow-up by week 24; attrition did not differ by study group (39 [30%] of 130 in the cigarette substitute group, 56 [43%] of 130 in the ENDS with 0 mg/mL nicotine group, 49 [38%] of 130 in the ENDS 8 mg/mL group, and 44 [34%] of 130 in the ENDS 36 mg/mL group). Urinary total NNAL at 24 weeks in the ENDS with 36 mg/mL nicotine group was 210·80 pg/mg creatinine (95% CI 163·03-274·42) compared with 346·09 pg/mg creatinine (265·00-455·32) in the cigarette substitute group (p=0·0061). No other significant differences between groups were observed for any time point for urinary total NNAL. Serious adverse event frequency was similar across groups (12 events in 12 participants [9%] in the ENDS with 36 mg/mL nicotine group, seven events in six participants [5%] in the 8 mg/mL group, 11 events in ten participants [8%] in the 0 mg/mL group, and 13 events in 13 participants [10%] in the cigarette substitute group), and all of these were deemed unrelated or unlikely to be related to study product use. There was one death between randomisation and 24 weeks (suicide; in the ENDS with 0 mg/mL nicotine group). Use of an ENDS with cigarette-like nicotine delivery can reduce exposure to a major pulmonary carcinogen, NNAL, even with concurrent smoking. Future ENDS trials should involve products with well characterised nicotine delivery, including those with nicotine delivery approaching that of a cigarette. National Institutes of Health, US Food and Drug Administration.

Demand for tobacco products in Bangladesh

BackgroundTobacco tax increase is considered as one of the most effective means to reduce tobacco consumption and its consequences. An increase in taxes, which results in an increase in the...

Investigating the Drivers of Smoking Cessation: A Role of Alternative Nicotine Delivery Systems?

Since 2010, several nations with impressive histories of smoking cessation have witnessed the proliferation of Alternative Nicotine Delivery Systems (ANDS). Advocates suggest that ANDS offer an effective and safer substitute for combustible tobacco. Critics fear that ANDS could expose consumers to novel harms, discourage smoking cessation and may even renormalize tobacco use. Different nations have adopted radically different regulatory strategies ranging from outright bans to active encouragement of ANDS-led smoking cessation. Economic, social and political factors also influence rates of smoking and uptake of ANDS. An investigation into the national-specific context for smoking cessation; including the role of ANDS in reducing cigarette consumption, is likely of value to regulators around the world hoping to reduce smoking-related morbidity and mortality in their own communities. Five case studies were conducted to review the evidence from Australia, Canada, Japan, South Korea and the UK, drawing on an interdisciplinary framework for investigation combining sociological, ethnographic, policy analytic and econometric disciplinary approaches into a schema for studying the drivers of smoking cessation at the individual, micro, meso and macro levels. Data on smoking, and cessation from four decades was combined with more recent data on ANDS use, to investigate the relationship between tobacco control policies, ANDS use and smoking cessation, as well as other salient aspects of the national tobacco control landscape. Each case study developed specific recommendations for policy makers and the research agenda. This report summarizes the findings of those studies. Taxation and Stop Smoking Services (SSS) were among the most effective cessation drivers. Smoke-free laws were also found to be of value, though the evidence for their efficacy in reducing smoking prevalence is mixed. Other policies that sought to reduce the appeal or opportunity to smoke such as plain pack legislation and health warnings, etc. were less associated with short term reductions in smoking prevalence, though these may yet reduce national smoking rates by discouraging uptake among future generations. Tobacco use continues to be concentrated in socially and economically disadvantaged groups. Where regulations allowed, ANDS (e-cigarettes and heated tobacco in particular) were associated with smoking cessation. Moreover, instances of tobacco use declining even as e-cigarette use increased suggests that e-cigarettes do not necessarily re-normalize tobacco use as feared. The results demonstrate how policy decisions affect ANDS use and the latter’s value as a cessation mechanism. The authors recommend that regulators continue to increase tobacco taxes carefully and study how to integrate ANDS with well-funded SSS provision. Regulators should also seek policies that differentiate among nicotine products with respect to their harms profiles. Future cessation programs should target socially and economically disadvantaged groups where tobacco harms continue to be concentrated. This research highlights the need for high quality open-access data collection and analysis, especially regarding use of ANDS.

Determinants of tobacco cessation among patients with chronic diseases (diabetes/hypertension) enrolled in Ministry of Health Tobacco Cessation Clinics, Kingdom of Saudi Arabia from 2012-2017

ABSTRACTObjectives:To investigate factors associated with tobacco cessation among patients with (diabetes or hypertension) who attended Ministry of Health (MOH) Tobacco Cessation Clinics (TCC), Saudi Arabia over the years 2012-2017.Methods:A case control study was conducted with 402 respondents. Data collection took place in Riyadh, Saudi Arabia from January 2018 to April 2018. Cases were patients with diabetes or hypertension who had been abstinent from tobacco for at least 6 months after attending MOH tobacco cessation clinics. Controls were patients with chronic diseases who had not quit tobacco after cessation clinics. Data were collected through a questionnaire by telephone interviews. Descriptive analysis, bivariate analysis, and multivariable regression were carried out.Results:Overall, 85 (21.1%) respondents had successfully quit tobacco, while 317 (78.9%) had not. Among those who had not quit cigarettes, 97 (42.4%) had reduced cigarette consumption, the mean difference in cigarette smoking from before to after MOH TCC was 01.812±5.928 (95% confidence interval [CI]: 2.584-1.040). Most of those who used other forms of tobacco 16 (72.7%) had not changed their consumption. The likelihood of successfully quitting tobacco increased with those lower educational level (adjusted odds ratio [AOR]=17.01, 95% CI: 1.00-289.2, p=0.05) and among those who reported controlled hypertension (AOR=17.8, 95% CI: 1.5-209.6, p=0.02).Conclusion:To increase abstention rates, chronic disease counseling with regular follow-ups, providing toll-free telephone services should be considered. More effort is needed to reduce non-cigarette tobacco consumption.

Impact of Cigarette Prices on Cigarette Sales and Consumption in Malaysia

To achieve the target and to reduce the cost and burden from smoking, the Malaysian government regulates and implements several tobacco control policies and campaigns to control cigarette consumption and reduce the proportion of smokers in the Malaysian population. It is undeniable that tobacco tax policy plays a significant role in reducing cigarette consumption globally, as mentioned in the World Health Organization (WHO) FCTC Article 6 (WHO, 2003). An effective taxation policy would reduce cigarette demand and at the same time, generate additional tax revenues for the government. For example, Ross & Al-Sadat (2007) predicted for Malaysia that an increase of 25% in excise tax would reduce cigarette consumption by 3.37% and will generate an increase of RM434 million in tax revenues. In addition, Mohamed Nor et al. (2013) contributed to a study which concluded that the excise tax rate in 2009 was not at the optimal level and had not garnered the maximum tax revenue, showing that the optimal real excise tax rate should have been about 16.5% higher in 2009. While the study was carried out in 2009, the findings have proven that Malaysia’s cigarette tax rate was not high enough at that point in time and even now. This suggests that the Malaysian government should continue to increase cigarette tax rates without worrying about the argument by the industry that higher tax will reduce government revenue.

Effects of a Cigarette Price Increase on the Smoking Behavior of Smokers and Non-smokers

Objectives: The government of the Republic of Korea (ie, South Korea) drastically increased cigarette prices by 80% in 2015. The exogenous regulatory change provided us with an opportunity to examine the effects of the cigarette price increase on smoking behavior. Methods: Utilizing 2011-2016 balanced panel data from the Korea Health Panel (3693 participants each year), we divided the sample into smokers and non-smokers and traced each individual's smoking behavior. Results: Overall smoking prevalence (OR = 0.476, p < .01) and daily cigarette consumption (IRR = 0.737, p < .01) were reduced after the cigarette price increase. However, although the cigarette price increase was inversely related to smokers' cigarette consumption (OR = 0.799, p < .01), we found no statistically significant impact on smoking cessation among smokers. On the other hand, the cigarette price increase was associated with decreased smoking onset among non-smokers (OR = 0.172, p < .01) and reduced cigarette consumption after they started smoking (IRR = 0.279, p < .01). Conclusions: The reduction in smoking prevalence after the increase of the cigarette price resulted from the fact that non-smokers did not start smoking rather than from a decrease in the number of existing smokers.

Analysis of Coping Strategy in Overcoming Lack of Food in Coastal Community Households in Lantagi Village, Kulisusu Sub District North Buton District

This study aims to determine Coping Strategy Analysis in Overcoming Deficienciesfood carried out by coastal community households in Lantagi Village, Kulisusu District, North Buton Regency. The research was conducted from January to March 2020 in Lantagi Village, Kulisusu District, North Buton Regency. The population in this study amounted to 175 households and the sample was taken by simple random sampling using the Slovin formula, namely 35 households. Coping Strategy Analysis in Overcoming Deficiencies household food using the Shariff and Khor approach which is divided into two categories, namely strategies related to food and strategies related to income or expenditure. The results showed that households in Lantagi Village, Kulisusu District, North Buton Regencyin The strategy to overcome food shortages related to food, the main strategy to be carried out is to reduce the portion of food and purchasing cheaper foodstuffs (substitution) by 77.1% and strategies related to household income or expenditure the main strategy is a strategy to reduce cigarette consumption by 65.7%.

Analysing the trend of illicit tobacco in the Philippines from 1998 to 2018

Tobacco taxation is the most effective measure to reduce cigarette consumption and consequently improve public health outcomes. It is also an important source of government revenue. The presence of an...

Reduction of bronchial response to mannitol after partial switch from conventional tobacco to electronic cigarette consumption

BackgroundRegarding the multiple health effects of e-cigarettes, there are insufficient data on potential effects on bronchial reactivity (BHR). In the present study, we assessed the impact of a switch from conventional to e-cigarettes on BHR under realistic conditions over a period of 3 months. MethodsSixty subjects who declared to reduce or stop their tobacco consumption by inhalation of nicotine-containing liquids via e-cigarette, and 20 volunteers participating in a stop-smoking program were included. Data was analysed using parametric and non-parametric statistical procedures. Spirometry, determinations of exhaled carbon monoxide (eCO) and nitric oxide (FeNO), provocation testing with mannitol as an indirect bronchial stimulus, and cotinine measurements were used to investigate BHR and nicotine abstinence. ResultsBHR to mannitol significantly decreased in the group using e-cigarettes and nicotine-containing liquids over a period of three months in this real-life setting. Participants reduced their tobacco consumption to about 25% or lower, confirmed by a reduction in eCO. Changes in lung function and FeNO were small and not statistically significant, and changes in the stop-smoking group were similar to those in the e-cigarette group. ConclusionThe reduction in BHR that can be expected after a reduction of cigarette consumption was not abolished by the concomitant use of e-cigarettes. Whether the decrease in BHR observed after 3 months is maintained when using e-cigarettes over longer time periods or has an individual prognostic value, must be clarified in long-term studies.

The interactive effect of anxiety sensitivity and negative smoking cessation cognitions on reductions in cigarette consumption during acute cessation

IntroductionAnxiety sensitivity (AS) as well as negative cognitions about one’s ability to quit smoking represent cognitive-affective vulnerabilities implicated in smoking cessation success. However, the extent to which one’s perceived sensitivity to anxiety and cessation-related cognitions uniquely and interactively affect acute abstinence outcomes has not been examined. The current study examined the interactive effects of AS and cessation cognitions on percent reductions in cigarettes smoked during the first 24-h of a quit attempt. MethodsAdult cessation-motivated smokers (n = 64; Mage = 34.21, SD = 11.49) completed a planned quit attempt. AS and cessation cognitions were evaluated prior to quit day. Percent cigarette reduction was assessed by number of cigarettes smoked the day before and during the first 24 h of the quit attempt. ResultsSignificant interactive effects between AS and cessation cognitions (i.e., expectation of success in quitting, intolerance of withdrawal symptoms, and lack of cognitive coping) were observed. Consistent with hypotheses, individuals reporting higher AS and a greater perceived ability to tolerate withdrawal as well as a greater expectation of success reported larger reductions in cigarettes post quit compared to those who did not endorse these beliefs. Unexpectedly, individuals reporting lower AS who did not endorse the belief that they should be able to tolerate withdrawal discomfort, or a lack of cognitive coping, reported larger reductions compared to those who did endorse this belief. ConclusionAS may interact with specific cessation cognitions. Pre-cessation beliefs that individuals will be successful and be able to tolerate withdrawal symptoms may support cessation efforts.