Reduce Tobacco Consumption Research Articles

Prevalence of tobacco consumption among the Northeast population of India

Background and Objectives: Widespread use of tobacco among Indians has been associated with several lung diseases; however, the exact prevalence of tobacco use, particularly in the northeastern region of India, is not known. Therefore, we conducted a systematic review and meta-analysis to evaluate the prevalence of tobacco use among the northeast population of India. Methodology: Four electronic databases were searched using the appropriate search strategy. A systematic search yielded 15 articles that were included in this review. Out of these, 13 studies were found to be eligible for meta-analysis. Risk of bias was assessed using the Hoy et al. scale. Statistical analysis was done using the STATA version 16. Results: Data from 453,844 participants, mean age range of 15–60 years, were collected from the northeastern states. The overall pooled prevalence estimate for the tobacco consumption reported was found to be 44.71% (95% confidence interval [CI]: 16.48%–72.93%). Manipur reported comparatively higher tobacco consumption than the other eastern northeastern states 45.13% (95% CI: 7.26%–72.93%). A higher pooled prevalence was found for the employed (31.10%; 95% CI: 24.83%–83.00%) versus unemployed (26.96%; 95% CI: 22.07%–31.86%), and literates (40.36%; 95% CI: 16.19%–64.54%) versus illiterates (19.87%; 95% CI: 3.95%–35.79%). In addition, smokeless tobacco (29.10%; 95% CI: 9.33%–48.88%) consumption was reportedly higher than that of smoked tobacco (22.96%; 95% CI: 1.74%–44.18%). Gender subgroup analysis showed a higher prevalence in males (28.59%; 95% CI: 24.16%–33.02%) as compared to females (25.77%; 95% CI: 17.68%–33.86%). Conclusion: A higher prevalence of tobacco use among the northeastern region of India, particularly males, the employed class, and illiterate people, suggests a dire need of more effective awareness programs to reduce tobacco consumption.

Reasons to decrease or stop nicotine and tobacco use among adults and association with MPOWER scores in twenty-one middle- and high-income countries, 2019-2020.

This study examined reasons why people planned to reduce or stop tobacco consumption and their relationship with MPOWER scores, adjusting for sociodemographic, cultural, and economic factors. Data used were Euromonitor International's Voice of the Consumer: Nicotine Survey 2019-2020, World Bank's country income and WHO's MPOWER policy scores. Analytical sample included 21913 adults of legal smoking age in 21 middle- and high-income countries who used nicotine and tobacco products and planned to reduce or stop their consumption in the next 12 months. Poisson regression models with robust error variance, adjusted for sociodemographic and tobacco use covariables, generated adjusted risk ratios (ARRs) of selecting a certain reason to reduce tobacco consumption dependent on continuous MPOWER scores. Main reasons to reduce or stop tobacco consumption were improving health (85%), saving money (65%), pressure from family (19%), and using another substance instead (4%). Country variation was observed by MPOWER scores. Positive associations were found between some MPOWER scores and reasons to reduce or stop tobacco consumption: enforcing bans on tobacco advertising and using another substance (ARR=1.28; 95% CI: 1.11-1.47); warning about dangers of tobacco and saving money (ARR=1.25; 95% CI: 1.19-1.32); offering help to quit tobacco and using another substance (ARR=1.26; 95% CI: 1.10-1.45) or family pressure (ARR=1.11; 95% CI: 1.04-1.17); anti-tobacco campaigns and using another substance (ARR=1.15; 95% CI: 1.08-1.23); and raising taxes and saving money (ARR=1.11; 95% CI: 1.09-1.13). MPOWER scores are associated with reported reasons to quit tobacco including to improve health, save money, respond to family pressure or use another substance instead.

SYSTEMATIC REVIEW OF THE RELATIONSHIP BETWEEN TOBACCO SMOKE AND CARBON MONOXIDE: IMPACT ON HEALTH AND DISEASE

Aim : The objective of this study is to evaluate the correlation between tobacco consumption and levels of exhaled carbon monoxide. Material and Methods : To conduct the literature review, multiple databases and sources were utilized. The search was conducted using MeSH Terms related to tobacco and exhaled carbon monoxide. Initially, 421 titles were identified from these sources, and after screening, 118 records were examined, resulting in 25 research-related articles. The review adhered to the PRISMA guidelines for systematic reviews to ensure a standardized and rigorous approach to the evaluation of the selected studies. Results: Six randomized controlled trials were incorporated in the analysis, aiming to compare the association between tobacco consumption and exhaled carbon monoxide levels. The findings from all six trials consistently demonstrated a significant correlation between these two variables. Conclusion: To sum up, the analysis of research publications focusing on tobacco consumption and exhaled carbon monoxide (CO) levels yields valuable insights regarding the correlation between smoking behavior, CO levels, and the associated health implications. This body of literature enhances our understanding of the relationship between smoke & implications on well being, shedding light on the potential risks and consequences of tobacco use. Clinical Significance: Gaining a deeper understanding of these relationships can play a significant role in developing impactful strategies for smoking cessation. Furthermore, it can help raise awareness about the detrimental effects of tobacco smoke and emphasize the importance of reducing tobacco consumption. By leveraging this knowledge, we can work towards implementing effective interventions and public health campaigns aimed at promoting smoking cessation and improving overall population health. KEYWORDS : Smoking cessation, tobacco, carbon monoxide

The Crowding-out Effect of Tobacco Expenditure on Health Expenditure: Evidence From a Lower-Middle-Income Country.

Poor people have remarkably lower health expenditures than rich people in Vietnam. According to the 2016 Vietnam Household Living Standard Survey (VHLSS), per capita health expenditure of the top quintile households is around 6 times higher than that of the bottom quintile households. We analyze economic inequalities in health expenditure using the concentration index approach and data from the VHLSS 2010-2016. Next, we use the instrumental-variable regression analysis to examine the crowding-out effect of tobacco expenditure on health expenditure. Finally, we use decomposition analysis to explore whether economic inequality in tobacco expenditure is associated with an economic inequality in health expenditure. We find a crowding-out effect of tobacco expenditure on health expenditure of households. The share of health expenditure of households with tobacco spending is 0.78% lower than that of households without tobacco spending. It is estimated that a one-VND increase in tobacco expenditure results in a 0.18 Vietnamese Dong (VND) (95% CI: -0.30 to -0.06) decrease in health expenditure. There is a negative association between economic inequality in tobacco expenditure and economic inequality in health expenditure. This means that if the poor consume less tobacco, their expenditure on health can be increased, resulting in a decrease in inequality in health expenditure. Findings from this study suggest that reducing tobacco expenditure could improve health care of the poor and reduce inequality in health care in Vietnam. Our study recommends that the government continuously increase the tobacco tax in order to effectively reduce tobacco consumption. Empirical studies show mixed results on the effect of tobacco expenditure on health expenditure. We find a crowding-out effect of tobacco expenditure on health expenditure of poor households in Vietnam. It implies that if the poor reduce their expenditure on tobacco, economic inequality in health expenditure can be reduced. Our findings suggest that reducing tobacco consumption in poor households can increase their health expenditure, therefore, decreasing inequality in health expenditure. Different policies to reduce tobacco consumption such as tobacco taxation, smoke-free areas, and tobacco advertisement bans should be strengthened.

Tobacco excise tax reform: From the perspective of "tax to control tobacco" policy in China.

The consumption of tobacco is harmful to health and has huge social costs. "Tax to control tobacco" is a widely implemented tobacco control measure all over the world. In order to examine the achievements of two tobacco excise tax reforms in China in 2009 and 2015 on controlling tobacco consumption, we first establish an intertemporal consumption model for addictive goods, and then validate the effectiveness of the two tobacco excise tax reforms using a Continuous Difference-in-Differences Model based on the panel data from 294 cities in China from 2007 to 2018. The results show that the tobacco excise tax reform in 2015 considerably reduced tobacco consumption, while the reform in 2009 did not, providing empirical evidence on the importance of "price links to tax" for tobacco control. Additionally, the study discovers that the tax reform has a heterogeneous effect on the age of smokers, the price of cigarettes, and city size.

Impact of Excise Tax on Reducing Tobacco Consumption – The Case of Vietnam

With rising tobacco consumption around the world, particularly in Vietnam. The essay examined and evaluated the excise duty on cigarettes in Vietnam. Moreover, the author developed a research model based on elements influencing tobacco consumption behavior, such as GDP, population, inflation, and excise tax rates. Besides, the authors discovered shortcomings in the current Vietnamese tax system after reviewing documents and data, such as the tax rate being too low in comparison to people's income and the taxable price being currently factory pricing. As a result, the essay provides important ideas for pushing the reform of Vietnam's tobacco excise tax policy in the next few years.

Impact of Excise Tax on Reducing Tobacco Consumption – The Case of Vietnam

Impact of Excise Tax on Reducing Tobacco Consumption – The Case of Vietnam

Perceived increased susceptibility to COVID-19 due to smoking was associated with reduced smoking at home but not on the streets amid the pandemic: A population-based cross-sectional study.

Perceived risk of COVID-19 infection is associated with smoking behaviors, but the change in smoking across different settings are uncertain. We examined the associations of perceived increased susceptibility to COVID-19 due to smoking with change in smoking at home and on the streets. We analyzed data of 1120 current cigarette smokers aged ≥15 years from a population-based telephone survey in Hong Kong. Perceived increased susceptibility to COVID-19 due to smoking, change in smoking, intention to quit, and tobacco dependence were measured. We used Poisson regression with robust variance to estimate adjusted risk ratio (ARR) for associations, adjusting for sociodemographic characteristics, intention to quit, and time to first cigarette after waking. More current smokers reduced smoking on the streets (46.1%; 95% CI: 42.8-50.0) than at home (8.7%; 95% CI: 7.0-10.8). Perceived increased susceptibility to COVID-19 due to smoking was associated with smoking reduction at home (ARR=3.29; 95% CI: 1.80-6.00, p<0.001) but not on the streets (ARR=1.13; 95% CI: 0.98-1.30, p=0.09). More smokers with stronger quit intention and lower tobacco dependence reduced smoking at home but not on the streets in those with high perceived increased susceptibility to COVID-19 due to smoking. This is the first report showing that more cigarette smokers reduced smoking on the streets than at home, and the perceived increased susceptibility to COVID-19 due to smoking was only associated with smoking reduction at home but not on the streets. Improving smokers' awareness of the susceptibility to COVID-19 may be an effective strategy to reduce tobacco consumption and secondhand smoke exposure at home within the context of future respiratory pandemics.

Discourse on Human Rights Issues and Public Policy Context: Prospect of Indonesia Tobacco Control Regulation

The efforts on tobacco control are based on two main philosophies which are focused on human rights and the economy. This is observed for every country that is willing to reduce tobacco consumption and slightly ensure prosperity at the same time. It is being discussed in the international community that some countries are not a party to FCTC (Framework Convention on Tobacco Control) but have a domestic regulatory system for tobacco or are committed to implementing other obligations based on international norms at the minimum. This research specifically examined institutions and rules besides politics and judiciary enforcement in tobacco control regulation through the application of comparative and system approaches within the legal political context and a qualitative method. It was discovered that Indonesia has the ability to deliberate domestic regulatory systems to combat and reduce tobacco use despite the strong interference by tobacco industries and markets that are approaching legislatures, politicians, or executive apparatus to create different institutional interests. This usually leads to a mixture of verdict and judgment for the judiciary and legal enforcement.

Causal Effect of Education on Tobacco Use in Low-and-Middle-Income Countries.

The prevalence of smoking is unequally distributed across certain groups. One significant dimension is education inequality, where higher smoking prevalence is generally observed in lower-educated groups. However, studies investigating educational inequality are mostly associative. Meanwhile, studies carrying out a causal investigation focus typically on developed countries. In this study, we consider a panel of low-and-middle-income countries (LMICs) to investigate the causal link between education and smoking behavior. We use detailed micro-level household surveys for 12 LMICs where the duration of compulsory schooling has been extended. By identifying the individuals subject to higher compulsory schooling and using the exogenous variation in education caused by the increase in the duration of compulsory schooling, we estimate the causal impact of education on tobacco consumption. We rely on regression analysis to estimate the effect. Our results reveal that those subject to higher years of compulsory schooling have lower smoking-related outcomes, suggesting that higher education significantly lowers tobacco consumption in LMICs. The effect is primarily observed for women, where, for instance, higher compulsory schooling reduces the probability of smoking by 23% and the number of cigarettes smoked by 27%. The study's results establish the causal link between education and smoking behavior in LMICs. This significant impact suggests that education policy is still an important tool to help reduce tobacco consumption, especially in settings where the average level of education is not high initially. Moreover, discouraging men from smoking requires other measures to complement education policy. Education might help reduce tobacco consumption. However, studies-primarily for developed countries-find mixed results. This paper investigates the causal role of education on smoking in LMICs. Education reduces tobacco consumption, especially for women. Thus, education policy can be effective in low-education settings. Nonetheless, education policy should be accompanied by other policies to discourage men from smoking.

Does India's Ban on Electronic Cigarettes Improve Public Health Outcomes?

&#x0D; In 2019, India banned Electronic Nicotine Delivery Systems (ENDS) – a broad category that includes electronic cigarettes, vaping devices, and Heat Not Burn (HNB) devices – because of concerns about health impacts, youth vulnerability, and their potential to undermine tobacco control efforts. This is a missed public health opportunity to reduce tobacco consumption, if ENDS actually help reduce and wean users off nicotine dependency in less harmful ways. This paper applies a risk analysis framework to examine whether India’s ban on ENDS improves public health outcomes, or whether an alternative approach such as regulation would be more effective. It studies global responses and compares how public health goals are served in the United States of America and the United Kingdom, based on four key parameters of concern – health impacts, normalisation of ENDS usage among non-smokers, appeal among youth, and device safety. This comparison demonstrates that the United Kingdom’s regulation-focused approach delivers superior outcomes across all four parameters. Thus, the evidence-based recommendation for India would be to regulate at least HNB devices under the Cigarettes and Other Tobacco Products Act (as they utilise tobacco), as this can help reduce harm and promote innovation in devices that can wean users off nicotine dependence.&#x0D;

An ecological study on MPOWER and smoking prevalence rate by Tobacco control law

Objectives: The Framework Convention on Tobacco Control (FCTC) is the first international convention in the public health field. This study examines whether countries have maximized the effectiveness of tobacco regulation by appropriately utilizing measures to reduce tobacco consumption and smoking rates. It studies the effectiveness of Tobacco control law policies in various countries. Methods: Using ecological and descriptive correlation, this study attempted to verify the correlation between the Tobacco control law, the measures that help countries reduce the demand for tobacco (MPOWER) and the smoking rate. Results: It was found that the Tobacco control law was related to lower smoking rates and higher levels of implementation of the MPOWER policy. The results showed that the performance of related MPOWER policies increased according to the category of the Tobacco control law. Conclusion: FCTC measures to reduce tobacco use are effective. Enacting and strengthening comprehensive Tobacco control laws is necessary for implementing more effective tobacco control policies.

Cost Analysis of Diagnosis and Treatment of Tobacco-Related Cancer.

Tobacco use is the leading cause of cancer, accounting for approximately 20% of all cancer deaths and 70% of lung cancer deaths worldwide. The use of tobacco has multiple consequences; it damages health and pushes the household below the poverty line. The treatment of cancer is very costly. The study attempts to determine the cost associated with the diagnosis and treatment of tobacco-related cancer in Nepal. A descriptive cross-sectional study was conducted among 103 patients from public and private hospitals in 2019. Patients with the second and third stages of cancer who had ever used tobacco were randomly selected for the study purpose. All patients who met the inclusion criteria were selected for interviews. The data were analyzed using SPSS version 22, and summarized in descriptive form only. The total cost of tobacco-related cancer was NPR 9,81,370 per patient in 2019. A patient's average direct medical cost was found to be NPR 5,88,740 (60%), whereas the average direct non-medical cost was NPR 1,23,147(13%). The wage loss as a result of illness accounted for over one-fourth (27%) of the total cost. Approximately one-sixth of the patients sold their property for the treatment of cancer. The majority of the cancer patients were found to be illiterate or with primary education only, and financially dependent on their families. Treatment of cancer is costly and patients in Nepal can hardly afford the expenses. Enrolling clients in health insurance and increasing the government subsidy by raising the tax on tobacco products can be a long-term source of health financing to protect patients from sliding into poverty. The increased price of tobacco due to an increase in tax would reduce tobacco consumption, particularly among youth and the poor.

Air pollution and lung cancer-A new era.

Air pollution and lung cancer-A new era.

A multi-country analysis of transnational tobacco companies' market share.

The international tobacco market is dominated by five transnational tobacco companies (TTCs) which continue to interfere with measures to reduce tobacco consumption. The aim of this study is to better understand the current international tobacco industry market structure by providing an overview of the market share of these five companies globally. A longitudinal multi-country study design was used to understand market share trends across 90 different countries from 2011 to 2020. Descriptive analyses were conducted based on market share and market size data obtained from Euromonitor Passport. Market share (%), maximal market share (%) and cumulative market share (%) were calculated. Maps and boxplots are used to present the descriptive analyses. Median cumulative TTC market share and interquartile ranges for each year were calculated and stratified by country income level. The average maximal market share of one company in a country was 50% (IQR: 40.0-63.5) in 2020 compared to 51.5% in 2011 (IQR: 41.3-69.0). One of the five TTCs had the highest market share in 77 out of the 90 countries. Philip Morris International was the main market player in 38 countries, followed by British American Tobacco (24), Japan Tobacco International (8), Imperial Brands (6), and lastly China National Tobacco Corporation was only dominant in China. The percentage of cigarettes manufactured by one of the five TTCs remained relatively stable between 2011 (86.4%) and 2020 (85.2%). Average cumulative TTC market shares increased between 2011 and 2020 in both low- and middle-, and high-income countries. The international tobacco market is concentrated with a small number of large players, and this has not changed substantially between 2011 and 2020. The impact of this on the ability of the tobacco industry to resist policy changes is unknown but presents a cause for concern.

Can the sustainable development goals for cancer be met in Brazil? A population-based study.

A one-third reduction in premature mortality (30-69 years) from chronic noncommunicable diseases is goal 3.4 of the United Nations Sustainable Development Goals (UN SDG). The burden of NCDs is expected to continue to increase in low- and middle-income countries, including Brazil. The aim of this study was to assess geographical and temporal patterns in premature cancer mortality in Brazil between 2001 and 2015 and to predict this to 2030 in order to benchmark against the 3.4 SDG target. We used data on deaths from cancer in those aged 30-69, by age group, sex and cancer site, between 2001 and 2015 from the National Mortality Information System of Brazil (SIM). After correcting for ill-defined causes, crude and world age-standardised mortality rates per 100,000 inhabitants were calculated nationally and for the 5 regions. Predictions were calculated using NordPred, up to 2030. The difference in observed (2011-2015) and predicted (2026-2030) mortality was compared against the SDG 3.4 target. Between 2011-2015 and 2026-2030a 12.0% reduction in premature cancer age-standardised mortality rate among males and 4.6% reduction among females is predicted nationally. Across regions this varied from 2.8% among females in North region to 14.7% among males in South region. Lung cancer mortality rates are predicted to decrease among males but not among females nationally (men 28%, females 1.1% increase) and in all regions. Cervical cancer mortality rates are projected to remain very high in the North. Colorectal cancer mortality rates will increase for both sexes in all regions except the Southeast. Cancer premature mortality is expected to decrease in Brazil, but the extent of the decrease will be far from the SDG 3.4 target. Nationally, only male lung cancer will be close to reaching the SDG 3.4 target, reflecting the government's long-term efforts to reduce tobacco consumption. Projected colorectal cancer mortality increases likely reflect the epidemiological transition. This and, cervical cancer control will continue to be major challenges. These results will help inform strategic planning for cancer primary prevention, early detection and treatment programs; such initiatives should take cognizance of the regional differences highlighted here.

Economic cost of cigarette smoking in Bosnia and Herzegovina

BackgroundCigarette use is one of the major risk factors for non-communicable diseases in Bosnia and Herzegovina, with 41.1% of adults being current smokers in 2019 and almost half of current...

Environmental tobacco smoke at home and in public places prior to smoking ban enforcement: Assessment by hair analysis in a population of young adult students.

Despite inititatives to reduce tobacco consumption, smoking remains a primary cause of death for both smokers and nonsmokers exposed to environmental tobacco smoke (ETS). The characteristics of some specific groups can make them more exposed to ETS or limit the benefit of prevention measures. This study investigated determinants of ETS in a population of young adult students, considered at higher risk of exposure due to their specific lifestyle. This cross-sectional study involved 90 students aged 20 ± 1.7 years, from the University of Luxembourg, prior to the smoking ban enforcement in public places in the country. Participants reported their tobacco consumption and exposure to ETS at home and/or in public places, and provided a hair sample analyzed for nicotine and cotinine. Nicotine and cotinine were significantly higher in smokers than in nonsmokers' hair in general (median: 2.6 vs. 0.9 ng/mg and 87.1 vs. 22.5 pg/mg respectively). However, nonsmokers exposed to ETS at home and in public places had comparable concentrations to smokers (nic = 2.2 ng/mg; cot = 56.2 pg/mg), whereas unexposed nonsmokers presented significantly lower values (nic = 0.4 ng/mg, cot = 8.5 pg/mg). Nonsmokers exposed to ETS only at home presented higher values than nonsmokers only exposed in public places (nic: 1.3 vs. 0.8 ng/mg, cot: 70.4 vs. 15.0 pg/mg). The study shows the widespread exposure to ETS in this population, the importance of exposure assessment, and the relevance of hair analysis for this purpose. Results suggest that ETS can lead to equivalent exposure to active smoking and that exposure at home can highly contribute to ETS, which is not solved by smoking ban in public places.

INDIRECT TAXES IN GEORGIA: PROBLEMS AND OPPORTUNITIES

The current tax systems in the world are quite substantially differ from each other in many parameters, including the role and ratio of direct and indirect taxes - both in terms of the implementation of the regulatory and fiscal functions. In the tax system of Georgia, indirect taxes have assumed an important role, especially in terms of the implementation of the fiscal function. Currently, the value added tax and the excise tax account for around 60% of consolidated budget revenues, and this percentage mostly keeps getting bigger. The article discusses the factors responsible for this, including the introduction of the new, so-called Estonian profit tax model, resulting in rapid decline in the percentage of the profit tax in the overall budget incomes; the inflationary processes have become more active, the results of which were directly reflected in the increase of mobilized indirect taxes; relative simplicity of administration of indirect taxes, as well as a sharp increase in excise rates (which, unlike other taxes, is allowed even without a referendum). The article discusses also legislative changes, as a result of which the topic of value added tax has been completely changed in the Tax Code. This necessity was caused by the association agreement signed with the European Union, through which Georgia has committed to obligation regarding gradual convergence between the tax legislation and the relevant legal standards of the European Union. These changes are also important in terms of improving the business environment and liberalizing tax conditions. However, along with undoubtedly positive results, certain problems, risks and threats have also been identified.. The simplification of the rules for return of tax surplus, which was mostly carried out within the framework of the reform of the main added tax, proved to be associated with particularly significant risks. The VAT excess refund system has become fully automated. This made it easier for taxpayers to claim back the excess, but resulted in increased burdens in term of tax control. Recent years, have seen a significant increase in the excise rates, especially on tobacco products. This, on the one hand, was due to the country's international obligations, as we are connected to the World Health Organization's Framework Convention on Tobacco Control, and we also have an association agreement with the European Union. In both cases, we undertook excise policies to reduce tobacco consumption and increase the burden of taxation. However, fiscal motivation is also an important factor - over the years, in order to balance the growing state expenses, excise rates have been systematically increased, which is allowed by Georgian legislation even without a referendum. We noted that an abrupt increase in excise rates and substantial increase in the burden of taxation on tobacco consumption caused a number of problems, including the risks of smuggling and illegal circulation of tobacco products have increased substantially. Given that indirect taxes play a crucial role in the financial provision of state revenues, the possible fiscal consequences of any new change must be calculated in detail and taking into account all possible causal relationships.

As countries improve their cigarette tax policy, cigarette consumption declines

BackgroundThis study examines the association between the Tobacconomics cigarette tax scores and cigarette consumption in 97 countries during the period of 2014–2020.MethodsData on countries’ retail cigarette sales and overall cigarette...