Marketing Of Tobacco Products Research Articles

Prevalence and risk factors for tobacco, khat, and alcohol consumption among high school students in Ethiopia

BackgroundTobacco, khat, alcohol, and marijuana are the main risk factors for non-communicable diseases. There are limited studies on substance use in Ethiopia, especially among secondary school students. This study aims to determine the epidemiology of substance use among secondary school students in Ethiopia.MethodsThis cross-sectional study was conducted in March 2020 in four large regions of Ethiopia and the capital Addis Ababa. We collected data from 3,355 grade 9 and grade 10 students in 36 randomly selected high schools. Data were collected on tobacco, khat, alcohol and other substances. Mixed effect logistic regression models were fitted to determine the predictors of cigarette smoking.Results157 (4.7%) of the participants ever smoked cigarettes and 81 (2.4%) were current smokers. 106 (3.2%) ever used smokeless tobacco, 1,342 (41.8%) had ever drunk alcohol, 290 (8.7%) ever used khat, 137 (4.8%) chewed khat regularly and 76 (2.3%) ever used marijuana. There was a significant regional variation in substance use patterns; cigarette and khat use was the highest in southern regions, whereas alcohol use was highest in the northern areas. Availability of cigarette and khat shops within a 100-meter radius of the school compound was reported by 1,229 (37.5%) and 816 (25%) students, respectively. Three hundred fifty-four (10.9%) students had ever seen someone smoking a cigarette in the school compound. Ever use of smokeless tobacco (Adjusted Odds Ratio (AOR) = 9.4, 95%CI: 4.9–17.9), ever use of shisha (AOR = 8, 95% CI: 3.9–16.3), ever use of khat (AOR = 4.1, 95%CI: 2.5–6.8), ever use of alcohol (AOR = 2.3, 95%CI: 1.4–3.7), having a friend who smoked a cigarette (AOR = 2, 95%CI: 1.2–3.5), and ever seen someone smoking a cigarette in the school compound (AOR = 1.9, 95%CI: 1.1–3.4) were associated with ever use of cigarettes.ConclusionSubstance use prevalence in Ethiopia has regional variations and prevention strategies should be tailored to the needs of the regions. Although this study reported a lower prevalence of cigarette smoking, students could access cigarettes and khat in nearby school areas. The existing tobacco control laws that prohibit selling tobacco products to children and adolescents under 21 years of age and ban establishing tobacco shops close to school compounds should be enforced.

Prevalence of tobacco use and awareness about its ill-effects amongst adult rural population of district Rewari

Background: To determine the extent of tobacco use and knowledge of its harmful consequences among the rural population of District Rewari, Haryana.Methods:A cross-sectional study was done in the month of November 2021. A total 600 participants were interviewed using a pre-designed questionnaire for data collection.Results: 23.3% of population consuming tobacco, with male population has highest tobacco consumption (84.97%). Tobacco consumption is in form of Bidi and Hookah (85.1%). People who tried quitting tobacco restarted due to withdrawal symptoms (64.3%), peer pressure (24.2%), and 11.5% due to other factors like stress, gastric problems. 29.5% females and 25.3% males find tobacco as the main cause of oral cancer. 94% of people consuming tobacco were aware about its ill-effects. 14.37% recognized swelling and ulcers, 3.27% red and white lesion, 1.64% hoarseness of voice as main symptoms of oral cancer, while, 76.8% didn’t recognize any. 84.8% were never educated about causes, and early signs and symptoms of oral cancer by any healthcare professional, But the majority knows the ill effects of tobacco through advertisements and social media.Conclusions: Although tobacco consumption has decreased so far even in the villages, people are still unaware of the risks associated with smoking, and those who wish to stop can’t, due to lack of any professional help. New programs should be implemented like organizing awareness camps. Strictly banning the advertisements and marketing of tobacco products is the most necessary step in eliminating it from our society completely.

A Long-Term National Survey of Compliance with the Ban on Selling Tobacco Products to Adolescents of Taiwan's Tobacco Hazards Prevention Act.

The data on long-term trends and factors of tobacco retailers’ compliance in Taiwan are limited. The new regulations of the Tobacco Hazards Prevention Act were established in 2009. Now, the government is planning to raise the minimum legal age (MLA) for purchasing tobacco products from 18 to 20, so the results of this study will be an important reference to promote new regulations in the future. We carried out an observational mystery shopping study design and data were collected from 2009 to 2019. In total, 6320 undercover tests were conducted to investigate selling by tobacco retailers to persons aged less than 18 years by an impartial third party annually. Logistic regression was used to analyze the factors influencing compliance by adjusting test variables and independent variables. The compliance rate increased by 8.4% annually and was better among tests conducted during summer vacation (AOR = 1.324), chain convenience stores (AOR = 3.651), supermarkets or hypermarkets (AOR = 1.973), and verifications with age (AOR = 15.345). It is the first study to explore long-term and national tobacco retailers’ enforcement effects by an impartial third party in Asia. The findings suggest that local health agencies should enhance enforcement on those stores which were tested during non-summer holidays and weekends, betel nut stands, and grocery stores.

A national assessment of on-premise drinking establishments near public universities: Drink prices, drink specials, indoor tobacco use, and state-level alcohol laws.

Inexpensive drinks and price promotions increase alcohol consumption and have been observed at on-premise drinking establishments near large colleges. Some bars may sell tobacco products and allow indoor tobacco use to encourage patrons to stay and drink more. This study examined drink prices/specials and associated practices of on-premise drinking establishments including tobacco sales and policies regarding tobacco use. In 2018, telephone calls about prices/practices were made to 403 randomly selected bars/nightclubs within 2 miles of large residential universities in each U.S. state. The Alcohol Policy Information System provided data on state-level alcohol laws. Multivariable linear and logistic regression models examined associations between alcohol prices/specials, state laws, and establishment practices. The average price for the least expensive draft beer and a vodka shot at each location were $3.62 (SD=$1.15) and $4.77 (SD=$1.16), respectively. Most establishments (65%) had happy hour specials, 6% had 2-for-1 specials, 91% sold food, 9% sold cigarettes, 8% allowed smoking indoors, and 18% permitted electronic cigarette (e-cigarette) use indoors. Allowing e-cigarette use indoors (b=-0.54) and selling cigarettes (b=-0.79) were associated with lower vodka prices; allowing cigarette smoking indoors (b=-0.46) was associated with lower beer prices. Lower beer prices (OR=1.38), selling food (OR=2.97), and no state law banning happy hour specials altogether (OR=4.24) or with full-day price reduction exemptions (OR=12.74) were associated with higher odds of having happy hour specials. Allowing e-cigarette use indoors was associated with having 2-for-1 specials (OR=6.38). In bars near large public universities, beers and shots were often available for less than $5 and drink specials were prevalent. Further, some establishments allowed tobacco use indoors and/or sold cigarettes. Laws that increase alcohol taxes, set minimum drink prices, and ban the sale and indoor use of tobacco products at on-premise drinking locations are important harm reduction tools.

Effects of Purchase Restrictions on Smoking During Pregnancy: An Analysis of U.S. Birth Records.

In December 2019, the minimum legal sales age (MLSA) for tobacco products in the United States was raised from 18 to 21 years as a measure of preventing smoking initiation. Smoking during pregnancy, which causes maternal, fetal, and infant morbidity and mortality, is a major public health concern. We first study the effects of purchase restrictions on smoking during different stages of pregnancy covering the entire United States and using the records of all live births during 2014-2018 by birthing people aged 18-21 years. Our identification strategy utilizes the variation in the MLSA of tobacco products over time and across counties in the United States during 2014-2018 using a two-way fixed effects model, modified to accommodate a partially observable treatment indicator. The results show that 37.4% of potential smokers in our study population would have been prevented from smoking before pregnancy, 50.5% during the first trimester, 53.4% during the second trimester, and 14.8% during the third trimester if the law prevented selling tobacco products to them in the locality they live. A purchase restriction is estimated to cause the smoking intensity of those who smoke, the intensive margin, to drop by 5.4% before pregnancy, 10.4% during the first trimester, 14.8% during the second trimester, and 5.2% during the third trimester. Our results show that purchase restrictions are highly effective in preventing smoking among birthing people in the 18-21 years age group. The effect on smoking prevalence during the first and second trimesters is more pronounced. Many countries around the world have recently tightened age-based purchase restriction policies as a tobacco control measure. We first study the effects of purchase restrictions on smoking during different stages of pregnancy using the birth records of all pregnancies in the United States by birthing people aged 18-21 years during 2014-2018. The study utilizes the variation in the MLSA of tobacco products over time and across counties during that period. Our results show that purchase restrictions are highly effective in preventing smoking among birthing people in the 18-21 years age group.

Correlates of Perceptions, Use, and Intention to Use Heated Tobacco Products Among US Young Adults in 2020.

Despite the increased heated tobacco product (HTP) marketing in the United States, little is known about HTP perceptions and correlates of HTP use and use intentions among young adults. Using 2020 cross-sectional data from 2,470 young adults (ages 18-34) from 6 US metropolitan areas, we conducted exploratory factor analysis to identify factors regarding perceived utility/appeal of HTPs, specifically IQOS, and examined these factors in relation to lifetime HTP use and use intentions, using multivariable logistic and linear regression, respectively. 19.1% had heard of HTPs and 4.1% ever used HTPs; 14.7% had heard of IQOS specifically and 2.8% were ever-users. Use intentions were low (M = 1.27, scale: 1 = not at all to 7 = extremely). Factor analysis identified five perceived utility/appeal factors: innovation (M = 3.17, scale: 1 = not at all to 7 = extremely), cigarette substitute (M = 2.99), and youth appeal (M = 2.82), e-cigarette/nicotine substitute (M = 2.36), and fashionable (M = 2.04). Controlling for sociodemographics and other tobacco use, perceiving IQOS as more fashionable and e-cigarette substitutes positively correlated with lifetime HTP use (aOR = 1.60, 95%CI = 1.17, 2.17; aOR = 1.48, 95%CI = 1.11, 1.97, respectively) and use intentions (β = 0.26, 95%CI = 0.21, 0.30; β = 0.14, 95%CI = 0.09, 0.18); perceiving IQOS as cigarette substitutes negatively correlated with ever use (aOR = 0.74, 95%CI = 0.56, 0.97) and use intentions (β = -0.06, 95%CI = -0.10, -0.03). Correlation patterns were similar among past-month cigarette, e-cigarette, and any-tobacco users. Although HTP awareness and use were low, monitoring HTP perceptions and reasons for use as HTPs become more prominent is critical in anticipating their potential impact, particularly as more products seek FDA authorization to use reduced risk or exposure marketing claims. Awareness, ever use, and intentions to use heated tobacco products (HTPs) were low among US young adults in 2020. Perceiving IQOS as fashionable and an e-cigarette substitute were positively correlated with ever use and intention to use HTPs. In addition, perceiving IQOS as a cigarette substitute was negatively correlated with ever use of HTPs and HTP use intentions. Continued surveillance on perceptions and use behaviors is needed to better understand use patterns, intentions to use, and reasons for using HTPs.

Marketing of tobacco products among Polish youth: Results of the PolNicoYouth survey

Marketing of tobacco products among Polish youth: Results of the PolNicoYouth survey

Do Budget Cigarettes Emit More Particles? An Aerosol Spectrometric Comparison of Particulate Matter Concentrations between Private-Label Cigarettes and More Expensive Brand-Name Cigarettes.

Private-label cigarettes are cigarettes that belong to the retailer itself. Private-label cigarettes from discounters or supermarkets are cheaper than brand-name cigarettes, and their lower price has allowed them to garner an ever-increasing share of the tobacco product market, especially among lower socioeconomic groups. Particulate matter (PM), a considerable component of air pollution, is a substantial health-damaging factor. Smoking is the primary source of PM in smokers’ homes. In a 2.88 m3 measuring chamber, the PM emission fractions PM10, PM2.5, and PM1 from three private-label cigarette brands and three brand-name cigarette brands with identical nicotine, tar, and carbon monoxide content were measured and compared to those of a reference cigarette by laser aerosol spectroscopy. All cigarette brands emitted PM in health-threatening quantities. The measurement results ranged from 1394 µg/m3 to 1686 µg/m3 PM10, 1392 µg/m3 to 1682 µg/m3 PM2.5, and 1355 µg/m3 to 1634 µg/m3 PM1, respectively. Only one private-label brand differed significantly (p < 0.001) from the other cigarette brands, which were tested with slightly lower PM levels. All other brands differed only marginally (not significant, p > 0.05) from one another. Significant (p < 0.05) negative correlations between private-label and brand-name cigarettes were found for PM10, PM2.5, and PM1 when accounting for tobacco filling densities, and for PM1 when accounting for filter lengths. The especially health-hazardous fraction PM1 accounted for the largest proportion of PM emissions from the cigarettes tested. The results of this study suggest that- cheaper tobacco products are as harmful as more expensive ones, at least regarding PM emissions. This highlights the importance of anti-smoking campaigns, especially for lower socioeconomic groups, where smoking is more widespread. Governments should reduce the price gap between cheap and more expensive tobacco products by implementing specific tobacco taxes. In such a case, at increasing prices of tobacco products, a downward shift to private-label cigarettes would probably decrease.

Environmental risk factors for cardiovascular diseases using geographic information systems in an urban slum, Bengaluru

Background: Cardiovascular disease (CVD), a growing epidemic, is influenced by various environmental factors, and the potential connection is not studied adequately. Objective: Hence, our study was aimed at assessing the environmental risk factors for CVD and assessing perceptions about the same among the adults residing in an urban slum, Bengaluru. Methods: A cross-sectional descriptive study was conducted using a validated environmental assessment tool – Environmental Profile of Community Health. It consists of two parts: (i) an assessment of the physical environment for CVD-risk behaviors and (ii) a questionnaire to collect residents' perceptions of their community's environmental risks for CVD. Results: The community had two environmental risk factors for CVD-tobacco stores and fast-food restaurants. The community had ten convenience stores, all of which sold tobacco products. Vegetables and fruits were available, and the community also had a park for recreation. We interviewed a total of four study participants with a mean age of 38.5 ± 5.4 years. All participants reported that they have seen people smoke outside public places and inside residences. They felt that society disapproved of women and children smoking while men were excluded. Study participants have reported seeing tobacco and junk food advertisements. Tobacco was easily accessible and available to all ages. Conclusions: The urban community was not CVD-friendly. Awareness regarding risk factors for CVD was good. Adequate urban planning, policy-level advocacy, and tailor-made lifestyle changes for patients are the key to preventing CVD.

Tobacco Product Use and Associated Factors Among Middle and High School Students - National Youth Tobacco Survey, United States, 2021.

Tobacco Product Use and Associated Factors Among Middle and High School Students - National Youth Tobacco Survey, United States, 2021.

Changes in Retail Tobacco Product Sales and Market Share Among Retail Payroll Establishments in the U.S. Economic Census between 1997 and 2017

Changes in Retail Tobacco Product Sales and Market Share Among Retail Payroll Establishments in the U.S. Economic Census between 1997 and 2017

Is Tobacco Marketing Overpowering Tobacco Control in India?

The tobacco industry has made a gradual move from developed countries to developing countries to expand its market. As part of this trend, tobacco companies in India invest a substantial amount of money in marketing activities. Although the government of India has gradually been increasing restrictions on marketing and sales of tobacco products, the creative and evolving marketing practices of tobacco companies have ensured that such measures have little effect. In this perspective paper, a critical evaluation of marketing practices used by the tobacco industry in India suggests that pro-tobacco marketing is a major hurdle towards bringing effective tobacco control policies and their successful implementation. It is demonstrated that the big tobacco companies in India backed by immense resources have been capable of countering the various legislative provisions for tobacco control in India through creative and manipulative marketing practices.

Prevalence of Tobacco use among Tunisian adolescents: a cross-sectional national survey

Abstract Introduction Tobacco use initiation mostly begins before the age of 18 years old. Being concerned by the increasing prevalence of smoking among adolescents, WHO developed the Global Youth Tobacco Survey. It focuses on youth addiction to tobacco products. This survey was carried out 4 times in Tunisia. GYTS 2017 is the most recent among them. Aim Describe the different tobacco products prevalence and access of smokers to tobacco products and to smoke cessation. Methods It is a school-based survey uses a two stages cluster sample design to produce a representative samples of students aged from 13 to 15 years old. It was conducted in April and May 2017 in 67 secondary school all over the country. The investigation tool was an anonymously answered questionnaire, which contained core questions about six majors tobacco related topics. Results One out of four students had ever tried to smoke a cigarette; 37.4% of boys vs. 10% of girls (p &amp;lt; 0.001). Lifetime cigarettes prevalence was 7.8%; 14.4% of boys vs. 1.6% of girls (p &amp;lt; 0.001). As for water pipe, 12.7% had ever tried to smoke, even for one or two snuffs. Lifetime water pipe use prevalence was 7.2% (13% of boys vs. 2.8% of girls, p &amp;lt; 0.001). Among cigarettes smokers, 62.5% were able to buy their own cigarettes. Therefore, 23.5% of cigarettes smokers and 41.5% of water pipe smokers were not able to buy their products because of their age. Sixty percent of smokers want to quit and 56.4% had already tried to stop during the year prior to the survey. Seventy-two percent had asked help to quit smoking. Eighteen percent had requested advice from a professional. Conclusions Cigarette and water pipe use prevalence among youth is alarming in Tunisia. Selling tobacco products to minors is not prohibited. Implementing such a law is necessary to reduce adolescents' access to cigarettes, and consequently, reduce tobacco use prevalence. Teenagers should benefit from smoke cessation programs, as well as adults. Key messages Tobacco prevalence among youth is alarming in Tunisia. Prohibiting tobacco sale to minors is necessary.

The changing retail landscape for tobacco: dollar stores and the availability of cheap cigarettes among tobacco-related priority populations

IntroductionDollar stores are rapidly altering the retail landscape for tobacco. Two of the three largest chains sell tobacco products in more than 24 000 stores across the USA. We sought...

Addicted to green: priming effect of menthol cigarette packaging on brain response to smoking cues

IntroductionMentholated tobacco cigarettes are believed to be more addictive than non-menthol ones. Packaging of most menthol cigarette brands includes distinctive green hues, which may act as conditioned stimuli (ie, cues)...

Real-Time Context of Tobacco Marketing Exposure and Community Vulnerability-An Ecological Momentary Assessment Among Young Adults.

Exposure to tobacco product marketing increases tobacco use among young adults, especially those from vulnerable communities (VCs). This study examined real-time tobacco marketing exposure among young adults from vulnerable and non-vulnerable communities using Ecological Momentary Assessment (EMA). This study used EMA data to assess context (e.g., location and activity) of tobacco marketing exposure using four text-messaging surveys per day over 2 weeks. Young adult non-current tobacco users living in Washington, D.C. (n = 146; ages 18-24) recorded 5,285 surveys, including 20 participants (13.2%) from VCs with high proportions of lower income and racial/ethnic minorities, and high smoking rates. Unadjusted and adjusted multilevel logistic regressions were used to assess the associations between exposure to any and flavored tobacco marketing, VC residence, and real-time context. Fifty-nine participants (40.4%) reported at least one tobacco marketing exposure and recorded 94 exposure moments. In adjusted models, odds of exposure were higher among VC residents (AOR = 2.6, 95% CI = 1.2-5.4), in the presence of anyone using tobacco versus no use (AOR = 4.0, 95% CI = 2.4-6.7), at store/retail (AOR = 17.0, 95% CI = 6.4-44.8), or outside/in transit (AOR = 4.1, 95% CI = 2.1-7.8) versus at home. VC residence (AOR = 7.2, 95% CI = 2.3-22.2) was the strongest predictor of flavored tobacco marketing exposure among all covariates examined. Young adults are predominantly exposed to tobacco marketing in their daily lives through retail advertisements. Young adults from VCs are at increased risks of seeing any tobacco and especially flavored tobacco marketing. Policies that curtail tobacco retailer density and advertisement displays may reduce overall and differential tobacco marketing exposure.

Knowledge, Attitude, and Practices of Tobacco Vendors toward Selling Tobacco Products to Young Children and Adolescents in Central Delhi.

BackgroundTobacco consumption by youth is a serious public health problem. Regulation on tobacco sales has been given enough attention in our country, but very less information exists about the knowledge and attitude regarding tobacco laws by tobacco vendors.Aim and objectiveTo study the knowledge, attitude, and practices of tobacco vendors regarding the selling of tobacco to children and adolescents up to 18 years of age in the Central Delhi area.Materials and methodsA total sample size of 60 tobacco vendors was selected by random sampling method. The procedure and objectives of the study were explained to them and written informed consent was obtained. A casual interview of the tobacco vendor was taken and answers given by them were recorded using a questionnaire. After completing the data, statistical analysis was performed.ResultsThe mean age of children and adolescents visiting tobacco shops was 11.83 years and the minimum age was 8 years. It was reported that 19 (31.7%) vendors always asked the age of the child while none of them asked for proof of age. Forty-two (70%) of them reported these children and adolescents visit their shop alone while 18 (30%) reported that they visit with friends. Khaini was the commonest form of tobacco bought/consumed by children and adolescents. Twenty-seven (45%) vendors reported that these children consume tobacco publically.ConclusionDespite knowing various anti-tobacco laws, tobacco vendors are selling harmful tobacco products to children and adolescents.How to cite this articleVerma AR, Goswami M. Knowledge, Attitude, and Practices of Tobacco Vendors toward Selling Tobacco Products to Young Children and Adolescents in Central Delhi. Int J Clin Pediatr Dent 2021;14(1):97–99.

Assessment of IQOS Marketing Strategies at Points-of-Sale in Israel at a Time of Regulatory Transition.

IQOS, a tobacco heating system, and accompanying tobacco sticks (HEETS) entered the Israeli market in 2016, prior to rapid regulatory change. This study assessed IQOS marketing strategies and regulatory compliance at IQOS and/or HEETS point-of-sale (POS) in Israel in December 17, 2019 to January 7, 2020, after the ban on advertisement went into effect in March 8, 2019. Research staff audited 80 randomly selected IQOS and/or HEETS POS in four cities using a structured form to assess store types, product placement, price, promotional strategies, and regulatory compliance. POS data were linked to neighborhood characteristics, including socioeconomic status, ethnicity, and proximity (under 300 m) to schools. Almost half of the stores (48.7%) were convenience stores. HEETS were visible to the customers in 46.1% of POS, 35% carried at least four HEETS colors, 20.0% had IQOS and/or HEETS special displays, and 13.8% displayed HEETS near youth-oriented merchandise. Mean HEETS pack price was US $8.7 (range: US $7.5-11.3), 27% more than the least expensive cigarette pack, and 39% less than the most expensive cigarette. HEETS promotions were uncommon. Compliance with the newly introduced advertisement ban was fairly high for HEETS (94.8%). Only one POS was located in a low-socioeconomic status area; 68.7% were near a school. The relatively limited IQOS and/or HEETS marketing at POS suggests that, with regulatory changes, online or other forms of marketing might be prioritized. IQOS may be promoted to higher socioeconomic status populations, as indicated by pricing and POS neighborhood characteristics. Access near schools and placement near youth-oriented merchandise are potential concerns necessitating further research. Globally, the POS is considered the least regulated channel for advertising and marketing of tobacco products. Assessing IQOS marketing strategies at the POS provides valuable findings that can inform regulatory efforts in Israel and other countries as well. Limited IQOS and/or HEETS marketing at POS suggests that primary marketing strategies may shift to online or other channels as regulatory contexts become more progressive and/or restrictive. Ongoing surveillance of IQOS via online marketing and POSs, specifically with regard to product placement and proximity to schools, is needed.

Underutilisation of no-tobacco-sale orders against retailers that repeatedly sell to minors, 2015–2019, USA

ImportanceResearch demonstrates that policies aimed at retailers who sell to minors must be strongly enforced to have an impact on youth usage rates.ObjectivesIn the USA, the Food and Drug Administration...

Exhibitions as Public Health Interventions: The University of Alabama Center for the Study of Tobacco and Society

Can exhibitions of artifacts from the tobacco industry, its allies and critics, act as a public health intervention? The University of Alabama Center for the Study of Tobacco and Society is a curatorial and research center dedicated to the creation of exhibitions on the tobacco industry and its allies, the marketing of cigarettes and other tobacco products, and the efforts to counteract the use and promotion of cigarettes throughout the 20th century to the present day. Physical and digital exhibitions provide social and historical context to increase public understanding of a deadly product which, according to the Centers for Disease Control and Prevention, kills 1,300 Americans a day. Center for the Study of Tobacco and Society collects “communication artifacts” of the tobacco industry, from ubiquitous advertisements to subtler promotional efforts such as financial support for museums and other cultural institutions. This summary of the center’s work spotlights archives, curated and made public through exhibitions.