Smoking Campaigns Research Articles

Abstract P285: Relationship Between Body Mass Index, Waist Measurement, Six-Minute Walk Performance and Whole-Body Strength in Adults With Cardiovascular Disease: Findings From the Lifestyle Heart Health Study

Introduction: Cardiovascular disease (CVD) is the leading cause of death, killing 17.9 million people annually worldwide. Key risk factors include physical inactivity, overweight/obesity, high blood pressure, high cholesterol which worsen with age, and smoking and excessive alcohol intake. Six-minute walk (6MW) performance and whole-body muscle strength are both related to cardiovascular mortality and also worsen with age, particularly in the absence of physical activity. The aims of this study were to understand levels of cardiovascular risk and compliance to usual medical treatment (medication, lifestyle modifications) in a high socioeconomic Australian population, and to identify relationships between key risk factors, 6MW and muscle strength. A secondary aim was to help inform development of the Lifestyle Heart Health Education Program. Methods: This was a cross-sectional study of 473 people with CVD in Sydney. Class was classified based on the Australian socioeconomic index for areas. Conditions were defined according to Australian national guidelines. Medical history, body mass index (BMI), waist measurement, whole-body muscle strength and 6MW measurements were assessed. Simple linear and stepwise regressions were used to assess potential relationships. Results: Mean age of the cohort was 66.8±11.6; range 21-94 yrs; 68.5% female; socioeconomic index was deemed high. All participants had CVD, of which 25% were on aspirin. Hypertension was prevalent in 65% (38% on anti-hypertensives); 65% had dyslipidaemia (40% on a statin); 91% had a BMI over 26.0; and 85% of males and 80% of females had a waist measurement over gender-specific heart health recommendations. Less than 3% of the cohort smoked, and less than 10% consumed alcohol at a level deemed high-risk. Almost 20% of the cohort were at risk of CV mortality according to 6MW performance with scores less than 350 metres. Waist measurement, BMI, and blood pressure were the greatest risk factors across the cohort. Muscle strength (r=-0.34; r 2 =0.17; p<0.001) and 6MW performance (r=-0.37; r 2 =0.17; p<0.001) both decreased with age. BMI and age were the most significant predictors of 6MW (r=-0.45; r 2 =0.20; p=0.004) and whole-body strength (r=0.49; r 2 =0.24; p<0.001) in females; waist and age were the most significant predictors of 6MW (r=-0.38; r 2 =0.14; p=0.11) and whole-body strength (r=0.41; r 2 =0.17; p=0.04) in males. Conclusion: Whilst alcohol and smoking campaigns are working to reduce consumption of these harmful substances, low cardiorespiratory and muscular fitness and overweight/obesity remain highly prevalent. Population-level interventions such as the Lifestyle Heart Health Program that aim to reduce weight and waist and improve physical activity, walking ability and muscle strength are urgently needed to reduce cardiovascular risk and mortality.

Who likely experiences reactance to quitting messages: How individual cultural identification moderates the effect of controlling language on psychological reactance

ObjectivePsychological reactance can undermine the persuasiveness of smoking campaigns, but this effect may vary as a function of culture. Previous research has been conducted at the national level or examined the influence of one cultural variable. This study investigated whether the boomerang effect of controlling language varied across countries and whether individualism and power distance moderated the relationship between controlling language and psychological reactance. MethodsA total of 400 Chinese and 441 American smokers were randomly assigned to either high or low controlling language. ResultsHigh controlling language elicited psychological reactance, which caused negative attitudes and eventually reduced intentions to quit smoking in both countries. Moreover, the effect of controlling language on reactance was stronger among low power distance Americans, Chinese of high individualism and high power distance as well as of low individualism and low power distance. ConclusionThe boomerang effect of controlling language held across cultures. Power distance moderated the relationship between controlling language and psychological reactance as well as the moderation effect of individualism on this relationship. Practice implicationsPractitioners should be cautious to evoke reactance especially when targeting at the three groups mentioned above.

Sociodemographic predictors for smoking persistence among young males in Indonesia

The prevalence and burden of non-communicable diseases (NCDs) in Indonesia are increasing. One major risk factor for NCDs is smoking. Thus, this study assessed sociodemographic predictors of smoking persistence among young males in Indonesia, who are at high risk for smoking and NCDs. We analysed the Indonesian Demographic and Health Survey (IDHS) conducted in 2017, a nationally representative survey in 34 provinces of Indonesia. We included data from 9957 young males aged 15-24 who had tried smoking and were interviewed by the IDHS enumerators for their smoking patterns and sociodemographic characteristics. Logistic regression analyses were used to assess the predictors of smoking persistency. Our analyses uncovered that those who started smoking at high-school age, lived in rural areas, had an occupation, and had lower education levels, had higher odds of smoking persistence than other young males. The use of internet, also increased the odds of smoking persistence, while those reading newspapers had lower odds of smoking persistence. Regarding household characteristics, young males who came from poor households, whose household heads were smokers or not married, also had higher odds of smoking. In conclusion, this study also showed the significance of several individual variables and household sociodemographic factors related to smoking persistence. Based on our findings, we recommend the need for intervention that aims not only at large-scale policy to ban smoking and educational campaigns through the internet but also specific educational intervention targeting families, particularly poor families with active smokers. The educational campaign is also needed to target the younger population, who are at higher risk for smoking persistence if they start smoking earlier.

Why Audiences’ Voice on Developing Anti-Smoking Messages Matters

messages about the danger of addictive substances. For example, smoking is framed as harmful and unfavourable. Anti-smoking Public Service Advertising (PSA) depicts the severe adverse effect of smoking on health, sometimes resulting in people resisting the message. In contrast, pro-smoking through tobacco advertisements is associated with fun and enjoyable behaviour, encouraging people to smoke or start smoking. Besides quality, anti-smoking PSAs in the country cannot compete with accessible cigarette advertising in terms of quantity. As a result, intervention to prevent tobacco use remains lacking. The effectiveness of anti-smoking PSA is usually assessed by looking at and counting the significant impact of the messages on people’s intention to change their behaviour. This top-down approach is missing from understanding why people perceive the messages as meaningful and how they are likely to accept or reject them, particularly where smoking remains socially and culturally normalised, like in Indonesia. By reviewing the relevant literature on audience research, this paper aims to propose the cultural media audience as a valuable approach and framework in health communication and provide an analysis of some mediated smoking campaigns in Indonesia. The existing PSA tends to underscore people’s perceptions and expectations of the messages. It is argued that a cultural-media audience approach allows for staging people’s voices about persuasive health messages and helps to develop meaningful smoking-related interventions or campaigns. Keywords: Anti-smoking, health communication, media audience, message, Indonesia.

Usia merokok pertama kali merupakan faktor yang meningkatkan risiko kejadian hipertensi: Besar risiko kejadian hipertensi menurut pola merokok

Cigarette smoking is a main risk factor for cardiovascular morbidity and mortality; one of them is hypertension. However, studies on hypertension still showed no significant relationship. The objective of the study was to assess odds ratio (OR) of the development of hypertension based on smoking pattern. The study was an observational research with case-control design. The inclusion criterias of the cases group consisting of 75 persons were hypertension patients and smokers, did not have any diseases related to hypertension, and participating in this study voluntary with informed consent. The control group consisting of 75 persons were smokers without primary and secondary hypertension, and participating in this study voluntary with informed consent. The analysis showed that persons who had smoked for 33 – 58 years were 5,21 times (95% CI with OR 2,02 – 13,68) more likely to have hypertension and persons who had smoked for 18 – 32 years were 3,78 times (95% CI with OR 1,51 – 9,58) more likely to have hypertension than those who had smoked for less than 18 years. Based on multivariate analysis, persons who smoked first time at 16 – 18 years old were 4,81 times (95% CI with OR 1,79 – 12,94) more likely to have hypertension than those who smoked at 19 years old and higher. Persons who smoked as many as 10 – 20 cigarettes a day were 3,02 times (95% CI with OR 1,19 – 7,63) more likely to had hypertension than those who smoked less than 10 cigarettes a day. The increasing factors for the development of hypertension were age initiation of smoking (16-18 years old), number of cigarettes smoked per day (10-20 sigarettes), and length of smoking habit (more than 17 years). Considering that smoking is a risk factor for hypertension, the most important measure is to run immediately “a comprehensive anti smoking campaign” whose target is not only smokers to stop smoking but teenagers as well, in order not to become a smoker. So, anti smoking campaign should be directed to earlier age group such as elementary school students.

Is Alcohol Consumption Related to Lifestyle Factors in Romanian University Students?

Poor eating habits and substance abuse are major public health concerns among young adults transitioning into university life. This study’s objective was to assess Romanian students’ alcohol consumption and correlate it with other lifestyle factors. We performed a cross-sectional study of 1212 students with a mean age of 21.1 ± 2.4 years. We applied a valid online questionnaire to evaluate and statistically analyze the interrelation between alcohol consumption and lifestyle factors by multivariate statistical analysis. The prevalence of alcohol consumption among the student population enrolled in the study was 79.9%. Multiple regression showed that alcohol consumption was positively associated with gender (p < 0.001), level of physical activity (p = 0.009), number of cigarettes (p < 0.001), and fast-food consumption (p < 0.001), and negatively associated with sleep (p = 0.012) and study hours (p < 0.001). The study revealed a high prevalence (18%) of binge drinking among males. The frequent use of illicit drugs is associated with alcohol consumption (p < 0.001) but present at low levels (1.6%). The study evidenced a high prevalence of alcohol consumption in students, especially in males, and poor food behavior related to the intake of vegetables and fruits. Health promotion campaigns regarding the harmful effects of alcohol, smoking, poor nutrition, and ongoing illicit drug prevention campaigns are needed to improve students’ performances.

A Systematic Review about Educational Campaigns on Smoking Cessation

Background:Health campaigns have been shown effective in the prevention of smoking. These campaigns convey messages about specific behavior to the audience and have a high penetration rate.Objective:This systematic review was conducted to summarize the effect of educational campaigns on smoking.Methods:The PubMed, Web of Science, Scopus, Embase, Google Scholar databases were searched on 16 March, 2019 by using the keywords “Waterpipe, Hookah, Shisha, Cigarette, Smoking” and “Campaign, Antismoking Campaign, Health campaign”.Results:A total of 15 articles related to smoking campaigns entered the review. Campaigns were divided into two broad categories: (1) Campaigns aimed at public education and social change; (2) Campaigns aimed at changing policy or attracting the attention of politicians. The largest campaign was conducted in England. All educational campaigns showed at least one positive effect on preventing and controlling smoking.Conclusion:Anti-smoking campaigns are important investments, and as part of comprehensive tobacco control programs, they can educate people about the harms of smoking, change smoking attitudes and beliefs, increase quitting intentions, promote quitting, and decrease smoking.

Education Policy on The Prohibition of Smoking In A Campus Environment

The existence of a smoking prohibition policy in the campus environment is the best effort in maintaining a good and conducive learning environment. The purpose of this study was to find out the response and a model for the prohibition of smoking. The research location at the Islamic University of Jakarta (UID), using the research method used by Research and Development (RnD). This development research will involve 18 respondents consisting of 6 lecturers/staff and 12 students with random respondents. The findings showed that 1) The response to the establishment of a smoking prohibition policy in the UID environment was still low. Does not reach more than more than 70% of the respondent’ answers. The model for a smoking prohibition policy that can be taken by university leaders is to hold various activities that support the go green program. As; stop smoking campaign, hold seminars or workshops, and add symbols that prohibit smoking in a campus environment.

The Association Between Knowledge, Attitudes, and Smoking Practice with Relating Factors in a Junior High School

Smoking habit in adolescents has been increasing recently. Some factors are associated with the smoking habit. However, there are lacks of information regarding influencing factors to smoking habit in the adolescent. The study aimed to examine how knowledge, attitudes, practice, and other factors play a role in adolescents' smoking. There were 381 female and male students of a junior high school in Jakarta who participated. Influencing factors were knowledge, attitudes, practice, social influence, anti-smoking campaigns. The association between factors was analyzed using appropriate statistical tests. Most students had better knowledge, attitude, and practice. Only two students smoked cigarettes (0.5%). Gender was significantly associated with knowledge (p=0.048), social influence (p=0.000), an anti-smoking campaign (p=0.024). Knowledge had an association with social influence (p=0.002) and anti-smoking campaign (p=0.000), whereas attitudes with practice smoking (p=0.005) and anti-smoking campaign (p=0.000). Social influence was also associated with the anti-smoking campaign (p=0.000). In conclusion, students of Permai junior high school had good knowledge, attitudes, and practice of smoking. There are associations between factors that contribute to smoking habit in adolescents.

A Qualitative Study: The Perception on Anti- Smoking Campaign among Smokers in Kuantan

Smoking is an inevitably unhealthy habit among Malaysian that could harm not only the smokers but also the community. Even though there are a lot of anti-smoking campaign had been introduced by the government but the effectiveness is still marginal. Thus, the objectives of this study were to explore the main factor related to the failure of anti-smoking campaign in Malaysia, to explore the effectiveness of “Smoking Cessation Clinic” and to discover the best solution to ensure the campaign is effective in the future. This is a qualitative cross-sectional study. Interviews were conducted among five voluntary respondents which were smokers and ex-smoker at Public area and selected smoking cessation clinics in Kuantan. This study used thematic analysis to analyse the data. This study found that few contributing factors from the perspective of smokers need to be prioritised by higher authority for improvements. Those contribution factors are minimal creativity on managing anti-smoking promotion, low self-awareness about health, demand on energizer at workplace and poor stress management. Findings recommend that the campaign shall start from primary and secondary school, improvise warning sign of disease, widening the promotion area, provides reward during campaign and smokers to take initiative to involve in the program. Furthermore, the government also needs to focus on the prevention of start smoking rather than the intervention to quit smoking that may cost lots of financial demand. ********************************************************************************* Tabiat merokok adalah perilaku yang tidak sihat malah membahayakan bukan sahaja diri sendiri malahan masyarakat sekeliling. Walaupun terdapat banyak kempen anti-merokok telah diperkenalkan oleh kerajaan, namun keberkesanannya masih di tahap rendah. Oleh itu objektif kajian ini adalah untuk meneroka faktor utama kegagalan kempen anti-merokok di Malaysia, meneroka keberkesanan “Klinik Berhenti Merokok” dan menemui penyelesaian terbaik untuk memastikan kempen yang dijalankan berkesan pada masa akan datang. Ini adalah kajian rentas kualitatif di mana temuduga dijalankan di kalangan lima sukarela responden yang terdiri dari perokok dan bekas perokok di kawasan awam dan tiga klinik berhenti merokok yang terpilih. Data dianalisis dengan menggunakan analisis bertema. Kajian ini mendapati beberapa faktor penyumbang dari perspektif perokok dan pihak berkuasa perlu diberi keutamaan untuk penambahbaikan iaitu kurang kreativiti yang minimum dalam menguruskan promosi anti-merokok, kurang kreatitivi dah terhadap kesihatan, permintaan bahan pencetus semangat di tempat kerja, dan dalam pengurusan tekanan yang lemah. Hasil kajian mengesyorkan bahawa kempen bermula di sekolah rendah dan menengah, improvisasi tanda amaran penyakit, meluaskan kawasan promosi, memberi ganjaran semasa kempen dan perokok perlu mengambil inisiatif melibatkan diri dalam program ini. Kerajaan perlu menumpukan perhatian kepada program pencegahan merokok terlebih dahulu, daripada program intervensi berhenti merokok yang mungkin melibatkan kos kewangan yang tinggi.

Community pharmacy teams\u2019 experiences of general practice-based pharmacists: an exploratory qualitative study

BackgroundIn England, since 2015, there has been a formal drive to integrate pharmacists into general practice as a new healthcare service. Research efforts have offered insights into how general practice-based professionals and patients view the service, however, they took no account of community pharmacy teams’ opinions. There have been anecdotal statements about opposition from community pharmacies to the service, due to fears of losing business. The aim of the current study was to identify the experiences and perceptions of community pharmacy teams regarding pharmacists’ presence in general practice.MethodsThe National Health Service Choices website was used to identify community pharmacies within a radius of two miles from eight West London general practices. The search resulted in 104 community pharmacies which were all contacted via telephone. Pharmacy staff who verbally expressed their interest to participate were then provided with the study’s documents. Qualitative, face-to-face, semi-structured interviews were conducted inside the pharmacy from which each participant was recruited. Interviews lasted 30 to 45 min and were audio-recorded. Audio-recordings were transcribed verbatim and transcripts analysed thematically.ResultsForty-eight community pharmacy staff participated. Four themes were discerned: awareness (“I knew that [pharmacists] have already been implemented [in general practice] but I haven’t really followed it … where does the pharmacist role come?”); interactions (“I’m just so pleased that there’s a pharmacist professional in the general practice … because we speak the same language!”); patient care (“if I was a patient knowing that there is a general practitioner and a pharmacist [in general practice], I would … think ‘nothing can go wrong at the moment’”); and funding challenges (“if general practices take on the extra responsibility of stop smoking or flu vaccination campaigns … financially, this would affect this pharmacy”).ConclusionsThe current study revealed the perceived impact of general practice-based pharmacists on community pharmacies would be improved communication between pharmacies and practices. Findings will inform policy so that any future framing of pharmacists’ presence in general practice considers the needs of community pharmacies.

Smoking habit: a bio mathematical study

Smoking habit is an addiction to both physical and psychological. Nicotine from cigarettes temporarily experiences physical withdrawal symptoms and cravings. Because of nicotine effects on the brain, as a quick and reliable way to boost our outlook, relieve stress, and unwind. To stop the smoking habit, you’ll need to address both the addiction and habits. With the proper support and right planning, any smoker can kick the addiction. In this research work, we formulate a mathematical model which analyse the smoking habit in the human population. Here we divide the total population into three classes: potential smokers, smokers and media aware population. We discuss the dynamical behaviour of the model. Finally, we justify our finding through numerical simulation. Our mathematical study reflects that anti smoking campaign plays a pivotal role for reducing number of smoker as well as smoking habit.

Application of a Fluorescent Probe for the Online Measurement of PM-Bound Reactive Oxygen Species in Chamber and Ambient Studies.

This manuscript details the application of a profluorescent nitroxide (PFN) for the online quantification of radical concentrations on particulate matter (PM) using an improved Particle Into Nitroxide Quencher (PINQ). A miniature flow-through fluorimeter developed specifically for use with the 9,10-bis(phenylethynyl)anthracene-nitroxide (BPEAnit) probe was integrated into the PINQ, along with automated gas phase corrections through periodic high efficiency particle arrestor (HEPA) filtering. The resulting instrument is capable of unattended sampling and was operated with a minimum time resolution of 2.5 min. Details of the fluorimeter design and examples of data processing are provided, and results from a chamber study of side-stream cigarette smoke and ambient monitoring campaign in Guangzhou, China are presented. Primary cigarette smoke was shown to have both short-lived (t1/2 = 27 min) and long-lived (t1/2 = indefinite) PM-bound reactive oxygen species (ROS) components which had previously only been observed in secondary organic aerosol (SOA).

Predictors of people's perceptions of second hand smoke exposure as a risk factor for multiple sclerosis

BackgroundThere are both environmental and genetic factors which are associated with multiple sclerosis (MS) development. The primary objective of this study was to examine the predictors associated with people's attitudes towards second hand smoke exposure being a risk factor for development of MS. MethodsThe data set was drawn from the Health Canada: Smoking Survey conducted in 2004 and 2005 by Environics Research Group in partnership with Health Canada to survey the public in the province of British Columbia (N = 1468), Newfoundland (N = 1442), Quebec (N = 1404), Ontario (N = 1443) and Saskatchewan (N = 1413). A multilevel mixed effects logistic regression model analysis was carried out in order to determine whether people's perceptions of second hand smoking as a risk factor for MS varied based on the province of residence. ResultsAge, sex, having a household member who smoked inside their home, if respondents were bothered by second hand smoke exposure and smoking status were associated with increased odds of people agreeing to second hand smoke exposure being a risk factor for MS development. The province of residence was also a factor in people's perceptions. ConclusionThe study results could guide in the development of stop second hand smoking campaigns on social media, TV and bus stop shelters and enforcement of stricter policies on smoking areas. This could help raise awareness about the risk of second hand smoking and its detrimental effect on people living with MS.

Smoking Patterns and Willingness to Quit: A Cross-sectional Study in Al Ain City, UAE.

Background:Tobacco use is the major cause of preventable morbidity and mortality. The main objectives of this study were to identify smokers willing to participate in quit smoking campaigns using social media and to identify smoking habits of everyday smokers in Al Ain City, United Arab Emirates (UAE).Research Design and Methods:Everyday smokers from Al Ain city of the UAE were surveyed in different locations of the city including malls and specialized tobacco-selling shops. They were interviewed using a semi-structured survey and the information was recorded by one assessor. The information gathered included type and frequency of tobacco use, smoking history and habits, quitting history, desire to quit, and the preferred communication platform.Result:A total of 412 regular adult smokers were interviewed in which the majority (95%) reported first smoking at or before the age of 28 years. Participants were mainly UAE nationals (33.7%), Egyptians (14.1%), Syrians (12.9%), and Jordanians (10.9%). Manufactured cigarettes were the main form of tobacco consumption (59.5%), and smoking was mainly solitary (56.3%) and at home (26.3%) and coffee shops (24.9%). The majority of interviewed subjects (76.7%; 95% confidence interval [CI]: 72.4%–80.5%) expressed their interest to quit smoking in the future and 55.3% (95% CI: 50.5%–60.2%) were ready to get involved immediately in a smoking cessation program. Of those, 80.3% (95% CI: 74.6%–84.9%) preferred WhatsApp for receiving smoking cessation motivational education.Conclusion:The majority of smokers started at younger ages, which warrant the age of smoking restriction to be raised to 29 years instead of 18 years by the health authority. Everyday smokers were aware of the potentially hazardous effects of tobacco smoking and many were willing to accept help to quit smoking that involves the use of WhatsApp.

Juicy June: a mass-participation snack-swap challenge\u2014results from a mixed methods feasibility study

BackgroundImproving diet as a means of reducing the development of disease states and obesity is a public health priority. Although a growing number of countries have adopted policies to improve dietary patterns at the population level, as yet there are no established means of successfully bringing about change, suggesting that new approaches are needed. This study aimed to investigate the feasibility and proof of concept of a theoretically informed healthy eating intervention based on the model of successful month-long alcohol reduction or stop smoking campaigns (i.e. a mass-participation ‘challenge’ format).MethodsThe study was a mixed methods feasibility trial and proof of concept of an online intervention. Adults were recruited to take part in a month-long ‘Juicy June’ challenge in which they nominated one unhealthy daily snack and committed to replace this with fruit or vegetables. Behaviour change techniques to promote motivation, increase self-efficacy, promote social support, self-regulation and habit formation were integrated into materials provided off- and online to support dietary change. A Facebook group was used to provide information, encouragement and foster social support. Diet quality was assessed before and after the intervention. Reasons for taking part, adherence to the snack swap, use of the intervention materials and experience of taking part were explored using quantitative and qualitative measures.ResultsNinety-one adults of whom 42% were either overweight or obese took part. Over the 4-week intervention period, participants consumed their intended fruit/vegetable snack on average 5 days/week; however, they still consumed their target unhealthy snack on average 2 days/week. Adherence to the snack swap was stable over the 4-week intervention period. The use of specific behaviour change tools (e.g. self-monitoring) was low. Sixty-seven percent of participants accessed the online Facebook forum, but there were no user-generated posts or content.ConclusionsThe study demonstrated that the concept of a novel snack swap mass participation campaign is acceptable and feasible. Further piloting to explore how to promote greater engagement with men and ethnic minority groups and how to promote social support and maximise engagement with behaviour change techniques would be valuable.

Response Analysis of Stop Smoking Campaign Webtoon Using Text Mining Technology: Focused on the “Tale of Cigarette” Comments

Response Analysis of Stop Smoking Campaign Webtoon Using Text Mining Technology: Focused on the “Tale of Cigarette” Comments

How the science of injury prevention contributes to advancing home fire safety in the USA: successes and opportunities

BackgroundIn the decades since the landmark report-America Burning-was published in 1973, the number of home fire deaths has shrunk from >5500 per year to 2650 in 2015. This paper: (1)...

Dinamika Konsumsi Rokok Dan Impor Tembakau Indonesia

&lt;em&gt;The tobacco control and the danger of smoking campaigns have given quite much impact into the lower nicotine and tar cigarettes consumption pattern. This fact affects the higher demand of imported tobacco in which are believed to be better than locals. Object of this research are to analyze trend of Indonesian tobacco import in the next 3 years and analyze factors that influence Indonesian tobacco import. Method of the research used descriptive method which using time series secondary data for 27 years from 1990 to 2016. Data is taken from few institusions and literatures. Analysis method used linier trend and multiple linier regression. Results of this research indicate that from 2018 to 2020 import of Indonesian tobacco trend will increase about 3 percent every year. Consumption of cigarettes kretek industries, income and import tariff affect to Indonesian tobacco import significantly. The increasing of imported tobacco is caused by the high demand of virginia tobacco of cigarettes industries that increased their cigarettes production cause high consumption of mild (low nicotine and tar) cigarettes. Therefore, Indonesia government has to support tobacco’s farmer in developing low nicotine and tar tobacco production that is needed by cigarettes industries through cooperation partnership with cigarettes producer, so the dependency of imported tobacco can be decreased.&lt;/em&gt;

Mass media interventions for preventing smoking in young people.

Mass media interventions can be used as a way of delivering preventive health messages. They have the potential to reach and modify the knowledge, attitudes and behaviour of a large proportion of the community. To assess the effects of mass media interventions on preventing smoking in young people, and whether it can reduce smoking uptake among youth (under 25 years), improve smoking attitudes, intentions and knowledge, improve self-efficacy/self-esteem, and improve perceptions about smoking, including the choice to follow positive role models. We searched the Cochrane Tobacco Addiction Group Specialized Register, with additional searches of MEDLINE and Embase in June 2016. This is an update of a review first published in 1998. Randomized trials, controlled trials without randomization and interrupted time-series studies that assessed the effect of mass media campaigns (defined as channels of communication such as television, radio, newspapers, social media, billboards, posters, leaflets or booklets intended to reach large numbers of people and which are not dependent on person-to-person contact) in influencing the smoking behaviour (either objective or self-reported) of young people under the age of 25 years. We define smoking behaviour as the presence or absence of tobacco smoking or other tobacco use, or both, and the frequency of tobacco use. Eligible comparators included education or no intervention. Two review authors independently extracted information relating to the characteristics and the content of media interventions, participants, outcomes, methods of the study and risks of bias. We combined studies using qualitative narrative synthesis. We assessed the risks of bias for each study using the Cochrane 'Risk of bias' tool, alongside additional domains to account for the nature of the intervention. We assessed the quality of evidence contributing to outcomes using GRADE. We identified eight eligible studies reporting information about mass media smoking campaigns, one of which is new for this update. Seven of the studies used a controlled trial design and one an interrupted time-series analysis. Risks of bias were high across all included studies and there was considerable heterogeneity in study design, intervention and population being assessed.Three studies (n = 17,385), one of which compared a mass media intervention to no intervention and two of which evaluated mass media interventions as adjuncts to school-based interventions, found that the mass media interventions reduced the smoking behaviour of young people. The remaining five studies (n = 72,740) did not detect a significant effect on smoking behaviour. These included three studies comparing a mass media intervention to no intervention, one study evaluating a mass media intervention as an adjunct to a school-based intervention, and one interrupted time-series study of a social media intervention. The three campaigns which found a significant effect described their theoretical basis, used formative research in designing the campaign messages, and used message broadcast of reasonable intensity over extensive periods of time. However, some of the campaigns which did not detect an effect also exhibited these characteristics. Effective campaigns tended to last longer (minimum 3 years) and were more intense (more contact time) for both school-based lessons (minimum eight lessons per grade) and media spots (minimum four weeks' duration across multiple media channels with between 167 and 350 TV and radio spots). Implementation of combined school-based components (e.g. school posters) and the use of repetitive media messages delivered by multiple channels (e.g. newspapers, radio, television) appeared to contribute to successful campaigns. Certainty about the effects of mass media campaigns on smoking behaviour in youth is very low, due to inconsistency between studies in both design and results, and due to methodological issues amongst the included studies. It would therefore be unwise to offer firm conclusions based on the evidence in this review. Methodologically rigorous studies investigating the effect of social media and novel forms of technology as part of tobacco prevention campaigns for youth are needed.