Tobacco Control Research Articles

Support for and likely impacts of endgame measures in the Smokefree Aotearoa Action Plan: findings from the 2020-2021 International Tobacco Control New Zealand (EASE) surveys.

In February 2024, the Aotearoa New Zealand Government repealed legislation to mandate very low nicotine cigarettes (VLNCs), greatly reduce the number of tobacco retailers and disallow sale of tobacco products to people born after 2008 (smokefree generation). We investigated acceptability and likely impacts of these measures among people who smoke or who recently (≤2 years) quit smoking. We analysed data from 1,230 participants from Wave 3 (conducted in late 2020 and early 2021) and 615 participants from Wave 3.5 (conducted in June/July 2021) of the New Zealand arm of the International Tobacco Control (ITC) Policy Evaluation Project. Data were weighted to represent the national population of people who smoke and who recently quit smoking. Support (excluding "Don't know" responses) was 82.7% (95% confidence interval 77.9, 86.6) for a smokefree generation, 75.0% (95% CI 71.4, 78.3) for mandated VLNCs and 35.2% (95% CI 31.7, 38.9) for retailer reduction. Support was mostly similar by ethnicity, gender, age and evidence of financial hardship, but was higher among people who had recently quit smoking. Around half of the participants who smoked anticipated quitting completely, switching to vaping or cutting down the amount they smoke if mandated VLNCs or substantial retailer reductions were introduced. If VLNCs were mandated, 19% of people who smoked stated they would carry on smoking like they do now and find a way to get the cigarettes or tobacco they want to smoke. Support for and anticipated actions in response to the smokefree legislation measures call into question the Government's decision to repeal them.

Conceptions of Freedom in the Regulation of Junk Food and Tobacco

Conceptions of Freedom in the Regulation of Junk Food and Tobacco

A descriptive study of smoking, socioeconomic position, and health-related behaviors in urban Colombia

IntroductionData about recent trends in smoking in Latin America are scarce. We estimated the prevalence of smoking, and explored its association with socioeconomic position, health-related behaviors, perceptions, and trusted information sources in Colombian cities.MethodsWe collected a population-based, multi-stage, stratified probabilistic sample of individuals aged 14–80 years, between November and December 2022. We compared the prevalence of health-related behaviors and perceptions in smokers versus non-smokers employing sample weights according to the sampling design.ResultsThe study included 1904 participants (53.9% female, age 47 ± 19 years). The estimated prevalence of smoking was 22.0% (29.0% in males, 15.7% in females), underage smoking was 4.8%. Among males, the prevalence of smoking was highest in the lowest socioeconomic stratum (31.0%), while among females it was lowest in this stratum (8.3%). Educational level was negatively associated with smoking among men, going from 38.8% for those with only elementary school to 25.5% for college graduates, while among women the trend was the complete opposite. Perceptions about healthy foods and lifestyle habits incorporated in the last year were largely similar between smokers and non-smokers. Smokers and non-smokers appealed essentially to the same health information sources, especially healthcare professionals.ConclusionThe worldwide trend towards a reduction in smoking seems to have been reversed in Colombia, smoking is increasing fast in disadvantaged population segments. Strong tobacco control policies should focus on men with less income and lower education. The same communication avenues can be used to convey health information and motivational campaigns to smokers and non-smokers.

Trends in Mental Health Symptoms, Nicotine Product Use, and their Association Over Time Among Adolescents in Canada, England, and the US: Findings from the ITC Adolescents Tobacco and Vaping Survey, 2020-2023.

There is a well-established bi-directional relationship between cigarette smoking and internalizing mental health (IMH) symptoms (e.g., symptoms of depression, symptoms of anxiety). However, it is unclear whether IMH symptoms are associated with using different types or combinations of nicotine products (e.g., combustible, non-combustible, exclusive product use or multi-product use). The purpose of this study is to improve our understanding of the relationship between adolescent IMH symptoms and use of a wide variety of nicotine products by examining the association between IMH symptoms and current nicotine use from 2020-2023. Data come from the 2020-2023 waves of the International Tobacco Control (ITC) Adolescents Tobacco and Vaping Survey, an online repeat cross-sectional survey of adolescents aged 16-19 in Canada, England, and the US (n=80,427). Current nicotine use was examined in four categories: 1) no use, 2) exclusive non-combustible product use, 3) exclusive combustible product use, and 4) use of both product types. Respondents reported current symptoms of depression or anxiety, and we generated a dichotomous IMH symptoms variable (yes vs. no). We examined the association between IMH symptoms and current nicotine use using multinomial logistic regression models that adjusted for covariates. IMH symptoms were most strongly associated with use of both product types (adjusted relative risk ratio [ARRR]: 1.91, 95% confidence interval [CI] 1.80-2.03), followed by exclusive non-combustible use (ARRR: 1.70, 95% CI=1.61-1.80), and then exclusive combustible use (ARRR: 1.29, 95% CI=1.21-1.37). Adolescents with IMH symptoms are more likely to use nicotine products in general than adolescents without IMH symptoms. Specifically, non-combustible product use may have a particularly strong relationship with poor mental health among adolescents. Longitudinal research is needed to better understand directionality. This study provides an up-to-date understanding of how mental health and nicotine use are related among adolescents, particularly during the COVID-19 pandemic and its aftermath. Results indicate that youth mental health may be related to nicotine use, particularly non-combustible use, which is largely driven by e-cigarette use. Efforts to reduce youth e-cigarette use may consider emphasizing its relationship with mental health. Efforts to promote e-cigarette use as a less harmful alternative to cigarette smoking should be aware of the association between vaping and youth mental health.

Describing ZYN-related content on TikTok: content analysis.

Nicotine pouches are the fastest-growing oral smokeless tobacco or nicotine product category in the United States, and there are concerns about their potential appeal to youth. Few studies have surveilled discussions about nicotine pouches on TikTok, an audiovisual platform popular among youth. To address this gap, this study conducted a content analysis of TikTok posts related to the leading nicotine pouch brand, ZYN. Publicly available posts (N=665) from 10 ZYN-related hashtags were collected from the TikTok Application Programming Interface between January 2023 and February 2024. The number of likes, comments, shares, and plays were collected for each post and the number of followers for each account profile was recorded. Posts were coded for themes like product marketing and use, health warnings, and demographics. The most prevalent theme was humor (n=581, 87.4%), followed by product use (n=378, 56.8%), and branded merchandise (n=378, 56.8%). Young people (i.e., persons in the video who appeared younger than 30) were identified in 48.3% (n=321) of posts, and 61.5% (n=409) of posts featured people who appeared to be male. Cessation (n=12, 1.8%) was an uncommon theme. Most posts came from non-commercial accounts (n=420, 63.1%), followed by commercial accounts (n=158, 23.8%), and content creators/influencers (n=87, 13.1%). This study showed that ZYN-related posts on TikTok often featured pro-tobacco themes, such as humor and product use, while rarely mentioning anti-tobacco themes like cessation. Future research should examine the relationship between exposure to pro-tobacco content on TikTok and tobacco-related attitudes and behaviors. This study highlighted the potential role of TikTok in normalizing tobacco and nicotine product use, and in particular ZYN product use, including among youth. While increased enforcement of online tobacco control policies can help reduce exposure to ZYN-related content in youth, prevention programs and interventions that incorporate tobacco-related digital media literacy are needed to inoculate adolescents and young adults from the pro-tobacco content found online.

Stroke Subtypes Mortality Attributable to Smoking in China: A Study Based on the Global Burden of Disease Database 2021

Background: The objective of this study was to analyze long-term trends in ischemic stroke (IS), subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH) mortality from smoking in China from 1992 to 2021, to provide scientific advice on stroke prevention and treatment in China. Methods: The mortality data of smoking-related stroke and its subtypes in China during 1992–2021 were collected from the Global Burden of Disease 2021. Joinpoint regression model and Age-period-cohort (APC) model were used for trend analysis. Results: The age-standardized mortality rate of stroke and subtypes caused by smoking showed a decreasing trend in China from 1992 to 2021. The decline was greater for women than for men. According to APC model analysis, the age effect showed that ICH and IS showed an increasing trend, while SAH increased first and then decreased. The results of the cohort effect were similar to those of the period effect, with relative risk decreasing for all subtypes. The local drift showed that the stroke and subtypes in males showed a “U” shaped trend, a relatively stable trend for stroke and is in females, and a downward trend for SAH and ICH. Conclusions: Over the past 30 years, the burden of stroke and stroke subtype deaths attributable to smoking in China has decreased. However, future efforts should focus on preventing ICH. Strengthening tobacco control legislation, particularly targeting older men and young people, is crucial for further reducing smoking-related stroke risk.

Tobacco Smoking in Early Adulthood and Labor Market Performance: The Cardiovascular Risk in Young Finns Study.

Tobacco smoking has been associated with reduced success in the labor market, potentially due to its negative impact on labor productivity, especially in physically demanding jobs, as it affects physical fitness and performance adversely. This prospective study used data from the Cardiovascular Risk in Young Finns Study survey, linked to register information on labor market outcomes and education attainment, to examine the association between tobacco smoking and long-term labor market outcomes (earnings and employment, N = 1953). Smoking levels were determined by cigarette pack-years in 2001, as reported in the survey, whereas annual earnings and employment status were tracked from 2001 to 2019. A one-unit increase in pack-year of smoking was associated with a 1.8% decrease in earnings (95% confidence interval [CI]: -2.6% to -0.9%) and a 0.5% reduction in years employed (95% CI: -0.6% to -0.3%). This association was pronounced among participants with lower education levels. The earnings difference was evident among younger cohorts, whereas a negative correlation with employment was observed most strongly in older cohorts among individuals with lower education. Our findings suggest that smoking had a negative effect on earnings among the younger generation, particularly among the less well-educated. The finding of greater impacts on years of employment among the older age group, particularly among groups with low education levels, is consistent with the delayed onset of most health impacts, which may particularly affect productivity in physically demanding jobs that are more common among people with less education. Adverse consequences of smoking include reduced earnings and labor market participation, particularly among less well-educated groups. Tobacco control advocates should draw attention to these consequences in arguing for effective measures to reduce smoking initiation and increase cessation in order to achieve socially optimal outcomes.

Comprehensive Review of Tobacco Control Measures in Sri Lanka: Insights from the WHO Report on the Global Tobacco Epidemic, 2023

This review article provides a comprehensive analysis of the tobacco control measures in Sri Lanka as outlined in the WHO Report on the Global Tobacco Epidemic, 2023: (1) Assessing the implementation and efficacy of the MPOWER measures, (2) monitoring tobacco use, (3) protecting people from tobacco smoke, (4) offering assistance to quit tobacco use, (5) warning about the dangers of tobacco, (6) enforcing bans on tobacco advertising, promotion, and sponsorship, and (7) raising taxes on tobacco. The review focuses on the current prevalence of tobacco use among adults and adolescents. The results emphasize notable advancements in the implementation of health warnings and advertising prohibitions. However, there are still obstacles to overcome in order to reduce the affordability of tobacco, enforce smoke-free policies in public spaces, and provide comprehensive cessation support. In addition to recommendations for strengthening tobacco control policies, the article concludes with further suggestions for the future development of Sri Lanka.

Patterns of use of heated tobacco products: a comprehensive systematic review.

Relative or absolute safety of heated tobacco products (HTP) remains unknown, while independent literature suggests that these products do not favour tobacco control. We conducted a comprehensive systematic review and meta-analysis to evaluate HTP usage patterns and the effect of HTP use on conventional tobacco smoking (use transitions). We used Pubmed/MEDLINE, Embase and the Cochrane Library to identify all articles published up to February 2022 on HTP use. For the present review, we included all representative cross-sectional studies dealing with HTP use, and all prospective cohort studies or cross-sectional studies on conventional tobacco smoking transitions due to HTP use. From 610 non-duplicate articles, 76 were eligible (71 cross-sectional and 5 prospective cohort studies). Compared with young adults, HTP use was less frequent among middle-aged (pooled odds ratio, OR=0.59; 95% confidence interval, CI: 0.48-0.74; number of studies, n=15) and older adults (OR=0.17; 95%-CI: 0.07-0.38; n=12). HTP use was more frequent among former (OR=2.73; 95%-CI: 1.03-7.25; n=6) and current smokers (OR=14.53; 95%-CI: 6.34-33.31; n=12). Overall, 68.3% of HTP users were dual users (n=26). Eight studies (including 5 cohorts) showed that HTP users were more likely than non-users to start conventional cigarette smoking (OR=6.31; 95%-CI: 4.13-9.65; n=2), whereas current cigarette smokers using HTPs were less likely to quit (OR=0.84; 95%-CI: 0.80-0.89; n=4). We found that HTPs are specifically popular among young generations. More than two out of three HTP users are dual users. Prospective studies consistently show that in real life HTPs are not effective smoking cessation tools.

Tobacco control in Türkiye: A brief review of achievements, challenges, and prospects.

The global burden of tobacco is a significant public health concern, causing millions of deaths, illnesses, and economic losses annually. In Türkiye, tobacco use is deeply ingrained in society, with historical roots dating back to Ottoman times. The nation faces challenges such as high smoking rates, gender disparities, and the popularity of non-cigarette tobacco products. Despite these issues, Türkiye has adhered to the WHO Framework Convention on Tobacco Control (FCTC) and implemented MPOWER strategies to combat tobacco use effectively. This review aims to synthesize Türkiye's comprehensive tobacco control measures, including legislation, smoking cessation initiatives, public awareness campaigns, and taxation policies. The study examines the country's strategic actions against the backdrop of its historical context and current challenges. The review leverages data from various sources, including the Global Burden of Disease, national health surveys, and reports on tobacco control efforts and achievements. Stakeholder activities, such as those by the Turkish Ministry of Health and non-governmental organizations, are also explored. Türkiye has made substantial progress in tobacco control, evidenced by reduced tobacco consumption and addressing key challenges like gender disparities and youth smoking. However, the country continues to face obstacles such as tobacco smuggling, the rise of narghile (hookah) smoking, and ongoing high daily smoking rates. The review highlights the tobacco industry's influence in Türkiye despite strong adherence to FCTC. Türkiye's efforts in tobacco control represent a significant endeavor to mitigate the public health crisis posed by tobacco use. Through adherence to WHO FCTC guidelines and MPOWER strategies, notable progress has been achieved. Yet, challenges persist, requiring continuous, comprehensive strategies and robust enforcement. Future efforts must focus on strengthening tobacco control measures, ensuring accessibility to smoking cessation services, and countering the tobacco industry's influence, to further reduce tobacco use and its health and economic burdens.

Exploring public support for novel tobacco and alcohol control policies in Great Britain 2021-2023: A population-based cross-sectional survey.

This study assessed support for novel tobacco compared with alcohol control policies among adults in Great Britain in 2021-2023. Objectives were to assess 1) overall level of support for tobacco compared to alcohol control policies; 2) level of support for tobacco compared to alcohol control policies among people who smoke tobacco or who consume alcohol at increasing and higher risk levels, or who do both; 3) level of support for tobacco compared to alcohol control policies among different sociodemographic groups? Data were collected in September/October 2021-2023 in a monthly population-based survey on smoking and drinking behaviour of adults across Great Britain (N=6311), weighted to match the overall population. Outcome measure was level of support for each seven tobacco and alcohol control policies. More people were in support of tobacco than alcohol control policies (e.g., 57% vs. 51% for tax-related policies). This trend was apparent across all sociodemographic subgroups. With one exception, the policies included in this study were supported by more than half of the participants. The exception was decreasing the visibility of alcohol products in shops, which received 41% of support. People who engaged in the behaviour targeted by policies (tobacco more so than alcohol use) were generally less supportive. Overall, public support for tobacco and alcohol control policies is high in Great Britain. With one exception, the policies were supported by over half of participants, suggesting that the public is in favour of government regulations to reduce smoking and drinking prevalence in Great Britain.

Public's perception of policies reducing tobacco availability by regulating the tobacco retail environment: A case study in Egypt.

The tobacco industry presence in the retail environment ensures its access to current and potential tobacco users. Reduction of tobacco retail is an emerging tobacco control measure. Many policies that would potentially lead to reduction in retail are not covered by international tobacco laws and are individually adopted in some jurisdictions. This study examines public perception on potential effect of suggested policies in one of the few countries where tobacco market is increasing, Egypt. A cross-sectional online survey study was implemented in Egypt, June 2023 to March 2024 to assess the perception of the public towards 12 suggested policies that aim to reduce both tobacco availability and purchase by regulating the tobacco retail environment. The survey was disseminated through social media and 320 completed responses were received. Responses on perception followed five-point Likert scales. Participants felt they could easily access tobacco products around places of residence, work, and study. The largest proportion of participants (53.1%) reported good agreement that the suggested policies would have an impact in reducing tobacco availability and retail, while 39.7% had fair agreement, and only 7.2% had poor agreement. Most participants believe that policies reducing tobacco availability and sales would be effective. Non-users rated these policies as more effective than tobacco users. Younger adults viewed these policies more favorably than older adults. The study suggests public support for tobacco control measures to address the prevalent tobacco retail environment in Egypt, indicating a need for policymakers to adopt these measures to protect future generations. Additional research using larger randomly selected populations in Egypt is needed to corroborate these results.

Prevalence of quitting decision and the impact of increased cigarette prices on the smoking behaviours among the male garment workers in Bangladesh

ObjectivesThe prevalence of tobacco use is high in Bangladesh, with a cigarette being the most consumed tobacco product. Taxing tobacco is highly effective for tobacco control, raising costs and encouraging smokers to quit or reduce cigarette consumption. Garment workers are the major group of low-wage earners in Bangladesh. This study aims to determine the perceived effects of raising cigarette prices on smoking behaviors and their influences on quitting the decision of male garment workers in Bangladesh. Study designCross-sectional study. MethodsThe Study adopted a cross-sectional method among 739 male garment workers from Gazipur and Savar, Dhaka, for six months, using a semi-structured questionnaire. Factors such as the prevalence of lifetime tobacco use and rising cigarette prices on smoking behaviors were analyzed. ResultsThe study found that most participants began smoking before age 16, and increased tobacco prices influenced quitting decisions for both smoking and smokeless tobacco users, with reductions of 79% and 68%, respectively. Higher prices notably impacted smoking cessation among lower-income individuals, decreasing smoking frequency by 12-fold. Significantly changing their smoking behavior, on average, daily cigarette or biri consumption decreased from 7 to 5, with some participants switching to less expensive tobacco products. ConclusionFindings from the study depict that imposing a high tax on tobacco products such as cigarette or biri has a desirable impact on the smoking behavior of low earning community. The price of all tobacco products should be increased to auspicate a considerable positive change in the community.

Factors associated with shisha smoking: Results from a cross-sectional telephone-based survey among the general population adults in Nigeria.

In Nigeria, there is very limited evidence on factors that influence shisha smoking, and this hinders effective tobacco control policymaking. We, therefore, aimed to identify factors associated with shisha smoking among the general population adults in Nigeria. We conducted a telephone-based, cross-sectional survey between 28 July and 11 September 2022 in 12 states of Nigeria. Our outcome of interest was self-reported current shisha smoking status, and the independent variables included potential behavioral, biological, mental health, environmental, and social determinants of shisha smoking. We performed logistic regression analysis, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) as the measures of association. We surveyed 1278 individuals: 611 who currently smoked shisha and 667 who did not. The following increased the likelihood of being a person who currently smokes shisha: being a person who currently smokes cigarettes (AOR=5.54; 95% CI: 2.57-11.90) or consumes alcohol (AOR=3.46; 95% CI: 1.91-6.28); and having a family member (AOR=2.32; 95% CI: 1.23-4.40), or one (AOR=22.81; 95% CI: 9.99-52.06) or more (AOR=78.85; 95% CI: 22.50-276.33) close friends who smoke shisha. The following reduced the likelihood of being a person who currently smokes shisha: being older (AOR=0.92; 95% CI: 0.89-0.95) and screening positive for possible generalized anxiety disorder (AOR=0.60; 95% CI: 0.41-0.88). We found sex differences in the factors associated with shisha smoking, particularly on the effects of household wealth, employment status, having family members who smoke shisha, and mental health. Strategies to curb shisha smoking need to account for the associated biological, social and behavioral factors, including age, cigarette smoking, alcohol consumption, and having family members or close friends who smoke shisha. They should also account for sex differences, and differences that exist between shisha smoking behavior and the smoking of other tobacco products.

A study on awareness regarding cigarettes and other tobacco products act (COTPA Act) among hospital staff of medical college, Kanpur: A mixed method study

ABSTRACT Context: In 2003, the government of India formulated “the cigarettes and other tobacco products Act (prohibition of advertisement and regulation of trade and commerce, production, supply, and distribution) (COTPA)”. The aim of the study is to evaluate hospital staff’s knowledge of the COTPA Act and their enablers and hurdles using qualitative analysis. Settings and Design: This study was conducted in GSVM Medical College, and this was a convergent parallel mixed-methods study, with a quantitative component (cross-sectional survey) complemented by a qualitative component (descriptive study). Methods and Material: A pre-tested, semi-structured, face-validated questionnaire was incorporated into the Epicollect5 application for data collection. The qualitative study was conducted among 11 hospital staff. Statistical Analysis Used: The collected data were imported into a Microsoft Excel spreadsheet and analysed with Jamovi version 2.0. To determine associations between variables, appropriate tests of significance were applied. For qualitative analysis, an interview guide was prepared. Results: On quantitative analysis, hospital personnel’s overall awareness of any tobacco control law was 59.4%, with 56.6% being tobacco abusers and 69.5% being non-abusers. On qualitative analysis by in-depth interview framework analysis, decalogues were taken from the responses provided by the participants. After that, the decalogues were divided into three keynotes which were openers, hurdles, and recommendations. Conclusions: Study demonstrates that more than half of the employees are already aware of COTPA Act but still need more coordinated effort from all responsible authorities of medical institute to increase COTPA Act awareness.

Use of nicotine vaping products during an attempt to quit smoking by Canadian adults who smoke or recently quit: findings from the 2022 Canada International Tobacco Control Four Country Smoking and Vaping Survey.

An analysis of 1771 Canadian adults who smoke or used to smoke cigarettes was conducted using data from the 2022 International Tobacco Control Four Country Smoking and Vaping Survey. Using weighted data, we estimated the prevalence of Canadian adults who tried to quit smoking between 2020 and 2022, and the use of a nicotine vaping product (NVP) and the flavours and devices used most often at their most recent quit attempt. Overall, 36.5% made a quit attempt; of those, 19.4% used an NVP. Those who were younger and quit smoking were more likely to have used an NVP. Prefilled cartridges or pods (36.3%) and fruit flavours (39.5%) were used most frequently.

Understanding Tobacco Control: Global and National Strategies

Tobacco use is a significant global health crisis, impacting over 1.1 billion individuals and leading to approximately 8 million deaths annually. This narrative review evaluates the tobacco control policies worldwide, focusing on India, where both smoked and smokeless tobacco prevalence remains high. Historical interventions highlight ongoing efforts to combat tobacco use; however, challenges in public awareness and access to cessation resources persist. There is an urgent need for effective policies and comprehensive public health strategies to reduce tobacco consumption, underscoring the critical role of health professionals in promoting cessation efforts.

The impact of goods and services tax increase on economic crime: Evidence from China's tobacco tax hike.

Despite the acknowledged interconnection between socioeconomic environment and economic crime, research on the relationship between Goods and Services Tax (GST) and economic crime is scarce because of their complicated relationship. This study examines the impact of the GST increase on the illicit tobacco trade. Based on China's tobacco excise tax shock in 2015, this study employs a difference-in-difference (DID) method to analyze the impact of the GST increase on economic crime. Panel data used in this research are collected by combining prefecture-level socioeconomic data with smuggling data from 2011 to 2016, including variables such as economic crime, wages, GDP per capita, and population. Economic crime, our core dependent variable, is evaluated by the seized-illegal value of smuggling tobacco (SIVST). In order to estimate the heterogeneity effect of tax hikes by region, we classify prefectures into three groups and add a triple interaction term into the regression model. We find that economic crime will be further elevated in places where it was initially higher, stimulated by the excise tax hike. Specifically, areas with high per capita tobacco smuggling in 2014 showed a significant increase in cigarette crime following the 2015 cigarette excise tax increase. For every 1-unit increase in per capita illicit trade in cigarettes in the region in 2014, the local illicit trade increased by 0.25 units after 2015. Heterogeneity analysis shows that the impact of GST increase on the SIVST among prefectures is more pronounced among the coastal prefectures. At the same time, there is no significant difference between border and central prefectures. To mitigate the adverse effects of GST increases on economic crime, governments should implement measures to combat tobacco smuggling, particularly in regions with prevalent criminal activity. This is especially crucial when policymakers opt to raise tobacco taxes for fiscal purposes or tobacco control initiatives.

A cross-sectional study on exposure to secondhand smoke in indoor public places and attitudes of residents towards the smoke control ordinance in public places.

Secondhand smoke (SHS) exposure is a serious public health problem. This study aims to collect data on tobacco control since the implementation of the new version of the Smoke Control Ordinance in Public Places of Hangzhou (the Ordinance), combined with questionnaire surveys to understand the SHS exposure situation in public places, relevant knowledge and attitudes of residents in Hangzhou. We used data from a population-based tobacco control survey of 2746 adults aged 15-75 years conducted in Hangzhou, Zhejiang Province in March 2023. Data were collected using a self-administered questionnaire consisting of demographic characteristics, exposure to tobacco, awareness of tobacco hazards, knowledge of the Ordinance, and behaviors and attitudes towards tobacco control in public places. Chi-squared tests were performed to examine the differences in knowledge and attitudes related to tobacco control in indoor public places among residents with different characteristics in Hangzhou. Multivariable logistic regression was used to identify variables affecting satisfaction with the effectiveness of tobacco control in public places. Of the 2155 non-smokers, 1006 (46.68%) had been exposed to SHS in public places. More than 89.00% of participants supported the Ordinance. Satisfaction with effectiveness of tobacco control in public places in Hangzhou was 68.54%, and the subcomponents that influenced it were satisfaction with tobacco control publicity campaigns (AOR=1.85; 95% CI: 1.19-2.88), satisfaction with tobacco control surveillance and enforcement (AOR=3.91; 95% CI: 2.43-6.30), satisfaction with the smoke-free demonstration for government departments (AOR=5.79; 95% CI: 3.96-8.47), and satisfaction with individual tobacco control behavior (AOR=11.68; 95% CI: 8.53-15.99). It is necessary to strengthen tobacco control publicity to increase the participation of residents and to gain a deeper understanding of the subjective willingness and needs of residents to participate in tobacco control campaigns in order to improve residents' individual satisfaction.

Public support for new tobacco control measures in Poland: A cross-sectional survey 2024.

This study assessed public support for new tobacco control measures in Poland, including a smoking ban on private balconies, regular tobacco tax increases, and a total ban on tobacco sales. A nationwide cross-sectional survey was conducted in 2024 using a computer-assisted web interview (CAWI). The 1080 adults (aged 18-82 years) were interviewed, of which 53% were females. A self-prepared questionnaire included questions on support for various tobacco control measures. The primary outcomes were levels of support for each proposed measure. Attitudes were measured using a 5-point Likert scale, and independent variables included sociodemographic factors and smoking status. The smoking ban on private balconies was supported by 44.1% of respondents, with higher support among older adults, non-smokers, and those with higher education. Support for annual tobacco tax increases was 47.1%, particularly among younger and middle-aged adults, the educated, and non-smokers. A total of 41.8% of respondents declared support for the total ban on tobacco sales. Higher education, non-smoking status, and voluntary smoke-free home rules were significantly associated (p<0.05) with higher support for all three tobacco control measures. There was no significant impact (p>0.05) of the gender, financial status, household size, and location of the place of residence on public support of analyzed tobacco control measures. This study revealed that less than half of adults in Poland declare support for extensive tobacco regulations such as a smoking ban on private balconies, taxation increases, and a ban on tobacco sales. Educational level and smoking status are significantly associated with public attitudes toward tobacco control measures.