Citation

Li, Q., Hyland, A., Fong, G.T., Wang, H., Zhengzhong, M. (2010). Use of less expensive cigarettes in six cities in China: Findings from the ITC China Survey. Tobacco Control, 19(Suppl 2), i63-i68.

Abstract

Objective: The existence of less expensive cigarettes in China may undermine public health. The aim of the current study is to examine the use of less expensive cigarettes in six cities in China.

Methods: Data was from the baseline wave of the International Tobacco Control (ITC) China Survey of 4815 adult urban smokers in 6 cities, conducted between April and August 2006. The percentage of smokers who reported buying less expensive cigarettes (the lowest pricing tertile within each city) at last purchase was computed. Complex sample multivariate logistic regression models were used to identify factors associated with use of less expensive cigarettes. The association between the use of less expensive cigarettes and intention to quit smoking was also examined.

Results: Smokers who reported buying less expensive cigarettes at last purchase tended to be older, heavier smokers, to have lower education and income, and to think more about the money spent on smoking in the last month. Smokers who bought less expensive cigarettes at the last purchase and who were less knowledgeable about the health harm of smoking were less likely to intend to quit smoking.

Conclusions: Measures need to be taken to minimise the price differential among cigarette brands and to increase smokers' health knowledge, which may in turn increase their intentions to quit.

Citation

Liu, R.L., Yang, Y., Travers, M.J., Fong, G.T., O’Connor, R.J., Hyland, A., Nan, Y., Feng, G., Li, Q., Jiang, Y. (2010). A cross-sectional study on levels of second-hand smoke in restaurants and bars in five cities in China. Tobacco Control, 19(Suppl 2), i24-i29.

Abstract

Objectives: To assess indoor second-hand smoke (SHS) exposure in restaurants and bars via PM2.5 (fine particles 2.5 mm in diameter and smaller) level measurements in five cities in China.

Methods: The study was conducted from July to September in 2007 in Beijing, Xi’an, Wuhan, Kunming and Guiyang. Portable aerosol monitors were used to measure PM2.5 concentrations in 404 restaurants and bars. The occupant density and the active smoker density were calculated for each venue sampled.

Results: Among the 404 surveyed venues, 23 had complete smoking bans, 9 had partial smoking bans and 313 (77.5%) were observed to have allowed smoking during sampling. The geometric mean of indoor PM2.5 levels in venues with smoking observed was 208 mg/m3 and 99 mg/m3 in venues without observed smoking. When outdoor PM2.5 levels were adjusted, indoor PM2.5 levels in venues with smoking observed were consistently significantly higher than in venues without smoking observed (F=80.49, p,0.001). Indoor PM2.5 levels were positively correlated with outdoor PM2.5 levels (partial rho=0.37 p,0.001) and active smoker density (partial rho=0.34, p,0.001).

Conclusions: Consistent with findings in other countries, PM2.5 levels in smoking places are significantly higher than those in smoke-free places and are strongly related to the number and density of active smokers. These findings document the high levels of SHS in hospitality venues in China and point to the urgent need for comprehensive smoke-free laws in China to protect the public from SHS hazards, as called for in Article 8 of the Framework Convention on Tobacco Control, which was ratified by China in 2005.

Citation

Nagelhout, G.E., Willemsen, M.C., Thompson, M.E., Fong, G.T., van den Putte, B., de Vries, H. (2010). Is web interviewing a good alternative to telephone interviewing? Findings from the International Tobacco Control (ITC) Netherlands Survey. BioMed Central Public Health, 10, 351

Abstract

Background: Web interviewing is becoming increasingly popular worldwide, because it has several advantages over telephone interviewing such as lower costs and shorter fieldwork periods. However, there are also concerns about data quality of web surveys. The aim of this study was to compare the International Tobacco Control (ITC) Netherlands web and telephone samples on demographic and smoking related variables to assess differences in data quality.

Methods: Wave 1 of the ITC Netherlands Survey was completed by 1,668 web respondents and 404 telephone respondents of 18 years and older. The two surveys were conducted in parallel among adults who reported smoking at least monthly and had smoked at least 100 cigarettes over their lifetime.

Results: Both the web and telephone survey had a cooperation rate of 78%. Web respondents with a fixed line telephone were significantly more often married, had a lower educational level, and were older than web respondents without a fixed line telephone. Telephone respondents with internet access were significantly more often married, had a higher educational level, and were younger than telephone respondents without internet. Web respondents were significantly less often married and lower educated than the Dutch population of smokers. Telephone respondents were significantly less often married and higher educated than the Dutch population of smokers. Web respondents used the "don't know" options more often than telephone respondents. Telephone respondents were somewhat more negative about smoking, had less intention to quit smoking, and had more self efficacy for quitting. The known association between educational level and self efficacy was present only in the web survey.

Conclusions: Differences between the web and telephone sample were present, but the differences were small and not consistently favourable for either web or telephone interviewing. Our study findings suggested sometimes a better data quality in the web than in the telephone survey. Therefore, web interviewing can be a good alternative to telephone interviewing.

Citation

O’Connor, R.J., Li, Q., Stephens, W.E., Hammond, D., Elton-Marshall, T., Cummings, K.M., Giovino, G.A., Fong, G.T. (2010). Cigarettes sold in China: Design, emissions, and metals. Tobacco Control, 19(Suppl 2), i47-i53.

Abstract

Background: China is the home to the world's largest cigarette maker, China National Tobacco Company (CNTC), yet little is known publicly about the design and emissions of Chinese cigarettes. CNTC is currently in the process of consolidating its brands and has ambitions to export its cigarettes. Machine-measured tar yields of many of its cigarette brands have also been reduced, similar to what occurred in Western countries from the 1970s through the 1990s with so-called ‘low-tar’ cigarettes introduced to address consumer concerns about health risks from smoking.

Method: The current study examines the design and physical characteristics, labelled smoke emissions and tobacco metals content of leading brands of Chinese cigarettes from seven cities purchased in 2005–6 and in 2007.

Results: Findings suggest that similar to most countries, tar levels of Chinese cigarettes are predicted primarily by tobacco weight and filter ventilation. Ventilation explained approximately 50% of variation observed in tar and 60% variation in carbon monoxide yields. We found little significant change in key design features of cigarettes purchased in both rounds. We observed significant levels of various metals, averaging 0.82 μg/g arsenic (range 0.3–3.3), 3.21 μg/g cadmium (range 2.0–5.4) and 2.65 μg/g lead (range 1.2–6.5) in a subsample of 13 brands in 2005–6, substantially higher than contemporary Canadian products.

Conclusion: Results suggest that cigarettes in China increasingly resemble those sold in Western countries, but with tobacco containing higher levels of heavy metals. As CNTC looks to export its product around the world, independent surveillance of tobacco product characteristics, including tobacco blend characteristics, will become increasingly important.

Citation

Siahpush, M., Yong, H.H., Borland, R., Reid, J. (2010). Socioeconomic position and abrupt versus gradual method of quitting smoking: Findings from the International Tobacco Four Country Survey. Nicotine & Tobacco Research, 12(Suppl 1), S58-63.

Abstract

Introduction: Our aim was to investigate the association between socioeconomic position (income and education) and abrupt versus gradual method of smoking cessation.

Methods: The analysis used data (n = 5,629) from Waves 1 through 6 (2002–2008) of the International Tobacco Control Four-Country Survey, a prospective study of a cohort of smokers in the United States, Canada, the United Kingdom, and Australia.

Results: Logistic regression analyses using generalized estimating equations showed that higher income (p < .001) and higher education (p = .011) were associated with a higher probability of abrupt versus gradual quitting. The odds of adopting abrupt versus gradual quitting were about 40% higher among respondents with high income ($60,000 and more in the United States/Canada/Australia and £30,000 and more in the United Kingdom) compared with those with low income (less than $30,000 in the United States/Canada/Australia; £15,000 and less in the United Kingdom). Similarly, the odds of abrupt versus gradual quitting were about 30% higher among respondents with a high level of education (university degree) compared with those with a low level of education (high school diploma or lower).

Discussion: Higher socioeconomic position is associated with a higher probability of quitting abruptly rather than gradually reducing smoking before quitting.

Citation

Thomson, G., Wilson, N., Blakely, T., Edwards, R. (2010). Ending appreciable tobacco use in a nation: Using a sinking lid on supply. Tobacco Control, 19(5), 431-435.

Abstract

We discuss some of the practical and ethical questions that may arise for a jurisdiction where a sinking lid endgame strategy for tobacco supply is implemented. Such a strategy would involve regular required reductions in the amount of tobacco released to the market for sale, sufficient to achieve the desired level of commercial sales by a target date. Tobacco manufacturers would periodically bid to the government for a residual quota. Prices would increase as supply reduced. The price level would be influenced by demand, which in turn would reflect the impact of other interventions to reduce demand and the changing normality of smoking. Higher priced tobacco could result in increased smuggling, theft, illegal sales and short-to-medium-term aggravation of some social inequalities. We suggest that the strategy be introduced in conjunction with a range of complementary interventions that would help reduce demand, and thus help ensure that the possible adverse effects are minimised. These complementary interventions include: providing comprehensive best practice smoking cessation support, better information to smokers and the public, strengthened regulation of tobacco retailing and supply, further controlling the pack and product design, measures to restrict supplies that bypass the increases in product price, strengthened enforcement and combating industry attacks. General prerequisites for a sinking lid strategy include public support for the goal of a tobacco-free society, and strong political leadership. The likely context for initial success in jurisdictions includes geographical isolation and/or strong border controls, absence of significant tobacco production and/or manufacturing and low government corruption.

Citation

Wilson, N., Weerasekera, D., Edwards, R., Thomson, G., Devlin, M., Gifford, H. (2010). Characteristics of smoker support for increasing a dedicated tobacco tax: National survey data from New Zealand. Nicotine & Tobacco Research, 12(2), 168-173.

Abstract

Aim: To examine smoker support for tobacco tax and for increased dedicated tobacco taxes, along with associations forany such support.

Methods: The New Zealand (NZ) arm of the International Tobacco Control Policy Evaluation Survey utilizes the NZ Health Survey (a national sample). From this sample, we surveyed adult smokers (N = 1,376).

Results: Most smokers considered that the current level of tobacco tax is "too high" (68%), but a majority (59%) would support an increase in tobacco tax if the extra revenue was used to promote healthy lifestyles and support quitting. There was majority support for a dedicated tobacco tax increase among all sociodemographic groups of smokers (including Māori, Pacific, and Asian smokers). In the fully adjusted multivariate model, significant associations with support for a dedicated tax increase included higher deprivation level (adjusted odds ratio [AOR] = 1.15) and suffering one form of financial stress (AOR = 1.81, 95% CI = 1.18-2.78). Other significant associations with support included concern about the smoking impacts on health and quality of life (AOR = 1.41), expressing support for tobacco control regulation (AOR = 1.83), and strength of intention to quit (AOR = 1.30).

Discussion: A majority of smokers from all sociodemographic groups supported an increase in tobacco tax if it was dedicated to quitting support and health promotion. The higher support among smokers with stronger intentions to quit is consistent with other evidence that smokers value tobacco control regulation such as high taxes to help them achieve their long-term quitting goals.

Citation

Wilson, N., Weerasekera, D., Blakely, T., Edwards, R., Thomson, G., Gifford, H. (2010). What is behind smoker support for new smokefree areas? National survey data. BioMed Central Public Health, 10(1), 498.

Abstract

Background: Some countries have started to extend indoor smokefree laws to cover cars and various outdoor settings. However, policy-modifiable factors around smoker support for these new laws are not well described.

Methods: The New Zealand (NZ) arm of the International Tobacco Control Policy Evaluation Survey (ITC Project) derives its sample from the NZ Health Survey (a national sample). From this sample we surveyed adult smokers (n = 1376).

Results: For the six settings considered, 59% of smokers supported at least three new completely smokefree areas. Only 2% favoured smoking being allowed in all the six new settings. Support among Maori, Pacific and Asian smokers relative to European smokers was elevated in multivariate analyses, but confidence intervals often included 1.0.

Also in the multivariate analyses, "strong support" by smokers for new smokefree area laws was associated with greater knowledge of the second-hand smoke (SHS) hazard, and with behaviours to reduce SHS exposure towards others. Strong support was also associated with reporting having smokefree cars (aOR = 1.68, 95% CI = 1.21 - 2.34); and support for tobacco control regulatory measures by government (aOR = 1.63, 95% CI = 1.32 - 2.01). There was also stronger support by smokers with a form of financial stress (not spending on household essentials).

Conclusions: Smokers from a range of population groups can show majority support for new outdoor and smokefree car laws. Some of these findings are consistent with the use of public health strategies to support new smokefree laws, such as enhancing public knowledge of the second-hand smoke hazard.

Citation

Wilson, N., Weerasekera, D., Hoek, J., Li, J., Edwards, R. (2010). Increased smoker recognition of a national quitline number following introduction of improved pack warnings: ITC Project New Zealand. Nicotine & Tobacco Research, 12(Suppl 1), S72-77.

Abstract

Introduction: We examined how recognition of a national quitline number changed after new health warnings were required on tobacco packaging in New Zealand (NZ).

Methods: The NZ arm of the International Tobacco Control Policy Evaluation Survey (ITC Project) is a cohort study that surveyed smokers in two waves (N = 1,376 and N = 923). Wave 1 respondents were exposed to text-based warnings with a quitline number but no wording to indicate that it was the "Quitline" number. Wave 2 respondents were exposed to pictorial health warnings (PHWs) that included the word "Quitline" beside the number as well as a cessation message featuring the Quitline number and repeating the word "Quitline."

Results: The introduction of the new PHWs was associated with a 24 absolute percentage point between-wave increase in Quitline number recognition (from 37% to 61%, p < .001). Recognition increased from a minority of respondents to a majority for all age groups, genders, deprivation levels (using small area and individual measures), financial stress (two measures), and ethnic groups (e.g., the level for Maori in Wave 2: 62%, Pacific peoples: 61%, and European/other: 62%). There was also an equalizing effect on previous differences in Quitline recognition by gender, ethnic group, and for both deprivation measures.

Discussion: This study provides some evidence for the value of clearly identifying quitline numbers on tobacco packaging as part of PHWs. While this finding is consistent with previously published studies, the finding that this intervention appeared to benefit all sociodemographic groups is novel.

Citation

Wu, C., Thompson, M.E., Fong, G.T., Li, Q., Jiang, Y., Yang, Y., Feng, G. (2010). Methods of the International Tobacco Control (ITC) China Survey. Tobacco Control, 19(Suppl 2), i1-i5.

Abstract

This paper describes the design features, data collection methods and analytical strategies of the ITC China Survey, a prospective cohort study of 800 adult smokers and 200 adult non-smokers in each of six cities in China . In addition to features and methods which are common to ITC surveys in other countries, the ITC China Survey possesses unique features in frame construction, a large first phase data enumeration and sampling selection; and it uses special techniques and measures in training, field work organisation and quality control. It also faces technical challenges in sample selection and weight calculation when some selected upper level clusters need to be replaced by new ones owing to massive relocation exercises within the cities.

Citation

Yang, J., Hammond, D., Driezen, P., Fong, G.T., Jiang, Y. (2010). Health knowledge and perception of risks among Chinese smokers and non-smokers: Findings from ITC China Survey. Tobacco Control, 19(Suppl 2), i18-i23.

Abstract

Background: Awareness of health risks of smoking is strongly associated with smoking behaviour. However, there are no population-based studies of smoking-related health knowledge in China.

Objective: The aim of current study was to use a population-based sample from the International Tobacco Control China Wave 1 survey to examine variations between current, former and never smokers' health knowledge about smoking and the impact of health knowledge awareness on smokers' intention to quit.

Methods: A face-to-face interview was conducted with 5986 adult smokers and non-smokers from six cities in China. Respondents were asked whether they believed smoking causes heart disease, stroke, impotence, lung cancer, emphysema, stained teeth, premature ageing in smokers and lung cancer in non-smokers. Current smokers were also asked additional questions on how smoking affects their current and future health as well as whether they had plans to quit smoking and if they believe they would have health benefit from quitting.

Findings: The overall awareness of health risks of smoking in China was low compared to developed countries. Current smokers in China were less likely than non-smokers and former smokers to acknowledge the consequences of smoking. Current smokers who were more aware of the health consequences of smoking were more likely to intend to quit smoking.

Conclusion: These findings highlight the need to increase awareness about the health effects of smoking in China, particularly among current smokers to increase quitting.

Citation

Yang, Y., Li, L., Yong, H.H., Borland, R., Wu, X., Li, Q., Wu, C., Kin, F. (2010). Regional differences in awareness of tobacco advertising and promotion in China: Findings from the ITC China Survey. Tobacco Control, 19(2), 117-124.

Abstract

Objective: To examine whether levels of, and factors related to, awareness of tobacco advertising and promotion differ across six cities in China.

Methods: Data from wave 1 of the International Tobacco Control (ITC) China Survey (April to August 2006) were analysed. The ITC China Survey employed a multistage sampling design in Beijing, Shenyang, Shanghai, Changsha, Guangzhou and Yinchuan. Face-to-face interviews were conducted with a total of 4763 smokers and 1259 non-smokers. Multivariate logistic regression models were used to identify factors associated with awareness of tobacco advertising and promotion.

Results: The overall levels of noticing advertisements varied considerably by city. Cities reporting lower levels of advertising tended to report higher levels of point of sale activity. Noticing tobacco industry promotions was associated with more positive attitudes to tobacco companies.

Conclusion: The awareness of tobacco advertising and promotional activities was not homogeneous across the six Chinese cities, suggesting variations in the tobacco industry's activities and the diversity of implementing a central set of laws to restrict tobacco promotion. This study clearly demonstrates the need to work with the implementation agencies if national laws are to be properly enforced.

Citation

Yong, H.H., Borland, R., Cooper, J., Cummings, K.M. (2010). Postquitting experiences and expectations of adult smokers and their association with subsequent relapse: Findings from the International Tobacco Control (ITC) Four Country Survey. Nicotine & Tobacco Research, 12(Suppl 1), S12-19.

Abstract

Introduction: This paper explores postquitting experiences and expectations of adult ex-smokers and their utility as predictors of smoking relapse after prolonged abstinence.

Methods: Data are from 1,449 ex-smokers (providing 2,234 observations) recruited as smokers as part of the International Tobacco Control (ITC) Four Country Survey (Australia, Canada, the United Kingdom, and the United States) but surveyed after they had quit. Controlling for length of time quit, reported postquitting experiences, and expectations assessed at one of three waves were used as predictors. Smoking status (whether they had relapsed) at the next wave was used as the outcome of interest.

Results: Postquitting experiences and expectations, such as capacity to enjoy life’s simple pleasures, ability to cope with stress, ability to control negative emotions, and health concerns, changed systematically over time but at different rates. The trajectory of change for life enjoyment and health concerns followed a rapidly asymptoting logarithmic function, while that of stress and negative affect coping followed a slower asymptoting square root function. After controlling for sociodemographic and abstinence duration, only reported decline in capacity to control negative affect since quitting was associated with increased relapse risk.

Discussion: The varying patterns of change in postquitting experiences suggest that psychological gains over time following smoking cessation do not all occur at the same rate. The relative importance of each factor in maintaining abstinence is also not the same with deficits in perceived control of negative emotions being the only one predictive of subsequent relapse. Strategies to improve impulse control over negative emotions postquitting may help to reduce relapse risk.

Citation

Yong, H.H., Kin, F., Borland, R., Omar, M., Hamann, S.L., Sirirassamee, B., Fong, G.T., Fotuhi, O., Hyland, A. (2010). Support for and reported compliance among smokers with smoke-free policies in air-conditioned hospitality venues in Malaysia and Thailand: Findings from the International Tobacco Control Southeast Asia Survey. Asia-Pacific Journal of Public Health, 22(1), 98-109.

Abstract

This study examined support for and reported compliance with smoke-free policy in air-conditioned restaurants and other similar places among adult smokers in Malaysia and Thailand. Baseline data (early 2005) from the International Tobacco Control Southeast Asia Survey (ITC-SEA), conducted face-to-face in Malaysia and Thailand (n = 4005), were used. Among those attending venues, reported total smoking bans in indoor air-conditioned places such as restaurants, coffee shops, and karaoke lounges were 40% and 57% in Malaysia and Thailand, respectively. Support for a total ban in air-conditioned venues was high and similar for both countries (82% Malaysian and 90% Thai smokers who believed there was a total ban), but self-reported compliance with bans in such venues was significantly higher in Thailand than in Malaysia (95% vs 51%, P < .001). As expected, reporting a ban in air-conditioned venues was associated with a greater support for a ban in such venues in both countries.

Citation

Young, D., Wilson, N., Borland, R., Edwards, R., Weerasekera, D. (2010). Prevalence, correlates of, and reasons for using roll-your-own tobacco in a high RYO use country: Findings from the ITC New Zealand Survey. Nicotine & Tobacco Research, 12(11), 1089-1098.

Abstract

Aim: To describe the prevalence, correlates of, and reasons for use of roll-your-own (RYO) tobacco in a high RYO use and ethnically diverse country: New Zealand (NZ).

Methods: The NZ arm of the International Tobacco Control Policy Evaluation Survey (ITC Project) is sampled from the New Zealand Health Survey, with boosted sampling of Māori, Pacific peoples, and Asian New Zealanders. We surveyed 1,376 current adult smokers using standard ITC project procedures in 2007-2008.

Results: Prevalence of regularly smoking RYOs was 53% (with 38% of all smokers being exclusive RYO smokers). RYO use was higher among disadvantaged smokers, heavier smokers, those with a relatively low intention of quitting, and those with more friends who smoke. RYO use increased more in the youngest age groups as disadvantage increased. "Lower price" dominated the reasons smokers' cited for smoking RYOs (at 83%). About one fifth cited "less health concerns" as a reason.

Conclusions: RYO smoking is particularly associated with individual deprivation and high levels of dependence. Its capacity to blunt price signals provided by tobacco taxes is accompanied by misperceptions that it is less hazardous to health and it is particularly prevalent among vulnerable disadvantaged populations (including Māori, young people, and those with mental health problems). Governments should reconsider removing any tax advantages given to RYO tobacco, ensure RYO smokers are properly informed of health risks, and supported to quit as strongly as other smokers. However, governments should also examine a broader range of options including a higher differential tax on RYO tobacco, removing flavors, and controlling all tobacco marketing.

Citation

Thrasher, J.F., Swayampakala, K., Arillo-Santillán, E., Sebrie, E.M., Walsemann, K.M., Bottai, M. (2010). Differential impact of local and federal smoke-free legislation in Mexico: A longitudinal study among adult smokers. Salud Publica de Mexico, 52(Suppl 2), S244-253.

Abstract

Objective: To assess the impact of Mexico City and federal smoke-free legislation on secondhand tobacco smoke (SHS) exposure and support for smoke-free laws.

Material and Methods: Pre- and post-law data were analyzed from a cohort of adult smokers who participated in the International Tobacco Control (ITC) Policy Evaluation Suvey in four Mexican cities. For each indicator, we estimated prevalence, changes in prevalence, and between-city differences in rates of change.

Results: Self-reported exposure to smoke-free media campaigns generally increased more dramatically in Mexico City. Support for prohibiting smoking in regulated venues increased overall, but at a greater rate in Mexico City than in other cities. In bars and restaurants/cafés, self-reported SHS exposure had significantly greater decreases in Mexico City than in other cities; however, workplace exposure decreased in Tijuana and Guadalajara, but not in Mexico City or Ciudad Juárez.

Conclusions: Although federal smoke-free legislation was associated with important changes smoke-free policy impact, the comprehensive smoke-free law in Mexico City was generally accompanied by a greater rate of change.

Citation

Borland, R., Hyland, A., Cummings, K.M., Fong, G.T. (2010). One size does not fit all when it comes to smoking cessation: Observations from the International Tobacco Control Policy Evaluation Project. Nicotine & Tobacco Research, 12(Suppl 1), S1-3.

Abstract

The global community, through the World Health Organization’s Framework Convention on Tobacco Control (FCTC), is seeking to develop Guidelines for the implementation of Article 14 of the Convention, which deals with support for smoking cessation. This development requires models of how best to develop infrastructure and measures to promote and support cessation around the world. This special issue of Nicotine & Tobacco Research provides some evidence from the International Tobacco Control (ITC) Policy Evaluation Project that is contributing to an increased understanding of the challenges associated with encouraging and supporting smoking cessation. The ITC project (of which we are all leaders) is a research collaborative of more than 80 tobacco control researchers across 20 countries of which data from 7 countries are featured in this supplement. This commentary discusses three areas where the research reported here makes a contribution: our understanding of dependence; the effects of socioeconomic factors on cessation; and the potential utility of support programs. But first, we describe the context for this research.

Citation

Hyland, A., Cummings, K.M. (2010). Using tobacco control policies to increase consumer demand for smoking cessation. American Journal of Preventive Medicine, 38(Suppl 3), S347-350.

Abstract

Population-based indicators of smoking cessation have stalled in recent years. This commentary focuses attention on tobacco control policies that can be used to stimulate renewed consumer demand for smoking cessation. Tobacco use as reflected in population trends is the product of the interaction of three broad categories of factors: agent, host, and environment. Government policies are an important, modifıable environmental influence that can directly or indirectly influence smoking behavior. For example, numerous studies have shown that a hike in tobacco taxes reduces cigarette consumption and encourages smokers to quit.

Citation

Li, X., Dong, L., Sun, B., Liang, H., Chen, J., Zhang, L., Jiang, Y., Lv, Y. (2010). The willingness of smoking cessation and its determinants. Chinese Journal of Preventive Medicine, 11(7), 663-667.

Abstract

Objective: To explore the determinants of willingness to quit smoking among regular smokers, and to provide a scientific basis for establishing smoking cessation strategies for adult smokers.

Methods: The study was conducted between April to August 2006. A stratified multistage cluster sampling design was used to select residents from 10 streets in Shenyang. Households were then randomly selected from the communities of the selected streets. The average of 40 adult smokers were selected from each of 20 communities. The information of age, gender and smoking status was collected from 801 participants.

Results: The rate of voluntary cessation of smoking was 30.7%(29.8% in male and 46.7%in female). The government employees had the highest proportion of voluntary cessation of smoking (47.5%), followed by retired population (36.7%) and technical professionals (21.4%). The associated factors of smoking cessation include objection from relatives, public opinion, the advocacy efforts and measures of tobacco control.

Conclusion: The proportion of voluntary smoking cessation was low in Shenyang. Additional advocacy efforts and control measures should be taken to encourage the cessation of smoking.

Citation

O'Connor, R. J., Fix, B. V., Hammond, D., Giovino, G. A., Hyland, A., Fong, G. T., & Cummings, K. M. (2010). The impact of reduced ignition propensity cigarette regulation on smoking behaviour in a cohort of Ontario smokers. Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, 16(6), 420–422. https://doi.org/10.1136/ip.2009.025114

Abstract

This study examined the degree to which legislation intended to reduce the incidence of cigarette-caused fires influenced the behaviours of a cohort of smokers in Ontario. A random digit dialled telephone survey of adult smokers residing in Ontario was conducted in 2005, ending 1 month prior to the reduced ignition propensity (RIP) regulation's implementation date. A follow-up survey was conducted one year later. Of the baseline participants, 73.0% (n=435) completed the follow-up survey. The frequency of fire risk behaviours was similar across both surveys. At baseline, only 3.7% of smokers interviewed reported that their cigarettes went out on their own 'often' while smoking. Following the implementation of the reduced ignition propensity legislation, this increased significantly to 14.7%. Results suggest that the proportion of Ontario smokers who reported engaging in behaviour such as leaving a cigarette burning unattended and smoking in bed actually declined, although these declines were not statistically significant across all measures of fire risk.

Citation

Thrasher, J.F., Villalobos, V., Szklo, A.S., Fong, G.T., Perez, C., Sebrie, E.M., Sansone, N., Figueiredo, V., Boado Martinez, M., Arillo-Santillán, E., Bianco, E. (2010). Assessing the impact of cigarette package health warning labels: A cross-country comparison in Brazil, Uruguay and Mexico. Salud Publica de Mexico, 52(Suppl 2), S206-215.

Abstract

Objective: To assess the impact of different health warning labels (HWL).

Material and Methods: Data from the International Tobacco Control Survey (ITC Survey) were analyzed from adult smokers in Brazil, Uruguay and Mexico, each of which used a different HWL strategy (pictures of human suffering and diseased organs; abstract pictorial representations of risk; and text-only messages, respectively). Main outcomes were HWL salience and cognitive impact.

Results: HWLs in Uruguay (which was the only country with a HWL on the front of the package) had higher salience than either Brazilian or Mexican packs. People at higher levels of educational attainment in Mexico were more likely to read the text-only HWLs whereas education was unassociated with salience in Brazil or Uruguay. Brazilian HWLs had greater cognitive impacts than HWLs in either Uruguay or Mexico. HWLs in Uruguay generated lower cognitive impacts than the text-only HWLs in Mexico. In Brazil, cognitive impacts were strongest among smokers with low educational attainment.

Conclusions: This study suggests that HWLs have the most impact when they are prominent (i.e., front and back of the package) and include emotionally engaging imagery that illustrates negative bodily impacts or human suffering due to smoking.

Citation

Xu, J., Liang, B., Li, X., Xie, F., Yao, H., Li, Q., Jiang, Y., Yang, Y., Feng, G., Jiao, S., Li, X., Zhu, G. (2010). Health consciousness and its influential factors among low tar cigarette smokers in six cities of China (Language: Chinese). Chinese Journal of Public Health, 25(10).

Abstract

Publication written in Chinese. Please visit link to view article.

Citation

Wilson, N., Edwards, R., Thomson, G., Weerasekera, D., Talemaitoga, A. (2010). High support for a tobacco endgame by Pacific peoples who smoke: National survey data. New Zealand Medical Journal, 123(1316), 131-134.

Abstract

The attitudes of smokers to tobacco control interventions is highly topical in New Zealand given the current inquiry by the Maori Affairs Select Committee into tobacco issues. Presenters to this Committee have raised the need for a tobacco endgame strategy (e.g.), and this idea has currency among Maori leadership, nongovernmental organisations, and amongst other researchers. In the 2006 Census 30.3% of adult Pacific peoples in New Zealand reported being smokers, compared to 19.4% of the European population.7 Tobacco use is a substantial burden on the health of Pacific peoples and is likely to be contributing significantly to the health inequalities between Pacific peoples and other New Zealanders (e.g. see the emerging differences in lung cancer mortality rates). Harm to health and expenditure on tobacco is also likely to be holding back the social and economic development of Pacific communities. Pacific peoples support improved tobacco control, and in a 2008 national survey (smokers and nonsmokers) there was much stronger support than average for tobacco regulation. This high level of support contrasts somewhat to that of Pacific policymakers—at least for extending smokefree regulations. Here we describe the results of another national survey that considered attitudes of Pacific smokers to a range of tobacco control policy options.

Citation

Wilson, N., Edwards, R., Thomson, G., Weerasekera, D., Gifford, H., Hoek, J. (2010). High and increased support by Maori and non-Maori smokers for a ban on point-of-sale tobacco displays: National survey data. New Zealand Medical Journal, 123(1317), 84-86.

Abstract

Considerations around advancing tobacco control are particularly relevant to New Zealand at present, given the current Inquiry by the Māori Affairs Select Committee into the tobacco industry. While there are good arguments for a rapid endgame solution to the tobacco epidemic (involving a phase out of tobacco sales over 10 years) other supplementary measures should also be considered to help lower demand for tobacco – regardless of the adoption of endgame policies. There is international evidence, and evidence from New Zealand, that point of-sale (PoS) tobacco displays encourage tobacco uptake among children and undermine cessation among smokers wishing to quit and who have recently quit. Other New Zealand research has identified that the arguments for tobacco displays are contradictory and flawed and that there is poor compliance with the current (albeit relatively weak) law on tobacco displays. New Zealand data indicate majority public support for additional marketing restrictions on tobacco. Around half (53.4%) of respondents to a national survey agreed that “tobacco companies should not be allowed to promote cigarettes by having different brand names and packaging” (22.6% disagreed), and 65.6% wanted fewer tobacco retailers. We have previously reported that a majority (62.5%) of Māori smokers support a ban on PoS tobacco displays. Here we draw on additional survey data to examine this issue further.

Citation

Elkin, L., Wilson, N., Thomson, G. (2010). Connecting world youth with tobacco brands: YouTube and the internet policy vacuum on Web 2.0. Tobacco Control, 5, 361-366.

Abstract

Background: The internet is an ideal forum for tobacco marketing, as it is largely unregulated and there is no global governing body for controlling content. Nevertheless, tobacco companies deny advertising on the internet.

Objective: To assess the extent and nature of English language videos available on the Web 2.0 domain 'YouTube' that contain tobacco brand images or words.

Methods: The authors conducted a YouTube search using five leading non-Chinese cigarette brands worldwide. The themes and content of up to 40 of the most viewed videos returned for each search were analysed: a total of 163 videos.

Results: A majority of the 163 tobacco brand-related videos analysed (71.2%, 95% CI 63.9 to 77.7) had pro-tobacco content, versus a small minority (3.7%) having anti-tobacco content (95% CI 1.4 to 7.8). Most of these videos contained tobacco brand content (70.6%), the brand name in the title (71.2%) or smoking imagery content (50.9%). One pro-smoking music video had been viewed over 2 million times. The four most prominent themes of the videos were celebrity/movies, sports, music and 'archive', the first three of which represent themes of interest to a youth audience.

Conclusions: Pro-tobacco videos have a significant presence on YouTube, consistent with indirect marketing activity by tobacco companies or their proxies. Since content may be removed from YouTube if it is found to breach copyright or if it contains offensive material, there is scope for the public and health organisations to request the removal of pro-tobacco content containing copyright or offensive material. Governments should also consider implementing Framework Convention on Tobacco Control requirements on the internet, to further reduce such pro-tobacco content.