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Emerging infectious diseases like COVID-19 will remain a concern for the foreseeable future, and determinants of vaccination and other mitigation behaviors are therefore critical to understand. Using data from the first two waves of the Canadian COVID-19 Experiences Survey (CCES; N = 1,958; 66.56 % female), we examined social cognitive predictors of vaccination status, transition to acceptance and mitigation behaviors in a population-representative sample. Findings indicated that all social cognitive variables were strong predictors of mitigation behavior performance at each wave, particularly among unvaccinated individuals. Among those who were vaccine hesitant at baseline, most social cognitive variables predicted transition to fully vaccinated status at follow-up. After controlling for demographic factors and geographic region, greater odds of transitioning from unvaccinated at CCES Wave 1 to fully vaccinated at CCES Wave 2 was predicted most strongly by a perception that one's valued peers were taking up the vaccine (e.g., dynamic norms (OR = 2.13 (CI: 1.54,2.93)), perceived effectiveness of the vaccine (OR = 3.71 (CI: 2.43,5.66)), favorable attitudes toward the vaccine (OR = 2.80 (CI: 1.99,3.95)), greater perceived severity of COVID-19 (OR = 2.02 (CI: 1.42,2.86)), and stronger behavioral intention to become vaccinated (OR = 2.99 (CI: 2.16,4.14)). As a group, social cognitive variables improved prediction of COVID-19 mitigation behaviors (masking, distancing, hand hygiene) by a factor of 5 compared to demographic factors, and improved prediction of vaccination status by a factor of nearly 20. Social cognitive processes appear to be important leverage points for health communications to encourage COVID-19 vaccination and other mitigation behaviors, particularly among initially hesitant members of the general population.

Cigarette gifting is pervasive in China. As the Chinese are increasingly aware of harm from smoking cigarettes, e-cigarettes, often promoted as less harmful alternatives to cigarettes, may be viewed as appropriate gifts. This study is the first using population-based survey data to examine receiving and giving e-cigarettes as gifts in China. We analyzed 9,274 adults from Wave 5 of the International Tobacco Control China Survey, which was completed in July 2015. We found that the prevalence of receiving e-cigarettes as gifts was 1.3% among all respondents and 5.3% among urban smokers; the prevalence of giving e-cigarettes as gifts was 0.5% among all respondents and 1.2% among urban smokers. These prevalence estimates were very low among nonsmokers and rural respondents. Further analysis on urban smokers (N=3,312) found that those aged 40-54 and 55+, those with high education levels, heavy smokers, and those who perceived e-cigarettes as equally/more harmful than cigarettes were more likely to receive e-cigarette gifts; and those who ever used e-cigarettes were significantly more likely to both receive and give e-cigarette gifts. Urban smokers with positive attitude about cigarette gifting were also more likely to give e-cigarette gifts to others, but those aged 55+ were less likely to gift e-cigarettes. Findings of this study indicate that the Chinese may perceive e-cigarettes as appropriate gifts for smokers, especially heavy smokers. Precautions should be taken to prevent e-cigarettes from becoming a gift choice for nonsmokers. Health campaigns designed to combat the social acceptance of cigarette gifting may also help reduce e-cigarette gifting.

Background Menthol and other flavorings are appealing to young people. They mask the adverse effects of cigarette smoke, such as throat irritation, and are marketed as less harmful to appeal to health-concerned smokers. In March 2012, Brazil banned all flavors in tobacco products, including menthol, but the ban has not been implemented due to industry legal challenges. This is the first study in Brazil to examine menthol use and beliefs about menthols (particularly harm perceptions). Such research can increase an understanding of menthol use to inform/support regulatory action in Brazil and other countries. Methods Data were from Wave 3 (2016-17) of the International Tobacco Control (ITC) Brazil Survey, a cohort survey of adult smokers and non-smokers in Rio de Janeiro, São Paulo, and Porto Alegre. This study analyzed responses from 1216 smokers on prevalence and predictors of menthol use, beliefs about harmfulness, and support for banning additives. Results In 2016-17, 7.8% of smokers with a regular cigarette brand reported that they smoked menthols (lowest of 10 ITC LMICs). 12.5% of smokers erroneously believed that menthol cigarettes are less harmful than regular cigarettes (lowest of 7 ITC middle-income countries); 33.4% believed menthols are smoother on the throat and chest (lowest of 4 LMICs). 59.6% of smokers support a complete ban on all additives including flavorings (3rd highest among 14 ITC countries). Conclusions These findings support Brazil's effort to ban all additives including menthol: menthol prevalence is comparatively low, erroneous beliefs that menthols are less harmful is low, and support for an additive ban is high. Brazilian media reporting of the risks of additives in the context of the tobacco industry injunction may have raised public awareness of the harms of additives and support for the ban. Also, the 2014 ban on advertising at points of sale may have reduced exposure to marketing of menthols.