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Outside, that is, on TV, the President bellows beside a helicopter about China and the farmers of America who are so great they will chop plants into the dirt instead of harvesting the beans. Because what farm girl does not dream of becoming “permanently entwined with both politics and export...

ObjectivesThis study presents an analysis of vaping products (VPs) purchased in the USA, Canada, England and Australia and assesses whether differences in regulations were associated with differences in the chemical composition of the VPs.MethodsApril–September 2017, a total of 234 VP refill liquids and prefilled cartridges were purchased in convenience samples of retail locations in each country. Products were chosen from brands and styles most commonly reported by current VP users in the 2016 ITC Four Country Smoking and Vaping Survey. All products were tested for nicotine, tobacco-specific nitrosamines (TSNAs), minor tobacco alkaloids, organic acids and flavouring chemicals.ResultsConsistent with the laws in Canada and Australia at the time of product purchase, nicotine was not detected in any of the VPs (n=10 in Canada; n=15 in Australia). US liquids (n=54) had a mean nicotine concentration of 16.2 mg/mL, (range=0.0–58.6) and English liquids (n=166) had a mean concentration of 11.9 mg/mL ((range=0.0–31.2) F(3244)=12.32, pConclusionsVP composition, particularly with respect to nicotine and flavouring, varies by country, likely reflecting both marketplace preferences and country-specific regulations. There are differences between nicotine levels claimed on the package and actual levels, particularly in England.

Many people understand chemicals as entities that do not occur naturally, and which are also invariably toxic. Tobacco control messages liberally use the term ‘chemicals’ to evoke these meanings and create concern among smokers. This may reinforce misunderstandings, potentially leading to smokers making harmful choices. To investigate smokers’ understandings of chemicals, we conducted qualitative research using 18 individual interviews and three focus groups with Australian smokers and recently quit smokers. The research was guided by the ‘mental models’ framework and the recently developed Context, Executive, and Operational Systems theory. We discerned two clusters of mental models: the first cluster focused on combustion as the overarching cause of harm (and were largely consistent with the science) and the second cluster focused on additives as causes of harm. We found most participants displayed limited knowledge of the causes of harm from smoking and some held mutually incompatible beliefs. Most participants believed that cigarettes differ significantly in harmfulness according to whether or not they were believed to contain additives. Only a minority understood that the bulk of the toxicants to which smokers are exposed are combustion products. These findings are directly relevant to tobacco control but also have broader relevance to risk communications about toxic exposures.

BackgroundFilter ventilation creates sensations of ‘lightness’ or ‘smoothness’ and is also highly effective for controlling machine-tested yields of tar, nicotine and carbon monoxide. Nearly all factory-made cigarettes (FMC) now have filter ventilation in countries such as Australia, Canada, the UK and the USA. Research conducted before ‘light’ and ‘mild’ labelling was banned found low smoker awareness of filter ventilation and its effects. This study explores current levels of awareness of filter ventilation and current understanding of its effects in these four countries.MethodsWe used data from the 2018 wave of the ITC Four Country Smoking and Vaping Survey with samples from USA, England, Canada and Australia. Analyses were conducted initially on a weighted sample of 11 844, and subsequently on 7541 daily FMC smokers.FindingsOnly 40.3% of all respondents reported being aware of filter ventilation. Among daily FMC smokers, only 9.4% believed their cigarettes had filter ventilation. Believing that their usual cigarettes are smoother was positively associated with believing they are also less harmful. Both these beliefs independently predict believing their cigarettes are ventilated (smoother OR=1.97 (95% CI 1.50 to 2.59) and less harmful OR=2.41 (95% CI 1.66 to 3.49) in relation to those believing each characteristic is average.InterpretationAwareness of filter ventilation is currently low, despite decades of public ‘education efforts around the misleading nature of ‘light’ and ‘mild” descriptors. Few smokers realise that their cigarettes almost certainly are vented. Smokers who believed their cigarettes have filter ventilation were more likely to believe they were both smoother and less harmful. Awareness of the technology appears to be insufficient to prevent smokers being deceived by it. Filter ventilation is inherently misleading to smokers and it is time to ban it.

Background: Filter ventilation creates impressions of ‘lightness’ and controls machine-tested yields of tar and nicotine. Virtually all factory made cigarettes now have filter ventilation in Australia, Canada, the UK and the US. Previous research, conducted before ‘light’ and ‘mild’ labelling was banned, found low awareness of filter ventilation. This study explores current levels of awareness and understandings. Methods: We used data from the 2018 wave of the ITC Four Country Smoking and Vaping Survey with samples from USA, England, Canada and Australia. Analyses were conducted initially on a weighted sample of 11,844, and subsequently on 7,541 daily factory made cigarette (FMC) smokers. Findings: Only 38.5% of all respondents reported being aware of filter ventilation. Among daily FMC smokers, only 9.4% believed their cigarettes had filter ventilation. Respondents who believed their usual cigarettes had filter ventilation were more likely to believe their usual cigarettes were both less harmful (18.2% vs 8.8%, p

Introduction and aims: To investigate relationships between smoking-related behaviours and knowledge of the disease risks of smoking and the causes of smoking harms, using a four-way division of “component causes”: nicotine, other substances found in unburned tobacco, combustion products of tobacco, and additives. Design and methods: The data were collected using an on-line survey in Australia with 1047 participants in three groups; young non-smokers (18 to 25), young smokers (18 to 25) and older smokers (26 and above). Results: Most participants agreed that cancer and heart disease are major risks of smoking but only a quarter accurately quantified the mortality risk of lifetime daily smoking. Very few (2 of 1047) correctly estimated the relative contributions of all four component causes. Post-hoc analyses reinterpreting responses as expressions of relative concern about combustion products and nicotine showed that 29% of participants rated combustion products above nicotine. We delineated six relative concern segments, most of which had distinctive patterns of beliefs and actions. However, higher levels of concern about combustion products were only weakly positively associated with harm reducing beliefs and actions.Discussion and conclusions: Most smokers do not appear to understand the risks of smoking and their causes well enough to be able to think systematically about the courses of action open to them to reduce their health risk. To facilitate informed decision-making, tobacco control communicators may need to better balance the dual aims of creating fear/negative affect about smoking and imparting knowledge about the health harms and their mechanisms.

To identify the range and coherence of smokers and recent ex-smokers' general beliefs about the harms associated with smoking and the implications of these beliefs for their assessments of the relative harms and addictiveness of various nicotine containing products.The study consisted of 18 single participant interviews with current smokers or vapers (13 M, 5 F) and three focus groups (15 M, 14 F) with current smokers/vapers and recent quitters. Both individual interviews and focus groups included semi-structured discussions of how nicotine and cigarette smoke cause disease and addiction, and a structured task involving rating the relative harmfulness and addictiveness of 17 nicotine products against a reference, popular, cigarette.Most participants were able to give adequate accounts of what makes cigarette smoking harmful and addictive but this general knowledge was not consistently applied to making harmfulness and addictiveness judgements about specific products. Many participants applied simple affect-based heuristics to harmfulness and addictiveness judgments, even when they had apparently demonstrated more sophisticated knowledge earlier. Most used binary safe/dangerous thinking, with addictiveness and harmfulness strongly linked and a decoupling of satisfaction and addictiveness.Many smokers appear to have reasonable general knowledge of the risks of smoking but cannot reliably apply this knowledge to practical risk judgements. We need to rethink how we communicate with the public about the risks of smoking, and using other nicotine products, in ways that allow them to make more informed decisions about their smoking.

While the recycling of asphalt shingles is beneficial in reducing the consumption of virgin materials, pavement performance should not be compromised. One major concern with recycled asphalt shingles (RAS) relates to the variability in the properties of the recycled materials originating from different sources. In addition, the rheological properties of RAS have not been evaluated as well as its influence on the virgin binder when used in asphalt mixtures. Therefore, the objectives of this study were to characterize the rheological properties and molecular fractions of RAS materials sampled from different sources around the country. In addition, the influence of RAS on the Superpave Performance Grade (PG) of the binder was investigated. Results of the experimental program indicated that the asphalt cement (AC) content in tear-off shingles was consistent among different RAS sources across the country. However, AC content in manufacturer waste shingles was noticeably lower than in tear-off shingles. In addition, all extracted RAS binders were graded as PG 118 or higher using the Superpave binder specification system but the low temperature grade was not measurable due to the high stiffness of the binder. This stiff behavior is due to the binder used in shingle manufacturing, which is an air-blown asphalt binder with stiff characteristics and low elongation properties. Results showed that at a RAS content of up to 5%, the high temperature grade of the blends was increased by one to seven grades and the low temperature grade was increased by one grade. The use of binder blending charts is recommended to account for the influence of RAS in the mix design. At a RAS content of 10%, the binder blends did not pass the Superpave criterion at low temperature.

Warm mix asphalt (WMA) describes various technologies that allow asphalt mixtures to be produced at lower temperatures as compared with hot mix asphalt (HMA). WMA technologies also offer improvements in workability, cost, and environmental sustainability, such as reduced fuel usage, greenhouse gas emissions, and wear and tear at plants, while enhancing worker health and safety conditions. The objective of this study was to quantify the laboratory performance of field-produced mixtures that utilize WMA technologies and to evaluate the influence of lowering the production temperature on the mixture properties in the field. To achieve this objective, three field projects across Louisiana were selected to provide eight mixtures for the evaluation of WMA technologies. Plant-produced mixtures were sampled and the laboratory performance of WMA mixtures and conventional HMA was evaluated. Further, the characteristics of WMA mixtures were compared with conventional HMA mixtures during production and constr...

While the recycling of asphalt shingles is beneficial in reducing the consumption of virgin materials, road performance should not be compromised. One major concern with recycled asphalt shingles (RAS) relates to the variability in the properties of the recycled materials originating from different sources. In addition, the rheological properties of RAS have not been evaluated as well as its influence on the virgin binder when used in asphalt mixtures. Therefore, the objectives of this study were to characterize the rheological properties and molecular fractions of RAS materials sampled from different sources across the country. In addition, the influence of RAS on the Superpave performance grade (PG) of the binder in the mix was investigated. Results of the experimental program indicated that the asphalt cement (AC) content in tear-off shingles was consistent among different RAS sources across the country. However, AC content in manufacturer waste shingles was noticeably lower than in tear-off shingles. In addition, all extracted RAS binders were graded as PG 118 + - xx using the Superpave binder specification system. This stiff behavior is due to the binder used in shingle manufacturing, which is an air-blown asphalt binder with stiff characteristics and low elongation properties. Results showed that at a RAS content of up to 5%, the high temperature grade of the blends was increased by one to seven grades and the low temperature grade was reduced by one grade. The use of binder blending charts is recommended to account for the influence of RAS in the mix design. At a RAS content of 10%, the binder blends did not pass the Superpave criterion at low temperature.

Background and Purpose— Preclinical data suggest that cell-based therapies have the potential to improve stroke outcomes. Methods— Eighteen patients with stable, chronic stroke were enrolled in a 2-year, open-label, single-arm study to evaluate the safety and clinical outcomes of surgical transplantation of modified bone marrow–derived mesenchymal stem cells (SB623). Results— All patients in the safety population (N=18) experienced at least 1 treatment-emergent adverse event. Six patients experienced 6 serious treatment-emergent adverse events; 2 were probably or definitely related to surgical procedure; none were related to cell treatment. All serious treatment-emergent adverse events resolved without sequelae. There were no dose-limiting toxicities or deaths. Sixteen patients completed 12 months of follow-up at the time of this analysis. Significant improvement from baseline (mean) was reported for: (1) European Stroke Scale: mean increase 6.88 (95% confidence interval, 3.5–10.3; P P P P P Conclusions— In this interim report, SB623 cells were safe and associated with improvement in clinical outcome end points at 12 months. Clinical Trial Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT01287936.

INTRODUCTION Concerns have been expressed that menthol cigarettes are highly conducive to uptake and hence function as "starter cigarettes" for adolescents. There is strong evidence for this in the United States. If menthol cigarettes are critical to uptake for some adolescents, they might be expected to remain popular among adolescents independent of promotional activity. We analyzed trends in the market share of menthol brands in Australia among both adolescents and adults to provide further insights into the determinants of menthol cigarette smoking. METHODS We used the Australian Secondary Students Alcohol and Drug Survey (1984-2008), the Smoking and Health Survey (1980-1998), and the International Tobacco Control Four Nations Survey (2002-2008) to estimate market share of brands. Measures were reported use of all menthol brands for adults and use of the Alpine brand for adolescents. RESULTS Menthol smoking was much more popular among female smokers of all age groups in the early 1980s. During the 1980s and 1990s, use declined markedly in the 18-29 age groups, while remaining relatively stable among older smokers. Use of Alpine declined markedly among adolescents in the 1980s and 1990s. However, during this period, Alpine remained more popular among experimenting than regular smokers. CONCLUSIONS Both Alpine and other menthol brands are now primarily "older women's cigarettes" in Australia. The trends in declining popularity among younger smokers suggest that targeted marketing plays a major role in determining menthol brand market share. Alpine has played a role as a "starter" cigarette in Australia but that role has decreased markedly since the 1980s. Within the Australian context, "light/mild" brands may have taken over the role of easier-to-smoke cigarettes that attract experimenting smokers.

The tobacco industry conducts some very interesting research but tobacco industry scientists generally do not make their findings public. We know this from numerous studies of the millions of previ...

A laboratory design procedure was developed to evaluate the skid resistance of asphalt pavement with laboratory test results. For the development of the procedure, twelve typical asphalt wearing course mixtures with different combinations of aggregate sources and mix types were considered. The frictional performance of asphalt mixtures was evaluated with an accelerated polishing and testing procedure developed at the National Center for Asphalt Technology. The circular texture meter and the dynamic friction tester at various predetermined polishing cycles were used to evaluate the variations in surface texture and friction characteristics of asphalt testing slabs during accelerated polishing. The skid resistance of asphalt mixtures attributable to accelerated polishing was quantified with the international friction index number F60, which was computed with the friction numbers measured with the dynamic friction tester at 20 km/h and the obtained mean profile depth values. The analysis of F60 results led to the development of a set of friction prediction models and a laboratory friction-resistant mix design procedure. The developed procedure, which allows estimation of asphalt pavement skid resistance based on laboratory measured micro- and macrotexture results, is a useful tool for laboratory evaluation of a mixture's friction resistance. The procedure can also facilitate the use of locally available aggregates with lower skid resistance in a wearing course mix design and thereby produce both cost-effective and skid-resistant surface mixtures.

In this issue of Tobacco Control , Agaku, Omaduvie, Fillipidis and Vardavas ( see page e233 ) make an important contribution to the case for stronger tobacco product regulation. Using data from the 2012 Eurobarometer survey, the authors analyse the influences of cigarette design and marketing elements on European smokers’ current brand choices, initiation to smoking and beliefs in less harmful cigarettes. The study is timely, because the International Tobacco Control Community needs to reinvigorate the conversation about which directions we should take in advocating for new tobacco control measures. There are good reasons for taking much stronger action to regulate the contents and construction of cigarettes, as there are limits to what can be achieved with a continuing focus on the packaging and labelling of cigarettes, and public education as the twin means for countering smokers’ misperceptions.1–4 Regulation of contents and construction could provide important additional means for discouraging initiation and facilitating cessation. It would do so in two ways: first, by making …

Aim This paper examines how smokers' beliefs about ‘light/mild’ cigarettes in Australia, Canada and the United Kingdom were affected by the removal of misleading ‘light/mild’ terms from packs. Design, setting and participants The data come from the first seven waves (2002–09) of the International Tobacco Control Policy Evaluation (ITC) Four-Country Survey, an annual cohort telephone survey of adult smokers in Canada, the United States, the United Kingdom and Australia (21 613 individual cases). ‘Light’ and ‘mild’ descriptors were removed in 2003 in the United Kingdom, in 2006 in Australia and in 2007 in Canada. We compare beliefs about ‘light’ cigarettes both before and after the bans, with those of smokers in the United States serving as the control condition. Measures Smokers' beliefs about ‘light’ cigarettes were assessed using a set of statements rated on a five-point ‘agree’–‘disagree’ scale. Findings The proportions of respondents reporting misperceptions about light cigarettes declined between 2002 and 2009 in all four countries. There were marked temporary reductions in reported misperceptions in the United Kingdom and Australia, but not in Canada, following the removal of ‘light/mild’ descriptors. Conclusions Removal of ‘light/mild’ descriptors and tar, nicotine and carbon monoxide yield information from cigarette packs is insufficient to effectively eliminate false beliefs. The combination of alternative descriptors and design features that produce differences in taste strength and harshness, independent of actual intakes, are sufficient to produce or sustain the same misbeliefs.

Background: Many smokers in Western countries perceive ‘‘light’’ or ‘‘low tar’’ cigarettes as less harmful and less addictive than ‘‘regular’’ or ‘‘full flavoured’’ cigarettes. However, there is little research on whether similar perceptions exist among smokers in low and middle incomes, including China. Objective: To characterise beliefs about ‘‘light’’ and ‘‘low tar’’ cigarettes among adult urban smokers in China. Methods: We analysed data from Wave 1 of the ITC China Survey, a face-to-face household survey of 4732 adult Chinese smokers randomly selected from six cities in China in 2006. Households were sampled using a stratified multistage design. Findings: Half (50.0%) of smokers in our sample reported having ever tried a cigarette described as ‘‘light,’’ ‘‘mild’’ or ‘‘low tar’’. The majority of smokers in our sample (71%) believed that ‘‘light’’ and/or ‘‘low tar’’ cigarettes are less harmful compared to ‘‘full flavoured’’ cigarettes. By far the strongest predictor of the belief that ‘‘light’’ and/or ‘‘low tar’’ cigarettes are less harmful was the belief that ‘‘light’’ and/or ‘‘low tar’’ cigarettes feel smoother on the respiratory system (p,0.001, OR = 53.87, 95% CI 41.28 to 70.31). Conclusion: Misperceptions about ‘‘light’’ and/or ‘‘low tar’’ cigarettes were strongly related to the belief that these cigarettes are smoother on the respiratory system. Future tobacco control policies should go beyond eliminating labelling and marketing that promotes ‘‘light’’ and ‘‘low tar’’ cigarettes by regulation of product characteristics (for example, additives, filter vents) that reinforce perceptions that ‘‘light’’ and ‘‘low tar’’ cigarettes are smoother on the respiratory system and therefore less harmful.

Background: Smokers are exposed to significant doses of carcinogens, including tobacco-specific nitrosamines (TSNA). Previous studies have shown significant global differences in the levels of TSNAs in cigarette smoke because of the variation in tobacco blending and curing practices around the world. Methods: Mouth-level exposure to 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) measured in cigarette butts and urinary concentrations of its major metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) were examined among 126 daily smokers in four countries over a 24-hour study period. Results: As mouth-level exposure of NNK increased, the urinary NNAL increased even after adjustment for other covariates (β = 0.46, P = 0.004). The relationship between mouth-level exposure to nicotine and its salivary metabolite, cotinine, was not statistically significant (β = 0.29, P = 0.057), likely because of the very limited range of differences in mouth-level nicotine exposure in this population. Conclusions: We have shown a direct association between the 24-hour mouth-level exposure of NNK resulting from cigarette smoking and the concentration of its primary metabolite, NNAL, in the urine of smokers. Internal dose concentrations of urinary NNAL are significantly lower in smokers in countries that have lower TSNA levels in cigarettes such as Canada and Australia in contrast to countries that have high levels of these carcinogens in cigarettes, such as the United States. Impact: Lowering the levels of NNK in the mainstream smoke of cigarettes through the use of specific tobacco types and known curing practices can significantly affect the exposure of smokers to this known carcinogen. Cancer Epidemiol Biomarkers Prev; 19(6); 1389–98. ©2010 AACR.

telephone survey. The added burden of the sample collection did not reduce survey retention rates. Participants who initially agreed to participate in the sample collection were more likely to participate in the subsequent survey than participants who were not asked or declined to participate (odds ratio (OR) = 1.28; 95% CI = 1.01-1.62, p = .021). Further, those who provided samples were also more likely to participate in the subsequent survey than those who did not (OR = 2.78; 95% CI = 1.71-4.52, p < .001). Discussion: Collecting saliva and cigarette butt samples from a group of smokers is feasible, yields a representative sample, and the added participant burden does not reduce subsequent sur- vey response rates. Abstract Introduction: Large-scale epidemiological surveys have fre- quently relied upon clinic-based sample collection to incorpo- rate biological data, which can be costly and result in nonrepresentative data. Collecting samples in a nonclinical set- ting (i.e., through postal mail or at the subject's home) offers an alternative option that is minimally invasive and can be incor- porated into large population-based studies. Objectives: (a) To assess the feasibility of collecting biological data from a cohort of smokers in the International Tobacco Control (ITC) study, through the mail and in the home; (b) to examine whether participants are representative of the popula- tion under consideration; and (c) to evaluate how the added burden of providing biomarker samples might impact subse- quent participation in a follow-up survey. Methods: Participants were asked to provide a saliva sample and five cigarette butts from cigarettes smoked on a single day, using standardized procedures. Sample collection kits were mailed to a random sample of 400 daily cigarette smokers who were involved in the 2006 annual ITC Four Country (United Kingdom, United States, Canada, and Australia) telephone sur- vey and agreed to participate in sample collection. A random sample of 179 daily smokers who participated in a face-to-face ITC survey in Mexico and Uruguay and agreed to participate in sample collection were also asked to provide samples. Results: Samples were collected from 96% of invited partici- pants in the face-to-face surveys and 52% of participants in the

Objectives: To examine the associations among cigarette design features and tar yields of leading cigarette brands sold in the United States, Canada, Australia and the United Kingdom. Methods: Government reports and numbers listed on packs were used to obtain data on International Organization for Standardization (ISO)/Federal Trade Commission (FTC) yields for the tar of 172 cigarette varieties sold in the United States, Canada, Australia and the United Kingdom. We used standardised methods to measure the following 11 cigarette design parameters: filter ventilation, cigarette pressure drop, filter pressure drop, tobacco rod length, filter length, cigarette diameter, tipping paper length, tobacco weight, filter weight, rod density and filter density. Results: Filter ventilation was found to be the predominant design feature accounting for the variations between brands in ISO/FTC tar yields in each of the four countries. After accounting for filter ventilation, design parameters such as overwrap length, tobacco weight and rod density played comparatively minor roles in determining tar yields. Conclusions: Variation in ISO/FTC tar yields are predicted by a limited set of cigarette design features, especially filter ventilation, suggesting that governments should consider mandatory disclosure of cigarette design parameters as part of comprehensive tobacco product regulations.

This study examined reported use of, and beliefs about, so-called light cigarettes among adult smokers in four countries: Australia (Aus), Canada (Can), the United Kingdom (U.K.) and the United States (U.S.). The method used was parallel telephone surveys among 9,046 smokers across the four countries. The results indicated that more than half of all smokers in each country except the U.K. reported smoking light cigarette brands. A majority of smokers surveyed in each country except Canada continue to believe that light cigarettes offer some health benefit compared to regular cigarettes (Canada 43%, U.S. 51%, Australia 55%, U.K. 70%). A majority of smokers in all four countries believed that light cigarettes are smoother on the throat and chest than regular cigarettes. Predictors of use of light cigarettes and beliefs about possible benefits were very similar in the four countries. These results demonstrate an ongoing need for public education about why light cigarettes do not reduce harm and do not make quitting easier. The results provide further evidence for the need for regulatory measures in all four countries to prohibit the use of misleading light and mild descriptors including package imagery in product marketing (as prescribed in Article 11 of the Framework Convention on Tobacco Control), abandon the use of standard FTC/ISO tar and nicotine yields as consumer information, and adopt policies to regulate deceptive design features of cigarettes, such as ventilated filters.

INTRODUCTION Many governments around the world have banned the use of misleading cigarette descriptors such as "light" and "mild" because the cigarettes so labeled were found not to reduce smokers' health risks. However, underlying cigarette design features, which are retained in many brands, likely contribute to ongoing belief that these cigarettes are less harmful by producing perceptions of lightness/smoothness through lighter taste and reduced harshness and irritation. METHODS Participants (N = 320) were recruited from the International Tobacco Control U.S. Survey conducted in 2009 and 2010, when they answered questions about smoking behavior, attitudes and beliefs about tobacco products, and key mediators and moderators of tobacco use behaviors. Participants also submitted an unopened pack of their usual brand of cigarettes for analysis using established methods. RESULTS Own-brand filter ventilation level (M 29%, range 0%-71%) was consistently associated with perceived lightness (p < .001) and smoothness (p = .005) of own brand. Those whose brand bore a light/mild label (55% of participants) were more likely to report their cigarettes were lighter [71.9% vs. 41.9%; χ(2)(2) = 38.1, p < .001] and smoother than other brands [75.5% vs. 68.7%; χ(2)(2) = 7.8, p = .020]. CONCLUSION Product design features, particularly filter ventilation, influence smokers' beliefs about product attributes such as lightness and smoothness, independent of package labels. Regulation of cigarette design features such as filter ventilation should be considered as a complement to removal of misleading terms in order to reduce smokers' misperceptions regarding product risks.

BACKGROUND:: Since 1987, the American Academy of Pediatrics (AAP) has had a policy regarding the use of all-terrain vehicles (ATVs) by children, which calls for pediatricians to educate families regarding the dangers of ATV use and to give recommendations for safety. Given the high incidence of ATV-related injuries in Alabama, our objective was to determine if pediatricians in our state are educating patients on ATV hazards and safety. METHODS:: All general pediatricians in Alabama who are members of the AAP were asked to complete a survey distributed through e-mail using Survey Monkey (Survey Monkey Palo Alto, Calif). Data were entered into Microsoft Excel (Microsoft Corporation Redmond, Wash). RESULTS:: Of the 353 general pediatricians in Alabama, 104 responded. Forty-one percent of the respondents were not aware that there is an AAP policy. Of the 59% who knew of the policy, 36% correctly identified the age limit recommendations. Forty-eight percent said that they routinely give anticipatory guidance regarding ATV use. Of them, 63% gave age recommendations younger than stated in the AAP policy. In addition, only 52% of them recommend helmet use, 5% recommend use of reflective clothing, 35% discourage passenger riding, and 8% encourage ATV training classes. Respondents who had patients treated for ATV-related injuries were more likely to give anticipatory guidance than those who had not had patients treated (χ = 5.3; P = 0.02; odds ratio, 3.9 [95% confidence interval, 1.2-13.6]). Respondents who practice in rural areas were more likely not to give anticipatory guidance than those who practice in urban areas (χ = 2.1; P = 0.14; odds ratio, 2.9 [95% confidence interval, 0.8-5.4]). CONCLUSIONS:: Many general pediatricians in a state where ATV use is popular are not familiar with the current AAP policy and do not routinely follow its guidelines. Given the high incidence of ATV-related injuries and the complexities of general practice, exploring multiple methods to modify risk-taking ATV behavior is warranted. Language: en

This paper examines how smokers' beliefs about 'light/mild' cigarettes in Australia, Canada and the United Kingdom were affected by the removal of misleading 'light/mild' terms from packs. The data come from the first seven waves (2002-09) of the International Tobacco Control Policy Evaluation (ITC) Four-Country Survey, an annual cohort telephone survey of adult smokers in Canada, the United States, the United Kingdom and Australia (21 613 individual cases). 'Light' and 'mild' descriptors were removed in 2003 in the United Kingdom, in 2006 in Australia and in 2007 in Canada. We compare beliefs about 'light' cigarettes both before and after the bans, with those of smokers in the United States serving as the control condition. Smokers' beliefs about 'light' cigarettes were assessed using a set of statements rated on a five-point 'agree'-'disagree' scale. The proportions of respondents reporting misperceptions about light cigarettes declined between 2002 and 2009 in all four countries. There were marked temporary reductions in reported misperceptions in the United Kingdom and Australia, but not in Canada, following the removal of 'light/mild' descriptors. Removal of 'light/mild' descriptors and tar, nicotine and carbon monoxide yield information from cigarette packs is insufficient to effectively eliminate false beliefs. The combination of alternative descriptors and design features that produce differences in taste strength and harshness, independent of actual intakes, are sufficient to produce or sustain the same misbeliefs.

Background This study explored the value of providing information in a Fact Sheet to correct misperceptions about the relative harmfulness of nicotine replacement products (NRT) and smokeless tobacco (ST), when compared to cigarette smoking. Methods Four convenience samples from different countries (Australia, UK, Sweden and USA) were surveyed concerning their beliefs about the relative harmfulness of smokeless tobacco and NRT. Study participants were given the Fact Sheet that explained that nicotine, as used by consumers, is not particularly harmful and explained why. They were resurveyed one week later regarding their beliefs about the relative harmfulness of smokeless tobacco and NRT and future intentions to use the products. Results In all four samples knowledge increased by similar amounts and beliefs regarding the lower harmfulness of smokeless tobacco increased. However, misconceptions remained common and responses to belief measures were not always consistent. Likelihood of use of ST increased in all four samples after exposure to the Fact Sheet, but interest in NRT use only increased in the US sample. Conclusions A Fact Sheet such as this one can help address misconceptions about NRT and smokeless tobacco, at least in the short term. However, as is true of most educational interventions, exposure to a single educational session is not sufficient to overcome misperceptions that smokers have about the relative harmfulness of oral versus combustible forms of nicotine delivery.

Objective This study explored the extent to which Malaysian and Thai smokers believe “light” and menthol cigarettes are less harmful than “regular” cigarettes and the correlates of these beliefs. Methods The study used data from wave 1 of the International Tobacco Control Southeast Asia Survey. 2006 adult smokers (95.3% male) from Malaysia and 2000 adult smokers (94.5% male) from Thailand were interviewed face to face in 2005. Results 29% of Malaysian respondents reported currently smoking light cigarettes and 14% menthols, with 19% agreeing that lights are less harmful and 16% agreeing that menthols are less harmful. 38% of Thai respondents reported currently smoking light cigarettes and 19% menthols, with 46% agreeing that lights are less harmful and 35% agreeing that menthols are less harmful. Malaysian smokers reporting current use of light or menthol cigarettes were more likely to believe that they are less harmful. Reported use of lights did not relate to beliefs for Thai respondents. The belief that light and/or menthol cigarettes are less harmful was strongly related to the belief that they have smoother smoke. Conclusions The experience of smoother smoke is likely to produce some level of belief in reduced harm, regardless of how brands are labelled and whether or not Federal Trade Commission FTC/International Organisation for Standardisation tar, nicotine and carbon monoxide yield figures are used.

Objectives To investigate how the tobacco industry is adapting to regulatory action in accordance with provisions of the Framework Convention on Tobacco Control that targets misleading packaging and labelling. To relate the packaging and labelling of new cigarette varieties to their construction and performance. Methods The principal design features and tar, nicotine and carbon monoxide yields of the Marlboro ‘brand family’ in Australia were measured and compared with those of the US equivalents. Results Marlboro Red and Blue/Medium, could not be differentiated in preliminary tests in Australia, but were different in the USA. However, yield testing showed Marlboro Blue/Medium did not have lower tar and nicotine yields in either country, indeed being higher in Australia. Conclusions Colour can be used to market cigarettes as ‘milder’, independently of ISO yields and ‘Light’/’Mild’ descriptors. Banning of ‘Light’ and ‘Mild’ brand descriptors may be inadequate to end belief in less harmful cigarettes so long as the tobacco industry remains free to engineer ‘mildness’ and to use colours, other descriptors and design features to characterise varieties it wants to market as ‘milder’.