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Background: The prevalence of tobacco use, especially hookah, has increased in Iran In recent years, particularly among young people and women, and the age of onset of use has decreased. Tobacco use is the fourth leading risk factor for non-communicable diseases in Iran. These issues cause concerns in the country and led to the present study on tobacco control agenda-setting in Iran over a 30-year timeframe.Methods: We conducted this retrospective analytical study to investigate process analysis in Iran using Kingdon's multiple-streams framework (MSF). We collected the data using semi-structured interviews with key informants (n = 36) and reviewing policy documents (n > 100). Then, we analyzed the policy documents and in-depth interviews using the document and framework analysis method. We used MAXQDA 11 software to classify and analyze the data.Results: Iran's accession to the Framework Convention on Tobacco Control (FCTC) opened a window of opportunity for tobacco control. The policy window opens when all three streams have already been developed. The adoption of the comprehensive law on the national control and campaign against tobacco in the Islamic Consultative Assembly in 2006 is a turning point in tobacco control activities in Iran.Conclusions: The tobacco control agenda-setting process in Iran was broadly consistent with MSF. The FCTC strengthened the comprehensive plan for national control of tobacco as a policy stream. However, there are several challenges in developing effective policies for tobacco control in the Iranian setting. [ABSTRACT FROM AUTHOR]

INTRODUCTION Georgia made steps forward in 2017 and adopted new amendments to its tobacco control legislation, which mostly correspond to the FCTC requirements. Among other changes in the regulations is a ban on smoking in public buildings and public transport, with a few exemptions (casinos, big slot clubs, performances in theatres, taxis). The regulation entered into force on 1 May 2018. METHODS The aim of the study is to assess the outcomes of the comprehensive smoke-free legislation in Georgia. We used a logical model for data collection and analysis. Our evaluation focuses on smoking prevalence related survey data, SHS exposure, monitoring results on compliance of new tobacco control regulations, Quitline data, and air quality measurement results. RESULTS The indoor air quality improved by 91% in the hospitality sector (from 1408 to 126 µg/m³ in 2018 and 117 µg/m³ in 2019), by 80% in public settings (from 531 to 112 µg/m³ in 2018 and 98 µg/m³ in 2019) and sufficiently in healthcare facilities (from 219 to 97-98 µg/m³ in 2018-2019). Demand for Quitline services increased by 30%. New cases of AMI declined by 32% during 2017-2019. CONCLUSIONS A comprehensive smoke-free policy with a high level of compliance (=95%) had a positive impact on the decline of SHS exposure and tremendous improvement of indoor air quality in public places and promotes a decrease in illnesses related to the cardiovascular system in Georgia. Also, demand increased for smoking-cessation services. [ABSTRACT FROM AUTHOR]

This article studies why some countries have more stringent policies for tobacco control than others. Three cases were studied that confirm two hypotheses of the advocacy coalition framework (acf). First, in all cases the policies intensified, to great extent, due to external perturbations of a normative type (epn). Second, only in Uruguay did the policies intensify due to external perturbations by changes in government (epcg). For the epn we find that the factors that enabled the change in policies were the durability and internal coordination within the minority coalition. And for the epcg were the position of the new ruling coalition and its ability to change the policy on its own. Also, the epn were more important for Spain while the epgc were more relevant for Mexico and Uruguay. This should be further investigated to determine if there is a relation between external perturbations and the context of each country. [ABSTRACT FROM AUTHOR]

Even though most African states have signed and ratified the Framework Convention on Tobacco Control (FCTC), a global treaty to limit tobacco use, African states have been slow to pass and implement tobacco control policies like regulations on sales, smoke-free environments and taxes. This article examines how the ineffectiveness of local tobacco-control advocacy contributes to this suboptimal outcome. It asserts that the disconnect between the global tobacco-control advocacy network and local advocates shapes this ineffectiveness. With funding and direction predominately from the Bloomberg Initiative, local advocates emulate the funders' goal of achieving quick, measurable policy results. Their reliance on the network drives African advocates to strive to pass legislation, even in difficult political climates, and to remake their agendas when funders change their priorities. They also emulate the network's focus on evidence-based arguments that stress epidemiological data and biomedical interventions, even when this issue frame does not resonate with policy-makers. Financial dependence can draw local advocates into expectations about patronage politics, undermine their ability to make principled arguments, and lead them to downplay the ways that their home country's socioeconomic and cultural contexts affect tobacco use and control. Based on key informant interviews with African advocates, media analysis and the case-studies of Ghana and Tanzania, the article broadens the study of philanthropy in global health, it adds an African perspective to the literature on global health advocacy, and it deepens knowledge on power dynamics between external funders and local actors in the realms of health and development. [ABSTRACT FROM AUTHOR]

Background and Aims: The United States Food and Drug Administration has proposed regulation to require that cigarettes contain very low nicotine content (VLNC). In contrast, reducing the number of cigarettes per day (CPD) is the most common current method to reduce nicotine. This trial aims to explore whether gradually transitioning to VLNC cigarettes plus nicotine patch or reducing CPD plus nicotine patch is more effective at decreasing nicotine dependence. Design A two‐arm, individually randomized open‐label trial. Setting Community setting, Vermont, USA. Participants: Sixty‐eight adult daily smokers (40% female) of ≥ 10 cigarettes/day who were not planning to quit in the next 30 days. Interventions: All participants smoked study cigarettes with a nicotine yield similar to most commercial cigarettes ad libitum for 1 week (baseline). Participants then gradually reduced to 70, 35, 15 and 3% of baseline nicotine over 4 weeks by either (a) transitioning to lower nicotine content cigarettes (n = 36) or (b) reducing the number of full nicotine cigarettes (n = 32). All participants received nicotine patches. Measurements The primary outcome was change in nicotine dependence assessed at baseline and weekly during the intervention with the Nicotine Dependence Syndrome Scale. Findings Dependence declined over time for both VLNC and CPD participants, but declined more for VLNC (mean decrease in Z‐score of 1.0) than CPD (mean decrease in Z‐score of 0.5) participants over time (interaction P = 0.018). Conclusions: Transitioning to very low nicotine content cigarettes reduced nicotine dependence over a 4‐week period to a greater extent than reducing cigarettes per day when both conditions were aided by nicotine patch. [ABSTRACT FROM AUTHOR]

Background and Aims: While research has focused on outcomes of tobacco control policies, less is known about the mechanisms by which policies may affect tobacco use. We estimated the associations of changes in cigarette taxes and smoke‐free legislation with (1) any household cigarette expenditure and (2) the level of household expenditure on cigarettes, as well as (3) tested interactions with socio‐economic circumstances. Design Difference‐in‐differences regression models to estimate the associations between changes in US state cigarette taxes and smoke‐free legislation with changes in household expenditure on cigarettes. Setting: Forty US states and District of Columbia. Participants: From annual, cross‐sectional surveys (with a longitudinal component) between 2000 and 2014, 128 138 households interviewed quarterly in the Consumer Expenditure Survey. Measurements Dependent measures included any household cigarette expenditure, expenditure in real dollars and budget share of cigarette expenditure. Policy measures included state cigarette taxes and 100% smoke‐free legislation. Covariates included respondent age, race/ethnicity, sex; household education; poverty level; family structure; and number of children and adults. Findings: Every $1.00 cigarette tax increase was associated with a 1.5 percentage point (−0.028, −0.002) reduction in any cigarette expenditure and an increase of 0.1% (0.1%, 0.1%) budget share and $10.11 ($8.38, $11.84) absolute expenditure. The association with absolute expenditure was stronger among smoking households above poverty level ($10.73; $8.94, $12.51) than below ($4.72; $2.37, $7.07). The enactment of smoke‐free legislation was associated with $2.33 (−$4.56, −$0.10) less expenditure, but not with any expenditure (0.1%; −1.6%, 1.8%) or budget share (−0.1%; −0.1%, 0.1%). The association with absolute expenditure was stronger among households above poverty level (−$2.62; −$4.95, −$0.29) than below (−$0.34; −$4.27, $3.58) Conclusion: Cigarette tax increases in the United States between 2000 and 2014 may have reduced smoking prevalence due to an absolute and relative increase in household tobacco expenditure while smoke‐free policies appear to have led to a reduction in expenditure. Although tax increases had a stronger impact on absolute expenditure among households above the poverty level, impact on relative expenditure was similar, and consequences for socio‐economic inequalities in smoking will vary based on the broader financial situation of households. [ABSTRACT FROM AUTHOR]

The article reviews the current obesity trends in the U.S. Topics discussed include interventions that were used to decrease tobacco use such as enactment of Family Smoking Prevention and Tobacco Control Act of 2009; arguments advanced by legal scholars and anti-obesity advocates that obesity should use the same tobacco playbook to successfully combat the obesity epidemic; and the efforts of Centers for Disease Control and Prevention in improving public health.

Most U.S. adults have voluntary rules prohibiting the use of smoked tobacco products in their homes and vehicles. However, the prevalence of similar rules for electronic vapor products (EVPs) is uncertain. This study assessed the prevalence and correlates of rules prohibiting EVP use inside homes and vehicles. Data from a 2017 Internet-based panel survey of U.S. adults aged ≥18 years (n = 4107) were analyzed. For homes and vehicles, prevalence of reporting that EVP use was not allowed, partially allowed, fully allowed, or unknown was assessed overall and by covariates. Correlates of prohibiting EVP use was assessed by multivariable logistic regression. In homes, 58.6% of adults did not allow EVP use, 7.7% partially allowed use, 10.1% fully allowed use, and 23.6% were unsure of the rules. In vehicles, 63.8% of respondents did not allow EVP use, 6.0% partially allowed use, 8.9% fully allowed use, and 21.4% were unsure of the rules. Following multivariable adjustment, prohibiting EVP use inside homes and vehicles was more likely among respondents with higher income and education, and with a child aged <18 years. Users of EVPs and other tobacco products, and respondents living with users of EVPs and other tobacco products, were less likely to prohibit EVP use in these locations. These findings show that about 6 in 10 U.S. adults have rules prohibiting EVP use inside homes and vehicles, but variations exist by population subgroups. Voluntary smoke-free rules in homes and vehicles that include EVPs can help protect children and non-users from secondhand EVP aerosol exposure. [ABSTRACT FROM AUTHOR]

Background and aims The US Family Smoking Prevention and Tobacco Control Act provides a pathway for manufacturers to market a modified risk tobacco product (MRTP). This study examines socio-demographic and tobacco use correlates of interest in a hypothetical MRTP in a nationally representative sample of US adults. Design Cross sectional wave 1 data from the 2013-14 Population Assessment of Tobacco and Health (PATH) Study. Setting Household Audio-Computer Assisted Self-Interviews of US adults conducted in 2013-14. Participants A total of 32 320 civilian, non-institutionalized adults in the United States. Measurements Interest in using a hypothetical MRTP ('If a tobacco product made a claim that it was less harmful to health than other tobacco products, how likely would you be to use that product?'), socio-demographics, tobacco use history and mental health and substance use problems. All estimates were weighted. Findings Overall, 16.7% [95% confidence interval (CI) = 16.28, 17.18] of US adults reported interest in a hypothetical MRTP. Tobacco use was associated significantly with interest in a hypothetical MRTP, with interest most common among current established smokers (54.4%; 95% CI = 53.31, 55.39) and least common among never tobacco users (3.0%; 95% CI = 2.49, 3.55). Interest in a hypothetical MRTP was associated with experimental e-cigarette use among current experimental, current established and former smokers. Among non-smokers, race, age, education and substance use were associated with interest in using a hypothetical MRTP. Conclusions Among adults in the United States, interest in using a hypothetical modified risk tobacco product is low overall, and highest among current experimental and established smokers. A small percentage of non-smokers are interested in using a hypothetical hypothetical modified risk tobacco product. [ABSTRACT FROM AUTHOR]

Background: Although menthol was not banned under the Tobacco Control Act, the law made it clear that this did not prevent the Food and Drug Administration from issuing a product standard to ban menthol to protect public health. The purpose of this review was to update the evidence synthesis regarding the role of menthol in initiation, dependence and cessation.Methods: A systematic review of the peer-reviewed literature on menthol cigarettes via a PubMed search through May 9, 2017. The National Cancer Institute's Bibliography of Literature on Menthol and Tobacco and the FDA's 2011 report and 2013 addendum were reviewed for additional publications. Included articles addressing initiation, dependence, and cessation were synthesized based on study design and quality, consistency of evidence across populations and over time, coherence of findings across studies, and plausibility of the findings.Results: Eighty-two studies on menthol cigarette initiation (n = 46), dependence (n = 14), and cessation (n = 34) were included. Large, representative studies show an association between menthol and youth smoking that is consistent in magnitude and direction. One longitudinal and eight cross-sectional studies demonstrate that menthol smokers report increased nicotine dependence compared to non-menthol smokers. Ten studies support the temporal relationship between menthol and reduced smoking cessation, as they measure cessation success at follow-up.Conclusions: The strength and consistency of the associations in these studies support that the removal of menthol from cigarettes is likely to reduce youth smoking initiation, improve smoking cessation outcomes in adult smokers, and in turn, benefit public health. [ABSTRACT FROM AUTHOR]

The article presents addiction-related news briefs on topics including opposition to the Australian coalition government's plan to implement a drug testing trial for welfare payment recipients in Mandurah, Western Australia. According to the article, criticism of the Filipino government's drug war has increased in the wake of the police shooting death of a schoolboy named Kian Delos Santos. It states that New York, New York Mayor Bill De Blasio signed a package of tobacco control laws in 2017.

Background: Smoking is the largest preventable cause of death in the world, killing nearly 6 million people annually. This article is an investigation of measures implemented laws in the Iran to study the proposed strategy of control and reduce tobacco use based on the monitor, protect, offer, warn, enforce and raise (MPOWER) policy. Methods: All laws approved by the Parliament along with the instructions on tobacco control prepared by the Ministry of Health and Medical Education, Ministry of Industry, Mine and Trade were collected and studied. Moreover, practical steps of Ministry of Health and other organizations were examined in this regard. Findings: Iranian Parliament after the adoption of the Framework Convention on Tobacco Control (FCTC) acts to create a comprehensive and systematic program for tobacco control legislation as a first step towards comprehensive national tobacco control and combat. In this law and its implementing guidelines and based on the strategy of MPOWER, specific implement is done to monitor tobacco use and prevention policies, protect people from tobacco smoke, offer help to quit tobacco use, warn about the dangers of tobacco, enforce bans on tobacco advertising, promotion and sponsorship and raise taxes on tobacco. However, the full objectives of the legislation have not achieved yet. Conclusion: According to Iran's membership in the FCTC and executive producer of tobacco control laws and regulations, necessary infrastructure is ready for a serious fight with tobacco use. In Iran, in comparison with developed countries, there is a huge gap between ratified laws and performing of laws. [ABSTRACT FROM AUTHOR]

This report analyses the outcome of the latest meeting of the Conference of the Parties to the Framework Convention on Tobacco Control. In this context, it concentrates on the adopted amendments to the partial guidelines for implementation of Articles 9 and 10 of the Framework Convention, recommendations on the regulation of e-cigarettes, and discussion on the interactions between international trade/investment obligations and implementation of the obligations of the Convention. [ABSTRACT FROM AUTHOR]

Objectives: This study identifies the specific product characteristics driving mass-merchandise cigar sales in the context of the changing regulatory environment. Methods: Cigar sales data in US convenience stores during 2008-2015 were purchased from Nielsen's Convenience Track system. Descriptive statistics highlight changes in the cigar market over time. Results: Sales of flavored cigars increased by nearly 50% since 2008 and now make up over half of the cigar market. Fruit remains the most popular flavor group, but the sale of non-descript flavors such as "Jazz" and "Green" has grown substantially. Inexpensive 2-and 3-packs made up less than 1% of cigar sales in 2008, but by 2015 this packaging style held 40% of the market share. Black & Mild and Swisher Sweets dominate the convenience store channel and together are responsible for nearly 60% of total mass-merchandise cigar sales. Conclusions: Cigar companies take advantage of features recently banned for cigarettes, such as flavorings and small pack sizes to maintain strong sales. Given the appeal of mass-merchandise cigars to youth and young adults, the FDA and other governing bodies should regulate the manufacturing and promotion of cigars in the same way they have regulated cigarettes. [ABSTRACT FROM AUTHOR]

Online networks can serve as a platform to diffuse policy innovations and enhance global health governance. This study focuses on how shifts in global health governance may influence related online networks. We compare social network metrics (average degree centrality [AVGD], density [D] and clustering coefficient [CC]) of Globalink, an online network of tobacco control advocates, across three eras in global tobacco control governance; pre-Framework Convention on Tobacco Control (FCTC) policy transfer (1992-1998), global regime formation through the FCTC negotiations (1999- 2005), and philanthropic funding through the Bloomberg Initiative (2006-2012). Prior to 1999, Globalink was driven by a handful of high-income countries (AVGD=1.908 D=0.030, CC=0.215). The FCTC negotiations (1999-2005) corresponded with a rapid uptick in the number of countries represented within Globalink and new members were most often brought into the network through relationships with regional neighbors (AVGD=2.824, D=0.021, CC=0.253). Between 2006 and 2012, the centrality of the US in the network increases significantly (AVGD=3.414, D=0.023, CC=0.310). The findings suggest that global institutionalization through WHO, as with the FCTC, can lead to the rapid growth of decentralized online networks. Alternatively, private initiatives, such as the Bloomberg Initiative, can lead to clustering in which a single source of information gains increasing influence over an online network. [ABSTRACT FROM AUTHOR]

Background and Aims In addition to some electronic cigarettes (e-cigarettes), new heat-not-burn tobacco products Ploom and iQOS have recently begun to be sold by tobacco companies. These products are regulated differently in Japan, depending on whether the contents are liquid or tobacco leaf. Our objective was to estimate percentages of awareness and use of e-cigarettes and heat-not-burn tobacco products among the Japanese population, including minors. Design and Setting An internet survey (randomly sampled research agency panellists) with a propensity score adjustment for "being a respondent in an internet survey" using a nationally representative sample in Japan. Participants A total of 8240 respondents aged 15-69 years in 2015 (4084 men and 4156 women). Measurements Adjusted percentages of awareness and use of e-cigarettes (nicotine or non-nicotine e-cigarettes) and heat-not-burn products among total participants; product types and percentages ever used among e-cigarettes ever users. Findings Of respondents in Japan, 48% [95% confidence interval (CI) = 47-49] were aware of e-cigarettes and heat-not-burn tobacco products, 6.6% (95% CI = 6.1-7.1) had ever used, 1.3% (95% CI = 1.0-1.5) had used in the last 30 days and 1.3% (95% CI = 1.1-1.6) had experience of > 50 sessions. Seventy-two per cent (95% CI = 69-76) of ever users used non-nicotine e-cigarettes, while 33% (95% CI = 30-37) of them used nicotine e-cigarettes, which has the majority share world-wide; 7.8% (95% CI = 5.5-10.0) and 8.4% (95% CI = 6.1-10.7) of them used the new devices, Ploom and iQOS, respectively, with a relatively higher percentage among the younger population. Conclusions Approximately half the respondents in a Japanese internet survey were aware of e-cigarettes and heat-not-burn tobacco products, 6.6% had ever used. More than 70% of ever users used non-nicotine e-cigarettes, the sale of which is not legally prohibited, even to minors, in Japan, and 33% of them used nicotine e-cigarettes; 3.5% of never smoking men and 1.3% of never smoking women had ever used e-cigarettes. Corresponding figures for use in the last 30 days were 0.6% and 0.3%, predominantly non-nicotine e-cigarettes. [ABSTRACT FROM AUTHOR]

Objectives. We sought to evaluate the effect of ratifying the World Health Organization Framework Convention on Tobacco Control (FCTC) on countries enacting smoke-free laws covering indoor workplaces, restaurants, and bars. Methods.We compared adoption of smoke-free indoor workplace, restaurant, and bar laws in countries that did versus did not ratify the FCTC, accounting for years since the ratification of the FCTC and for countries' World Bank income group. Results. Ratification of the FCTC significantly (P<.001) increased the probability of smoke-free laws. This effect faded with time, with a half-life of 3.1 years for indoor workplaces and 3.8 years for restaurants and bars. Compared with high-income countries, upper-middle-income countries had a significantly higher probability of smoke-free indoor workplace laws. Conclusions.The FCTC accelerated the adoption of smoke-free indoor workplace, restaurant, and bar laws, with the greatest effect in the years immediately following ratification. The policy implication is that health advocates must increase efforts to secure implementation of FCTC smoke-free provisions in countries that have not done so. [ABSTRACT FROM AUTHOR]

Objectives: We examined if: (1) exposure to marketing of e-cigarettes, harm perceptions, and beliefs about government evaluation of e-cigarettes were associated with e-cigarette use among college students; and (2) whether the aforementioned factors differed by current cigarette smoking status. Methods: Overall, 5028 students 18-24 years old completed an online survey in spring 2012. Results: Current cigarette smokers were more likely than non-smokers to use e-cigarettes, to report lower e-cigarette harm perceptions, and surprisingly, less exposure to e-cigarette marketing. There were no group differences on beliefs about government evaluation. Sex, race/ethnicity, current cigarette smoking, and harm perceptions were associated with e-cigarette use. Conclusion: Findings highlight the need to address harm perceptions regarding e-cigarette use, with focus on college students, particularly ones who smoke cigarettes. [ABSTRACT FROM AUTHOR]

There is a tension in the policy field about the way that the policy process should occur and the manner in which evidence should inform policy decisions. This article presents findings from a qualitative study on the introduction of point-of-sale tobacco display bans in Australia to provide an insight into the way this public policy was introduced and the way that evidence was used and communicated to influence the policy outcome. This study highlights that tobacco control policy does not merely consist of a series of segmented and unconnected decisions. It is an ongoing process, whereby the acceptability of forms of knowledge has shifted over time. This has enabled the introduction of tobacco control initiatives on the basis of good judgement when there is a paucity of specific evaluation information to support a policy's introduction. [ABSTRACT FROM AUTHOR]

Objective: This research examined e-cigarette use among menthol smokers and the role of ecigarettes in response to a proposed ban on menthol cigarettes. Methods: Data were obtained from the 2014 Minnesota Adult Tobacco Survey. Results: Among Minnesota adult smokers, 25% use menthol cigarettes. Approximately half reported they would quit smoking if menthol cigarettes were banned; 12.3% reported they would switch to menthol e-cigarettes. Almost 75% of menthol smokers have tried e-cigarettes; 58% of whom used them to try to quit cigarettes. Conclusions: Nearly half of menthol smokers are ready to quit, and report that a ban would provide additional momentum for quitting. Many are already using e-cigarettes as cessation aids, despite a lack of evidence regarding efficacy. [ABSTRACT FROM AUTHOR]

Objective: This paper presents an argument that tobacco regulatory research must reflect current science regarding tobacco addiction. Methods: The systematic literature review contained herein provides an overview of clinical and neuroscience research. Results: The literature supports the case of tobacco addiction as a neurobiological disorder that develops in a set sequence with characteristic signs and symptoms. Moreover, research suggests that it cannot be assumed that non-rewarding doses of nicotine are incapable of triggering addiction. Conclusion: Beyond the physical attributes of the product, regulatory science also should consider the role of environmental factors such as cues, price, availability, and promotion in fostering and sustaining nicotine addiction. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) is a unique global health instrument, since it is in the health field the only instrument that is international law. After the 10 years of its existence an Independent Expert Group assessed the impact of the FCTC using all available data and visiting a number of countries interviewing different stakeholders. It is quite clear that the Treaty has acted as a strong catalyst and framework for national actions and that remarkable progress in global tobacco control can be seen. At the same time FCTC has moved tobacco control in countries from a pure health issue to a legal responsibility of the whole government, and on the international level created stronger interagency collaboration. The assessment also showed the many challenges. The spread of tobacco use, as well as of other risk lifestyles, is related to globalization. FCTC is a pioneering example of global action to counteract the negative social consequences of globalization. A convention is not an easy instrument, but the FCTC has undoubtedly sparked thinking and development of other stronger public health instruments and of needed governance structures. [ABSTRACT FROM AUTHOR]

Objective: To describe the knowledge and attitudes that the students of a University on cigarette smoking and the regulations that rule it, and how these regulations are applied in their practices. Methodology: Cross-section descriptive study, application of random stratified sampling. We developed the instrument taking some variables from the GATS and GYTS surveys. Results and Discussion: Women considered themselves passive smokers (10%) and men, former smokers (18.9%) The life prevalence was 53.3%; prevalence during last month was 37.7% in males. 67.7% affirmed that the prevention measures of the Anti-tobacco law in Colombia have not had influence on the reduction of smoking in society. They recognized that there are measures to prevent smoking in the institution, but they consider that these should be strengthened to create a larger impact, both in the instruction and in the national level. [ABSTRACT FROM AUTHOR]

The article reflects on the role of the U.S. Food and Drug Administration (FDA) in regulating e-cigarettes and a need for the FDA to make efforts under the U.S. Tobacco Control Act. It discusses the steps taken by the FDA to regulate e-cigarettes and other tobacco products such as blocking e-cigarettes imports under the U.S. Federal Food, Drug, and Cosmetic Act (FDCA).

The practice of selling single cigarettes (loosies) through an informal economy is prevalent in urban, low socioeconomic (low SES) communities. Although US state and federal laws make this practice illegal, it may be occurring more frequently with the recent increase in taxes on cigarettes. This investigation provides information concerning the illegal practice of selling single cigarettes to better understand this behavior and to inform intervention programs and policymakers. A total of 488 African American young adults were recruited and surveyed at two education and employment training programs in Baltimore City from 2005 to 2008. Fifty-one percent of the sample reported smoking cigarettes in the past month; only 3.7 % of the sample were former smokers. Approximately 65 % of respondents reported seeing single cigarettes sold daily on the street. Multivariate logistic regression modeling found that respondents who reported seeing single cigarettes sold on the street several times a week were more than two times as likely to be current smokers compared to participants who reported that they never or infrequently saw single cigarettes being sold, after controlling for demographics (OR = 2.16; p = 0.034). Tax increases have led to an overall reduction in cigarette smoking. However, smoking rates in urban, low SES communities and among young adults remain high. Attention and resources are needed to address the environmental, normative, and behavioral conditions influencing tobacco use and the disparities it causes. Addressing these factors would help reduce future health care costs and save lives. [ABSTRACT FROM AUTHOR]

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This study investigates heterogeneous response to state cigarette tax increases using unconditional quantile regression (UQR). We make two contributions to the empirical policy analysis literature. First, we argue that UQR provides more policy-relevant information than conventional quantile regression in most empirical state policy analyses. Second, we document cigarette tax elasticity across a sample of adult smokers in the Current Population Survey Tobacco Use Supplements between 1992 and 2011. Our ordinary least squares regression show an imprecise negative relationship between taxes and cigarettes smoked in the past 30 days, while UQR reveals a U-shaped relationship: Only moderate smokers reduce their smoking following a cigarette tax increase, and the magnitude of the effect is small. A $1.00 (135 percent) increase in the cigarette tax leads to a 3.5 percent reduction in the number of cigarettes smoked in the past 30 days among the most responsive smokers (implied tax elasticity = −0.03). [ABSTRACT FROM AUTHOR]

This survey of three hundred and twenty undergraduate students attempted to determine their knowledge of crime and punishment in North Carolina. Respondents answered a series of open- and closed-ended questions regarding various legal topics, such as statutory rape and the legal ages for tobacco and alcohol use. The participants were also asked to list punishments for various offenses, such as possession of marijuana, driving while intoxicated, and rape. They were then asked to define certain legal terms such as larceny. The results indicated that most students were unable to provide correct corresponding punishments for many offenses. They were also unable to accurately define various legal terms, such as robbery or rape. The implications for stronger education in the area of criminal justice are discussed. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the effectiveness of an institutional intervention aimed at decreasing prevalence of tobacco use over a 4-year period. Methods: Participants were undergraduate students (N = 2,293) enrolled at a large Midwestern university between 2007 and 2010. In 2008, tobacco use was banned on campus. Additionally, campus-wide tobacco cessation services and information were provided to all students. A self-report measure assessing demographics and tobacco use prevalence was administered at baseline and at 3 timepoints over the following 3 years. Results: Results indicated that smokeless tobacco use decreased significantly after the ban. Members of fraternities (a high-risk group) reported significant decreases in smokeless tobacco use for the first 2 years following the ban; however, this trend did not persist during the 3rd year of assessment. Off-campus residents displayed similar trends as fraternities. Conclusions: It appears that a campus-wide tobacco ban is an effective prevention method for decreasing smokeless tobacco use. However, initial decreases in smokeless tobacco use may not persist for some at risk groups, namely members of fraternities and students living off-campus. Future studies should examine prevalence of use over longer periods of time with a particular focus on at risk groups. Overall, this study lends considerable support for efforts toward tobacco-free campuses. [ABSTRACT FROM AUTHOR]

This article investigates elements of tobacco control issues in Romania. Using European Union requirements for tobacco control legislation as a backdrop, it examines the key issues of smuggling, taxation, and unemployment in a transitional economy. Romania has made some progress by adding text and pictorial warnings to cigarette packages and offering comprehensive help to quit smoking. Using empirical examples, it is argued that more progress in tobacco control is needed in the area of increased taxation, enforcement of non-smoking bans, and new legislation requiring advertising bans at point of sale, kiosks, and billboards. This article draws wider public attention to the problems that smuggling and taxation present for tobacco control, helps identify other countries confronting similar issues, and stimulates effective interventions. [ABSTRACT FROM AUTHOR]

The article focuses on the laws and legislations made for the regulation of toxic foods. Topics discussed include associated health risks with the sugar consumption, impact of educational incentives, warning labels and age limitations on the tobacco regulation and laws associated against regulation of the tobacco products. It also discusses the regulations of Food and Drug Administration (FDA) related to the regulation of the sugar products.

Background: Research has shown that tobacco control policies have helped produce the dramatic decline in use over the decades following the 1964 surgeon general's report. However, prevalence rates have stagnated during the past two decades in the US, even with large tobacco taxes and expansions of clean air laws. The observed differences in tobacco control policy effectiveness and why policies do not help all smokers are largely unexplained. Objective: The aim of this study was to determine the importance of genetics in explaining response to tobacco taxation policy by testing the potential of gene-policy interaction in determining adult tobacco use. Methods: A moderated regression analysis framework was used to test interactive effects between genotype and tobacco policy in predicting tobacco use. Cross sectional data of US adults from the National Health and Nutrition Examination Survey (NHANES) linked with genotype and geocodes were used to identify tobacco use phenotypes, state-level taxation rates, and variation in the nicotinic acetylcholine receptor (CHRNA6) genotype. Tobacco use phenotypes included current use, number of cigarettes smoked per day, and blood serum cotinine measurements. Results: Variation in the nicotinic acetylcholine receptor was found to moderate the influence of tobacco taxation on multiple measures of tobacco use. Individuals with the protective G/G polymorphism (51% of the sample) responded to taxation while others had no response. The estimated differences in response by genotype were C/C genotype: b =-0.016 se = 0.018; G/C genotype: b = 0.014 se = 0.017; G/G genotype: b =-0.071 se 0.029. Conclusions: This study provides novel evidence of "gene-policy" interaction and suggests a genetic mechanism for the large differences in response to tobacco policies. The inability for these policies to reduce use for individuals with specific genotypes suggests alternative methods may be needed to further reduce use. [ABSTRACT FROM AUTHOR]

The article focuses on the implementation of comprehensive smoke-free (CSF) laws across the U.S. between 2000 and 2012. It provides a historical perspective the implementation of CSF law across the U.S., including data on local smoking restrictions. It describes the changes and developments in CSF policies and policy coverage. The author also ponders on the factors that influence the success of CSF law implementation.

Purpose. To review published state tobacco control plans (STCPs) to determine the extent to which the needs of the states' populations are being addressed. Design. A qualitative cross-sectional comparison of states' strategic plans for tobacco control as of March 2010. Setting. Online searches. Participants. The 50 states and the District of Columbia. Method. Internet-based searches were completed using tobacco and other keywords (control, prevention, strategies, comprehensive/strategic plan) to obtain all publicly available STCPs; telephone follow-up was conducted to ensure that all publicly available plans were captured. Each plan was coded by two researchers using a standardized protocol to assess provisions made for addressing disparate populations as defined by the states. Results. A total of 43 states addressed disparate populations. Thirty-six states addressed these populations within published STCPs, six states had separate stand-alone tobacco disparities plans, and one addressed it within their cancer plan. Specific populations addressed included racial and ethnic minorities, blue-collar employees, pregnant women, children under the age of 18, and college students. There were also several STCPs that cited the general goal of eliminating tobacco use disparities. Conclusion. More work is needed to address tobacco disparities, including additional planning efforts in some states and effective implementation and evaluation among states with plans. States can look to the experiences of other states to help guide tobacco control planning for their own populations. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the differences in cigarette smoking prevalence rates in Brazil between 1989 and 2008. Methodology: We calculated absolute and relative differences in smoking prevalences, overall and stratified by gender, age, place of residence, educational level and birth cohort. Data were obtained from random samples from two National Household Surveys (1989,n=39,969; 2008,n=38,461). GLM models were specified to obtain estimates and assess whether differences in proportions of smokers differed by categories of the stratification variables. Results: Adjusted absolute and relative differences in smoking prevalence rates between 1989 and 2008 were, respectively, −12.4% and −41.0%. Individuals aged 15–34years and those with 9 or more years of education presented larger relative declines than their counterparts (ps ≤0.001). After stratification by birth cohort, men presented larger reductions than women, only in the absolute scale (ps ≤0.001), with the exception of the youngest birth cohort (i.e.,1965–1974). Conclusions: In Brazil, several tobacco control measures have been adopted since 1986, in particular increasing taxation of tobacco products and strong health warnings, which may have contributed to the marked decline in smoking prevalence. It is important to understand the evolution of the tobacco epidemic to propose new actions to prevent initiation and encourage cessation among those who started/continued smoking. [Copyright &y& Elsevier]

The use of law and policy to limit tobacco consumption illustrates one of the greatest triumphs of public health in the late twentieth and early twenty-first centuries, as well as one of its most fundamental failures. Overall decreases in tobacco consumption throughout the developed world represent millions of saved lives and unquantifiable suffering averted. Yet those benefits have not been equally distributed. The poor and the undereducated have enjoyed fewer of the gains. In this review, we build on existing tobacco control scholarship and expand it both conceptually and comparatively. Our focus is the social gradient of smoking both within and across borders and how policy makers have been most effective in limiting smoking prevalence among the more privileged segments of society. To illustrate that point, we reference a range of literature on tobacco taxation, advertising, and public smoking in five economically advanced democracies-France, Germany, Japan, the United Kingdom, and the United States-and four less developed nations-India, China, Brazil, and South Africa-that together comprise 40%% of the world's population. [ABSTRACT FROM AUTHOR]

BACKGROUND: The minimum age for the legal purchase of tobacco increased from 16 to 18 years in England, Scotland and Wales on 1 October 2007. The authors examined the impact of this legislation on disparities in smoking behaviour and access to cigarettes among youth in England. METHODS: A multivariate logistic regression analysis was carried out adjusting for secular trends in regular smoking using data from the Smoking, Drinking and Drug Use Survey, a national survey of 11–15 year olds. The primary outcome measure was regular smoking and the predictor variables were the law increasing the minimum age for purchase and eligibility for free school meals (FSM). RESULTS: Increasing the minimum age for purchase was associated with a significant reduction in regular smoking among youth (adjusted OR 0.67; 95% CI 0.55 to 0.81, p=0.0005). This effect was not significantly different in pupils eligible for FSM compared with those that were not (adjusted OR 1.29; 95% CI 0.95 to 1.76, p=0.10 for interaction term). The percentage of pupils who stated that they found it difficult to buy cigarettes from a shop did not increase in those eligible for FSM (25.2% to 33.3%; p=0.21) but did increase significantly in others (21.2% to 36.9%; p<0.01) between 2006 and 2008. No differences in ease of purchase were found between pupils eligible for FSM and those not before or after the legislation (2006: p=0.34, 2008: p=0.55). CONCLUSIONS: Increasing the age for the legal purchase of tobacco was associated with reduced regular smoking among youth in England and appeared to have a similar impact in different socio-economic groups. [ABSTRACT FROM AUTHOR]

In this essay, I first describe some examples of curiosity-based, basic research inspired by Lewin's famous dictum that there is nothing so practical as a good...theory. Then, I describe several examples of recent intervention studies that leverage basic research to make the world a better place. Next, in the spirit of Lewin, I suggest that there is nothing so practical as a good...design-and describe 'state of the art' quasi-experimental designs to evaluate tobacco control policies and suggest the sort of designs one might employ to evaluate smoking prevention programs implemented before kids have even started smoking. Finally, I conclude by suggesting the need to change our academic culture to encourage more emphasis on mobilizing the knowledge we obtain from our research. [ABSTRACT FROM AUTHOR]

This article discusses an analysis of preemptive state tobacco control legislation in the U.S. that prohibits localities from enacting more stringent tobacco control laws. Conducted by the Centers for Disease Control and Prevention (CDC), the analysis identified three types of state preemption: smoking in workplaces and public places; tobacco advertising; and youth access to tobacco products. It showed an increase in the number of states with preemptive provisions.

The main target of this reflex paper is to explain some ideas about behavioral economics, such as the prospect theory and the framing effect, as well as its possible implications for the law, especially in the context of tobacco control law in Colombia and the current package warning labels. The paper concludes that these warnings have the potential to reduce the tobacco consumption. However, the effectiveness of these messages could be increased if the information is reframed in an alternative way. [ABSTRACT FROM AUTHOR]

Introduction: Most correctional facilities have implemented tobacco restrictions in an effort to reduce costs and improve prisoner health, but little has been done to evaluate the impact of these policy changes. Patterns of tobacco use among prisoners were explored to determine the impact of incarceration in a facility with an indoor smoking ban on tobacco use behaviors. Methods: Recently incarcerated male inmates (n = 200) were surveyed about their tobacco use prior to and during incarceration. Results: Tobacco use was prevalent prior to arrest (77.5%) and increased during incarceration (81.0%). Though the number of cigarette smokers increased during imprisonment, per-capita cigarette consumption declined by 7.1 cigarettes/day (p < .001). Despite widespread tobacco use, most participants recognized that smoking is a cause of lung cancer (96.0%) and heart disease (75.4%) and that it can be addicting (97.5%). Most tobacco users (70.0%) reported a desire to quit, with 63.0% saying they intended to try quitting in the next year. Conclusions: Indoor smoking bans do not promote cessation in prisons but may reduce the amount of tobacco consumed. Though smoking is commonplace in prisons, most prisoners recognize the risks involved and wish to quit. This creates an ideal setting for intervention. Evidence-based cessation assistance should be made freely available to all incarcerated smokers. [ABSTRACT FROM AUTHOR]

This study examined whether menthol cigarette smoking is related to exposure to smoke-free home and work-place policies, availability of cessation services at work and knowledge of cessation resources among current smokers. Secondary analysis was conducted using logistic regression of cross-sectional data. The 2003 and 2006/07 Tobacco Use Supplement (TUS) to the Current Population Survey, administered by the National Cancer Institute, the Centers for Disease Control and Prevention (CDC) and the Census Bureau, formed the basis for this investigation. A total of 66 145 current smokers who participated in the TUS CPS administrations in 2003 and 2006/07. Demographic characteristics (gender, race/ethnicity, age, education, income), smoking frequency, menthol cigarette use, status of smoking bans in the work-place and at home, availability of cessation services at work and knowledge of quitting resources were assessed. Among all current smokers with an indoor job, with no smoke-free restrictions at either work or home as the reference, those who smoked menthol cigarettes were about one-third as likely to have a smoke-free policy at both work and home [odds ratio (OR) = 0.32; 95% confidence interval (CI): 0.27-0.38]. In the comparison of those with an indoor smoke-free policy at work only versus those with no restrictions, menthol status was a risk factor for not having a work-place restriction (OR = 0.79; 95% CI: 0.67-0.93); similarly, within this sample, menthol use was a risk factor for not having a home restriction (OR = 0.38; 95% CI: 0.31-0.46). Among all current smokers, the use of menthol cigarettes was a risk factor for not having a smoking restriction at home (OR = 0.93; 95% CI: 0.88-0.98). Menthol smoking was not related to availability of cessation services offered at work or knowledge of cessation services. This study suggests that menthol smoking is associated with lack of policy protection from second-hand smoke exposure. Policymakers and tobacco control professionals should monitor tobacco control efforts to ensure that policies and interventions reach all menthol smokers. [ABSTRACT FROM AUTHOR]

We use systems thinking to develop a strategic framework for analyzing the tobacco problem and we suggest solutions. Humans are vulnerable to nicotine addiction, and the most marketable form of nicotine delivery is the most harmful. A tobacco use management system has evolved out of governments' attempts to regulate tobacco marketing and use and to support services that provide information about tobacco's harms and discourage its use. Our analysis identified 5 systemic problems that constrain progress toward the elimination of tobacco-related harm. We argue that this goal would be more readily achieved if the regulatory subsystem had dynamic power to regulate tobacco products and the tobacco industry as well as a responsive process for resourcing tobacco use control activities. [ABSTRACT FROM AUTHOR]

The article presents an example of how a coalition-based advocacy strategy that engaged a diverse group of stakeholders and was supported by a national coordinating movement achieved state level fire-safe cigarette legislation in a tobacco-producing and manufacturing state. The creation, work and success of the North Carolina Coalition for Fire-Safe Cigarettes to reduce the impact of smoking-related fires through legislative action and the factors in building a strong coalition are discussed.

The article discusses government-led initiatives to tobacco control in Sweden based on the implementation of European Union (EU) Directive on Tobacco Products and the Framework Convention on Tobacco Control (FCTC) of the World Health Organization (WHO). Topics addressed include requirements for the labeling of tobacco packages, taxation and price aspects of tobacco control, and the health aspect of cigarette smoking. Public support for smoking ban in public places in Sweden is mentioned.