Tobacco Control最新文献

Objective: To examine the potential implications and challenges posed by the global expansion of China National Tobacco Corporation (CNTC) for global tobacco control efforts.

Methods: We used publicly available financial and operational data from 2021 to 2023 of CNTC and four major transnational tobacco companies-Philip Morris International, British American Tobacco, Japan Tobacco International and Imperial Brands-to assess company performance across six dimensions: enterprise scale, cost efficiency, tax exposure, profitability, market presence, investment in technological innovation and product diversification.

Results: CNTC operates at larger scale than its international counterparts, with higher total assets, production and profits, alongside a lower liability-to-asset ratio and a higher effective corporate tax burden. However, CNTC exhibits limited diversification into non-combustible products and lower research and development investment than transnational tobacco companies. CNTC's large-scale production and growing overseas footprint may enable lower pricing in global markets, particularly in low- and middle-income countries, with potential consequences for global tobacco control.

Conclusions: CNTC's international expansion brings significant but under-recognised risk to global tobacco control efforts. CNTC's large scale and financial structure enable robust capacity to influence international tobacco markets in ways that may undermine taxation, regulation and public health objectives. Stronger international coordination as well as enhanced fiscal and regulatory tools are essential to protect global tobacco control efforts.

Background: Flavours play a key role in e-cigarette initiation and continued use among US youth. In 2021, e-cigarette manufacturers introduced ostensibly unflavoured products using a 'clear' descriptor. Using a mixed-methods approach, this study describes trends in retail sales and terminology used in online marketing or advertising of clear-flavoured e-cigarettes.

Methods: We used NielsenIQ retail scanner data from October 2021 to August 2024 to estimate market share and changes in market share of clear-flavoured e-cigarettes. In addition, using the keywords "vape," "e-cigarette," "clear," and "flavor," six online searches were conducted in January and June 2024 to determine whether flavour or sensory terminology was used to describe clear-flavoured e-cigarettes. Trained coders recorded terminology in the product descriptions.

Results: NielsenIQ data showed the market share of clear-flavoured e-cigarettes increased from US$34K in October 2021 to over US$1M by August 2024, representing 0.03% and 0.59% of the disposable e-cigarette market, respectively. Our analysis of product descriptions found that cooling-related terms like 'menthol' appeared in 25 of the 47 online listings (53.2%). An additional 10 (21.3%) descriptions included non-specific flavour and taste language, such as 'classic taste' and 'smooth flavour', suggesting the presence of flavourings without clearly indicating the specific taste profile.

Conclusion: The presence of flavour terminology in clear-flavoured e-cigarette product descriptions suggests that purportedly unflavoured products, such as clear-flavoured e-cigarettes, are marketed with language that implies flavoured characteristics. E-cigarettes classified as 'clear' flavour may bypass state and local flavour restrictions, advertising flavour experiences that appeal to youth.

Introduction: Despite decades of research-informed policy implementation, tobacco smoking remains a leading cause of preventable death worldwide, disproportionately affecting disadvantaged populations. In Aotearoa New Zealand, ethnic inequities in smoking prevalence have become a driver of public health policy. In 2021, the government introduced the Smokefree Aotearoa 2025 Action Plan to minimise smoking prevalence for all population groups, including the indigenous Māori population. Key policies included denicotinisation of tobacco products, reductions in tobacco retailers and a smoke-free generation law. The aims of this study were to identify and evaluate strategies used by tobacco control advocacy groups to support the introduction of the Action Plan.

Methods: A qualitative study was conducted using semistructured interviews with 20 stakeholders from different sectors of the tobacco control community. Data collection and directed content analysis were guided by the coalition theory of change framework.

Results: Three primary strategies were identified: coordination with decision-makers, generation and translation of evidence to influence policy and changing public opinion. Māori leadership was critical to successful outcomes which included changes in smoking norms, strengthened coalitions, broadened alliances and increased political will.

Discussion: While evidence-based advocacy, public engagement and Māori leadership were effective in influencing tobacco policy reform and changing public norms, the subsequent repeal of smoke-free legislation raises questions about how to sustain progressive health policies in the face of industry-driven political pressure.

Conclusion: New Zealand's tobacco control strategies can provide valuable insights for global health coalitions. Future research should focus on the sustainability and resilience of science-driven public health policies.

Introduction: In 2022, a US Federal District Court ordered cigarette companies to display 'corrective statements' in over 200 000 tobacco retailers to remediate years of consumer fraud. This study conducted store assessments in a sample of affected retailers in New York City and New Jersey to document implementation features and differences by store type and community characteristics.

Methods: Addresses of retailers required to display statements were geocoded and spatially joined with US Census Zip Code Tabulation Areas. Within nine counties, 627 retailers were randomly sampled and visited for inperson assessments between October 2024 and May 2025 to document sign presence, number and characteristics (eg, size, location, obstruction). Multilevel logistic regressions measured differences by store type and zip code demographics (in quartiles).

Results: Signage display was generally high (92.2%), but lower in non-chain convenience stores (91.4%; OR: 0.33 (0.13, 0.84)) and smoke/vape shops (84%; OR: 0.14 (0.05, 0.43)) versus chain convenience stores (97.2%), which also displayed a higher volume of signs. Stores in zip codes with the highest percentage of non-Hispanic Black residents (Q4) had significantly lower display rates (88.6%; OR: 0.22 (0.06, 0.77)) versus Q1 (96.4%). Among 906 coded signs, 63.5% were the larger format, 40.3% were located above the tobacco display, 36.6% were near the exterior entrance and 6.1% were obstructed, indicating high visibility.

Conclusions: Differences in corrective statement display and volume may shape exposure opportunities, influencing population impacts. Future research should examine whether consumers notice and process these messages in real-world conditions, critical precursors to knowledge or behavioural change.

Background: Instagram hosts pro-tobacco content that may reach youth despite existing US federal and platform-specific policies designed to restrict such content. This study assessed compliance with platform-specific and federal tobacco control policies among leading tobacco brands on Instagram.

Methods: This study collected 1654 Instagram posts between October 1, 2022, and September 29, 2024, from the main page and tagged sections of six leading tobacco brand accounts (Vuse, Lost Mary, ZYN, Velo, Lucky Strike, Winston). Posts were coded for compliance with Instagram, Federal Trade Commission (FTC) and US Food and Drug Administration (FDA) policies, including age-gating, financial disclosure, presence of health warnings and restricted URLs.

Results: 69.4% (n=1148) of posts contained URL links to commercial tobacco websites. Unrestricted access to tobacco content was observed among 46.7% (n=772) of posts. Influencers or celebrities appeared in 19.2% (n=317) of posts, of which 41.6% (n=132) of posts did not disclose a financial relationship between the brand and the influencer or celebrity. 72.6% (n=1200) of posts had a health warning label, while 41.3% (n=683) of posts had an age warning label.

Conclusions: Leading tobacco brands on Instagram often violated platform and federal policies, particularly those concerning age verification, sponsorship disclosure and health warning labelling. Stronger enforcement by Instagram, the FTC and the FDA may be needed to reduce youth exposure to tobacco marketing on social media.

Introduction: Duty-free sales of tobacco reduce the impact of excise tax increases, a measure many governments have introduced to reduce tobacco consumption and smoking prevalence. We investigated the excise tax revenue foregone in Aotearoa (New Zealand), a country once regarded as having progressive tobacco control policies.

Methods: Using data tobacco companies are required to supply to the NZ Ministry of Health, we estimated the revenue from excise tax and the Goods and Services sales tax(GST) forgone by sales of duty-free tobacco since 2014, when duty-free allowances were reduced.

Results: The number of cigarettes and volume of roll-your-own(RYO) tobacco released for sale decreased following changes to the duty-free allowance and declined sharply in 2020 and 2021, when the international border was closed as a COVID-19 pandemic measure. Since 2022, forgone excise revenue has risen steadily and, in 2024, had nearly reached prepandemic levels. In total, the foregone revenue between 2015 and 2024 amounted to between NZ$60 million and NZ$96 million.

Conclusion: Duty-free sales of tobacco products represent a government-sanctioned price discount that has undermined Aotearoa's Smokefree 2025 goal and its obligations as a Party to the Framework Convention on Tobacco Control.

Background: Changes in population estimates for electronic nicotine delivery systems (ENDS) have not been investigated in people with schizophrenia-spectrum disorders (SSDs). We assess the prevalence of daily use of ENDS, cigarettes or dual use, and changes in daily use among individuals with SSDs compared with the general population.

Methods: Respondents are from the Population Assessment of Tobacco and Health Study, 2016-2023 (age 18+ years) reporting (yes/no) daily combustible cigarette, daily ENDS or daily dual use at each wave (n=33 689 (517 SSD) in 2016-2017). Weighted generalised linear regression models were used to assess changes in odds of use for each product by self-reported SSD diagnosis.

Results: In 2023, people with SSDs reported significantly higher rates of daily cigarette smoking (31.5%, 95% CI 28.6% to 34.4%), ENDS use (6.6%, 95% CI 5.2% to 8.0%) and dual use (1.8%, 95% CI 0.9% to 2.7%), relative to the general population (cigarettes: 10.0% (95% CI 9.7% to 10.2%); ENDS: 3.2% (95% CI 3.1% to 3.4%); dual use: 0.4% (95% CI 0.3% to 0.4%)). From 2016-2023, odds of daily cigarette smoking decreased comparably in people with and without SSDs, but remained significantly higher among people with SSDs over time. Additionally, there was an increase in the odds of ENDS use among people with (OR 1.26, 95% CI 1.11 to 1.43) and without SSDs (OR 1.07, 95% CI 1.05 to 1.10), that was comparable after adjusting for age. Odds of all three daily nicotine use patterns, as well as ENDS and cigarette dependence, were higher in people with SSDs over time.

Conclusions and relevance: Despite comparable declines in daily smoking and increases in daily vaping, rates of smoking, ENDS use and dual use were persistently higher among people with SSDs, demonstrating continued nicotine/tobacco health disparities.

Introduction: Little is known about the impact of viewing commercial e-cigarette advertisements (ads) with varying fruit flavour features among young adults.

Methods: US young adult (18-30 years) non-use group (n=1078), cigarette-only group (n=1005) and dual-use group (n=1000) participated in a web-based randomised controlled trial and viewed an ad from six conditions: (1) control condition 1: grey device, 'tobacco' flavour name; (2) condition 2: grey device, 'strawberry' flavour name; (3) condition 3: coloured (red) device, 'strawberry' flavour name; (4) condition 4: condition 3+ strawberry imagery; (5) condition 5: condition 4+ flavour sensation claim; and (6) condition 6: condition 5+ flavour choice claim. Immediately afterwards, participants reported intentions to use (and completely switch to) the advertised e-cigarette and other e-cigarette-related perceptions.

Results: Among the dual-use group, the trial overall increased e-cigarette use intention, full-switch intention, relative use intentions (vs cigarettes and other e-cigarettes) and positive sensory appeal and use expectancy, compared with the control. Specifically, each non-control condition was associated with higher use intention; conditions 4, 5 and 6 were associated with higher switching intention; and condition 5 produced the highest use and switching intentions. Among non-use and cigarette-only groups, the trial affected sensory appeal and use expectancy.

Discussion: e-Cigarette ads with fruit flavour features, compared with ads promoting tobacco-flavoured products, increased try-and-switch intentions among the young adult dual-use group but influenced only positive sensory and expectancy perceptions among non-use and cigarette-only groups. Policymakers should consider the impact of fruit flavour features in e-cigarette marketing on complete product switching.

Objective: To review and synthesise European evidence identifying loopholes in 'Tobacco Advertising, Promotion and Sponsorship' (TAPS) regulations and actions undertaken by European countries to curb TAPS.

Data sources: We conducted a comprehensive search across seven databases (Medline/PubMed, Embase, Web of Science, Sociological abstracts, Global health, CINAHL and PsycInfo) along with grey literature from relevant tobacco control organisation websites. Searches were restricted by publication date (2005-2023), geographical setting (EU & European Free Trade Association countries) and language (English).

Study selection: All reviewers independently screened titles and abstracts using a purpose-designed Excel spreadsheet to identify sources addressing loopholes in national or supranational settings, deciding on inclusion accordingly.

Data extraction: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist, we extracted data based on the 'Population, Concept and Context' framework, covering tobacco product type, media communication channel and findings indicating TAPS loopholes. Two reviewers used an Excel sheet to extract data.

Data synthesis: Of 1477 sources, 140 were included in the review. Analysis identified five key loopholes: (a) smoking depictions and tobacco advertising in traditional mass media (films and television), (b) cross-border branding and sponsorships, (c) point-of-sale marketing, (d) e-cigarette and tobacco advertising and promotion on the internet and (e) promotion and advertising of tobacco and novel nicotine products on social media.

Conclusions: Curbing TAPS through comprehensive national bans and cross-border cooperation remains challenging because of the permeability of mass media, social media and other digital tools. Further research is necessary to develop strategies for effective implementation and enforcement to ensure compliance with TAPS regulations.