Tobacco Control最新文献

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.

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.

Background: Spree Bar, a line of e-cigarette devices introduced in 2023, leverages 6-methylnicotine (6-MN) as its primary ingredient and is available in nine flavours, each represented by artificial intelligence (AI)-generated avatars.

Aims: To characterise the popularity (via social media analysis and survey data), content (nicotine, nicotine analogues, common flavouring chemicals) and marketing strategy (product avatars and flavour descriptions created by the company on its website and Instagram) of Spree Bar.

Results: Publicly available secondary data (Population Assessment of Tobacco and Health, National Youth Tobacco Survey (NYTS), International Tobacco Control (ITC) Youth survey) have not captured any reported use of Spree Bar. Social media observations revealed little public discussion of Spree Bar, aside from activity surrounding news stories. Chemical analysis confirmed that Spree Bar did not contain nicotine and that the levels of 6-MN were significantly lower than claimed (approximately 0.3% vs 5%). Wilkinson Sword (WS)-23, a synthetic coolant, was present in all varieties, regardless of nominal flavour. Linguistic analysis of Spree Bar promotional text from their novel marketing strategy indicates very little difference in language used across avatars or nominal flavours.

Conclusions: There is limited evidence of widespread uptake of Spree Bar to date. However, its marketing approach and striking mislabeling and coolant ubiquity underscore the need for regulatory vigilance.

Background: Modelling studies find the smokefree generation (SFG) policy could help achieve the tobacco endgame. The UK is on course to introduce an SFG in 2027 that prohibits tobacco sales to individuals born in or after 2009.

Methods: We adapted an individual-level microsimulation model with a synthetic representative English population, and used previously validated smoking initiation, quit and relapse probabilities by age and deprivation quintile. We simulated four scenarios from 2023 to 2075: no intervention, pessimistic SFG, central SFG and optimistic SFG. Proportionate universalism sensitivity analyses assumed effective targeting led to greater effects in more deprived areas and smaller effects in less deprived areas. Equity was assessed using slope and relative indices of inequality.

Results: The central SFG scenario forecast smoking prevalence to be reduced to <5% in 12-30 year-olds by 2049, but not until 2055 for males and not until 2059 for those living in the most deprived quintile. Absolute socioeconomic inequalities were reduced but not relative inequalities. Under proportionate universalism, <5% prevalence is achieved a year earlier (2048) and both absolute and relative inequalities by index of multiple deprivation quintile are substantially reduced by 2050. By 2075, 87 899 (85 293-90 791) discounted quality-adjusted life years were gained in the central scenario compared with baseline.

Conclusions: The SFG policy has potential to reduce absolute inequalities among its target population and achieve significant gains in quality and length of life. Achieving reductions in relative inequalities will likely require targeted interventions that lead to greater effectiveness in lower socioeconomic areas and for males.

Background: Recreational cannabis legalisation has been associated with increases in adult cannabis use. However, it is unclear whether legalisation is driving the rising levels of co-use of tobacco and cannabis.

Methods: We linked 2016-2023 Behavioural Risk Factor Surveillance System data on 854 878 adults aged 18+ years from 38 states with data on state recreational cannabis legalisation and retail sales availability. Using multinomial logit regression models, we examined the associations between legalisation and the use and co-use of tobacco and cannabis overall and by demographic (age, sex, education, race and ethnicity) and higher-risk (mental health, alcohol use) strata, with demographic and policy controls and state and year fixed effects.

Results: Recreational cannabis legalisation was associated with overall increases in cannabis-only use (adjusted relative risk ratio (aRRR) 1.88; 95% CI 1.78 to 1.99) and co-use of tobacco and cannabis (1.44; 1.34 to 1.54) compared with no use, and with decreases in tobacco-only use (0.87; 0.83 to 0.91). Similar patterns emerged in response to the start of cannabis retail sales. There was some evidence of increases in co-use of tobacco and cannabis post-legalisation and/or retail sales among adults aged 18-24 and 55+ years, with a high school degree or higher, and who identified as White or Black. No differential effects for co-use emerged across higher-risk strata.

Conclusion: Recreational cannabis legalisation is increasing cannabis-only use and co-use of tobacco and cannabis, including rises in co-use among populations with lower levels of cannabis use. Increased surveillance of and screening for co-use of tobacco and cannabis can help inform public health responses to legalisation.

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: 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.

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.