Tobacco Control最新文献

Background: In April 2020, Japan's revised Health Promotion Act (HPA) banned cigarette smoking and heated tobacco products (HTP) use in indoor public places but exempted small establishments and permitted smoking-designated/HTP-designated rooms. This pre-post study evaluated the effectiveness of the HPA.

Methods: Data were from waves 1 to 4 (2018-2021) of the International Tobacco Control Japan Surveys among a national cohort of adults who smoke cigarettes, use HTPs and do not use any tobacco products. The sample sizes in the respective surveys were 4615, 4222, 4387 and 4254. Multivariable logistic regression models employing generalised estimating equations estimated the prevalence of observed and self-reported indoor smoking/HTP use in key public venues (restaurants/cafés, bars/pubs and workplaces), smoke-free places, and homes, and smoke-free/HTP aerosol-free home policies (model 1). The models were additionally adjusted for waves 1-4 to estimate the impacts of the HPA (model 2).

Results: The implementation of the HPA significantly reduced observed indoor smoking in bars/pubs (model 1: 82.2% (pre) to 55.5% (post), model 2: p=0.04) but not in restaurants/cafés (model 1: 53.0%-24.9%, model 2: p=0.15) or workplaces (model 1: 35.3%-30.1%, model 2: p=0.62). Observed indoor HTP use was also common postimplementation (restaurants/cafés: 19.6%, bars/pubs: 53.9%, workplaces: 36.4%). The implementation of the HPA was associated with a significant increase in observed HTP use in smoke-free places (model 1: 26.3%-33.3%, model 2: p=0.001) and a suggestive increase in homes without HTP aerosol-free policies among adults who smoke (model 1: 64.0%-77.0%, model 2: p=0.09).

Conclusions: The implementation of the HPA was limited in its effectiveness. Comprehensive regulations with no exemptions are needed in Japan.

Introduction: Tobacco smoke exposure (TSE) among individuals who do not smoke has declined in the USA, however, gaps remain in understanding how TSE patterns across indoor venues-including in homes, cars, workplaces, hospitality venues, and other areas-contribute to TSE disparities by income level.

Methods: We obtained data on adults (ages 18+, N=9909) and adolescents (ages 12-17, N=2065) who do not smoke from the National Health and Nutrition Examination Survey, 2013-2018. We examined the prevalence of self-reported, venue-specific TSE in each sample, stratified by poverty income ratio (PIR) quartile. We used linear regression models with a log-transformed outcome variable to explore associations between self-reported TSE and serum cotinine. We further explored the probability of detectable cotinine among individuals who reported no recent TSE, stratified by PIR.

Results: Self-reported TSE was highest in cars (prevalence=6.2% among adults, 14.2% among adolescents). TSE in own homes was the most strongly associated with differences in log cotinine levels (β for adults=1.92, 95% CI=1.52 to 2.31; β for adolescents=2.37 95% CI=2.07 to 2.66), and the association between home exposure and cotinine among adults was most pronounced in the lowest PIR quartile. There was an income gradient with regard to the probability of detectable cotinine among both adults and adolescents who did not report recent TSE.

Conclusions: Homes and vehicles remain priority venues for addressing persistent TSE among individuals who do not smoke in the USA. TSE survey measures may have differential validity across population subgroups.

Objective: This study updates a previous paper that examined trends in the sale of cigarettes and heated tobacco products (HTPs) in Japan between 2011 and part way through 2019. The current study includes complete unit sales data through 2023.

Methods: Data on cigarette and HTP sales were obtained from public sources available from the websites and stockholder reports for the Tobacco Institute of Japan, Philip Morris International and Japan Tobacco. We used joinpoint regression using the parametric method to test for trends in both per capita and total sales for the three outcome variables assessed between 2011 and 2023: (1) cigarette sales, (2) HTP sales and (3) combined cigarette and HTP sales. Joinpoint regression identifies changes in trends and estimates the annual per cent change (APC) for each trend segment.

Results: Between 2011 and 2023, per capita and total cigarette sales declined by 52.6% and 52.7%, respectively. From 2011 to 2015, per capita cigarette sales in Japan decreased -1.5% APC; from 2015 to 2018, the decline accelerated to -10.5% APC and continued to fall -7.3% APC between 2018 and 2023. Between 2016 and 2018, per capita HTP sales increased by 149.0% APC, and since 2018, they have increased by 8.1% APC.

Conclusion: While many factors may account for the decreased sale of cigarettes in Japan over the past 12 years, the increased sale of HTPs appears to be a factor.

Significance: E-cigarettes with candy-themed marketing are implicated in decisions to first try e-cigarettes but have unknown effects on the experience of vaping. We compared adults' perceived appeal and sensory attributes after self-administering flavoured e-cigarettes in experimentally manipulated packaging with candy-themed versus standard marketing. We also assessed effect modification by salt vs free-base nicotine formulation.

Methods: Adults who currently used e-cigarettes and/or cigarettes (N=72; age M(SD)=31.4 (12.8) years) completed single-puff self-administrations from eight individually-packaged pods containing fruit or dessert-flavoured e-liquid via staff-guided video sessions. For each e-liquid flavour, we custom-manufactured packaging with standard (eg, 'mango'; mango fruit image) and candy (eg, 'mango gummy bear'; gummy bear image) marketing versions, which we varied within-subject (four pods candy; four pods standard). After participants opened the package and vaped the pod inside, they rated its sensory attributes and appeal (0-100 scale). Participants were randomised between subjects to salt or free-base ~2.3% nicotine in all pods.

Results: Marketing theme had no significant main effects on outcomes. Marketing theme × nicotine formulation interactions were significant; candy-themed (vs standard) packaging elevated composite appeal (B_{difference [estimated mean difference between marketing themes]}=7.7), liking (B_difference=8.4), and sweetness (B_difference=5.7) ratings in free-base but not salt nicotine formulations. Marketing theme did not affect smoothness, harshness and bitterness ratings regardless of nicotine formulation.

Conclusion: Candy-themed marketing may heighten the appeal and sweet sensory experience of vaping flavoured free-base nicotine e-cigarettes. While marketing restrictions are predominantly intended to prevent e-cigarette initiation, candy-themed marketing restrictions could also prevent persistent use by lowering the appeal of flavoured free-base nicotine e-cigarettes.

Significance: The tobacco industry uses different descriptors to market unflavoured cigarillos, which represent around half of all cigarillos sold. Limited research has focused on perceptions of unflavoured cigarillos.

Methods: We conducted an online between-subjects experiment with n=742 US youth and young adults (ages 15-20) recruited July-November 2024 through Qualtrics who reported ever/past 30-day little cigar or cigarillo use or susceptibility to using little cigars or cigarillos. Participants were randomly assigned to view one of four fictitious cigarillo packages with descriptors commonly used to market unflavoured cigarillos-'un-sweet', 'tobacco', 'silver' and no descriptor. Cigarillos were chosen for their popularity among youth and young adults and dominance in cigar sales. Outcomes included perceived product flavour and taste, appeal, susceptibility and purchase intentions.

Results: The silver descriptor led to more favourable flavour and taste perceptions, higher appeal and higher purchase intentions compared with the un-sweet descriptor (ps <0.05). The silver descriptor also led to higher purchase intentions compared with the tobacco descriptor and no descriptor (ps <0.05). The unsweet descriptor led to less favourable flavour and taste perceptions, compared with the tobacco descriptor and no descriptor (ps <0.05).

Conclusions: Among a sample of US youth and young adults who have used little cigars or cigarillos or are susceptible to use, the silver descriptor was the least effective way to communicate that cigarillos were unflavoured and was viewed the most favourably. Even though a silver descriptor is currently used to market unflavoured cigarillos, it likely still communicates flavour/taste characteristics and could therefore increase purchase intentions and use.

Trial registration number: Clinicaltrials.gov ID: NCT06413797.

Background: Canada has become the first country in the world to require warnings to be displayed on cigarette sticks. Tobacco companies were given a transition period, from 30 April to 31 July 2024 to ensure that all king size cigarettes sold in the country included warnings on the filter of each cigarette stick. Warnings on the filter of regular size cigarettes will be implemented from April 2025.

Methods: We used an online panel provider to recruit an open cohort of adults in Canada who smoked factory-made or roll-your-own cigarettes. Seven waves of data were collected at 3-month intervals between February 2023 to August 2024, with 10 521 observations across 4310 participants. Participants were asked about support for the inclusion of warnings on cigarette filters, accompanied by an image of one of the six prescribed warnings (eg, 'Cigarettes damage your organs'). Smoking behaviours and sociodemographic characteristics were also queried.

Results: Generalised estimated equations were used to estimate support at each wave. At W1 (February 2023, prior to the policy announcement), 25% of participants reported supporting printed health messages on cigarette sticks, significantly increasing to 27% by W7 (August 2024, at the end of the implementation transition period). Participants were more likely to support the policy if they used other nicotine/tobacco products, roll-your-own cigarettes, had a recent quit attempt, intended to quit, or had higher risk perception of smoking harms, and less likely if they were older, female, white or reported greater reactance to warnings on cigarette packs.

Conclusion: Just as increased support has been found for a range of tobacco control policies post-implementation, we found increased support for warnings on cigarettes during the transition period. However, support for this policy among people who smoke remains low. Other countries considering implementing this policy may consider these findings.

Objective: To describe the scope of published literature about tobacco-related policy discussions from social media data and discuss implications for tobacco control policy and future research.

Data sources: PubMed, Medline, CINAHL and Web of Science were searched on 20 November 2023, using search terms for social media, tobacco, and policy. The search was limited from 2005 to 2023.

Study selection: After removing duplicates, 2 authors reviewed 1118 articles. Those found to be irrelevant based on title (1078) and abstract (18) review were removed.

Data extraction: Data included study descriptions (eg, policy discussed, social media platform and number of posts), study characteristics (eg, methodology, sentiment analysis (propolicy, antipolicy, neutral policy and unclear policy)), and major and additional findings.

Data synthesis: Of the 22 articles, most examined discussions about USA (n=18) federal regulations (n=17) via human annotation (n=18), using Twitter (X; n=20). Of the 14 papers that discussed sentiment, 4 collected data at different time points; frequency of positive posts typically decreased after policy announcements. Policies discussed in articles included flavour restrictions; USA ban of Puff Bar; Tobacco 21; tobacco taxes; e-cigarette regulation; UK's standardised packaging; product authorisation; regulating e-cigarettes as a medical product; WHO Framework Convention on Tobacco Control regulatory actions; Australia's import restrictions on vaping products and smoke-free and tobacco-free college campus policies.

Conclusions: Social media data can be leveraged to examine timely discourse regarding tobacco control policies. Identified methods of circumventing proposed tobacco control laws and enforcement challenges should be considered by regulatory agencies to close policy loopholes and inform implementation practices.