Tobacco Control最新文献

Background: For decades, the tobacco industry has engineered the sensory characteristics of combustible tobacco products including the degree of harshness experienced at the back of the throat. Commonly referred to as 'throat hit', this harshness derives from absorption of gas phase nicotine and other constituents by the sensory nerves. People who use tobacco products associate throat hit with the positive psychological effects of nicotine, making it a secondary reinforcer for smoking. On the other hand, high throat hit can make products aversive to naïve nicotine users and serves as a barrier to consumption of tobacco products.

Methods: We developed a first-principles theoretical model to predict nicotine absorption in the throat as a function of electronic nicotine delivery systems (ENDS) device power, liquid composition and puffing topography. The predicted nicotine absorption was compared with subjective throat harshness reported by human participants. We also simulated several ENDS use scenarios to identify the most important processes and factors that govern nicotine absorption in the throat.

Results: Across various ENDS configurations, we found that computed nicotine gas absorption in the throat was associated with subjective harshness scores (r=0.62; p<0.00001). We also found that liquid nicotine concentration, nicotine form, aerosol temperature and inhalation rate strongly influence nicotine absorption in the throat per unit of nicotine emitted by an ENDS.

Conclusions: Nicotine throat hit can be predicted and manipulated through ENDS device and liquid design variables. Regulating ENDS throat hit is feasible and may help reduce product appeal to nicotine-naïve individuals while maintaining acceptability for smokers.

Introduction: Although the popularity of oral nicotine products (ONPs) such as ZYN and On! is growing globally, there is limited research on their marketing and advertising. This report describes recent ONP marketing communication to retailers. Promotion to retailers can provide insight into new product flavours and styles, as well as future marketing strategies targeting consumers.

Methods: We obtained all unique ONP print and online advertisements (ads) (N=50) targeted towards US businesses between January 2016 and August 2022 from Vivvix (formerly Numerator Ad Intel). Two independent reviewers coded for type of ONP, brand, nicotine strength(s), flavour(s), slogan(s), claim(s) and frequency of each component.

Results: Most ads featured nicotine pouches alone (52%), while 22% featured a mix of ONPs including pouches, tablets and lozenges. By brand, Rogue constituted 36% of ads, followed by Zyn and On! (16% each). Most (82%) ads featured at least one cooling flavour and 48% displayed at least one fruit flavour. Wintergreen flavour appeared most frequently (48%). Most (72%) ads contained a slogan, which frequently highlighted convenience of use (eg, 'Chew on this Anywhere… Anytime'), bypassing current restrictions on other tobacco and nicotine products use (eg, 'Laughs at no smoking signs') and highlighting big profit margins from sales of ONPs for retailers (eg, 'small pouches big margins').

Conclusion: This analysis provides insight into tobacco companies' strategies for increasing ONP endorsement among retailers. Strategies include appealing to profitability, emphasising convenience of product use and primarily promoting non-tobacco flavours. These findings highlight new trends in ONP products and marketing tactics and identify important areas to monitor to inform tobacco marketing regulations.

Background: E-cigarette products are the most popular tobacco/nicotine product used among youth and young adults in the USA. While emerging research has shown that e-cigarette taxes increase their price, no study to date has examined e-cigarette tax burdens nor their affordability for youth and young adults.

Methods: Using real (2021 US dollars) prices per mL of e-liquid data from NielsenIQ and annual real (2021 US dollars) personal income data from Integrated Public Use Microdata Series, we calculate relative income prices and examine average annual percentage changes in affordability using Joinpoint trend analysis from 2015 to 2021. In addition, we use tax data to calculate e-cigarette tax burdens as a percentage of price per 1 mL of e-liquid.

Results: In all states analysed, tax burdens increased from 2015 to 2021. E-cigarette prices decreased considerably from 2019 to 2021; in 2021 the real (2021 US dollars) average price of 1 mL of e-liquid was US$4.45. E-cigarettes on average became more affordable for all age groups and states; however, e-cigarettes tended to be less affordable in states with ad-valorem tax structures. On average, 16-17-year-olds needed 31% of their annual income to purchase 100 mL of e-liquid, whereas 18-19-year-olds, 20-24-year-olds and 25-34-year-olds needed 9%, 3% and 1%, respectively.

Conclusions: E-cigarettes have become more affordable for young people, but less so in states with ad-valorem tax structures. Policy efforts should focus on reducing e-cigarette affordability, especially for youth, through tax-induced increases in e-cigarette prices to levels high enough to outpace income growth.

Introduction: Rising use of electronic nicotine delivery system (ENDS) among young people, especially those who have never smoked, has received considerable attention from the health community. However, fewer studies have examined the mental health impacts of ENDS use. We addressed this gap by exploring the stigma, altered self-perceptions and negative affect experienced by adolescents who assessed themselves as addicted to using ENDS.

Methods: We interviewed 20 adolescents aged 16-18 who lived in Aotearoa New Zealand and assessed themselves as moderately or highly addicted to ENDS use. Using in-depth, semistructured qualitative interviews, we explored participants' experiences of addiction and its effects on their well-being. We interpreted the data using an inductive reflexive thematic analysis approach.

Results: We identified four key themes. First, addiction to ENDS use adversely affected participants' physical and mental health. Second, addiction greatly diminished the pleasurable effects ENDS use first provided and participants who initially enjoyed using ENDS now felt unable to stop. Third, participants felt judged, stigmatised and belittled by others who did not understand their struggle with addiction. Fourth, they experienced several negative emotions, including self-blame, regret, disappointment and embarrassment that diminished how they saw themselves.

Conclusions: We extend earlier studies by probing the mental health burden ENDS use imposes on young people, offer new insights into how they experience addiction and outline potential policy responses. Measures reducing young people's access to ENDS are urgently needed alongside empathetic, youth-oriented cessation support.

Introduction: This study explored the association between food insecurity and tobacco product use and urine cotinine-measured smoking intensity.

Methods: This cross-sectional study included 13 705 adults representative of the Korean population. The 18-item Household Food Security Survey Module was administered to the primary food managers in households with the scores applied to household members. The use of three tobacco products-combustible cigarettes, heated tobacco products and electronic cigarettes (e-cigarettes)-was assessed. Based on the urine cotinine level, the smoking status of each participant was classified into one of three groups: non-smoker, low-intensity smoker and high-intensity smoker. Logistic regression analysis was used to determine the association between food insecurity and tobacco product use and urine cotinine-measured smoking intensity. ORs and 95% CIs were estimated.

Results: Among the survey participants, 3.2% had mild food insecurity and 0.7% had moderate-to-severe food insecurity. Those with mild food insecurity (23.5%, OR: 1.38, 95% CI: 1.01 to 1.89) and those with moderate-to-severe food insecurity (45.1%, OR: 3.36, 95% CI: 1.87 to 6.03) compared with those with non-food insecurity (18.4%) were positively associated with combustible cigarette use. Those with moderate-to-severe food insecurity was positively associated with e-cigarette use (5.5%, OR: 3.49, 95% CI: 1.31 to 9.28). Compared with those with non-food security (7.9%), those with mild food insecurity (14.3%, OR: 1.61, 95% CI: 1.09 to 2.38) and moderate-to-severe food insecurity (22.1%, OR: 2.25, 95% CI: 1.04 to 4.86) were associated with high-intensity smoking.

Conclusion: Food insecurity is associated with both combustible and e-cigarette use. Those with food insecurity are associated with engagement in high-intensity smoking.

Background: Tobacco industry tactics that have proven effective in the past, such as using corporate social responsibility initiatives to curry favour with policymakers, have been examined in India. However, reporting the tobacco industry's financial contributions to political parties must be closely monitored, and their reporting made transparent.

Methods: Document analysis was conducted for: (i) 'recognised' national and state political parties in India (as on 15 May 2023), (ii) Electoral Trusts listed by Central Board of Direct Taxes, and (iii) Electoral Bonds, available from the Election Commission of India (ECI) website. Annual contributions from top four publicly listed companies (Bombay Stock Exchange 'Top 2000 Companies 2023') and one major non-listed smokeless tobacco company-along with their subsidiaries, associates and joint ventures-were examined. Contribution pathways included direct transfers or indirect routes via Electoral Trusts and Electoral Bonds, spanning 2013-2014 to 2022-2023.

Results: A total of 485 (62.2%) of the 780 expected reports of parties and Trusts were available on ECI website. These were analysed for contributions by 103 tobacco companies and their affiliated entities. Tobacco companies had contributed more than US$ 65 million to 17 political parties between 2013 and 2023. The largest contributors were ITC Limited and its subsidiaries-ITC Infotech India and Russell Credit.

Conclusions: This study documents a less-discussed area in the Indian landscape of tobacco industry interference and highlights the pressing need for comprehensive implementation of the WHO-Framework Convention on Tobacco Control Article 5.3, to prohibit financial contributions by tobacco companies to political parties in India, and ultimately protect public health.

Background: Hand-rolling tobacco (HRT) remains more affordable than factory-made (FM) cigarettes in the UK, which could undermine the health benefits of tobacco tax increases. This study modelled health and economic impacts of raising HRT duty annually to reduce this affordability gap.

Methods: We used the Sheffield Tobacco and Alcohol Policy Model V.2.5.0, an individual-level microsimulation, to project tobacco consumption, spending and health outcomes for adults in England aged 18-89 from 2024 to 2030. Four duty policies were compared against a business-as-usual scenario of duty rising 2% above the Retail Price Index (RPI) annually: Policy A increased duty by RPI+12% in 2024 only (the UK Government's October 2023 policy); Policy B applied RPI+10% annually to align with FM duty by 2030; Policy C applied RPI+12% annually; and Policy D applied RPI+18% annually to equalise average HRT and FM prices by 2030.

Results: Policy A was estimated to prevent 1770 deaths, add 36 947 life years and save the National Health Service £12 million, with greater gains in deprived areas. Policies B-D achieved larger health benefits and reduced inequalities, but increased spending by people who smoke. Policy D generated £3.19 billion additional tax revenue and reduced tobacco industry revenue by £400 million by 2030. Revenue effects depended on assumptions about how higher HRT prices affected FM consumption.

Conclusions: Sustained duty increases on the least expensive tobacco products could deliver substantial public health gains and reduce health inequalities. Such measures should coincide with strong enforcement against illicit tobacco and comprehensive smoking cessation support.