Tobacco Control最新文献

Objective: To systematically review available data on the effects of heated tobacco products (HTPs) on biomarkers of potential harm (BoPH) and adverse events, including comparison to cigarettes, e-cigarettes and smoking abstinence.

Data sources: Web of Science, Scopus, MedRxiv, ClinicalTrials.gov, ICTRP database and HTP manufacturer libraries were searched from January 2010 to December 2024.

Study selection: Included studies were interventional clinical trials of any design that measured BoPH or adverse events in adults assigned a marketed HTP and another assigned either cigarettes, e-cigarettes or smoking abstinence.

Data extraction: Two reviewers independently extracted data into a predesigned form and assessed risk of bias using Cochrane's Risk of Bias tool version 1.

Data synthesis: BoPH data were synthesised using effect direction plots. A random-effects model was used to calculate pooled risk ratios for adverse event data. 40 studies (10 independent, 29 industry-affiliated and 1 of unclear affiliation) were included. Only nine studies lasted longer than 5 days. 19 involved using the intervention just once. Risk of bias was high for 32 studies and unclear for 8. Data on 143 BoPH indicated short-term HTP use had mixed effects compared with cigarettes, e-cigarettes and smoking abstinence. The rate of adverse event reporting was not significantly different between HTP and any comparator group.

Conclusions: Despite a growing evidence base, significant limitations hinder interpretation of the data, which do not yet provide clear indication of harm or benefit, even compared with cigarettes. Longer, better quality studies independent of tobacco industry funding are needed to determine the health impacts of HTPs.

Introduction: This study offers a comprehensive examination of the pricing strategies/dynamics used by the tobacco/nicotine industry in response to tax increases using Ukraine as a case study during the 2019-2022 tax reforms. This period saw the introduction of new tax categories for heated tobacco products (HTPs) and electronic cigarettes (e-cigs) with concomitant tax increases. This is the first systematic consideration of taxation on these products. The primary objectives are to examine how tax changes influence product pricing and how HTPs are priced vis-a-vis cigarettes, particularly in the context of harmonisedspecific tax rates.

Methodology: NielsenIQ monthly price and sales data for cigarettes, HTPs, and e-cigs, along with official tax data, were used. Tax pass-through analysis was conducted to examine the relationship between tax increases and retail prices by market segment, with net revenue calculations used to evaluate impacts.

Results: The industry usually overshifted taxes on cigarettes (mid-price and premium), HTPs, and e-cigs while undershifting on economy cigarettes during the study period. However, a big HTP tax increase in 2021 was not overshifted to a great extent. The industry also employed a price-smoothing strategy where initial price increases following tax increases were kept moderate, with further increases introduced gradually throughout the year.

Conclusion: The study shows that the industry has used tax increases on HTPs and e-cigs as an opportunity to raise prices but with lower net revenue per stick. The findings suggest that fully harmonising HTP taxes with those on traditional cigarettes could limit the industry's pricing strategies and hence help reduce consumption and generate additional government revenue.

Introduction: In 2012, the Vietnamese government launched its first national tobacco control law, incorporating both demand- and supply-reduction policies. Yet, how people who smoke experience these policies remains unclear. This study explored the experiences of men who currently and formerly smoked cigarettes with existing tobacco control policies.

Methods: We conducted a qualitative focus group study with men who currently and formerly smoked cigarettes. Participants were recruited from two districts of Hanoi, one urban and one mountainous/rural area. Nine focus group discussions were held with 51 individuals (mean age 44 years old, 35 smoked daily, 4 smoked occasionally and 12 smoked formerly), using a semi-structured guide. Findings were analysed using manifest content analysis with an inductive approach.

Results: The analysis identified three main categories: health warnings shift attitudes towards smoking; inconsistent enforcement undermines compliance; and persistent barriers to behaviour change. Participants described how health warnings prompted them to reconsider their smoking habits, while also highlighting barriers in translating policy awareness into sustained behavioural change.

Conclusion: Men who smoke in Vietnam described a nuanced interplay between awareness of tobacco control policies and their behavioural responses. Their narratives revealed a gap between recognising policies and experiencing their implementation in daily life. These challenges underscore the need for stronger enforcement of smoke-free environments, stricter regulation on youth tobacco access, increased cigarette taxation and culturally tailored, continuous public education campaigns. A comprehensive approach addressing both individual and systemic barriers is essential to advancing smoking cessation efforts in Vietnam.

Background: Tobacco price is an important determinant of smoking behaviour. Using electronic point-of-sales (EPOS) data, this study assesses purchase price of factory-made cigarettes (FMC) and roll-your-own (RYO) tobacco across neighbourhood deprivation and urban/rural status in Britain. It considers price changes, 2016-2021 and brand price segmentation.

Methods: The analysis uses EPOS data describing 10 156 106 tobacco packs sold from 1012 convenience stores, across 24 seasonally-distributed weeks (2016-2021). Gross sales prices were adjusted for inflation and presented per 20 cigarette sticks of FMC and equivalent RYO. Tobacco brand variants were assigned to four price segments (sub value, value, midprice and premium).

Results: Between 2016-2021, the sales-weighted price of tobacco (20 sticks or equivalent) reduced from £8.72 to £8.10, reflecting a shift from FMC to RYO (RYO increasing from 32-46% of tobacco sales). The mean price of 20 sticks of FMC in the most deprived neighbourhoods was 5% (£0.51-£0.59) lower compared with the least deprived in all years; for RYO, this price difference grew from 3% to 5% (£0.13-£0.28). The greater likelihood that tobacco was from lower price segments in more deprived areas largely accounted for this price difference.

Conclusions: Differences in average price paid for tobacco between more and less deprived neighbourhoods reflect variations in numbers of purchases across price segments. Combined (FMC and RYO) tobacco prices per stick have fallen, reflecting increasing RYO sales. Innovative approaches are required to respond to the tobacco industry's price differentiation by both price segment and product type and the growing importance of lower price RYO products.

Background: Tobacco imagery in music videos can glamorise smoking, influencing youth attitudes and behaviours, yet its prevalence in Nigerian music, a global cultural force driven mainly by the Afrobeats genre, remains underexplored.

Methods: This content analysis examined tobacco imagery in 880 Nigerian music videos from 1999 to 2023, sourced from YouTube based on top song charts. Videos were coded for user demographics, tobacco product types and paraphernalia across 15 s episodes. Trends were analysed, and future prevalence was forecasted to 2050 using the Holt-Winters method.

Results: Tobacco imagery was observed in 153 of 880 videos (17.4%), having combined 3.1 billion YouTube views. Cigarettes (51%) and cigars (34%) dominated, followed by shisha (7%), tobacco pipe (5%) and e-cigarettes (3%). Tobacco imagery appeared in the first 15 s of 23% of videos. Five artists accounted for 28% of videos with tobacco imagery and 33% of the tobacco events. The proportion of videos with tobacco imagery increased by 1.58 percentage points annually and is projected to exceed 55% by 2050 without intervention.

Conclusions: Tobacco imagery is prevalent in Nigerian music videos, amplified by Afrobeats' global reach and youth viewership. The upward trend and shift towards newer products like shisha and e-cigarettes signal evolving public health risks and underscores the need for robust enforcement of existing regulations, alongside artist and corporate engagement to mitigate tobacco normalisation.

Objective: Financial incentives, provided following validated smoking cessation, hold substantial potential to cost-effectively promote cessation. To facilitate wider adoption, we systematically reviewed evidence addressing the barriers and facilitators to successful implementation of incentive-based smoking cessation interventions among (expectant) parents.

Data sources: We conducted a systematic search to identify scientific and grey literature across nine electronic databases, from inception to 15 August 2024. Search terms included combinations of "smoking cessation", "incentive", "pregnancy", "preconception" and "parent".

Study selection: Eligible records reported and reflected on the implementation of smoking cessation programmes with incentives for (expectant) parents. Inclusion criteria were applied by two reviewers independently, with discrepancies resolved through consensus. Of 1100 unique records identified, 37 met inclusion criteria.

Data extraction: Characteristics of the studies, interventions, incentives and implementation, along with barriers and facilitators, were independently extracted by two reviewers. Thematic analysis identified barriers and facilitators. Subgroup analysis explored patterns specific to lower socioeconomic populations.

Data synthesis: Studies reported on implementation in the USA (n=18), UK (n=10), Australia (n=4), the Netherlands (n=2), New Zealand (n=1), France (n=1) and international contexts (n=1). Barriers included misalignment with participants' context and resources, recruitment and retention challenges, limited reliability of abstinence verification and high resource demands. Facilitators included ensuring acceptability, accessibility, feasibility, funding and integration into health services.

Conclusions: With the cost-effectiveness of financial incentives for smoking cessation among (expectant) parents already well-documented, this first systematic synthesis of the barriers and facilitators to implementing them in daily practice offers valuable guidance for advancing implementation efforts.

Prospero registration number: 2023:CRD42023407648.

Objective: The aim of this study was to investigate the presence and the evolution of synthetic coolants in cigarettes and heated tobacco products (HTPs) in the context of the recent ban on characterising flavours in these tobacco products including the menthol-flavoured ones in the European Union (EU).

Methodology: A list of synthetic coolants was set up. A data search was conducted in the EU Common Entry Gate for cigarettes and HTPs registered in the period 2017 to 2023 containing one or more of these synthetic coolants. Within this timeframe, the prohibition of menthol as a characterising flavour, in cigarettes and HTPs, entered into force in 2020 and 2023 respectively.

Results: Seven synthetic coolants (n=7) were identified in cigarettes and HTPs: WS3, WS23, WS5, WS27, isopulegol, menthyl lactate and monomenthyl succinate. WS3 and WS23 were the predominant coolants in cigarettes and HTPs. WS27 and monomenthyl succinate were mainly applied in cigarettes, while isopulegol was strongly present in HTPs. WS5 and menthyl lactate were the least applied substances. With some exceptions, menthol has been increasingly removed from cigarettes containing synthetic coolants. A significant increase in the number of cigarettes and HTPs containing synthetic coolants was recorded for 2022, with products being marketed in almost all EU Member States.

Conclusions: From 2020 onwards, a trend towards the addition of synthetic coolants was observed. In more and more EU Member States, industry has been steadily bringing more products containing synthetic coolants onto the market. The compatibility of these products with the provisions of EU tobacco legislation is being questioned.

Objective: Places with more tobacco retailers have higher smoking prevalence levels, but whether this is because retailers locate where people who smoke live or whether tobacco availability prompts tobacco use is unknown. In this study, we compare the role of consumer demand with that of tobacco supply in longitudinal, area-based associations of tobacco retailer density with smoking prevalence.

Methods: We merged annual adult smoking prevalence estimates derived from the USA Behavioural Risk Factor Surveillance System data with annual county estimates of tobacco retailer density calculated from the National Establishment Time Series data for 3080 counties between 2000 and 2010. We analysed relationships between retailer density and smoking in 3080 counties, using random intercept cross-lagged panel models and employing two measures of tobacco retailer density capturing the number of likely tobacco retailers in a county divided by either the population or land area.

Results: Both density models provided evidence of significant demand and supply effects; in the population-based model, the association of smoking prevalence in 1 year with tobacco retailer density in the next year (standardised coefficient=0.038, p<0.01) was about double the association between tobacco retailer density with subsequent smoking prevalence (0.017, p<0.01). The reverse was true in the land area-based model, where the supply effect (0.042, p<0.01) was more than 10 times stronger than the demand effect (0.003, p<0.01).

Conclusions: Policies that restrict access to retail tobacco have the potential to reduce smoking prevalence, but pairing such policies with interventions to reduce consumer demand remains important.