Tobacco Prevention & Cessation最新文献

Introduction: Tobacco use is a global epidemic, with two out of three smokers trying to quit. In Oman, little progress has been made in implementing the WHO FCTC best practice recommendations. This study aims to examine the determinants of quit attempts among tobacco users in Oman.

Methods: A cross-sectional study was conducted using secondary data from the STEPS, Oman, 2017. Descriptive and bivariate analyses were performed initially. Binary logistic regression analysis was performed to examine the association between quit advice and quit attempt (the primary outcome of interest), after adjustments for possible confounders.

Results: Quit attempts were significantly higher among tobacco users with higher level of education (AOR=3.35; 95% CI: 1.67-6.72, p<0.0001), older age groups (AOR=1.77; 95% CI 1.00-3.13, p=0.048), and higher income groups (AOR=2.21; 95% CI: 1.24-3.93, p=0.007), compared to their counterparts. After adjusting for possible confounders, receiving advice from a healthcare worker to quit tobacco products was associated with a 3.13 times higher likelihood of attempting to quit (AOR=3.13; 95% CI: 1.46-6.71, p=0.003). Participants who had seen a health warning on television were 2.06 times more likely to attempt to quit compared to those who did not see one (AOR=2.6; 95% CI: 1.02-4.12, p<0.043).

Conclusions: This study indicates a socioeconomic disparity in quit attempts, with higher rates observed among older adults, individuals with higher level of education, employed individuals, and those with higher monthly income. Quit advice provided by healthcare professionals was significantly associated with more quit attempts. These results highlight the importance of national-level coordination and monitoring to enhance the effectiveness of tobacco cessation program as part of comprehensive multi-sectoral tobacco control efforts. Further research is warranted to explore the broader determinants of quit attempts in Oman.

Introduction: Tobacco product marketing uses flavors to influence consumer perceptions, especially among youth and young adults. In Georgia, where tobacco use is among the highest in the WHO European Region, flavored products are widely available and unregulated. Limited data exist on young adults' perceptions of flavored versus unflavored products.

Methods: This study aimed to assess how young adults in Georgia perceive flavored versus unflavored tobacco products in terms of harm, addictiveness, and social acceptability, and how these perceptions relate to their use intentions. A cross-sectional online survey (April-June 2024) included 400 participants aged 18-25 years measured perceptions on a 1-7 scale for flavored and unflavored cigarettes, e-cigarettes, and heated tobacco products. Perceptions were categorized as less, equal, or more harmful/addictive/acceptable. Multivariable logistic regression examined associations between these perceptions and past-month use and use intentions.

Results: Most participants perceived flavored and unflavored products similarly, but perceptions varied across product types. Flavored e-cigarettes were most often rated as more acceptable (13%) and addictive (12.5%) compared to unflavored e-cigarettes - more frequently than flavored cigarettes (9.5% acceptable, 7.5% addictive) or flavored HTPs (7% acceptable, 9.8% addictive) when compared to their unflavored counterparts. Perceiving flavored products as more harmful to self was associated with lower past-month cigarette use (adjusted odds ratio, AOR=0.18; 95% CI: 0.08-0.40), while perceiving flavored products as more addictive was associated with higher e-cigarette use (AOR=2.78; 95% CI: 1.06-7.28). Among non-past-month users, higher perceived harm to others was associated with lower intention to use flavored cigarettes (AOR=0.040; 95% CI: 0.003-0.622).

Conclusions: Although most participants perceived flavored and unflavored products similarly, small differences in some perceptions contributed to differences in certain use behaviors, supporting stronger regulation of flavored products in Georgia. However, as this is a cross-sectional study, further prospective research is needed to confirm these findings and guide policy.

Introduction: Cue-Restricted Smoking (CRS) is a behavioral technique for smoking cessation that has shown efficacy as an adjunct to pharmacotherapy. In CRS, individuals limit smoking to a standing position while facing a wall in an isolated environment devoid of sensory stimulation. This study aimed to assess the potential impact of CRS in a randomized trial evaluating deep transcranial magnetic stimulation (dTMS), which failed to show significant treatment effects.

Methods: In a randomized, double-blind, sham-controlled trial evaluating dTMS for smoking cessation, 100 participants were instructed to quit smoking by the end of week 1. None achieved cessation. Only 85 participants remained in the protocol beyond week 1 and received guidance to implement CRS during cravings. Cigarette consumption was monitored through self-report, exhaled carbon monoxide (COex), and plasma cotinine levels. Participants were categorized as: no reduction, additional reduction, or cessation. Joinpoint regression was used to assess longitudinal trends.

Results: The 85 participants (68% male; mean age 49 ± 11.6 years) reported a mean of 31 ± 11.2 years of smoking. Beyond week one, 33% had not reduced their consumption, 8% showed a mild reduction, 43% a moderate reduction, and 15% a significant reduction; none achieved cessation. After CRS, 40% (95% CI: 29.5-51.2) reported further reduction, and 16.5% (95% CI: 9.3-26.1) achieved verified cessation by week 12. Joinpoint analysis confirmed significant decreasing trends in cigarette use and COex among the significant reduction and cessation groups.

Conclusions: CRS was associated with clinically meaningful reductions in smoking and biochemically confirmed cessation. It is a low-cost, scalable technique that does not require intensive training or pharmacotherapy. This approach may be advantageous in low-resource settings. It warrants evaluation in larger randomized trials across diverse populations.

Clinical trial registration: The study is registered on the official website of ClinicalTrials.gov.

Identifier: ID NCT03264313.

Introduction: Despite the lack of evidence supporting an association between certain cigarette design features (e.g. filter ventilation) and harm reduction, such features often perpetuate false perceptions of safety among people who smoke. Evaluating how product characteristics shape perceptions and behaviors can help clarify these misconceptions and support the importance of restricting deceptive manufacturing. We explore relationships between cigarette design features and perceptions of smoothness and harm, as well as intention to quit.

Methods: Cigarette brand/variety and consumer perceptions/behaviors data come from the 2019 ITC France Survey, which was administered to a nationally representative sample of French adults. This cross-sectional secondary analysis incorporated cigarette product information reported to the Agency for Food, Environmental and Occupational Health & Safety in 2021. Logistic regression analyses were done using SPSS V27.

Results: Greater own brand cigarette filter length (mm) (adjusted odds ratio, AOR=1.11; 95% CI: 1.05-1.17) was significantly associated with higher odds of perceiving one's own brand as smoother than other brands, while greater open pressure drop (mmWG) (AOR=1.02; 95% CI: 1.00-1.05) was associated with perceiving own-brand as safer than other brands. Respondents who described themselves as being in poor or fair health (vs good health) were more likely to perceive smooth/ultra (AOR=1.70; 95% CI: 1.22-2.37) and their own cigarettes (AOR=1.76; 95% CI: 1.05-2.95) as less harmful, as well as less likely to perceive their own brand as smoother (AOR=0.66; 95% CI: 0.47-0.93). Male (vs female) respondents were more likely to perceive smooth/ultra (AOR=1.88; 95% CI: 1.38-2.55) and their own cigarettes (AOR=1.89; 95% CI: 1.12-3.19) as less harmful.

Conclusions: We found evidence that certain design features and participant characteristics are associated with misconceptions regarding the smoothness and safety of cigarettes. These findings support greater monitoring of potentially deceptive product characteristics.

Introduction: We have developed the 'Two Weeks to Quit' (TWTQ) program, a self-help smoking cessation toolkit. Self-help programs represent a cost-effective and accessible option for successful smoking cessation. TWTQ includes a two-week preparation phase leading up to a quit-smoking date at the end of week two and a four-week period focused on maintaining a smoke-free status. The objective was to assess its effectiveness.

Methods: This prospective observational study, conducted without a control group, evaluated the TWTQ program among smokers aged 18-60 years in Paris, France, between February 2023 and April 2024. Participants were recruited via pharmacies, social media platforms, and through outreach to the general population. Program adherence was monitored weekly by email. The primary outcome was smoking cessation, assessed at the end of the program using the Fagerström test for nicotine dependence and a self-reported smoking status question, corresponding to one month after the theoretical quit date.

Results: Of the 97 participants enrolled, 47 completed the program. At six weeks, 57.4% reported smoking cessation, all on the scheduled quit date. At five months, 40.4% of these participants remained abstinent, with an intent-to-treat abstinence rate of 19.6%. The mean Fagerström score decreased significantly from 4 to 0.87 at six weeks (p<0.001), with sustained reductions at two and five months. Adherence to the step order, pacing, and older age significantly predicted short-term cessation. In contrast, no factor predicted abstinence at five months, and greater use of customizable tools was unexpectedly associated with higher relapse risk.

Conclusions: TWTQ demonstrates potential benefits as a structured self-help program for smoking cessation and tobacco consumption reduction, with sustained effects. Results underscore the need to evaluate both engagement and effectiveness in large-scale campaigns like 'Stoptober'.

The UK Tobacco Industry Interference Index (UKTI) is part of the Global Tobacco Industry Interference Index (GTI). Based on a survey methodology developed by the Southeast Asia Tobacco Control Alliance (SEATCA), and published by the Global Center for Good Governance in Tobacco Control (GGTC), the GTI is a global survey on how governments respond to tobacco industry interference and to what extent they protect their public health policies from the commercial and vested interests of the tobacco industry, as required under the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). Since the first GTI in 2019, the UKTI has been compiled by the Tobacco Control Research Group (TCRG) at the University of Bath. The latest UKTI, the fourth in the series, was published in November 2023. Monitoring, investigating and reporting on industry interference is complex, with large volumes of publicly available information found in multiple locations and formats. These include government sources such as lobbying registers, Hansard reports and registers of interests; tobacco industry sources such as company reports, websites and press releases; and external media including the industry and retail press. TCRG has implemented some innovative methods using a wide range of tools and resources, including open-source intelligence techniques (OSINT) and freedom of information requests (FOIs). These methods are outlined and critically assessed in this article. In doing so, we hope that lessons learned in the UK may be relevant to monitoring of tobacco industry interference elsewhere.

Introduction: Workplace smoking cessation programs are effective in reducing smoking prevalence among employees with a lower socioeconomic position (SEP). However, effective participation of these employees remains challenging. This study evaluates a communication training program designed to equip managers with the skills to personally and actively engage employees in workplace smoking cessation initiatives.

Methods: This study, conducted in the Netherlands (September 2021-March 2023), used Intervention Mapping to develop a 90-minute interactive webinar to improve managers' knowledge, attitudes, self-efficacy, and communication skills related to talking with employees about smoking cessation. A total of 107 managers participated. A mixed-methods approach was used for evaluation, including pre- and post-webinar questionnaires (completed by 50 participants) and two rounds of semi-structured interviews with 18 managers, around 3 and 12 months post-training.

Results: The training led to a small increase in self-efficacy regarding smoking cessation conversations from 3.2 to 3.5 on a scale of 1 to 5 (p=0.015). In the first round of interviews, 5 of the 18 managers had engaged in personal conversations with employees about smoking cessation. Facilitators were a strong belief in one's own ability to succeed; opportunities to practice communication skills; positive past experiences addressing smoking behavior; supportive company regulations and national smoke-free policies and assistance provided by colleagues. Barriers included low confidence in communication skills; perceived time burden; limited motivation or perceived role responsibility; the social sensitivity of the topic and fear of negative reactions; the absence of an in-house cessation program and insufficient organizational support. One year post-training, only one manager had consistently implemented personal communication strategies, while most others cited unchanged barriers and a lack of organizational support as reasons for inaction.

Conclusions: While managers recognized the importance of personal communication for smoking cessation, implementation and maintenance were limited due to personal and organizational barriers. Future training programs should be more extensive and ensure structural organizational support for workplace smoking cessation initiatives.

Introduction: The Global Youth Tobacco Survey (GYTS) is a cross-sectional, schoolbased survey that provides insight into tobacco use and related behaviors among adolescents aged 13-15 years. This study examines trends in tobacco-related attitudes, education, and media exposure among Polish youth, using data from the 2022 GYTS alongside previous surveys conducted in 2003 and 2016.

Methods: The study sample was stratified by geographical regions: rural areas, small towns, and large cities. Data were collected from 98 schools across Poland, involving 95 schools (96.9%), 224 classes (97.8%), and 3985 students (78.9%). The primary analysis focused on 3573 students aged 13-15 years. Data from 2003 and 2016 GYTS editions were also used for comparison. Sampling, data weighting, and the methodological framework followed WHO guidelines.

Results: Between 2003 and 2022, there was a notable decline in the proportion of Polish adolescents receiving tobacco education in school, from 61.4% to 43.1%. Perceptions of the harms of secondhand smoke also fell substantially, from 65.8% to 34.4%. Support for smoke-free policies weakened, with a decline in support for both indoor and outdoor smoking bans. Exposure to anti-tobacco messages in media dropped dramatically, from 89.4% in 2003 to 34.9% in 2022. On the other hand, perceptions that smoking enhances social interactions rose from 40.8% to 45.5%, while tobacco industry advertising and depictions of tobacco use in media remained prevalent, though declining over time.

Conclusions: The findings suggest concerning trends in tobacco-related attitudes and behaviors among Polish adolescents, indicating weakened prevention efforts and a shift towards pro-tobacco norms. The decline in tobacco education, public support for smoke-free policies, and media exposure to anti-tobacco messages highlight the need for renewed public health interventions. Strengthening school-based education, reinforcing smoke-free policies, and regulating tobacco portrayals in media are critical to reversing these trends. Additionally, policy measures such as plain packaging and a ban on tobacco displays at points of sale are necessary to protect future generations from tobacco initiation. Without decisive action, there is a risk of undermining the progress made in tobacco control.