Tobacco Prevention & Cessation最新文献

The illicit trade of tobacco products trade continues to challenge tobacco control efforts in several African countries, including Ghana. Ghana recently ratified the Framework Convention for Tobacco Control (FCTC) Protocol to Eliminate Illicit Trade in Tobacco Products ('the Protocol'). This Protocol aims to eliminate all kinds of illicit tobacco. This study aims to enhance understanding of Ghana's illicit cigarette market size, nature, and contributing factors. In doing so, it will help to inform future tobacco control policy. This study included a desk-based mapping of unpublished data looking at existing documents, reports, and websites (n=24 data sources) from 2012 to 2023 and semi-structured interviews with key informants representing government, civil society organizations, media, and international organizations (n=10). Stakeholders indicated the illicit cigarette market in Ghana to be a cross-border issue, with its extent ranging from 10% to 35% of the total cigarette market. Porous borders, lack of political interest, the tobacco tax structure, industry interference, and poor awareness and capacity of customs officials, were identified as contributing factors. Documents reviewed, highlighted the introduction of tax stamps in 2018, ratification of the Protocol in 2021, and the recent review of tobacco taxes as important steps taken by the government to address the illicit cigarette market. This study provides novel insights into the illicit cigarette market in Ghana and identifies major advances in the government's strategy to address it. However, there remains a need for continuous monitoring of borders, alongside more investment in enforcement, national workshops, and training for customs and government officials on the current tax structure, industry tactics, and full Protocol implementation.

Introduction: In Nigeria, there is very limited evidence on factors that influence shisha smoking, and this hinders effective tobacco control policymaking. We, therefore, aimed to identify factors associated with shisha smoking among the general population adults in Nigeria.

Methods: We conducted a telephone-based, cross-sectional survey between 28 July and 11 September 2022 in 12 states of Nigeria. Our outcome of interest was self-reported current shisha smoking status, and the independent variables included potential behavioral, biological, mental health, environmental, and social determinants of shisha smoking. We performed logistic regression analysis, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) as the measures of association.

Results: We surveyed 1278 individuals: 611 who currently smoked shisha and 667 who did not. The following increased the likelihood of being a person who currently smokes shisha: being a person who currently smokes cigarettes (AOR=5.54; 95% CI: 2.57-11.90) or consumes alcohol (AOR=3.46; 95% CI: 1.91-6.28); and having a family member (AOR=2.32; 95% CI: 1.23-4.40), or one (AOR=22.81; 95% CI: 9.99-52.06) or more (AOR=78.85; 95% CI: 22.50-276.33) close friends who smoke shisha. The following reduced the likelihood of being a person who currently smokes shisha: being older (AOR=0.92; 95% CI: 0.89-0.95) and screening positive for possible generalized anxiety disorder (AOR=0.60; 95% CI: 0.41-0.88). We found sex differences in the factors associated with shisha smoking, particularly on the effects of household wealth, employment status, having family members who smoke shisha, and mental health.

Conclusions: Strategies to curb shisha smoking need to account for the associated biological, social and behavioral factors, including age, cigarette smoking, alcohol consumption, and having family members or close friends who smoke shisha. They should also account for sex differences, and differences that exist between shisha smoking behavior and the smoking of other tobacco products.

Introduction: The tobacco industry presence in the retail environment ensures its access to current and potential tobacco users. Reduction of tobacco retail is an emerging tobacco control measure. Many policies that would potentially lead to reduction in retail are not covered by international tobacco laws and are individually adopted in some jurisdictions. This study examines public perception on potential effect of suggested policies in one of the few countries where tobacco market is increasing, Egypt.

Methods: A cross-sectional online survey study was implemented in Egypt, June 2023 to March 2024 to assess the perception of the public towards 12 suggested policies that aim to reduce both tobacco availability and purchase by regulating the tobacco retail environment. The survey was disseminated through social media and 320 completed responses were received. Responses on perception followed five-point Likert scales.

Results: Participants felt they could easily access tobacco products around places of residence, work, and study. The largest proportion of participants (53.1%) reported good agreement that the suggested policies would have an impact in reducing tobacco availability and retail, while 39.7% had fair agreement, and only 7.2% had poor agreement.

Conclusions: Most participants believe that policies reducing tobacco availability and sales would be effective. Non-users rated these policies as more effective than tobacco users. Younger adults viewed these policies more favorably than older adults. The study suggests public support for tobacco control measures to address the prevalent tobacco retail environment in Egypt, indicating a need for policymakers to adopt these measures to protect future generations. Additional research using larger randomly selected populations in Egypt is needed to corroborate these results.

Introduction: The global burden of tobacco is a significant public health concern, causing millions of deaths, illnesses, and economic losses annually. In Türkiye, tobacco use is deeply ingrained in society, with historical roots dating back to Ottoman times. The nation faces challenges such as high smoking rates, gender disparities, and the popularity of non-cigarette tobacco products. Despite these issues, Türkiye has adhered to the WHO Framework Convention on Tobacco Control (FCTC) and implemented MPOWER strategies to combat tobacco use effectively. This review aims to synthesize Türkiye's comprehensive tobacco control measures, including legislation, smoking cessation initiatives, public awareness campaigns, and taxation policies.

Methods: The study examines the country's strategic actions against the backdrop of its historical context and current challenges. The review leverages data from various sources, including the Global Burden of Disease, national health surveys, and reports on tobacco control efforts and achievements. Stakeholder activities, such as those by the Turkish Ministry of Health and non-governmental organizations, are also explored.

Results: Türkiye has made substantial progress in tobacco control, evidenced by reduced tobacco consumption and addressing key challenges like gender disparities and youth smoking. However, the country continues to face obstacles such as tobacco smuggling, the rise of narghile (hookah) smoking, and ongoing high daily smoking rates. The review highlights the tobacco industry's influence in Türkiye despite strong adherence to FCTC.

Conclusions: Türkiye's efforts in tobacco control represent a significant endeavor to mitigate the public health crisis posed by tobacco use. Through adherence to WHO FCTC guidelines and MPOWER strategies, notable progress has been achieved. Yet, challenges persist, requiring continuous, comprehensive strategies and robust enforcement. Future efforts must focus on strengthening tobacco control measures, ensuring accessibility to smoking cessation services, and countering the tobacco industry's influence, to further reduce tobacco use and its health and economic burdens.

Introduction: Many tobacco smokers try to quit with electronic nicotine delivery systems (ENDS or e-cigarettes). We aimed to describe e-liquid flavors and nicotine concentration use over 6 months in a prospective cohort of smokers willing to quit with ENDS.

Methods: We included 622 participants from the intervention group of the Efficacy, Safety and Toxicology of ENDS randomized controlled trial. Participants were adult smokers smoking at least five cigarettes a day. They received free ENDS and a choice of 6 e-liquid flavors in 4 nicotine concentrations and smoking cessation counseling. We tracked flavor choice and nicotine concentration at 1, 2, 4, and 8 weeks, and at 6 months, after the target quit date, comparing participants who reported only vaping (exclusive e-cigarette users) to those who vaped and smoked (dual users) over the last 7 days. We applied multivariable regression models to compute adjusted risk ratios (ARR).

Results: At Week 1, 66% (n=409) were exclusive e-cigarette users, and 21% (n=129) were dual users. At Month 6, 43% (n=266) were exclusive e-cigarette users, and 16% (n=102) were dual users. While flavor choices were similar at Week 1, at 6 months, exclusive e-cigarette users reported using more fruity flavors than dual users (31% vs 22%, ARR=2.10; 95% CI: 1.21-3.66). The nicotine concentration used initially was similar in both groups and diminished over time. At 6 months, exclusive e-cigarette users used a lower mean nicotine concentration than dual users (6.3 vs 8.2 mg/mL, difference= -1.55; 95% CI: -2.84 - -0.25 mg/mL).

Conclusions: After 6 months, exclusive e-cigarette users used more fruity-flavored e-liquids and chose a lower mean nicotine concentration than dual users.

Introduction: Challenges with designing invitation materials and accessing high risk communities are all factors in encouraging attendance at lung screening. This study focused on ways to improve participation in those potentially eligible for lung screening.

Methods: A total of 50 qualitative interviews and 4 focus groups (n=17) were undertaken with people aged 50-75 years from East Midlands, UK. Individuals were purposively sampled to include those who were potential lung screening participants (PSP: n=39) and family members (FM: n=11) of people who smoke, and therefore potentially eligible for participation. Semi-structured discussion guides explored views on lung screening and ways to support uptake. Interviews and focus groups were audio-recorded, transcribed verbatim and analyzed using the framework approach.

Results: Data highlighted a number of novel findings. Themes centered on involving family members in encouraging lung screening attendance, appropriate phrasing around differing types of tobacco use and considering people who do not smoke within the context of lung screening eligibility.

Conclusions: Exploring the use of family members in encouraging attendance in lung screening may be a valuable, but as yet underused approach. Additional phrasing around varying types of tobacco use may help to clarify invitational materials. Clearer eligibility guidelines regarding lung screening may clarify the role of smoking in lung screening.

Data visualization can communicate information clearly and effectively through graphical means. We developed an industry landscape map to help tobacco regulatory scientists and policymakers understand a high-level overview of the US tobacco industry. This kind of mapping of the market data and deep visualization of companies and their products benefits regulatory science and public health policy in supporting potential knowledge gaps in the regulated industry.

Introduction: Tobacco consumption poses severe health risks, particularly for pregnant women, where it exacerbates maternal and fetal morbidity and mortality. This issue is especially critical among minority groups such as the Roma, who face unique socio-economic and cultural challenges that contribute to higher smoking rates. This study investigates the smoking behaviors of pregnant Roma women and the general population, highlighting the role of midwives in smoking cessation.

Methods: The study involved 142 pregnant women, split equally between Roma women from specific regions in Greece and their counterparts from the general population in 2023. We conducted data collection through multiple site visits, utilizing a comprehensive questionnaire that covered aspects like tobacco use, exposure to passive smoking, and the role of midwives. We performed statistical analysis using SPSS, focusing on differences between the two groups using chisquared tests and linear regression analyses.

Results: We noted significant differences between the groups in age, education level, income, and living conditions (p<0.05). The Roma participants displayed a higher prevalence of smoking during pregnancy (76% vs 54.9%, p=0.018). A higher proportion of the Roma group exhibited moderate to high nicotine dependence compared to the non-Roma group, with 27.8% having moderate and 24.1% having high nicotine dependence (p=0.029). The study also found that Roma women are less likely to have structured healthcare support (17.2% had monitoring from a specific doctor compared to 78.9% of non-Roma, p=0.020) and more likely to engage midwives in discussions about smoking cessation (56.5% vs 48.7%, p=0.024).

Conclusions: The findings emphasize the need for culturally informed healthcare interventions that enhance the training of midwives in smoking cessation techniques. Such approaches are vital for improving health outcomes for pregnant women within marginalized communities like the Roma, where socio-economic and cultural barriers significantly influence health behaviors.

Introduction: This study assessed public support for new tobacco control measures in Poland, including a smoking ban on private balconies, regular tobacco tax increases, and a total ban on tobacco sales.

Methods: A nationwide cross-sectional survey was conducted in 2024 using a computer-assisted web interview (CAWI). The 1080 adults (aged 18-82 years) were interviewed, of which 53% were females. A self-prepared questionnaire included questions on support for various tobacco control measures. The primary outcomes were levels of support for each proposed measure. Attitudes were measured using a 5-point Likert scale, and independent variables included sociodemographic factors and smoking status.

Results: The smoking ban on private balconies was supported by 44.1% of respondents, with higher support among older adults, non-smokers, and those with higher education. Support for annual tobacco tax increases was 47.1%, particularly among younger and middle-aged adults, the educated, and non-smokers. A total of 41.8% of respondents declared support for the total ban on tobacco sales. Higher education, non-smoking status, and voluntary smoke-free home rules were significantly associated (p<0.05) with higher support for all three tobacco control measures. There was no significant impact (p>0.05) of the gender, financial status, household size, and location of the place of residence on public support of analyzed tobacco control measures.

Conclusions: This study revealed that less than half of adults in Poland declare support for extensive tobacco regulations such as a smoking ban on private balconies, taxation increases, and a ban on tobacco sales. Educational level and smoking status are significantly associated with public attitudes toward tobacco control measures.