Pub Date : 2020-07-31DOI: 10.1108/dat-05-2020-0025
Linda Somerville, B. Thom, R. Herring
The Police Reform and Social Responsibility Act of 2011, added ‘health bodies’ as responsible authorities in licensing and, in practice, Directors of Public Health undertook this role. Despite this legislation facilitating the inclusion of public health in partnerships around licensing in England, wide variations in involvement levels by Public Health professionals persist This article is based on the findings from interviews that explored the experiences of public health professionals engaging with local established partnerships around alcohol licensing. Qualitative data were collected through twenty-one interviews in a purposeful sample of London boroughs. These data were combined with analyses of relevant area documentation and observations of fourteen licensing sub-committee meetings in one London borough over a seven-month period. Thematic analysis of all data sources was conducted to identify emerging themes. This study highlighted the importance of successful navigation of the ‘contested space’ (Hunter and Perkins, 2014) surrounding both public health practice and licensing partnerships. In some instances, contested spaces were successfully negotiated and public health departments achieved an increased level of participation within the partnership. Ultimately, improvements in engagement levels of public health teams within licensing could be achieved. The paper explores a neglected aspect of research around partnership working and highlights the issues arising when a new partner attempts to enter an existing partnership.
{"title":"Public health participation in alcohol licensing decisions in England: the importance of navigating “contested space”","authors":"Linda Somerville, B. Thom, R. Herring","doi":"10.1108/dat-05-2020-0025","DOIUrl":"https://doi.org/10.1108/dat-05-2020-0025","url":null,"abstract":"The Police Reform and Social Responsibility Act of 2011, added ‘health bodies’ as responsible authorities in licensing and, in practice, Directors of Public Health undertook this role. Despite this legislation facilitating the inclusion of public health in partnerships around licensing in England, wide variations in involvement levels by Public Health professionals persist This article is based on the findings from interviews that explored the experiences of public health professionals engaging with local established partnerships around alcohol licensing. Qualitative data were collected through twenty-one interviews in a purposeful sample of London boroughs. These data were combined with analyses of relevant area documentation and observations of fourteen licensing sub-committee meetings in one London borough over a seven-month period. Thematic analysis of all data sources was conducted to identify emerging themes. \u0000 \u0000This study highlighted the importance of successful navigation of the ‘contested space’ (Hunter and Perkins, 2014) surrounding both public health practice and licensing partnerships. In some instances, contested spaces were successfully negotiated and public health departments achieved an increased level of participation within the partnership. Ultimately, improvements in engagement levels of public health teams within licensing could be achieved. \u0000 \u0000The paper explores a neglected aspect of research around partnership working and highlights the issues arising when a new partner attempts to enter an existing partnership.","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-05-2020-0025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44647945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-31DOI: 10.1108/dat-02-2020-0005
Alexandra H. Solomon
Purpose This paper aims to provide a gendered analysis of the WHO Framework Convention on Tobacco Control (FCTC) benchmarked upon the global commitments to women’s health and well-being in the UN Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and the Beijing Declaration and Platform for Action. It reviews evidence of the global consequences of neglecting women’s tobacco use and health, as well as analyzes persistent issues related to sex and gender that compromise the efficacy of tobacco control and science. Actionable recommendations are made to the Conference of the Parties to the FCTC and other key stakeholders. Design/methodology/approach This paper draws upon empirical studies, literature reviews and global health data at the varying intersections of gender, sex, tobacco and global health. Findings The global tobacco control framework and its implementation by state governments have been largely gender blind to date with dire health and economic consequences, including inequitable positive outcomes for men compared to women, and an increase in women’s smoking with associated morbidity and mortality. Gender equitable progress in combatting the tobacco epidemic will not be possible without resolving the gender bias, stigmatization, sexism and lack of intersectionality that plague tobacco control policy, research and interventions for cessation and harm reduction. Originality/value This paper provides an updated global overview of current trends in women’s tobacco use and comprehensively details the persistent structural barriers in tobacco control and science that limit their capacity to effectively analyze and address tobacco use and its impact on women.
{"title":"Gender, women, and the future of tobacco control","authors":"Alexandra H. Solomon","doi":"10.1108/dat-02-2020-0005","DOIUrl":"https://doi.org/10.1108/dat-02-2020-0005","url":null,"abstract":"\u0000Purpose\u0000This paper aims to provide a gendered analysis of the WHO Framework Convention on Tobacco Control (FCTC) benchmarked upon the global commitments to women’s health and well-being in the UN Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and the Beijing Declaration and Platform for Action. It reviews evidence of the global consequences of neglecting women’s tobacco use and health, as well as analyzes persistent issues related to sex and gender that compromise the efficacy of tobacco control and science. Actionable recommendations are made to the Conference of the Parties to the FCTC and other key stakeholders.\u0000\u0000\u0000Design/methodology/approach\u0000This paper draws upon empirical studies, literature reviews and global health data at the varying intersections of gender, sex, tobacco and global health.\u0000\u0000\u0000Findings\u0000The global tobacco control framework and its implementation by state governments have been largely gender blind to date with dire health and economic consequences, including inequitable positive outcomes for men compared to women, and an increase in women’s smoking with associated morbidity and mortality. Gender equitable progress in combatting the tobacco epidemic will not be possible without resolving the gender bias, stigmatization, sexism and lack of intersectionality that plague tobacco control policy, research and interventions for cessation and harm reduction.\u0000\u0000\u0000Originality/value\u0000This paper provides an updated global overview of current trends in women’s tobacco use and comprehensively details the persistent structural barriers in tobacco control and science that limit their capacity to effectively analyze and address tobacco use and its impact on women.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-02-2020-0005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46589999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-15DOI: 10.1108/dat-02-2020-0006
A. Yurekli, P. Kovacevic, E. Sunley, Karthika Ranganathan
This paper aims to describe the various government measures that regulate the market for novel tobacco harm reduction products (THRPs), with an emphasis on e-cigarettes [electronic nicotine delivery systems (“ENDS”)], and evaluates the public health impact of excise taxes levied on these products.,The paper reviews the economic research on the impact ENDS. Using cited evidence, the paper compares the tax treatment of ENDS and cigarettes and provides a simulation of potential lives that can be saved under alternative tax treatment of ENDS.,ENDS are considerably less harmful than cigarettes. Imposing the same tax burden on them (per unit of “harm”) as on cigarettes leads to poorer health outcomes. Differential tax treatment of ENDS will encourage more cigarette smokers to switch to ENDS and could save millions of lives worldwide.,Country experiences with regulatory measures on ENDS are limited to those with high THRP penetration. The paper’s simulation analysis used evidence from a limited number of studies. Rigorous economic analysis is needed to understand how ENDS could save lives and could prevent expected one billion premature deaths by the end of this century.,The paper uses research evidence in its analysis of the impact that the differential taxation of cigarettes and ENDS would have. It also provides a rough estimate of the number of lives that could be saved if more smokers who are trying to quit can make the switch to ENDS.
{"title":"Government intervention in the market for electronic nicotine delivery systems (ENDS). The known, the unknown and challenges","authors":"A. Yurekli, P. Kovacevic, E. Sunley, Karthika Ranganathan","doi":"10.1108/dat-02-2020-0006","DOIUrl":"https://doi.org/10.1108/dat-02-2020-0006","url":null,"abstract":"This paper aims to describe the various government measures that regulate the market for novel tobacco harm reduction products (THRPs), with an emphasis on e-cigarettes [electronic nicotine delivery systems (“ENDS”)], and evaluates the public health impact of excise taxes levied on these products.,The paper reviews the economic research on the impact ENDS. Using cited evidence, the paper compares the tax treatment of ENDS and cigarettes and provides a simulation of potential lives that can be saved under alternative tax treatment of ENDS.,ENDS are considerably less harmful than cigarettes. Imposing the same tax burden on them (per unit of “harm”) as on cigarettes leads to poorer health outcomes. Differential tax treatment of ENDS will encourage more cigarette smokers to switch to ENDS and could save millions of lives worldwide.,Country experiences with regulatory measures on ENDS are limited to those with high THRP penetration. The paper’s simulation analysis used evidence from a limited number of studies. Rigorous economic analysis is needed to understand how ENDS could save lives and could prevent expected one billion premature deaths by the end of this century.,The paper uses research evidence in its analysis of the impact that the differential taxation of cigarettes and ENDS would have. It also provides a rough estimate of the number of lives that could be saved if more smokers who are trying to quit can make the switch to ENDS.","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-02-2020-0006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47490702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-15DOI: 10.1108/dat-04-2020-0021
Linda Sowoya, Chifundo Akamwaza, A. Matola, A. Klein
Purpose The purpose of this paper is to illustrate the opportunities for tobacco farmers in Malawi from diversifying to cannabis, and the potential benefits for reducing deforestation by producing a cannabis based alternative fuel. It further argues that there are tensions between the conflicting objectives of the Framework Convention on Tobacco Control and the Single Convention on Narcotic Drugs. Design/methodology/approach Field interviews were conducted with cannabis farmers, traders and sellers in different parts of Malawi. Findings The findings of this study show that there are opportunities for cannabis farmers but they have been blocked by legal impediments. Now that legislative reform have made cannabis cultivation possible, farmers need support in developing products. Research limitations/implications Any attempt to provide a precise assessment of the cannabis market in Malawi is constrained by the criminalised status of the product. The suitability of cannabis briquettes as an fuel has yet to be trialled in Malawi. Social implications There is an urgent need to revise the drug control conventions to address environmental degradation and deforestation. Originality/value The linkage between tobacco farming, deforestation and desertification in Malawi has not been made. This is the first time that hemp has been suggested as an alternative crop for farmers and as a solution to deforestation.
{"title":"Goodbye Nicky hello Goldie – exploring the opportunities for transitioning tobacco farmers into cannabis production in Malawi","authors":"Linda Sowoya, Chifundo Akamwaza, A. Matola, A. Klein","doi":"10.1108/dat-04-2020-0021","DOIUrl":"https://doi.org/10.1108/dat-04-2020-0021","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to illustrate the opportunities for tobacco farmers in Malawi from diversifying to cannabis, and the potential benefits for reducing deforestation by producing a cannabis based alternative fuel. It further argues that there are tensions between the conflicting objectives of the Framework Convention on Tobacco Control and the Single Convention on Narcotic Drugs.\u0000\u0000\u0000Design/methodology/approach\u0000Field interviews were conducted with cannabis farmers, traders and sellers in different parts of Malawi.\u0000\u0000\u0000Findings\u0000The findings of this study show that there are opportunities for cannabis farmers but they have been blocked by legal impediments. Now that legislative reform have made cannabis cultivation possible, farmers need support in developing products.\u0000\u0000\u0000Research limitations/implications\u0000Any attempt to provide a precise assessment of the cannabis market in Malawi is constrained by the criminalised status of the product. The suitability of cannabis briquettes as an fuel has yet to be trialled in Malawi.\u0000\u0000\u0000Social implications\u0000There is an urgent need to revise the drug control conventions to address environmental degradation and deforestation.\u0000\u0000\u0000Originality/value\u0000The linkage between tobacco farming, deforestation and desertification in Malawi has not been made. This is the first time that hemp has been suggested as an alternative crop for farmers and as a solution to deforestation.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-04-2020-0021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44650127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-13DOI: 10.1108/dat-01-2020-0001
S. Patwardhan, J. Rose
The purpose of this paper is to review the barriers in the dissemination of effective smoking cessation treatments and services globally. Offering tobacco users help to stop using tobacco is a key demand reduction measure outlined under Article 14 of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC). Implementing Article 14 can reap great dividends for the billion plus tobacco users around the world and their families, friends and societies.,A review of the status of the global implementation of Article 14 using available literature on smoking cessation products, services and national guidelines. Discussing innovative approaches being currently explored in South Asia that can lead to faster adoption and implementation of Article 14 globally.,Major gaps remain in cessation products’ availability and resource allocation for cessation services globally. Current licensed products are falling short on delivering and sustaining smoking cessation. Innovation in cessation products and services needs to build on learnings in nicotine pharmacokinetics, behavioural insights from consumer research and tap into 21st century tools such as mobile based apps. National implementation of FCTC’s Article 14 needs to follow guidelines that encourage integration into existing health programmes and health-care practitioners’ (HCPs) upskilling.,Smoking cessation is a desirable health outcome and nicotine replacement products are a means of achieving cessation through tobacco harm reduction. E-cigarettes are sophisticated nicotine replacement products. Innovation is urgently needed to fill the gaps in smoking cessation products and services, and for converting global policy into local practice. In low- and middle-income countries (LMICs), HCPs’ knowledge, attitudes and practice regarding tobacco use and cessation may hold the key to rapidly scaling up cessation support and delivery to achieve FCTC objectives sooner. Additionally, HCPs can play an important role in offering smoking cessation support in existing national health programmes for TB, cancer screening and maternal and child health. Also, widely prevalent smartphone devices may deliver smoking cessation through telemedicine in LMICs sooner, leapfrogging the hurdles of the existing health-care infrastructure.
{"title":"Overcoming barriers to disseminate effective smoking cessation treatments globally","authors":"S. Patwardhan, J. Rose","doi":"10.1108/dat-01-2020-0001","DOIUrl":"https://doi.org/10.1108/dat-01-2020-0001","url":null,"abstract":"The purpose of this paper is to review the barriers in the dissemination of effective smoking cessation treatments and services globally. Offering tobacco users help to stop using tobacco is a key demand reduction measure outlined under Article 14 of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC). Implementing Article 14 can reap great dividends for the billion plus tobacco users around the world and their families, friends and societies.,A review of the status of the global implementation of Article 14 using available literature on smoking cessation products, services and national guidelines. Discussing innovative approaches being currently explored in South Asia that can lead to faster adoption and implementation of Article 14 globally.,Major gaps remain in cessation products’ availability and resource allocation for cessation services globally. Current licensed products are falling short on delivering and sustaining smoking cessation. Innovation in cessation products and services needs to build on learnings in nicotine pharmacokinetics, behavioural insights from consumer research and tap into 21st century tools such as mobile based apps. National implementation of FCTC’s Article 14 needs to follow guidelines that encourage integration into existing health programmes and health-care practitioners’ (HCPs) upskilling.,Smoking cessation is a desirable health outcome and nicotine replacement products are a means of achieving cessation through tobacco harm reduction. E-cigarettes are sophisticated nicotine replacement products. Innovation is urgently needed to fill the gaps in smoking cessation products and services, and for converting global policy into local practice. In low- and middle-income countries (LMICs), HCPs’ knowledge, attitudes and practice regarding tobacco use and cessation may hold the key to rapidly scaling up cessation support and delivery to achieve FCTC objectives sooner. Additionally, HCPs can play an important role in offering smoking cessation support in existing national health programmes for TB, cancer screening and maternal and child health. Also, widely prevalent smartphone devices may deliver smoking cessation through telemedicine in LMICs sooner, leapfrogging the hurdles of the existing health-care infrastructure.","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-01-2020-0001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47098354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-13DOI: 10.1108/dat-12-2019-0054
Andreas Zaunseder, A. Bancroft
Purpose Trading illicit drugs on cryptomarkets differs in many ways from material retail markets. This paper aims to contribute to existing studies on pricing by studying the relationship between price changes in relation to changes in nominal value of the cryptocurrency. To this, the authors qualitatively study product descriptions and images to expand the knowledge on price formation. Design/methodology/approach The authors analysed 15 samples based on visual and textual scrapes from two major drug markets – for Dream Market between January 2014 and July 2015 and for Tochka between January 2015 and July 2015. This longitudinal study relates changes in process to variations in the Bitcoin exchange rate and selling strategies. The analysis of the marketing of drugs online also addressed the development of the vendor profile and product offers. Findings Product prices change in relation to variations in the Bitcoin exchange rate. This points to the application of mechanisms for automatic price adaptations on the market level. Real prices of the drug offers constantly increase. The authors assert that there is a bidirectional relationship. Vendors structure price and discounts to encourage feedback. And feedback in combination with signals of commitment and authenticity inform pricing. Product descriptions are an important feature in the successful marketization of goods, whereas product images are predominantly used as an aspect of recognisability and feature of the vendor’s identity. Research limitations/implications Findings suggest that there is great potential for further qualitative research into the relationship between the online and offline identity of drug vendors, as well as price setting when entering the market and subsequent changes for offered products. Practical implications Findings also suggest that further investigation into the constitution and management of vendor’s identity on the cryptomarkets would allow a better understanding of vendors and their interactions on cryptomarkets. Social implications A better understanding of drug trading on cryptomarkets helps to more effectively address potentials for harm in the online drug trade. Also targetting crime would benefit from a better understanding of vendor idenities and pricing. Originality/value The findings represent a valuable contribution to existing knowledge on drug trading on cryptomarkets, particularly in view of pricing and vending strategies.
{"title":"Pricing of illicit drugs on darknet markets: a conceptual exploration","authors":"Andreas Zaunseder, A. Bancroft","doi":"10.1108/dat-12-2019-0054","DOIUrl":"https://doi.org/10.1108/dat-12-2019-0054","url":null,"abstract":"\u0000Purpose\u0000Trading illicit drugs on cryptomarkets differs in many ways from material retail markets. This paper aims to contribute to existing studies on pricing by studying the relationship between price changes in relation to changes in nominal value of the cryptocurrency. To this, the authors qualitatively study product descriptions and images to expand the knowledge on price formation.\u0000\u0000\u0000Design/methodology/approach\u0000The authors analysed 15 samples based on visual and textual scrapes from two major drug markets – for Dream Market between January 2014 and July 2015 and for Tochka between January 2015 and July 2015. This longitudinal study relates changes in process to variations in the Bitcoin exchange rate and selling strategies. The analysis of the marketing of drugs online also addressed the development of the vendor profile and product offers.\u0000\u0000\u0000Findings\u0000Product prices change in relation to variations in the Bitcoin exchange rate. This points to the application of mechanisms for automatic price adaptations on the market level. Real prices of the drug offers constantly increase. The authors assert that there is a bidirectional relationship. Vendors structure price and discounts to encourage feedback. And feedback in combination with signals of commitment and authenticity inform pricing. Product descriptions are an important feature in the successful marketization of goods, whereas product images are predominantly used as an aspect of recognisability and feature of the vendor’s identity.\u0000\u0000\u0000Research limitations/implications\u0000Findings suggest that there is great potential for further qualitative research into the relationship between the online and offline identity of drug vendors, as well as price setting when entering the market and subsequent changes for offered products.\u0000\u0000\u0000Practical implications\u0000Findings also suggest that further investigation into the constitution and management of vendor’s identity on the cryptomarkets would allow a better understanding of vendors and their interactions on cryptomarkets.\u0000\u0000\u0000Social implications\u0000A better understanding of drug trading on cryptomarkets helps to more effectively address potentials for harm in the online drug trade. Also targetting crime would benefit from a better understanding of vendor idenities and pricing.\u0000\u0000\u0000Originality/value\u0000The findings represent a valuable contribution to existing knowledge on drug trading on cryptomarkets, particularly in view of pricing and vending strategies.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-12-2019-0054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44598864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-13DOI: 10.1108/dat-02-2020-0007
R. O’Leary, R. Polosa
Purpose This paper aims to overview the need for tobacco harm reduction, the consumer products that facilitate tobacco harm reduction and the barriers to its implementation. The worldwide endemic of tobacco smoking results in the death of over seven million smokers a year. Cigarette quit rates are very low, from 3%–12%, and relapse rates are high, from 75%–80% in the first six months and 30%–40% even after one year of abstinence. In addition, some smokers do not desire to quit. Cigarette substitution in tobacco harm reduction is one strategy that may reduce the burden of morbidity and mortality. Design/methodology/approach This review examines the displacement of smoking through substitution of non-combustible low-risk products such as snus, heated tobacco products and e-cigarettes. Findings Toxicological testing, population studies, clinical trials and randomized controlled trials demonstrate the potential reductions in exposures for smokers. Many barriers impede the implementation of product substitution in tobacco harm reduction. These products have been subjected to regulatory bans and heavy taxation and are rejected by smokers and society based on misperceptions about nicotine, sensational media headlines and unsubstantiated fears of youth addiction. These barriers will need to be addressed if tobacco harm reduction is to make the maximum impact on the tobacco endemic. Originality/value This review provides the rationale for tobacco harm reduction, evaluates the current products available and identifies the barriers to implementation.
{"title":"Tobacco harm reduction in the 21st century","authors":"R. O’Leary, R. Polosa","doi":"10.1108/dat-02-2020-0007","DOIUrl":"https://doi.org/10.1108/dat-02-2020-0007","url":null,"abstract":"\u0000Purpose\u0000This paper aims to overview the need for tobacco harm reduction, the consumer products that facilitate tobacco harm reduction and the barriers to its implementation. The worldwide endemic of tobacco smoking results in the death of over seven million smokers a year. Cigarette quit rates are very low, from 3%–12%, and relapse rates are high, from 75%–80% in the first six months and 30%–40% even after one year of abstinence. In addition, some smokers do not desire to quit. Cigarette substitution in tobacco harm reduction is one strategy that may reduce the burden of morbidity and mortality.\u0000\u0000\u0000Design/methodology/approach\u0000This review examines the displacement of smoking through substitution of non-combustible low-risk products such as snus, heated tobacco products and e-cigarettes.\u0000\u0000\u0000Findings\u0000Toxicological testing, population studies, clinical trials and randomized controlled trials demonstrate the potential reductions in exposures for smokers. Many barriers impede the implementation of product substitution in tobacco harm reduction. These products have been subjected to regulatory bans and heavy taxation and are rejected by smokers and society based on misperceptions about nicotine, sensational media headlines and unsubstantiated fears of youth addiction. These barriers will need to be addressed if tobacco harm reduction is to make the maximum impact on the tobacco endemic.\u0000\u0000\u0000Originality/value\u0000This review provides the rationale for tobacco harm reduction, evaluates the current products available and identifies the barriers to implementation.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-02-2020-0007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43749303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-10DOI: 10.1108/dat-04-2020-0022
Sarah Rajkumar, Nada Adibah, Michael J. Paskow, Brian E. Erkkila
Nicotine is widely known as a tobacco constituent and for its use as a tobacco cessation aid. The development of new devices for nicotine delivery in recent years has led to uncertainty among consumers regarding the health risks of nicotine relative to tobacco. The purpose of this study was to discover if current and former consumers of tobacco and tobacco harm reduction (THR) products could distinguish between “nicotine” and “cigarettes” and examined the preceding media dialogue to determine if conflicting messages by the media influence public perceptions.,A quantitative survey was administered online in Norway (NO), Japan (JP), the United Kingdom (UK) and the United States (US), while face-to-face computer-aided interviews were conducted with randomly selected samples in India (IN), Greece (GR) and South Africa (SA). Participants were between 18 and 69 years of age and either current users of tobacco and THR products or previous users who quit within the past five years. Questions assessed beliefs about harmfulness of nicotine. Nicotine and other products and substances were also independently rated for harmfulness on a scale of 1–10 and subsequently compared. In addition, the authors examined the media dialogue of top media outlets in four countries to assess the potential influence on people’s beliefs.,A total of 54,267 participants (NO: 1,700, JP: 2,227, UK: 2,250, USA: 2,309, IN: 41,633, GR: 1,801, SA: 2,359) were sampled with the percentage of women participants ranging from 14.8% (IN) to 53.8% (UK). Between 68.3% (men, IN) and 88.7% (men, USA) of current consumers believed nicotine is harmful. Current consumers who agreed with the statement that nicotine is the primary cause of tobacco-related cancer ranged from 43.7% (men, UK) to 78.0% (men, SA). In six countries nicotine was rated nearly as harmful as cigarettes and alcohol, while other substances such as sugar, salt or caffeine, were usually rated as less harmful.,A large proportion of consumers across all surveyed countries view nicotine and cigarettes similarly. Clearer communication on the harmful properties of both by the media is needed to help consumers make informed decisions about products across the continuum of risk. Messaging to consumers, especially via the media, propagates misinformation about the relative harms of tobacco and nicotine through reporting that is often incomplete and biased toward more negative aspects.,This study specifically assessed public perceptions of nicotine as opposed to products containing nicotine, which is the focus of previous studies. Apart from showing that consumers often incorrectly perceive nicotine and cigarettes as similar in terms of harmfulness, the authors highlight the need for more accurate and complete reporting by the media to clarify widespread misunderstandings and mitigate public uncertainty.
{"title":"Perceptions of nicotine in current and former users of tobacco and tobacco harm reduction products from seven countries","authors":"Sarah Rajkumar, Nada Adibah, Michael J. Paskow, Brian E. Erkkila","doi":"10.1108/dat-04-2020-0022","DOIUrl":"https://doi.org/10.1108/dat-04-2020-0022","url":null,"abstract":"Nicotine is widely known as a tobacco constituent and for its use as a tobacco cessation aid. The development of new devices for nicotine delivery in recent years has led to uncertainty among consumers regarding the health risks of nicotine relative to tobacco. The purpose of this study was to discover if current and former consumers of tobacco and tobacco harm reduction (THR) products could distinguish between “nicotine” and “cigarettes” and examined the preceding media dialogue to determine if conflicting messages by the media influence public perceptions.,A quantitative survey was administered online in Norway (NO), Japan (JP), the United Kingdom (UK) and the United States (US), while face-to-face computer-aided interviews were conducted with randomly selected samples in India (IN), Greece (GR) and South Africa (SA). Participants were between 18 and 69 years of age and either current users of tobacco and THR products or previous users who quit within the past five years. Questions assessed beliefs about harmfulness of nicotine. Nicotine and other products and substances were also independently rated for harmfulness on a scale of 1–10 and subsequently compared. In addition, the authors examined the media dialogue of top media outlets in four countries to assess the potential influence on people’s beliefs.,A total of 54,267 participants (NO: 1,700, JP: 2,227, UK: 2,250, USA: 2,309, IN: 41,633, GR: 1,801, SA: 2,359) were sampled with the percentage of women participants ranging from 14.8% (IN) to 53.8% (UK). Between 68.3% (men, IN) and 88.7% (men, USA) of current consumers believed nicotine is harmful. Current consumers who agreed with the statement that nicotine is the primary cause of tobacco-related cancer ranged from 43.7% (men, UK) to 78.0% (men, SA). In six countries nicotine was rated nearly as harmful as cigarettes and alcohol, while other substances such as sugar, salt or caffeine, were usually rated as less harmful.,A large proportion of consumers across all surveyed countries view nicotine and cigarettes similarly. Clearer communication on the harmful properties of both by the media is needed to help consumers make informed decisions about products across the continuum of risk. Messaging to consumers, especially via the media, propagates misinformation about the relative harms of tobacco and nicotine through reporting that is often incomplete and biased toward more negative aspects.,This study specifically assessed public perceptions of nicotine as opposed to products containing nicotine, which is the focus of previous studies. Apart from showing that consumers often incorrectly perceive nicotine and cigarettes as similar in terms of harmfulness, the authors highlight the need for more accurate and complete reporting by the media to clarify widespread misunderstandings and mitigate public uncertainty.","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-04-2020-0022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47518732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1108/dat-02-2020-0004
M. Glover, P. Patwardhan, K. Selket
Purpose This paper aims to investigate the extent to which three subgroups – people with mental health conditions, people belonging to sexual minority and gender groups and Indigenous peoples – have been “left behind” by countries implementing the World Health Organization’s Framework Convention on Tobacco Control. Design/methodology/approach A general review of electronic bibliographical databases to provide an overview of smoking prevalence among the three groups and interventions designed specifically to reduce their smoking rates. Findings Although explanations and specific rates differ, two trends are consistent across all three groups. First, information reported in the past two decades suggests that smoking prevalence is disproportionately high among people with mental health conditions, and in the rainbow and indigenous communities. Second, most cessation programmes are targeted at majority politically dominant groups, missing opportunities to reduce smoking rates in these minority communities. Research limitations/implications There is a general dearth of data preventing detailed analysis. Better data collection efforts are required. Trials to identify effective smoking reduction interventions for marginalised groups are needed. Social implications It is socially unjust that these groups are being systematically ignored by tobacco control initiatives. A failure to equitably reduce tobacco harms among all groups across society has contributed to the perceived concentration of smoking in some subgroups. The increasing stigmatisation of people who smoke then adds a marginality, compounding the negative effects associated with belonging to a marginalised group. Ongoing marginalisation of these groups is an important determinant of smoking. Originality/value Cross-case analysis of neglected subgroups with disproportionately high smoking rates suggests social marginalisation is a shared and important determinant of smoking prevalence.
{"title":"Tobacco smoking in three “left behind” subgroups: indigenous, the rainbow community and people with mental health conditions","authors":"M. Glover, P. Patwardhan, K. Selket","doi":"10.1108/dat-02-2020-0004","DOIUrl":"https://doi.org/10.1108/dat-02-2020-0004","url":null,"abstract":"\u0000Purpose\u0000This paper aims to investigate the extent to which three subgroups – people with mental health conditions, people belonging to sexual minority and gender groups and Indigenous peoples – have been “left behind” by countries implementing the World Health Organization’s Framework Convention on Tobacco Control.\u0000\u0000\u0000Design/methodology/approach\u0000A general review of electronic bibliographical databases to provide an overview of smoking prevalence among the three groups and interventions designed specifically to reduce their smoking rates.\u0000\u0000\u0000Findings\u0000Although explanations and specific rates differ, two trends are consistent across all three groups. First, information reported in the past two decades suggests that smoking prevalence is disproportionately high among people with mental health conditions, and in the rainbow and indigenous communities. Second, most cessation programmes are targeted at majority politically dominant groups, missing opportunities to reduce smoking rates in these minority communities.\u0000\u0000\u0000Research limitations/implications\u0000There is a general dearth of data preventing detailed analysis. Better data collection efforts are required. Trials to identify effective smoking reduction interventions for marginalised groups are needed.\u0000\u0000\u0000Social implications\u0000It is socially unjust that these groups are being systematically ignored by tobacco control initiatives. A failure to equitably reduce tobacco harms among all groups across society has contributed to the perceived concentration of smoking in some subgroups. The increasing stigmatisation of people who smoke then adds a marginality, compounding the negative effects associated with belonging to a marginalised group. Ongoing marginalisation of these groups is an important determinant of smoking.\u0000\u0000\u0000Originality/value\u0000Cross-case analysis of neglected subgroups with disproportionately high smoking rates suggests social marginalisation is a shared and important determinant of smoking prevalence.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-02-2020-0004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46575484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-17DOI: 10.1108/dat-12-2019-0049
C. Kock, E. Blomme, J. Antoine
Purpose Substance use treatment (SUT) among migrants and ethnic minorities is an underresearched domain in European countries, although preliminary studies point out disparities in treatment use and access compared to general populations. This paper aims to identify the main characteristics of and the types of services solicited by non-nationals in Belgium. Design/methodology/approach This paper compares the types of SUT services used by Belgian and non-national clients. Second, the referral source for Belgian and non-national clients is considered. Third, the study compares the client characteristics of Belgian and non-national clients. This descriptive analysis is based on aggregated data sets in the European treatment demand indicator (TDI) registry including all Belgian treatment episodes between 2012 and 2014. Findings Non-national clients were more often located in outpatient SUT and were less often referred by general practitioners and hospitals, compared to Belgian clients. Third-country clients appear to have lower socioeconomic statuses (education, employment, housing) than Belgian clients. Non-national youngsters and third-country females appear to be underrepresented in Belgian SUT compared to their presence in the general population. The gender gap is larger among third-country clients than among Belgian clients. Research limitations/implications These associations between nationality and solicited services, gender, education, employment, housing and referral document treatment gaps among some non-nationals that require special attention in targeted treatment. In the European context, further research is needed on better monitoring migration background in the European TDI registries. Practical implications The overrepresentation of non-nationals in low-threshold opioid substitution treatment services and their underrepresentation in high-threshold residential services requires an in-depth analysis of the core goals of these respective services. Residential services, for instance, should consider how a dominant focus on speech therapy hampers access to treatment for these populations and how access for these populations could be enhanced by modifying or diversifying methods in treatment. Originality/value To the best of the authors’ knowledge, this is the first paper that analyses the national indicator in a European TDI data set.
{"title":"Non-national clients in Belgian substance use treatment","authors":"C. Kock, E. Blomme, J. Antoine","doi":"10.1108/dat-12-2019-0049","DOIUrl":"https://doi.org/10.1108/dat-12-2019-0049","url":null,"abstract":"\u0000Purpose\u0000Substance use treatment (SUT) among migrants and ethnic minorities is an underresearched domain in European countries, although preliminary studies point out disparities in treatment use and access compared to general populations. This paper aims to identify the main characteristics of and the types of services solicited by non-nationals in Belgium.\u0000\u0000\u0000Design/methodology/approach\u0000This paper compares the types of SUT services used by Belgian and non-national clients. Second, the referral source for Belgian and non-national clients is considered. Third, the study compares the client characteristics of Belgian and non-national clients. This descriptive analysis is based on aggregated data sets in the European treatment demand indicator (TDI) registry including all Belgian treatment episodes between 2012 and 2014.\u0000\u0000\u0000Findings\u0000Non-national clients were more often located in outpatient SUT and were less often referred by general practitioners and hospitals, compared to Belgian clients. Third-country clients appear to have lower socioeconomic statuses (education, employment, housing) than Belgian clients. Non-national youngsters and third-country females appear to be underrepresented in Belgian SUT compared to their presence in the general population. The gender gap is larger among third-country clients than among Belgian clients.\u0000\u0000\u0000Research limitations/implications\u0000These associations between nationality and solicited services, gender, education, employment, housing and referral document treatment gaps among some non-nationals that require special attention in targeted treatment. In the European context, further research is needed on better monitoring migration background in the European TDI registries.\u0000\u0000\u0000Practical implications\u0000The overrepresentation of non-nationals in low-threshold opioid substitution treatment services and their underrepresentation in high-threshold residential services requires an in-depth analysis of the core goals of these respective services. Residential services, for instance, should consider how a dominant focus on speech therapy hampers access to treatment for these populations and how access for these populations could be enhanced by modifying or diversifying methods in treatment.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge, this is the first paper that analyses the national indicator in a European TDI data set.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-12-2019-0049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49564406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：