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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.

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.

The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) is the first treaty negotiated under the auspices of the WHO. This study aims to describe progress toward the framework’s goals, setbacks and strategies to update its articles to optimize outcomes.

A review of relevant literature, including papers in this special issue, forms the basis for identifying steps necessary to amplify the impact of the FCTC.

The WHO suggests that there are 1.3 billion users of tobacco globally. The expected deaths associated with tobacco use could be dramatically reduced by hundreds of millions between now and 2060 through measures that improve cessation and harm reduction support among adults. Additional steps needed to achieve the goals of the FCTC include developing new initiatives to address areas of profound neglect (for example, women); investing in global research and innovation; addressing the needs of vulnerable populations; and establishing a mechanism to fund priority actions required by low- and middle-income countries, including support for alternative livelihoods for smallholder farmers.

In November 2020, the WHO FCTC Parties will host their next Conference of the Parties (COP9) in the Netherlands. This paper aims to contribute to the needed policy decisions related to this meeting. Since acceptance of this article, the WHO FCTC team announced that doe to the COVID-19 pandemic COP9 has been rescheduled till November 2021.

There exists a need to prioritize the goals of tobacco control and offer clear strategies for its execution. This paper fills this niche via a thorough and up-to-date analysis of how to amend and enforce the FCTC.

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.

This paper draws upon empirical studies, literature reviews and global health data at the varying intersections of gender, sex, tobacco and global health.

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.

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.

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.

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.

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.

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.

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.

Cross-case analysis of neglected subgroups with disproportionately high smoking rates suggests social marginalisation is a shared and important determinant of smoking prevalence.

Health promotion strategies often attempt to change people’s behavior through targeting their risk perceptions. These perceptions may, however, be moderated by other factors. This study therefore aimed at investigating the trustworthiness and consistency of risk information, as well as respondent perceptions of the adequacy of amount received among a representative sample of former smokers, and how this information is related to gender, age, education level and whether using nicotine or not.

The respondents are part of a seven-year follow-up of former smokers in Sweden. Initially, 1400 respondents were contacted, whereof 705 (response rate 50%) answered a Web-survey. The majority (85 %) was still nicotine-free but some made use of nicotine in different forms. The data analysis includes descriptive statistics and logistic regressions.

Most respondents trusted risk information whether offered by the public authorities or came from other sources such as media, and generally perceived that there was an adequate amount. However, there were some differences between the products, where quite a few distrusted information on Nicotine Replacement Therapies (NRTs) and some perceived the information on snus and NRTs as contradictory and too little.

Knowledge about how former smokers perceive information regarding negative aspects of cigarette use may facilitate more effective risk communication with current smokers, and it may also be important for communicating information about other nicotine products to those who are trying to or who already have quit smoking.

This study aimed to examine factors associated with electronic cigarette use among adolescents aged 15–19 in Jakarta, Indonesia.

The study was a school-based survey involving 1,318 students from 14 high schools in Jakarta. A multistage cluster sampling methodology was used. The authors used the chi-square test and multiple logistic regression to examine the association between electronic cigarette use and sociodemographic, social influences, health risk perceptions, availability, affordability and conventional cigarette smoking status.

Overall, 6.3% of females and 29% of males reported ever having used electronic cigarettes. Electronic cigarette use was independently associated with sex, school locations, conventional cigarette smoking status, peer use, availability and perceptions that electronic cigarettes aid conventional cigarette smoking cessation. Compared with non-smokers, lifetime (AOR: 8.740, 95% CI: 5.126–14.901) and current conventional cigarette smokers (AOR: 18.380, 95% CI: 10.577–31.938) were more likely to use electronic cigarettes.

The use of electronic cigarettes among adolescents was considerably high in this study. Therefore, the tobacco control policy should be extended to regulate the marketing and use of all types of tobacco products and not just conventional cigarettes.

The study explored beyond individual lifestyle factors that contributed to electronic cigarette use in Indonesia such as affordability, school locations and availability of electronic cigarettes. These issues have not been specifically discussed in previous studies.

A large increase in robberies of convenience stores in New Zealand (NZ) in 2016 and 2017 was anecdotally attributed to persistent and substantial increases in excise tax on tobacco products. This study aims to explore the validity of that claim by examining the characteristics of the robberies through the lens of online news coverage.

Google, Bing and main online NZ news outlets were searched for news reports between 2009 and 2018 of tobacco-related store robberies. Content analysis was used to extract characteristics such as date of robbery, type of store, items targeted or stolen and demographic profile of offenders. The prevalence of reported robberies by socioeconomic level of the surrounding community was assessed using nearest primary school decile rating. Descriptive statistics and statistical analysis were used to discuss trends and key findings in the data.

Reports on 572 robberies were unevenly distributed across the years with a large increase in 2016 and 2017, followed by a substantial decrease in 2018. Local community convenience stores were primarily hit – more so in lower socioeconomic communities. Robberies occurred nationwide and disproportionately so during colder months in lower socioeconomic communities. Many robberies were aggravated resulting in serious injury to shopkeepers. Tobacco and cash were predominantly targeted.

The large increase in robberies that occurred in 2016–2017 likely resulted from tax-driven tobacco price hikes combined with reduced duty-free tobacco coming into NZ with travellers. Installation of security in stores, news fatigue and other explanations are potential reasons for the 2018 decrease in reported robberies despite tobacco prices increasing. Frequent robberies of local stores, many including violence, should be a public health concern as destruction of community well-being can be a determinant of other health problems. The negative consequences for communities, particularly lower socioeconomic communities, need to be factored into the cost benefit analysis of raising the tax on tobacco.

This study provides much needed detail on the negative health and social consequences of tobacco-related store robberies.

The purpose of this paper is to offer original ideas into a potential future cannabis industry in the UK. This paper presents novel approaches regarding the potential existence of cannabis for the tourism industry. It presents an idea in which the UK Government could produce, distribute and control the industry. The proposed idea presents a scheme in which the UK could encourage regional tourism (inclusive to domestic and international travellers) through a controlled but innovative cannabis market scheme. This paper presents a future scenario aiming to encourage dialogue and critique, at a time when attitudes to cannabis are changing.

This research takes a scenario narrative approach in presenting and exploring a potential future cannabis market in the UK. The importance of narrative writing as a method is recognised by Lindgren and Bandhold (2009), who identify the significance in telling a story to the reader. Taking a pragmatic approach, embracing diverse philosophical methods, this research explores past and current trends via a mixture of secondary data sources to create and present a scenario narrative of the future.

This paper identified that trends in legalising cannabis for cultivation, medical and recreational purposes continue to become more liberal globally. However, cannabis laws mainly focus on the use for residents. Consequently, domestic tourism markets have the potential to grow. However, there is limited consideration regarding the potential for international tourism cannabis markets. Thus, the findings of this research are based on the potential for the UK to implement and promote a cannabis industry for international travellers.

This paper offers original ideas in exploring a future cannabis market in the UK, one where regional tourism is considered. The paper presents a novel approach that encourages domestic and international tourists to engage with the cannabis industry by navigating a well-managed, local approach to supplying cannabis in the UK.

The purpose of this study is to calculate the smoking quit rate and to examine the factors influencing smoking abstinence among Thai Buddhist monks with noncommunicable diseases (NCDs).

This was a cross-sectional study of 136 Buddhist monks with NCDs purposively sampled from the Priest Hospital. The participants were between 20 and 59 years of age, smoked at least one cigarette a day and received cessation advice from nurses or other health professionals. The dependent variable was self-reported 7-day point-prevalence smoking abstinence assessment at a three-month follow-up. Independent variables were age, schooling level, nicotine dependence, intention to quit, physical activity and perceived self-efficacy in quitting cessation. Logistic regression was performed to evaluate the factors influencing smoking cessation.

50 of the 136 Thai Buddhist monks (36.8%) reported the 7-day point prevalence abstinence at a three-month follow-up. About two-thirds of the participants indicated health concern as the motivation to quit smoking. Perceived self-efficacy of abstinence (odds ratio 1.04; 95% confidence interval 1.014–1.074) and intention to quit smoking (odds ratio 1.34; 95% confidence interval 1.129–1.599) were significant predictors of abstinence.

This is the first study of its kind to investigate the predictors of smoking cessation in Thai Buddhist monks with NCDs. The findings will be of help to healthcare counselors seeking to motivate monks to quit smoking.