Search results

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.

This review examines the displacement of smoking through substitution of non-combustible low-risk products such as snus, heated tobacco products and e-cigarettes.

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.

This review provides the rationale for tobacco harm reduction, evaluates the current products available and identifies the barriers to implementation.

Taxing tobacco is one of the most effective means to reduce smoking but concerns about the impact on poor smokers are a barrier. New Zealand resumed increasing tobacco taxes in April 2010. The paper hypothesised smokers would attempt to stop smoking and/or adapt, changing their smoking behaviours in response to price increases. The paper aims to discuss these issues.

The authors conducted a door knock survey of smokers and recent ex-smokers who were home when visited. Participants (n=428) were from socioeconomically deprived neighbourhoods of Auckland with large proportions of Māori and Pacific Island people.

Many smokers (66 per cent) attempted to quit an average of 3 times. More than 40 per cent stopped for at least 24 hours without intending to quit altogether, monthly or more. Consumption reduced among 40 per cent of participants, by an average 7.1 cigarettes daily. More than a fifth of participants switched to cheaper brands. Switching from factory made cigarettes to roll your own tobacco (6 per cent) or vice versa (5 per cent) was uncommon.

The method resulted in a low response rate. Tobacco tax is associated with reduced consumption and high levels of frequent quit attempts in socioeconomically deprived communities therefore our study supports tax increases as a means of reducing smoking.

This is the first paper to investigate the effect of large recent New Zealand tobacco tax increases on low-income smokers’ adaptive behaviours.

The goal of the special issue is to review current cigarette smoking trends in China; this article aims to provide an overview of the main themes of the special issue.

The instruments for data collection of the five studies in this special issue are surveys. One study used a random sampling method, one used an intercept survey method, and three used a convenience sampling method.

Highlights of the findings include: among the 677 physicians surveyed, 31.6 percent of the men and 0.9 percent of the women were current smokers; 79.2 percent of the cigarette users reported smoking on duty; 15 percent of the cigarette users smoked in front of patients. Sixty‐one percent of the physicians often advised patients to quit smoking. Two factors significantly influenced a physician's anti‐smoking frequencies: whether they were smokers themselves and whether they had received training on helping patients to quit smoking. About half of the 269 patients surveyed reported seeing someone smoking inside the hospital, and 22.3 percent had seen physicians and/or nurses smoking. Among the 758 medical students surveyed, 26.5 percent of males and 1.6 percent of females had smoked in the previous 30 days.

The exclusive coverage of a western journal on cigarette smoking in China can draw the attention of Chinese and western scholars in the field, as well as the attention of the Chinese Ministry of Health, to this major national problem. This attention should help to advance anti‐smoking educational campaigns in China.

This is the first special issue by a western academic journal on cigarette smoking in China, where rates are far higher than in most other parts of the world, and are a major health concern. Two studies have large sample sizes and all five studies have high response rates.

This study aims to evaluate the association between dietary patterns with health status and smoking-related knowledge, attitudes and practices (s-KAP) among Bangladeshi adolescent smokers.

An analytical cross-sectional study was conducted among 205 randomly selected adolescents. Socio-demographic, health status, s-KAP related data were collected in face-to-face interviews. Dietary intake data were calculated using the food frequency questionnaire.

The practices score (44.8%) was comparatively poor among adolescent smokers. Among the respondents, around 56.1%, 38.1% and 49.3% were suffering from gastric problems, nausea and the loss of appetite, respectively, because of smoking. There was a significant relationship between dietary diversity and the occurrence of several diseases such as gastric problems, nausea and loss of appetite. The respondents who consumed fresh fruits and vegetables regularly might reduce gastric problems (OR: 0.53, 95% CI: 0.27–1.04 and OR: 0.64, 95% CI: 0.25–1.65), nausea (OR: 0.72, 95% CI: 0.38–1.37 and OR: 0.28, 95% CI: 0.13–0.84) and loss of appetite (OR: 0.52, 95% CI: 0.32–1.21 and OR: 0.16 95% CI: 0.27–0.68).

In conclusion, smoking has been associated with multiple health problems because of poor practices score. Consumption of a balanced diet, better smoking-related knowledge, attitudes and practices needs to be improved among adolescents.

The purpose of this paper is to test the effects of cigarette warning labels that used text-only or text-plus relevant graphics. The labels were framed in terms of either the negative consequences of smoking (loss frame) or the benefits of not smoking (gain frame). The role of smoking identity – the centrality of being a smoker to one's self-concept – in the effects of the warning labels was also examined.

An experiment was conducted online with 132 college smokers. Participants were randomly assigned to viewing either graphic or text-only labels that were either gain or loss framed. Smoking identity was measure prior to viewing. Message evaluations and smoking intentions were assessed after exposure as dependent measures.

A consistent interaction between graphics and framing emerged across a number of dependent measures. For graphic warning labels, the loss frame was more advantageous than the gain frame. For text-only warning labels, framing did not make any difference. This two-way interaction was further qualified by smoking identity for some, but not all, dependent measures.

Findings from this study support the use of graphic warning labels that focus on the negative health consequences of smoking.

Experimental research on graphic cigarette warning labels is limited and rarely considers the roles of framing and smoking identity. This study offered an initial test of the complex interaction among these message and audience variables as they jointly influence message reception and smoking intentions.

The purpose of this historical paper is to examine arguably the most controversial advertising campaign of all time. Critics have condemned tobacco marketer George Washington Hill's “Reach for a Lucky Instead of a Sweet” campaign in the late 1920s and early 1930s for its explicit attempt to encourage smoking among women by linking cigarettes with themes of slenderness and youth.

The paper relies on primary sources obtained chiefly from the important advertising trade journals Printers' Ink and Advertising and Selling. Many sources, in turn, pointed to historically significant advertisements from the “Reach for a Lucky […]” campaign, some of which are included among the findings. Tentative themes of analysis were: the strategic motives behind the “Reach for a Lucky […]” campaign and the campaign's outcomes and consequences, both positive and negative.

Hill aggressively pursued the female smoker of the 1920s, as did other cigarette marketers of the period. However, the paper's findings support a conclusion that Hill had additional motives for attacking “sweets,” other than merely encouraging women to smoke with a slenderness appeal. Hill's primary strategic concern must have been how to address the extraordinarily competitive situation he faced with the other “big four” cigarette brands.

Focusing on the strategic intent of the campaign and its outcomes and consequences, findings strongly suggest that prior perspectives and conclusions found in advertising history texts regarding this infamous campaign often fail to reveal its significance as an historical event.

This paper aims to describe the relationship between functional health literacy level and smoking cessation outcomes.

Participants in an inpatient smoking cessation program in a mid‐western city in the USA were enrolled and the Short Test of Functional Health Literacy in Adults was administered while the participant was still admitted. A follow‐up telephone call was made three months after the intervention in order to assess self‐reported smoking cessation.

A total of 30 participants were enrolled. At the three‐month follow‐up, 22 patients were currently smoking and eight had quit smoking. Chi‐square analysis indicated that there was no difference in the incidence of successful smoking cessation based on level of functional health literacy. The results of a stepwise logistic regression analysis suggest that predicting whether a study participant will quit smoking or not appears to be a function of the participant's environment, since the only variable that contributed significantly to the equation was environmental factors.

The results of this study suggest that the participants had a relatively high level of functional health literacy. Participants with all levels of functional health literacy were able to quit smoking, as the incidence of smoking cessation was no different across levels of functional health literacy. A participant's ability to quit smoking did not appear to be a function of their functional health literacy, but instead appeared to be a function of their environment.

Health educators and smoking cessation counselors need to consider all factors that have an impact on people's ability to quit smoking, but environmental factors may deserve additional consideration.

This study tests the first two tenets of the fundamental causes theory – that socioeconomic status influences a variety of risk factors for poor health and that it affects multiple health outcomes – by examining the associations between adverse socioeconomic circumstances and five measures of health.

We employ bivariate and logistic regression analyses of data from the Centers Disease Control and Prevention 2011 Behavioral Risk Factor Surveillance Survey (BRFSS) to test the individual and cumulative associations between three measures of socioeconomic position and five measures of health risk factors and outcomes.

The analysis demonstrates support for the fundamental causes theory, indicating that measures of adverse socioeconomic conditions have independent and cumulative associations with multiple health outcomes and risk factors among U.S. adults aged 18–64.

The findings of this chapter are generalizable to adults aged 18–64 living in the United States and may not apply to individuals living outside the United States, older Americans, and children.

Adverse socioeconomic circumstances are not only associated with self-rated health but are also associated with the two leading causes of death in the United States (cancer and heart disease) and risk factors that contribute to these causes of death (smoking and high blood pressure). Improving access to socioeconomic resources is critical to reducing health disparities in leading causes of death and health risk factors in the United States.