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Article
Publication date: 10 September 2020

Sudhanshu Patwardhan and Jed E. 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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

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Article
Publication date: 7 June 2013

Sudhanshu Ramesh Patwardhan and Marina A. Murphy

Despite substantial declines in cigarette smoking in England since the 1970s, around 20 per cent of the adult population still smokes. In Sweden, 10 per cent of adult…

Abstract

Purpose

Despite substantial declines in cigarette smoking in England since the 1970s, around 20 per cent of the adult population still smokes. In Sweden, 10 per cent of adult males and 12 per cent of adult females smoke cigarettes, while snus use is prevalent among 19 per cent of adult males and 4 per cent of adult females. Traditional cessation‐only approaches may need to be supplemented with broader tobacco harm reduction measures to reduce smoking prevalence further. General practitioners (GPs) are well placed to give patients advice on tobacco harm reduction. This paper seeks to address these issues.

Design/methodology/approach

The authors administered an online survey to assess knowledge, perceptions and attitudes to tobacco and nicotine products to 220 GPs (100 in England and 120 in Sweden).

Findings

Most GPs (96 [96 per cent] England, 115 [98 per cent] Sweden) addressed smoking cessation with patients as part of their regular practice. Most GPs (87 [87 per cent] England, 102 [85 per cent] Sweden) felt extremely or fairly knowledgeable about the risks associated with cigarettes, but less so about nicotine in tobacco products and pharmaceutical nicotine. When asked to rank various products on a risk continuum, GPs rated cigarettes as riskiest and tobacco cessation and nicotine‐containing products as least risky. However, when asked to rank components of cigarettes based on their health risks, GPs ranked nicotine as the third riskiest (74 [74 per cent] England, 104 [87 per cent] Sweden), after tar and carbon monoxide, but before smoke or tobacco. When asked questions about a hypothetical nicotine replacement therapy (NRT) product that looks like a cigarette and is licensed for harm reduction, GPs perceived that sensory experience and tobacco harm reduction could be benefits to patients, but perceived appeal to children and risk for abuse could be drawbacks.

Originality/value

Most respondent GPs are well informed about the relative risks of nicotine and tobacco, but more research needs to be done to investigate their concerns over the long‐term substitution of cigarettes with alternative nicotine products.

Details

Drugs and Alcohol Today, vol. 13 no. 2
Type: Research Article
ISSN: 1745-9265

Keywords

Content available
Article
Publication date: 10 September 2020

Derek Yach

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Practical implications

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.

Originality/value

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.

Details

Drugs and Alcohol Today, vol. 20 no. 3
Type: Research Article
ISSN: 1745-9265

Keywords

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Article
Publication date: 7 June 2013

Karl Erik Lund

In Norway, snus (low nitrosamine smokeless tobacco) is allowed to compete with cigarettes for market share, and over the past decades the prevalence of snus users has…

Abstract

Purpose

In Norway, snus (low nitrosamine smokeless tobacco) is allowed to compete with cigarettes for market share, and over the past decades the prevalence of snus users has increased as the prevalence of smokers has decreased. The author has aimed to sum up the findings from research that has tried to identify the role of snus in smoking cessation and how availability to snus in Norway has affected the magnitude of concomitant use of snus and cigarettes.

Design/methodology/approach

Relevant results from Norwegian studies are presented, and, if possible, compared to findings from studies conducted in other countries.

Findings

Snus is reported by ever‐smokers to be the most preferred method for quitting, and former smokers make up the largest segment of Norwegian snus users. The quit rate for smoking is consistently observed to be higher for snus users than for smokers who have no experience of use of snus. Moreover, those using snus are more likely to have quit smoking completely or considerably reduced their cigarette smoking than users of medicinal smoking cessation products. The increase in snus use among men in Norway has not been paralleled by an increase in dual use of snus and cigarettes.

Research limitations/implications

The results observed in Norway might not be extrapolated to other countries that do not have the same history of use of snus.

Practical implications

The replacement of cigarettes by snus has been the most typical pattern of use in Norway, and the availability of snus may have been beneficial to public health.

Originality/value

Besides neighbouring Sweden, Norway is the only country in the eurozone with a tradition of snus use. Knowledge about the pattern of snus use in these countries is relevant for policymakers when deciding the legal status of snus in the EU.

Details

Drugs and Alcohol Today, vol. 13 no. 2
Type: Research Article
ISSN: 1745-9265

Keywords

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Book part
Publication date: 6 August 2018

Emily B. Peterson, Xiaoquan Zhao, Xiaomei Cai and Kyeung Mi Oh

Purpose: The public health burden caused by tobacco is heavy among first-generation Chinese immigrant men whose home country has significantly higher smoking rates than

Abstract

Purpose: The public health burden caused by tobacco is heavy among first-generation Chinese immigrant men whose home country has significantly higher smoking rates than the United States. The current study is part of a larger effort to pilot an mHealth tobacco cessation intervention using MMS (graphic) mobile phone technologies to target East Asian immigrant populations. Grounded in the Extended Parallel Process Model (EPPM), our specific aims were to determine what message themes, level of graphic intensity, and types of efficacy information are most appropriate and useful for mHealth interventions targeting this population.

Methodology/Approach: A qualitative study utilizing a series of focus groups (k = 5) was conducted with male adult smokers who were born in China and currently reside in the United States. The primary aim of the focus groups was to solicit reactions to a series of preliminary messages developed by the research team. A secondary aim was to gauge receptivity to the use of MMS as a vehicle for smoking cessation intervention. Participants (n = 32) were recruited from local Chinese communities in a large Mid-Atlantic metropolitan area.

Findings: Opinions about different message strategies were mixed. However, participants tended to rate messages more positively when they focused on the impact of smoking on family and loved ones, particularly children. Messages with fear-arousing images were also perceived to be effective at low frequency of exposure, but there were concerns that they may backfire at high exposure. Awareness of and interest in Quitline were low, and concrete quitting tips were perceived as more effective. Participants reported a preference for receiving messages a few times a week, and an MMS message platform was generally preferred to WeChat (a Chinese social media platform).

Implications: Our results suggest that graphic MMS messaging holds promise as an effective intervention method for this population and that EPPM is an appropriate framework to develop, test, and analyze mHealth intervention messages. While messages that focused primarily on impact on children, health, and specific quitting tips were generally found to be more effective, a mix of different types of messages that address a wide range of issues may be most appropriate for this population.

Originality/Value: This study is the first to explore the utility of graphic text messaging as an intervention method to promote smoking cessation among male Chinese immigrants. Findings from the study provide important insights for future intervention work targeting this underserved population.

Details

eHealth: Current Evidence, Promises, Perils and Future Directions
Type: Book
ISBN: 978-1-78754-322-5

Keywords

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Article
Publication date: 22 March 2013

Sunder Lokhande, Marewa Glover and Kyro Selket

The purpose of this paper is to explore the use of chewing tobacco by South East Asian men in Auckland and their difficulty in giving up the habit.

Abstract

Purpose

The purpose of this paper is to explore the use of chewing tobacco by South East Asian men in Auckland and their difficulty in giving up the habit.

Design/methodology/approach

Semi‐structured interviews with ten men were conducted in a grounded theory case study design. Snowball sampling was used to identify and recruit participants from hard‐to‐find populations. Written consents were obtained.

Findings

Each of the men attributed their initiation to chewing tobacco to the influence of friends and the society in which they lived. They all were aware that chewing tobacco could increase their risk for oral cancer and wanted to quit. New Zealand law prohibits the import and sale of oral forms of tobacco. However, the men in this study were still able to get chewing tobacco via friends and family bringing it into the country “for personal use”.

Research limitations/implications

This paper opens up a space for further research within the South East Asian communities, with the view to identifying and developing effective cessation methods.

Originality/value

This paper is significant as there has been minimal research conducted on the pervasiveness of chewing tobacco in the South East Asian communities in New Zealand.

Details

International Journal of Migration, Health and Social Care, vol. 9 no. 1
Type: Research Article
ISSN: 1747-9894

Keywords

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Article
Publication date: 12 June 2017

Oliwier Dziadkowiec and Reese Jenniges

The purpose of this paper is to understand how the Wyoming Quit Tobacco Program (WQTP) is used by its subscribers and to better understand how WQTP might be connected to…

Abstract

Purpose

The purpose of this paper is to understand how the Wyoming Quit Tobacco Program (WQTP) is used by its subscribers and to better understand how WQTP might be connected to WQTP outcomes.

Design/methodology/approach

Provider intake and program use data corresponding to the May 2010 to March 2012 enrollment period (n=6,168) were used. All program flows were constructed using frequencies and crosstabs, based on an initial theoretical model prepared by the program provider. Data were adjusted based on analysis that explored all possible uses beyond those specified by the provider’s theoretical model.

Findings

Although the authors could replicate the structure – the theoretical model constructed by the provider – the authors were not able to replicate all relationships between program components. The authors also found that most individuals signed up and used web-based services. Only a few individuals finished their treatment regimens in the way they were designed to be used by the program.

Originality/value

This is the first case study to use a program flow method to investigate an entire comprehensive tobacco cessation program structure and delivery.

Details

International Journal of Health Care Quality Assurance, vol. 30 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

Content available
Article
Publication date: 10 September 2020

Renée O'Leary and Riccardo Polosa

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…

Abstract

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.

Details

Drugs and Alcohol Today, vol. 20 no. 3
Type: Research Article
ISSN: 1745-9265

Keywords

Content available
Article
Publication date: 10 September 2020

Alexandra Solomon

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…

Abstract

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.

Details

Drugs and Alcohol Today, vol. 20 no. 3
Type: Research Article
ISSN: 1745-9265

Keywords

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Article
Publication date: 16 March 2015

Ashleigh Djachenko, Winsome St John and Creina Mitchell

– The purpose of this paper is to review the available literature relating to smoking cessation (SC) for the male prisoner population.

Abstract

Purpose

The purpose of this paper is to review the available literature relating to smoking cessation (SC) for the male prisoner population.

Design/methodology/approach

Databases PubMed, CINAHL and MEDLINE were searched for English language studies from 1990 to 2012. The authors identified 12 papers examining SC in male prisoners. Full-text articles were analysed for inclusion.

Findings

A total of 12 studies were identified for inclusion. Four studies focused on forced abstinence (a smoking ban) while the remainder looked at various combinations of nicotine replacement, pharmacology and behavioural techniques. No robust studies were found that examined nursing approaches to SC for the prisoner population. The evidence shows a strong “pro-smoking” culture in prison and that many prisoners continue to smoke irrespective of an enforced ban. However, SC strategies can be successful if implemented systematically and supported by consistent policies.

Research limitations/implications

Female-only prisoner studies were excluded as females comprise just 7 per cent of the Australian prisoner population. The analysis does not differentiate between maximum- or minimum-security prisons, or length of prison sentence. Results cannot be generalised to other forms of detention such as police custody or immigration detention centres. Studies were not appraised for quality, as exclusion on that basis would render further exploration untenable. The analysis was presented in a narrative rather than meta-analytical format and may be subject to interpretation.

Practical implications

This paper provides a foundation on which to build further research evidence into the smoking behaviour of prisoners. This information can be used to advocate for healthier public policy for a vulnerable and marginalised population.

Originality/value

To the authors’ knowledge, this is the first literature review into SC interventions in prisons. The authors apply the findings of this literature review to the five strategies for health promotion to propose a population approach to smoking cessation in male prisoners. Recommendations specific to the correctional environment are outlined for consideration by correctional health professionals.

Details

International Journal of Prisoner Health, vol. 11 no. 1
Type: Research Article
ISSN: 1744-9200

Keywords

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