Search results

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.

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.

Tobacco has exercised the interest of the nation since Elizabethan times, and the inhalation of its smoke for pleasure has become very widespread. It was not until the mid‐twentieth century, however, that its effects upon health were suspected. It is now widely accepted that tobacco smoke is implicated in a range of dangerous diseases, although the tobacco industry sometimes argues that the link is not proven. The arguments about the conflicting needs of a large, world‐wide industry and the health and prosperity of individuals and society are complex, and often influenced by conflicting vested interests. Government's involvement in the issues is further complicated by its reliance upon large tobacco revenues. The link between advertising and increased smoking, either by existing or new smokers, is not proved by research, although there are strong indications that it exists. The behaviour of most parties involved, including the tobacco companies, indicates that they share the belief of a link. Voluntary controls upon tobacco advertising have had some effect, in that, for example, advertising in the U.K. is no longer overtly directed at children, but various anti‐smoking lobbies believe voluntary control to be ineffective. The present British government has toyed wth the possibility of statutory control, but faces stiff opposition from back‐benchers and within the cabinet; it is also probably philosophically opposed to such measures. More research is needed into the link between advertising and smoking behaviour.

Tobacco is the most widely used substance in the world that has been linked to several psychological problems. Few studies have assessed the relationship between dual (waterpipe and cigarette) tobacco smoking. This study aims to examine the relationship between dual tobacco use and symptoms of depression amongst its users.

A cross-sectional study using a random sample of school students was conducted to assess youth tobacco smoking in the central region of Jordan. A self-reported questionnaire including biographical information, smoking status and experience of depression symptoms was used with a sample of 9th to 12th-grade students. χ² and regression test were used to analyze the data.

The final sample comprised 576 school students, of whom 60% were males. The age range was between 16 and 18 years (mean = 15.84 years, SD ± 0.97). 30% of the participants were dual tobacco smokers. A significant difference was found between males and females, with males being more likely to be dual tobacco smokers compared to females. Two depressive symptoms (“feeling sad” and “having crying spells”) had a significant likelihood amongst the youth who were dual smokers.

To the best of the authors' knowledge, this is the first study that aims to report the relationship between dual tobacco smoking and depressive symptoms. Prevention programs are crucial for raising awareness of the harmful effects of dual tobacco smoking and smoking cessation amongst the youth

We explore the simultaneous influence of activist organizations and corporations on institutional change. Focusing on protests, campaign contributions, and lobbyists as the strategies used by activist organizations and corporations to influence institutional change, we study the dynamics between movements and counter-movements and their influence on the probability of institutional change. In the context of the US tobacco industry, the results shed light on the effectiveness of these strategies and uncover potential moderators of this relationship. Overall, we demonstrate the simultaneous and asymmetric effects of activist organizations and corporations that use conspicuous and inconspicuous strategies to change institutions.

In Chapter 3, the author will problematise the youth smoking epidemic within SEA, in order to justify why the regional impacts of the tobacco trade on youths are worrisome. The author will present the major youth smoking trends in SEA, for the purpose of illustrating how the presence of tobacco products has adversely affected regional youths to a concerning degree. The author, next, will highlight the causes of the youth smoking epidemic, namely susceptibility and positive advertising. The author follows by emphasising the national and regional costs of youth smoking, by arguing how such a lifestyle results in negative consequences in relation to the delinquency itself. Lastly, the author will recommend policies for tobacco control that SEA governments should consider to contain the epidemic of youth smoking. It is noteworthy that all SEA governments have some degree of tobacco control policies in place. However, many lack the implementation of comprehensive national tobacco control strategic plans and tightened law enforcement endeavours to specifically target the problem of youth smoking. Therefore, the outputs of this chapter should contain scholarly values that are conducive to the betterment of policy-making.

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 U.S. 2009 Tobacco Control Act opened the door for new antismoking policies by giving the Food and Drug Administration broad regulatory authority over the tobacco industry. We develop a behavioral welfare economics approach to conduct cost-benefit analysis of FDA tobacco regulations. We use a simple two-period model to develop expressions for the impact of tobacco control policies on social welfare. Our model includes: nudge and paternalistic regulations; an excise tax on cigarettes; internalities created by period 1 versus period 2 consumption; and externalities from cigarette consumption. Our analytical expressions show that in the presence of uncorrected internalities and externalities, a nudge or a tax to reduce cigarette consumption improves social welfare. In sharp contrast, a paternalistic regulation might either improve or worsen social welfare. Another important result is that the social welfare gains from new policies do not only depend on the size of the internalities and externalities, but also depend on the extent to which current policies already correct the problems. We link our analytical expressions to the graphical approach used in most previous studies and discuss the information needed to complete cost-benefit analysis of tobacco regulations. We use our model as a framework to reexamine the evidence base for strong conclusions about the size of the internalities, which is the key information needed.

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.

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).

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.

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.

This study aims to show how diary-style voice recordings can be used to provide social marketers with greater insights into the influences on behaviour than those obtained from interviews. Diary data have the potential to provide deeper insight into the causes of behaviour than can be obtained from retrospective interviews or surveys.

Data were collected from 31 smokers and attempting quitters exploring their attributions for smoking and cigarette purchase, using both face-to face interviews and event-contingent voice recordings over a four-day period, with participants asked to make a recording whenever they were tempted to smoke or buy cigarettes.

Voice recordings provided additional insights into the influences on smoking and cigarette purchase compared to face-to-face interviews. In particular, voice recordings appeared to provide insight into prompts for purchase and smoking that were not recalled during interviews, and, for some respondents, gave them greater control over unwanted behaviour.

The study relies on participants’ self-reports, and individuals may be unaware of some of the influences on their behaviour.

The study shows that voice-recordings offer a novel method of obtaining insight into subtle influences on consumer behaviour that are insufficiently salient to be recalled in retrospective interviews.

The study shows the value of voice recordings for providing near-real-time insights into triggers for different behaviours, and offers potential for extending the method into other areas of social marketing.