Journal articles: 'Cigarette smokers Australia'

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Thomas, David P., Nadia Lusis, Anke E. Van der Sterren, and Ron Borland. "Electronic Cigarette Use and Understanding Among a National Sample of Australian Aboriginal and Torres Strait Islander Smokers." Nicotine & Tobacco Research 21, no. 10 (July 19, 2018): 1434–40. http://dx.doi.org/10.1093/ntr/nty154.

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Abstract Introduction Adult daily smoking prevalence in the Aboriginal and Torres Strait Islander population is 2.8 times that of other Australians. There is little data on prevalence of electronic cigarette (e-cigarette) use among Aboriginal and Torres Strait Islander peoples. We measured e-cigarette use and beliefs about their harmfulness in national samples of Aboriginal and Torres Strait Islander smokers and of all Australian smokers. Methods The Talking About the Smokes project interviewed a nationally representative quota sample of 1301 Aboriginal and Torres Strait Islander smokers between August 2013 and August 2014. The Australian Wave 9 survey of the long-running International Tobacco Control Project interviewed 1093 smokers between February and May 2013. Estimates for all Australian smokers were standardized to the age and sex distribution of Aboriginal and Torres Strait Islander smokers. Results Fewer Aboriginal and Torres Strait Islander than all Australian smokers had tried an e-cigarette (21% vs. 30%). This was in part because of more Aboriginal and Torres Strait Islander smokers having not heard of e-cigarettes. Fewer Aboriginal and Torres Strait Islander smokers than all Australian smokers agreed that e-cigarettes are less harmful than conventional cigarettes (22% vs. 50%). Conclusions Many Aboriginal and Torres Strait Islander smokers have used e-cigarettes. However, there is considerable misunderstanding about the relative harm of e-cigarettes compared with conventional cigarettes, in part because of the tight regulatory environment in Australia. Implications The study describes e-cigarette use and understanding in national samples of Aboriginal and Torres Strait Islander smokers and of all Australian smokers. Only small studies have reported on e-cigarette use in this high smoking prevalence population. Fewer Aboriginal and Torres Strait Islander smokers than all Australian smokers had tried an e-cigarette and fewer agreed that e-cigarettes are less harmful than conventional cigarettes. Australian governments, health authorities, health professionals, and e-cigarette regulations should provide clearer messages that e-cigarettes are less harmful.

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Li, Lin, Ron Borland, K. Michael Cummings, Shannon Gravely, Anne C. K. Quah, Geoffrey T. Fong, Connor R. Miller, Maciej L. Goniewicz, Michael Le Grande, and Ann McNeill. "Patterns of Non-Cigarette Tobacco and Nicotine Use Among Current Cigarette Smokers and Recent Quitters: Findings From the 2020 ITC Four Country Smoking and Vaping Survey." Nicotine & Tobacco Research 23, no. 9 (March 8, 2021): 1611–16. http://dx.doi.org/10.1093/ntr/ntab040.

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Abstract Introduction This study explores patterns of use of non-cigarette tobacco and nicotine products among adult cigarette smokers and recent ex-smokers. Along with cigarette smoking status we explore differences as a function of countries with different product regulations, gender, and age. Methods Data came from the ITC Four Country Smoking and Vaping Wave 3 Survey conducted between February–June 2020. The analytic sample consisted of 9112 current cigarette smokers (at least monthly) and 1184 recent ex-smokers (quit cigarettes ≤ 2 years) from Australia, Canada, England, and the United States. Respondents were asked about their cigarette smoking and current use of the following non-cigarette products: combustible tobacco (cigars, cigarillos, pipe, waterpipe); noncombustible tobacco (smokeless tobacco, and heated tobacco products [HTPs]); and non-tobacco nicotine products (nicotine vaping products [NVPs], nicotine replacement therapy [NRT], and nicotine pouches). Results Overall, NVPs (13.7%) and NRT (10.9%) were the most reported nicotine products used, followed by cigars (5.3%), cigarillos (4.2%), and HTPs (3.5%). More than 21% current and recent ex-smokers of cigarettes reported using a non-tobacco nicotine product and noncombustible product, with respondents in England reporting the highest levels of use (>26%). Males, younger respondents, and current non-daily cigarette smokers were more likely to use non-cigarette nicotine products. Notably, 11.6% of ex-cigarette smokers were using other combustible tobacco. Conclusion Considerable percentages of current cigarette smokers and ex-smokers use non-cigarette nicotine products, and there are unexpectedly high levels of use of other combustible products by those recent ex-smokers of cigarettes which is concerning and has important implications for definitions of smoking cessation. Implications The tobacco product market has evolved to include new products which add to existing non-cigarette tobacco products creating a much more diverse nicotine market. This brief report provides a snapshot of use of various combustible and noncombustible nicotine-containing products among current cigarette smokers and recent ex-smokers in four western countries. Our results indicate that use of non-cigarette tobacco and nicotine products among these cigarette smokers and recent ex-smokers is not low, particularly among males, younger and non-daily cigarette smokers. Use of other combustible tobacco among respondents that recently quit cigarette smoking is concerning and has important implications for definitions of smoking cessation. Increased emphasis on researching non-cigarette nicotine product use is warranted in tobacco control generally and smoking cessation in particular.

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Wu, Daphne C., Beverley M. Essue, and Prabhat Jha. "Impact of vaping introduction on cigarette smoking in six jurisdictions with varied regulatory approaches to vaping: an interrupted time series analysis." BMJ Open 12, no. 5 (May 2022): e058324. http://dx.doi.org/10.1136/bmjopen-2021-058324.

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ObjectiveWe sought to quantify the impact of vaping introduction on cigarette smoking across settings with varied regulatory approaches to vaping.DesignInterrupted time series analysis, adjusted for cigarette tax levels.SettingFour Canadian provinces, UK and Australia.ParticipantsEntire population of smokers in each country.InterventionsThe year that vaping was widely introduced in each country.Primary and secondary outcome measuresThe primary outcome is cigarette consumption per adult, and the secondary outcome is smoking prevalence among young adults.ResultsBased on allowable nicotine levels, restrictions on e-cigarette advertising, sales and access, and taxation, the least to most restrictive jurisdictions were, in order, Alberta, Ontario, Quebec and British Columbia (all in Canada), UK and Australia. In most, but not all, settings where higher nicotine content was permitted in vaping products (66 mg/mL), vaping introduction led to a reduction in cigarette consumption per capita (Ontario: p=0.037, Quebec: p=0.007) or in smoking prevalence among young adults (Alberta men, p=0.027; Quebec men, p=0.008; Quebec women, p=0.008). In the UK, where the maximum permitted nicotine content in vaping products was 20 mg/mL, vaping introduction slowed the declining trend in cigarette smoking among men aged 16–24 years (p=0.031) and 25–34 years (p=0.002) but not in cigarette consumption per adult. In Australia, where nicotine was not permitted in e-cigarettes, e-cigarette introduction slowed the declining trend in cigarette consumption per capita and in smoking prevalence among men aged 18–24 years (cigarette consumption: p=0.015, prevalence: p=0.044).ConclusionIn environments that enable substitution of cigarettes with e-cigarettes, e-cigarette introduction reduces overall cigarette consumption. Thus, to reduce cigarette smoking, policies that encourage adults to substitute cigarette smoking with vaping should be considered.

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Bayly, Megan, Michelle M. Scollo, and Melanie A. Wakefield. "Who uses rollies? Trends in product offerings, price and use of roll-your-own tobacco in Australia." Tobacco Control 28, no. 3 (July 20, 2018): 317–24. http://dx.doi.org/10.1136/tobaccocontrol-2018-054334.

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ObjectiveWe examined the roll-your-own (RYO) tobacco product market in Australia from 2001 to 2016. Trends in use of RYO tobacco among Australian adults were examined for 2004–2016.MethodsChanges in brand availability, pouch sizes and lowest priced products were noted from trade magazines. Prevalence of smoking of RYO and factory-made (FM) cigarettes among those 18 years and older was obtained from five consecutive waves of a large (n>21 000) nationally representative triennial survey from 2004 to 2016. Trends in cigarette use were examined using logistic regression.ResultsChanges in the Australian RYO market from 2001 to 2016 included a doubling in the number of brands, progressively smaller pouch sizes with smaller increases in price than in traditional RYO and comparable FM products. While use of FM cigarettes declined between 2004 and 2016, the proportion of adults exclusively using RYO tobacco linearly increased with each survey wave (OR 1.03, 95% CI 1.02 to 1.05, p<0.001), from 1.2% in 2004 to 1.7% in 2016. Exclusive RYO use among current smokers increased more among females than males, and young adults compared with those aged 30 years or older, but did not differ by socioeconomic status.ConclusionsIn contrast to substantial declines in FM cigarette use, exclusive use of RYO cigarettes increased in Australians since 2004, particularly among females and young adults. This has corresponded to a period of substantial changes to the RYO market, including progressively smaller and relatively more affordable products. Policy action to reduce price-related marketing and correct consumer misinformation about RYO tobacco are urgently required.

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Buchanan, Tanya, Christopher A. Magee, and Peter J. Kelly. "Smokers who do not quit: Can the precaution adoption process model help identify hard-core smokers?" Journal of Smoking Cessation 15, no. 1 (October 30, 2019): 6–13. http://dx.doi.org/10.1017/jsc.2019.20.

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AbstractIntroductionHard-core smokers have been identified as a potential public health challenge. The trans-theoretical model lacks the specificity to identify hard-core smokers. The precaution adoption process model (PAPM) is a stage-based behaviour change model which includes ‘no intent to quit’ as a distinct stage and so may be useful in identifying hard-core smokers.AimsThe aim of this study was to apply the PAPM to a community based sample of smokers to determine whether it provides a useful approach to identifying hard-core smokers.MethodsWe surveyed smokers in Australia who were recruited through social media and an online data collection agency.ResultsThe sample included 336 current smokers, 11.9% were in Stage 4 of the PAPM – i.e. had decided not to quit. Stage 4 smokers are more resistant to quitting and marked by their similarities to hard-core smokers. This is further amplified when addressing Stage 4 smokers with no previous quit attempt.ConclusionsStage 4 smokers with no previous quit attempts are aligned with a hard-core smoker profile with higher levels of nicotine dependence, greater cigarette consumption and low socio-economic status. Further research is required to determine if PAPM is a valid predictive model for identifying hard-core smokers in clinical practice.

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How, Liau Chee, Leanne White, Keith Thomas, and Tan Seng Teck. "“Resilient Young Smokers” - A Proposed Study in Determining Young Adult Smokers’ Responses Towards Anti-Smoking Initiatives in Australia." Asian Social Science 14, no. 10 (September 28, 2018): 91. http://dx.doi.org/10.5539/ass.v14n10p91.

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Although cigarette smoking rate has declined consistently in the past four decades in Australia, the smoking habit remains popular among some groups. From a marketer’s vantage point, this slowed reduction portrays the less effective implementation of anti-smoking campaigns in Australia. Ideally, each anti-smoking intervention ought to break the chain of marginal utility and lead to a sharp or stepped decline of smoking prevalence. This paper explores the inadequacies of fear factored anti-smoking campaigns and some prevailing reasons why young adult smokers continue to smoke. This paper begins with a review and categorisation of the different reasons of why young adults continue to smoke. These reasons draw on addiction, stress, habit, social-economic factors, self-identity and peer pressure. The rationale for studying these anti-smoking initiatives is to evaluate if these initiatives address the issues of smoking amongst young adults. This paper is significant for formulating effective anti-smoking messages and policy developments in Australia.

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Young, David, Hua-Hie Yong, Ron Borland, Lion Shahab, David Hammond, K. Michael Cummings, and Nick Wilson. "Trends in Roll-Your-Own Smoking: Findings from the ITC Four-Country Survey (2002–2008)." Journal of Environmental and Public Health 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/406283.

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Objective. To establish the trends in prevalence, and correlates, of roll-your-own (RYO) use in Canada, USA, UK and Australia, 2002–2008.Methods. Participants were 19,456 cigarette smokers interviewed during the longitudinal International Tobacco Control (ITC) Four-Country Survey in Canada, USA, UK, and Australia.Results. “Predominant” RYO use (i.e., >50%of cigarettes smoked) increased significantly in the UK and USA as a proportion of all cigarette use (bothP<.001) and in all countries as a proportion of any RYO use (allP<.010). Younger, financially stressed smokers are disproportionately contributing to “some” use (i.e., ≤50%of cigarettes smoked). Relative cost was the major reason given for using RYO, and predominant RYO use is consistently and significantly associated with low income.Conclusions. RYO market trends reflect the price advantages accruing to RYO (a product of favourable taxation regimes in some jurisdictions reinforced by the enhanced control over the amount of tobacco used), especially following the impact of the Global Financial Crisis; the availability of competing low-cost alternatives to RYO; accessibility of duty-free RYO tobacco; and tobacco industry niche marketing strategies. If policy makers want to ensure that the RYO option does not inhibit the fight to end the tobacco epidemic, especially amongst the disadvantaged, they need to reduce the price advantage, target additional health messages at (young) RYO users, and challenge niche marketing of RYO by the industry.

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Beard, Emma, Paul Aveyard, Susan Michie, Ann McNeill, and Robert West. "Does Use of Nicotine Replacement Therapy While Continuing to Smoke Undermine Cessation?: A Systematic Review." Journal of Smoking Cessation 8, no. 1 (January 16, 2013): 45–56. http://dx.doi.org/10.1017/jsc.2012.21.

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Aims: To review population surveys to assess (a) prevalence of the use of NRT for smoking reduction (SR) and temporary abstinence (TA) and (b) how far this is associated with attempts to stop smoking, smoking cessation and reduction in cigarette consumption.Methods: An electronic search was undertaken of EMBASE, MEDLINE, Web of Science and PsycINFO. Articles were selected if they (1) assessed whether smokers had used or were currently using NRT for SR and/or TA; (2) involved smokers who had not taken part in a harm reduction programme; and (3) assessed prevalence and/or association of SR and/or TA with reductions in cigarette consumption and/or attempts to stop smoking and/or with smoking cessation. Twelve studies met the inclusion criteria and results were extracted independently by two researchers.Results: Data were available from five countries (US, UK, Canada, Switzerland and Australia). Between 1% and 23% of smokers reported having ever used NRT for smoking reduction and between 2% and 14% during periods of temporary abstinence. Use of NRT for SR and/or TA was associated with little or no reduction in cigarette consumption. There was some evidence that it was positively associated with attempts to stop smoking and smoking cessation.Conclusion: In smoking populations use of NRT to aid SR and in situations where smoking is not permitted appears to be having little effect on achieving a reduction in cigarette consumption but does not undermine cessation and may promote it.

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Heather, Nick, and Robyn Richmond. "Research into Brief Interventions for Excessive Alcohol Consumers and Cigarette Smokers in Australia." Journal of Drug Issues 22, no. 3 (July 1992): 641–60. http://dx.doi.org/10.1177/002204269202200313.

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Over the past five years there has been a strong move toward the development, evaluation and implementation of brief interventions for smokers and excessive drinkers. In this article we review some of the issues related to brief interventions which include: the range of the methods used, the channels and settings of their delivery, the evidence available for their effectiveness, and some recent research priority-setting exercises. We conclude with likely further directions.

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Li, Lin, Ron Borland, Kenneth Michael Cummings, Geoffrey T. Fong, Shannon Gravely, Danielle M. Smith, Maciej L. Goniewicz, Richard J. O’Connor, Mary E. Thompson, and Ann McNeill. "How Does the Use of Flavored Nicotine Vaping Products Relate to Progression Toward Quitting Smoking? Findings From the 2016 and 2018 ITC 4CV Surveys." Nicotine & Tobacco Research 23, no. 9 (February 25, 2021): 1490–97. http://dx.doi.org/10.1093/ntr/ntab033.

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Abstract Introduction There is limited research on the role of flavors in nicotine vaping products (NVPs) in relation to smoking. We examined patterns of flavor use in NVPs in relation to progression toward quitting. Aims and Methods Data come from 886 concurrent users of NVPs (at least weekly) and cigarettes who were first surveyed in 2016 and then successfully recontacted in 2018 as part of the ITC 4CV Surveys conducted in Australia, Canada, England, and the United States. Participants were asked about their main vaping flavor categorized as: (1) tobacco or unflavored, (2) menthol or mint flavored, and (3) “sweet” flavors (eg, fruit or candy). We examined whether flavor was associated with progression toward quitting smoking between survey years. Results Overall, 11.1% of baseline concurrent users quit smoking by 2018. Compared with users of tobacco flavors, those vaping “sweet” flavors were more likely to quit smoking between surveys (13.8% vs. 9.6%; adjusted odds ratio [aOR] = 1.61, 95% confidence interval [CI] 1.01–2.58, p < .05), but those using menthol flavors were no more likely to quit smoking (8.3% vs. 9.6%, aOR = 0.87, 95% CI 0.43–1.47, p = .69). Among those who had quit smoking in 2018, 52.0% were still vaping, which was lower than the 65.8% among continuing smokers (aOR = 0.60, 95% CI 0.39–0.92, p = .02). Sweet flavor users were no more likely to continue vaping compared with tobacco flavor users, either for those continuing smoking or those having quit smoking by 2018. There was a net shift away from tobacco flavor among those who continued to vape at follow-up. Conclusions Use of fruit and other sweet flavored e-liquids is positively related to smokers’ transition away from cigarettes. Implications With multiple jurisdictions considering limiting or banning the sale of flavored NVPs, it is important to consider how such policies may impact smokers using NVPs to transition away from cigarette smoking. Our results indicate that vapers who used sweet flavors were more likely to transition away from cigarette smoking and quit cigarette use, at least in the short term, compared with those who used tobacco or unflavored NVPs. Randomized clinical trials are needed to establish if the observed association between use of flavored e-liquids and smoking cessation is due to self-selection or is truly causal.

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Mitchell, Danielle, Nathan Critchlow, Crawford Moodie, and Linda Bauld. "Reactions to Standardized Cigarette Packs With Varying Structural Designs, and the Association With Smoking Susceptibility: A Postimplementation Cross-Sectional Survey With Never-Smoking Adolescents in Scotland." Nicotine & Tobacco Research 22, no. 11 (June 23, 2020): 2041–50. http://dx.doi.org/10.1093/ntr/ntaa109.

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Abstract Introduction From May 20, 2017, cigarettes in the United Kingdom must be sold in standardized (plain) packaging. We explore postimplementation reactions to standardized cigarette packaging among never-smokers in Scotland, whether reactions vary in relation to permitted variations in pack structure, and whether reactions are associated with susceptibility. Aims and Methods A cross-sectional survey with 12–17-year-old never-smokers (n = 507) in Scotland, conducted November 2017–November 2018. Participants were shown one “regular” standardized cigarette pack (flip-top lid and straight-edged pack, similar to designs in Australia) and three standardized packs with varied pack structures (beveled-edges, slim pack, and shoulder box), which are permitted postimplementation in the United Kingdom. Participants rated each pack on eight five-point reaction measures (eg, attractiveness). Participants also indicated which pack, if any, they would choose. Smoking susceptibility was the outcome. Results The mean reaction scores for all four packs were mostly negative, however the shoulder box was consistently rated less negatively than the regular, slim, or beveled-edge packs. Most participants (87%) said they would not select any of the four packs, although susceptible participants were more likely to select one than nonsusceptible participants (25% vs. 7%; χ 2 = 29.70; p < .001). For all four packs, not finding them off-putting was associated with susceptibility (Adjusted Odds Ratio range: 2.73–3.69), albeit only a minority of adolescents did not find each pack off-putting. Conclusions Adolescents have negative reactions to the standardized cigarette packs implemented in the United Kingdom, albeit permitted variations in structure can reduce the extent of negativity. Most reactions to standardized packaging had no association with susceptibility. Implications We provide the first empirical evidence that adolescents find the standardized cigarette packs implemented in the United Kingdom unappealing and that most pack reactions have no association with susceptibility among never-smokers, with the exception of the minority who did not think that they would put them off smoking. This suggests that the legislation is achieving one of its primary aims, to reduce the appeal of packaging. That permitted variations in pack structure (eg, shoulder boxes) somewhat reduce negative reactions suggests that the United Kingdom, and other countries introducing similar legislation, should ensure that all aspects of pack design are fully standardized.

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Mucan, Burcu, and Crawford Moodie. "Young adult smokers’ perceptions of plain packs, numbered packs and pack inserts in Turkey: a focus group study." Tobacco Control 27, no. 6 (November 9, 2017): 631–36. http://dx.doi.org/10.1136/tobaccocontrol-2017-053902.

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IntroductionThe Turkish Government’s ‘National Tobacco Control Program 2015–2018’ included plans to introduce plain packaging and also a ban on brand names on cigarette packs, allowing only assigned numbers on packs. We explored perceptions of these proposed measures, and also pack inserts with cessation messages, another novel way of using the packaging to communicate with consumers.MethodsEight focus groups were conducted with 47 young adult smokers in Manisa and Kutahya (Turkey) in December 2016. Participants were shown three straight-edged plain cigarette packs, as required in Australia, and then three bevelled-edged plain packs, as permitted in the UK. They were then shown plain packs with numbers rather than brand names, and finally three pack inserts with messages encouraging quitting or offering tips on how to do so. Participants were asked about their perceptions of each.ResultsPlain packs were considered unappealing and off-putting, although the bevelled-edged packs were viewed more favourably than the straight-edged packs. Numbered packs were thought by some to diminish the appeal created by the brand name and potentially decrease interest among never smokers and newer smokers. Pack inserts were thought to have less of an impact than the on-pack warnings, but could potentially help discourage initiation and encourage cessation.ConclusionsThat bevelled-edged plain packs were perceived more positively than straight-edged plain packs is relevant to countries planning to introduce plain packaging. The study provides a first insight into smokers’ perceptions of a ban on brand names, which was perceived to reduce appeal among young people.

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Odutola, Michael K., Marina T. van Leeuwen, Jennifer Turner, Fiona Bruinsma, John F. Seymour, Henry M. Prince, Samuel T. Milliken, et al. "Associations between Smoking and Alcohol and Follicular Lymphoma Incidence and Survival: A Family-Based Case-Control Study in Australia." Cancers 14, no. 11 (May 30, 2022): 2710. http://dx.doi.org/10.3390/cancers14112710.

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The association between smoking and alcohol consumption and follicular lymphoma (FL) incidence and clinical outcome is uncertain. We conducted a population-based family case-control study (709 cases: 490 controls) in Australia. We assessed lifetime history of smoking and recent alcohol consumption and followed-up cases (median = 83 months). We examined associations with FL risk using unconditional logistic regression and with all-cause and FL-specific mortality of cases using Cox regression. FL risk was associated with ever smoking (OR = 1.38, 95%CI = 1.08–1.74), former smoking (OR = 1.36, 95%CI = 1.05–1.77), smoking initiation before age 17 (OR = 1.47, 95%CI = 1.06–2.05), the highest categories of cigarettes smoked per day (OR = 1.44, 95%CI = 1.04–2.01), smoking duration (OR = 1.53, 95%CI = 1.07–2.18) and pack-years (OR = 1.56, 95%CI = 1.10–2.22). For never smokers, FL risk increased for those exposed indoors to >2 smokers during childhood (OR = 1.84, 95%CI = 1.11–3.04). For cases, current smoking and the highest categories of smoking duration and lifetime cigarette exposure were associated with elevated all-cause mortality. The hazard ratio for current smoking and FL-specific mortality was 2.97 (95%CI = 0.91–9.72). We found no association between recent alcohol consumption and FL risk, all-cause or FL-specific mortality. Our study showed consistent evidence of an association between smoking and increased FL risk and possibly also FL-specific mortality. Strengthening anti-smoking policies and interventions may reduce the population burden of FL.

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Miller, Connor R., Edward Sutanto, Danielle M. Smith, Sara C. Hitchman, Shannon Gravely, Hua-Hie Yong, Ron Borland, et al. "Characterizing Heated Tobacco Product Use Among Adult Cigarette Smokers and Nicotine Vaping Product Users in the 2018 ITC Four Country Smoking & Vaping Survey." Nicotine & Tobacco Research 24, no. 4 (October 20, 2021): 493–502. http://dx.doi.org/10.1093/ntr/ntab217.

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Abstract Introduction Heated tobacco products (HTP) have diversified global tobacco markets, and user characteristics remain understudied. This study evaluated sociodemographic characteristics, nicotine-related perceptions, and behaviors of current HTP users within a sample of adult (18+ years) nicotine users across four countries. Aims and Methods Data were from current smokers or nicotine vaping product (NVP; known as “e-cigarettes”) users from Canada, England, the United States, and Australia (n = 11 421) who participated in the 2018 ITC Four Country Smoking and Vaping Survey. Current (at-least-monthly) HTP users were characterized (n = 441), and weighted multivariable logistic regressions examined correlates of HTP use. Results Compared to nonusers, current HTP users were younger (mean age: 44.4 vs 31.0 years; p < .001) and had higher socioeconomic status (p < .001). A majority of current HTP users used HTPs nondaily (daily: 40.3% vs nondaily: 59.7%). Most HTP users concurrently used both cigarettes and NVPs (90.5%). Among concurrent cigarette-HTP-NVP users, 36.2% used all three products daily. Use of other combusted tobacco products (cigars, cigarillos, pipe, waterpipe/hookah), cannabis, and binge drinking were each associated with current HTP use. HTP use was more common among smokers intending to quit within 6 months or reporting a quit attempt in the past 18 months, and vapers who had experienced negative side effects. Conclusion HTP users in this sample tended to be younger and more affluent. Most reported concurrent use of multiple nicotine products and other substances. Those cigarette smokers who used HTPs appeared more interested in smoking cessation, while some characteristics of concurrent HTP-NVP users were suggestive of dissatisfaction with NVPs. Implications Few studies have scrutinized characteristics of HTP early adopters in emerging markets. Our results indicate that in 2018, characteristics of established nicotine users who adopted HTP use in four high-income Western countries mirror those of HTP users in East Asian markets (South Korea and Japan) where HTPs are popular. HTP users reported high levels of concurrent use of noncigarette-combusted tobacco products (e.g., cigars, pipe tobacco). These findings point to the need for future longitudinal studies of HTP use given the implications of those use patterns on the harm reduction potential of HTPs. HTP user characteristics may yield important information to consider in regulation of these products.

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Yong, Hua-Hie, Ron Borland, David Hammond, James F. Thrasher, K. Michael Cummings, and Geoffrey T. Fong. "Smokers’ reactions to the new larger health warning labels on plain cigarette packs in Australia: findings from the ITC Australia project." Tobacco Control 25, no. 2 (February 19, 2015): 181–87. http://dx.doi.org/10.1136/tobaccocontrol-2014-051979.

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Oktavia, Ega, Alika Fitri Azizah, Baby Shafira Zaintira, and Carlina Surya. "Overview of E-Cigarette (Vape) Usage Behavior in 2021 UMJ FKM Students." Muhammadiyah International Public Health and Medicine Proceeding 1, no. 1 (November 1, 2021): 617–26. http://dx.doi.org/10.53947/miphmp.v1i1.108.

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E-cigarettes were first created in a modern way by a pharmacist from China in 2003 and patented in 2004 and then began to spread throughout the world. The results of a survey conducted by the International Tobacco Control Survey in America, Canada, Australia, and England, currently 29% of former smokers use electronic cigarettes, 7.6% have tried using electronic cigarettes and 46.6% are aware of the existence of electronic cigarettes. Some conditions that can arise from long-term use of nicotine are increased blood pressure and heart rate, as well as an increased risk of developing insulin resistance, type 2 diabetes, and heart disease. This research uses a qualitative approach with a descriptive method. Based on in-depth interviews with the informants, it was found that the informants had various reasons for using vapor, both for health reasons and for environmental reasons. All resource persons also argue that the dominant factor that makes a person use vapor is environmental factors. Meanwhile, when viewed from the behavior of all informants, they do not use vapor continuously but at certain times, even one of the informants still uses conventional cigarettes to be accompanied by vapor.

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Baker, Amanda, Robyn Richmond, Terry J. Lewin, and Frances Kay-Lambkin. "Cigarette Smoking And Psychosis: Naturalistic Follow up 4 Years After an Intervention Trial." Australian & New Zealand Journal of Psychiatry 44, no. 4 (April 2010): 342–50. http://dx.doi.org/10.3109/00048670903489841.

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Objective: Cigarette smoking is very common among people with a psychotic disorder and is often not addressed by clinicians. Additionally, few studies have evaluated smoking interventions among this group. The present study reports findings from a naturalistic follow up 4 years after a smoking intervention trial. Method: Longer-term smoking, symptomatology and functioning were examined among 247 participants (recruited in Sydney and Newcastle, Australia) who initially attended a 1 year follow up of an eight-session individually administered trial for regular smokers with a psychotic disorder. Variables profiled included continuous and point prevalence abstinence rates, smoking reduction status (no reduction, <50%, ≥50%, or abstinence) and changes in anxiety, depression and current functioning. Results: Two-thirds of those who completed the 1 year assessment were followed up at 4 years (164/247, 66.4%), of whom 79.2% reported maintenance or improvement in their smoking reduction status relative to 1 year. Abstinence at 1 year was significantly associated with 4 year point prevalence abstinence. Lengthy periods of abstinence were also evident among those reporting 4 year point prevalence abstinence or at least a 50% reduction. No baseline or intervention status variables predicted smoking status at 4 years. Symptomatology and functioning also improved between baseline and 4 years. Conclusions: Smokers with a psychotic disorder are capable of long-term change. It is recommended that clinicians address and monitor smoking during treatment of people with psychosis, emphasizing potential lifestyle and harm reduction benefits, with a view to eventual smoking cessation.

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Miller, C. L., D. J. Hill, P. G. Quester, and J. E. Hiller. "Response of mass media, tobacco industry and smokers to the introduction of graphic cigarette pack warnings in Australia." European Journal of Public Health 19, no. 6 (July 9, 2009): 644–49. http://dx.doi.org/10.1093/eurpub/ckp089.

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Thrasher, J. F., A. Osman, C. Moodie, D. Hammond, M. Bansal-Travers, K. M. Cummings, R. Borland, H. H. Yong, and J. Hardin. "Promoting cessation resources through cigarette package warning labels: a longitudinal survey with adult smokers in Canada, Australia and Mexico." Tobacco Control 24, e1 (July 22, 2014): e23-e31. http://dx.doi.org/10.1136/tobaccocontrol-2014-051589.

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Chan, Gary, Janni Leung, Coral Gartner, Hua-Hie Yong, Ron Borland, and Wayne Hall. "Correlates of electronic cigarette use in the general population and among smokers in Australia – Findings from a nationally representative survey." Addictive Behaviors 95 (August 2019): 6–10. http://dx.doi.org/10.1016/j.addbeh.2019.02.012.

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Bell, Kirsten, Simone Dennis, Jude Robinson, and Roland Moore. "Does the hand that controls the cigarette packet rule the smoker? Findings from ethnographic interviews with smokers in Canada, Australia, the United Kingdom and the USA." Social Science & Medicine 142 (October 2015): 136–44. http://dx.doi.org/10.1016/j.socscimed.2015.08.021.

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Sun, Tianze, Carmen C. W. Lim, Brienna N. Rutherford, Benjamin Johnson, Janni Leung, Coral Gartner, Wayne D. Hall, Jason P. Connor, and Gary C. K. Chan. "Is smoking reduction and cessation associated with increased e-cigarette use? Findings from a nationally representative sample of adult smokers in Australia." Addictive Behaviors 127 (April 2022): 107217. http://dx.doi.org/10.1016/j.addbeh.2021.107217.

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May, Robin, Frances Walker, Simon de Burgh, Roger Bartrop, and Geoffrey H. Tofler. "Pilot Study of an Internet-Based, Simulated Teachable Moment for Smoking Cessation." Journal of Smoking Cessation 14, no. 3 (September 28, 2018): 139–48. http://dx.doi.org/10.1017/jsc.2018.32.

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AbstractIntroductionThe internet has the potential to overcome geographic limitations for smoking cessation interventions, but further telehealth-based studies of utility are required.AimsTo investigate the efficacy of an internet-based version of a quit smoking approach using a personalised video to create a simulated teachable moment.MethodsSmokers within Australia were recruited through a dedicated website. After consent, eligible subjects, aged ≥30 years with a non-smoking partner, uploaded pictures of themselves, their partner and family, to be inserted into a video depicting the subject having a heart attack due to smoking, with consequences to them and their family. Nicotine replacement therapy (NRT) began prior to the quit attempt. The video was shown during two videoconference counselling sessions, with follow-up phone calls and text messaging support. Smoking status at 6 months by self-report (primary endpoint) was verified by partner/proxy and salivary cotinine (NicAlert™).Results/FindingsSeventy seven smokers were screened, of whom 50 were eligible, and 17 of these (34%) were enrolled; 11 men and 6 women, aged 41.5 ± 6.9 years, daily cigarette consumption 20.8 ± 8.9, Heaviness of Smoking Index score 3.7 ± 1.7. Participants reported feeling personally involved with the video (5.9 ± 1.1), which felt real (5.8 ± 1.1) and emotionally moving (5.6 ± 1.5) [7-point Likert Scale]. A similar video response was reported by the four participants (24%), who due to bandwidth limitations, watched the video after the counselling session instead of during it. Non-smoking rates at 6 months were 65% (11/17) by self-report with proxy confirmation, and 47% (8/17) by self-report with biologic confirmation. Three non-smokers by self-report could not provide a valid NicAlert™ result due to current NRT use. One participant who by self-report smoked once in the prior 14-days was assessed as a non-smoker by both proxy and NicAlert™.ConclusionsThis pilot study demonstrates efficacy for an internet-based version of a quit smoking program based on creating a simulated teachable moment. The findings provide support for further research into this technique, with the internet enabling greater reach than face-to-face.

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Thrasher, James F., Kamala Swayampakala, Ron Borland, Gera Nagelhout, Hua-Hie Yong, David Hammond, Maansi Bansal-Travers, Mary Thompson, and James Hardin. "Influences of Self-Efficacy, Response Efficacy, and Reactance on Responses to Cigarette Health Warnings: A Longitudinal Study of Adult Smokers in Australia and Canada." Health Communication 31, no. 12 (May 2, 2016): 1517–26. http://dx.doi.org/10.1080/10410236.2015.1089456.

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Thrasher, James F., Erika N. Abad-Vivero, Crawford Moodie, Richard J. O'Connor, David Hammond, K. Michael Cummings, Hua-Hie Yong, Ramzi G. Salloum, Christine Czoli, and Luz Myriam Reynales-Shigematsu. "Cigarette brands with flavour capsules in the filter: trends in use and brand perceptions among smokers in the USA, Mexico and Australia, 2012–2014." Tobacco Control 25, no. 3 (April 27, 2015): 275–83. http://dx.doi.org/10.1136/tobaccocontrol-2014-052064.

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Leas, Eric Craig, John P. Pierce, Claudiu V. Dimofte, Dennis R. Trinidad, and David R. Strong. "Standardised cigarette packaging may reduce the implied safety of Natural American Spirit cigarettes." Tobacco Control 27, e2 (December 18, 2017): e118-e123. http://dx.doi.org/10.1136/tobaccocontrol-2017-053940.

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BackgroundOver two-thirds of Natural American Spirit (NAS) smokers believe their cigarettes might be ‘less harmful’, but toxicological evidence does not support this belief. We assessed whether standardised packaging could reduce the possibility of erroneous inferences of ‘safety’ drawn from NAS cigarette packaging.MethodsUS adult smokers (n=909) were recruited to a between-subject survey experiment (3 brands×3 packaging/labelling styles) through Amazon Mechanical Turk and rated their perception of whether a randomly assigned cigarette package conveyed that the brand was ‘safer’ on a three-item scale (Cronbach’s α=0.92). We assessed whether NAS packs were rated higher on the ‘implied safety’ scale than two other brands and estimated the effect that plain packaging (ie, all branding replaced with a drab dark brown colour) and Australian-like packaging (ie, all branding replaced with a drab dark brown colour and a graphic image and text on 75% of the pack surface) had on perceptions of the NAS cigarette package.ResultsSmokers’ ratings of the standard NAS pack on the implied safety scale (mean=4.6; SD=2.9) were 1.9 times (P <0.001) higher than smokers’ ratings of a Marlboro Red pack (mean=2.4; SD=2.3) and 1.7 times (P <0.001) higher than smokers’ ratings of a Newport Menthol pack (mean=2.7; SD=2.4). These perceptions of implied safety were lower when plain packaging was used (Cohen’s d=0.66; P <0.001) and much lower when Australian-like packaging was used (Cohen’s d=1.56; P <0.001).ConclusionThe results suggest that NAS cigarette packaging conveys that its cigarettes are ‘safer’ and that such perceptions are lower with standardised packaging, both with and without warning images.

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Cho, Yoo Jin, James F. Thrasher, Kamala Swayampakala, Hua-Hie Yong, Robert McKeever, David Hammond, Dien Anshari, K. Michael Cummings, and Ron Borland. "Does Reactance against Cigarette Warning Labels Matter? Warning Label Responses and Downstream Smoking Cessation amongst Adult Smokers in Australia, Canada, Mexico and the United States." PLOS ONE 11, no. 7 (July 13, 2016): e0159245. http://dx.doi.org/10.1371/journal.pone.0159245.

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Kulinski, Kasia, and Natalie A. Smith. "Surgical prehabilitation using mobile health coaching in patients with obesity: A pilot study." Anaesthesia and Intensive Care 48, no. 5 (September 2020): 373–80. http://dx.doi.org/10.1177/0310057x20947731.

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Many patients spend months waiting for elective procedures, and many have significant modifiable risk factors that could contribute to an increased risk of perioperative morbidity and mortality. The minimal direct contact that usually occurs with healthcare professionals during this period represents a missed opportunity to improve patient health and surgical outcomes. Patients with obesity comprise a large proportion of the surgical workload but are under-represented in prehabilitation studies. Our study piloted a mobile phone based, multidisciplinary, prehabilitation programme for patients with obesity awaiting elective surgery. A total of 22 participants were recruited via the Wollongong Hospital pre-admissions clinic in New South Wales, Australia, and 18 completed the study. All received the study intervention of four text messages per week for six months. Questionnaires addressing the self-reported outcome measures were performed at the start and completion of the study. Forty percent of participants lost weight and 40% of smokers decreased their cigarette intake over the study. Sixty percent reported an overall improved health score. Over 80% of patients found the programme effective for themselves, and all recommended that it be made available to other patients. The cost was A$1.20 per patient per month. Our study showed improvement in some of the risk factors for perioperative morbidity and mortality. With improved methods to increase enrolment, our overall impression is that text message–based mobile health prehabilitation may be a feasible, cost-effective and worthwhile intervention for patients with obesity.

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Scollo, Michelle, Megan Bayly, Sarah White, Kylie Lindorff, and Melanie Wakefield. "Tobacco product developments in the Australian market in the 4 years following plain packaging." Tobacco Control 27, no. 5 (October 9, 2017): 580–84. http://dx.doi.org/10.1136/tobaccocontrol-2017-053912.

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This paper aimed to identify continued and emerging trends in the Australian tobacco market following plain packaging implementation, over a period of substantial increases in tobacco taxes. Since 2012, our surveillance activities (including review of trade product and price lists, ingredient reports submitted by tobacco companies to government and monitoring of the retail environment) found several trends in the factory-made cigarette market. These include the continued release of extra-long and slim cigarettes and packs with bonus cigarettes, particularly in the mainstream and premium market segments; new menthol capsule products; other novel flavourings in cigarettes; filter innovations including recessed and firm filters; continued use of evocative and descriptive product names; the proliferation of the new super-value market segment; and umbrella branding, where new products are introduced within established brand families. Several similar trends were also observed within the smoking tobacco market. While not all of these trends were new to the Australian market at the time of plain packaging implementation, their continued and increased use is notable. Plain packaging legislation could be strengthened to standardise cigarette and pack size, restrict brand and variant names, and ban features such as menthol capsules and filters innovations that provide novelty value or that may provide false reassurance to smokers.

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King, Bill, Ron Borland, Kylie Morphett, Coral Gartner, Kelly Fielding, Richard J. O’Connor, Kim Romijnders, and Reinskje Talhout. "‘It’s all the other stuff!’ How smokers understand (and misunderstand) chemicals in cigarettes and cigarette smoke." Public Understanding of Science 30, no. 6 (February 24, 2021): 777–96. http://dx.doi.org/10.1177/0963662521991351.

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Many people understand chemicals as entities that do not occur naturally, and which are also invariably toxic. Tobacco control messages liberally use the term ‘chemicals’ to evoke these meanings and create concern among smokers. This may reinforce misunderstandings, potentially leading to smokers making harmful choices. To investigate smokers’ understandings of chemicals, we conducted qualitative research using 18 individual interviews and three focus groups with Australian smokers and recently quit smokers. The research was guided by the ‘mental models’ framework and the recently developed Context, Executive, and Operational Systems theory. We discerned two clusters of mental models: the first cluster focused on combustion as the overarching cause of harm (and were largely consistent with the science) and the second cluster focused on additives as causes of harm. We found most participants displayed limited knowledge of the causes of harm from smoking and some held mutually incompatible beliefs. Most participants believed that cigarettes differ significantly in harmfulness according to whether or not they were believed to contain additives. Only a minority understood that the bulk of the toxicants to which smokers are exposed are combustion products. These findings are directly relevant to tobacco control but also have broader relevance to risk communications about toxic exposures.

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Cho, Yoo Jin, James F. Thrasher, Kamala Swayampakala, Isaac Lipkus, David Hammond, Kenneth Michael Cummings, Ron Borland, Hua-Hie Yong, and James W. Hardin. "Does Adding Information on Toxic Constituents to Cigarette Pack Warnings Increase Smokers’ Perceptions About the Health Risks of Smoking? A Longitudinal Study in Australia, Canada, Mexico, and the United States." Health Education & Behavior 45, no. 1 (July 17, 2017): 32–42. http://dx.doi.org/10.1177/1090198117709884.

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Mancuso, Serafino, Emily Brennan, Kimberley Dunstone, Amanda Vittiglia, Sarah Durkin, James F. Thrasher, Janet Hoek, and Melanie Wakefield. "Australian Smokers’ Sensory Experiences and Beliefs Associated with Menthol and Non-Menthol Cigarettes." International Journal of Environmental Research and Public Health 18, no. 11 (May 21, 2021): 5501. http://dx.doi.org/10.3390/ijerph18115501.

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Many current smokers incorrectly believe that menthol cigarettes are less harmful, likely due to the biological and sensory effects of menthol, which can lead smokers to have favourable sensory experiences. In this study, we measured the extent to which Australian smokers associate certain sensory experiences with smoking menthol and non-menthol cigarettes, and their beliefs about how damaging and enjoyable they find cigarettes with each of these sensory experiences. A sample of 999 Australian 18–69-year-old weekly smokers was recruited from a non-probability online panel; this study focuses on the 245 respondents who currently smoked menthol cigarettes at least once per week. Current menthol smokers were four to nine times more likely to experience menthol rather than non-menthol cigarettes as having favourable sensory experiences, including feeling smooth, being soothing on the throat, fresh-tasting and clean-feeling. Menthol smokers perceived cigarettes with these favourable sensations as less damaging and more enjoyable than cigarettes with the opposite more aversive sensory experience. Efforts to correct these misperceptions about risk will likely require messages that provide new information to help smokers understand that these sensations do not indicate a lower level of risk. Banning menthol in tobacco products—as has recently been done in some nations—would also be a timely and justified strategy for protecting consumers.

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Harris, Jeffrey E., Gastón Ares, Mariana Gerstenblüth, Leandro Machin, and Patricia Triunfo. "Impact of plain packaging of cigarettes on the risk perception of Uruguayan smokers: an experimental study." Tobacco Control 27, no. 5 (September 8, 2017): 513–18. http://dx.doi.org/10.1136/tobaccocontrol-2017-053639.

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BackgroundUruguay, a South American country of 3.4 million inhabitants that has already banned tobacco advertising, prohibited such terms as light, mild and low-tar and required graphic warnings covering 80% of cigarette packs, is considering the imposition of plain, standardised packaging.MethodsWe conducted an experimental choice-based conjoint analysis of the impact of alternative cigarette package designs on the risk perceptions of 180 adult current Uruguayan smokers. We compared plain packaging, with a standardised brand description and the dark brown background colour required on Australian cigarette packages, to two controls: the current package design with distinctive brand elements and colours; and a modified package design, with distinctive brand elements and the dark brown background colour. Graphic warnings were also varied.ResultsPlain packaging significantly reduced the probability of perceiving the stimulus cigarettes as less harmful in comparison to the current package design (OR 0.398, 95% CI 0.333 to 0.476, p<0.001) and the modified package design (OR 0.729, 95% CI 0.626 to 0.849, p<0.001).ConclusionsPlain packaging enhanced the perceived risk of cigarette products even in a highly regulated setting such as Uruguay. Both the elimination of distinctive brand elements and the use of Australia’s dark brown background colour contributed to the observed effect.

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Pergadia, Michele L., Arpana Agrawal, Andrew C. Heath, Nicholas G. Martin, Kathleen K. Bucholz, and Pamela A. F. Madden. "Nicotine Withdrawal Symptoms in Adolescent and Adult Twins." Twin Research and Human Genetics 13, no. 4 (August 1, 2010): 359–69. http://dx.doi.org/10.1375/twin.13.4.359.

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AbstractWe examined the variation and heritability of DSM-IV nicotine withdrawal (NW) in adult and adolescent male and female twin cigarette smokers (who reported smoking 100 or more cigarettes lifetime). Telephone diagnostic interviews were completed with 3,112 Australian adult male and female smokers (53% women; age: 24–36) and 702 Missouri adolescent male and female smokers (59% girls; age: 15–21). No gender or cohort differences emerged in rates of meeting criteria for NW (44%). Latent class analyses found that NW symptoms were best conceptualized as a severity continuum (three levels in adults and two levels in adolescents). Across all groups, increasing NW severity was associated with difficulty quitting, impairment following cessation, heavy smoking, depression, anxiety, conduct disorder and problems with alcohol use. NW was also associated with seeking smoking cessation treatment and with smoking persistence in adults. The latent class structure of NW was equally heritable across adult and adolescent smokers with additive genetic influences accounting for 49% of the variance and the remaining 51% of variance accounted for by unique environmental influences. Overall, findings suggest remarkable similarity in the pattern and heritability of NW across adult and adolescent smokers, and highlight the important role of NW in psychiatric comorbidity and the process of smoking cessation across both age groups.

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Fitrianto, Eko Mohammad. "Plain Package; Can It Affect Health Awareness and Quit Smoking Attempt Behavior?" JURNAL MANAJEMEN DAN BISNIS SRIWIJAYA 16, no. 3 (March 21, 2019): 185–93. http://dx.doi.org/10.29259/jmbs.v16i3.7382.

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AbstractPurpose: Graphic Pictorial Health Warnings (GPHW) Policy has been implemented in Indonesia since 2014, but the numbers have never shown declining yet. A few countries like Australia and Canada use plain package policy as a new approach to reducing it. Even the plain package policy has been not implemented in Indonesia, this could be preliminary research as an alternative solution.Design/Methodology/Approach: Paired t-test conducted to test the significant difference between smoker’s perception about a regular and plain package. Because of a plain package has not implemented yet, we demonstrate a product’s prototype and ask them to imagine if the policy has actually implemented. This preliminary research use cross-section methods to gain the data. To test the effect, we collected information from 200 active smokers in Palembang, Indonesia using a questionnaire.Findings: Significant difference (< 0.05 ) occurs between smoker's perception about health awareness and quit smoking behavior at the regular and plain package. There is 9 item to compare each other and two overall variables. Six of a nine-item variable has significant difference each other (< 0.05), and also two others (< 0.05).Practical implication: As preliminary findings, this significant difference addressed to formulate a better GPHW Policy. It can use to gain more smoker's attention to health awareness and drive quit smoking attempt behavior. And we propose ongoing social marketing campaign related to amplify the effect of a plain package according to research findings.Originality/value: We conduct a preliminary test to compared smoker’s perception at the regular package and plain package, even the plain ones have been not implemented yet. To make more realistic about plain package’s response, we use a prototype to amplify their visualization. Social marketing campaign related to a plain package ongoing.Keywords: disturbing pictures on cigarettes pack, graphical picture health warning, health awareness, quit smoking attempt behavior, social marketing.

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Ghassempour, Nargess, Wadad Kathy Tannous, Kingsley Emwinyore Agho, Gulay Avsar, and Lara Ann Harvey. "The Impact of Reduced Fire Risk Cigarettes Regulation on Residential Fire Incidents, Mortality and Health Service Utilisation in New South Wales, Australia." International Journal of Environmental Research and Public Health 19, no. 19 (September 30, 2022): 12481. http://dx.doi.org/10.3390/ijerph191912481.

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Smoking materials are a common ignition source for residential fires. In Australia, reduced fire risk (RFR) cigarettes regulation was implemented in 2010. However, the impact of this regulation on residential fires is unknown. This paper examines the impact of the RFR cigarettes regulation on the severity and health outcomes of fire incidents in New South Wales (NSW), Australia, from 2005 to 2014. Fire department data from 2005 to 2014 were linked with ambulance, emergency department, hospital, outpatient burns clinic and mortality datasets for NSW. Negative binomial regression analysis was performed to assess the changes to fire incidents’ severity pre- and post-RFR cigarettes regulation. There was an 8% reduction in total fire incidents caused by smokers’ materials post-RFR cigarettes regulation. Smokers’ materials fire incidents that damaged both contents and structure of the building, where fire flames extended beyond the room of fire origin, with over AUD 1000 monetary damage loss, decreased by 18, 22 and 12%, respectively. RFR cigarettes regulation as a fire risk mitigation has positively impacted the residential fire incident outcomes. This provides support for regulation of fire risk protective measures and bestows some direction for other fire safety policies and regulations.

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Gilbert, Emilee. "Constructing ‘Fashionable’ Youth Identities: Australian Young Women Cigarette Smokers." Journal of Youth Studies 10, no. 1 (February 2007): 1–15. http://dx.doi.org/10.1080/13676260701196079.

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Prabowo, Doni MS, and Haris B. Widodo. "Nicotine stomatitis in smokers: a case report." Journal of Dentomaxillofacial Science 3, no. 1 (April 1, 2018): 58. http://dx.doi.org/10.15562/jdmfs.v3i1.708.

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Objective: The aim of this study is to describe and analyse nicotine stomatitis in smokers. Of the world population that consumes tobacco, Asia and Australia make up 57% of tobacco consumers. Tobacco can be consumed by various ways such as smoked tobacco, commonly known as cigarettes, or smokeless tobacco. Cigarettes are known to cause nicotine stomatitis in the oral cavity.Methods: A 28-year-old man patient came with complaints of white spots on his hard palate. The patient has a medical history of asthma as a child and has been taking salbutamol. The patient has been smoking 3 packs of cigarettes a day since being 16 years old.Results: Nicotine stomatitis that occurs on the hard palate appears as circular reddish shapes on the orifice of minor salivary glands. These lesions are formed from physically irritation caused by smoking. The lesions were benign and reversible.Conclusion: Thought appropriate examination and treatment, these lesions were healed.

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Wise, J. "Smokers come to accept plain cigarette packaging, Australian study shows." BMJ 349, no. 10 18 (November 10, 2014): g6717. http://dx.doi.org/10.1136/bmj.g6717.

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Guillaumier, Ashleigh, Billie Bonevski, and Christine Paul. "‘Cigarettes are priority’: a qualitative study of how Australian socioeconomically disadvantaged smokers respond to rising cigarette prices: Table I." Health Education Research 30, no. 4 (June 25, 2015): 599–608. http://dx.doi.org/10.1093/her/cyv026.

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Erku, Daniel A., Kylie Morphett, Kathryn J. Steadman, and Coral E. Gartner. "Policy Debates Regarding Nicotine Vaping Products in Australia: A Qualitative Analysis of Submissions to a Government Inquiry from Health and Medical Organisations." International Journal of Environmental Research and Public Health 16, no. 22 (November 18, 2019): 4555. http://dx.doi.org/10.3390/ijerph16224555.

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Australia has maintained a highly restrictive regulatory framework for nicotine vaping products (NVPs) and the regulatory approach differs from most other high income countries. This paper employed a thematic analysis to assess policy consultation submissions made to a government inquiry regarding use and marketing of NVPs. We included in the analysis submissions (n = 40) made by Australian institutions that influence or contribute to health policy-making including government agencies, health bodies and charities (n = 23), and public health academics and healthcare professionals (n = 18). Submissions from commercial entities and consumers were excluded. The majority of submissions from representatives of government agencies, health bodies and charities recommended maintaining current restrictions on NVPs. Arguments against widening access to NVPs included the demand for long-term evidence on safety and efficacy of an unusually high standard. There was widespread support for restrictions on sales, advertising and promotion, with most submissions supporting similar controls as for tobacco products. In contrast, the majority of individual submissions from healthcare professionals and public health academics advocated for widening access to NVPs for smokers and emphasized the potential benefits of smokers switching to vaping and the policy incoherence of regulating less harmful nicotine products more strictly than tobacco cigarettes. Progress in resolving the policy debate concerning NVP regulation in Australia will require policy makers, clinicians and the public health community to engage in a meaningful dialogue which gives due consideration to both intended and unintended consequences of proposed policies.

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Hawkins, Summer Sherburne, Janet Chung-Hall, Lorraine Craig, Geoffrey T. Fong, Ron Borland, K. Michael Cummings, David Levy, and Sara C. Hitchman. "Support for Minimum Legal Sales Age Laws Set to Age 21 Across Australia, Canada, England, and United States: Findings From the 2018 ITC Four Country Smoking and Vaping Survey." Nicotine & Tobacco Research 22, no. 12 (July 1, 2020): 2266–70. http://dx.doi.org/10.1093/ntr/ntaa119.

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Abstract Introduction Although the United States has seen a rapid increase in tobacco minimum legal sales age (MLSA) laws set to age 21, there is wide variation across high-income countries and less is known about policy support outside of the United States. We examined the prevalence of support for tobacco MLSA 21 laws as well as associations by sociodemographic, smoking, and household characteristics among current and former adult smokers. Methods In this cross-sectional analysis, we used the 2018 International Tobacco Control Four Country Smoking and Vaping Survey to examine support for MLSA 21 laws among 12 904 respondents from Australia, Canada, England, and United States. Results Support for raising the legal age of purchasing cigarettes/tobacco to 21 ranged from 62.2% in the United States to 70.8% in Canada. Endorsement also varied by age, such that 40.6% of 18–20 years old supported the policy compared with 69.3% of those aged ≥60 years. In the adjusted regression model, there was also higher support among respondents who were female than male, non-white than white, those who did not allow smoking in the household than those that did, and those who had children in the household than those that did not. There were no differences by household income, education, or smoking status. Conclusions Most current and former smokers, including a sizable minority of those aged ≤20 years, support raising the legal age of purchasing cigarettes/tobacco to 21. Implications There was strong support for MLSA 21 laws among smokers and former smokers across Australia, Canada, England, and the United States, providing evidence for the increasing public support of the passage of these laws beyond the United States.

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Cheng, Kai-Wen, Ce Shang, Hye Myung Lee, Frank J. Chaloupka, Geoffrey T. Fong, Ron Borland, Bryan W. Heckman, et al. "Costs of vaping: evidence from ITC Four Country Smoking and Vaping Survey." Tobacco Control 30, no. 1 (February 21, 2020): 94–97. http://dx.doi.org/10.1136/tobaccocontrol-2019-055344.

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Study objectivesTo compare the prices paid for nicotine vaping products (NVPs) and supplies among current NVP users to prices paid for cigarettes among current smokers.DataThe 2016 International Tobacco Control Four Country Vaping and Smoking Survey (4CV1). Key measures included: (1) self-reported prices paid for reusable NVPs (eg, rechargeable devices with cartridges and tank system devices with e-liquids) in the 3-month period prior to the survey among current NVP users, (2) prices paid for disposable NVPs, cartridges and e-liquids purchased in the last 30 days among current NVP users and (3) self-reported prices paid for cigarettes among current smokers.ResultsDisposable NVP price was higher than the price of a comparable unit for combustible cigarettes in England (EN), USA and Canada (CA). Prefilled cartridge price was higher than the price of a comparable unit of cigarettes in USA and CA, but lower in EN and Australia. E-liquid price was consistently lower than the price of a comparable unit of cigarettes across four countries. For start-up costs, price of a rechargeable device is approximately 3–5 times higher than a pack of cigarettes in four countries.ConclusionNVP prices were generally higher than prices of combustible cigarettes, especially the high upfront NVP devices. The high upfront costs of purchasing a reusable NVP may discourage some smokers from switching to vaping. However, the average lower costs of cartridges and e-liquids relative to a package of cigarettes make switching to a NVP an attractive alternative to smoking in the long term so long as smokers switch completely to vaping.

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McRobbie, Hayden J., Anna Phillips-Waller, Catherine El Zerbi, Ann McNeill, Peter Hajek, Francesca Pesola, James Balmford, et al. "Nicotine replacement treatment, e-cigarettes and an online behavioural intervention to reduce relapse in recent ex-smokers: a multinational four-arm RCT." Health Technology Assessment 24, no. 68 (December 2020): 1–82. http://dx.doi.org/10.3310/hta24680.

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Background Relapse remains an unresolved issue in smoking cessation. Extended stop smoking medication use can help, but uptake is low and several behavioural relapse prevention interventions have been found to be ineffective. However, opportunistic ‘emergency’ use of fast-acting nicotine replacement treatment or electronic cigarettes may be more attractive and effective, and an online behavioural Structured Planning and Prompting Protocol has shown promise. The present trial aimed to evaluate the clinical effectiveness and cost-effectiveness of these two interventions. Design A randomised controlled trial. Setting English stop smoking services and Australian quitlines, Australian social media and St Vincent’s Hospital Melbourne, Fitzroy, VIC. Participants Ex-smokers abstinent for at least 4 weeks, with some participants in Australia also recruited from 1 week post quit date. The planned sample size was 1400, but the trial was curtailed when 235 participants were recruited. Interventions Participants were randomised in permuted blocks of random sizes to (1) oral nicotine replacement treatment/electronic cigarettes to use if at risk of relapse, plus static text messages (n = 60), (2) the Structured Planning and Prompting Protocol and interactive text messages (n = 57), (3) oral nicotine replacement treatment/electronic cigarettes plus the Structured Planning and Prompting Protocol with interactive text messages (n = 58) or (4) usual care plus static text messages (n = 59). Outcome measures Owing to delays in study set-up and recruitment issues, the study was curtailed and the primary outcome was revised. The original objective was to determine whether or not the two interventions, together or separately, reduced relapse rates at 12 months compared with usual care. The revised primary objective was to determine whether or not number of interventions received (i.e. none, one or two) affects relapse rate at 6 months (not biochemically validated because of study curtailment). Relapse was defined as smoking on at least 7 consecutive days, or any smoking in the last month at final follow-up for both the original and curtailed outcomes. Participants with missing outcome data were included as smokers. Secondary outcomes included sustained abstinence (i.e. no more than five cigarettes smoked over the 6 months), nicotine product preferences (e.g. electronic cigarettes or nicotine replacement treatment) and Structured Planning and Prompting Protocol coping strategies used. Two substudies assessed reactions to interventions quantitatively and qualitatively. The trial statistician remained blinded until analysis was complete. Results The 6-month relapse rates were 60.0%, 43.5% and 49.2% in the usual-care arm, one-intervention arm and the two-intervention arm, respectively (p = 0.11). Sustained abstinence rates were 41.7%, 54.8% and 50.9%, respectively (p = 0.17). Electronic cigarettes were chosen more frequently than nicotine replacement treatment in Australia (71.1% vs. 29.0%; p = 0.001), but not in England (54.0% vs. 46.0%; p = 0.57). Of participants allocated to nicotine products, 23.1% were using them daily at 6 months. The online intervention received positive ratings from 63% of participants at 6 months, but the majority of participants (72%) completed one assessment only. Coping strategies taught in the Structured Planning and Prompting Protocol were used with similar frequency in all study arms, suggesting that these are strategies people had already acquired. Only one participant used the interactive texting, and interactive and static messages received virtually identical ratings. Limitations The inability to recruit sufficient participants resulted in a lack of power to detect clinically relevant differences. Self-reported abstinence was not biochemically validated in the curtailed trial, and the ecological momentary assessment substudy was perceived by some as an intervention. Conclusions Recruiting recent ex-smokers into an interventional study proved problematic. Both interventions were well received and safe. Combining the interventions did not surpass the effects of each intervention alone. There was a trend in favour of single interventions reducing relapse, but it did not reach significance and there are reasons to interpret the trend with caution. Future work Further studies of both interventions are warranted, using simpler study designs. Trial registration Current Controlled Trials ISRCTN11111428. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 68. See the NIHR Journals Library website for further project information. Funding was also provided by the National Health and Medical Research Council, Canberra, ACT, Australia (NHMRC APP1095880). Public Health England provided the funds to purchase the nicotine products in England.

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Wen, Li Ming, Chris Rissel, Yan Cheng, Juliet Richters, and Richard O. de Visser. "Tobacco smoking and sexual difficulties among Australian adults: a cross-sectional study." Sexual Health 14, no. 4 (2017): 313. http://dx.doi.org/10.1071/sh17005.

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Background Few studies have examined smoking and female sexual difficulties. The aim of this study was to investigate the association between current tobacco smoking and sexual difficulties in Australian men and women. Methods: Data for this study came from the Second Australian Study of Health and Relationships (2012–13), which includes a representative sample of 18 427 sexually active Australian adults (aged 16–69 years). The main study and outcome measures were tobacco smoking and sexual difficulties. A multiple logistic regression analysis was conducted to adjust for potential confounders. Results: Male heavy smokers (>20 cigarettes per day) were significantly more likely than non-smokers to have trouble keeping an erection [adjusted odds ratio (AOR) 4.14, 95% confidence interval (CI) 1.87–9.20; P < 0.0001], lack interest in having sex (AOR 2.18, 95% CI 1.20–3.97; P = 0.011), have anxiety about performance (AOR 2.46, 95% CI 1.24–4.86; P = 0.010) and be unable to come to orgasm (AOR = 2.81, 95% CI 1.23–6.42; P = 0.015). Female smokers were also significantly more likely than non-smokers to not find sex pleasurable (AOR 1.48, 95% CI 1.05–2.07; P = 0.025); and light female smokers were significantly more likely than non-smokers to be unable to come to orgasm (AOR = 1.44, 95% CI 1.05–1.98; P = 0.025). Conclusions: Current tobacco smoking was associated with sexual difficulties in both men and women. For women, even light smoking was associated with not finding sex pleasurable and being unable to come to orgasm.

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Foulstone, Alexis R., Temesgen Kifle, and Adrian B. Kelly. "The Influence of Partner Smoking, Relationship Satisfaction and Parental Stress on Tobacco Use." Journal of Smoking Cessation 14, no. 3 (December 14, 2018): 155–60. http://dx.doi.org/10.1017/jsc.2018.37.

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AbstractIntroductionDespite declines in tobacco use during pregnancy and after childbirth, smoking remains unacceptably high among many parents. Smoking maintenance or relapse may be common in couple relationships when the other parent continues to smoke, when relationship satisfaction is low, or parental stress high.AimTo examine the longitudinal influence of partner tobacco use, relationship satisfaction and parental stress on tobacco use after childbirth.MethodsData was obtained from 115 Australian heterosexual adult couples (Mean age = 31.8) who reported being pregnant in the previous year and the female partner was a previous or current smoker. A household longitudinal survey was administered in which measures of tobacco use, relationship satisfaction and parental stress were assessed on four occasions over nine years.ResultsOverall reductions in tobacco use occurred over the nine-year assessment period, although a small percentage (9.6%) of parents reported being daily smokers at every assessment. Similarly, a small proportion (13.1%) of parents relapsed to using tobacco during the assessment period. A random effects binary logit model indicated that mothers and fathers were more likely to continue or relapse to tobacco use if their partners smoked. Mothers were more likely to quit smoking if they became pregnant between the assessment waves, but for males, having a pregnant partner was not a significant predictor of tobacco cessation.ConclusionWhile pregnancy is associated with smoking cessation for mothers, both mothers and fathers are at elevated risk of continued tobacco smoking or relapse if their partner smokes during the first nine years after childbirth. For parents who continue to smoke cigarettes or relapse after childbirth, engagement of the partner in smoking cessation may be a key factor in promoting positive outcomes.

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Jin, Xingzhong, Stuart A. Kinner, Robyn Hopkins, Emily Stockings, Ryan J. Courtney, Anthony Shakeshaft, Dennis Petrie, Timothy Dobbins, and Kate Dolan. "Brief intervention on Smoking, Nutrition, Alcohol and Physical (SNAP) inactivity for smoking relapse prevention after release from smoke-free prisons: a study protocol for a multicentre, investigator-blinded, randomised controlled trial." BMJ Open 8, no. 10 (October 2018): e021326. http://dx.doi.org/10.1136/bmjopen-2017-021326.

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IntroductionSmoking remains the leading risk factor for disease burden and mortality worldwide. Heavy Smoking is often associated with poor Nutrition, Alcohol abuse and Physical inactivity (known as ‘SNAP’). Australia’s first prison smoking ban was introduced in the Northern Territory in July 2013. However, relapse to smoking after release from prison is normative. Holistic and cost-effective interventions are needed to maintain post-release abstinence to realise the potential public health impact of smoke-free prison policies. Rigorous, large-scale trials of innovative and scalable interventions are crucial to inform tobacco control policies in correctional settings.Methods and analysisThis multicentre, investigator-blinded, randomised parallel superiority trial will evaluate the effectiveness of a brief intervention on SNAP versus usual care in preventing smoking relapse among people released from smoke-free prisons in the Northern Territory, Australia. A maximum of 824 participants will be enrolled and randomly assigned to either SNAP intervention or usual care at a 1:1 ratio at baseline. The primary endpoint is self-reported continuous smoking abstinence three months after release from prison, verified by breath carbon monoxide test. Secondary endpoints include seven-day point prevalence abstinence, time to first cigarette, number of cigarettes smoked post release, Health Eating Index for Australian Adults, Alcohol Use Disorder Identification Test-Consumption and International Physical Activity Questionnaire scores. The primary endpoint will be analysed on an intention-to-treat basis using a simple log binomial regression model with multiple imputation for missing outcome data. A cost-effectiveness analysis of the brief intervention will be conducted subsequently.Ethics and disseminationThis study was approved by the University of New South Wales Human Research Ethics Committee (HREC), Menzies HREC and Central Australia HREC. Primary results of the trial and each of the secondary endpoints will be submitted for publication in a peer-review journal.Trial registration numberACTRN12617000217303; Pre-results.

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Gravely, Shannon, Lorraine V. Craig, K. Michael Cummings, Janine Ouimet, Ruth Loewen, Nadia Martin, Janet Chung-Hall, et al. "Smokers’ cognitive and behavioural reactions during the early phase of the COVID-19 pandemic: Findings from the 2020 ITC Four Country Smoking and Vaping Survey." PLOS ONE 16, no. 6 (June 4, 2021): e0252427. http://dx.doi.org/10.1371/journal.pone.0252427.

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Introduction COVID-19 is primarily a respiratory illness, and smoking adversely impacts the respiratory and immune systems; this confluence may therefore incentivize smokers to quit. The present study, conducted in four high-income countries during the first global wave of COVID-19, examined the association between COVID-19 and: (1) thoughts about quitting smoking; (2) changes in smoking (quit attempt, reduced or increased smoking, or no change); and (3) factors related to a positive change (making a quit attempt or reducing smoking) based on an adapted framework of the Health Belief Model. Methods This cross-sectional study included 6870 adult smokers participating in the Wave 3 (2020) ITC Four Country Smoking and Vaping Survey conducted in Australia, Canada, England, and United States (US). These four countries had varying responses to the pandemic by governments and public health, ranging from advising voluntary social distancing to implementing national and subnational staged lockdowns. Considering these varying responses, and the differences in the number of confirmed cases and deaths (greatest in England and the US and lowest in Australia), smoking behaviours related to COVID-19 may have differed between countries. Other factors that may be related to changes in smoking because of COVID-19 were also explored (e.g., sociodemographics, nicotine dependence, perceptions about personal and general risks of smoking on COVID-19). Regression analyses were conducted on weighted data. Results Overall, 46.7% of smokers reported thinking about quitting because of COVID-19, which differed by country (p<0.001): England highest (50.9%) and Australia lowest (37.6%). Thinking about quitting smoking because of COVID-19 was more frequent among: females, ethnic minorities, those with financial stress, current vapers, less dependent smokers (non-daily and fewer cigarettes smoked/day), those with greater concern about personal susceptibility of infection, and those who believe COVID-19 is more severe for smokers. Smoking behaviour changes due to COVID-19 were: 1.1% attempted to quit, 14.2% reduced smoking, and 14.6% increased smoking (70.2% reported no change). Positive behaviour change (tried to quit/reduced smoking) was reported by 15.5% of smokers, which differed by country (p = 0.02), where Australia had significantly lower rates than the other three countries. A positive behavioural smoking change was more likely among smokers with: lower dependence, greater concern about personal susceptibility to infection, and believing that COVID-19 is more severe for smokers. Conclusions Though nearly half of smokers reported thinking about quitting because of COVID-19, the vast majority did not change their smoking behaviour. Smokers were more likely to try and quit or reduce their smoking if they had greater concern about susceptibility and severity of COVID-19 related to smoking. Smokers in Australia were least likely to reduce or try to quit smoking, which could be related to the significantly lower impact of COVID-19 during the early phase of the pandemic relative to the other countries.

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King, Bill, Ron Borland, and Jeff Fowles. "Mainstream smoke emissions of Australian and Canadian cigarettes." Nicotine & Tobacco Research 9, no. 8 (August 2007): 835–44. http://dx.doi.org/10.1080/14622200701485109.

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Drovandi, Aaron, Peta-Ann Teague, Beverley Glass, and Bunmi Malau-Aduli. "Do health warnings on cigarette sticks dissuade smokers and non-smokers? A focus group and interview study of Australian university students." Psychology Research and Behavior Management Volume 12 (May 2019): 361–73. http://dx.doi.org/10.2147/prbm.s193754.

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Journal articles on the topic 'Cigarette smokers Australia'

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