Journal articles on the topic 'Tobacco control; social marketing; health warnings'
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Weiger, Caitlin Victoria, Katherine Smith, Amy Y. Hong, and Joanna E. Cohen. "Cigarette Packs With URLs Leading to Tobacco Company Websites: Content Analysis." Journal of Medical Internet Research 22, no. 6 (June 9, 2020): e15160. http://dx.doi.org/10.2196/15160.
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Background Tobacco companies include on the packaging of their products URLs directing consumers to websites that contain protobacco messages. Online media tend to be underregulated and provide the industry with an opportunity to present users with protobacco communication. Objective The objective of our study was to document the content of websites that were advertised on tobacco packs in 14 low- and middle-income countries. Methods We purchased tobacco packs from 14 low- and middle-income countries in 2013 and examined them for the presence of URLs. We visited unique URLs on multiple occasions between October 1, 2016 and August 9, 2017. We developed a coding checklist and used it to conduct a content analysis of active corporate websites to identify types of protobacco communication. The coding checklist included the presence of regulatory controls and warnings, engagement strategies, marketing appeals (eg, description of product popularity, luxury/quality, taste), corporate social responsibility programs, and image management. We coded brand websites separately and also described social media and other website types. Results We identified 89 unique URLs, of which 54 were active during the search period. We assessed 26 corporate websites, 21 brand websites, 2 nontobacco websites, and 5 social media pages. We excluded 2 corporate websites and 14 brand websites due to limited accessible content or incomplete content. Corporate social responsibility was discussed on all corporate websites, and marketing appeals were also common. Corporate websites were also more likely to include more nonspecific (12/24, 50%) than specific (7/24, 29%) health warnings. Promotions (6/7, 86%) and sociability appeals (3/7, 43%) were common on brand websites. The small number of social media webpages in our sample used gendered marketing. Conclusions URLs appearing on tobacco packs direct consumers to websites where users are exposed to marketing that highlights the “positive” contributions of tobacco companies on corporate websites, and extensive promotions and marketing appeals on brand websites and social media pages. It is essential that marketing regulations become more comprehensive and ban all protobacco communication, a policy that is in line with articles 5.3 and 13 of the World Health Organization Framework Convention on Tobacco Control. For countries that already ban internet tobacco advertising, enforcement efforts should be strengthened. Tobacco companies’ use of URLs on packs may also be compelling for plain packaging advocacy, where all branding is removed from the pack and large graphic health warning labels are the only communication on the tobacco packaging. Future research should consider including tobacco websites in marketing surveillance.
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Chung-Hall, Janet, Lorraine Craig, Shannon Gravely, Natalie Sansone, and Geoffrey T. Fong. "Impact of the WHO FCTC over the first decade: a global evidence review prepared for the Impact Assessment Expert Group." Tobacco Control 28, Suppl 2 (June 7, 2018): s119—s128. http://dx.doi.org/10.1136/tobaccocontrol-2018-054389.
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ObjectiveTo present findings of a narrative review on the implementation and effectiveness of 17 Articles of the WHO Framework Convention on Tobacco Control (FCTC) during the Treaty’s first decade.Data sourcesPublished reports on global FCTC implementation; searches of four databases through June 2016; hand-search of publications/online resources; tobacco control experts.Study selectionWHO Convention Secretariat global progress reports (2010, 2012, 2014); 2015 WHO report on the global tobacco epidemic; studies of social, behavioural, health, economic and/or environmental impacts of FCTC policies.Data extractionProgress in the implementation of 17 FCTC Articles was categorised (higher/intermediate/lower) by consensus. 128 studies were independently selected by multiple authors in consultation with experts.Data synthesisImplementation was highest for smoke-free laws, health warnings and education campaigns, youth access laws, and reporting/information exchange, and lowest for measures to counter industry interference, regulate tobacco product contents, promote alternative livelihoods and protect health/environment. Price/tax increases, comprehensive smoking and marketing bans, health warnings, and cessation treatment are associated with decreased tobacco consumption/health risks and increased quitting. Mass media campaigns and youth access laws prevent smoking initiation, decrease prevalence and promote cessation. There were few studies on the effectiveness of policies in several domains, including measures to prevent industry interference and regulate tobacco product contents.ConclusionsThe FCTC has increased the implementation of measures across several policy domains, and these implementations have resulted in measurable impacts on tobacco consumption, prevalence and other outcomes. However, FCTC implementation must be accelerated, and Parties need to meet all their Treaty obligations and consider measures that exceed minimum requirements.
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Levy, David T., Zhe Yuan, Yuying Luo, and Darren Mays. "Seven years of progress in tobacco control: an evaluation of the effect of nations meeting the highest level MPOWER measures between 2007 and 2014." Tobacco Control 27, no. 1 (December 12, 2016): 50–57. http://dx.doi.org/10.1136/tobaccocontrol-2016-053381.
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ObjectiveSince WHO released the package of six MPOWER measures to assist nations with implementing the WHO Framework Convention for Tobacco Control (FCTC), 88 countries adopted at least one highest level MPOWER measure. We estimated the subsequent reduction in smoking-related deaths from all new highest level measures adopted between 2007 and 2014.MethodsPolicy effect sizes based on previously validated SimSmoke models were applied to the number of smokers in each nation to determine the reduction in the number of smokers from policy adoption. On the basis of research that half of all smokers die from smoking, we derived the smoking-attributable deaths (SADs) averted of those smokers alive today.FindingsIn total, 88 countries adopted at least one highest level MPOWER policy between 2007 and 2014, resulting in almost 22 million fewer projected SADs. The largest number of future SADs averted was due to increased cigarette taxes (7.0 million), followed by comprehensive smoke-free laws (5.4 million), large graphic health warnings (4.1 million), comprehensive marketing bans (3.8 million) and comprehensive cessation interventions (1.5 million).ConclusionsThese findings demonstrate the immense public health impact of tobacco control policies adopted globally since the WHO-FCTC and highlight the importance of more countries adopting highest level MPOWER measures to reduce the global burden of tobacco use. Substantial additional progress could be made, especially if heavily populated nations with high smoking prevalence were to reach highest level MPOWER measures.
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Vijayaraghavan, Maya, Pamela Olsen, John Weeks, Karma McKelvey, Claudia Ponath, and Margot Kushel. "Older African American Homeless-Experienced Smokers’ Attitudes Toward Tobacco Control Policies—Results from the HOPE HOME Study." American Journal of Health Promotion 32, no. 2 (September 12, 2017): 381–91. http://dx.doi.org/10.1177/0890117117729928.
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Purpose: To examine attitudes toward tobacco control policies among older African American homeless-experienced smokers. Approach: A qualitative study. Setting: Oakland, California. Participants: Twenty-two African American older homeless-experienced smokers who were part of a longitudinal study on health and health-related outcomes (Health Outcomes of People Experiencing Homelessness in Older Middle Age Study). Method: We conducted in-depth, semistructured interviews with each participant to explore beliefs and attitudes toward tobacco use and cessation, barriers to smoking cessation, and attitudes toward current tobacco control strategies including raising cigarette prices, smoke-free policies, and graphic warning labels. We used a grounded theory approach to analyze the transcripts. Results: Community social norms supportive of cigarette smoking and co-use of tobacco with other illicit substances were strong motivators of initiation and maintenance of tobacco use. Self-reported barriers to cessation included nicotine dependence, the experience of being homeless, fatalistic attitudes toward smoking cessation, substance use, and exposure to tobacco industry marketing. While participants were cognizant of current tobacco control policies and interventions for cessation, they felt that they were not specific enough for African Americans experiencing homelessness. Participants expressed strong support for strategies that de-normalized tobacco use and advertised the harmful effects of tobacco. Conclusion: Older African American homeless-experienced smokers face significant barriers to smoking cessation. Interventions that advertise the harmful effects of tobacco may be effective in stimulating smoking cessation among this population.
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Lee, Cheol Min. "Current status of tobacco use, cessation and control policy in Korea." Journal of the Korean Medical Association 65, no. 12 (December 10, 2022): 789–800. http://dx.doi.org/10.5124/jkma.2022.65.12.789.
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Background: Tobacco use is a leading cause of countless deaths and disabilities worldwide. An estimated 11 million Korean adults were still using tobacco in 2020, according to the Korea National Health and Nutrition Examination Survey. This review aims to explain the current trends in tobacco use, sales, cessation, and control policies in South Korea.Current Concepts: Heated tobacco products (HTPs), a hybrid between conventional and electronic cigarettes, were first launched in South Korea in June 2017. Advertisements stating that HTPs are odorless, tar-free, and less harmful to health have caused sales of HTPs to grow quickly over the past 5 years, such that they account for about 15% of the total tobacco market. According to national smoking rate statistics and tobacco sales trends, declines in current smoking rates have slowed and even risen in some groups, and declines in total tobacco sales have slowed but also risen again during the coronavirus 19 pandemic. In addition, the number of visitors to smoking cessation clinics decreased just after the advent of HTPs and social distancing policies triggered by the coronavirus. Nicotine replacement therapy can serve as a drug therapy for smoking cessation, or bupropion and varenicline can be prescribed. Korea’s representative tobacco control policies include the tax increase policy, non-smoking area policy, cigarette pack warning picture policy, and support policy for visiting smoking cessation clinics.Discussion and Conclusion: There is a pressing need to reflect tobacco control policies in line with changes in tobacco user behaviors and tobacco company marketing strategies.
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Brewer, Noel T., Michelle Jeong, Marissa G. Hall, Sabeeh A. Baig, Jennifer R. Mendel, Allison J. Lazard, Seth M. Noar, Madeline R. Kameny, and Kurt M. Ribisl. "Impact of e-cigarette health warnings on motivation to vape and smoke." Tobacco Control 28, e1 (July 10, 2019): e64-e70. http://dx.doi.org/10.1136/tobaccocontrol-2018-054878.
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BackgroundA prevailing hypothesis is that health warnings for electronic cigarettes (e-cigarettes) could drive people away from vaping and towards smoking cigarettes. We consider an alternative hypothesis that e-cigarette warnings discourage both vaping and smoking.MethodsParticipants were a national convenience sample of 2218 US adults who used e-cigarettes, cigarettes or both. In August 2018, we randomised participants to one of three warning types (control text about littering, text-only e-cigarette warning or pictorial e-cigarette warning). We further randomised participants viewing e-cigarette warnings to one of three topics (nicotine addiction, health hazards of use, or both health hazards and harms of use). The preregistered primary outcome was intentions to quit vaping among e-cigarette users. Secondary outcomes included interest in smoking and Tobacco Warnings Model constructs: attention, negative affect, anticipated social interactions and cognitive elaboration.ResultsText warnings elicited higher intentions to quit vaping than control among e-cigarette users (d=0.44, p<0.001), and pictorial warnings elicited still higher intentions to quit vaping than text (d=0.12, p<0.05). Text warnings elicited lower interest in smoking compared with control among smokers (p<0.05); warnings had no other effects on interest in smoking among smokers or non-smokers. Text warnings about health hazards elicited higher intentions to quit vaping than nicotine addiction warnings. E-cigarette warnings also increased Tobacco Warnings Model constructs.DiscussionE-cigarette health warnings may motivate users to quit vaping and discourage smoking. The most promising warnings include health hazards (other than nicotine addiction) and imagery. We found no support for the hypothesis that e-cigarette warnings could encourage smoking cigarettes.
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Nakkash, R., and K. Lee. "The tobacco industry's thwarting of marketing restrictions and health warnings in Lebanon." Tobacco Control 18, no. 4 (July 24, 2009): 310–16. http://dx.doi.org/10.1136/tc.2008.029405.
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O’Brien, Erin Keely, Mario Antonio Navarro, and Leah Hoffman. "Mobile website characteristics of leading tobacco product brands: cigarettes, smokeless tobacco, e-cigarettes, hookah and cigars." Tobacco Control 28, no. 5 (August 30, 2018): 532–39. http://dx.doi.org/10.1136/tobaccocontrol-2018-054549.
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SignificanceMost US adults use smartphones for internet access. Understanding what they see when they view smartphone-optimised (mobile) tobacco websites is important, as it can inform tobacco education and cessation strategies. This study describes mobile tobacco websites for leading brands of cigarettes, cigars, smokeless tobacco (smokeless), e-cigarettes and hookah.MethodsWe identified 130 leading tobacco brands based on sales, advertising spending and self-report data. Of these, 62 brands had mobile websites. We conducted an inductive content analysis (ie, where we derived the coding scheme from what we observed) of website characteristics by dual-coding: age requirements, warning display, brand engagement methods (eg, social features) and sales strategies (eg, coupons).ResultsAll cigarette and most smokeless websites required age-verified accounts for entry, while 76% of e-cigarette websites required accounts only for making purchases. All cigarette and smokeless websites showed warnings, but a minority of e-cigarette and cigar websites did, and no hookah websites did. Many websites required users to scroll up to view warnings. Most e-cigarette websites, most hookah websites, and half of cigar websites linked to multiple social media platforms; however, most cigarette and smokeless websites facilitated socialisation internally. All cigarette, most smokeless and no hookah websites offered coupons. Many cigarette and smokeless coupons were time-sensitive and location-based.ConclusionsWe highlight issues in how tobacco brand websites address youth access, display warnings, engage consumers and facilitate purchase. Results can help public health educators and practitioners better understand tobacco marketing as a context for designing tobacco interventions.
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Guillory, Jamie, Annice E. Kim, Leah Fiacco, Margaret Cress, Jessica Pepper, and James Nonnemaker. "An Experimental Study of Nicotine Warning Statements in E-cigarette Tweets." Nicotine & Tobacco Research 22, no. 5 (March 1, 2019): 814–21. http://dx.doi.org/10.1093/ntr/ntz029.
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Abstract Introduction It is unclear whether warnings on electronic cigarette (e-cigarette) advertisements required by the US Food and Drug Administration (FDA) will apply to social media. Given the key role of social media in marketing e-cigarettes, we seek to inform FDA decision making by exploring how warnings on various tweet content influence perceived healthiness, nicotine harm, likelihood to try e-cigarettes, and warning recall. Methods In this 2 × 4 between-subjects experiment participants viewed a tweet from a fictitious e-cigarette brand. Four tweet content versions (e-cigarette product, e-cigarette use, e-cigarette in social context, unrelated content) were crossed with two warning versions (absent, present). Adult e-cigarette users (N = 994) were recruited via social media ads to complete a survey and randomized to view one of eight tweets. Multivariable regressions explored effects of tweet content and warning on perceived healthiness, perceived harm, and likelihood to try e-cigarettes, and tweet content on warning recall. Covariates were tobacco and social media use and demographics. Results Tweets with warnings elicited more negative health perceptions of the e-cigarette brand than tweets without warnings (p < .05). Tweets featuring e-cigarette products (p < .05) or use (p < .001) elicited higher warning recall than tweets featuring unrelated content. Conclusions This is the first study to examine warning effects on perceptions of e-cigarette social media marketing. Warnings led to more negative e-cigarette health perceptions, but no effect on perceived nicotine harm or likelihood to try e-cigarettes. There were differences in warning recall by tweet content. Research should explore how varying warning content (text, size, placement) on tweets from e-cigarette brands influences health risk perceptions. Implications FDA’s 2016 ruling requires warnings on advertisements for nicotine-containing e-cigarettes, but does not specify whether this applies to social media. This study is the first to examine how e-cigarette warnings in tweets influence perceived healthiness and harm of e-cigarettes, which is important because e-cigarette brands are voluntarily including warnings on Twitter and Instagram. Warnings influenced perceived healthiness of the e-cigarette brand, but not perceived nicotine harm or likelihood to try e-cigarettes. We also saw higher recall of warning statements for tweets featuring e-cigarettes. Findings suggest that expanding warning requirements to e-cigarette social media marketing warrants further exploration and FDA consideration.
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van Mourik, Dirk-Jan A., Math J. J. M. Candel, Gera E. Nagelhout, Marc C. Willemsen, Hua-Hie Yong, Bas van den Putte, Geoffrey T. Fong, and Hein de Vries. "How the New European Union’s (Pictorial) Tobacco Health Warnings Influence Quit Attempts and Smoking Cessation: Findings from the 2016–2017 International Tobacco Control (ITC) Netherlands Surveys." International Journal of Environmental Research and Public Health 16, no. 21 (November 2, 2019): 4260. http://dx.doi.org/10.3390/ijerph16214260.
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In 2016, the Netherlands was required to introduce new European Union (EU)’s (pictorial) tobacco health warnings. Our objective was to describe the pathways through which the new EU tobacco health warnings may influence quit attempts and smoking cessation among Dutch smokers. Longitudinal data from 2016 and 2017 from the International Tobacco Control (ITC) Netherlands Survey were used. Smokers who participated in both surveys were included (N = 1017). Structural equation modeling was applied to examine the hypothesized pathways. Health warning salience was positively associated with more health worries (β = 0.301, p < 0.001) and a more positive attitude towards quitting (β = 0.180, p < 0.001), which, in turn, were associated with a stronger quit intention (health worries: β = 0.304, p < 0.001; attitude: β = 0.340, p < 0.001). Quit intention was a strong predictor of quit attempts (β = 0.336, p = 0.001). Health warning salience was also associated with stronger perceived social norms towards quitting (β = 0.166, p < 0.001), which directly predicted quit attempts (β = 0.141, p = 0.048). Quit attempts were positively associated with smoking cessation (β = 0.453, p = 0.043). Based on these findings, we posit that the effect of the EU’s tobacco health warnings on quit attempts and smoking cessation is mediated by increased health worries and a more positive attitude and perceived social norms towards quitting. Making tobacco health warnings more salient (e.g., by using plain packaging) may increase their potential to stimulate quitting among smokers.
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Berman, Micah L. "Commercial Speech Law and Tobacco Marketing: A Comparative Discussion of the United States and Canada." American Journal of Law & Medicine 39, no. 2-3 (June 2013): 218–36. http://dx.doi.org/10.1177/009885881303900202.
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In November 2011, U.S. District Court Judge Richard Leon ruled that the U.S. Food and Drug Administration's (FDA’s) proposed graphic health warnings for cigarette packages violated tobacco companies’ First Amendment rights. In doing so, he pointedly refused to consider the experiences of Canada, the United Kingdom, and the more than thirty other countries that had adopted similar graphic warnings in the past decade. Rather, he swatted away all references to those other countries’ experiences by stating (first at oral argument and then in his decision) that “none of [those countries] afford First Amendment protections like those found in our Constitution.”While it is true that no other country uses the First Amendment per se, many other countries do offer constitutional protection to freedom of speech and/or freedom of expression. Indeed, several other countries apply “strikingly similar” legal tests when reviewing restrictions on speech (and on commercial speech in particular). Thus, the statement that other countries do not “afford First Amendment protections like those found in our Constitution” is an oversimplification.
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Grummon, Anna H., and Noel T. Brewer. "Health Warnings and Beverage Purchase Behavior: Mediators of Impact." Annals of Behavioral Medicine 54, no. 9 (March 17, 2020): 691–702. http://dx.doi.org/10.1093/abm/kaaa011.
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Abstract Background To reduce diet-related chronic disease, policymakers have proposed requiring health warnings on sugar-sweetened beverages (SSBs). Health warnings reduced purchases of these products by 22% in our recent randomized controlled trial, but the mechanisms remain unclear. Purpose We sought to identify the psychological mechanisms that explain why SSB health warnings affect purchase behavior. Methods In 2018, we recruited 400 adult SSB consumers to complete a shopping task in a naturalistic convenience store laboratory in North Carolina, USA. We randomly assigned participants to either a health warning arm (all SSBs in the store displayed a text health warning) or to a control arm (SSBs displayed a control label). Participants selected items to purchase with cash. Results Compared to control labels, health warnings elicited more attention, negative affect, anticipated social interactions, and thinking about harms (range of ds = 0.63–1.34; all p < .001). Health warnings also led to higher injunctive norms about limiting SSB consumption (d = 0.27, p = .008). Except for attention, all of these constructs mediated the effect of health warnings on SSB purchases (all p < .05). In contrast, health warnings did not influence other attitudes or beliefs about SSBs or SSB consumption (e.g., healthfulness, outcome expectations, and response efficacy). Conclusions Health warnings on sugar-sweetened beverages affected purchase behavior by eliciting negative emotions, increasing anticipated social interactions, keeping SSBs’ harms at top of mind, and shifting norms about beverage consumption. Results are consistent with recent studies of why tobacco warnings influence quitting behavior, pointing toward a general framework for understanding how health warnings affect behavior. Clinical Trials Registration NCT #03511937.
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Woelbert, Eva, and Béatrice d’Hombres. "Pictorial health warnings and wear-out effects: evidence from a web experiment in 10 European countries." Tobacco Control 28, e1 (January 4, 2019): e71-e76. http://dx.doi.org/10.1136/tobaccocontrol-2018-054402.
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ObjectiveThis paper examines whether there are possible wear-out effects associated with repeated exposure to pictorial health warnings on tobacco products. Wear-out effects can be general, that is, people get used to the presence of pictorial warnings in general, or specific to the content of the warnings (ie, the images used). Distinguishing between these two types of wear-out is important for understanding how to maintain the effectiveness of health warnings over time.MethodsThis study used data from two surveys carried out in 10 European countries. Participants (n=12 600) were exposed in a random order to a series of health warnings and assessed the salience of the warnings as well as their effects on smoking intentions. Using these data and country variations in health warning legislation, we tested whether warning pictures are subject to general and/or specific wear-out effects.ResultsResponses were stronger to combined text+picture warnings than to text-only warnings. This effect was lower for smokers living in countries where combined warnings were already in place at the time of the data collection, compared with smokers residing in countries where text-only warnings were in use. This result, observed for combined warnings with new pictures, is in line with the presence of general wear-out effects. Combined warnings with an unknown pictorial content were more effective than those including pictorial warnings already in use, suggesting that specific wear-out effects are also at play.ConclusionsThese findings strengthen the evidence that pictorial health warnings are an effective tool for tobacco control policies and suggest that, even in the presence of a general wear-out effect among smokers, periodically introducing new pictures helps to maintain warning effectiveness over time.
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Marques de Pinho, M. Coutinho, C. Abreu Perez, and C. Galhardo Ferreira Vianna. "Contribution and Influence of the Civil Society for the New Health Warning Label of Tobacco Products in Brazil." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 134s. http://dx.doi.org/10.1200/jgo.18.55300.
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Background and context: In April 2017, National Agency for Health Surveillance (Anvisa) launched a public consultation for the revision of Resolution Number 335/2003, on health warning labels. Aim: A group of representatives from civil society and tobacco control advocates in Brazil met in person and virtually to make contributions to the Anvisa´s proposal for new health warning label for tobacco products packages, considering the civil rights for participation and collaboration to Brazilian policies provided by public consultation. Strategy/Tactics: The advocates and researches consulted the Framework Convention on Tobacco Control of the World Health Organization and its Guideline for Article 11 (Packaging and Labeling of Tobacco Products) implementation adopted in 2008 based on scientific studies and successful experiences in other countries. In addition, international researchers and representatives of international institutions were also consulted to collect successful examples of health warnings in the world. Program/Policy process: In October 2017, the Anvisa Board of Directors at a public ordinary meeting approved the new health warnings and in December of the same year, published the new resolution about it. Outcomes: In a comparative analysis, even if all the recommendations made in the CP have not been complied with, the influence of the contributions of the group of tobacco control advocates to the final version of the warnings is evident. The main contributions considered by Anvisa were: 1) to increase the effectiveness of the health warnings using colored images instead of black and white images, 2) the use of yellow in the upper and lower tiers was also one of the points suggested by the group, and 3) the concept proposed by the group for side warnings was fully complied. What was learned: Civil society participation for the agency´s public policy implementation process is essential and has been possible through the regulatory agenda, public consultations and regular public meetings. However, as is expected, the regulated sector has been quite active. The group recognizes the importance of the Anvisa measure in proposing new health warnings, however, significant recommendations have not been adopted and it may interfere with the goals of the measure. Anvisa´s strategy of allowing the social participation is essential, in accordance with Universal Health System principles and must be maintained. Regarding to the next health warnings and messages on packages of tobacco products, it would be greater to consider higher frequency of updating the images and recover the scientific process of development of the 3rd round of health warnings labels coordinated by the National Institute of Cancer in 2007/2008.
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Gendall, Philip, Christine Eckert, Janet Hoek, and Jordan Louviere. "Estimating the effects of novel on-pack warnings on young adult smokers and susceptible non-smokers." Tobacco Control 27, no. 5 (August 19, 2017): 519–25. http://dx.doi.org/10.1136/tobaccocontrol-2017-053719.
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BackgroundOn-pack tobacco warnings can deter smoking initiation and provide powerful cessation cues. However, these warnings typically feature graphic health images, which many young adults dismiss as irrelevant. We estimated responses to more diverse warnings and examined how these performed relative to each other.MethodsWe conducted a behavioural likelihood experiment and a choice modelling experiment in which 474 smokers and 476 susceptible non-smokers aged between 16 and 30 years evaluated 12 warnings featuring health, social, financial and cosmetic themes. The choice data were analysed by estimating Sequential-Best-Worst Choice and Scale-Adjusted Latent Class Models.ResultsSmokers found all test warnings aversive, particularly warnings featuring the effect of smoking on vulnerable third parties, including babies and animals, and showing a dying smoker. Susceptible non-smokers found graphic health warnings and a warning that combined graphic health with loss of physical attractiveness, significantly more aversive than other images tested.ConclusionsIllustrating the harms smoking causes to vulnerable groups may reduce the temporal distance and perceived control over smoking that young adults use to rationalise health warnings. Introducing more diverse warnings could recognise heterogeneity within smoker and susceptible non-smoker populations, and complement warnings featuring long-term health harms.
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BinDhim, Nasser F., Kevin McGeechan, Anwar K. T. Alanazi, Hossam M. S. Alanazi, Sasoun A. J. Alanazi, Solaiman M. Al-Hadlaq, Hisham Aljadhey, et al. "Evaluating the pictorial warnings on tobacco products in Arabian Gulf countries against other international pictorial warnings." Tobacco Control 27, no. 3 (May 12, 2017): 261–65. http://dx.doi.org/10.1136/tobaccocontrol-2016-053323.
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BackgroundFew assessments of pictorial warnings (PWs) on cigarette packs implemented in Gulf Cooperation Council (GCC) countries have been done.MethodsThis article includes two cross-sectional studies. In Study 1, convenience samples of adults from the Kingdom of Saudi Arabia (n=111) and USA (n=115) participated in a consumer survey to rate a total of nine PWs from the GCC, Australia and the UK. Outcome measures were affective responses to PWs and concerns about smoking. In Study 2, tobacco control experts (n=14) from multiple countries rated the same PWs on a potential efficacy scale and completed one open-ended question about each. The PWs were altered to mask their country of origin. Analyses compared ranking on multiple outcomes and examined ratings by country of origin and by smoking status.ResultsIn the consumer survey, participants from both countries rated the PWs from GCC lower than PWs from other countries on the two measures. The mixed-model analysis showed significant differences between the PWs from Australia and those from the GCC and between the PWs from the UK and those from the GCC (p<0.001) in the consumer and expert samples. The experts’ comments about the PWs implemented in the GCC were negative overall and confirmed previously identified themes about effective PWs.ConclusionThis study shows PWs originating from the GCC had significantly lower ratings than those implemented in Australia and the UK. The GCC countries may need to re-evaluate the currently implemented PWs and update them periodically.
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Mia, Md Tuhin, Mohammad Mahbub Alam Talukder, Md Mokshead Ali, and Md Ismael. "Effects of Graphic Health Warning on Tobacco Packs: A Cross-Sectional Study among Low Socioeconomic Group in Bangladesh." Journal of Smoking Cessation 2021 (December 13, 2021): 1–9. http://dx.doi.org/10.1155/2021/1354885.
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Background. Tobacco use is a significant health concern in Southeast Asia, particularly in Bangladesh, where the greatest incidence of tobacco consumption occurs in a number of forms smoking, smokeless, and indigenous. The WHO Framework Convention on Tobacco Control (FCTC) requires tobacco product packaging to include adequate health warnings (text and visual). The study’s objective is to investigate the effects of graphic health warnings on tobacco packs among Bangladeshi low socioeconomic groups. Study Design. Cross-sectional study. Methods. The study was conducted with 400 participants (low socioeconomic people) by using the systematic sampling technique through a semistructured questionnaire in Demra and Tongi industrial areas of Dhaka city in Bangladesh during September 2019-November 2020. Descriptive statistics (frequencies, percentages, means, and standard deviations) and inferential analysis (i.e., chi-square tests) were performed by Statistical Package for Social Sciences (SPSS version 25.0) to explore the relationship between the graphic warning and the use of tobacco. Results. This study illustrates that 89% of respondents smoke only cigarette or bidi, where 95.1% were daily smokers. About 72.2% reported pictorial warning message was more understandable while 90.8% reported the existing text warnings explicitly visualize the health harms. It has been found that there was a significant association between the respondent’s opinion on the text warning that encouraged the respondent to quit tobacco use and the text messages “smoking causes throat and lung cancer” ( p < 0.001 ) and “smoking causes respiratory problems” ( p < 0.001 ). Around 96.7% knew about the graphic health warnings on the cigarette packets where 99.2% reported graphic warning explicitly visualizes the health harms. In graphical warnings, text messages have a great influence on quitting smoking where “smoking causes throat and lung cancer” ( p < 0.001 ) and “smoking causes stroke” ( p < 0.001 ). Nearly 79.2% of respondents thought the color of the graphic warning should be “Red” and a significant association between the color and the education level of the respondents explored here ( p < 0.05 ). Conclusions. GHWs are more understandable on tobacco packets, and it has significant impacts on being aware of health consequences from tobacco consumption.
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Waqa, Gade, Judith McCool, Wendy Snowdon, and Becky Freeman. "Adolescents Perceptions of Pro- and Antitobacco Imagery and Marketing: Qualitative Study of Students from Suva, Fiji." BioMed Research International 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/602635.
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Background. Many studies examining smoking uptake among young people in the Pacific have not included their exposure to tobacco control promotions in the media in their assessment. This study examines how Fijian students view tobacco and tobacco-related media depictions to gain insight into both drivers of smoking uptake and potential directions for prevention interventions.Methods. A sample of thirty Fijian students (15 male and 15 female) aged 14–17 years, was recruited from a Suva school between September and October 2013 and participated in a one-to-one in-depth interview about their views on tobacco use, media consumption patterns and preferences and awareness of tobacco use in media.Results. Despite radical developments in access to media, television remains the most popular. Yet, the majority of participants were unaware of any protobacco imagery on television or other entertainment media. Tobacco-related imagery was more likely to be seen in connection with point of sale advertising and branding. The advertising potential of the shop counter was acutely apparent to some participants and this space was considered highly influential.Conclusions. Despite the fact that the recently introduced graphic health warnings were generally well received, more can be done to extend the use of media for tobacco control benefits in Fiji.
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Diaz, Megan C., Elexis C. Kierstead, Domonique Edwards, Yoonsang Kim, Shyanika W. Rose, Sherry Emery, Bushraa Khatib, Michael Liu, and Ganna Kostygina. "Online Tobacco Advertising and Current Chew, Dip, Snuff and Snus Use among Youth and Young Adults, 2018–2019." International Journal of Environmental Research and Public Health 19, no. 8 (April 14, 2022): 4786. http://dx.doi.org/10.3390/ijerph19084786.
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Objective: To understand the relationship between exposure to online tobacco advertising and current smokeless tobacco use in the context of tobacco control policies. Methods: Three waves of a national probability-based sample of (n = 15,985) youth and young adults were used. Analysis consisted of GEE logistic models controlling for social media use, demographics, tobacco use, average price of smokeless tobacco inclusive of taxes, smoke-free indoor air laws (SFIA) and state tobacco control expenditures. Results: Frequent exposure to tobacco advertising on social media is associated with greater odds of current smokeless use (aOR: 2.05, 95% CI: 1.62, 2.60). Higher prices and SFIA coverage were associated with reduced current smokeless use when examined separately from other tobacco policy variables (aOR: 0.79, CI: 0.73, 0.85; aOR: 0.44, CI: 0.28, 0.70). Conclusions: Greater exposure to tobacco advertising online is associated with greater odds of smokeless use among surveyed youth and young adults. This effect of social media marketing exposure on smokeless use outweighs the mitigating impact of existing tobacco control policies. The findings underscore the need for strong advertising regulation of evolving tobacco products, including smokeless products, on social media and surveillance of digital marketing tactics to young people.
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Gupta, Prakash C., Namrata Puntambekar, and Mary Assunta. "South Asia’s evolving tobacco hydra: moving from quandary to hope." Tobacco Control 31, no. 2 (March 2022): 142–45. http://dx.doi.org/10.1136/tobaccocontrol-2021-057013.
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The South Asian region occupies a unique place in global tobacco control because of a broad spectrum of widely used tobacco products and the consequent mix of local and transnational tobacco industries. Cigarette use is especially high among males in many countries, while bidis are widely used in India, Bangladesh and Sri Lanka, and are very inexpensive. Smokeless tobacco use is a global problem, but the bulk of use is in South Asia and there is emerging promotion of newly developed tobacco and nicotine products across the region. With the transnational cigarette industry contributing a significant amount in taxes, the bidi industry employing millions of workers and many farmers engaged in tobacco farming, the industry is powerful and exploits this when countering proposed advancements in tobacco control policy. Despite industry interference and major challenges, this region has achieved remarkable successes in tobacco control, including large pictorial warnings that cover up to 80%–90% of the pack in some countries, stringent rules on depiction of tobacco in movies, bans on advertising and promotion, and smoke-free public places. Key challenges include increasing the tax component of retail prices and reducing tax concessions, regulating newly developed products and countering the aggressive tactics of the tobacco industry. Strategies to advance tobacco control in the region may also include standardised packaging of tobacco products, sustained mass media campaigns to warn the population of the harms of tobacco use and promote use of available cost-covered cessation services, and supply-side measures such as vendor licensing.
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Vardavas, Constantine I. "European Tobacco Products Directive (TPD): current impact and future steps." Tobacco Control 31, no. 2 (March 2022): 198–201. http://dx.doi.org/10.1136/tobaccocontrol-2021-056548.
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Efforts to reduce the toll of tobacco-related morbidity and mortality in the European Union are spearheaded by the Tobacco Products Directive (TPD), a legal act implemented during 2016–2021, with the overall aim to reduce tobacco consumption by 2% in Europe. Within this time frame, several core tobacco control measures were implemented, the impact of which is outlined within this manuscript. Key successful legislative actions implemented in this time frame led to greater availability of information and further regulation of additives, the banning of mentholated cigarettes, enhanced pictorial package warnings and a regulatory framework for e-cigarettes. While repeated cross-sectional data indicated a 12.5% relative reduction in smoking prevalence after implementation of the TPD, the differential regulation of cigarettes and roll-your-own tobacco compared with other products, such as cigarillos, e-cigarettes and heated tobacco products, may have also led to product displacement. Moreover, as the TPD could not keep up with the ever-changing nicotine product landscape, further adaptations may be needed.
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Hammond, D. "Tobacco on campus: industry marketing and tobacco control policy among post-secondary institutions in Canada." Tobacco Control 14, no. 2 (April 1, 2005): 136–40. http://dx.doi.org/10.1136/tc.2004.009753.
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Bialous, Stella A., and Stanton A. Glantz. "Heated tobacco products: another tobacco industry global strategy to slow progress in tobacco control." Tobacco Control 27, Suppl 1 (September 12, 2018): s111—s117. http://dx.doi.org/10.1136/tobaccocontrol-2018-054340.
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There has been a global decline in tobacco consumption that, if continued, will negatively impact the tobacco industry’s profits. This decline led the industry to invent and market new products, including heated tobacco products (HTP). HTP are an extension of the industry’s strategies to undermine government’s tobacco regulatory efforts as they are being promoted as part of the solution for the tobacco epidemic. Under the moniker of ‘harm reduction’, the tobacco companies are attempting to rehabilitate their reputation so they can more effectively influence governments to roll back existing tobacco control policies or create exemptions for their HTP. Rolling back tobacco control policies will make it easier for the companies to renormalise tobacco use to increase social acceptability for all their products. When regulations are absent or when loopholes exist in classifying HTP as a tobacco product (thus subject to all tobacco control regulations), the industry’s marketing of HTP is making these products more visible to the public and more accessible. Governments need to ensure that HTP are regulated as tobacco products or drugs and reject partnerships with the tobacco companies to promote ‘harm reduction’. The tobacco companies remain the vector of the tobacco-caused epidemic and cannot be part of the global tobacco control solution.
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Laestadius, Linnea I., Kendall E. Penndorf, Melissa Seidl, and Young I. Cho. "Assessing the Appeal of Instagram Electronic Cigarette Refill Liquid Promotions and Warnings Among Young Adults: Mixed Methods Focus Group Study." Journal of Medical Internet Research 21, no. 11 (November 25, 2019): e15441. http://dx.doi.org/10.2196/15441.
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Background While marketing for electronic cigarette refill liquids (e-liquids) is widespread on Instagram, little is known about the post elements that create appeal among young adult Instagram users. Further information is needed to help shape regulatory strategies appropriate for social media. Objective This study examined young adult Instagram user perceptions of actual e-liquid marketing posts and US Food and Drug Administration (FDA)–mandated nicotine addiction warning statements on Instagram. Methods A series of 12 focus groups (n=69) were held with non–tobacco users, vapers, smokers, and dual users in Wisconsin between September and December 2018. Participants discussed the elements of posts that they found appealing or unappealing, in addition to completing a survey about each post and e-liquid. Focus group transcripts were analyzed by smoking status using a framework analysis approach. Results Although willingness to try e-liquids was highest among nicotine users, focus group discussions indicated that Instagram posts promoting e-liquids held appeal for individuals across smoking statuses. The primary elements that created appeal were the perceived trustworthiness of the Instagram account, attractive design and flavor visuals, and promotion of flavors and nicotine levels that met personal preferences. Post appeal was reduced by references to vaping subcultures, indicators that the post creator did not take nicotine addiction seriously, and FDA-mandated nicotine warning statements. Non–tobacco users were particularly drawn to posts featuring nicotine-free e-liquids with attractive visual designs and flavors known from foods. Conclusions Young adults consider a broad range of elements in assessing the appeal of e-liquid marketing on Instagram, with minor but notable distinctions by smoking status. Non–tobacco users are uniquely drawn to nicotine-free e-liquids and are more deterred by the FDA’s mandated nicotine addiction warning statements than those from other smoking statuses. This suggests that it may be possible to tailor policy interventions in a manner that helps to reduce novel uptake of vaping without significantly diminishing its potential harm-reduction benefits.
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Soneji, Samir, JaeWon Yang, Meghan Bridgid Moran, Andy S. L. Tan, James Sargent, Kristin E. Knutzen, and Kelvin Choi. "Engagement With Online Tobacco Marketing Among Adolescents in the United States: 2013–2014 to 2014–2015." Nicotine & Tobacco Research 21, no. 7 (May 5, 2018): 918–25. http://dx.doi.org/10.1093/ntr/nty086.
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Abstract Objective To assess changes in engagement with online tobacco and electronic cigarette (e-cigarette) marketing (online tobacco marketing) among adolescents in the United States between 2013 and 2015. Methods We assessed the prevalence of six forms of engagement with online tobacco marketing, both overall and by brand, among adolescents sampled in Wave 1 (2013–2014; n = 13651) and Wave 2 (2014–2015; n = 12172) of the nationally representative Population Assessment for Tobacco and Health Study. Engagement was analyzed by tobacco use status: non-susceptible never tobacco users; susceptible never tobacco users; ever tobacco users, but not within the past year; and past-year tobacco users. Results Among all adolescents, the estimated prevalence of engagement with at least one form of online tobacco marketing increased from 8.7% in 2013–2014 to 20.9% in 2014–2015. The estimated prevalence of engagement also increased over time across all tobacco use statuses (eg, from 10.5% to 26.6% among susceptible adolescents). Brand-specific engagement increased over time for cigarette, cigar, and e-cigarette brands. Conclusion Engagement with online tobacco marketing, both for tobacco and e-cigarettes, increased almost twofold over time. This increase emphasizes the dynamic nature of online tobacco marketing and its ability to reach youth. The Food and Drug Administration, in cooperation with social networking sites, should consider new approaches to regulate this novel form of marketing. Implications This is the first study to estimate the national prevalence of engagement with online tobacco marketing among adolescents over time. The estimated prevalence of this engagement approximately doubled between 2013–2014 and 2014–2015 among all adolescents and, notably, among adolescents at relatively low risk to initiate tobacco use. This increase in engagement could represent public health harm if it results in increased initiation and use of tobacco products. Stronger federal regulation of online tobacco marketing and tighter control of access to tobacco-related content by social media sites could reduce adolescents’ exposure to and engagement with online tobacco marketing.
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Hwang, Ji-eun, Youjin Choi, Yu-seon Yang, and Yumi Oh. "Gender differences in the perceived effectiveness of female-focused graphic health warnings against smoking in South Korea." Health Education Journal 79, no. 1 (July 9, 2019): 58–72. http://dx.doi.org/10.1177/0017896919862308.
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Objective: Numerous studies have examined the effectiveness of graphic health warnings on different population segments, including male and female smokers, in an effort to reduce health disparities in Europe and the USA. However, research exploring the impact of gender-specific tobacco control interventions on Asian smokers is lacking. This study aimed to assess the perceived effectiveness of graphic health warning images featuring women smokers compared to gender-neutral warnings on South Korean women and men, by smoking status. Setting: Online survey with 1,200 adults (500 women; 475 smokers) in South Korea Design: A survey with four graphic health warnings (two female-focused and two gender-neutral warnings). Method: Participants were assigned to view two female-focused warnings (depicting smoking during pregnancy and risk of premature skin aging) or two gender-neutral warnings (depicting lung cancer and oral cancer), and rated their effectiveness in terms of persuading smokers to quit smoking and non-smokers to not begin smoking. Results: A significant interaction between gender and smoking status was found with the pregnancy warning. A post hoc comparison showed a significant difference between female smokers and female non-smokers, between male smokers and male non-smokers, and between female non-smokers and male non-smokers in their perceptions of warning effectiveness. Female non-smokers showed higher perceived effectiveness than male non-smokers and female smokers. Male non-smokers rated its perceived effectiveness lower than male smokers. Regarding the gender-neutral warnings, a participant’s age affected their perceived effectiveness of the cancer warnings. Conclusion: Findings suggest that graphic health warnings of smoking during pregnancy are perceived more effective by female non-smokers than female smokers and male non-smokers. Gender-neutral warnings with cancer images are perceived differently by age group. Future studies need to examine how social and cultural factors surrounding female smokers in South Korea affect their perceptions about female-focused warnings and the effects of the warnings on their motivation to quit smoking.
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Hall, Marissa G., Anna H. Grummon, Isabella C. A. Higgins, Allison J. Lazard, Carmen E. Prestemon, Mirian I. Avendaño-Galdamez, and Lindsey Smith Taillie. "The impact of pictorial health warnings on purchases of sugary drinks for children: A randomized controlled trial." PLOS Medicine 19, no. 2 (February 1, 2022): e1003885. http://dx.doi.org/10.1371/journal.pmed.1003885.
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Background Pictorial warnings on tobacco products are promising for motivating behavior change, but few studies have examined pictorial warnings for sugary drinks, especially in naturalistic environments. This study aimed to examine the impact of pictorial warnings on parents’ purchases of sugary drinks for their children in a naturalistic store laboratory. Methods and findings Parents of children ages 2 to 12 (n = 325, 25% identifying as Black, 20% Hispanic) completed a shopping task in a naturalistic store laboratory in North Carolina. Participants were randomly assigned to a pictorial warnings arm (sugary drinks displayed pictorial health warnings about type 2 diabetes and heart damage) or a control arm (sugary drinks displayed a barcode label). Parents selected 1 beverage and 1 snack for their child, as well as 1 household good; one of these items was selected for them to purchase and take home. The primary outcome was whether parents purchased a sugary drink for their child. Secondary outcomes included reactions to the trial labels, attitudes toward sugary drinks, and intentions to serve their child sugary drinks. Pictorial warnings led to a 17-percentage point reduction in purchases of sugary drinks (95% CI for reduction: 7% to 27%), with 45% of parents in the control arm buying a sugary drink for their child compared to 28% in the pictorial warning arm (p = 0.002). The impact of pictorial warnings on purchases did not differ by any of the 13 participant characteristics examined (e.g., race/ethnicity, income, education, and age of child). Pictorial warnings also led to lower calories (kcal), purchased from sugary drinks (82 kcal in the control arm versus 52 kcal in the pictorial warnings arm, p = 0.003). Moreover, pictorial warnings led to lower intentions to serve sugary drinks to their child, feeling more in control of healthy eating decisions, greater thinking about the harms of sugary drinks, stronger negative emotional reactions, greater anticipated social interactions, lower perceived healthfulness of sugary drinks for their child, and greater injunctive norms to limit sugary drinks for their child (all p < 0.05). There was no evidence of difference between trial arms on noticing of the labels, appeal of sugary drinks, perceived amount of added sugar in sugary drinks, risk perceptions, or perceived tastiness of sugary drinks (all p > 0.05). Conclusions Pictorial warnings reduced parents’ purchases of sugary drinks for their children in this naturalistic trial. Warnings on sugary drinks are a promising policy approach to reduce sugary drink purchasing in the US. Trial registration The trial design, measures, power calculation, and analytic plan were registered before data collection at www.clinicaltrials.gov NCT04223687.
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Mohan, Priya, Harry A. Lando, and Sigamani Panneer. "Assessment of Tobacco Consumption and Control in India." Indian Journal of Clinical Medicine 9 (January 1, 2018): 117991611875928. http://dx.doi.org/10.1177/1179916118759289.
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Tobacco consumption is a huge public health issue in India and its impact is especially devastating among the poor. Effective tobacco control should be a top priority, both as a health issue and as a method to reduce poverty. Tobacco use is deeply ingrained as a cultural practice and there are a myriad of tobacco types. We reviewed multiple determinants of tobacco consumption including socio-economic status, marriage, population growth, marketing strategies, and price. We also considered the tobacco burden including economic and social costs and adverse health impacts especially those resulting from oral cancer. We then addressed the history of tobacco control legislation in India and challenges in implementation. Tobacco consumption in India is continuing to increase despite tobacco control policy. Needed are more visible and aggressive anti-tobacco campaigns including increased public awareness of tobacco harms and active engagement of worksites and health professionals in promoting tobacco cessation.
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Levy, David T., Hana Ross, Alexandra Kmetova, Eva Kralikova, Michal Stoklosa, and Kenneth Blackman. "The Czech Republic SimSmoke: The Effect of Tobacco Control Policies on Smoking Prevalence and Smoking Attributable Deaths in the Czech Republic." ISRN Public Health 2012 (April 3, 2012): 1–8. http://dx.doi.org/10.5402/2012/329721.
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Background. The Czech Republic has a weak tobacco control record. This paper describes a simulation model examining the effect of future tobacco control policies in the Czech Republic on smoking prevalence and associated future premature mortality. Methods. The model is developed using the SimSmoke simulation model of tobacco control policy. The model uses population, smoking rates and tobacco control policy data for the Czech Republic. It assesses, individually and in combination, the effect of taxes, smoke-free air laws, mass media campaigns, advertising bans, warning labels, cessation treatment, and youth access policies. Results. With a comprehensive set of policies, smoking prevalence can be reduced by as much as 22% in the first year, by 35% in 20 years, and up to 40% in 30 years. By 2040, 5,873 deaths can be averted in that year alone. Without these policies, 113,004 people in the Czech Republic will die prematurely in the next 30 years. Conclusions. The model shows that significant inroads to reducing smoking prevalence and premature mortality can be achieved through tax increases, a high intensity media campaign, a comprehensive cessation treatment program, strong health warnings, stronger smoke-free air laws and marketing bans, and well-enforced youth access laws.
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Aguilar Castro, Nadia, and Eduardo Hernández Martínez. "World Health Organization Strategies to Reduce Smoking." Mexican Journal of Medical Research ICSA 7, no. 13 (January 5, 2019): 7–11. http://dx.doi.org/10.29057/mjmr.v7i13.3795.
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Today, tobacco is a serious public health problem considered a risk factor in chronic diseases and its complications. Tobacco habit is a risk factor completely modifiable, so it is important to quit this bad habit at all ages. Due to tobacco epidemic, the World Health Organization (WHO) established the Framework Convention on Tobacco Control (FCTC) and the Monitor, Protect, Offer, Warn, Enforce and Raise (MPOWER) Brochures and the importance of the use of social marketing as a tool of educational communication to transmit health information clearly, and promote healthy lifestyles, reinforce knowledge, attitudes or behaviors.
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Stumberg, Robert. "Safeguards for Tobacco Control: Options for the TPPA." American Journal of Law & Medicine 39, no. 2-3 (June 2013): 382–441. http://dx.doi.org/10.1177/009885881303900210.
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With tobacco trade, the past is prologue. In the 1980s, the U.S. government used domestic trade remedies (“Super 301”) to pry open markets for U.S. tobacco companies. The targets included Japan, South Korea, Taiwan, and Thailand. A grateful tobacco industry donated a renovation of the Treaty Room in the U.S. Department of State, declaring at the dedication: “Tobacco is intimately and historically associated with American diplomacy.”Thailand responded by banning imported cigarettes on grounds that the imports were more addictive and marketing of imports was driving up consumption. The United States then challenged Thailand for violating the General Agreement on Tariffs and Trade (GATT). The GATT panel ruled against Thailand, finding that the import ban failed to satisfy the health exception of GATT Article XX.
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Little, Megan, Hana Ross, George Bakhturidze, and Iago Kachkachishvili. "Illicit tobacco trade in Georgia: prevalence and perceptions." Tobacco Control 29, Suppl 4 (January 18, 2019): s227—s233. http://dx.doi.org/10.1136/tobaccocontrol-2018-054839.
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BackgroundIn lower-income and middle-income countries, limited research exists on illicit tobacco trade and its responsiveness to taxation. Tobacco taxes are critical in reducing tobacco consumption, thereby improving public health. However, the tobacco industry claims that tax increases will increase illicit tobacco trade. Therefore, research evidence on the size of the illicit cigarette market is needed in Georgia and other low-income and middle-income countries to inform tobacco tax policies.MethodsIn 2017, a household survey using stratified multistage sampling was conducted in Georgia with 2997 smokers, to assess illicit tobacco consumption. Smokers were asked to show available cigarette packs to the surveyors. These were examined for tax stamps and health warnings which allowed for an assessment of illegal cigarette consumption in Georgia.FindingsThe packs shown to surveyors suggest illicit cigarette trade is low (1.5%), although with regional differences, as illicit cigarette packs were present in 6% of the households in Zugdidi. Most illicit cigarettes were purchased at kiosks or informal outlets. This estimate might be conservative, as 28% of respondents did not show any packs to the surveyors.ConclusionsDespite recent tobacco tax increases, illicit cigarette trade in Georgia seems to be negligible. The market is more vulnerable to illicit cigarette trade close to the border with Abkhazia (near Zugdidi). Tighter control or ban of tobacco sales at kiosks and informal outlets may reduce illicit cigarette trade. Further investigation is planned to better understand why a large proportion of survey participants said they had no pack available at home.
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Trimble, Deana G., Kevin Welding, Katherine Clegg Smith, and Joanna E. Cohen. "Smoke and Scan: A Content Analysis of QR Code-Directed Websites Found on Cigarette Packs in China." Nicotine & Tobacco Research 22, no. 10 (May 24, 2020): 1912–16. http://dx.doi.org/10.1093/ntr/ntaa091.
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Abstract Introduction Quick Response codes, or “QR” codes, are used widely in China—for mobile payment, marketing, public transportation, and various other applications. In this study, we examined the content of websites linked from QR codes on cigarette packs collected in China. Aims and Methods In February 2017, 738 unique cigarette packs were collected from five Chinese cities (Beijing, Guangzhou, Shanghai, Kunming, and Chengdu) using a systematic protocol. Cigarette packs were coded for presence of QR codes on packaging. Packs containing QR codes were then scanned using the WeChat app. Websites sourced from QR codes were coded for required verification, website type, age- and health-related statements, engagement strategies, and marketing appeals. Results From the sample of 738 unique packs, 109 packs (14.8%) had a QR code on the packaging. The QR codes were linked to 24 unique websites of which 23 could be analyzed. All 23 unique websites were either brand-specific or social media websites; none focused on health or quit information. Of the 23 websites, only three (13.0%) websites had age-restricted site access and just six (26.1%) had any mention of health-related risks associated with product usage. Engagement strategies and/or marketing appeals were found on 20 (87.0%) websites. Conclusions The Chinese tobacco industry uses QR codes on cigarette packaging to link to web-based marketing content including social media recruitment, contests and giveaways, and product advertisement. It is important to understand where packs send consumers online and what messages they receive, and to consider QR codes on packaging when drafting policy. Implications Scanning QR codes in China is a commonplace activity. The authors are aware of no published studies on the role QR codes play on the marketing of cigarette packs, in China or elsewhere. This study demonstrates QR codes on cigarette packs can expose users and nonusers to cigarette marketing on interactive websites and protobacco social media pages, mostly without restrictive access or health warnings. This is an area that health authorities can consider regulating, given that this is a channel through which the tobacco industry can communicate with current and potential consumers.
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Moodie, Crawford, Janet Hoek, Janne Scheffels, Karine Gallopel-Morvan, and Kylie Lindorff. "Plain packaging: legislative differences in Australia, France, the UK, New Zealand and Norway, and options for strengthening regulations." Tobacco Control 28, no. 5 (August 1, 2018): 485–92. http://dx.doi.org/10.1136/tobaccocontrol-2018-054483.
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By July 2018, five countries (Australia, France, the UK, New Zealand and Norway) had fully implemented plain (standardised) packaging. Using government documents, we reviewed the key legislative differences between these five countries to identify best practice measures and potential lacuna. We then discuss how governments planning to introduce plain packaging could strengthen their legislation. Differences between countries include the terminology used (either ‘plain’, ‘standardised’ or ‘plain and standardised’), products covered and transition times (ranging from 2 to 12 months). Myriad differences exist with respect to the packaging, including the dimensions (explicitly stated for height, width and depth vs minimum dimensions for the health warnings only), structure (straight-edged flip-top packs vs straight, rounded and bevelled-edged flip-top packs and shoulder boxes) and size (minimum number of cigarettes and weight of tobacco vs fixed amounts) and warning content (eg, inclusion of a stop-smoking web address and/or quitline displayed on warnings on one or both principal display areas). Future options that merit further analysis include banning colour descriptors in brand and variant names, allowing pack inserts promoting cessation and permitting cigarettes that are designed to be dissuasive. Plain packaging legislation and regulations are divergent. Countries moving towards plain packaging should consider incorporating the strengths of existing policies and review opportunities for extending these. While plain packaging represents a milestone in tobacco-control policy, future legislation need not simply reflect the past but could set new benchmarks to maximise the potential benefits of this policy.
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Kerrigan, Vicki, Rarrtjiwuy Melanie Herdman, David P. Thomas, and Marita Hefler. "'I still remember your post about buying smokes': a case study of a remote Aboriginal community-controlled health service using Facebook for tobacco control." Australian Journal of Primary Health 25, no. 5 (2019): 443. http://dx.doi.org/10.1071/py19008.
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Many Aboriginal Community Controlled Health Services (ACCHS) embrace Facebook as an organisational tool to share positive stories, which counter the negative narrative surrounding Aboriginal issues. However, the Facebook algorithm prioritises posts on personal pages over organisations. To take advantage of the algorithm, this project paid three Yolŋu employees of a north-east Arnhem Land ACCHS to share quit smoking messages on their personal Facebook pages. Smoking prevalence among Aboriginal and Torres Strait Islander Australians is nearly three-fold higher than non-Indigenous Australians, and previous research has identified the need for culturally appropriate communication approaches to accelerate the decline in Indigenous smoking. This research found Yolŋu participants nurtured healthy behaviours through compassionate non-coercive communications, in contrast to fear-inducing health warnings prevalent in tobacco control. Cultural tailoring of tobacco control messages was achieved by having trusted local health staff sharing, and endorsing, messages regardless of whether the content was Indigenous specific. This research also revealed online Facebook activity does not reflect the reach of posts, which may extend beyond social media users to individuals who do not have a Facebook profile.
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Ling, Pamela M., Minji Kim, Catherine O. Egbe, Roengrudee Patanavanich, Mariana Pinho, and Yogi Hendlin. "Moving targets: how the rapidly changing tobacco and nicotine landscape creates advertising and promotion policy challenges." Tobacco Control 31, no. 2 (March 2022): 222–28. http://dx.doi.org/10.1136/tobaccocontrol-2021-056552.
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Tobacco, nicotine and related products have and continue to change rapidly, creating new challenges for policies regulating their advertising, promotion, sponsorship and sales. This paper reviews recent commercial product offerings and the regulatory challenges associated with them. This includes electronic nicotine delivery systems, electronic non-nicotine delivery systems, personal vaporisers, heated tobacco products, nicotine salts, tobacco-free nicotine products, other nicotine products resembling nicotine replacement therapies, and various vitamin and cannabis products that share delivery devices or marketing channels with tobacco products. There is substantial variation in the availability of these tobacco, nicotine, vaporised, and related products globally, and policies regulating these products also vary substantially between countries. Many of these products avoid regulation by exploiting loopholes in the definition of tobacco or nicotine products, or by occupying a regulatory grey area where authority is unclear. These challenges will increase as the tobacco industry continues to diversify its product portfolio, and weaponises ‘tobacco harm reduction’ rhetoric to undermine policies limiting marketing, promotion and taxation of tobacco, nicotine and related products. Tobacco control policy often lags behind the evolution of the industry, which may continue to sell these products for years while regulations are established, refined or enforced. Policies that anticipate commercial tobacco, nicotine and related product and marketing changes and that are broad enough to cover these product developments are needed.
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De Gruchy, Jeanelle, and Dara Coppel. "“Listening to Reason”: A Social Marketing Stop-Smoking Campaign in Nottingham." Social Marketing Quarterly 14, no. 1 (February 26, 2008): 5–17. http://dx.doi.org/10.1080/15245000801910624.
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Nottingham's high level of smoking (34% prevalence) is a significant contributor to its poor health profile. This article focuses on the development, implementation and evaluation of a social marketing campaign which aimed to reduce smoking in adults living in its most deprived areas. The campaign was part of a comprehensive program of tobacco control and smoking cessation interventions. A local team of National Health Service staff coordinated the campaign. Insight into the smoking behavior of the target groups was developed through geodemographic profiling, literature review, and qualitative research in semi-structured sessions and street interviews. A marketing agency developed the intervention mix, which included billboards, bus and tram banners, posters, and beer mats. Lessons learned from the campaign are presented, along with early findings from its evaluation which suggest a modest impact on behavior. The difficulty of evaluating a small campaign at local level, particularly in an area such as tobacco control where there is a concurrent, multi-component program in place, is discussed.
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Campbell, M. A., S. Finlay, K. Lucas, N. Neal, and R. Williams. "Kick the habit: a social marketing campaign by Aboriginal communities in NSW." Australian Journal of Primary Health 20, no. 4 (2014): 327. http://dx.doi.org/10.1071/py14037.
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Tackling smoking is an integral component of efforts to improve health outcomes in Aboriginal communities. Social marketing is an effective strategy for promoting healthy attitudes and influencing behaviours; however, there is little evidence for its success in reducing smoking rates in Aboriginal communities. This paper outlines the development, implementation and evaluation of Kick the Habit Phase 2, an innovative tobacco control social marketing campaign in Aboriginal communities in New South Wales (NSW). The Aboriginal Health & Medical Research Council worked with three Aboriginal communities and a creative agency to develop locally tailored, culturally relevant social marketing campaigns. Each community determined the target audience and main messages, and identified appropriate local champions and marketing tools. Mixed methods were used to evaluate the campaign, including surveys and interviews with community members and Aboriginal Community Controlled Health Service staff. Community survey participants demonstrated high recall of smoking cessation messages, particularly for messages and images specific to the Kick the Habit campaign. Staff participating in interviews reported an increased level of interest from community members in smoking cessation programs, as well as increased confidence and skills in developing further social marketing campaigns. Aboriginal community-driven social marketing campaigns in tobacco control can build capacity, are culturally relevant and lead to high rates of recall in Aboriginal communities.
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Lempert, Lauren Kass, and Stanton A. Glantz. "Heated tobacco product regulation under US law and the FCTC." Tobacco Control 27, Suppl 1 (October 5, 2018): s118—s125. http://dx.doi.org/10.1136/tobaccocontrol-2018-054560.
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Tobacco companies are marketing new ‘heated tobacco products’ (HTPs) composed of battery-powered holders, chargers and tobacco plugs or sticks. The non-tobacco HTP components have escaped effective regulation under many countries’ tobacco control laws because they are packaged and sold separately from the tobacco-containing components. In the USA, HTPs cannot be marketed unless the Food and Drug Administration determines that allowing their sale would be ‘appropriate for the protection of the public health’. Philip Morris International (PMI) is seeking permission to market its IQOS HTP in the USA with ‘modified risk tobacco product’ (MRTP) claims that it reduces exposure to harmful substances and is less harmful than other tobacco products. However, PMI has not submitted adequate scientific evidence required by US law to demonstrate that the product is significantly less harmful to users than other tobacco products, that its labelling would not mislead consumers, or that its marketing—with or without MRTP claims—would benefit the health of the population as a whole. Parties to the WHO Framework Convention on Tobacco Control (FCTC) must take measures to reduce tobacco use and nicotine addiction, and prevent false or misleading tobacco product labelling, advertising and promotions; the introduction of new HTPs must be assessed according to these goals. All components of HTPs should be regulated at least as stringently as existing tobacco products, including restrictions on labelling, advertising, promotion and sponsorship, sales to minors, price and taxation policies and smokefree measures. There is nothing in US law or the FCTC that prevents authorities from prohibiting HTPs.
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Dewhirst, Timothy. "Price and tobacco marketing strategy: lessons from ‘dark’ markets and implications for the WHO Framework Convention on Tobacco Control." Tobacco Control 21, no. 6 (September 29, 2012): 519–23. http://dx.doi.org/10.1136/tobaccocontrol-2012-050693.
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Unger, Jennifer B., Frank J. Chaloupka, Donna Vallone, James F. Thrasher, Destiney S. Nettles, Tabitha P. Hendershot, and Gary E. Swan. "PhenX: Environment measures for Tobacco Regulatory Research." Tobacco Control 29, Suppl 1 (January 2020): s35—s42. http://dx.doi.org/10.1136/tobaccocontrol-2018-054469.
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ObjectiveA Working Group (WG) of tobacco regulatory science experts identified measures for the tobacco environment domain.MethodsThis article describes the methods by which measures were identified, selected, approved and placed in the PhenX Toolkit.FindingsThe WG identified 20 initial elements relevant to tobacco regulatory science and determined whether they were already in the PhenX Toolkit or whether novel or improved measures existed. In addition to the 10 complementary measures already in the Toolkit, the WG recommended 13 additional measures: aided and confirmed awareness of televised antitobacco advertising, interpersonal communication about tobacco advertising, media use, perceived effectiveness of antitobacco advertising, exposure to smoking on television and in the movies, social norms about tobacco (for adults and for youth), worksite policies, youth cigarette purchase behaviours and experiences, compliance with cigarette packaging and labelling policies, local and state tobacco control public policies, and neighbourhood-level racial/ethnic composition. Supplemental measures included youth social capital and compliance with smoke-free air laws and with point of sale and internet tobacco marketing restrictions. Gaps were identified in the areas of policy environment (public and private), communications environment, community environment and social environment (ie, the norms/acceptability of tobacco use).ConclusionsConsistent use of these tobacco environment measures will enhance rigor and reproducability of tobacco research.
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Chandra, A., A. Yadav, K. Chandan, and R. Mehrotra. "Regulatory Compliance: A Challenge for Unbranded Smokeless Tobacco Products." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 197s. http://dx.doi.org/10.1200/jgo.18.79402.
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Background: Smokeless tobacco (SLT) is available in many forms in India and is widely used by all social groups. SLT market in India is the world largest market. Over the last 2 decades, the SLT industry in India has grown immensely, mostly in cottage industry sector and unorganized sector. Several SLT products are self-made or mixed by users themselves. This presents a great challenge for regulation of such unbranded and loose products. Cancer of the oral cavity and the pharynx are a major public health problem in India. At least 90% of these cancers are caused by SLT products use. Aim: To study the challenges for unbranded SLT products in implementing the mandated regulatory compliances under the Indian Tobacco Control Law that applies to all tobacco products. Methods: The information on unbranded/loose SLT products was collected through literature search, field trips, discussions with SLT product vendors and with community members of different age group. Results: Several types of unbranded SLT products are sold both in urban and rural India. These unbranded products vary from state to state. In some cases they vary from 1 place to another within a state. Most of the unbranded products do not comply with the legal mandates of the Indian tobacco control (COTPA) and food safety (FSSA) laws that regulate sale of tobacco products. The biggest fall-out of unbranded sale is that there is no pictorial health warnings to warn the users about the ill effects of these SLT products as required under section 7 of COTPA. In addition these products also do not mention the minimum requirement of the packaging and labeling under the legal metrology law. In absence of the pictorial health warnings these SLT products become more accessible and affordable to minors. The FSSA prohibits use of tobacco and nicotine as ingredient in any food item, however, most of the unbranded SLT products are sold with added flavorings, condiments and spices which are classified as food. Conclusion: Strict implementation of the mandated regulatory provisions is needed to check the unrestricted sale of unbranded products. Noncompliant unbranded/loose SLT products should be confiscated as per the prescriptions of the existing tobacco control and food safety laws. Findings from this paper calls for development of policies that will prevent sale of unbranded/loose SLT products in India to protect the unsuspecting youth and other vulnerable group of population from these cancer traps.
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Chu-Jun, Yang, Wu Chih-Fu, and Zhang Jun-Zhu. "Study on the Learning Effectiveness of the Tobacco Control Window Design Course in Line with the Visual Marketing Standards of the World Skills Competition." Tobacco Regulatory Science 7, no. 5 (September 30, 2021): 2362–72. http://dx.doi.org/10.18001/trs.7.5.1.6.
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Objectives: Almost all smokers started smoking cigarettes before the age of 18 then became addicted to tobacco. Therefore, tobacco prevention education must be carried out throughout high school and university. Shunde Polytechnic integrates tobacco control health education into the window design curriculum, which allows students to complete and display tobacco control window design works on campus to cause discussion, thus achieving the promotion of tobacco control publicity and education. Based on the competition standards of the Visual Merchandising project of World Skills Competition, the original teaching methods were reformed in this research and the nine standards of the competition were divided into four modules for teaching. The required knowledge, specific skill requirements, and workflow were well integrated into the teaching of smoke control window design tasks to foster students’ abilities to display innovative design, window production, installation and operation, and teamwork. And the teaching results were verified according to World Skills Competition scoring methods and standards. The results showed that with the import of the Visual Merchandising project competition standard of World Skills Competition into the original window design course, on the one hand, the effects of students’ works and their self-satisfaction with their works have shown a significant improvement. On the other hand, although this kind of teaching method does not relieve the students’ mental, physical, time, and frustration pressure, it has stimulated and cultivated students’ good professional qualities. However, this research focuses on the assessment of professional skills and professionalism. Therefore, future research will more focus on evaluating the effectiveness of window design courses under the new teaching model in preventing youngsters from smoking or encouraging students to quit smoking, popularizing correct knowledge about the health hazards of tobacco, and establishing positive life beliefs.
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Hardardottir, Agnes, Mohammed Al-Hamdani, Raymond Klein, Austin Hurst, and Sherry H. Stewart. "The Effect of Cigarette Packaging and Illness Sensitivity on Attention to Graphic Health Warnings: A Controlled Study." Nicotine & Tobacco Research 22, no. 10 (January 7, 2020): 1788–94. http://dx.doi.org/10.1093/ntr/ntz243.
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Abstract Introduction The social and health care costs of smoking are immense. To reduce these costs, several tobacco control policies have been introduced (eg, graphic health warnings [GHWs] on cigarette packs). Previous research has found plain packaging (a homogenized form of packaging), in comparison to branded packaging, effectively increases attention to GHWs using UK packaging prototypes. Past studies have also found that illness sensitivity (IS) protects against health-impairing behaviors. Building on this evidence, the goal of the current study was to assess the effect of packaging type (plain vs. branded), IS level, and their interaction on attention to GHWs on cigarette packages using proposed Canadian prototypes. Aims and Methods We assessed the dwell time and fixations on the GHW component of 40 cigarette pack stimuli (20 branded; 20 plain). Stimuli were presented in random order to 50 smokers (60.8% male; mean age = 33.1; 92.2% daily smokers) using the EyeLink 1000 system. Participants were divided into low IS (n = 25) and high IS (n = 25) groups based on scores on the Illness Sensitivity Index. Results Overall, plain packaging relative to branded packaging increased fixations (but not dwell time) on GHWs. Moreover, low IS (but not high IS) smokers showed more fixations to GHWs on plain versus branded packages. Conclusions These findings demonstrate that plain packaging is a promising intervention for daily smokers, particularly those low in IS, and contribute evidence in support of impending implementation of plain packaging in Canada. Implications Our findings have three important implications. First, our study provides controlled experimental evidence that plain packaging is a promising intervention for daily smokers. Second, the findings of this study contribute supportive evidence for the impending plain packaging policy in Canada, and can therefore aid in defense against anticipated challenges from the tobacco industry upon its implementation. Third, given its effects in increasing attention to GHWs, plain packaging is an intervention likely to provide smokers enhanced incentive for smoking cessation, particularly among those low in IS who may otherwise be less interested in seeking treatment for tobacco dependence.
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Halas, Gayle, Annette S. H. Schultz, Janet Rothney, Pamela Wener, Maxine Holmqvist, Benita Cohen, Leanne Kosowan, Jennifer E. Enns, and Alan Katz. "A Scoping Review of Foci, Trends, and Gaps in Reviews of Tobacco Control Research." Nicotine & Tobacco Research 22, no. 5 (February 2, 2019): 599–612. http://dx.doi.org/10.1093/ntr/nty269.
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Abstract Introduction The burden of disease associated with tobacco use has prompted a substantial increase in tobacco-related research, but the breadth of this literature has not been comprehensively examined. This review examines the nature of the research addressing the action areas in World Health Organization’s Framework Convention on Tobacco Control (FCTC), the populations targeted and how equity-related concepts are integrated. Method A scoping review of published reviews addressing tobacco control within the primary prevention domain. We searched PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Educational Resources Information Centre, and PsycInfo from 2004 to 2018. Results The scoping review of reviews offered a “birds-eye-view” of the tobacco control literature. Within the 681 reviews meeting inclusion criteria, there was a strong focus on smoking cessation targeting individuals; less attention has been given to product regulation, packaging, and labeling or sales to minors. Equity-related concepts were addressed in 167/681 (24.5%); few were focused on addressing inequity through structural and systemic root causes. Conclusion This analysis of foci, trends, and gaps in the research pursuant to the FCTC illustrated the particular action areas and populations most frequently addressed in tobacco control research. Further research is needed to address: (1) underlying social influences, (2) particular action areas and with specific populations, and (3) sustained tobacco use through the influence of novel marketing and product innovations by tobacco industry. Implications This scoping review of the breadth of tobacco control research reviews enables a better understanding of which action areas and target populations have been addressed in the research. Our findings alongside recommendations from other reviews suggest prioritizing further research to support policymaking and considering the role of the tobacco industry in circumventing tobacco control efforts. The large amount of research targeting individual cessation would suggest there is a need to move beyond a focus on individual choice and decontextualized behaviors. Also, given the majority of reviews that simply recognize or describe disparity, further research that integrates equity and targets various forms of social exclusion and discrimination is needed and may benefit from working in collaboration with communities where programs can be tailored to need and context.
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Chan, Lilian, Blythe O'Hara, Philayrath Phongsavan, Adrian Bauman, and Becky Freeman. "Review of Evaluation Metrics Used in Digital and Traditional Tobacco Control Campaigns." Journal of Medical Internet Research 22, no. 8 (August 11, 2020): e17432. http://dx.doi.org/10.2196/17432.
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Background Mass media campaigns for public health are increasingly using digital media platforms, such as web-based advertising and social media; however, there is a lack of evidence on how to best use these digital platforms for public health campaigns. To generate this evidence, appropriate campaign evaluations are needed, but with the proliferation of digital media–related metrics, there is no clear consensus on which evaluation metrics should be used. Public health campaigns are diverse in nature, so to facilitate analysis, this review has selected tobacco control campaigns as the scope of the study. Objective This literature review aimed to examine how tobacco control campaigns that use traditional and digital media platforms have been evaluated. Methods Medicine and science databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature [CINAHL], and Scopus), and a marketing case study database (World Advertising Research Center) were searched for articles published between 2013 and 2018. Two authors established the eligibility criteria and reviewed articles for inclusion. Individual campaigns were identified from the articles, and information on campaigns and their evaluations were supplemented with searches on Google, Google Scholar, and social media platforms. Data about campaign evaluations were tabulated and mapped to a conceptual framework. Results In total, 17 campaigns were included in this review, with evaluations reported on by 51 articles, 17 marketing reports, and 4 grey literature reports. Most campaigns were from English-speaking countries, with behavioral change as the primary objective. In the process evaluations, a wide range of metrics were used to assess the reach of digital campaign activities, making comparison between campaigns difficult. Every campaign in the review, except one, reported some type of engagement impact measure, with website visits being the most commonly reported metric (11 of the 17 campaigns). Other commonly reported evaluation measures identified in this review include engagement on social media, changes in attitudes, and number of people contacting smoking cessation services. Of note, only 7 of the 17 campaigns attempted to measure media platform attribution, for example, by asking participants where they recalled seeing the campaign or using unique website tracking codes for ads on different media platforms. Conclusions One of the key findings of this review is the numerous and diverse range of measures and metrics used in tobacco control campaign evaluations. To address this issue, we propose principles to guide the selection of digital media–related metrics for campaign evaluations, and also outline a conceptual framework to provide a coherent organization to the diverse range of metrics. Future research is needed to specifically investigate whether engagement metrics are associated with desired campaign outcomes, to determine whether reporting of engagement metrics is meaningful in campaign evaluations.
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Sanders-Jackson, Ashley, Robyn B. Adams, and Raymond Jussaume. "A Qualitative Evaluation of Tobacco Consumption in the Rural Context." Tobacco Regulatory Science 6, no. 4 (July 1, 2020): 224–34. http://dx.doi.org/10.18001/trs.6.4.1.
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Objectives: Understanding what rural adult tobacco users think about tobacco use, tobacco control policies and health may help create acceptable policies and interventions. Methods: We completed 8 focus groups in rural Michigan from winter 2016 through summer 2018. Interviews were transcribed and an iterative thematic analysis was completed during fall 2018. Results: Although our primary themes of Independence, Respect, Social Context, Economic Calculus, and Policy with an underlying theme of health were similar to themes that typically arise in tobacco control research, their application and social context appear to be unique in rural communities. Issues of respect for tobacco users, and well as third-party individuals affected by tobacco use, were paramount for participants. They viewed tobacco use as an individual choice and not a structural or policy-relevant issue, although they accepted restrictions on tobacco use in most settings where non-smokers are present. Conclusions: Participants understood that smoking is problematic and seem to be open to anti-smoking messaging and policies when correctly framed. Participants blame themselves for their smoking (ignoring industry responsibility) and used language that can be found in tobacco marketing. Framing tobacco control as a way to protect children while respecting smokers as people may be successful.
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Ang, Tyson, Shuqin Wei, and Denni Arli. "Social distancing behavior during COVID-19: a TPB perspective." Marketing Intelligence & Planning 39, no. 6 (June 1, 2021): 809–24. http://dx.doi.org/10.1108/mip-08-2020-0352.
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PurposeIn responding to the Coronavirus (COVID-19) pandemic, drastic public health measures such as social distancing and lockdowns have been implemented across the globe to slow the spread of the virus. In the USA, the public's reaction to social distancing has been mixed, evident in a high number of people flocking to beaches, bars and shops as coronavirus cases soar. Public health officials have issued strong warnings about the danger people face but the problem persists. To fill this gap, informed by the theory of planned behavior (TPB), this research explores why many people refuse to practice social distancing.Design/methodology/approachTwo studies were conducted during the ongoing COVID-19 pandemic. In the first study, a sample of 750 respondents was recruited from a US online consumer panel to complete a structured survey questionnaire. The data were analyzed using confirmatory factor analysis and structural equation modeling. In the second study, an open-ended questionnaire was administered to 50 US online participants to further uncover people's in-depth perceptions and perspectives toward the pandemic and social distancing. Thematic analysis was used to analyze the data.FindingsThe results from the first study show that risk-taking attitude, authoritarianism and subjective norm are significant predictors of social distancing intention and behavior, through perceived severity of COVID-19. Four themes emerged from the second study, which are consistent with the proposed conceptual framework in the first study.Originality/valueTheoretically, the authors’ findings first contribute to the emerging marketing literature that focuses on creating sustained positive changes and improving the well-being of consumers, communities and societies. Secondly, their findings corroborate with previous findings documented in the social influence literature by showing that during the times of uncertainty and confusion such as COVID-19, social norms (not forced by laws and regulations) play the most critical role in influencing a voluntary, socially beneficial behavior (such as social distancing). Third, this study extends the application of the TPB into the realm of social distancing behavior. The three main components of the TPB, namely attitude, behavioral control and subjective norm, are shown to predict social distancing behavior. Practically, the results of this research have important implications for public health policies on how to encourage positive public health behavior amid pandemics such as COVID-19.
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Harris, F. "Effects of the 2003 advertising/promotion ban in the United Kingdom on awareness of tobacco marketing: findings from the International Tobacco Control (ITC) Four Country Survey." Tobacco Control 15, suppl_3 (June 1, 2006): iii26—iii33. http://dx.doi.org/10.1136/tc.2005.013110.
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Thrasher, James F., Noel T. Brewer, Jeff Niederdeppe, Ellen Peters, Andrew A. Strasser, Rachel Grana, and Annette R. Kaufman. "Advancing Tobacco Product Warning Labels Research Methods and Theory: A Summary of a Grantee Meeting Held by the US National Cancer Institute." Nicotine & Tobacco Research 21, no. 7 (February 10, 2018): 855–62. http://dx.doi.org/10.1093/ntr/nty017.
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Abstract Background The World Health Organization’s Framework Convention on Tobacco Control recommends prominent pictorial health warnings on tobacco products. To advance research methods, theory and understanding of how tobacco product warning labels (TPWLs) work, the US National Cancer Institute convened a grantee meeting. Our article describes the key insights that emerged from the meeting, situated within the context of the scientific literature. Results & Recommendations First, presentations confirmed that large, pictorial TPWLs motivate people to try to quit and encourage smoking cessation. Second, pictorial TPWLs increase attention, knowledge, negative affect, and thinking about the warning. Third, TPWL studies have primarily used brief-exposure laboratory studies and observational studies of sustained exposure through national policy implementation, with a few randomized trials involving several weeks of exposure—with generally consistent results found across study designs. Fourth, novel assessment methods include brain imaging, eye tracking and “best-worst” discrete choice experiments. To make TPWL even more effective, research is needed to confirm the mechanisms of their influence, their impact across vulnerable populations, and their effect on social media posts about tobacco products. Research is also needed on the effect of trial design choices, the predictive validity of new measurement approaches, and warning labels for non-cigarette tobacco products. Implications To improve scientific understanding of TPWL effects, this grantee meeting summary describes emerging research methods, theory and study results. Directions for future research include examination of the mechanisms of how warning labels work across diverse tobacco products and across different populations and contexts.