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Current Status of Tobacco Control Policies

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 24793

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Special Issue Editors

Dr. Zubair Kabir

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Guest Editor

School of Public Health, University College Cork, Room 4.20 Western Gateway Building, T12 XF62 Cork, Ireland
Interests: tobacco control; non-communicable disease epidemiology (CVD epidemiologic policy modelling; lung health and cancer); burden of disease study; health literacy
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Kenneth D. Ward

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Guest Editor

Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN 38152, USA
Interests: tobacco use epidemiology and intervention; global tobacco control; waterpipe (hookah)

Dr. Christopher Seitz

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Guest Editor

Department of Health & Exercise Science, Appalachian State University, Boone, NC 28608, USA
Interests: tobacco control; e-cigarette use; photovoice

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on the “Current status in tobacco control policies” in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://0-www-mdpi-com.brum.beds.ac.uk/journal/ijerph.

Tobacco kills 8 million people globally and 1 billion people will die of tobacco by the turn of this century. Worldwide, current tobacco control policies are in a state of flux across several nations and in vulnerable population settings. Many high-income nations in Europe and in North America have made significant progress in implementing the “best buys” of the WHO tobacco control MPOWER policies. However, there are high-, middle-, and low-income nations who have yet to implement the FCTC guidelines in their entirety. This Special Issue will aim to highlight populations and nations which are in different stages of tobacco control policies in light of FCTC guidelines. This Issue will also compile some “best practice” case studies that point to successful strategies on both the supply and demand sides of tobacco. Researchers involved in tobacco control policies currently in operation or being evaluated in specific population settings, such as prisons, mental hospitals, nursing homes, public housing, parks, beaches, and playgrounds are also encouraged to submit their work.

This Special Issue is open to any subject area related to the current status of tobacco control policies across different population settings and nations. The listed keywords suggest just a few of the many possibilities.

Disclaimer: We will not accept research funded in part or full by any tobacco companies in this Special Issue. For more details, please check: https://0-www-mdpi-com.brum.beds.ac.uk/1660-4601/15/12/2831/htm.

Dr. Zubair Kabir
Prof. Dr. Kenneth D. Ward
Dr. Christopher Seitz
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Tobacco
FCTC
MPOWER
WHO
Vulnerable population
Smoke-free policies
Parks
Playgrounds
Prisons
Beaches
Mental hospitals
Nursing homes
Demand
Supply
Best practice

Published Papers (10 papers)

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Research

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12 pages, 320 KiB

Open AccessArticle

Cigar Warning Noticing and Demographic and Usage Correlates: Analysis from the United States Population Assessment of Tobacco and Health Study, Wave 5

by Stefanie K. Gratale, Arjun Teotia, Julia Chen-Sankey, Ollie Ganz, Cristine D. Delnevo, Andrew A. Strasser and Olivia A. Wackowski

Int. J. Environ. Res. Public Health 2022, 19(6), 3221; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19063221 - 09 Mar 2022

Cited by 4 | Viewed by 1593

Abstract

Although cigars pose health risks similar to cigarettes, their packaging/marketing is not subject to commensurate regulation in the US. In a 2000 agreement with the Federal Trade Commission, seven major manufacturers agreed to use some form of cigar warning. In 2016, the Food and Drug Administration passed a rule requiring larger standardized warnings, but the requirement was successfully challenged in court. Here, we examined U.S. population-level trends in noticing existing cigarillo, traditional and filtered cigar warnings. We analyzed Wave 5 Population Assessment of Tobacco and Health adult data to assess prevalence of past-30 day warning noticing and associations with socio-demographic and tobacco use variables. Noticing was higher among current users of cigarillos (27%), filtered (34%) and traditional cigars (21%), than non-users (8% for each product, p < 0.0001), and among every-day vs. some-day users, established vs. experimental users, and past-30 day users vs. those without past-30 day use. Results varied by product, but generally indicated lower noticing among non-Hispanic Whites and dual cigarette users, but higher noticing among those purchasing cigars by the box/pack (vs. not purchasing for themselves). Low overall noticing but higher prevalence among frequent users underscores a need for a stronger, uniform cigar warning label policy in the US. Full article

(This article belongs to the Special Issue Current Status of Tobacco Control Policies)

10 pages, 308 KiB

Open AccessArticle

Tobacco Industry Efforts to Respond to Smoke-Free Policies in Multi-Unit Housing: An Evaluation of Tobacco Industry Documents

by Joshua Miller and Maya Vijayaraghavan

Int. J. Environ. Res. Public Health 2022, 19(5), 3053; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19053053 - 05 Mar 2022

Cited by 3 | Viewed by 1686

Abstract

The tobacco industry’s efforts to undermine clean indoor air policies in the hospitality industry, public spaces and workspaces is well documented, but less is known about their efforts to respond to the implementation of smoke-free policies in multi-unit housing (MUH). From 1988 to 2018, public and private multi-unit housing properties voluntarily implemented smoke-free polices in their buildings. We searched the UCSF’s Truth Tobacco Industry Documents Library to examine whether the tobacco industry responded to the implementation of these smoke-free policies in MUH using the same strategies they deployed to respond to smoke-free policies in other industries. We found that the tobacco industry used two primary strategies to respond to smoke-free policies in multi-unit housing: (1) distortion, which included funding studies that downplayed the link between SHS and asthma among low-income, inner-city MUH residents; and (2) deflection, which included engaging in corporate responsibility for youth living in low-income MUH. Despite these efforts, local jurisdictions continued to voluntarily implement smoke-free policies in MUH, pointing to a potential counter strategy to the tobacco industry influence. Full article

(This article belongs to the Special Issue Current Status of Tobacco Control Policies)

10 pages, 330 KiB

Open AccessArticle

Has the National Fall in Smoking Rates in Ireland Been Replicated in Cancer Patients? A 5-Year Report

by Patricia Fitzpatrick, Nancy Bhardwaj, Ailsa Lyons, Kirsten Doherty, Kate Frazer, Amanda McCann, Vikram Niranjan, Shiraz Syed and Patricia Fox

Int. J. Environ. Res. Public Health 2022, 19(4), 2348; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19042348 - 18 Feb 2022

Cited by 1 | Viewed by 2008

Abstract

Smoking among cancer patients leads to poorer outcomes, yet many patients continue smoking. As part of a feasibility study of smoking cessation for cancer patients in Ireland, smoking rates were reviewed. Hospital Inpatient Enquiry (HIPE) data on the smoking status of discharges with a cancer diagnosis (overall, breast, lung, cervical and head and neck cancer) were used (2014–2018). During 2014–2017, current smoking increased for overall (10.5–11.7%) and lung cancer (24.7–27.2%), then decreased to 11.4% and 24.1%, respectively, in 2018. Current smoking increased for cervical during 2014–2018 (11–19.8%) and initially (2014–2016) for head and neck (3–12.7%) cancer, decreasing to 7.6% in 2018; breast cancer was stable at 6 ± 0.6%. These rates are lower than the Irish (23–20%) and European (29% (average)) general population. During 2014–2017, past smoking increased among overall (15.2–21%) and specific cancers, which was lower than the Irish general population (23–28%). Current smoking was highest among 50–59-year-olds (14–16%), which contrasts with the Irish general population (24–35 years at 32–28%). HIPE data are subject to potential duplicate episodes of care and under-documentation of smoking. However, trend analysis is useful, as these limitations should be stable. Rates remain high; therefore, robust documentation and smoking cessation referrals for cancer patients are important. Full article

(This article belongs to the Special Issue Current Status of Tobacco Control Policies)

13 pages, 1419 KiB

Open AccessArticle

Gender Differences in Smoking Initiation and Cessation Associated with the Intergenerational Transfer of Smoking across Three Generations: The Nagahama Study

by Sachiko Nakagawa, Yoshimitsu Takahashi, Takeo Nakayama, Shigeo Muro, Michiaki Mishima, Akihiro Sekine, Yasuharu Tabara, Fumihiko Matsuda and Shinji Kosugi

Int. J. Environ. Res. Public Health 2022, 19(3), 1511; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031511 - 28 Jan 2022

Cited by 2 | Viewed by 2721

Abstract

Global tobacco policies lowered overall and male smoking rates, but female smoking rates have remained unchanged. Parent–child studies revealed the effects of parental smoking, but gender differences had mixed results. We investigated the effects of long-term smoking behavior in families over three generations in order to clarify gender differences. A cross-sectional study in a community-based genome cohort was conducted using a self-reported questionnaire. A total of 8652 respondents were stratified by gender regarding smoking initiation. A logistic regression analysis was performed to analyze the family smoking history. A total of 2987 current smokers and ever-smokers were compared regarding smoking cessation. With respect to smoking initiation, women were affected by their smoking mothers (odds ratio (OR), 2.4; 95% confidence interval (CI), 1.8–3.2) and grandmothers (OR, 1.7; CI, 1.1–2.4). Women who continued smoking were affected only by their smoking mothers (OR, 1.6; CI, 1.05–2.49). In conclusion, gender differences in smoking initiation and cessation are possibly associated with family smoking history. Mothers and grandmothers were shown to have a strong influence on women with respect to both smoking initiation and cessation. Future research should focus on providing evidence for effective gender-specific intervention programs to curb long-term smoking in women. Full article

(This article belongs to the Special Issue Current Status of Tobacco Control Policies)

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12 pages, 320 KiB

Open AccessArticle

Using COVID-19 Symbols in Anti-Smoking Fear Appeal Advertisements for Encouraging Smoking Cessation among Israeli Smokers

by Iris Gavish and Yossi Gavish

Int. J. Environ. Res. Public Health 2021, 18(20), 10839; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010839 - 15 Oct 2021

Viewed by 1999

Abstract

The current study aims to reveal whether using COVID-19 as the threatening message in anti-smoking ads will influence smokers differently than other threat appeals. All ads that were chosen for this study were created by the Israel Cancer Association/the Israeli Ministry of Health. Since the coronavirus has proven to have far-reaching effects on the human respiratory system, it is directly connected to smoking. The present study included semi-structured in-depth interviews with experts, a pre-test (n = 106) and an online questionnaire including 721 participants (adults aged 18–30 versus 55+). The findings indicated that when using the COVID-19 symbol as the threatening message in an anti-smoking ad for the older participants, smoking cessation intentions were higher than when using a cigarette simulating a ‘gunpoint’ threat (p < 0.08). Additionally, when using the COVID-19 symbol, there was a positive relation between participants’ age and smoking cessation intentions. The average smoking cessation intention for the participants from the older age group (M = 3.05, SD = 1.07) was higher than the average for the participants from the young age group (M = 2.80, SD = 1.13). Finally, when using impotence (for men) and pregnancy risks (for women) as the threatening message in the ads for young respondents, smoking cessation intentions were higher than when using COVID-19 (p < 0.05). The results may help decision-makers and public health officials in choosing the marketing communication suited for conveying messages aimed to encourage people to reduce/quit smoking. Full article

(This article belongs to the Special Issue Current Status of Tobacco Control Policies)

11 pages, 5866 KiB

Open AccessArticle

Novel Insights into Young Adults’ Perceived Effectiveness of Waterpipe Tobacco-Specific Pictorial Health Warning Labels in Lebanon: Implications for Tobacco Control Policy

by Rima Nakkash, Malak Tleis, Sara Chehab, Wu Wensong, Michael Schmidt, Kenneth D. Ward, Wasim Maziak and Taghrid Asfar

Int. J. Environ. Res. Public Health 2021, 18(13), 7189; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137189 - 05 Jul 2021

Cited by 5 | Viewed by 2117

Abstract

This study aims to explore the perceived effectiveness of waterpipe (WP) tobacco specific health warning labels (HWLs) among young adult WP smokers and nonsmokers in Lebanon. Before participating in focus group discussions, participants (n = 66; WP smokers n = 30; nonsmokers n = 36; age 18–33) completed a brief survey to rate the effectiveness of 12 HWLs’ and rank them according to four risk themes (WP health effects, WP harm to others, WP-specific harm, and WP harm compared to cigarettes). Differences in HWLs ratings by WP smoking status were examined and the top-ranked HWL in each theme were identified. HWLs depicting mouth cancer and harm to babies were rated as the most effective by both WP smokers and non-smokers. WP smokers rated HWLs which depicted harm to children and infants as more effective than non-smokers. The top-ranked HWLs for perceived overall effectiveness were those depicting “oral cancer”, “harm to babies”, “orally transmitted diseases” and “mouth cancer”. HWLs depicting oral lesions and harm to babies were rated as most effective, while HWLs showing the harmful effects of WP secondhand smoke on infants and children were rated as less effective by nonsmokers compared to smokers. Our study provides evidence on the potential effectiveness of HWLs for further evaluation in Lebanon and the Eastern Mediterranean region. The results will inform and guide the development and implementation of tobacco control policy. Full article

(This article belongs to the Special Issue Current Status of Tobacco Control Policies)

14 pages, 694 KiB

Open AccessArticle

Adoption of Tobacco 21: A Cross-Case Analysis of Ten US States

by Shawna V. Hudson, Marin Kurti, Jenna Howard, Bianca Sanabria, Kevin R. J. Schroth, Mary Hrywna and Cristine D. Delnevo

Int. J. Environ. Res. Public Health 2021, 18(11), 6096; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116096 - 05 Jun 2021

Cited by 7 | Viewed by 2971

Abstract

Despite the recent push for Tobacco 21 legislation in the US and the national adoption of Tobacco 21, there is a paucity of data on the process of policy adoption. To explore the key factors that served as facilitators or challenges to the passage of state T21 laws that apply to the sale of all tobacco products to anyone under 21 years of age, we conducted a comparative, cross-case study in ten states that adopted Tobacco 21 between 2016 and 2019. Stakeholders from selected states were identified via snowball sampling, and interviews were conducted from November 2018 to March 2020. Three primary factors emerged as facilitators to the passage of state T21 laws: (1) increased attention on e-cigarettes as the product driving an overall increase in youth tobacco use and depiction of an “e-cigarette epidemic”, (2) having at least one influential policy entrepreneur or champion, and (3) traction from other states or local municipalities passing T21 legislation. Challenges to T21′s success included (1) influence of the tobacco industry, (2) the bill’s low ranking among legislative priorities, and (3) controversy among advocates and policymakers over bill language. As e-cigarette rates spiked, T21 bills became legislative priorities, traction from other successful efforts mounted, and ultimately, the tobacco industry flipped from opposing to supporting T21 laws. Despite these favorable headwinds, advocates struggled increasingly to pass bills with ideal policy language. Full article

(This article belongs to the Special Issue Current Status of Tobacco Control Policies)

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13 pages, 381 KiB

Open AccessArticle

The Utilization of National Tobacco Cessation Services among Female Smokers and the Need for a Gender-Responsive Approach

by Ahnna Lee, Kang-Sook Lee, Dahyeon Lee, Hyeju Ahn, Hyun-Kyung Lee, Hyekyeong Kim, Jakyoung Lee and Hong-Gwan Seo

Int. J. Environ. Res. Public Health 2021, 18(10), 5313; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18105313 - 17 May 2021

Cited by 2 | Viewed by 3443

Abstract

Despite the steadily increasing prevalence of female smoking, gender-responsive tobacco cessation services have not been widely provided worldwide. The purpose of this study is to identify factors associated with the use of tobacco cessation services among female tobacco product users in Korea from a national perspective. We performed a logistic regression analysis using data from 663 female smokers; 11.0% of female smokers had used government-supported smoking cessation services. A logistic regression model showed a statistically significant association between the utilization of smoking cessation services and a history of pregnancy and childbirth, depression, current use of heated tobacco products and multiple tobacco products, parental smoking status and receiving advice to quit. With regard to the motivation ruler, those in their 50s reported a higher importance than those in their 20s. Weight gain concerns when quitting smoking were the lowest among the participants aged 19–29. The need to develop gender-specific smoking cessation programs is the highest among the participants aged 39–49 and the lowest among those aged 19–29. This study suggests several factors related to the utilization of national health services among female smokers. Further studies considering gender-specific needs for the development of gender-responsive tobacco cessation support are needed. Full article

(This article belongs to the Special Issue Current Status of Tobacco Control Policies)

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15 pages, 1754 KiB

Open AccessArticle

The Association between Quitline Characteristics and Smoking Cessation by Educational Attainment, Income, Race/Ethnicity, and Sex

by David C. Colston, Bethany J. Simard, Yanmei Xie, Marshall Chandler McLeod, Michael R. Elliott, James F. Thrasher and Nancy L. Fleischer

Int. J. Environ. Res. Public Health 2021, 18(6), 3297; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18063297 - 23 Mar 2021

Cited by 3 | Viewed by 3212

Abstract

Little research examines how tobacco quitlines affect disparities in smoking cessation in the United States. Our study utilized data from the Tobacco Use Supplement to the Current Population Survey (2010, 2011, 2012, 2015, 2018) (TUS-CPS) and state-level quitline data from the North American Quitline Consortium and National Quitline Data Warehouse. We ran multilevel logistic regression models assessing a state-run quitline’s budget, reach, number of counseling sessions offered per caller, and hours of operation on 90-day smoking cessation. Multiplicative interactions between all exposures and sex, race/ethnicity, income, and education were tested to understand potential effect modification. We found no evidence that budget, reach, number of counseling sessions, or hours available for counseling were associated with cessation in the main effects analyses. However, when looking at effect modification by sex, we found that higher budgets were associated with greater cessation in males relative to females. Further, higher budgets and offering more sessions had a stronger association with cessation among individuals with lower education, while available counseling hours were more strongly associated with cessation among those with higher education. No quitline characteristics examined were associated with smoking cessation. We found evidence for effect modification by sex and education. Despite proven efficacy at the individual-level, current resource allocation to quitlines may not be sufficient to improve rates of cessation. Full article

(This article belongs to the Special Issue Current Status of Tobacco Control Policies)

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7 pages, 286 KiB

Open AccessBrief Report

Quitline Information Included on Cigarette Packaging: An Assessment of Country Adherence to WHO FCTC Guidelines, 2007 to 2018

by Christopher M. Seitz, Kenneth D. Ward and Zubair Kabir

Int. J. Environ. Res. Public Health 2021, 18(22), 12193; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212193 - 20 Nov 2021

Viewed by 1215

Abstract

The purpose of this study is to evaluate country adherence to the World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC) guidelines in terms of including quitline information on cigarette packaging. Data were gathered from the WHO’s Global Health Observatory database. The study included countries that were signatories to the FCTC, had a toll-free quitline, and required health warnings on cigarette packaging. Countries were then classified by income level according to the World Bank. From 2007 to 2018, the number of countries that established a quitline increased from 34 to 60. During the same timeframe among those countries, the number of countries that included information about the quitline on cigarette packaging increased from 5 to 37, with a larger proportion (79%) of high-income countries promoting their quitlines on cigarette packaging compared to middle-income (45%) countries. Although there was an increase in adherence to the WHO FCTC guidelines, there is still a need for several countries to include quitline information on cigarette packaging. Full article

(This article belongs to the Special Issue Current Status of Tobacco Control Policies)

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