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Tobacco Control

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 October 2014) | Viewed by 67670

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Guest Editor
Advisor Tobacco Control Pan American Health Organization/World Health Organization, 525 23rd Street, Washington, DC 20037, USA
Interests: tobacco control policies (health warnings, tobacco advertisement promotion and sponsorship, smoke-free environments); second hand smoke; tobacco industry; tobacco prevention; Smoking cessation, Framework Convention on Tobacco Control, Protocol on Illicit Trade of tobacco products. Trade and Tobacco)
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Special Issue Information

Dear Colleagues,

The tobacco epidemic remains a major public health problem. It is not only one of the singular leading causes of preventable death and disability, it is also a common risk factor for the main chronic non-communicable diseases (NCD). The burdens caused by NCDs go beyond their health consequences, and the 2011 Political Declaration of the High-Level meeting of the General Assembly on the Prevention and Control of NCD, stated that “they constitutes one of the major challenges for development in the twenty-first century, which undermines social and economic development throughout the world…” (Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable diseases RES/66/2).

Different from other risk factors, tobacco consumption and exposure to second hand smoke are totally preventable and the WHO Framework Convention in Tobacco Control (FCTC) shows which interventions to curtail the epidemic are proven. Even though the WHO FCTC has been in force since February 2005 and more than 170 countries are Parties to it (such that they are legally bound by its measures), only one third of the world population is covered by at least one of its measures at the highest level of achievement. If the WHO FCTC is not implemented rapidly, one billion people will still be killed by tobacco in this century.

Data provided by the Global Tobacco Surveillance System shows that figures among youth (13 to 15 years old) do not forecast any improvement in the situation; furthermore, girls’ smoking is growing and in some countries of the Region of the Americas, has already outpaced boys’ consumption.

This Special Issue is open to any subject area of public health, economics, and policy related to the tobacco epidemic. The listed keywords suggest just a few of the many possibilities.

Dr. Adriana Blanco Marquizo
Guest Editor

Manuscript Submission Information

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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 smoking
  • public health
  • smoking cessation, smoking initiation
  • tobacco control policies/interventions
  • tobacco control legislation impact (health, economic)
  • bans on cigarette advertising and promotions
  • tobacco taxation
  • secondhand smoke
  • clean-indoor air laws, public smoking bans, smoke-free environments
  • framework convention on tobacco control
  • tobacco industry interference
  • economic costs of tobacco use/exposure
  • tobacco and trade
  • tobacco surveillance

Published Papers (10 papers)

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Research

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691 KiB  
Article
Health Care Workers’ Knowledge, Attitudes and Practices on Tobacco Use in Economically Disadvantaged Dominican Republic Communities
by Michael G. Prucha, Susan G. Fisher, Scott McIntosh, John C. Grable, Heather Holderness, Kelly Thevenet-Morrison, Zahíra Quiñones De Monegro, José Javier Sánchez, Arisleyda Bautista, Sergio Díaz and Deborah J. Ossip
Int. J. Environ. Res. Public Health 2015, 12(4), 4060-4075; https://doi.org/10.3390/ijerph120404060 - 13 Apr 2015
Cited by 7 | Viewed by 6205
Abstract
Tobacco use is increasing globally, particularly in low and middle-income countries like the Dominican Republic (DR) where data have been lacking. Health care worker (HCW) interventions improve quit rates; asking patients about tobacco use at each visit is an evidence-based first step. This [...] Read more.
Tobacco use is increasing globally, particularly in low and middle-income countries like the Dominican Republic (DR) where data have been lacking. Health care worker (HCW) interventions improve quit rates; asking patients about tobacco use at each visit is an evidence-based first step. This study provides the first quantitative examination of knowledge, attitudes and practices of DR HCWs regarding tobacco use. All HCWs (N = 153) in 7 economically disadvantaged DR communities were targeted with anonymous surveys. Approximately 70% (N = 107) completed the primary outcome item, asking about tobacco use at each encounter. Despite >85% strongly agreeing that they should ask about tobacco use at each encounter, only 48.6% reported doing so. While most (94.39%) strongly agreed that smoking is harmful, knowledge of specific health consequences varied from 98.13% for lung cancer to 41.12% for otitis media. Few received training in tobacco intervention (38.32%). Exploratory analyses revealed that always asking even if patients are healthy, strongly agreeing that tobacco causes cardiac disease, and always advising smoke-free homes were associated with always asking. Overall, results demonstrate a disconnect between HCW belief and practice. Though most agreed that always asking about tobacco was important, fewer than half did so. Gaps in HCW knowledge and practices suggest a need for education and policy/infrastructure support. To our knowledge, this is the first reported survey of DR HCWs regarding tobacco, and provides a foundation for future tobacco control in the DR. Full article
(This article belongs to the Special Issue Tobacco Control)
753 KiB  
Article
Reducing Environmental Tobacco Smoke Exposure of Preschool Children: A Randomized Controlled Trial of Class-Based Health Education and Smoking Cessation Counseling for Caregivers
by Yun Wang, Zhiqiang Huang, Mei Yang, Fuzhi Wang and Shuiyuan Xiao
Int. J. Environ. Res. Public Health 2015, 12(1), 692-709; https://doi.org/10.3390/ijerph120100692 - 13 Jan 2015
Cited by 10 | Viewed by 6694
Abstract
Objectives: To assess counseling to caregivers and classroom health education interventions to reduce environmental tobacco smoke exposure of children aged 5–6 years in China. Methods: In a randomized controlled trial in two preschools in Changsha, China, 65 children aged 5–6 years [...] Read more.
Objectives: To assess counseling to caregivers and classroom health education interventions to reduce environmental tobacco smoke exposure of children aged 5–6 years in China. Methods: In a randomized controlled trial in two preschools in Changsha, China, 65 children aged 5–6 years old and their smoker caregivers (65) were randomly assigned to intervention (n = 33) and control (no intervention) groups (n = 32). In the intervention group, caregivers received self-help materials and smoking cessation counseling from a trained counselor, while their children were given classroom-based participatory health education. Children’s urinary cotinine level and the point prevalence of caregiver quitting were measured at baseline and after 6 months. Results: At the 6-month follow-up, children’s urinary cotinine was significantly lower (Z = –3.136; p = 0.002) and caregivers’ 7-day quit rate was significantly higher (34.4% versus 0%) (p < 0.001; adjusted OR = 1.13; 95% CI: 1.02–1.26) in the intervention than control group. Conclusions: Helping caregivers quitting smoke combined with classroom-based health education was effective in reducing children’s environmental tobacco smoke exposure. Larger-scale trials are warranted. Full article
(This article belongs to the Special Issue Tobacco Control)
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731 KiB  
Article
The Effect of Smoke-Free Air Law in Bars on Smoking Initiation and Relapse among Teenagers and Young Adults
by Ce Shang
Int. J. Environ. Res. Public Health 2015, 12(1), 504-520; https://doi.org/10.3390/ijerph120100504 - 09 Jan 2015
Cited by 25 | Viewed by 6684
Abstract
Background: Existing evidence has shown that most smoking uptake and escalation occurs while smokers are teenagers or young adults. Effective policies that reduce smoking uptake and escalation will play an important role in curbing cigarette smoking. This study aims to investigate the [...] Read more.
Background: Existing evidence has shown that most smoking uptake and escalation occurs while smokers are teenagers or young adults. Effective policies that reduce smoking uptake and escalation will play an important role in curbing cigarette smoking. This study aims to investigate the effect of smoke-free air (SFA) laws in bars on smoking initiation/relapse while controlling for other confounders. Methods: The national longitudinal Survey of Youth 1997 (NLSY97) from 1997–2009 was linked to state-level scores for the strength of SFA laws in order to carry out the analysis. Results and Conclusion: We find that SFA laws in bars with exemptions significantly reduce (p ≤ 0.01) the probability of smoking initiation (one-puff, daily, and heavy smoking initiation). The 100% SFA law in bars without exemption significantly deters smoking relapse from abstinence into daily smoking (p 0.05) or relapse from abstinence into heavy smoking (p ≤ 0.01) among people age 21 or older. The reduction of one-puff and daily smoking initiation is larger among ages 20 or younger than ages 21 or older, while the reduction in relapse does not differ by whether respondents reach the drinking age. Results also indicate that higher cigarette taxes significantly reduce daily smoking initiation and relapse into nondaily and light smoking. Full article
(This article belongs to the Special Issue Tobacco Control)
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665 KiB  
Article
Multi-Stakeholder Taskforces in Bangladesh — A Distinctive Approach to Build Sustainable Tobacco Control Implementation
by Angela M. Jackson-Morris, Ishrat Chowdhury, Valerie Warner and Kayleigh Bleymann
Int. J. Environ. Res. Public Health 2015, 12(1), 474-487; https://doi.org/10.3390/ijerph120100474 - 07 Jan 2015
Cited by 7 | Viewed by 6035
Abstract
The MPOWER policy package enables countries to implement effective, evidence-based strategies to address the threat posed to their population by tobacco. All countries have challenges to overcome when implementing tobacco control policy. Some are generic such as tobacco industry efforts to undermine and [...] Read more.
The MPOWER policy package enables countries to implement effective, evidence-based strategies to address the threat posed to their population by tobacco. All countries have challenges to overcome when implementing tobacco control policy. Some are generic such as tobacco industry efforts to undermine and circumvent legislation; others are specific to national or local context. Various factors influence how successfully challenges are addressed, including the legal-political framework for enforcement, public and administrative attitudes towards the law, and whether policy implementation measures are undertaken. This paper examines District Tobacco Control Taskforces, a flexible policy mechanism developed in Bangladesh to support the implementation of the Smoking and Tobacco Products Usage (Control) Act 2005 and its 2013 Amendment. At the time of this study published research and/or data was not available and understanding about these structures, their role, contribution, limitations and potential, was limited. We consider Taskforce characteristics and suggest that the “package” comprises a distinctive tobacco control implementation model. Qualitative data is presented from interviews with key informants in ten districts with activated taskforces (n = 70) to provide insight from the perspectives of taskforce members and non-members. In all ten districts taskforces were seen as a crucial tool for tobacco control implementation. Where taskforces were perceived to be functioning well, current positive impacts were perceived, including reduced smoking in public places and tobacco advertising, and increased public awareness and political profile. In districts with less well established taskforces, interviewees believed in their taskforce’s ‘potential’ to deliver similar benefits once their functioning was improved. Recommendations to improve functioning and enhance impact were made. The distinctive taskforce concept and lessons from their development may provide other countries with a flexible local implementation model for tobacco control. Full article
(This article belongs to the Special Issue Tobacco Control)
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2902 KiB  
Article
Brand Cigarillos — A Cheap and Less Harmful Alternative to Cigarettes? Particulate Matter Emissions Suggest Otherwise
by Alexander Gerber, Alexander Bigelow, Michaela Schulze and David A. Groneberg
Int. J. Environ. Res. Public Health 2015, 12(1), 428-438; https://doi.org/10.3390/ijerph120100428 - 06 Jan 2015
Cited by 12 | Viewed by 6650
Abstract
Background: Environmental tobacco smoke (ETS)-associated particulate matter (PM) constitutes a considerable health risk for passive smokers. It ought to be assessed separately from the other known toxic compounds of tobacco smoke. Brand-specific differences between cigarettes and particularly between cigarettes and favorably taxed [...] Read more.
Background: Environmental tobacco smoke (ETS)-associated particulate matter (PM) constitutes a considerable health risk for passive smokers. It ought to be assessed separately from the other known toxic compounds of tobacco smoke. Brand-specific differences between cigarettes and particularly between cigarettes and favorably taxed cigarillos, are of public interest and therefore worth being investigated. Methods: An automatic environmental tobacco smoke emitter (AETSE) was developed to generate cigarette and cigarillo smoke in a reliable and reproducible way. John Player Special (JPS) Red cigarettes, JPS filter cigarillos and 3R4F standard research cigarettes were smoked automatically in a 2.88 m3 glass chamber according to a standardized protocol until 5 cm from the top were burned down. Results: Mean concentrations (Cmean) and area of the curve (AUC) of PM2.5 were measured and compared. Cmean PM2.5 were found to be 804 µg/m3 for 3R4F reference cigarettes, 1633 µg/m3 for JPS cigarettes, and 1059 µg/m3 for JPS filter cigarillos. AUC PM2.5-values are 433,873 µg/m3×s for 3R4F reference cigarettes, 534,267 µg/m3×s for JPS Red cigarettes and 782,850 µg/m3×s for JPS filter cigarillos. Conclusion: Potential brand-specific differences of ETS-associated PM emissions among brands of cigarettes, and between cigarettes and cigarillos of the same brand and size should be investigated and published. Information about relative PM-emissions should be printed on the package. Full article
(This article belongs to the Special Issue Tobacco Control)
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688 KiB  
Article
Secondhand Smoke Exposure, Indoor Smoking Bans and Smoking-Related Knowledge in China
by Yue Jin, Ling Wang, Bo Lu and Amy K. Ferketich
Int. J. Environ. Res. Public Health 2014, 11(12), 12835-12847; https://doi.org/10.3390/ijerph111212835 - 11 Dec 2014
Cited by 16 | Viewed by 5848
Abstract
Although previous studies have provided strong evidence that Chinese individuals are exposed to secondhand smoke (SHS) and lack knowledge of its harmful effects, there has not been an in-depth exploration of the variability in exposure and knowledge by geographic region, occupation, and socioeconomic [...] Read more.
Although previous studies have provided strong evidence that Chinese individuals are exposed to secondhand smoke (SHS) and lack knowledge of its harmful effects, there has not been an in-depth exploration of the variability in exposure and knowledge by geographic region, occupation, and socioeconomic status. The objectives of this study were to examine: (1) the demographic factors associated with the level of knowledge of the harmful effects of smoking; (2) the factors related to implementation of in-home and workplace smoking bans; and (3) geographic differences in being exposed to SHS in government buildings, healthcare facilities, restaurants, public transportations, and schools. We used data from the 2010 Global Adult Tobacco Survey-China. Chi-square tests were used for statistical analysis. The results suggested that among Chinese citizens age 15 years and older, there is poor knowledge of the harmful effects of tobacco, and knowledge varies with region and socioeconomic status. Over three-quarters of the households had no smoking restrictions, and a large percentage of workers reported working in places with no smoking ban. In public places, exposure to SHS was high, particularly in rural areas and in the Southwest. These results suggest Chinese individuals are not well informed of smoking and SHS associated risks and are regularly exposed to SHS at home, work and public places. Full article
(This article belongs to the Special Issue Tobacco Control)
706 KiB  
Article
Smoke-Free Homes and Home Exposure to Secondhand Smoke in Shanghai, China
by Pinpin Zheng, Carla J. Berg, Michelle C. Kegler, Wenjie Fu, Jing Wang, Xilan Zhou, Dong Liu and Hua Fu
Int. J. Environ. Res. Public Health 2014, 11(11), 12015-12028; https://doi.org/10.3390/ijerph111112015 - 20 Nov 2014
Cited by 21 | Viewed by 6695
Abstract
Few studies have examined home exposure to secondhand smoke (SHS) in China. This study aimed to document: (1) the prevalence and correlates of exposure to SHS in homes (in adult non-smokers) in Shanghai, and (2) enforcement of rules, harm reduction behaviors, and self-efficacy [...] Read more.
Few studies have examined home exposure to secondhand smoke (SHS) in China. This study aimed to document: (1) the prevalence and correlates of exposure to SHS in homes (in adult non-smokers) in Shanghai, and (2) enforcement of rules, harm reduction behaviors, and self-efficacy for maintaining smoke-free homes in Shanghai. A total of 500 participants were recruited using a multistage proportional random sampling design in an urban and suburban district to complete a survey. Among the total 355 nonsmokers, 127 (35.8%) participants reported being exposed to SHS in the past 7 days. Participants living with smokers in the home, with no smoking restriction at home, and having children younger than 18 were more likely to be exposed to SHS at home. Higher self-efficacy in maintaining a smoke-free home was negatively associated with home SHS exposure. Having visitors who smoke was the greatest policy enforcement challenge. Ineffective measures such as opening windows were more commonly used in homes with partial bans. Educational initiatives to protect against SHS exposure in the home should promote smoke-free homes, address challenges to implementing such policies, and address misconceptions regarding the effectiveness of supposed harm reduction behaviors. Full article
(This article belongs to the Special Issue Tobacco Control)
343 KiB  
Article
The Role of Cities in Reducing Smoking in China
by Pamela Redmon, Jeffrey Koplan, Michael Eriksen, Shuyang Li and Wang Kean
Int. J. Environ. Res. Public Health 2014, 11(10), 10062-10075; https://doi.org/10.3390/ijerph111010062 - 26 Sep 2014
Cited by 14 | Viewed by 8591
Abstract
China is the epicenter of the global tobacco epidemic. China grows more tobacco, produces more cigarettes, makes more profits from tobacco and has more smokers than any other nation in the world. Approximately one million smokers in China die annually from diseases caused [...] Read more.
China is the epicenter of the global tobacco epidemic. China grows more tobacco, produces more cigarettes, makes more profits from tobacco and has more smokers than any other nation in the world. Approximately one million smokers in China die annually from diseases caused by smoking, and this estimate is expected to reach over two million by 2020. China cities have a unique opportunity and role to play in leading the tobacco control charge from the “bottom up”. The Emory Global Health Institute—China Tobacco Control Partnership supported 17 cities to establish tobacco control programs aimed at changing social norms for tobacco use. Program assessments showed the Tobacco Free Cities grantees’ progress in establishing tobacco control policies and raising public awareness through policies, programs and education activities have varied from modest to substantial. Lessons learned included the need for training and tailored technical support to build staff capacity and the importance of government and organizational support for tobacco control. Tobacco control, particularly in China, is complex, but the potential for significant public health impact is unparalleled. Cities have a critical role to play in changing social norms of tobacco use, and may be the driving force for social norm change related to tobacco use in China. Full article
(This article belongs to the Special Issue Tobacco Control)
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154 KiB  
Article
Comparison of Barriers to Cessation among Arab American Smokers of Cigarettes and Waterpipe
by Linda Haddad, Omar El-Shahawy and Roula Ghadban
Int. J. Environ. Res. Public Health 2014, 11(9), 9522-9531; https://doi.org/10.3390/ijerph110909522 - 15 Sep 2014
Cited by 10 | Viewed by 5028
Abstract
This cross-sectional study examined the differences in barriers to cessation and reasons for quitting smoking among dual smokers of cigarettes and waterpipe tobacco, exclusive cigarette smokers and exclusive waterpipe smokers. Participants were Arab American adults residing in Richmond, Virginia, who were recruited from [...] Read more.
This cross-sectional study examined the differences in barriers to cessation and reasons for quitting smoking among dual smokers of cigarettes and waterpipe tobacco, exclusive cigarette smokers and exclusive waterpipe smokers. Participants were Arab American adults residing in Richmond, Virginia, who were recruited from Middle Eastern grocery stores, restaurants/lounges and faith and charity organizations. The study yielded several key findings: (1) Exclusive cigarette and waterpipe smokers had similar mean barriers to quitting and were more concerned about their health than dual smokers. (F(2, 150) = 5.594, p = 0.0045). This implies that barriers to smoking and health concerns could be a function of the individual who smokes rather than the modality of smoking itself. (2) Exclusive cigarette or waterpipe smokers and dual smokers may have different reasons for quitting, since they have different reasons for smoking. The proportion of smokers who endorsed smoking as a messy habit as the reason among exclusive cigarette smokers was 0.37, whereas the proportion among exclusive waterpipe smokers was 0.04 and among dual smokers 0.39. The difference in proportions is significant, χ2 (df = 2, N = 154) = 13.17, p = 0.0014. In summary, this study supports the need to further investigate dual cigarette and waterpipe smokers, as the study results indicate greater barriers to smoking cessation in this group. Recognition and understanding of these barriers among dual tobacco users would be important for any future tobacco intervention among waterpipe smokers. Full article
(This article belongs to the Special Issue Tobacco Control)

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670 KiB  
Commentary
The Meanings of Smoking to Women and Their Implications for Cessation
by Lorraine Greaves
Int. J. Environ. Res. Public Health 2015, 12(2), 1449-1465; https://doi.org/10.3390/ijerph120201449 - 27 Jan 2015
Cited by 49 | Viewed by 8635
Abstract
Smoking cigarettes is a gendered activity with sex- and gender-specific uptake trends and cessation patterns. While global male smoking rates have peaked, female rates are set to escalate in the 21st century, especially in low and middle income countries. Hence, smoking cessation for [...] Read more.
Smoking cigarettes is a gendered activity with sex- and gender-specific uptake trends and cessation patterns. While global male smoking rates have peaked, female rates are set to escalate in the 21st century, especially in low and middle income countries. Hence, smoking cessation for women will be an ongoing issue and requires refreshed attention. Public health and health promotion messages are being challenged to be increasingly tailored, taking gender into account. Women-centred approaches that include harm-reduction, motivational interviewing and trauma-informed elements are the new frontiers in interventions to encourage smoking cessation for women. Such approaches are linked to the meanings of smoking to women, the adaptive function of, and the overall role of smoking cigarettes in the context of women’s lives. These approaches respect gender and sex-related factors that affect smoking and smoking cessation and respond to these issues, not by reinforcing destructive or negative gender norms, but with insight. This article discusses a women-centred approach to smoking cessation that could underpin initiatives in clinical, community or public health settings and could inform campaigns and messaging. Full article
(This article belongs to the Special Issue Tobacco Control)
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