Tobacco control policies are egalitarian: A vulnerabilities perspective on clean indoor air laws, cigarette prices, and tobacco use disparities

IntroductionChina consumes 44% of the world’s cigarettes. Robust tobacco control measures are needed to contain the trend of increasing cigarette consumption. This paper examines the effectiveness of policy interventions introduced in China on reducing the country’s tobacco use.MethodsThe paper uses data on China’s monthly cigarette consumption per capita from January 2000 to June 2017 to estimate the impact of specific policies on China’s tobacco consumption. Tobacco consumption is calculated from monthly sales data from the China National Tobacco Corporation and demographic data from the China National Bureau of Statistics. The policies studied include the WHO Framework Convention on Tobacco Control (FCTC), national tobacco-related policy changes and two tobacco tax increases implemented in China during the study period. Segmented regression analysis is used to estimate the immediate effects of the policies studied and changes in the time trends resulted from these policy changes.FindingsThe impact of national policy changes in China is almost 20 times greater than the impact of the WHO FCTC treaty itself, and national policy changes in tobacco control are a determining factor in reversing the trend of increasing tobacco consumption in China. The 2015 tax increase, which raised retail cigarette prices, produced both immediate and trend effects, with a total incremental effect 7.8 times that of the 2009 tax increase, which did not result in higher cigarette prices for the consumer.InterpretationsTranslating global tobacco control policies into domestic policies will generate a much greater impact on reducing average cigarette consumption, and tobacco taxes that are reflected in the retail prices of cigarettes will be more effective in reducing cigarette consumption.

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Impact of nations meeting the MPOWER targets between 2014 and 2016: an update

Tobacco Control ◽

10.1136/tobaccocontrol-2018-054837 ◽

2019 ◽

pp. tobaccocontrol-2018-054837 ◽

Cited By ~ 4

Author(s):

David T Levy ◽

Yameng Li ◽

Zhe Yuan

Keyword(s):

Tobacco Control ◽

Tobacco Use ◽

Health Impact ◽

Health Warnings ◽

Control Policies ◽

The Public ◽

Policy Effect ◽

Tobacco Taxes ◽

Tobacco Control Policies ◽

Free Air

ObjectiveSince the WHO released the Monitoring tobacco use and tobacco control policies; Protecting from the dangers of tobacco smoke; Offering help to quit tobacco; Warning the public about the dangers; Enforcing bans on advertising, promotion and sponsorship; and Raising tobacco taxes (MPOWER) policy package to assist nations with implementing the Framework Convention on Tobacco Control (FCTC), 88 countries have adopted at least one MPOWER policy at the highest level as of 2014. Building on previous evaluations, we estimated the reduction in smoking-attributable deaths (SADs) from all policies newly adopted at the highest level between 2014 and 2016.MethodsFor each nation that implemented highest level policies, the difference in policy effect sizes from previously validated SimSmoke models for the policies in effect in 2014 and 2016 were multiplied by the number of smokers in that nation to derive the reduction in the number of smokers. Based on research that half of all smokers die from smoking, we derived SADs averted.FindingsIn total, 43 nations adopted at least one highest-level MPOWER policy between 2014 and 2016, resulting in 14.6 million fewer SADs. The largest number of SADs averted were due to stronger health warnings (13.3 million), followed by raising taxes (0.6 million), increased marketing bans (0.4 million), smoke-free air laws (0.3 million) and cessation interventions (2500).ConclusionThese findings demonstrate the continuing public health impact of tobacco control policies adopted globally since the FCTC, and highlight the importance of more countries adopting MPOWER policies at the highest level to reduce the global burden of tobacco use.

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Women and tobacco control policies: Social-structural and psychosocial contributions to vulnerability to tobacco use and exposure

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2009.05.001 ◽

2009 ◽

Vol 104 ◽

pp. S121-S130 ◽

Cited By ~ 37

Author(s):

Lorraine Greaves ◽

Natalie Hemsing

Keyword(s):

Tobacco Control ◽

Tobacco Use ◽

Control Policies ◽

Tobacco Control Policies ◽

Social Structural

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Flavoured tobacco product restrictions in Massachusetts associated with reductions in adolescent cigarette and e-cigarette use

Tobacco Control ◽

10.1136/tobaccocontrol-2020-056159 ◽

2021 ◽

pp. tobaccocontrol-2020-056159

Author(s):

Summer Sherburne Hawkins ◽

Claudia Kruzik ◽

Michael O'Brien ◽

Rebekah Levine Coley

Keyword(s):

Tobacco Control ◽

Tobacco Use ◽

Tobacco Product ◽

County Level ◽

Cigarette Use ◽

Youth Health ◽

Control Policies ◽

Tobacco Control Policies ◽

The Usa ◽

Adolescent Tobacco Use

BackgroundIn the USA, many states do not pre-empt municipalities from enacting stricter tobacco-control policies than state or federal laws. Several municipalities in Massachusetts have passed progressive local laws aimed at reducing adolescent tobacco use. We exploited this variability to examine the associations between county-level flavoured tobacco product restrictions, tobacco 21 policies and smoke-free laws prohibiting e-cigarettes with adolescent cigarette and e-cigarette use in Massachusetts, and to assess whether policy effects varied by age.MethodsWe conducted difference-in-differences models to link changes in county-level tobacco-control policies to changes in adolescents’ use of cigarettes and e-cigarettes using 2011–2017 biennial Massachusetts Youth Health Surveys.ResultsCounties with greater implementation of flavoured tobacco product restrictions were associated with a decrease in the level of cigarette use among users (incidence rate ratio −1.56; 95% CI −2.54 to −0.58). A significant interaction (p=0.03) revealed the largest reductions among 14 and 18 year olds. Increasing flavoured tobacco product restrictions were also associated with reductions in the likelihood of e-cigarette use (OR −0.87; 95% CI −1.68 to −0.06). Increasing tobacco 21 restrictions were associated with decreases in cigarette use only among 18 year olds, while there was no evidence of associations between smoke-free laws with use of either tobacco product.ConclusionsAdolescents in Massachusetts decreased their use of cigarettes and e-cigarettes in response to local restrictions that limited the sale of flavoured tobacco products to adult-only retail tobacco stores. Local legislation can reduce adolescent tobacco use and municipalities should enact stricter tobacco-control policies when not pre-empted by state law.

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The Effect of Tobacco Control Policies on US Smokeless Tobacco Use: A Structured Review

Nicotine & Tobacco Research ◽

10.1093/ntr/ntw291 ◽

2016 ◽

Vol 20 (1) ◽

pp. 3-11 ◽

Cited By ~ 13

Author(s):

David T Levy ◽

Darren Mays ◽

Raymond G Boyle ◽

Jamie Tam ◽

Frank J Chaloupka

Keyword(s):

Tobacco Control ◽

Tobacco Use ◽

Smokeless Tobacco ◽

Control Policies ◽

Tobacco Control Policies ◽

Smokeless Tobacco Use

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Older African American Homeless-Experienced Smokers’ Attitudes Toward Tobacco Control Policies—Results from the HOPE HOME Study

American Journal of Health Promotion ◽

10.1177/0890117117729928 ◽

2017 ◽

Vol 32 (2) ◽

pp. 381-391 ◽

Cited By ~ 6

Author(s):

Maya Vijayaraghavan ◽

Pamela Olsen ◽

John Weeks ◽

Karma McKelvey ◽

Claudia Ponath ◽

...

Keyword(s):

Smoking Cessation ◽

African American ◽

Tobacco Control ◽

Tobacco Use ◽

Strong Support ◽

Theory Approach ◽

Control Policies ◽

Tobacco Control Policies ◽

Harmful Effects ◽

Current Tobacco

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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