A Qualitative Evaluation of Tobacco Consumption in the Rural Context

2020 ◽  
Vol 6 (4) ◽  
pp. 224-234
Author(s):  
Ashley Sanders-Jackson ◽  
Robyn B. Adams ◽  
Raymond Jussaume
Keyword(s):  
Social Context ◽  
Rural Communities ◽  
Tobacco Control ◽  
Tobacco Use ◽  
Qualitative Evaluation ◽  
Tobacco Consumption ◽  
Third Party ◽  
Individual Choice ◽  
Tobacco Marketing ◽  
Control Research

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.

scholarly journals A Scoping Review of Foci, Trends, and Gaps in Reviews of Tobacco Control Research

2019 ◽  
Vol 22 (5) ◽  
pp. 599-612 ◽  
Author(s):  
Gayle Halas ◽  
Annette S H Schultz ◽  
Janet Rothney ◽  
Pamela Wener ◽  
Maxine Holmqvist ◽  
...  
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Scoping Review ◽  
Tobacco Industry ◽  
World Health ◽  
Cochrane Library ◽  
Individual Choice ◽  
Product Regulation ◽  
Control Research ◽  
Review Of Reviews

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.

scholarly journals An Intertemporal Analysis of Post-FCTC Era Household Tobacco Consumption in Pakistan

2019 ◽  
Vol 16 (14) ◽  
pp. 2532
Author(s):  
Biplab Kumar Datta ◽  
Muhammad Jami Husain ◽  
Nigar Nargis
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
National Level ◽  
Tobacco Consumption ◽  
Smoking Rate ◽  
Middle Income ◽  
Household Level ◽  
The Poor ◽  
Smokeless Tobacco Use

Since the ratification of the WHO Framework Convention on Tobacco Control (FCTC) in 2004, Pakistan has taken various measures of tobacco control. This study examines how these tobacco control measures are associated with change in household-level tobacco consumption patterns in Pakistan over the decade (2005 to 2016) after FCTC ratification. We used multiple waves of the household survey data of Pakistan from 2004–2005 to 2015–2016 for analyzing household-level tobacco use. We find that tobacco consumption remains at a significantly high level (45.5%) in Pakistan despite the recent declining trend in the post-FCTC era. During the preparatory phase of FCTC implementation between 2005 and 2008, the smoking rate was on the rise, and smokeless tobacco use was declining. Over the implementation phase of FCTC policies between 2008 and 2016, the pattern of change in tobacco use reversed—the smoking rate started to decrease while smokeless tobacco use started to rise. However, the decrease in the smoking rate was slower and the increase in smokeless tobacco use at the national level was driven by an increase among the poor and middle-income households. These trends resulted in the growing burden of tobacco expenditure among the poor and middle-income households relative to the wealthier households.

scholarly journals The Global Laboratory of Tobacco Control: Research to Advance Tobacco Cessation in LMICs

2016 ◽  
Vol 11 (2) ◽  
pp. 70-77 ◽  
Author(s):  
Mark Parascandola ◽  
Michele Bloch
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
Large Body ◽  
High Income ◽  
Health Priorities ◽  
Tobacco Products ◽  
The Us ◽  
Control Research ◽  
The U.S

For over half a century, the U.S. National Cancer Institute (NCI) has supported research on tobacco and health, which has contributed to reductions in tobacco-caused morbidity and mortality in the U.S. But while tobacco use has been slowly declining in most high-income nations, including the US, it has continued to increase in other parts of the globe. Of the 800 million adult men who currently smoke cigarettes, over 80% are in low- and middle-income countries (LMICs), and these countries will bear an increasing share of the health and economic burden of tobacco use. At the same time, there are additional challenges to implementing tobacco control programs in LMICs, including a diversity of tobacco products, limited capacity and resources for tobacco control, and competing health priorities. While a large body of evidence has been generated around tobacco dependence treatment and other measures in high-income countries, this work is only partly applicable to many LMICs. In this paper we focus on research needs and opportunities around tobacco cessation interventions for LMICs, highlighting four areas: understanding diverse tobacco products, development of low-cost cessation interventions, integrating tobacco cessation into health systems, and understanding tobacco use behaviors across different contexts. Expanding tobacco control research and research capacity in LMICs is crucial to reducing tobacco use and cancer rates worldwide. Furthermore, research conducted in countries around the world can yield important insights for understanding tobacco use behaviors and the effectiveness of tobacco control interventions in the US.

scholarly journals We are in This Together: Promoting Health Equity, Diversity, and Inclusion in Tobacco Research for Sexual and Gender Minority Populations

2020 ◽  
Vol 22 (12) ◽  
pp. 2276-2279 ◽  
Author(s):  
Sarah S Dermody ◽  
Jaimee L Heffner ◽  
Josephine T Hinds ◽  
Julia McQuoid ◽  
Amanda J Quisenberry ◽  
...  
Keyword(s):  
Health Disparities ◽  
Tobacco Control ◽  
Health Equity ◽  
Tobacco Use ◽  
Scientific Community ◽  
Gender Minority ◽  
Diversity And Inclusion ◽  
Control Research ◽  
Sexual And Gender Minority ◽  
And Gender

Abstract Introduction Sexual and gender minority (SGM) individuals have higher tobacco use prevalence and consequently higher burden of tobacco-caused diseases, including cancer and cardiovascular disease compared with their heterosexual or cisgender counterparts. Yet, there is a critical gap in research focused on measuring SGM tobacco-related health disparities and addressing unmet needs of SGM individuals in the context of nicotine and tobacco research. Aims and Methods In this commentary, we summarize recommendations discussed during a pre-conference workshop focused on challenges and opportunities in conducting SGM tobacco control research at the 2019 Society for Research on Nicotine and Tobacco Annual Meeting. Results Specifically, we recommend defining and measuring SGM identity in all nicotine and tobacco research routinely, using novel methods to engage a demographically diverse sample of the SGM population, and eliciting SGM community voices in tobacco control research. Conclusions Addressing these critical research gaps will enable the scientific community to generate the data to fully understand and support SGM individuals in tobacco use prevention and cessation. Implications Tobacco use and its consequences have become increasingly concentrated in disadvantaged groups, including sexual and gender minority (SGM) populations. Through concrete recommendations in this commentary, we aimed to promote health equity, diversity, and inclusion in tobacco research for SGM populations by urging the scientific community to consider expanding efforts to monitor and address tobacco-related health disparities of SGM populations within their respective research programs.

The heterogeneous impact of a successful tobacco control campaign: a case study of Mauritius

2017 ◽  
Vol 27 (1) ◽  
pp. 83-89 ◽  
Author(s):  
Hana Ross ◽  
Leelmanee Moussa ◽  
Tom Harris ◽  
Rajive Ajodhea
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Low Income ◽  
Tobacco Consumption ◽  
Control Measures ◽  
Control Policies ◽  
Tobacco Control Policies ◽  
Tobacco Tax ◽  
The Impact ◽  
Low Income Households

BackgroundMauritius has one of the highest smoking prevalences in Africa, contributing to its high burden of non-communicable diseases. Mauritius implemented a series of tobacco control measures from 2009 to 2012, including tobacco tax increases. There is evidence that these policies reduced tobacco consumption, but it is not clear what impact they had across different socioeconomic groups.MethodThe impact of tobacco control measures on different income groups was analysed by contrasting household tobacco expenditures reported in 2006–2007 and 2012 household expenditure surveys. We employed the seemingly unrelated regression model to assess the impact of tobacco use on other household expenditures and calculated Gini coefficients to assess tobacco expenditure inequality.ResultsFrom 2006 to 2012, excise taxes and retail cigarette prices increased by 40.6% and 15.3% in real terms, respectively. These increases were accompanied by numerous non-price tobacco control measures. The share of tobacco-consuming households declined from 35.7% to 29.3%, with the largest relative drop among low-income households. The Gini coefficient of household tobacco expenditures increased by 10.4% due to decreased spending by low-income households. Low-income households demonstrated the largest fall in their tobacco budget shares, and the impact of tobacco consumption on poverty decreased by 26.2%. Households that continued purchasing tobacco reduced their expenditures on transportation, communication, health, and education.ConclusionsThese results suggest that tobacco control policies, including sizeable tax increases, were progressive in their impact. We conclude that tobacco use increases poverty and inequality, but stronger tobacco control policies can mitigate the impact of tobacco use on impoverishment.

scholarly journals Social capital and peer influence of tobacco consumption: a cross-sectional study among household heads in rural Uttar Pradesh, India

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e037202
Author(s):  
Md Zabir Hasan ◽  
Joanna E Cohen ◽  
David Bishai ◽  
Caitlin E Kennedy ◽  
Krishna D Rao ◽  
...  
Keyword(s):  
Social Capital ◽  
Tobacco Control ◽  
Tobacco Use ◽  
Peer Influence ◽  
Social Engagement ◽  
Uttar Pradesh ◽  
Tobacco Consumption ◽  
Gender Mainstreaming ◽  
Cross Sectional ◽  
Household Heads

ObjectiveHaving the world’s second-largest tobacco-consuming population, tobacco control is a priority agenda of the Indian Government. Yet, there is no evidence of how peer influence and nature of social relationships—defined as social capital—affect tobacco use. This study aimed to explore the role of social capital and peer influence on tobacco consumption among household heads in rural Uttar Pradesh (UP), India.Design and settingThis study was embedded within the baseline evaluation of Project Samuday. A cross-sectional multistage cluster survey was implemented in six census blocks of Hardoi and Sitapur districts of UP from June to August 2017. Self-reported tobacco consumption status of randomly selected 6218 household heads (≥18 years; men vs women=5312 vs 906) was assessed from 346 rural communities. Peer influence of tobacco use was measured by the non-self cluster proportion of tobacco consumption among respondents. Community engagement, social support, trust and social cohesion were separately measured as unique facets of social capital both at individual and community levels using the Shortened Adapted Social Capital Assessment Tool in India (SASCAT-I). The explanatory power of covariates was assessed using gender-stratified generalised estimating equations (GEE) with robust-variance estimator.ResultTobacco consumption patterns were starkly different for men and women (71% vs 14%). The peer influence only affected men (adjusted odds ratio (AOR)=1.10, 95% CI: 1.05 to 1.16, p<0.01), whereas women were more likely to consume tobacco if they were more engaged with community organisations (AOR=1.33, 95% CI=1.07 to 1.66, p<0.01).ConclusionGender alters the way social engagement affects tobacco use in rural India. Countering peer influence on Indian men should be prioritised as a tobacco control strategy. Moreover, as gender mainstreaming is a critical egalitarian agenda in India, further research is needed to understand how social engagement affects tobacco consumption behaviours among women.

scholarly journals Analysis of the illicit tobacco market in Georgia in response to fiscal and non-fiscal tobacco control measures

2021 ◽  
pp. tobaccocontrol-2020-056404
Author(s):  
Megan Little ◽  
Hana Ross ◽  
George Bakhturidze ◽  
Iago Kachkachishvili
Keyword(s):  
Tobacco Control ◽  
Household Survey ◽  
Tobacco Consumption ◽  
Control Measures ◽  
Cigarette Consumption ◽  
Control Law ◽  
Excise Tax ◽  
Cigarette Taxes ◽  
Illicit Trade ◽  
Cigarette Pack

BackgroundGeorgian illicit cigarette consumption was 1.5% in 2017. In 2018, a new tobacco control law took effect followed by a substantial cigarette excise tax increase in 2019. Research shows these policies reduce tobacco consumption, but the tobacco industry argues they increase illicit trade. There is limited evidence on this, particularly from developing countries.MethodsA panel household survey in Georgia obtained data over three waves: 2017 baseline, 2018 after the tobacco control law took effect and 2019 after taxes increased. A sample of 1578 smokers (and quitters in later waves) from five regions reported their tobacco use and were asked to present a cigarette pack in their possession. These were examined for tax stamps and health warnings to establish legality.FindingsThere was no evidence of an increase in illicit cigarette consumption in Tbilisi, Kutaisi, Akhaltsikhe or Gori in any wave. In Zugdidi, near the Russian-occupied Abkhazia, illicit cigarette consumption was increasing even prior to the tax increase, reaching 30.9% by wave 3. A country-wide shift occurred from manufactured cigarettes to roll-your-own tobacco (whose tax remained unchanged) between waves 2 and 3.ConclusionNo evidence of a country-wide increase in illicit cigarette trade was found after non-fiscal tobacco measures took effect and cigarette taxes increased. Relatively high illicit cigarette consumption in Zugdidi highlights the role of disputed territories and border administration in illicit cigarette supply. Substitution towards roll-your-own tobacco after manufactured cigarette taxes increased demonstrates the importance of equalising taxes on tobacco products to maximise public health benefits.

scholarly journals Alcohol and Tobacco Use in a Tuberculosis Treatment Cohort during South Africa’s COVID-19 Sales Bans: A Case Series

2021 ◽  
Vol 18 (10) ◽  
pp. 5449
Author(s):  
Bronwyn Myers ◽  
Tara Carney ◽  
Jennifer Rooney ◽  
Samantha Malatesta ◽  
Laura F. White ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Tobacco Use ◽  
Heavy Drinking ◽  
Case Series ◽  
Tobacco Consumption ◽  
Tuberculosis Treatment ◽  
Behavior Change Interventions ◽  
Patterns Of Drinking ◽  
Tobacco Ban ◽  
Drinking Occasion

Background: South Africa temporarily banned alcohol and tobacco sales for about 20 weeks during the COVID-19 lockdown. We described changes in alcohol and tobacco consumption after implementation of these restrictions among a small number of participants in a tuberculosis treatment cohort. Method: The timeline follow-back procedure and Fägerstrom test for nicotine dependence was used to collect monthly alcohol and tobacco use information. We report changes in heavy drinking days (HDD), average amount of absolute alcohol (AA) consumed per drinking day, and cigarettes smoked daily during the alcohol and tobacco ban compared to use prior to the ban. Results: Of the 61 participants for whom we have pre-ban and within-ban alcohol use information, 17 (27.9%) reported within-ban alcohol use. On average, participants reported one less HDD per fortnight (interquartile range (IQR): −4, 1), but their amount of AA consumed increased by 37.4 g per drinking occasion (IQR: −65.9 g, 71.0 g). Of 53 participants who reported pre-ban tobacco use, 17 (32.1%) stopped smoking during the ban. The number of participants smoking >10 cigarettes per day decreased from 8 to 1. Conclusions: From these observations, we hypothesize that policies restricting alcohol and tobacco availability seem to enable some individuals to reduce their consumption. However, these appear to have little effect on the volume of AA consumed among individuals with more harmful patterns of drinking in the absence of additional behavior change interventions.

scholarly journals Building Capacity for International Tobacco Control Research: The Global Tobacco Research Network

2005 ◽  
Vol 95 (6) ◽  
pp. 965-968 ◽  
Author(s):  
Frances A. Stillman ◽  
Heather L. Wipfli ◽  
Harry A. Lando ◽  
Scott Leischow ◽  
Jonathan M. Samet
Keyword(s):  
Tobacco Control ◽  
Research Network ◽  
Building Capacity ◽  
Control Research
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