scholarly journals The Recalled Age of Initiation of Multiple Tobacco Products among 26–34 Year Olds: Findings from the Population Assessment of Tobacco and Health (PATH) Study Wave 1 (2013–2014)

2020 ◽  
Vol 17 (23) ◽  
pp. 9000
Author(s):  
Adriana Pérez ◽  
Elena Penedo ◽  
Meagan A. Bluestein ◽  
Baojiang Chen ◽  
Cheryl L. Perry ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Smokeless Tobacco ◽  
Smoking Status ◽  
Tobacco Product ◽  
Tobacco Products ◽  
Replication Method ◽  
Cox Proportional Hazard Models ◽  
Secondary Analyses ◽  
Race Ethnicity ◽  
The Impact

This study examined the recalled age of initiation of seven different tobacco products (TPs) and explored potential influences of sex, race/ethnicity, and cigarette-smoking status on tobacco use initiation among adults 26–34 years old using the PATH study. Methods: Secondary analyses were conducted in the adult restricted PATH wave 1 (2013–2014) dataset. Weighted statistics are reported using the balanced repeated replication method and Fay’s correction to account for PATH’s complex study design. Distributions and histograms of the recalled age of initiation of seven different TPs (cigarettes, cigarillos, traditional cigars, filtered cigars, hookah, smokeless tobacco, and e-cigarettes) are reported, as well as the impact of sex and race/ethnicity using Cox proportional hazard models. The impact of cigarette-smoking status on the recalled age of initiation of each tobacco product other than cigarettes was explored. Results: The highest modes of the recalled age of initiation of cigarette use were at 14–15 and 15–16 years old. The distributions of the recalled age of initiation of cigarillos, traditional cigars, filtered cigars, hookah, and smokeless tobacco occurred later, with the highest modes at 15–16 and 17–18 years old. The distribution of the recalled age of initiation of e-cigarettes had a different shape than the other TPs, with the highest mode reported at 27–28 years old. Conclusion: Due to the ever-changing tobacco marketplace, understanding when contemporary adults aged 26–34 years recall initiating TP use is important and will inform prevention researchers.

Patterns of non-cigarette tobacco and nicotine use among current cigarette smokers and recent quitters: Findings from the 2020 ITC Four Country Smoking and Vaping Survey

2021 ◽  
Author(s):  
Lin Li ◽  
Ron Borland ◽  
K Michael Cummings ◽  
Shannon Gravely ◽  
Anne C K Quah ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Cigarette Smoking ◽  
Smoking Status ◽  
Tobacco Product ◽  
Cigarette Tobacco ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Patterns Of Use ◽  
Levels Of Use ◽  
Current Cigarette

Abstract Introduction This study explores patterns of use of non-cigarette tobacco and nicotine products among adult cigarette smokers and recent ex-smokers. Along with cigarette smoking status we explore differences as a function of countries with different product regulations, gender and age. Methods Data came from the ITC Four Country Smoking and Vaping Wave 3 Survey conducted between February-June 2020. The analytic sample consisted of 9112 current cigarette smokers (at least monthly) and 1184 recent ex-smokers (quit cigarettes ≤ 2 years) from Australia, Canada, England, and the US. Respondents were asked about their cigarette smoking and current use of the following non-cigarette products: combustible tobacco (cigars, cigarillos, pipe, waterpipe); non-combustible tobacco (smokeless tobacco, and heated tobacco products (HTPs)); and non-tobacco nicotine products (nicotine vaping products (NVPs), nicotine replacement therapy (NRT), and nicotine pouches)). Results Overall, NVPs (13.7%) and NRT (10.9%) were the most reported nicotine products used, followed by cigars (5.3%), cigarillos (4.2%), and HTPs (3.5%). More than 21% current and recent ex-smokers of cigarettes reported using a non-tobacco nicotine product and non-combustible product, with respondents in England reporting the highest levels of use (>26%). Males, younger respondents, and current non-daily cigarette smokers were more likely to use non-cigarette nicotine products. Notably, 11.6% of ex-cigarette smokers were using other combustible tobacco. Conclusion Considerable percentages of current cigarette smokers and ex-smokers use non-cigarette nicotine products, and there are unexpectedly high levels of use of other combustible products by those recent ex-smokers of cigarettes which is concerning and has important implications for definitions of smoking cessation. Implications The tobacco product market has evolved to include new products which add to existing non-cigarette tobacco products creating a much more diverse nicotine market. This brief report provides a snapshot of use of various combustible and non-combustible nicotine containing products among current cigarette smokers and recent ex-smokers in four western countries. Our results indicate that use of non-cigarette tobacco and nicotine products among these cigarette smokers and recent ex-smokers is not low, particularly among males, younger and non-daily cigarette smokers. Use of other combustible tobacco among respondents that recently quit cigarette smoking is concerning and has important implications for definitions of smoking cessation. Increased emphasis on researching non-cigarette nicotine product use is warranted in tobacco control generally and smoking cessation in particular.

Evaluating tobacco retailer experience and compliance with a flavoured tobacco product restriction in Boston, Massachusetts: impact on product availability, advertisement and consumer demand

2019 ◽  
pp. tobaccocontrol-2019-055124 ◽  
Author(s):  
Lindsay Kephart ◽  
Claude Setodji ◽  
Joseph Pane ◽  
William Shadel ◽  
Glory Song ◽  
...  
Keyword(s):  
Policy Implementation ◽  
Smokeless Tobacco ◽  
Consumer Demand ◽  
Tobacco Product ◽  
Tobacco Products ◽  
Process Measures ◽  
Product Availability ◽  
The Impact ◽  
The City

BackgroundFlavoured tobacco products are widely available in youth-accessible retailers and are associated with increased youth initiation and use. The city of Boston, Massachusetts restricted the sale of flavoured tobacco products, including cigars, smokeless tobacco and e-cigarettes, to adult-only retailers. This paper describes the impact of the restriction on product availability, advertisement and consumer demand.MethodsBetween January and December 2016, data were collected in 488 retailers in Boston at baseline and 469 retailers at 8-month follow-up, measuring the type, brand and flavour of tobacco products being sold. Process measures detailing the educational enforcement process, and retailer experience were also captured. McNemar tests and t-tests were used to assess the impact of the restriction on product availability.ResultsAfter policy implementation, only 14.4% of youth-accessible retailers sold flavoured products compared with 100% of retailers at baseline (p<0.001). Flavoured tobacco product advertisements decreased from being present at 58.9% of retailers to 28.0% at follow-up (p<0.001). Postimplementation, retailers sold fewer total flavoured products, with remaining products often considered as concept flavours (eg, jazz, blue). At follow-up, 64.0% of retailers reported that customers only asked for flavoured products a few times a week or did not ask at all. Retailers reported that educational visits and the flavoured product guidance list aided with compliance.ConclusionTobacco retailers across Boston were largely in compliance with the regulation. Availability of flavoured tobacco products in youth-accessible retailers declined city-wide after policy implementation. Strong educational and enforcement infrastructure may greatly enhance retailer compliance.

scholarly journals Age of Onset of Susceptibility to Different Tobacco Products Among Non-Susceptible US Young Adults: Findings from the Population Assessment of Tobacco and Health Study Waves 2-4 (2014-2017)

2021 ◽  
Vol 14 ◽  
pp. 1179173X2110656
Author(s):  
Adriana Pérez ◽  
Meagan A. Bluestein ◽  
Arnold E. Kuk ◽  
Baojiang Chen ◽  
Kymberle L. Sterling ◽  
...  
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Smokeless Tobacco ◽  
Age Of Onset ◽  
Tobacco Product ◽  
Tobacco Products ◽  
Population Assessment ◽  
Increased Risk ◽  
Interval Censored ◽  
Race Ethnicity

Introduction Initiation of tobacco products is increasing in young adulthood. This study prospectively estimated the age of onset of susceptibility to cigarettes, e-cigarettes, hookah, smokeless tobacco, and cigarillos among young adults, which is a cognitive precursor to initiation. Methods Secondary data analyses of the Population Assessment of Tobacco and Health (PATH) study, a nationally representative longitudinal cohort study of US adults. Young adults (18-24 years) who were non-susceptible to each tobacco product (cigarettes, e-cigarettes, hookah, smokeless tobacco, and cigarillos) at waves 2 or 3 were followed-up into waves 3-4 to prospectively estimate the age of onset of susceptibility to each tobacco product. Weighted interval-censored survival methods and interval-censored Cox regression models were implemented to estimate the age of onset of susceptibility, and to estimate differences in the hazard function by sex and by race/ethnicity, while controlling for the total number of other tobacco products ever used at their first wave of participation in PATH. Results By age 21, 16.5%, 16.0%, 12.6%, 12.4%, and 5.9% of young adults reported onset of susceptibility to hookah, e-cigarettes, cigarillos, cigarettes, and smokeless tobacco, respectively. Among young adults who were non-susceptible to each tobacco product at waves 2 or 3, the highest increase in onset of susceptibility occurred between ages 18 and 19 for cigarettes, e-cigarettes, and hookah, while the highest increase in onset of susceptibility occurs between ages 22 and 23 for cigarillos. Young adult males had increased risk of onset of susceptibility to cigarillos and smokeless tobacco at earlier ages than young adult females. Differences in onset of susceptibility to each tobacco product were also observed by race/ethnicity among young adults. Conclusions With the changing landscape of tobacco products, monitoring the age of onset of susceptibility of tobacco product use among non-susceptible young adults longitudinally is critical to prevent initiation. Communication and education campaigns tailored to address differences in susceptibility among young adults by tobacco product and sociodemographic factors will be useful.

scholarly journals Six-Week Actual Use Study to Evaluate the Impact of Oral Tobacco-Derived Nicotine Pouches on Cigarette Smoking and Smokeless Tobacco Product Use Behaviors

2021 ◽  
Author(s):  
Stacey McCaffrey ◽  
Jennifer Lewis ◽  
Elizabeth Becker ◽  
Andrea Vansickel ◽  
Elsa Larson ◽  
...  
Keyword(s):  
Smokeless Tobacco ◽  
Tobacco Product ◽  
Daily Consumption ◽  
Open Label ◽  
Tobacco Products ◽  
Use Patterns ◽  
Product Use ◽  
Actual Use ◽  
Smokeless Tobacco Product ◽  
The Impact

Abstract Background Oral tobacco-derived nicotine (OTDN) products are a rapidly emerging, innovative category of noncombustible tobacco products. These products are tobacco-leaf free and do not contain or generate many of the harmful and potentially harmful constituents (HPHCs) found in combustible cigarettes or smokeless tobacco (ST) products. OTDN products may therefore offer adult tobacco consumers a potentially reduced harm alternative. However, little is known about OTDN product use patterns or their ability to substitute for more harmful tobacco products.Methods We conducted an open-label, 2-phase, actual use study designed to characterize OTDN pouch product (on!® nicotine pouches - NP) use patterns, including impact on other tobacco use behaviors among adult tobacco consumers interested in using NP. Adult current cigarette smokers (AS) and/or adult ST users (ASTU) (n = 1,147 complete) who were not planning to quit were offered free choice of a portfolio of NP (seven flavors at five nicotine levels) to use at-home, ad-libitum, for 6-weeks following an initial 5-day trial. Participants responded to daily electronic surveys that captured the amount, frequency, and topography (e.g., time in mouth, placement in mouth) of NP and other tobacco product use. Results The majority (99 to 100%) of study participants used NP throughout the 6-week period. Participants used ~5-6 pouches/day of a variety of flavors and nicotine levels. At the end of 6 weeks, a modest proportion of AS (27%) and a substantial proportion of ASTU (71%) reported no use of cigarettes or ST respectively, while reporting continued use of NPs. Additionally, 39% of AS and 14% of ASTU reduced daily consumption of cigarettes or ST products, respectively by 50-99%. Conclusions Participants found NPs acceptable with a sizeable proportion completely switching away from or substantially reducing (50-99%) their cigarette or ST consumption by week 6. Availability of a variety of flavors and nicotine levels appeared to facilitate the conversion to NP. These data suggest that, under the conditions of the study, NP can be a potential substitute for cigarettes or ST products and may offer harm reduction potential for adult smokers and smokeless tobacco users not interested in quitting.Trial Registration Note: This study is an observational study with tobacco products currently available in the marketplace for adult tobacco consumers. Since there is no intervention per se and we did not collect any biosamples this is not a “clinical study” and there is no appropriate registry for such behavioral observational studies, we do not believe that this requirement is applicable.

scholarly journals E-cigarettes from the perspective of teenagers – results of focus studies

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Pluta ◽  
Ł Balwicki
Keyword(s):  
Young People ◽  
Preventive Measures ◽  
Electronic Cigarettes ◽  
Smoking Status ◽  
Risky Behaviors ◽  
Tobacco Prevention ◽  
Tobacco Products ◽  
Traditional Tobacco ◽  
The Impact ◽  
Natural Way

Abstract Research shows that over 80% of smokers start their habit under the age of 18. A few years ago young people undertook risky behaviors related to nicotine initiation mainly by smoking cigarettes. Today, next to traditional tobacco products, electronic cigarettes are becoming more and more popular. Due to the prevalence of new forms of nicotine addiction, modification of anti-tobacco prevention programs is required. The purpose of the research was exploration - learning the opinions and attitudes of young people towards e-cigarettes. The qualitative study was conducted using the FGI method (focus group interview). The meetings were modereted by specially trained psychologists. 48 students participated in the meetings of six focus groups, divided by gender and smoking status (smokers/non-smokers). The participants are young people aged 15-19, attending high schools in Warsaw, Kielce and Lublin. In conversations, young people emphasized the impact of e-cigarettes in smoking initiation - it usually occurs at the age of 12-14. E-cigarettes are perceived as cigarettes “for younger”, non-addictive, less serious, providing more entertainment. 'Cloud chasing' is particularly popular. They perform social functions - they are helpful in establishing relationships. Teenagers do not see the harmfulness of e-cigarettes. Participants mentioned their advantages over traditional tobacco products - they can be smoked everywhere and do not leave an unpleasant smell. Some of the respondents admit to the simultaneous use of electronic and traditional cigarettes. Moreover, many parents allow children to smoke electronic cigarettes. Vaping have become a natural way to relaxation and socialization for adolescents. E-cigarettes do not have such a negative connotation as traditional tobacco products. Young people do not see them as harmful, which is a challenge for effective preventive measures. Key messages Adolescents do not see e-cigarettes as harmful, which is a challenge for effective preventive measures. Vaping have become more and more popular - it's natural way to relaxation and socialization for young people.

Support for cigarette filter waste policies among US adults

2021 ◽  
pp. tobaccocontrol-2020-056451
Author(s):  
Minal Patel ◽  
Alison F Cuccia ◽  
Shanell Folger ◽  
Adam F Benson ◽  
Donna Vallone ◽  
...  
Keyword(s):  
Smoking Status ◽  
Population Based ◽  
Tobacco Product ◽  
Cross Sectional ◽  
Cigarette Filter ◽  
Logistic Regression Models ◽  
Knowledge And Beliefs ◽  
Cigarette Butts ◽  
Using Data ◽  
The Impact

IntroductionLittle is known on whether cigarette filter-related knowledge or beliefs are associated with support for policies to reduce their environmental impact.MethodsA cross-sectional, population-based sample of US adults aged 18–64 years (n=2979) was used to evaluate filter-related knowledge and beliefs by smoking status using data collected between 24 October 2018 and 17 December 2018. Multivariate logistic regression models explored whether these knowledge and belief items were associated with support for two policies, a US$0.75 litter fee and a ban on sales of filtered cigarettes, controlling for demographic characteristics and smoking status.ResultsRegardless of smoking status, 71% did not know plastic was a cigarette filter component and 20% believed filters were biodegradable. Overall, 23% believed filters reduce health harms and 60% believed filters make it easier to smoke; 90% believed cigarette butts are harmful to the environment. Individuals believing cigarette butts harmed the environment were more likely to support a litter fee (adjusted OR (aOR)=2.33, 95% CI: 1.71 to 3.17). Individuals believing that filters are not biodegradable had higher odds of supporting a litter fee (OR=1.47, 95% CI: 1.15 to 1.88). Respondents believing that filters do not make cigarettes less harmful were more likely to support a litter fee (aOR=1.50, 95% CI: 1.20 to 1.88) and filter ban (aOR=2.03, 95% CI: 1.64 to 2.50). Belief that filters make it easier to smoke was associated with decreased support for a filter ban (aOR=0.69, 95% CI: 0.58 to 0.83).ConclusionsComprehensive efforts are needed to educate the public about the impact of cigarette filters in order to build support for effective tobacco product waste policy.

scholarly journals Socioeconomic Disparities in Smoking Behavior and Early Smoking Initiation Among Men in Malawi

2017 ◽  
Vol 10 ◽  
pp. 1179173X1772629 ◽  
Author(s):  
Sanni Yaya ◽  
Ghose Bishwajit ◽  
Vaibhav Shah ◽  
Michael Ekholuenetale
Keyword(s):  
Smokeless Tobacco ◽  
Early Onset ◽  
Formal Education ◽  
Smoking Status ◽  
Smoking Behavior ◽  
Well Being ◽  
Smoking Initiation ◽  
Socioeconomic Disparities ◽  
Tobacco Products ◽  
Lower Odds

Background: Tobacco smoking is a growing concern for health care systems as it is projected to become the leading cause of death in the developing world. Knowledge of how smoking behavior differs across socioeconomic groups is crucial for designing effective preventive policies and alleviating the disparities. The aim of this study was to report the prevalence of (1) smoking status, (2) early smoking initiation, and (3) association with socioeconomic status (SES) of the 2 among Malawian men. Methods: Cross-sectional data on 1693 men aged between 15 and 49 years were collected from the latest 2013-2014 Multiple Indicator Cluster Survey in Malawi. Educational qualification and wealth index quintile were used as the indicators of SES. Outcome variables were smoking status, first age of smoking being below 18 years, and ever using any form of smokeless tobacco products. Multiple logistic regression models were used to see the contribution of SES to smoking status and early smoking initiation. Results: Mean age of the sample population was 33.23 years (SD: 8.25). Prevalence of smoking, early initiation, and ever using any form of smokeless tobacco were, respectively, 46.6%, 33.7%, and 6%. Compared with men who had higher education, those who had no formal education, primary-level, and secondary-level qualification had, respectively, 21% (adjusted odds ratio [AOR] = 1.209; 95% confidence interval [CI] = 0.498-2.935), 40% (AOR = 1.4; 95% CI = 0.647-3.029), and 26% (AOR = 1.256; 95% CI = 0.593-2.661) higher odds of being a smoker. Those who had no formal education were 2.7 times (AOR = 2.734; 95% CI = 1.123-6.653) as likely to try smoking before reaching 18 years of age. Compared with the richest, those in the lowest wealth quintile had 32% lower odds (AOR = 0.676; 95% CI = 0.455-1.006) of early onset of smoking, 63% lower odds (AOR = 0.372; 95% CI = 0.201-0.690) of trying other tobacco products. Conclusions: Addressing the socioeconomic disparities could play a vital role in delaying early onset and limiting overall consumption of tobacco. Ongoing health policy talks to reduce the prevalence of smoking should take into consideration improving educational and material well-being among men.

scholarly journals Impact of common tobacco products on human health and environmental pollution in Bangladesh

2021 ◽  
Vol 31 (3) ◽  
pp. 130-143
Author(s):  
MA Mondol ◽  
AMM Hosain ◽  
S Sultana ◽  
S Marzia ◽  
MA Islam ◽  
...  
Keyword(s):  
Environmental Pollution ◽  
Human Health ◽  
Smokeless Tobacco ◽  
Tobacco Product ◽  
Tobacco Products ◽  
Face To Face ◽  
Adverse Health Effects ◽  
Survey Results ◽  
Young Smokers ◽  
Structured Questionnaire

Worldwide, tobacco is one of the leading causes of disability and death. Over a million of pounds of toxic chemicals are released by tobacco products. This study aims to explore the effects of tobacco toxicants on human health and environmental pollution. Four districts (Dhaka, Kushtia, Chattogram and Rangpur) were selected where most of the tobacco product grown. Total 468 respondents were interviewed face-to-face using structured questionnaire to assess the knowledge about toxicant content in tobacco and health and environmental hazards of tobacco use. Survey results revealed that about 44.4% respondents used smoking tobacco products and 38.5% used smokeless tobacco, while only 17.1% used both. About two third (74.3%) of smoking tobacco users started smoking when they were between 15 to 24 years old and majority (61.6%) of smokeless tobacco users started tobacco when they were between 30 to 35 years above. Tobacco product has large impacts on health of young smokers. Smokers are suffering from various acute and chronic diseases. Among the respondents, 38% indicated that they were suffering from hypertension. The second most affected disease was COPD/Asthma (31.6%), while cancer was the least suffering disease (0.4%). Majority of the respondents were not aware about the presence of toxicants (i.e. nicotine, tar and metals) in tobacco products. However, 85.1% tobacco users had an idea about environmental pollution. There is a lack of knowledge among the survey respondents about toxicants in tobacco products that are linked to health hazards and environmental pollution. These results are important in strengthening existing policy considering adverse health effects of toxicants examined. Progressive Agriculture 31 (3): 130-143, 2020

scholarly journals Modelling the impact of a new tobacco product: review of Philip Morris International’s Population Health Impact Model as applied to the IQOS heated tobacco product

2018 ◽  
Vol 27 (Suppl 1) ◽  
pp. s82-s86 ◽  
Author(s):  
Wendy B Max ◽  
Hai-Yen Sung ◽  
James Lightwood ◽  
Yingning Wang ◽  
Tingting Yao
Keyword(s):  
Population Health ◽  
New Product ◽  
Health Impact ◽  
Tobacco Product ◽  
Dynamic State ◽  
Model Parameters ◽  
Impact Model ◽  
Tobacco Products ◽  
Philip Morris ◽  
The Impact

ObjectivesWe review the Population Health Impact Model (PHIM) developed by Philip Morris International and used in its application to the US Food and Drug Administration (FDA) to market its heated tobacco product (HTP), IQOS, as a modified-risk tobacco product (MRTP). We assess the model against FDA guidelines for MRTP applications and consider more general criteria for evaluating reduced-risk tobacco products.MethodsIn assessing the PHIM against FDA guidelines, we consider two key components of the model: the assumptions implicit in the model (outcomes included, relative harm of the new product vs cigarettes, tobacco-related diseases considered, whether dual or polyuse of the new product is modelled, and what other tobacco products are included) and data used to estimate and validate model parameters (transition rates between non-smoking, cigarette-only smoking, dual use of cigarettes and MRTP, and MRTP-only use; and starting tobacco use prevalence).ResultsThe PHIM is a dynamic state transition model which models the impact of cigarette and MRTP use on mortality from four tobacco-attributable diseases. The PHIM excludes morbidity, underestimates mortality, excludes tobacco products other than cigarettes, does not include FDA-recommended impacts on non-users and underestimates the impact on other population groups.ConclusionThe PHIM underestimates the health impact of HTP products and cannot be used to justify an MRTP claim. An assessment of the impact of a potential MRTP on population health should include a comprehensive measure of health impacts, consideration of all groups impacted, and documented and justifiable assumptions regarding model parameters.

scholarly journals Not Quite the Rule, But No Longer the Exception: Multiple Tobacco Product Use and Implications for Treatment, Research, and Regulation

2019 ◽  
Vol 22 (11) ◽  
pp. 2114-2117
Author(s):  
Lauren R Pacek ◽  
Andrea C Villanti ◽  
F Joseph Mcclernon
Keyword(s):  
United States ◽  
Cigarette Smoking ◽  
Tobacco Dependence ◽  
The United States ◽  
Tobacco Product ◽  
Regulatory Science ◽  
Tobacco Products ◽  
The Past ◽  
Product Use ◽  
Treatment Research

Abstract The patterns of tobacco product use in the United States have changed during the past several decades. Currently, a large proportion of tobacco users report using multiple tobacco products (MTPs). The prevalence of MTP use varies significantly by cigarette smoking frequency, as well: nearly half (46.9%) of all non-daily smokers report using other tobacco products within the past 30 days. Despite this, much of extant tobacco dependence treatment efforts, tobacco regulatory science research, and tobacco product research, in general, has focused largely on single product use (ie, cigarette smoking). To effectively design interventions and model the potential impact of regulations on tobacco products aimed at reducing tobacco use, as well as effectively study tobacco users, it is essential to consider actual use patterns in the population of tobacco users. Implications: MTP use is increasingly common in the United States. This commentary highlights the impact that MTP use has for efforts to treat tobacco dependence, tobacco regulatory science efforts, as well as on tobacco research, in general.

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