scholarly journals Associations between Cognitive and Affective Responses to Tobacco Advertisements and Tobacco Use Incidence: A Four-Year Prospective Study among Adolescent Boys

2021 ◽  
Vol 18 (21) ◽  
pp. 11666
Author(s):  
Brittney Keller-Hamilton ◽  
Hayley Curran ◽  
Elise M. Stevens ◽  
Michael D. Slater ◽  
Bo Lu ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Health Risks ◽  
Regression Models ◽  
Statistical Significance ◽  
Smoking Initiation ◽  
Tobacco Product ◽  
Affective Responses ◽  
Standard Errors ◽  
Health Warnings ◽  
Reduced Risk

Exposure to tobacco advertisements is associated with initiation of tobacco use among youth. The mechanisms underlying this association are less clear. We estimated longitudinal associations between youths’ cognitive and affective responses to advertisements for cigarettes, e-cigarettes, and smokeless tobacco (SLT) and initiation of these products. N = 1220 Ohio-residing boys of ages 11–16 were recruited into a cohort in 2015 and 2016. Participants completed surveys every six months for four years. Surveys assessed cognitive and affective responses to tobacco advertisements (which included health warnings) and tobacco use after an advertisement viewing activity. We used mixed-effects Poisson regression models with robust standard errors to estimate risk of initiating use of each tobacco product according to participants’ cognitive (i.e., memorability of health risks) and affective (i.e., likability of advertisement) responses to advertisements for that product. No associations between affective responses to advertisements and tobacco use outcomes were detected in adjusted models. However, finding health risks memorable was associated with reduced risk of ever smoking initiation (aRR = 0.57; 95% CI: 0.34, 0.95) and a reduced risk of ever SLT initiation that approached statistical significance (aRR = 0.61; 95% CI: 0.36, 1.05). Measures to increase saliency of health risks on cigarette and SLT advertisements might reduce use among youth.

scholarly journals Effectiveness of Text-Only Cigarette Health Warnings in Japan: Findings from the 2018 International Tobacco Control (ITC) Japan Survey

2020 ◽  
Vol 17 (3) ◽  
pp. 952 ◽  
Author(s):  
Janet Chung-Hall ◽  
Geoffrey T. Fong ◽  
Gang Meng ◽  
Mi Yan ◽  
Takahiro Tabuchi ◽  
...  
Keyword(s):  
Tobacco Control ◽  
Health Risks ◽  
Regression Models ◽  
Smoking Initiation ◽  
Effective Strategy ◽  
Health Warnings ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Logistic Regression Models ◽  
Pictorial Warnings

Health warnings are an effective strategy for communicating the health harms of smoking, encouraging quitting, and preventing smoking initiation. This study examines the effectiveness of existing text-only health warnings, identifies key predictors of warning effectiveness, and assesses support for pictorial warnings in Japan. Data are from the 2018 International Tobacco Control (ITC) Japan Survey, a cohort survey of adult cigarette smokers (n = 3306), dual users of cigarettes and heated tobacco products (n = 555), and non-cigarette smokers (n = 823). Weighted multivariable logistic regression models were used to assess predictors of warning effectiveness and support for pictorial warnings. Overall, 15.6% of respondents noticed warnings, and 7.9% read or looked closely at warnings. Overall, 10.3% of smokers and dual users said the warnings stopped them from having a cigarette, and 7.2% avoided warnings. Overall, 27.5% of respondents said the warnings made them think about health risks of smoking, but only 2.7% of smokers and dual users said the warnings made them more likely to quit. Overall, 57.6% of respondents supported pictorial warnings. The weak effectiveness of Japan’s text-only warnings is consistent with that in other countries with similar warnings. There is majority support for pictorial warnings in Japan, although the level of support is lower than in other countries.

scholarly journals Plain tobacco packaging, increased graphic health warnings and adolescents’ perceptions and initiation of smoking: DePICT, a French nationwide study

2018 ◽  
Vol 28 (e1) ◽  
pp. e31-e36 ◽  
Author(s):  
Fabienne El-Khoury Lesueur ◽  
Camille Bolze ◽  
Ramchandar Gomajee ◽  
Vicki White ◽  
Maria Melchior
Keyword(s):  
Tobacco Use ◽  
Regression Models ◽  
Telephone Survey ◽  
Smoking Initiation ◽  
Health Warnings ◽  
Significant Drop ◽  
Cross Sectional ◽  
Binomial Regression ◽  
Prevalence Ratios ◽  
Current Tobacco

BackgroundPlain packaging (PP) of tobacco products and increased graphic warnings may contribute to lower attractiveness of smoking, particularly among youths. In France, this policy was introduced on 1 January 2017. We examined changes in smoking-related perceptions and behaviours among a nationwide sample of French adolescents before (2016) and 1 year post (2017) implementation.MethodsDePICT is a two-wave cross-sectional national telephone survey of adolescents aged 12–17 years per study wave (2016: n=2046 2017: n=1999). All participants reported smoking-related perceptions, as well as ever and current tobacco use. Smokers were also asked about their perceptions of tobacco brands. Data were weighted to be representative of youths in the French population: adjusted prevalence ratios (PRs, 95% CI) estimating changes between the two study waves were calculated using multivariate log-binomial regression models.ResultsIn 2017, as compared with 2016, French adolescents were more likely to report fear of the consequences of smoking (PR=1.06, 95% CI 1.02 to 1.09) and that smoking is dangerous (PR=1.08, 95% CI 1.05 to 1.11). They were also less likely to report that their friends (PR=0.61, 95% CI 0.54 to 0.70) and family (PR=0.51, 95% CI 0.44 to 0.60) accept smoking. Additionally, smoking initiation significantly decreased (PR=0.96, 95% CI 0.93 to 0.98) and a non-statistically significant drop in current tobacco use was observed (PR=0.93, 95% CI 0.78 to 1.11). Smokers’ attachment to their tobacco brand also decreased (PR=0.47, 95% CI 0.30 to 0.73).ConclusionOur findings suggest that PP and increased graphic warnings could contribute to changes in smoking norms and rates among adolescents.

scholarly journals PMI’s heated tobacco products marketing claims of reduced risk and reduced exposure may entice youth to try and continue using these products

2020 ◽  
pp. tobaccocontrol-2019-055318 ◽  
Author(s):  
Karma McKelvey ◽  
Michael Baiocchi ◽  
Bonnie Halpern-Felsher
Keyword(s):  
Health Risks ◽  
Risk Group ◽  
Tobacco Product ◽  
Philip Morris ◽  
Randomised Controlled ◽  
Tobacco Initiation ◽  
Consumer Marketing ◽  
Reduced Risk ◽  
Tobacco Packaging ◽  
Specific Health

ImportancePhilip Morris International (PMI) is seeking Food and Drug Administration’s (FDA) authorisation to market IQOS as a modified risk tobacco product and to make marketing claims of reduced risk and reduced exposure. Such claims may be misunderstood by youth, thereby increasing their risk for tobacco initiation.ObjectiveTo assess youth (mean age 19.3, SD=1.7) understanding and perceptions of PMI’s proposed consumer marketing claims of reduced risk and reduced exposure, we embedded a randomised controlled experiment into a survey of 450 California youth (April to August 2018). Participants were randomised to see ‘reduced exposure’, ‘reduced risk’ or neither claim. Perceptions of IQOS-related health risks and general harm and understanding of the term ‘switching completely’ as used in PMI’s proposed claims were compared.ResultsMean expectancies to experience specific health risks did not differ by claim exposure. The reduced exposure group’s perceptions of general harm did not differ from those of controls nor from the reduced risk group. The reduced risk group had the largest proportion who perceived IQOS as moderately/less harmful (n=78, 52%); controls the largest proportion perceiving IQOS as quite/extremely harmful (n=91, 63%). While 71% of the sample understood the term ‘switch completely’ correctly as used in the reduced risk (n=194, 71%) and reduced exposure (n=206, 72%) claims, more than 1 in 4 did not.ConclusionsFDA and other regulators must use caution when considering allowing claims of reduced risk or reduced exposure to appear on retail tobacco packaging. Youth misunderstand such claims, and misperceptions of harm are known to lead to tobacco-use initiation.

scholarly journals Impact of the WHO FCTC over the first decade: a global evidence review prepared for the Impact Assessment Expert Group

2018 ◽  
Vol 28 (Suppl 2) ◽  
pp. s119-s128 ◽  
Author(s):  
Janet Chung-Hall ◽  
Lorraine Craig ◽  
Shannon Gravely ◽  
Natalie Sansone ◽  
Geoffrey T Fong
Keyword(s):  
Tobacco Control ◽  
Information Exchange ◽  
Data Extraction ◽  
Smoking Initiation ◽  
Tobacco Consumption ◽  
Tobacco Product ◽  
Health Warnings ◽  
Hand Search ◽  
Tobacco Epidemic ◽  
The Impact

ObjectiveTo present findings of a narrative review on the implementation and effectiveness of 17 Articles of the WHO Framework Convention on Tobacco Control (FCTC) during the Treaty’s first decade.Data sourcesPublished reports on global FCTC implementation; searches of four databases through June 2016; hand-search of publications/online resources; tobacco control experts.Study selectionWHO Convention Secretariat global progress reports (2010, 2012, 2014); 2015 WHO report on the global tobacco epidemic; studies of social, behavioural, health, economic and/or environmental impacts of FCTC policies.Data extractionProgress in the implementation of 17 FCTC Articles was categorised (higher/intermediate/lower) by consensus. 128 studies were independently selected by multiple authors in consultation with experts.Data synthesisImplementation was highest for smoke-free laws, health warnings and education campaigns, youth access laws, and reporting/information exchange, and lowest for measures to counter industry interference, regulate tobacco product contents, promote alternative livelihoods and protect health/environment. Price/tax increases, comprehensive smoking and marketing bans, health warnings, and cessation treatment are associated with decreased tobacco consumption/health risks and increased quitting. Mass media campaigns and youth access laws prevent smoking initiation, decrease prevalence and promote cessation. There were few studies on the effectiveness of policies in several domains, including measures to prevent industry interference and regulate tobacco product contents.ConclusionsThe FCTC has increased the implementation of measures across several policy domains, and these implementations have resulted in measurable impacts on tobacco consumption, prevalence and other outcomes. However, FCTC implementation must be accelerated, and Parties need to meet all their Treaty obligations and consider measures that exceed minimum requirements.

scholarly journals Adolescents’ knowledge and opinions about smoking: a qualitative study from the Jhaukhel-Duwakot Health Demographic Surveillance Site, Bhaktapur District, Nepal

2016 ◽  
Vol 30 (1) ◽  
Author(s):  
Lene Povlsen ◽  
Umesh Raj Aryal ◽  
Max Petzold ◽  
Alexandra Krettek
Keyword(s):  
Tobacco Use ◽  
Health Risks ◽  
Passive Smoking ◽  
Qualitative Content Analysis ◽  
Smoking Behavior ◽  
Deep Understanding ◽  
Peer Pressure ◽  
Smoking Initiation ◽  
Public Health Burden ◽  
Tobacco Epidemic

Abstract Background: The use of tobacco products among adolescents in Southeast Asia represents a major public health burden. Two out of ten adolescents attending school are tobacco users and several factors influence them to initiate tobacco use. Most studies related to tobacco use are quantitative, whereas qualitative studies exploring adolescents’ smoking behavior and their views, knowledge and experiences are scarce. Objective: To gain a deep understanding of Nepalese adolescents’ knowledge and opinions about smoking and reasons for smoking initiation. Subjects: Adolescents from four secondary schools in the Bhaktapur district, Nepal. Methods: Eight focus-group discussions were conducted with 71 adolescents aged 13–16 years and from grades 8–10. Data were analyzed using manifest qualitative content analysis. Results: The participants knew that smoking represents health risks as well as socio-economic risks, but few described the addictive nature of tobacco and health risks related to passive smoking. Most participants related smoking initiation to the smoking behavior of peers and family members, but easy accessibility to cigarettes, ineffective rules and regulations, and exposure to passive smoking also created environments for smoking. Some expressed confidence to resist peer pressure and refuse to start smoking, but also expressed the need for prevention strategies in schools and for governmental initiatives, such as more strict implementation of tobacco control and regulations to prevent and reduce smoking. Conclusion: Curbing the tobacco epidemic in Nepal requires healthy public policies and multifaceted interventions to address the knowledge gap on health consequences associated with smoking among adolescents, teachers and parents/adults.

scholarly journals Further investigation of gateway effects using the PATH study

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 607
Author(s):  
Peter N Lee ◽  
John S Fry
Keyword(s):  
Tobacco Use ◽  
Causal Effect ◽  
Smoking Initiation ◽  
Continuous Variable ◽  
Tobacco Product ◽  
Sensitivity Analyses ◽  
The Us ◽  
Never Smokers ◽  
Using Data ◽  
Confounding Adjustment

Background: Interest exists in whether youth e-cigarette use (“vaping”) increases risk of initiating cigarette smoking. Using Waves 1 and 2 of the US PATH study we reported that adjustment for vaping propensity using Wave 1 variables explained about 80% of the unadjusted relationship. Here we use data from Waves 1 to 3 to avoid over-adjustment if Wave 1 vaping affected variables recorded then. Methods: Our main analysis M1 concerned Wave 2 never smokers who never vaped by Wave 1, linking Wave 2 vaping to Wave 3 smoking initiation, adjusting for Wave 1 predictors. We conducted sensitivity analyses that: excluded Wave 1 other tobacco product users; included other product use as an extra predictor; or considered propensity for smoking or any tobacco use, rather than vaping. We also conducted analyses that: adjusted for propensity as derived originally; ignored Wave 1 data; used exact age (not previously available) as a confounder rather than grouped age; attempted residual confounding adjustment by modifying predictor values using data recorded later; or considered interactions with age. Results: In M1, adjustment removed about half the excess OR (i.e. OR–1), the unadjusted OR, 5.60 (95% CI 4.52-6.93), becoming 3.37 (2.65-4.28), 3.11 (2.47-3.92) or 3.27 (2.57-4.16), depending whether adjustment was for propensity as a continuous variable, as quintiles, or for the variables making up the propensity score. Many factors had little effect: using grouped or exact age; considering other products; including interactions; or using predictors of smoking or tobacco use rather than vaping. The clearest conclusion was that analyses avoiding over-adjustment explained about half the excess OR, whereas analyses subject to over-adjustment explained about 80%. Conclusions: Although much of the unadjusted gateway effect results from confounding, we provide stronger evidence than previously of some causal effect of vaping, though some doubts still remain about the completeness of adjustment.

scholarly journals Further investigations of gateway effects using the PATH study

2020 ◽  
Author(s):  
Peter N Lee ◽  
John S Fry
Keyword(s):  
Tobacco Use ◽  
Causal Effect ◽  
Smoking Initiation ◽  
Continuous Variable ◽  
Tobacco Product ◽  
Sensitivity Analyses ◽  
Health Study ◽  
Using Data ◽  
Confounder Adjustment ◽  
Confounding Adjustment

Abstract Background: Considerable interest exists in whether e-cigarette use (“vaping”) by youths increases the risk of initiating cigarette smoking. Based on Waves 1 and 2 of the Population Assessment of Tobacco and Health study we reported that adjustment for propensity for vaping using Wave 1 variables explained about 80% of the unadjusted relationship. This analysis may be over-adjusted had vaping at Wave 1 affected some variables recorded then. Here we present analyses using Waves 1 to 3 to avoid this possibility. Methods: Our main analysis M1 concerned those who had never smoked by Wave 2 and never vaped by Wave 1. Wave 2 vaping was linked to smoking initiation by Wave 3, adjusting for Wave 1 predictors. Sensitivity analyses excluded other tobacco product users at Wave 1, included other tobacco product use as an additional predictor, or were based on propensity for ever smoking or ever any tobacco use, rather than ever vaping. Other analyses adjusted for propensity as derived originally, or ignored Wave 1 data. Other analyses used grouped age (only available originally) or exact age (available now) as a confounder variable, attempted residual confounding adjustment by modifying values of predictor variables using data later recorded, or considered interactions with age. Results: In M1, propensity adjustment removed about 50% of the excess odds ratio (i.e. OR–1), the unadjusted OR, 5.60 (95% CI 4.52-6.93) becoming 3.37 (2.65-4.28), 3.11 (2.47-3.92) or 3.27 (2.57-4.16) depending whether adjustment was for propensity as a continuous variable, as quintiles, or for the 16 variables making up the propensity score. Many factors studied hardly affected the results, including using grouped or exact age, consideration of other tobacco products, including interactions, or using predictors of smoking or tobacco use rather than vaping. The clearest conclusion was that analyses avoiding over-adjustment only explained about 50% of the excess OR whereas analyses subject to over-adjustment explained about 80%. Conclusions: Although much of the unadjusted gateway effect results from uncontrolled confounding, our current analysis provides stronger evidence of a causal effect of vaping than did our earlier analysis. However, some doubts remain about the completeness of confounder adjustment.

scholarly journals Further investigation of gateway effects using the PATH study

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 607
Author(s):  
Peter N Lee ◽  
John S Fry
Keyword(s):  
Tobacco Use ◽  
Causal Effect ◽  
Smoking Initiation ◽  
Continuous Variable ◽  
Tobacco Product ◽  
Sensitivity Analyses ◽  
The Us ◽  
Never Smokers ◽  
Using Data ◽  
Confounding Adjustment

Background: Interest exists in whether youth e-cigarette use (“vaping”) increases risk of initiating cigarette smoking. Using Waves 1 and 2 of the US PATH study we previously reported adjustment for vaping propensity using Wave 1 variables explained about 80% of the unadjusted relationship. Here data from Waves 1 to 3 are used to avoid over-adjustment if Wave 1 vaping affected variables recorded then. Methods: Main analyses M1 and M2 concerned Wave 2 never smokers who never vaped by Wave 1, linking Wave 2 vaping to Wave 3 smoking initiation, adjusting for predictors of vaping based on Wave 1 data using differing  propensity indices.  M3 was similar but derived the index from Wave 2 data.  Sensitivity analyses excluded Wave 1 other tobacco product users, included other product use as another predictor, or considered propensity for smoking or any tobacco use, not vaping. Alternative analyses used exact age (not previously available) as a confounder not grouped age, attempted residual confounding adjustment by modifying predictor values using data recorded later, or considered interactions with age. Results: In M1, adjustment removed about half the excess OR (i.e. OR–1), the unadjusted OR, 5.60 (95% CI 4.52-6.93), becoming 3.37 (2.65-4.28), 3.11 (2.47-3.92) or 3.27 (2.57-4.16), depending whether adjustment was for propensity as a continuous variable, as quintiles, or the variables making up the propensity score. Many factors had little effect: using grouped or exact age; considering other products; including interactions; or using predictors of smoking or tobacco use rather than vaping. The clearest conclusion was that analyses avoiding over-adjustment explained about half the excess OR, whereas analyses subject to over-adjustment explained about 80%. Conclusions: Although much of the unadjusted gateway effect results from confounding, we provide stronger evidence than previously of some causal effect of vaping, though doubts still remain about the completeness of adjustment.

National prevalence, perceptions, and determinants of tobacco consumption in Saudi Arabia

2019 ◽  
Vol 2 (2) ◽  
pp. 1
Author(s):  
Aljoharah M Algabbani ◽  
Nora A Althumiri ◽  
Abdulrahman M. Almarshad ◽  
Nasser F. BinDhim
Keyword(s):  
Saudi Arabia ◽  
Cigarette Smoking ◽  
Tobacco Use ◽  
Health Risks ◽  
Smoking Prevalence ◽  
Electronic Cigarettes ◽  
Tobacco Consumption ◽  
Tobacco Product ◽  
Former Smokers ◽  
National Prevalence

Introduction Tobacco use has been associated with many health risks that can lead to premature death. This study aims to assess the national prevalence of tobacco consumption and the associated determinants in Saudi Arabia.  Methods The study involved a cross-sectional national survey of 5175 individuals conducted across the 13 official regions of Saudi Arabia. The sample included individuals aged 18 years and above from both genders recruited using a quota sampling technique. Data collection was carried out between September 2018 and May 2019 through Web-based computer-assisted telephone interviews (CATIs). Participants were asked to report their current consumption of tobacco products including cigarettes, shisha (waterpipe), smokeless tobacco, cigars, pipes, and electronic cigarettes/vaping. Knowledge of specific health risks associated with smoking and public perceptions of the smoking phenomenon were also assessed among never smokers, smokers, and former smokers. Results The national prevalence of tobacco consumption was 24.02% (1120/5175). Cigarettes were the most prevalent tobacco product consumed (16.18%; 95% CI: 14.5881–17.7663), and daily cigarette smoking prevalence was the highest (14.12%; 95% CI: 12.6433–15.5924). Shisha smoking prevalence was 8.12% (95% CI: 6.8054–9.4352). E-cigarette use prevalence was 2.22% (95% CI: 1.5770–2.8711). The most common tobacco product used among males was cigarettes (15.13%; 95% CI: 13.58–16.67), while shisha was commonly used among females (1.57%; 95% CI: 1.11–2.04). Cigarette smoking prevalence was the highest in the Aljawf region (21.12%; 95% CI: 17.07–25.18), shisha smoking prevalence was the highest in the Makkah region (12.41%; 95% CI: 8.64–16.17), whereas smokeless tobacco use was prevalent in the Najran region (4.75%; 95% CI: 2.81–6.70). Males (AOR: 8.17; 95% CI: 5.98–11.71; P < 0.0001), young adults below 45 years of age (AOR: 2.12; 95% CI: 1.50–2.98; P < 0.0001), and those with below a bachelor’s degree (AOR: 1.34; 95% CI: 1.01–1.77; P = 0.0396) were more likely to consume tobacco compared with others. The population mean knowledge scores of health risks associated with smoking among smokers was 1.91 ± 1.72 (Range: 0–10), with the highest knowledge scores (2.16 ± 1.68) among former smokers. Only 46.53% (95% CI: 44.30–48.75) of the population are bothered “to very large extent” by smoking health consequences. Conclusions Tobacco consumption is prevalent in Saudi Arabia. Different forms of tobacco use were reported, and the most common was cigarettes, followed by shisha and then electronic cigarettes. Tobacco use remains one of the major threats to the health of the population in Saudi Arabia.

Discordance between perceived and actual tobacco product use prevalence among US youth: a comparative analysis of electronic and regular cigarettes

2018 ◽  
Vol 28 (2) ◽  
pp. 212-219 ◽  
Author(s):  
Israel Terungwa Agaku ◽  
Satomi Odani ◽  
David Homa ◽  
Brian Armour ◽  
Rebecca Glover-Kudon
Keyword(s):  
Tobacco Use ◽  
Electronic Cigarettes ◽  
Statistical Significance ◽  
Tobacco Product ◽  
Cigarette Use ◽  
Cross Sectional ◽  
Media Messages ◽  
School Based ◽  
Nationally Representative ◽  
Actual Prevalence

ImportanceTwo components of social norms—descriptive (estimated prevalence) and injunctive (perceived acceptability)—can influence youth tobacco use.ObjectiveTo investigate electronic cigarettes (e-cigarette) and cigarette descriptive norms and measure the associations between overestimation of e-cigarette and cigarette prevalence and tobacco-related attitudes and behaviours.DesignCross-sectional.SettingSchool-based, using paper-and-pencil questionnaires.ParticipantsUS 6th-12th graders participating in the 2015 (n=17 711) and 2016 (n=20 675) National Youth Tobacco Survey.ExposureStudents estimated the percent of their grade-mates who they thought used e-cigarettes and cigarettes; the discordance between perceived versus grade-specific actual prevalence was used to categorise students as overestimating (1) neither product, (2) e-cigarettes only, (3) cigarettes only or (4) both products.OutcomesProduct-specific outcomes were curiosity and susceptibility (never users), as well as ever and current use (all students). Descriptive and multivariable logistic regression analyses were performed. Statistical significance was at P<0.05. Data were weighted to be nationally representative.ResultsMore students overestimated cigarette (74.0%) than e-cigarette prevalence (61.0%; P<0.05). However, the associations between e-cigarette-only overestimation and e-cigarette curiosity (adjusted OR (AOR)=3.29), susceptibility (AOR=2.59), ever use (AOR=5.86) and current use (AOR=8.15) were each significantly larger than the corresponding associations between cigarette-only overestimation and cigarette curiosity (AOR=1.50), susceptibility (AOR=1.54), ever use (AOR=2.04) and current use (AOR=2.52). Despite significant declines in actual e-cigarette use prevalence within each high school grade level during 2015–2016, perceived prevalence increased (11th and 12th grades) or remained unchanged (9th and 10th grades).ConclusionsFour of five US students overestimated peer e-cigarette or cigarette use. Counter-tobacco mass media messages can help denormalise tobacco use.

Sign in / Sign up

Export Citation Format

Share Document