Point of Sale Advertising and Promotion of Cigarettes, Electronic Cigarettes, and Heated Tobacco Products in Warsaw, Poland—A Pilot Study

Prevalence of smoking and e-cigarette use among teenagers in Poland is high. Polish law bans most advertising and promotion for cigarettes, e-cigarettes, and heated tobacco products (HTPs). This study investigates marketing for these products at points of sale (POS) near secondary schools in Warsaw, Poland, noting if the advertising and promotion were allowed under current Polish laws. All POS within 250 m radii of five selected secondary schools in each of three Warsaw districts were assessed for tobacco and e-cigarette direct advertising, inside and outside; offers of gifts or promotional discounts; tobacco merchandising, and tobacco displays. Of the 112 POS surveyed, 83% exposed customers to some form of advertising or promotion of cigarettes, e-cigarettes, or HTPs; in 76%, advertising or promotion that violated Polish law was present. More than 80% of POS surveyed displayed tobacco products; in 19%, these products were displayed near products of interest to minors. POS density observed here was 30.3 per km2, higher than in other European cities. In Poland, a high proportion of POS near schools violates the law banning the advertisement and promotion of tobacco and nicotine consumer products through a dense tobacco retailer network.

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Workplace smoke-free policies that allow heated tobacco products and electronic cigarettes use are associated with use of both these products and conventional tobacco smoking: the 2018 JASTIS study

Tobacco Control ◽

10.1136/tobaccocontrol-2019-055465 ◽

2020 ◽

pp. tobaccocontrol-2019-055465

Author(s):

Yanakawee Siripongvutikorn ◽

Takahiro Tabuchi ◽

Sumiyo Okawa

Keyword(s):

Regression Models ◽

Electronic Cigarettes ◽

Internet Survey ◽

Survey Study ◽

Cigarette Use ◽

Cigarette Smokers ◽

Tobacco Products ◽

National Legislation ◽

Adjusted Rate ◽

Rate Ratios

ObjectivesHeated tobacco products (HTPs) and electronic cigarettes (e-cigarettes) are rapidly gaining popularity, especially in Japan. However, at the time of the survey (2018), there was no national legislation banning HTPs or e-cigarette use in the workplace. The objective is to examine the current situation for workplace smoke-free policies which ban the use of HTPs/e-cigarettes and the associations of such rules with the use of HTP and e-cigarette as well as conventional cigarette smoking.MethodsAn internet-based self-reported questionnaire survey was conducted in 2018 as a part of the Japan Society and New Tobacco Internet Survey study. 5646 eligible employees aged 15–72 years were analysed. Proportions and adjusted rate ratios for HTP and e-cigarette use were calculated according to covariates, using Poisson regression models. Those who reported HTP or e-cigarette use within 30 days were defined as current user of the products.ResultsIn workplaces which prohibited smoking indoors but permitted the use of HTPs/e-cigarettes, the rate ratios of HTP use was 2.19 (95% CI 1.57 to 3.06), e-cigarette use was 3.86 (95% CI 1.97 to 7.57) and combustible cigarette use was 1.67 (95% CI 1.19 to 2.34) when using workplaces which also prohibited HTPs/e-cigarettes as a reference category.ConclusionsWorkplaces that allow HTP/e-cigarette use indoors were associated with higher rate for HTP and e-cigarette users, and for combustible cigarette smokers. National legislation banning tobacco should be enforced and also cover HTPs and e-cigarettes in order to avoid renormalisation of smoking and nicotine addiction.

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A Comparison of Dependence across Different Types of Nicotine Containing Products and Coffee

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15081609 ◽

2018 ◽

Vol 15 (8) ◽

pp. 1609

Author(s):

Karl Fagerstrom

Keyword(s):

Data Collection ◽

Random Sample ◽

Electronic Cigarettes ◽

Coffee Consumption ◽

Cigarette Use ◽

Tobacco Products ◽

Nicotine Replacement ◽

Heavy Smoking ◽

Different Types ◽

Smoking Index

Introduction: Few studies have compared the dependence to different tobacco and nicotine products. Even less is known about how it relates to dependence on other common drugs, e.g., caffeine. In this study degree of dependence was compared between snus, cigarettes, nicotine replacement (NR), electronic cigarettes and coffee. Methods: A random sample of Swedish citizens belonging to an internet panel were contacted from September to October 2017. The responders were asked among other related things about their use of snus, NR, traditional cigarette or e-cigarette use and coffee consumption. The indicators of dependence used were: (A) the Heavy Smoking Index, (B) The proportions that used within 30 min after raising in the morning, (C) rating the first use in the morning as the most important and (D) Stating that it would be very hard to give up entirely. Results: Significantly fewer coffee drinkers started use within 30 min of awakening compared with all other products. The first use of the day was found to be more important for snus users compared with other products. On HSI there was no difference between snus and cigarettes. Snus and cigarettes were rated as being more difficult to give up than NR and coffee. Conclusion: Dependence to traditional cigarettes and snus seem to be relatively similar while NR was rated lower and coffee lowest. Since the prevalence of caffeine use in all forms is so much more prevalent than nicotine there might be more persons in the society heavily dependent on caffeine. Implication: Tobacco products are likely more dependence forming than NR products and coffee although there might be more people dependent on caffeine. The addiction to coffee or caffeine is seldom discussed in the society probably because of the little or no harm it causes. Funding: The Snus Commission in Sweden (snuskommissionen) funded the data collection. No funding used for the analysis and writing of manuscript.

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Uptake and Perceptions of E-cigarette use in Vascular Patients

The Journal of Smoking Cessation ◽

10.1017/jsc.2018.17 ◽

2018 ◽

Vol 14 (2) ◽

pp. 83-87

Author(s):

Rachael Taylor ◽

David Sidloff ◽

Robert D. Sayers ◽

Matthew J. Bown ◽

Athanasios Saratzis

Keyword(s):

Smoking Cessation ◽

Risk Group ◽

Electronic Cigarettes ◽

High Risk Group ◽

Cigarette Use ◽

Structured Interviews ◽

Tobacco Products ◽

Patterns Of Use ◽

Initial Interviews

Introduction: Smoking is one of the most important risk factors for cardiovascular disease (CVD). Electronic cigarettes (e-cigarettes) are becoming increasingly popular. However, little is known regarding their patterns of use in patients with established CVD.Aims: We aimed to assess the perceptions and patterns of use of e-cigarettes in patients presenting to a vascular clinic.Methods: We performed a qualitative study to identify perceptions and beliefs about e-cigarettes. Semi-structured interviews of consecutive patients consenting to participate were performed over five-months. Individuals were recruited from a vascular surgery outpatient clinic. Initial interviews were based on a questionnaire. Further structured interviews were conducted with patients currently using e-cigarettes, which were transcribed and analysed to assess perceptions and patterns of use.Results/Findings: Four overarching themes emerged: attraction to e-cigarettes as a harm reduction/smoking cessation strategy; uncertainty regarding the risks of e-cigarettes; use of various types of smoking cessation strategies; dual use and often complete relapse to tobacco products.Conclusions: Patients with established CVD view e-cigarettes as a means of smoking cessation; however, many relapse to tobacco products or use both simultaneously. Further research is necessary regarding the role of e-cigarettes in smoking cessation in this high-risk group.

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Instruments to Measure E-Cigarette Related Constructs: A Systematic Review

10.21203/rs.3.rs-496491/v1 ◽

2021 ◽

Author(s):

Eunhee Park ◽

Misol Kwon ◽

Thomas Chacko ◽

Maciej Goniewicz ◽

Chin-Shang Li ◽

...

Keyword(s):

Systematic Review ◽

Content Validity ◽

Web Of Science ◽

Electronic Cigarettes ◽

Cigarette Use ◽

Public Attention ◽

Validation Process ◽

Cronbach’S Alpha ◽

Tobacco Products ◽

Cronbach's Alpha

Abstract Background Electronic cigarettes (e-cigarettes) are relatively new tobacco products that are attracting public attention due to their unique features, especially their many flavor options and their potential as an alternative to cigarettes. However, uncertainties remain regarding the determinants and consequences of e-cigarette use because current research on e-cigarettes is made more difficult due to the lack of valid and reliable instruments that measure e-cigarette related constructs. This systematic review therefore seeks to identify the instruments proposed by researchers in the field that are designed to assess various aspects of e-cigarette use or its related constructs and analyze the evidence presented regarding the psychometric properties of the identified instruments.Methods This systematic review utilized six search engines: PubMed, Medline, CINAHL, PsycINFO, Web of Science, and EMBASE, to identify articles published in the peer-reviewed journals from inception to June 2018 that contained development or validation processes for these instruments.Results Eighteen articles describing the development or validation of 20 unique instruments were identified. Beliefs, perception, motive, e-cigarette use, and dependence, were the most commonly assessed e-cigarette related constructs. The included studies reported either construct or criterion validity, with 14 studies reporting both. Most studies did not report the content validity; for reliability, most reported internal consistencies using Cronbach’s alpha, with 15 instruments reporting Cronbach’s alpha > 0.70 for the scale or its subscales.Conclusions Twenty instruments with a reported development or validation process to measure e-cigarette related constructs are currently available for practitioners and researchers.

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Comparing Factors Related to Any Conventional Cigarette Smokers, Exclusive New Alternative Product Users, and Non-Users among Japanese Youth: A Nationwide Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17093128 ◽

2020 ◽

Vol 17 (9) ◽

pp. 3128 ◽

Cited By ~ 1

Author(s):

Yuki Kuwabara ◽

Aya Kinjo ◽

Maya Fujii ◽

Aya Imamoto ◽

Yoneatsu Osaki ◽

...

Keyword(s):

Electronic Cigarettes ◽

Multivariable Analysis ◽

Nationwide Survey ◽

Public Health Issue ◽

Cigarette Use ◽

Cigarette Smokers ◽

Tobacco Products ◽

Alternative Product ◽

Japanese Youth ◽

The Impact

The impact of heated-tobacco-products (HTPs) and electronic cigarettes (e-cigarettes) on youth is a controversial public health issue, as it is unknown whether alternative products result in more youth using such products or smoking. In Japan, e-cigarettes with nicotine are prohibited, but e-cigarettes without nicotine are available. HTPs are marketed as tobacco products. Within this unique context, we aimed to compare any conventional cigarette smokers (including those who also used alternative products) with exclusive users of alternative products and examine factors relating to their use in Japan. In 2017, 22,275 students in grades 7–9 (age 12–15) and 42,142 in grades 10–12 (age 15–18) nationwide were surveyed. Overall, 1.8% were current users of any of the three products over the last month. Multivariable analysis revealed that risk factors for alternative product use were the same as those for cigarette use. Among all users, exclusive new product users were more likely to participate in club activities and intend to continue to higher education; any conventional cigarette users (including those who also used alternative products) were more likely to be exposed to secondhand smoke at home and to drink alcohol. Reducing adult smoking and disseminating health education remain relevant as strategies for preventing adolescents’ future tobacco use.

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Comparison of Urinary Biomarkers of Exposure in Humans Using Electronic Cigarettes, Combustible Cigarettes, and Smokeless Tobacco

Nicotine & Tobacco Research ◽

10.1093/ntr/nty089 ◽

2018 ◽

Vol 21 (9) ◽

pp. 1228-1238 ◽

Cited By ~ 25

Author(s):

Pawel Lorkiewicz ◽

Daniel W Riggs ◽

Rachel J Keith ◽

Daniel J Conklin ◽

Zhengzhi Xie ◽

...

Keyword(s):

Smokeless Tobacco ◽

First Generation ◽

Disease Risk ◽

Electronic Cigarettes ◽

Cardiovascular Disease Risk ◽

Urinary Metabolites ◽

Cigarette Use ◽

Tobacco Products ◽

Urinary Levels ◽

Methylhippuric Acid

Abstract Background Cigarette smoking is associated with an increase in cardiovascular disease risk, attributable in part to reactive volatile organic chemicals (VOCs). However, little is known about the extent of VOC exposure due to the use of other tobacco products. Methods We recruited 48 healthy, tobacco users in four groups: cigarette, smokeless tobacco, occasional users of first generation e-cigarette and e-cigarette menthol and 12 healthy nontobacco users. After abstaining for 48 h, tobacco users used an assigned product. Urine was collected at baseline followed by five collections over a 3-h period to measure urinary metabolites of VOCs, nicotine, and tobacco alkaloids. Results Urinary levels of nicotine were ≃2-fold lower in occasional e-cigarette and smokeless tobacco users than in the cigarette smokers; cotinine and 3-hydroxycotinine levels were similar in all groups. Compared with nontobacco users, e-cigarette users had higher levels of urinary metabolites of xylene, cyanide, styrene, ethylbenzene, and benzene at baseline and elevated urinary levels of metabolites of xylene, N,N-dimethylformamide, and acrylonitrile after e-cigarette use. Metabolites of acrolein, crotonaldehyde, and 1,3-butadiene were significantly higher in smokers than in users of other products or nontobacco users. VOC metabolite levels in smokeless tobacco group were comparable to those found in nonusers with the exception of xylene metabolite—2-methylhippuric acid (2MHA), which was almost three fold higher than in nontobacco users. Conclusions Smoking results in exposure to a range of VOCs at concentrations higher than those observed with other products, and first generation e-cigarette use is associated with elevated levels of N,N-dimethylformamide and xylene metabolites. Implications This study shows that occasional users of first generation e-cigarettes have lower levels of nicotine exposure than the users of combustible cigarettes. Compared with combustible cigarettes, e-cigarettes, and smokeless tobacco products deliver lower levels of most VOCs, with the exception of xylene, N,N-dimethylformamide, and acrylonitrile, whose metabolite levels were higher in the urine of e-cigarette users than nontobacco users. Absence of anatabine in the urine of e-cigarette users suggests that measuring urinary levels of this alkaloid may be useful in distinguishing between users of e-cigarettes and combustible cigarettes. However, these results have to be validated in a larger cohortcomprised of users of e-cigarettes of multiple brands.

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Electronic Cigarettes: Their Role in the Lives of College Students

Journal of Pharmacy Practice ◽

10.1177/08971900211026841 ◽

2021 ◽

pp. 089719002110268

Author(s):

Carla Daniel ◽

Christa Haddad ◽

Jamie L. McConaha ◽

Philip Lunney

Keyword(s):

United States ◽

College Students ◽

Smoking Cessation ◽

Healthcare Professionals ◽

Electronic Cigarettes ◽

The United States ◽

Descriptive Statistics ◽

Cigarette Use ◽

Tobacco Products ◽

High Prevalence

Background: Electronic cigarettes have increased in popularity amongst college-aged adults. Although often advertised as smoking cessation tools, students have taken to them as their primary exposure to nicotine. For many reasons, e-cigarettes are extremely convenient and have become the most common tobacco products among this generation. Objective: To assess perceptions and reasons for e-cigarette use in college students Methods: A 20 question online Qualtrics® survey was distributed to college students aged 18 and above across the United States. All responses were anonymous and data were analyzed using quantitative and qualitative inferential and descriptive statistics. Results: Of those who used e-cigarettes, 67.7% are not likely to smoke when they are upset or sad, 56.8% disagree that stress is a factor, and 83.5% cited that alcohol was involved when smoking. Most respondents, 74% (n = 467), associated smoking with emotions of happiness, joy or peace. 43.7% who associated e-cigarettes with happiness or peace were more likely to agree that stress was an influence versus 26.5% for those who did not (p = 0.004). Conclusion: Results show a high prevalence of e-cigarette usage among college-aged students. Emotional pleasurable connections with e-cigarettes, similar to traditional cigarettes, play a role in their use. This information will allow healthcare professionals to tailor educational messages surrounding cessation.

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Original Paper: Informing Young Adults about the Risks of Using Electronic Cigarettes: A Pilot Study of an Informational Mobile Phone Text Messaging Program (Preprint)

10.2196/preprints.11059 ◽

2018 ◽

Author(s):

Karen Sue Calabro ◽

Georges E Khalil ◽

Minxing Chen ◽

Cheryl L Perry ◽

Alexander V Prokhorov

Keyword(s):

Young Adults ◽

Risk Perception ◽

Pilot Study ◽

Text Messaging ◽

Text Messages ◽

Delivery Mode ◽

Cigarette Use ◽

Tobacco Products ◽

Health Claims Data ◽

The Impact

BACKGROUND Young adults are rapidly adopting electronic cigarette (e-cigarette) use. E-cigarettes’ popularity among young people can be attributed to heavy industry advertising and misleading health claims. Data indicate young e-cigarette users who never used conventional cigarettes are now progressing toward smoking combustible cigarettes. Literature documents the influence of text messaging as a delivery mode to support participants in behavioral interventions. Communicating e-cigarette risks via text messaging has not been tested. OBJECTIVE This pilot study assessed the impact of exposure to text messages on e-cigarette knowledge and risk perception outcomes. METHODS A 2-group randomized pretest and posttest study was conducted among young men and women recruited from vocational training programs. Personal phones were used to receive messages and 95 racially and ethnically diverse participants completed a pretest and posttest. Fifty percent were randomized to either receive gain- or loss-framed messages that integrated the latest scientific findings about e-cigarettes. All messages used wording suitable for audiences with low health literacy. Knowledge and risk perceptions about e-cigarettes and tobacco use were assessed pretest and posttest after message exposure. RESULTS The mean age of participants was 20.8 (SD = 1.7). At pretest, approximately 10.5% of the (n=10/95) participants were current e-cigarette users, and 27.4% (n=26/95) used a variety of tobacco products. Participants randomized to gain-framed messages reported a statistically significant higher risk perception for using e-cigarettes at posttest than those who received loss-framed messages (P = .018). After message exposure there was no change in use of e-cigarettes or other tobacco products. CONCLUSIONS Young adults were informed that e-cigarette use may lead to addiction to nicotine and other consequences. Delivery of effective text messages such as those tested in this pilot can assist young consumers to evaluate and make decisions about e-cigarettes and other evolving tobacco products. CLINICALTRIAL This was a pilot study and not a clinical trial, thus the project was not registered.

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Use of Electronic Cigarettes and Other Tobacco Products Among Active Component Services Members

Military Medicine ◽

10.1093/milmed/usab252 ◽

2021 ◽

Author(s):

Sierra Smucker ◽

Sarah O Meadows ◽

Robin Beckman

Keyword(s):

Health Behaviors ◽

Active Component ◽

Electronic Cigarettes ◽

Service Members ◽

Cigarette Use ◽

Physical And Mental Health ◽

Dual Use ◽

Tobacco Products ◽

Health Related Behaviors ◽

Health Related

ABSTRACT Introduction e-cigarettes have been touted as a safer alternative to classic cigarettes and other combustible tobacco products. However, a growing body of evidence finds that any risk reduction associated with e-cigarette use is eliminated when individuals use “both” e-cigarettes and other tobacco products. Recent analyses from the Health Related Behaviors Survey suggest that rates of e-cigarette use are higher among active component service members than in the general population. However, little is known about the frequency and health behaviors associated with the dual use of e-cigarettes and other tobacco products among service members. Data and Method Using data from the 2018 Health Related Behaviors Survey, this paper investigates whether active component service members who use both e-cigarettes and other tobacco products are more likely to engage in other types of substance use or negative health behaviors. Results We find that the dual use of e-cigarettes and other tobacco products is associated with poorer physical and mental health, higher rates of alcohol misuse, and higher rates of insufficient sleep. Conclusion The association between the dual use of e-cigarettes and tobacco products suggests that these individuals represent an important target group for health-related resources and attention in DoD.

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IQOS point-of-sale marketing strategies at a time of legislation transition in Israel

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.185 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

Y Bar Zeev ◽

C Berg ◽

L C Abroms ◽

H Levine

Keyword(s):

Electronic Cigarettes ◽

Economic Status ◽

Marketing Strategies ◽

Tobacco Products ◽

Point Of Sale ◽

Plain Packaging ◽

Socio Economic Status ◽

Philip Morris ◽

Regulatory Measures ◽

Promotional Strategies

Abstract Background Heated tobacco products (HTP), such as Philip Morris IQOS, have penetrated the global tobacco market. Currently the only HTP on the market in Israel, IQOS was introduced in 2016. The device is sold in specialty stores and online; while the heat sticks (HEETS) are sold at traditional retailers. In 01/2019 a ban on advertisements in all media (excluding print media) and at the point-of-sale (POS) went into effect. In 01/2020, a POS display ban and plain packaging went into effect. Understanding the POS marketing strategies at a time of regulatory transition could aid regulatory efforts in other countries. Methods Observations were conducted in 80 retailers carrying HEETS in 4 large Israeli cities in 12/2019, before the POS display ban and plain packaging went into effect. Data were collected using an adapted version of the Standardized Tobacco Assessment for Retail Settings, which assessed store characteristics, product offerings, pricing, promotional strategies, and placement. Results All retailers sold cigarettes; 51% carried also electronic cigarettes. Only one retailer carried the IQOS device. HEETS packages were visible to customers in 47% of retailers. Over 60% carried at least 3 HEETS different flavours (out of 5 available). In all but one retailer, HEETS were sold at higher prices than cigarettes, on average 21% more expensive. Posted ads were uncommon. In 14.5% of retailers, a special IQOS product display cast was prominent. Additionally, 25% of retailers placed cigarettes and 14% placed HEETS near youth-oriented merchandise. Conclusions This study provides insights into IQOS marketing strategies during a period of regulatory transition. Findings suggest that IQOS-specific promotions were not common, but a proportion of retailers highlighted IQOS via displays and/or proximity to youth-oriented merchandise. Moreover, IQOS may be promoted to higher socio-economic status populations, as indicated by pricing and possibly by availability of products. Key messages Understanding IQOS marketing strategies at point-of-sale is critical to inform regulatory measures globally. IQOS marketing strategies in Israel at the point-of-sale suggest that IQOS is promoted to higher socio-economic status populations.

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