Price promotion receipt and use progression of any tobacco, cigarettes, e-cigarettes and cigars among US youth between 2016 and 2018

BackgroundTobacco price promotions may prompt tobacco trials among youth. We assessed whether receiving price promotions for any tobacco, cigarettes, e-cigarettes and cigars was associated with product use progression.MethodsThe analysis included a nationally representative sample of youth never tobacco users (aged 12–16; n=9405) from wave 4 (2016–2018) of the Population Assessment of Tobacco and Health Study. We assessed past-year receipt of price promotions and use progression (initiation, current use and ever regular use) for any tobacco, cigarettes, e-cigarettes and cigars 1 year later at wave 4.5 (2017–2018). Multivariable logistic regressions were used to examine the associations between receiving price promotions and use progression by product type, controlling for covariates.ResultsAt wave 4.5, 9.4% of youth initiated any tobacco (1.8%, 7.8% and 0.9% for cigarettes, e-cigarettes and cigars), and 5.4% received any price promotions (3.8%, 3.1% and 0.9% for cigarettes, e-cigarettes and cigars). Receiving any tobacco price promotions was associated with any tobacco initiation (adjusted OR (AOR)=1.77; 95% CI 1.30 to 2.41), current use (AOR=1.54; 95% CI 1.06 to 2.23) and ever regular use (AOR=1.76; 95% CI 1.04 to 3.10). Receiving e-cigarette price promotions was associated with e-cigarette initiation (AOR=1.78; 95% CI 1.18 to 2.26), current use (AOR=1.88; 95% CI 1.17 to 3.02) and ever regular use (AOR=2.10; 95% CI 1.02 to 4.40). The associations specific to cigarettes and cigars were only found for product initiation.DiscussionReceiving price promotions for any tobacco and e-cigarettes was respectively associated with the use progression of any tobacco and e-cigarettes. Continuous monitoring of tobacco marketing activities is needed to identify youth-appealing price promotion tactics.

Smokeless Tobacco Point of Sale Advertising, Placement and Promotion: Associations With Store and Neighborhood Characteristics

Introduction: Objectives of this study were to determine retail and neighborhood characteristics associated with smokeless tobacco (ST) product promotion, price promotion, and storefront advertising among retailers in Oklahoma.Methods: In this statewide point-of-sale study, we collected data from 1,354 ST retailers. Using store characteristics and census tract information, we estimated summary statistics and adjusted prevalence ratios during 2019–2020.Results: Of ST retailers audited, 11.0% demonstrated ST youth promotion, 43.0% ST price promotions, and 19.6% ST storefront advertising. The adjusted prevalence ratio (aPR) for convenience stores was higher for all three ST strategies: youth promotion (aPR = 3.4, 95% CI 1.9, 6.2), price promotion (aPR = 3.8, 95% CI 2.9, 5.0), and storefront advertising (aPR=16.4, 95% CI 6.7, 40.3) compared to other store types. Metropolitan tobacco retailers had higher aPRs for youth promotion (aPR = 1.7, 95% CI 1.12 2.6) and storefront advertising (aPR = 1.5, 95% CI 1.2, 1.9).Conclusions: Findings of this study suggest there are currently ample opportunities for youth and adults at risk for tobacco initiation to be exposed to ST products in the retail environment. Convenience stores, more likely to be found and utilized in rural areas compared to metropolitan areas, are disproportionately more likely to engage in marketing strategies that could lure youth into trying smokeless tobacco.

PRODUTOS DO MESTRADO PROFISSIONAL: INSTRUMENTOS DE MUDANÇAS NA FORMAÇÃO E NAS PRÁTICAS PROFISSIONAIS NA PROMOÇÃO E PREVENÇÃO DO TABAGISMO

RESUMOTrata-se de um relato, que parte dos resultados obtidos na dissertação de mestrado profissional em ensino na saúde da Universidade Federal Fluminense que traz como problema o pouco envolvimento de profissionais de saúde e de alunos em formação no controle do tabagismo. Objetiva apresentar e trazer para reflexões a questão do tabagismo e as ações de promoção e prevenção a ele relacionadas, a partir de duas estratégias elaboradas com vistas a favorecer a formação e as práticas dos profissionais de saúde na Estratégia Saúde da família. Utiliza como referencial teórico metodológico a análise institucional, colocando em debates coletivos o problema do tabagismo em encontros de intervenção nos moldes da socioclínica institucional. Como resultados dos debates foram evidenciados que crianças e adolescentes eram o grupo mais vulnerável a iniciação ao tabaco e que esta temática era pouco abordada na formação. Foram elaboradas duas estratégias sendo uma delas um formulário para identificar os fumantes, quantos desejavam parar de fumar, e se tinham crianças e ou adolescentes nas famílias, e outra um curso de capacitação sobre tabagismo desenvolvido por estudantes de farmácia e aplicado aos agentes comunitários de saúde. Considera que o processo de intervenção contribuiu na elaboração dos produtos a partir das estratégias pensadas nos debates, e favoreceu mudanças na maneira dos participantes entenderem o tabagismo, enfatizando a corresponsabilidade dos serviços e do ensino na promoção e prevenção ao tabagismo. Palavras-chave: Promoção da saúde; Prevenção do hábito de fumar; Tabagismo; Pessoal de saúde; Estudantes. ABSTRACTIt is a report, that part of results achieved in the dissertation of professional masters in health education of Universidade Federal Fluminense, which brings as a problem the little involvement of health professionals and students in training in smoking control. Objective to introduce and to bring to reflections the question of smoking and the promotion and prevention actions related to it, from two elaborated strategies in order to favor the health professionals training and practices in Family Health Strategy. Used as a theoretical reference methodological an institutional analysis, putting in collective debates the smoking problem in intervention meetings in the molds of institutional socioclinical. As a result of the discussions, were evidenced that children and adolescentes were the most vulnerable group to tobacco initiation and that this theme was little approached in training. Two strategies were developed, being one of them one form to identify smokers, how many wanted to quit smoking, and if they had children and/or teens in the family, and a training course on smoking developed by pharmacy students and applied to community health agentes. Considers that the intervention process contributed in the elaboration of products from the strategies devised in debates, and favored changes at manner participants to understand smoking, emphasizing the co-responsibility of services and teaching on promotion and prevention to smoking. Key-words: Health promotion; Prevention of smoking habit; Smoking; Health staff; Students.

Welsh Primary Schoolchildren’s Perceptions of Electronic Cigarettes: A Mixed Methods Study

There are concerns that the growing popularity of e-cigarettes promotes experimentation among children. Given the influence of the early years on attitude and habit formation, better understanding of how younger children perceive vaping before experimentation begins is needed, to prevent uptake and inform tobacco control strategies. We explored Welsh primary schoolchildren’s (aged 7–11) awareness of e-cigarettes relative to tobacco smoking, their understanding of the perceived risks and benefits and their intentions and beliefs about vaping. Data was collected using a mix of methods in June and July 2017 from 8 purposively selected primary schools across Wales. Four hundred and ninety-five children (52% female) aged 7 years (n = 165), 9 years (n = 185) and 11 years (n = 145) completed a class-administered booklet encompassing a draw and write exercise and survey. Ninety-six children participated in 24 peer discussion groups comprised of 2 boys and 2 girls from each year group. Data were analysed independently and findings triangulated. Survey analyses used frequencies, descriptive statistics and chi-squared tests. Content analysis was undertaken on the draw and write data and peer discussion groups were analysed thematically. Study findings highlight that primary schoolchildren have general awareness of e-cigarettes. Vaping was perceived to be healthier than smoking and there was some recognition that e-cigarettes were used for smoking cessation. Understanding of any health harms was limited. Few children intended to smoke or vape in the future but almost half thought it was okay for grownups. Children’s perceptions were influenced by exposure through family and friends. Findings suggest a need for e-cigarette education in primary schools, to highlight the associated risks of e-cigarette experimentation including the potential for tobacco initiation.