RESUMO
OBJECTIVES: The illicit cigarette trade endangers public health because it increases access to cheaper tobacco products, hence fueling the tobacco epidemic and undermining tobacco control policies. The objective of this study was to evaluate the execution of an illicit cigarette eradication program under the jurisdiction of the local government in Indonesia. We sought to provide insights into the effectiveness of current policies and their impact on the illicit cigarette trade in line with the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) protocol to eliminate illicit trade in tobacco products. METHODS: We conducted semistructured interviews with key policy-makers and semistructured FGDs with consumers and small- to medium-scale cigarette manufacturers at the district level. We indentified Pasuruan and Kudus as the districts or cities with the highest proportion of DBH CHT, and Jepara and Malang as a district with a highest illicit cigarette incident. We used reflective thematic analysis to identify the important opportunities and challenges facing illicit cigarette eradication programs in the three districts. RESULTS: We identified four opportunities and four challenges related to illicit cigarette eradication program implementation under the local government. The opportunities for illicit cigarette eradication lie in strong central government regulatory and multisectoral authority support, consumer awareness, and local governments' commitment to tobacco supply chain control. The key challenges facing illicit cigarette eradication include ineffective public dissemination programs, rapidly changing regulatory designs, consumers' preferences for illicit products, and a lack of industrial involvement in tobacco supply chain control programs. CONCLUSION: In addition to significant budget allocation and increasing consumer awareness, local programs to eradicate illicit cigarette production require considerable evaluation to rethink the program's design and external stakeholders' engagement within the local government's scope.
Assuntos
Comércio , Impostos , Produtos do Tabaco , Humanos , Produtos do Tabaco/economia , Produtos do Tabaco/legislação & jurisprudência , Impostos/economia , Indonésia/epidemiologia , Comércio/economia , Pesquisa Qualitativa , Indústria do Tabaco/economia , Indústria do Tabaco/legislação & jurisprudência , Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/métodos , Crime/prevenção & controle , Crime/economia , Fumar/epidemiologia , Fumar/economiaRESUMO
BACKGROUND: Tobacco control investment cases analyse the health and socioeconomic costs of tobacco use and the benefits that can be achieved from implementing measures outlined in the WHO Framework Convention on Tobacco Control (WHO FCTC). They are intended to provide policy-makers and other stakeholders with country-level evidence that is relevant, useful and responsive to national priorities and policy context. METHODS: This paper synthesises findings from investment cases conducted in Armenia, Cabo Verde, Cambodia, Chad, Colombia, Costa Rica, El Salvador, Eswatini, Georgia, Ghana, Jordan, Laos, Madagascar, Myanmar, Nepal, Samoa, Sierra Leone, Sri Lanka, Suriname, Tunisia and Zambia. We examine annual socioeconomic costs associated with tobacco use, focusing on smoking-related healthcare expenditures, the value of lives lost due to tobacco-related mortality and workplace productivity losses due to smoking. We explore potential benefits associated with WHO FCTC tobacco demand-reduction measures. RESULTS: Tobacco use results in average annual socioeconomic losses of US$95 million, US$610 million and US$1.6 billion among the low-income (n=3), lower-middle-income (n=12) and upper-middle-income countries (n=6) included in this analysis, respectively. These losses are equal to 1.1%, 1.8% and 2.9% of average annual national gross domestic product, respectively. Implementation and enforcement of WHO FCTC tobacco demand-reduction measures would lead to reduced tobacco use, fewer tobacco-related deaths and reduced socioeconomic losses. CONCLUSIONS: WHO FCTC tobacco control measures would provide a positive return on investment in every country analysed.
Assuntos
Países em Desenvolvimento , Prevenção do Hábito de Fumar , Organização Mundial da Saúde , Gastos em Saúde/estatística & dados numéricos , Fumar/economia , Fumar/epidemiologia , Abandono do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/legislação & jurisprudência , Fatores Socioeconômicos , Controle do Tabagismo , Local de TrabalhoRESUMO
BACKGROUND: More than 80% of the world's 1.3 billion tobacco users live in low-income and middle-income countries (LMICs), where progress to address tobacco and its harms has been slow. The perception that tobacco control detracts from economic priorities has impeded progress. The Secretariat of the WHO Framework Convention on Tobacco Control (FCTC) is leading the FCTC 2030 project, which includes technical assistance to LMICs to analyse the economic costs of tobacco use and the benefits of tobacco control. METHODS: The Secretariat of the WHO FCTC, United Nations Development Programme and WHO supported 21 LMICs between 2017 and 2022 to complete national investment cases to guide country implementation of the WHO FCTC, with analytical support provided by RTI International. These country-level cases combine customised estimates of tobacco's economic impact with qualitative analysis of socio-political factors influencing tobacco control. This paper overviews the approach, observed tobacco control advancements and learnings from 21 countries: Armenia, Cabo Verde, Cambodia, Chad, Colombia, Costa Rica, El Salvador, Eswatini, Georgia, Ghana, Jordan, Laos, Madagascar, Myanmar, Nepal, Samoa, Sierra Leone, Sri Lanka, Suriname, Tunisia and Zambia. RESULTS: Tobacco control advancements in line with investment case findings and recommendations have been observed in 17 of the 21 countries, and many have improved collaboration and policy coherence between health and economic stakeholders. CONCLUSIONS: Tobacco control must be seen as more than a health concern. Tobacco control leads to economic benefits and contributes to sustainable development. National investment cases can support country ownership and leadership to advance tobacco control.
Assuntos
Países em Desenvolvimento , Prevenção do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/legislação & jurisprudência , Controle do Tabagismo , Uso de Tabaco/prevenção & controle , Uso de Tabaco/economia , Organização Mundial da SaúdeRESUMO
BACKGROUND: Across time, geographies and country income levels, smoking prevalence is highest among people with lower incomes. Smoking causes further impoverishment of those on the lower end of the income spectrum through expenditure on tobacco and greater risk of ill health. METHODS: This paper summarises the results of investment case equity analyses for 19 countries, presenting the effects of increased taxation on smoking prevalence, health and expenditures. We disaggregate the number of people who smoke, smoking-attributable mortality and cigarette expenditures using smoking prevalence data by income quintile. A uniform 30% increase in price was applied across countries. We estimated the effects of the price increase on smoking prevalence, mortality and cigarette expenditures. RESULTS: In all but one country (Bhutan), a one-time 30% increase in price would reduce smoking prevalence by the largest percent among the poorest 20% of the population. All income groups in all countries would spend more on cigarettes with a 30% increase in price. However, the poorest 20% would pay an average of 12% of the additional money spent. CONCLUSIONS: Our results confirm that health benefits from increases in price through taxation are pro-poor. Even in countries where smoking prevalence is higher among wealthier groups, increasing prices can still be pro-poor due to variable responsiveness to higher prices. The costs associated with higher smoking prevalence among the poor, together with often limited access to healthcare services and displaced spending on basic needs, result in health inequality and perpetuate the cycle of poverty.
Assuntos
Comércio , Fumar , Impostos , Produtos do Tabaco , Humanos , Impostos/economia , Impostos/estatística & dados numéricos , Produtos do Tabaco/economia , Prevalência , Comércio/estatística & dados numéricos , Comércio/economia , Fumar/epidemiologia , Fumar/economia , Organização Mundial da Saúde , Renda/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Prevenção do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar/economia , Pobreza/estatística & dados numéricosAssuntos
Política Antifumo , Prevenção do Hábito de Fumar , Fumar , Poluição por Fumaça de Tabaco , Humanos , Política Antifumo/economia , Política Antifumo/legislação & jurisprudência , Política Antifumo/tendências , Fumar/economia , Fumar/legislação & jurisprudência , Fumar/mortalidade , Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/legislação & jurisprudência , Prevenção do Hábito de Fumar/tendências , Poluição por Fumaça de Tabaco/economia , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Poluição por Fumaça de Tabaco/prevenção & controle , Prática Clínica Baseada em EvidênciasRESUMO
BACKGROUND: Tobacco consumption is one of the leading causes of preventable death. In this study, we analyze whether someone's genetic predisposition to smoking moderates the response to tobacco excise taxes. METHODS: We interact polygenic scores for smoking behavior with state-level tobacco excise taxes in longitudinal data (1992-2016) from the US Health and Retirement Study (N = 12,058). RESULTS: Someone's genetic propensity to smoking moderates the effect of tobacco excise taxes on smoking behavior along the extensive margin (smoking vs. not smoking) and the intensive margin (the amount of tobacco consumed). In our analysis sample, we do not find a significant gene-environment interaction effect on smoking cessation. CONCLUSIONS: When tobacco excise taxes are relatively high, those with a high genetic predisposition to smoking are less likely (i) to smoke, and (ii) to smoke heavily. While tobacco excise taxes have been effective in reducing smoking, the gene-environment interaction effects we observe in our sample suggest that policy makers could benefit from taking into account the moderating role of genes in the design of future tobacco control policies.
Assuntos
Abandono do Hábito de Fumar/psicologia , Prevenção do Hábito de Fumar/métodos , Fumar/genética , Bases de Dados Factuais , Predisposição Genética para Doença , Humanos , Nicotina/efeitos adversos , Nicotina/economia , Política Pública/economia , Fumar/economia , Fumar/psicologia , Abandono do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/economia , Impostos/economia , Impostos/tendências , Nicotiana/efeitos adversos , Indústria do Tabaco/tendências , Produtos do Tabaco , Fumar Tabaco/psicologia , Uso de Tabaco/economia , Estados UnidosAssuntos
Epidemias/estatística & dados numéricos , Uso de Tabaco/epidemiologia , Organização Mundial da Saúde , Sistemas Eletrônicos de Liberação de Nicotina/economia , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Epidemias/prevenção & controle , Saúde Global , Humanos , Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/estatística & dados numéricos , Produtos do Tabaco/economia , Produtos do Tabaco/estatística & dados numéricos , Uso de Tabaco/prevenção & controleAssuntos
Financiamento Governamental , Saúde Global/economia , Cooperação Internacional , Abandono do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/economia , Indústria do Tabaco/economia , Comércio/economia , Comércio/legislação & jurisprudência , Saúde Global/legislação & jurisprudência , Regulamentação Governamental , Humanos , Cooperação Internacional/legislação & jurisprudência , Formulação de Políticas , Abandono do Hábito de Fumar/legislação & jurisprudência , Prevenção do Hábito de Fumar/legislação & jurisprudência , Indústria do Tabaco/legislação & jurisprudênciaRESUMO
OBJECTIVE: Active smoking among patients undergoing interventions for intermittent claudication (IC) is associated with poor outcomes. Notwithstanding, current levels of active smoking in these patients are high. State-level tobacco control policies have been shown to reduce smoking in the general US population. We evaluated whether state cigarette taxes and 100% smoke-free workplace legislation are associated with active smoking among patients undergoing interventions for IC. METHODS: We queried the Vascular Quality Initiative database for peripheral endovascular interventions, infrainguinal bypasses, and suprainguinal bypasses for IC. Active smoking at the time of intervention was defined as smoking within one month of intervention. We implemented difference-in-differences analysis to isolate changes in active smoking owing to cigarette taxes (adjusted for inflation) and implementation of smoke-free workplace legislation. The difference-in-differences models estimated the causal effects of tobacco policies by adjusting for concurrent temporal trends in active smoking unrelated to cigarette taxes or smoke-free workplace legislation. The models controlled for age, sex, race/ethnicity, insurance type, diabetes, chronic obstructive pulmonary disease, state, and year. We tested interactions of taxes with age and insurance. RESULTS: Data were available for 59,847 patients undergoing interventions for IC in 25 states from 2011 to 2019. Across the study period, active smoking at the time of intervention decreased from 48% to 40%. Every $1.00 cigarette tax increase was associated with a 6-percentage point decrease in active smoking (95% confidence interval, -10 to -1 percentage points; P = .02), representing an 11% decrease relative to the baseline proportion of patients actively smoking. The effect of cigarettes taxes was greater in older patients and those on Medicare. Among patients aged 60 to 69 and 70 to 79 years, every $1.00 tax increase resulted in 14% and 21% reductions in active smoking relative to baseline subgroup prevalences of 53% and 29%, respectively (P < .05 for both); however, younger age groups were not affected by tax increases. Among insurance groups, only patients on Medicare exhibited a significant change in active smoking with every $1.00 tax increase (an 18% decrease relative to a 33% baseline prevalence; P = .01). The number of states implementing smoke-free workplace legislation increased from 9 to 14 by 2019; however, this policy was not significantly associated with active smoking prevalence. At follow-up (median, 12.9 months), $1.00 tax increases were still associated with decreased smoking prevalence (a 25% decrease relative to a 33% baseline prevalence; P < .001). CONCLUSIONS: Cigarette tax increases seem to be an effective strategy to decrease active smoking among patients undergoing interventions for IC. Older patients and Medicare recipients are the most responsive to tax increases.
Assuntos
Claudicação Intermitente/terapia , Doença Arterial Periférica/terapia , Abandono do Hábito de Fumar , Prevenção do Hábito de Fumar , Fumar/efeitos adversos , Produtos do Tabaco/efeitos adversos , Local de Trabalho , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Regulamentação Governamental , Humanos , Claudicação Intermitente/diagnóstico , Claudicação Intermitente/epidemiologia , Masculino , Medicare , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/epidemiologia , Formulação de Políticas , Prevalência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Política Antifumo/economia , Política Antifumo/legislação & jurisprudência , Fumar/economia , Fumar/epidemiologia , Fumar/legislação & jurisprudência , Abandono do Hábito de Fumar/economia , Abandono do Hábito de Fumar/legislação & jurisprudência , Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/legislação & jurisprudência , Impostos , Produtos do Tabaco/economia , Produtos do Tabaco/legislação & jurisprudência , Estados Unidos/epidemiologia , Local de Trabalho/legislação & jurisprudênciaRESUMO
OBJECTIVES: The current research aims to study the impact of raising tobacco tax and implementation of plain packaging on male smokers' quitting intentions in Saudi Arabia. METHODS: The study adopts a quantitative approach where close-ended questionnaires are distributed among 1,015 male participants from different regions of Riyadh city, Saudi Arabia. Bivariate analysis and logistic regression analysis are conducted using SPSS software to analyze the collected primary data. RESULTS: The study found a significant association of taxation and plain packaging on the quitting intentions of smokers. On taxation, while a considerable number of participants (46.5%) stated that they would not quit smoking if the cigarette prices increased, participants who were planning to give up smoking said it would strengthen their intention (p less than 0.001). In addition, logistic regression was performed to identify the independent predictors of quitting intention. Participants who did not want to apply the concept of plain packaging to Saudi Arabia were more likely to have quitting intention (odds ratio: 2.30 [1.61-3.28]) in comparison to those who wanted to apply the concept. CONCLUSION: Although the current price of cigarette packs reported to be very high by the participants, imposing a new higher tax may motivate smokers who had plans to quit in the near future. Plain packaging seems to be an effective new strategy in addition to tobacco taxation in Saudi Arabia, yet, more time and further research are required to assess the effectiveness of the strategy.
Assuntos
Atitude Frente a Saúde , Intenção , Embalagem de Produtos , Abandono do Hábito de Fumar/psicologia , Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/métodos , Impostos , Produtos do Tabaco/economia , Fumar Tabaco/economia , Fumar Tabaco/psicologia , Uso de Tabaco/economia , Uso de Tabaco/prevenção & controle , Adulto , Estudos Transversais , Humanos , Masculino , Arábia Saudita , Inquéritos e Questionários , Impostos/economia , Impostos/estatística & dados numéricosRESUMO
The 2012 Philippine Sin Tax Reform Law or Republic Act No. 10351 (RA10351) offers important lessons on tobacco taxation and tobacco control. In a span of five years, it increased the excise tax rate on cigarettes to as high as 1000% for low-priced brands. It is recognized by the international community not only because of the magnitude of the tobacco tax increase that it stipulated but also because of the challenging context within which it was achieved. This article presents the Philippine experience as a case study in pursuing bold reforms in tobacco taxation and tobacco control amidst strong opposition by the tobacco industry. It considers: 1) the key events and factors that led to successful reform of the Philippine tobacco tax system; 2) the impact of higher tobacco taxes on health and the economy; and 3) the emerging challenges in tobacco taxation in the Philippines.
.
Assuntos
Comércio/economia , Prevenção do Hábito de Fumar/métodos , Fumar/epidemiologia , Impostos/legislação & jurisprudência , Indústria do Tabaco/legislação & jurisprudência , Produtos do Tabaco/economia , Uso de Tabaco/prevenção & controle , Humanos , Filipinas/epidemiologia , Fumar/economia , Prevenção do Hábito de Fumar/economia , Impostos/economia , Indústria do Tabaco/economia , Uso de Tabaco/economiaRESUMO
In accordance with the provisions of the WHO Framework Convention on Tobacco Control (FCTC), each country shall promote and strengthen public awareness of tobacco control issues (Article 12). Many parties to the FCTC have adopted national tobacco control programs to organize their tobacco control activities. The aim of our study was to analyze the organization and funding of the Polish Tobacco Control Program in years 2000-2018. Document analysis of The Program and reports from its implementation were performed in accordance to the Agency for Health Technology Assessment in Poland (AHTAPol) recommendations and the WHO FCTC guidelines for Article 12 implementation. Spending was also analyzed. The study showed both inadequate planning of and funding for Polish Tobacco Control Program. The Program was developed without use of best practices detailed in the WHO FCTC guidelines as well as in national guidelines prepared by AHTAPol. The experience of Poland shows that although earmarking tobacco taxes has existed in the law, it has been largely ineffective due to the poor Tobacco Control Program design and insufficient funding resulting from a poor execution of the earmarking law. This may be a warning to other countries to strive to create law, compliance with which can be verified and controlled.
Assuntos
Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/organização & administração , Indústria do Tabaco/legislação & jurisprudência , Polônia , Fumar , Nicotiana , Organização Mundial da SaúdeRESUMO
INTRODUCTION: Tobacco control programs and policies reduce tobacco use and prevent health and economic harms. The majority of tobacco control programs and policies in the United States are implemented at local and state levels. Yet the literature on state-level initiatives reports a limited set of outcomes. To facilitate decision-making that is increasingly focused on costs, we provide estimates of a broader set of measures of the impact of tobacco control policy, including smoking prevalence, disease events, deaths, medical costs, productivity and tobacco tax revenues, using the experience of Minnesota as an example. METHODS: Using the HealthPartners Institute's ModelHealth™: Tobacco MN microsimulation, we assessed the impact of the stream of tobacco control expenditures and cigarette price increases from 1998 to 2017. We simulated 1.3 million individuals representative of the Minnesota population. RESULTS: The simulation estimated that increased expenditures on tobacco control above 1997 levels prevented 38,400 cancer, cardiovascular, diabetes and respiratory disease events and 4,100 deaths over 20 years. Increased prices prevented 14,600 additional events and 1,700 additional deaths. Both the net increase in tax revenues and the reduction in medical costs were greater than the additional investments in tobacco control. CONCLUSION: Combined, the policies address both short-term and long-term goals to reduce the harms of tobacco by helping adults who wish to quit smoking and deterring youth from starting to smoke. States can pay for initial investments in tobacco control through tax increases and recoup those investments through reduced expenditures on medical care.
Assuntos
Comércio/economia , Prevenção do Hábito de Fumar/economia , Impostos/legislação & jurisprudência , Produtos do Tabaco/economia , Fumar Tabaco/prevenção & controle , Adolescente , Adulto , Criança , Comércio/história , Comércio/legislação & jurisprudência , Comércio/estatística & dados numéricos , Simulação por Computador , Feminino , Política Fiscal/história , Gastos em Saúde/história , Gastos em Saúde/estatística & dados numéricos , História do Século XX , História do Século XXI , Humanos , Masculino , Minnesota/epidemiologia , Modelos Biológicos , Modelos Econômicos , Mortalidade/história , Prevalência , Prevenção do Hábito de Fumar/história , Prevenção do Hábito de Fumar/métodos , Impostos/história , Produtos do Tabaco/efeitos adversos , Produtos do Tabaco/história , Produtos do Tabaco/legislação & jurisprudência , Fumar Tabaco/efeitos adversos , Fumar Tabaco/economia , Fumar Tabaco/epidemiologia , Adulto JovemAssuntos
Política Antifumo/legislação & jurisprudência , Prevenção do Hábito de Fumar/métodos , Fumar/epidemiologia , Poluição por Fumaça de Tabaco/prevenção & controle , Inglaterra/epidemiologia , Promoção da Saúde/economia , Promoção da Saúde/métodos , Humanos , Política Antifumo/economia , Prevenção do Hábito de Fumar/economia , Indústria do Tabaco/economia , Indústria do Tabaco/legislação & jurisprudênciaAssuntos
Prevenção do Hábito de Fumar/organização & administração , Uso de Tabaco/epidemiologia , Uso de Tabaco/prevenção & controle , África do Norte/epidemiologia , Educação em Saúde/organização & administração , Humanos , Internacionalidade , Marketing/legislação & jurisprudência , Oriente Médio/epidemiologia , Vigilância de Evento Sentinela , Abandono do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/legislação & jurisprudência , Impostos/economia , Impostos/legislação & jurisprudência , Poluição por Fumaça de Tabaco/prevenção & controle , Organização Mundial da SaúdeRESUMO
BACKGROUND: In 2008, the World Health Organization (WHO) introduced a package of measures including 6 main policies (MPOWER) to control tobacco use. AIMS: This study aimed to perform a quantitative analysis of MPOWER in the WHO regions. METHODS: This cross-sectional study collected information in summer 2018 using pages 136-149 of the 2017 MPOWER report and a validated check list with 10 criteria, with a possible maximum score of 37. The scores were summed and presented in descending order for the 6 WHO regions. RESULTS: The highest mean score was recorded by the European Region (26.41), followed by: South-East Asia Region (25), Western Pacific Region (24.88), Region of the Americas (22.05), Eastern Mediterranean Region (21.40) and African Region (17.40). There were significant differences (P < 0.05) in the means. CONCLUSIONS: Although many efforts have been made in the Eastern Mediterranean Region, many challenges to policy implementation and enforcement remain compared with other regions, and require urgent action by governments in the Region.
Assuntos
Prevenção do Hábito de Fumar/organização & administração , Uso de Tabaco/epidemiologia , Uso de Tabaco/prevenção & controle , África do Norte/epidemiologia , Estudos Transversais , Saúde Global , Educação em Saúde/organização & administração , Política de Saúde , Humanos , Marketing/legislação & jurisprudência , Oriente Médio/epidemiologia , Vigilância de Evento Sentinela , Abandono do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/legislação & jurisprudência , Impostos/economia , Impostos/legislação & jurisprudência , Poluição por Fumaça de Tabaco/prevenção & controle , Organização Mundial da SaúdeRESUMO
BACKGROUND: Raising the prices of cigarettes is a common intervention to control tobacco use. In June 2017, Saudi Arabia imposed a 100% excise tax on tobacco products and energy drinks. AIMS: This study aimed to evaluate the impact of the increase in prices on tobacco products and the resulting cigarette smoking behaviour in Jeddah, Saudi Arabia before and after the increase in tobacco product prices. METHODS: This cross-sectional study was conducted between December 2017 and March 2018 in Saudi Arabian smokers aged 18 years and more. A validated questionnaire was distributed to a convenience sample in public places and through Twitter. The McNemar matched pairs chi-squared test was used to evaluate the self-reported difference in cigarette smoking before and after the tax came into effect. Binary logistic regression analysis was done to identify the socioeconomic and health factors associated with stopping smoking. RESULTS: In all, 376 participants (80.0% men) completed the questionnaire. A large proportion of the participants (39.6%) reported no change in their smoking behaviour after the tax was imposed, whereas 29.8% switched to cheaper brands. Before the tax, 154 participants smoked 15 cigarettes or more a day; this figure decreased to 134 after the tax (McNemar test, P < 0.001). Respondents who were married, unemployed, had a higher income or who rated their health as fair were significantly more likely to have stopped smoking after the tax. CONCLUSION: The sharp increase in cigarette prices in Saudi Arabia has led to a statistically significant reduction in smoking. Future research should assess the long-term effects of this intervention on smoking onset, prevalence and relapse.
Assuntos
Prevenção do Hábito de Fumar/organização & administração , Impostos/economia , Impostos/legislação & jurisprudência , Fumar Tabaco/economia , Fumar Tabaco/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Arábia Saudita , Abandono do Hábito de Fumar , Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/legislação & jurisprudência , Adulto JovemRESUMO
BACKGROUND: The World Health Organization (WHO) MPOWER measures are a set of highly effective tobacco control measures drawn from the WHO Framework Convention on Tobacco Control (FCTC), designed to help countries reduce the prevalence of tobacco use. The WHO Report on the Global Tobacco Epidemic is published biennially to monitor global implementation of these measures. AIMS: This review aimed to critically assess the status of MPOWER implementation in the Eastern Mediterranean Region. METHODS: Data were collected for WHO Reports on the Global Tobacco Epidemic, focusing on the most recent 2019 edition. Regional population coverage figures were calculated using this data and population figures for the countries of the Region. RESULTS: Between 2007 and 2018, for any MPOWER measure, there were 29 cases of countries progressing to the highest level of achievement; 23 cases of countries progressing to the intermediate levels from the lowest level; 12 cases of countries falling from the highest level; and 18 cases of countries falling to the lowest level. 57.7% of people are covered at the highest level for the monitoring measure; 63.7% for the smoke-free policies measure; 6.7% for the cessation measure; 60.7% for the health warnings measure; 37.4% for the mass media measure; 29.4% for the advertising bans measure; and 16.1% for the taxation measure. CONCLUSIONS: Countries must work comprehensively to improve tobacco control. Regional priorities should include lifting more people out of lowest level coverage for the health warnings and mass media measures, increasing taxation on tobacco products and improving access to cessation services.
Assuntos
Prevenção do Hábito de Fumar/organização & administração , Uso de Tabaco/epidemiologia , Uso de Tabaco/prevenção & controle , África do Norte/epidemiologia , Estudos Transversais , Saúde Global , Educação em Saúde/organização & administração , Política de Saúde , Humanos , Marketing/legislação & jurisprudência , Oriente Médio/epidemiologia , Vigilância de Evento Sentinela , Abandono do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/legislação & jurisprudência , Impostos/economia , Impostos/legislação & jurisprudência , Poluição por Fumaça de Tabaco/prevenção & controle , Organização Mundial da SaúdeRESUMO
INTRODUCTION: In 2009, New York City (NYC) restricted the sale of flavoured tobacco products. We assessed product availability as a proxy for potential non-compliance by analysing discarded cigar, cigarillo and blunt wrap packages in New York City. METHODS: A discarded cigar package survey was conducted in 2016, in a stratified random sample of 94 block groups in NYC resulting in the collection of 886 discarded cigar packages. Each package was coded for brand name, flavour description (explicit and implicit) and size. FINDINGS: Overall, 19.2% of the cigar packages were explicitly flavoured. An additional 9.4% of the packages reflected implicit flavours. Explicit flavoured cigar packages were at increased odds of being found in Staten Island (adjusted OR (AOR)=3.96, 95% CI=1.66 to 9.46), in packaging size of two or three (AOR=8.49, 95% CI=4.24 to 17.02) or four or more (AOR=4.26, 95% CI=1.95 to 9.30). CONCLUSION: Nearly one out of three cigar packages were flavoured products suggesting a problematic level of non-compliance and continued availability. Potential non-compliance is likely fueled by licensed wholesalers and retailers who continue to sell restricted flavoured products. Some retailers may be unaware that implicitly named cigars are typically flavoured and are, therefore, illegal. This lack of awareness of implicit flavoured cigars may be exacerbated by NYC's lack of education or enforcement specific to implicitly flavoured tobacco products.