Document analysis of the Foundation for a Smoke-Free World's scientific outputs and activities: a case study in contemporary tobacco industry agnogenesis.

BACKGROUND: Tobacco corporation Philip Morris International launched the Foundation for a Smoke-Free World (FSFW), a purportedly independent scientific organisation, in 2017. We aimed to systematically investigate FSFW's activities and outputs, comparing these with previous industry attempts to influence science, as identified in the recently developed typology of corporate influence on science, the Science for Profit Model (SPM). DESIGN: We prospectively collected data on FSFW over a 4-year period, 2017-2021, and used document analysis to assess whether FSFW's activities mirror practices tobacco and other industries have historically used to shape science in their own interests. We used the SPM as an analytical framework, working deductively to search for use of the strategies it identifies, and inductively to search for any additional strategies. RESULTS: Marked similarities between FSFW's practices and previous corporate attempts to influence science were observed, including: producing tobacco industry-friendly research and opinion; obscuring industry involvement in science; funding third parties which denigrate science and scientists that may threaten industry profitability; and promoting tobacco industry credibility. CONCLUSIONS: Our paper identifies FSFW as a new vehicle for agnogenesis, indicating that, over 70 years since the tobacco industry began to manipulate science, efforts to protect science from its interference remain inadequate. This, combined with growing evidence that other industries are engaging in similar practices, illustrates the urgent need to develop more robust systems to protect scientific integrity.

Seeking to be seen as legitimate members of the scientific community? An analysis of British American Tobacco and Philip Morris International's involvement in scientific events.

INTRODUCTION: For decades, tobacco companies manipulated and misused science. They funded and disseminated favourable research and suppressed research that showed the harms of their products, deliberately generating misinformation. While previous work has examined many of the practices involved, their engagement in scientific events has so far not been systematically studied. Here, we examine the involvement of British American Tobacco (BAT) and Philip Morris International (PMI) in scientific events, including conferences, symposia and workshops. METHODS: Our analysis involved two steps. First, we collected all available data PMI and BAT provided on their websites to identify events. Second, we extracted information about the nature of tobacco industry involvement from event websites and materials. RESULTS: We identified 213 scientific events that BAT and/or PMI representatives attended between April 2012 and September 2021. Most events took place in high-income countries in Europe and North America. They covered a diverse range of fields, including toxicology (n=60, 28.1%), medicine (n=25, 11.7%), biology (n=24, 11.3%), chemistry (n=23, 10.8%) and aerosol science (n=18, 8.5%), as well as dentistry (n=9, 4.2%), pharmaceutical science (n=8, 3.8%) and computing (n=8, 3.8%). We identified 356 posters provided by BAT and PMI that linked to 118 events (55.4%) as well as 77 presentations from 65 events (30.5%). Industry involvement through sponsorship (nine events), exhibition (three events) or organising committee (one event) was rare. CONCLUSION: BAT and PMI representatives attended a large number and wide range of scientific events. Given that scientific events could be a crucial platform for building connections in the scientific sphere and disseminating industry's messages, this work highlights the importance of denormalising the tobacco industry's involvement in scientific events.

Reframing social media discourse following the FDA's menthol ban announcement as industry agenda setting rather than public sentiment.

BACKGROUND: The tobacco industry has spent millions of dollars promoting racialised narratives against the US Food and Drug Administration's recently announced ban on menthol as a characterising cigarette flavour. This research investigates racialised narratives in online discourse following the ban's announcement. METHODS: Tweets and users responding to the April 2022 menthol ban announcement were content analysed to examine the influence of tobacco industry affiliates and potentially organic African-American/Black (AA/B) users. Next we investigated the extent to which the menthol ban was discussed on AA/B subreddits and used Latent Dirichlet Allocation topic modelling to provide an overview of the menthol ban discussion on Reddit. RESULTS: Only 28 (13.9%) tweets by 22 users claimed that the menthol ban would lead to police violence and/or racial discrimination. Of users who tweeted about over-policing, eight (36.4%) had financial connections to the tobacco industry. There were only three tweets receiving a combined seven retweets from potentially organic AA/B users. On Reddit, only two posts with one comment discussed the menthol ban on subreddits dedicated to AA/B issues and culture. Topic modelling showed that the most common topic related to the menthol ban involved the social and political implications of the ban followed by illicit markets and protecting youth. CONCLUSION: Tweets claiming a menthol ban will lead to police violence are indicative of industry agenda-setting. The menthol ban was not a prominent topic of discussion in AA/B subreddits although users discussing news and politics expressed concern for how AA/B people would respond to a ban politically.

Supply and demand effects between tobacco retailer density and smoking prevalence.

OBJECTIVE: Places with more tobacco retailers have higher smoking prevalence levels, but whether this is because retailers locate where people who smoke live or whether tobacco availability prompts tobacco use is unknown. In this study, we compare the role of consumer demand with that of tobacco supply in longitudinal, area-based associations of tobacco retailer density with smoking prevalence. METHODS: We merged annual adult smoking prevalence estimates derived from the USA Behavioural Risk Factor Surveillance System data with annual county estimates of tobacco retailer density calculated from the National Establishment Time Series data for 3080 counties between 2000 and 2010. We analysed relationships between retailer density and smoking in 3080 counties, using random intercept cross-lagged panel models and employing two measures of tobacco retailer density capturing the number of likely tobacco retailers in a county divided by either the population or land area. RESULTS: Both density models provided evidence of significant demand and supply effects; in the population-based model, the association of smoking prevalence in 1 year with tobacco retailer density in the next year (standardised coefficient=0.038, p<0.01) was about double the association between tobacco retailer density with subsequent smoking prevalence (0.017, p<0.01). The reverse was true in the land area-based model, where the supply effect (0.042, p<0.01) was more than 10 times stronger than the demand effect (0.003, p<0.01). CONCLUSIONS: Policies that restrict access to retail tobacco have the potential to reduce smoking prevalence, but pairing such policies with interventions to reduce consumer demand remains important.

A narrative analysis of a tobacco industry campaign to disrupt Aotearoa New Zealand's endgame policies.

BACKGROUND: Aotearoa New Zealand passed world-leading legislation to implement tobacco endgame policies, including greatly reducing the number of tobacco retailers. British American Tobacco New Zealand and Imperial Brands Australasia tried to undermine this policy via the 'Save Our Stores' (SOS) campaign, which purportedly represented small convenience store owners' interests. METHODS: We used the Policy Dystopia Model as a framework to review discursive and instrumental strategies employed in the SOS campaign. Specifically, we critically analysed the arguments, narratives and frames employed in the campaign. RESULTS: Most SOS arguments drew on discursive strategies that emphasised unanticipated costs to the economy and society, and presented a near-apocalyptic future. Adverse outcomes included economic mayhem, thriving illicit trade, increased violent crime, fewer police, and heavier individual tax burdens. The campaign framed the government as an authoritarian legislator with misplaced priorities and used disinformation to bolster these claims. We identified a new normalisation narrative used to present very low nicotine cigarettes (VLNCs) as experimental and, by implication, risky. A metanarrative of lawlessness and decreased public safety connected the different claims. CONCLUSION: To address the existential challenges they face, tobacco companies used several discursive strategies to oppose the retailer reduction and VLNC policies. Our findings could inform counterarguments, and help international policymakers and advocates anticipate opposition they may encounter when introducing endgame measures, such as reducing tobacco availability.

Lobbying against tobacco tax increases in France: arguments and strategies of the tobacco industry and tobacconists analysed through their trade press.

INTRODUCTION: Raising taxes is one of the most cost-effective measures to reduce tobacco use. France has a unique profile: it has high tobacco use prevalence and a state monopoly on tobacco sales for tobacconists who are both agents of the customs administration and a recognised tobacco industry (TI) front group. In this paper, we investigate the lobbying tactics and arguments against tobacco taxation mobilised by the TI and tobacconists in France. METHODS: We conducted a quantitative and qualitative analysis of the two leading French tobacco trade media outlets (La Revue des Tabacs and Le Losange) between 2000 and 2020. We performed a manual thematic content analysis based on existing conceptual models of TI political activity, including the policy dystopia model. RESULTS: Tobacconists actively lobbied against tobacco taxation, using traditional arguments highlighted in conceptual models (ie, the claim that 'taxation increases illicit trade and is ineffective'), but also France-centric arguments (ie, tobacconists denounced the impact of cross-border shopping and highlighted their role as pivotal to community life in rural areas). We also found lobbying strategies mirroring those identified previously (ie, coalition, information management and direct influence in public policy). CONCLUSIONS: Tobacconists in France hold a specific status that gives them privileged access to government bodies that can be exploited to successfully lobby against tobacco taxation. NGOs need to expose these lobbying activities and alert the public authorities to Article 5.3 of the WHO Framework Convention on Tobacco Control that requires countries to protect policies from TI interests.

PMI-funded foundation for a smoke-free world: application of criteria to assess funding models that include financial support from the tobacco industry.

Recent changes to the leadership and the terms of tobacco industry financing of the Foundation for a Smoke-Free World (FSFW) have called for a revisiting of a paper published in 2009 where we proposed criteria and other considerations to assess possible funding models for research that include financial support from the tobacco industry. This paper reviews and attempts to apply the elements laid out in 2009 to the current state of FSFW. After discussing each criterion and consideration we conclude that, at this point in time, conducting a thorough assessment using our 2009 paper is not possible because critical details related to FSFW governance, decision-making and process have not been announced. Nonetheless, we hope this paper will remind the tobacco control community that the 2009 criteria exist and highlight the information needed and questions that might be asked of FSFW to help form judgements about this new iteration of the foundation. We further hope this will put the FSFW on notice that they need to address each of these criteria and speak publicly about their plans regarding the specific issues raised in the 2009 paper.

Vuse Solo e-cigarettes do not provide net benefits to public health: a scientific analysis of FDA's marketing authorisation.

In October 2021, the US Food and Drug Administration (FDA) authorised marketing of RJ Reynolds Vapor Company's (RJR) Vuse Solo e-cigarette through FDA's Premarket Tobacco Product Application (PMTA) pathway. FDA concluded that RJR demonstrated Vuse products met the statutory standard of providing a net benefit to public health. A review of FDA's scientific justification reveals deficiencies: (1) not adequately considering Vuse's popularity with youth and evidence that e-cigarettes expanded the nicotine market and stimulate cigarette smoking; (2) trading youth addiction for unproven adult benefit without quantifying these risks and benefits; (3) not considering design factors that appeal to youth; (4) not addressing evidence that e-cigarettes used as consumer products do not help smokers quit and promote relapse in former smokers; (5) not discussing evidence that dual use is more dangerous than smoking; (6) narrowly focusing on the fact that e-cigarettes deliver lower levels of some toxicants without addressing direct evidence on adverse health effects; (7) downplaying significant evidence of other substantial harms; (8) not acting on FDA's own study showing no all-cause mortality benefit of reducing (but not stopping) cigarette use; and (9) improperly considering e-cigarettes' high abuse liability and potential for high youth addiction and undermining tobacco cessation. Because marketing these products is not appropriate for the protection of the public health, FDA should reconsider its Vuse marketing order as statutorily required and not use it as a template for other e-cigarette PMTAs. Policymakers outside the USA should anticipate that tobacco companies will use FDA's decision to try to weaken tobacco control regulation of e-cigarettes and promote their products.

Tobacco endgame goals and measures in Europe: current status and future directions.

The European Union (EU) aims for a tobacco use prevalence of less than 5% by 2040 with its Tobacco-Free Generation goal, aligning with the tobacco endgame approach. In the Joint Action on Tobacco Control 2 (JATC-2) -project, we examined adopted and planned endgame goals and measures as well as preparedness to counter tobacco industry interference in the process. We surveyed key informants in 24 out of 50 countries in the WHO European Region (19 of the 27 EU Member States, MS). Altogether, eight countries (7 EU MS) had official governmental endgame goals, and an additional six EU MS had similar proposals from government, civil society or research entities. Movement towards tobacco endgame was most evident in retail-oriented and consumer-oriented policies. These include restricting the sales of tobacco and related products and raising the age limit above 18 years. Product standards were used especially to regulate flavours but no measures to substantially reduce addictiveness were reported. Market-oriented measures that tap into industry profits were predominantly missing, and countries often lacked concrete tools to prevent industry interference. Respondents' concerns around tobacco endgame were related to high smoking prevalence in some population groups, non-combustible and new nicotine products, cross-border marketing, political will, challenges with the existing regulations and industry interference. Results indicate both momentum and challenges in adopting and disseminating measures that facilitate achieving tobacco endgame goals. The EU goal can be used to advocate for national endgame goals and measures, and for the strengthened implementation of the WHO Framework Convention on Tobacco Control.

Bitter taste of the tobacco industry interference in Brazil.

OBJECTIVE: Although Brazil became the first country worldwide to ban the sale of all tobacco products with any additive that could alter their flavours and tastes in 2012, its implementation was effectively halted by tobacco industry lawsuits, including a constitutional challenge filed in the Federal Supreme Court in 2013. This study aimed at examining, for the first time in the country, the evolution over time of the new registrations of tobacco products with additives that would have been banned if not for the tobacco industry's interference ('counterfactual scenario'). METHODS: We used the newly available public database on the registration of tobacco products developed by the Health Regulatory Agency (from 2008 onwards). All types of tobacco products intended for the domestic market that contained 'banned additives in a counterfactual scenario' and were registered between January 1 and December 31 of each year were selected. RESULTS: Between 2012 and 2023, a total of 1112 new registrations of tobacco products with 'banned additives' were recorded. The spread of hookah tobacco registrations started in 2014, and by 2023, the cumulative incidence of registrations containing 'banned additives' was 641. Both manufactured cigarettes and hookah products reached their peaks in new registrations in 2020. CONCLUSIONS: After 12 years since the resolution intended to ban all additives that change the aroma and taste of tobacco products in Brazil, primarily to prevent smoking initiation, the tobacco industry's interference continues to successfully block its implementation. Countries facing similar challenges in tobacco control could consider generating comparable national data that might help expose the adverse impacts of tobacco industry interference on public health.

Global policy scan of commercial combustible tobacco product retailing regulations by WHO region.

BACKGROUND/AIMS: Regulatory schemes for tobacco retailing help restrict the supply and availability of smoked tobacco products. Tobacco retailer density and the proximity of tobacco outlets to youth spaces, such as schools, are greater in more disadvantaged areas. Exposure to tobacco retailing normalises smoking and increases ease of access, thus increasing smoking uptake and undermining quitting. To inform future policy, we conducted a global scan of combustible tobacco retail regulatory schemes (We use the term schemes to refer to any kind of relevant initiative, policy, regulations or legislation that we found). METHODS: All types of English language records concerning the regulation of commercial tobacco product availability were considered, including peer-reviewed journal articles, key reports and policy documents. The key features of regulatory schemes were documented. In addition, we contacted key informants in different countries and regions for advice on additional sources and undertook targeted searching in regions where we initially found little data. RESULTS/FINDINGS: Although many countries have well-established and comprehensive tobacco control programmes, tobacco retail policy that actively addresses the availability of tobacco is underutilised. Many jurisdictions have implemented a minimum purchase age and restricted point-of-sale advertising and marketing. Other tobacco retailing regulations also included licensing systems with licence fees, caps on licences and restrictions on store location, type and retailer density/proximity. A very small number of jurisdictions have ended tobacco retailing altogether. CONCLUSIONS: At a minimum, policy-makers should implement licensing schemes, licence caps and proximity limits and invest in robust monitoring systems and compliance enforcement. Tobacco products' ubiquity is incompatible with its status as a dangerous addictive substance and does not align with tobacco endgame goals.

Analysis of Philip Morris International's 'aspirational' target for its 2025 cigarette shipments.

BACKGROUND: Philip Morris International (PMI) claims to be transforming and has committed to a 'smoke-free' future. In 2020, it announced an 'aspirational' target for reduced cigarette shipments by 2025. METHODS: PMI cigarette shipment data are taken from PMI quarterly financial reports 2008-2023. Trends in these data before and after the 2020 announcement are analysed using linear regression, and auto regressive integrated moving average and error, trend, seasonal time-series models to assess if PMI's 2025 target would be met on pre-existing trends, and if the trend changed after the announcement. These trends are also compared with the global retail market for cigarettes, using sales data from Euromonitor. RESULTS: Findings were consistent across all three models. PMI's shipment target of 550 billion cigarette sticks by 2025 would readily have been met given pre-existing shipment trends. Following the 2020 announcement, the decline in PMI cigarette shipments stalled markedly with a statistically significant change in trend (p<0.001). The current and projected trend to 2025 is consistent with no further decline in cigarette volumes, meaning PMI is unlikely to hit its target. This mirrors a global pattern in which declines in cigarette sales have stalled since 2020. CONCLUSIONS: PMI's 2025 target was not 'aspirational' but highly conservative-it would have been met based on pre-existing trends in declining cigarette shipments. Yet PMI will nonetheless fail to meet that target providing evidence it is not transforming. Stalling of the decline of PMI and global cigarette sales raises significant concerns about progress in global tobacco control.

Five years of discourse related to Indonesia tobacco control reform: a content analysis of online media coverage.

BACKGROUND: In 2017, Indonesia initiated the amendment of its 11-year-old tobacco control regulation (PP 109/2012) to reduce smoking among youth, but the process was stalled. The proposed changes in the regulation include a full ban on tobacco advertising, promotion and sponsorship (TAPS), increasing health warning label (HWL) size and regulating electronic cigarettes (e-cigarettes). This study analysed the arguments and actors for and against the PP 109/2012 amendment in online media articles. METHOD: Content analysis of 326 online articles reporting on the PP 109/2012 amendment published from 2018 to 2023, retrieved from the Tobacco Watcher platform. We coded articles for statements supporting or opposing the amendment (position statement), content of the arguments used to support (supporting argument) and oppose (opposing argument) the amendment, actors presenting the arguments and tobacco control measures. We iteratively reviewed and coded data and presented the frequency of categories. RESULTS: Of 332 position statements, 53.3% were against the amendment. The main categories of supporting arguments (N=1448) included smoking trends (21.1%), health implications (16.6%), science-based evidence (9.6%) and protecting the population (9.2%). Opposing arguments (N=1413) emphasised the tobacco farmers' welfare (16.6%), impact on the industry (16.4%) and current regulation is sufficient (11.0%). Supporting actors were predominantly health-related entities and government officials (89.3%), while 62.1% of opposing actors included trade and Islamic groups, the tobacco industry and front groups. HWLs, e-cigarette/heated tobacco product regulation and TAPS were the main (77.8%) tobacco control measures mentioned in the proamendment arguments, while HWLs, TAPS and cigarette sale restrictions were the dominant (79.3%) tobacco control measures in anti-amendment arguments. CONCLUSION: Indonesia's tobacco control reform faced opposition by false claims primarily from industry allies, resulting in a 5-year delay in enactment. Future tobacco control media advocacy must address these claims and emphasise the alignment of economic interests with public health goals.

Tobacco industry pricing strategies during recent tax adjustments in Mexico: evidence from sales data.

INTRODUCTION: Previous studies have identified pricing strategies that the tobacco industry employs to try to minimise the impact of tobacco taxation, but these studies are mostly about high-income countries. This research examines industry price responses to a recent cigarette tax increase in Mexico, including in the capsule cigarette segment that has expanded rapidly in Latin America. METHODS: Data of cigarette prices and sales in Mexico between October 2018 and September 2021 licensed from NielsenIQ were used following a quasi-experimental design to analyse price changes after excise tax increases with fixed effect models by product. To explore heterogeneous responses, estimates were disaggregated by cigarette attributes such as presence of capsules and market segment. Differential shifting was also assessed. RESULTS: Increasing the tobacco tax from 2011MX$0.35(≈US$0.02) to 2020 MX$0.4944(≈US$0.0283) in January 2020 was associated with an overall 8% cigarette price increase in real terms. However, some cigarette types, including premium to discount segments, exhibited price increases larger than the tax increase, which reduced the relative price of ultra-low-priced cigarettes. Instead of a single hike, prices were gradually raised throughout the first months of 2020 for all cigarette types. A combination of both pricing strategies was employed for capsule cigarettes. The 2021 smaller tax adjustment for annual inflation was fully passed onto consumer, maintaining real prices constant. CONCLUSIONS: The industry's ability to raise prices more than the tax increase and manage these price increases smoothly suggests that there was room for larger tobacco tax increases in Mexico. Future developments on tobacco taxes could consider a fully specific tax structure or minimum taxes to mitigate the adverse effects of market segmentation and differential shifting.

IQOS news media coverage in Israel: a comparison across three subpopulations.

BACKGROUND: Philip Morris International's (PMI) IQOS, a leading heated tobacco product globally, entered the Israeli market in 2016. IQOS and/or electronic cigarette use is higher in Israel's Arab population (2.8% vs 1.2% of Jews). However, previous research indicated possible targeting of the Ultra-orthodox Jewish population with more IQOS paid ads. This paper examined how IQOS is framed in news media articles directed at three subpopulations in Israel: Arab, Ultra-orthodox Jews and general public. METHODS: Media articles (January-October 2020) were obtained from Ifat media and were coded using abductive coding. Characteristics of articles (photo and article content) targeting each subpopulation were compared using χ2, Fisher's exact test, one-way analysis of variance and median test, as appropriate. RESULTS: Of the 63 unique articles identified, 16 targeted Arab, 24 Ultra-orthodox Jews and 23 general public. Arab and Ultra-orthodox Jewish media significantly differed from the general public's media in their positive framing of PMI (100% Arab and 75% Ultra-orthodox Jews vs 52% general public, p=0.004), and IQOS (100% Arab and 88% Ultra-orthodox Jews vs 61% general public, p=0.006). Arab media differed from others by highlighting IQOS' retail locations (81% vs 17% Ultra-orthodox Jews and 13% general public), social benefits (88% vs 8% Ultra-orthodox Jews and 17% general public) and reflecting content from PMI's press release (100% vs 46% Ultra-orthodox Jews and 35% general public; ps <0.001). CONCLUSIONS: IQOS was framed more positively in media targeting minority populations (Arab and Ultra-orthodox Jews), compared with general public. Arabic media in particular emphasised IQOS' retail accessibility and social benefits. These findings highlight the need for media surveillance and regulation, especially of minority-oriented media.

Hidden flaws in e-cigarette industry-funded studies.

Electronic cigarette (e-cigarette) use has increased since e-cigarettes were introduced to the market nearly 20 years ago. Researchers continue to conduct studies to understand the health risks and benefits of e-cigarettes to inform health education and promotion efforts as well as public policy. Studies funded by the tobacco industry examining the potential risks and benefits of e-cigarettes have also been conducted and are sometimes published in the scientific literature. Frequently, tobacco and e-cigarette industry-funded researchers report findings that contradict research funded by other sources. While many industry-funded studies may appear methodologically sound at first glance, in some cases, industry-funded studies include methodological flaws that result in misleading conclusions. The tobacco industry's use of biased research to influence tobacco-related policy decisions in the past is well-documented. This commentary provides specific examples of recent e-cigarette research funded by the tobacco/e-cigarette industry in which methodological flaws result in misleading conclusions that support industry goals. Given the long history of biased research conducted by the tobacco industry, there is a need to assess whether research funded by the e-cigarette industry similarly contains methodological flaws. We emphasise the need for tobacco and e-cigarette-funded research to be scrutinised by non-industry-funded subject matter experts and call for journals to not consider manuscripts that have received support from the tobacco or e-cigarette industry.

Birthdate-based commercial tobacco sales restrictions: will 'tobacco-free generation' policies advance or delay the endgame?

Endgame thinking means transitioning from merely trying to 'control' the tobacco epidemic to developing plans and measures to bring it to an end within a specific time, by changing the underlying dynamics that have created and perpetuated it for more than a century. Among the innovative policies characterised as 'endgame' policies are so-called 'tobacco-free generation' or 'smoke-free generation' policies, which prohibit sales of some or all tobacco products to individuals born on or after a particular date. Such birthdate-based sales restrictions (BSR) have intuitive appeal, largely because they do not appreciably disrupt the status quo of retail sales, which continue unchanged for all those born before the designated cut-off date. They also hold the potential for further denormalising tobacco use and sales by anticipating the long-term end of tobacco sales. In this Special Communication, we analyse BSR policies through an endgame lens and propose questions that should be discussed in jurisdictions considering them. We suggest that this policy has potential underexamined pitfalls, particularly related to equity, and that if enacted, it should include policy guardrails and be part of a package of endgame measures.

How can youth involvement in public health conferences promote a tobacco-free generation? Lessons from the ECToH 2023's Youth Committee.

Young health advocates have the legitimate aspiration to be masters of their future and are increasingly contributing to public health research and practice worldwide, yet their potential to contribute to the documentation and communication of outputs from public health conferences has not been fully realised. This short communication highlights the Youth Committee of the 2023 European Conference on Tobacco or Health as an example of youth involvement in a major public health conference focused on tobacco control. The authors explore the benefits, practicalities and challenges of incorporating young professionals into conference workflow, including creativity, networking and engagement with broader public health challenges within their communities. This article emphasises the active participation of Youth Committees in public health fora as a model for future conferences and underscores a commitment to achieving a tobacco-free generation.

Smoke-free legislation impact on the hospitality sector in the Republic of Georgia.

INTRODUCTION: Comprehensive smoke-free (SF) policies reduce secondhand smoke exposure and improve population-level health outcomes. However, some decision-makers heed the tobacco industry's argument that SF policies negatively impact the hospitality sector. This study examines the intermediate economic impact of the Republic of Georgia's SF legislation (effective since early 2018) on the hospitality sector in Georgia. METHODS: Analyses used 2015-2019 hospitality sector data from Georgia's National Statistics Office. Simple linear regression models were conducted to examine the impact of Georgia's SF policy on economic indicators (ie, number of employees, food service facilities, hotels and international visitor trips; employee remuneration; production value; turnover; hospitality sector value added tax (VAT)). RESULTS: Analyses indicated no negative impact on any of the economic indicators. Instead, from 2018 to 2019, the number of food service facilities, hotels and international visitor trips increased by 20%, 17% and 7%, respectively. Additionally, there were increases in the number of employees (9%), average employee remuneration (3%), production values (13%), turnover/total revenue (13%) and VAT (26%). Moreover, the economic indicator values during the studied period were strongly correlated with each other (p>0.95) and indicated a consistent and uniform improvement. CONCLUSIONS: After the SF legislation went into effect, the hospitality sector demonstrated significant growth and no adverse effects in the economic indicators studied. The findings underscore the importance of maintaining and enforcing SF policies in Georgia and expanding the evidence base for SF policies globally.

Association between tobacco industry denormalisation beliefs and support for tobacco endgame policies: a population-based study in Hong Kong.

OBJECTIVES: To examine the associations between tobacco industry denormalisation (TID) beliefs and support for tobacco endgame policies. METHODS: A total of 2810 randomly selected adult respondents of population-based tobacco policy-related surveys (2018-2019) were included. TID beliefs (agree vs disagree/unsure) were measured by seven items: tobacco manufacturers ignore health, induce addiction, hide harm, spread false information, lure smoking, interfere with tobacco control policies and should be responsible for health problems. Score of each item was summed up and dichotomised (median=5, >5 strong beliefs; ≤5 weak beliefs). Support for tobacco endgame policies on total bans of tobacco sales (yes/no) and use (yes/no) was reported. Associations between TID beliefs and tobacco endgame policies support across various smoking status were analysed, adjusting for sociodemographics. RESULTS: Fewer smokers (23.3%) had strong beliefs of TID than ex-smokers (48.4%) and never smokers (48.5%) (p<0.001). Support for total bans on tobacco sales (74.6%) and use (76.9%) was lower in smokers (33.3% and 35.3%) than ex-smokers (74.3% and 77.9%) and never smokers (76.0% and 78.3%) (all p values<0.001). An increase in the number of TID beliefs supported was positively associated with support for a total ban on sales (adjusted risk ratio 1.06, 95% CI 1.05 to 1.08, p<0.001) and use (1.06, 95% CI 1.05 to 1.07, p<0.001). The corresponding associations were stronger in smokers than non-smokers (sales: 1.87 vs 1.25, p value for interaction=0.03; use: 1.78 vs 1.21, p value for interaction=0.03). CONCLUSION: Stronger TID belief was associated with greater support for total bans on tobacco sales and use. TID intervention may increase support for tobacco endgame, especially in current smokers.