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.

#Bartender: portrayals of popular alcohol influencer's videos on TikTok©.

BACKGROUND: Despite widespread use of the short-video social media platform TikTok©, limited research investigates how alcohol is portrayed on the platform. Previous research suggests that a driver of alcohol content on TikTok©, in part, comes from bartenders demonstrating how to make drinks. This study aims to explore the characterizing patterns of how bartender influencers on TikTok© feature and incorporate alcohol in their videos. METHODS: We identified the global top 15 most followed bartenders on TikTok© in 2021 (cumulative 29.7 million subscribers) and the videos they posted in November and December 2021, the period just before Christmas and New Year, when alcohol tends to be more marketed than in other periods. The videos were coded based on five criteria: (1) the presence of alcohol or not; (2) alcohol categories; (3); alcohol brand(s) if visible; (4) the presence of candies and other sweet products; (5) presence of cues that refer to young people's interests. RESULTS: In total, we identified 345 videos, which received 270,325,600 views in total, with an average of 18,021,707 views per video. Among these 345 videos, 92% (n = 317) displayed alcohol in their cocktail recipes (249,275,600 views, with an average of 786,358 views). The most common types of alcohol present in videos were liquor, vodka, rum, and whiskey, all of which are high-ABV beverages. 73% (n = 230) displayed or mentioned an alcohol brand. 17% (n = 55) associated alcohol with sweet products such as different types of candy (53,957,900 views, with an average of 981,053 views per video). 13% (n = 43) contained cues appealing to young people (e.g., cartoons, characters) (15,763,300 views, with an average of 366,588 views per video). CONCLUSIONS: Our findings suggest a large presence of positively framed alcohol content posted by popular bartenders on TikTok©. As exposure to digital marketing is related to an increase in alcohol consumption, particularly among young people, regulations are needed to protect the public from alcohol-related harms.

Plain tobacco packaging: progress, challenges, learning and opportunities.

The aim of this paper is to overview progress made with respect to the adoption of plain (or standardised) packaging, key challenges faced, evaluative evidence and opportunities for extending this policy. It has been a decade since Australia became the first country to require tobacco products to be sold in plain packaging; after slow initial uptake, 16 countries have now fully implemented this policy. Since 2020, plain packaging laws have become more comprehensive in some countries, expanding coverage beyond traditional tobacco products to include heated tobacco, tobacco accessories (rolling papers) and other nicotine-containing products (e-cigarettes). Laws have also become more innovative: some now ban non-biodegradable filters, include provision for a periodic change of the pack colour or require both plain packaging and health-promoting pack inserts. The tobacco industry has and will continue to use multi-jurisdictional strategies to oppose this policy. Evaluations suggest that plain packaging has improved health outcomes and has not burdened retailers, although research is limited to early policy adopters and important gaps in the literature remain. While the power of packaging as a sales tool has diminished in markets with plain packaging, tobacco companies have exploited loopholes to continue to promote their products and have increasingly focused on filter innovations. Opportunities exist for governments to strengthen plain packaging laws.

Arrêt du tabac : une personnalisation nécessaire des programmes de sevrage.

OBJECTIVE: With 13 million smokers in France in 2019, smoking remains a major health issue. The LAST (Lieux d'accompagnement à la santé sans tabac [Locations for Health Support without Tobacco]) project set up in New-Aquitaine aims to encourage smokers to get help to quit smoking. METHOD: In order to identify the barriers and levers to be mobilized to encourage smokers to seek help and then build with them the ideal cessation program, an individual qualitative study based on semi-structured interviews was conducted in May 2019 with 19 smokers at the contemplation or preparation step (transtheo-retical model). RESULTS: Smokers interviewed were unfamiliar with the cessation aids available and use them infrequently. Reasons include lack of information about their effectiveness, perceived cost, and fear of developing another form of addiction. Regarding the ideal program for them, using a health professional was cited by the majority, followed by physical activity (to avoid weight gain), nicotine replacement therapy and other drug treatments. The need to combine aids and to personalize the withdrawal offer is a strong demand. CONCLUSION: The development of the "ideal", personalized cessation aid program seems to be an opportunity for each smoker to choose the aids that are most in line with his or her needs and values. First-line professionals, because of their proximity, appear to be a key entry point to accompany cessation attempts.

Social marketing interventions to promote physical activity among 60 years and older: a systematic review of the literature.

BACKGROUND: Falls are a significant source of morbidity in people aged 65 and over, affecting one in three people in this age group. The scientific evidence indicates that physical activity is the most effective method for preventing falls among seniors. Although public health professionals often use social marketing to design and plan successful interventions, its use to promote physical activity and prevent falls among older people remains low. This article aims to provide a new systematic literature review of social marketing interventions promoting physical activity and targeting people aged 60 and over. METHODS: Following CRD's guidance and PRISMA guidelines, we searched between January 2008 and July 2019 for relevant articles in five primary databases using predefined search and inclusion criteria. Two independent reviewers analysed the selected articles to identify evidence of the seven social marketing benchmark criteria, defined by experts in the field as the common elements that contribute to social marketing success. RESULTS: The final review included nine studies. Of the studies selected, three specifically targeted over 60-year-olds, whereas the others segmented the population into several age-based subcategories, including over 60-year-olds. Eight studies highlighted positive results for the participants with an increase in participation or an increase in physical activity level. None of the nine studies selected for this systematic review implemented the entire social marketing approach. CONCLUSION: Few published interventions use the seven social marketing criteria. Further research is required to encourage uptake and inclusion in successful social marketing interventions to increase program effectiveness in this target population.

Correction to: Social marketing interventions to promote physical activity among 60 years and older: a systematic review of the literature.

An amendment to this paper has been published and can be accessed via the original article.

Impact of alcohol marketing on drinkers with Alcohol use disorders seeking treatment: a mixed-method study protocol.

BACKGROUND: The marketing of alcohol influences patterns of alcohol consumption. Existing studies have focused, for the most part, on adolescents and the links between exposure to marketing and alcohol initiation. In France, the Evin law, a French exception, was set up in 1991 with the aim of regulating this exposure to marketing, but since 2009 it has been severely compromised. Alcohol consumption causes severe damage, which may be seenfrom 1 standard unit per day and mostly among adults who are regular users of alcohol. In this at-risk population, studies analysing the impact of marketing are sparse. The specific objectives include (i) the evaluation of the perception of alcohol marketing by patients with an AUD (ii) gaining understanding of the links between alcohol marketing and patients with AUD behaviours (iii) the development of alcohol demarketing strategy in patients receiving AUD coaching. METHODS: Our main objective isto evaluate the impact of marketing on a population with an AUD. The methodology was in 4 steps: step 1 is a pre-test (N = 100) selecting type of alcohol consumed and type of marketing stimuli identified by patients aged 18 + with an AUD. Step 2 is a qualitative study (N = 20), with in-depth interview, to understand links between alcohol marketing and patients with AUD behaviours. Step 3 is a quantitative study(N = 600) to confirm these links and the impact of alcohol marketing on patients with AUD behaviours. Step 4 is an interventional step, including and testing the impact of demarketing intervention on patients with AUD while using the results of the three first steps (N = 120). DISCUSSION: This study will contribute to a better definition of the impact of alcohol marketing on patients with AUD and will enable identification of the determinants of this impact. These data will inform the development of interventions that take into account demarketingstrategies on patients under AUD management. TRIAL REGISTRATION: The Trial registrationregistration number is NCT03876132, and it was registered on the 15th march 2019.

Consumer Perceptions of Cigarette Design in France: A Comparison of Regular, Slim, Pink and Plain Cigarettes.

INTRODUCTION: The cigarette, like the cigarette pack, is used by tobacco companies as a promotional tool. We explore how the cigarette could potentially be used as a dissuasive tool. METHODS: An online survey was conducted with 15-30-year-old smokers and nonsmokers (N = 998) in France to explore their perceptions of a plain cigarette (gray with no brand name) and three branded cigarettes (regular, slim, pink). Participants were randomly assigned to view the plain cigarette and either the regular, slim, or pink cigarette. They were asked to rate the cigarettes by Appeal (tastiest, highest quality, and most expensive), Harm (most dangerous and most effective for motivating people to talk about tobacco dangers), and Perceived behavioral impact (most effective to convince teenagers not to start and to motivate smokers to reduce consumption and quit). RESULTS: In comparison to the gray cigarette, each of the branded cigarettes were considered more appealing, less harmful, and more likely to motivate teenagers to start and less likely to motivate smokers to reduce consumption or quit. CONCLUSIONS: The study suggests that altering the appearance of the cigarette may reduce cigarette appeal, increase harm perceptions, and deter both young people and smokers. IMPLICATIONS: Very little research has focused on dissuasive cigarettes whereas the cigarette stick has become very important for tobacco companies for communication purposes. This is the first study to compare the effect of various branded cigarettes (regular, slim, and pink) with a plain gray cigarette on young adult smokers and nonsmokers. The findings suggest that a plain gray cigarette can reduce cigarette appeal, increase perceptions of harm, and may deter use among both smokers and nonsmokers.

Plain packaging: legislative differences in Australia, France, the UK, New Zealand and Norway, and options for strengthening regulations.

By July 2018, five countries (Australia, France, the UK, New Zealand and Norway) had fully implemented plain (standardised) packaging. Using government documents, we reviewed the key legislative differences between these five countries to identify best practice measures and potential lacuna. We then discuss how governments planning to introduce plain packaging could strengthen their legislation. Differences between countries include the terminology used (either 'plain', 'standardised' or 'plain and standardised'), products covered and transition times (ranging from 2 to 12 months). Myriad differences exist with respect to the packaging, including the dimensions (explicitly stated for height, width and depth vs minimum dimensions for the health warnings only), structure (straight-edged flip-top packs vs straight, rounded and bevelled-edged flip-top packs and shoulder boxes) and size (minimum number of cigarettes and weight of tobacco vs fixed amounts) and warning content (eg, inclusion of a stop-smoking web address and/or quitline displayed on warnings on one or both principal display areas). Future options that merit further analysis include banning colour descriptors in brand and variant names, allowing pack inserts promoting cessation and permitting cigarettes that are designed to be dissuasive. Plain packaging legislation and regulations are divergent. Countries moving towards plain packaging should consider incorporating the strengths of existing policies and review opportunities for extending these. While plain packaging represents a milestone in tobacco-control policy, future legislation need not simply reflect the past but could set new benchmarks to maximise the potential benefits of this policy.

Impact of a negative emotional antitobacco mass media campaign on French smokers: a longitudinal study.

BACKGROUND: Mass media campaigns to encourage smoking cessation have been shown to be effective in a context of comprehensive tobacco control programme. The effectiveness of antismoking ads that evoke negative emotions remains unclear, in particular in countries with high smoking prevalence and among smokers with low perceived susceptibility, low self-efficacy or who are not users of smoking cessation services. OBJECTIVE: To evaluate short-term and long-term effects of a 1-month French national highly emotional media campaign, with a focus on these specific targets. DESIGN: A 6-month longitudinal survey by Internet. A sample of 3000 smokers were interviewed before the media campaign (T0). They were contacted again just after (T1) and 6 months after the campaign (T2). OUTCOMES: Perceived susceptibility to the risks of smoking, self-efficacy to quit smoking, use of smoking cessation services (quitline and website) and 7-day quitting. METHODS: The analysis was carried out on 2241 individuals who answered at T1 and T2. Multiple logistic regressions were computed to test the association between the change in each outcome at T1 and T2 and the level of exposure based on self-reported recall. RESULTS: Self-reported recall was associated with an increase in perceived susceptibility and with use of cessation services. Campaign recall was also associated with higher 7-day quitting immediately after the campaign (OR=1.8 (1.0 to 3.2), P<0.05). CONCLUSIONS: Fear-appeal mass media campaigns can be effective in encouraging cessation among smokers in a country with high smoking prevalence (France), but should be accompanied by convincing self-efficacy messages.

Adolescents' Perceptions of an On-cigarette Health Warning.

INTRODUCTION: In most countries, health warnings have been on cigarette packs for decades. We explored adolescents' perceptions of a health warning on cigarettes. METHODS: Data come from the 2014 wave of a cross-sectional in-home survey with 11- to 16-year olds (N = 1205) from across the UK, with participants recruited from the general population using random location quota sampling. Participants were shown an image of a standard cigarette which displayed the warning "Smoking kills" and asked whether they thought this would (not) put people off starting to smoke, (not) make people want to give up smoking, and whether all cigarettes should (not) have health warnings on them. RESULTS: Most (71%) thought that an on-cigarette warning would put people off starting, although this decreased with age. Never smokers were more likely than current smokers to think that it would put people off starting. Approximately half (53%) thought that an on-cigarette warning would make people want to give up smoking, with this higher for never smokers and experimenters/past smokers than for current smokers. Most (85%) supported a warning on all cigarettes. There was support among each smoking group, although this was higher for never smokers and experimenters/past smokers than for current smokers, and higher for those indicating that most of their close friends do not smoke than for those indicating that most of their close friends do smoke. CONCLUSIONS: The perception among adolescents that an on-cigarette warning could deter smoking, and the high support for a warning on all cigarettes, warrants further research. IMPLICATIONS: Research on dissuasive cigarettes is at a nascent stage. This is the first study to explore how adolescents perceive a health warning ("Smoking kills") on cigarettes. Almost three quarters of participants indicated that on-cigarette health warnings would deter people from starting to smoke, and 85% supported the inclusion of a warning on all cigarettes. While further research is clearly needed, these findings suggest that the inclusion of health warnings on cigarettes is considered appropriate by young people and may have a dissuasive effect.

The effectiveness of current French health warnings displayed on alcohol advertisements and alcoholic beverages.

Background: Many countries use health warnings in an attempt to regulate alcohol consumption. However, there is a lack of conclusive evidence in the research on alcohol warnings to support decision-making on effective health policies. This study explores the effectiveness of two mandatory warnings introduced in France in 1991 and 2007: the first (Alcohol abuse is harmful) is displayed on alcohol advertisements; the second (a pictogram) on bottles. Given that advertising content regulations have been implemented in some countries to reduce the attractiveness of alcohol marketing (e.g. the Evin law in France), this research also aims to explore whether such regulations can improve the effectiveness of warnings. Methods: In-depth interviews were conducted with 26 French people aged 15-29 years. The effectiveness of health warnings was assessed in terms of recall, noticeability, credibility, comprehension, responsiveness, and ability to encourage moderate drinking and abstinence during pregnancy. Participants were shown alcohol advertisements and bottles that either followed or challenged content regulations. The data were analyzed using double manual coding and NVivo software. Results: While both warnings suffered from a lack of visibility and noticeability due to their size, location, and outdatedness and because of competition from marketing design elements, the warning on the advertisement that followed content regulations was most visible. Both warnings were considered to be informationally vague, lacking in credibility and ineffective in terms of making participants feel concerned and influencing consumption habits. Conclusions: Current French warnings are ineffective and require modification. Improvements are suggested regarding the design and content of warnings to help increase their effectiveness.

The Impact of Cigarette Packaging Design Among Young Females in Canada: Findings From a Discrete Choice Experiment.

INTRODUCTION: The tobacco industry uses various aspects of cigarette packaging design to market to specific groups. The current study examined the relative importance of five cigarette packaging attributes--pack structure (eg, "slims"), brand, branding, warning label size, and price--on perceptions of product taste, harm, and interest in trying, among young females in Canada. METHODS: A discrete choice experiment was conducted with smoking and nonsmoking females, aged 16 to 24 (N = 448). Respondents were shown 10 choice sets, each containing four packs with different combinations of the attributes: pack structure (slim, lipstick, booklet, traditional); brand ("Vogue," "du Maurier"); branding (branded, plain); warning label size (50%, 75%); and price ($8.45, $10.45). For each choice set, respondents chose the brand that they: (1) would rather try, (2) would taste better, and (3) would be less harmful, or "none." For each outcome, the attributes' impact on consumer choice was analyzed using a multinomial logit model. RESULTS: The multinomial logit analyses revealed that young females weighted pack structure to be most important to their intention to try (46%), judgment of product taste (52%), and judgment of product harm (48%). Price and branding were weighted important in trial intent decisions (23% and 18%, respectively) and product taste judgments (29% and 15%, respectively). Whereas warning label size and brand were weighted important when judging product harm (23% and 17%, respectively). CONCLUSION: The findings suggest that standardized cigarette packaging may decrease demand and reduce misleading perceptions about product harm among young females.

Qualitative exploration of young adult RYO smokers' practices.

BACKGROUND: Although roll-your-own (RYO) tobacco often elicits negative connotations of a lower class product, uptake and use by young adult smokers has grown because RYO is more cost-effective than tailor-made (TM) cigarettes. We explored the practices and beliefs young adults develop to distance themselves from unattractive stereotypes of RYO smokers. METHODS: We conducted 20 in-depth interviews with New Zealand young adult RYO users aged between 18 and 30 years, and used thematic analysis to interpret the transcripts. RESULTS: We identified three themes: establishing the superiority of RYO tobacco; creating and enacting usage rituals, and ritual disruption. Participants regarded RYO tobacco as more natural and better-tasting; they used it to control their tobacco use and facilitate interactions with others. Many described rolling rituals where they used specific artefacts and microbehaviours to construct cigarettes they saw as personal and artisanal. Several, though not all, disliked unattractively coloured papers as these disrupted the value their rituals created. CONCLUSIONS: Young adults imbue RYO tobacco with positive attributes, many of which centre on rolling rituals or draw on widely held misperceptions of RYO tobacco as less harmful. Excise tax increases could counter perceptions of RYO as more cost-effective while mandating that dissuasively coloured paper could disrupt reduced-harm connotations. However, evidence that erroneous harm beliefs are widespread and entrenched may justify restricting or eliminating the key artefact-the product itself.

Perceptions of plain packaging among young adult roll-your-own smokers in France: a naturalistic approach.

BACKGROUND: We explored, for the first time, young adult roll-your-own smokers' response to using plain packaging in real-world settings. METHODS: Naturalistic research was employed, where 133 French young adult smokers (18-25 years of age) used plain roll-your-own packs for 10 days; the plain packs they were provided with contained their usual brand of rolling tobacco and displayed the name of their usual brand. Participants were recruited in five cities in France (Paris, Marseille, Metz, Nantes, Toulouse) and completed two questionnaires to measure their response to their own branded packs and the plain packs. Both questionnaires assessed pack perceptions, brand attachment, product perceptions (eg, taste, quality, natural), feelings about smoking (satisfying, pleasurable), feelings when using the pack in front of others (embarrassment, image), warning response (credibility, awareness of risks) and smoking-related behaviour (eg, consumption, quitting). RESULTS: Compared to their own fully branded packs, plain packs were associated with less positive pack and product perceptions, lower brand attachment and less positive feelings about smoking and feelings when using the pack in front of others. Participants were also more likely to report feeling like reducing consumption and quitting when using the plain packs, and more likely to feel like missing out on rolling a cigarette. No significant differences between the two pack types (plain and branded) were found in terms of credibility of warnings and perceptions of level of tar. CONCLUSIONS: The study suggests that the impacts of plain packaging for roll-your-own cigarette smokers are the same as for smokers of factory-made cigarettes.

Analyzing arguments on tobacco tax increases. Focus on French parliamentary questions and responses, 2000-2020.

INTRODUCTION: Tax increases are the most effective but still the least-used tobacco control measure. The tobacco industry (TI) employs lobbying strategies to oppose the implementation of tax policies on its products. Over the past two decades, French tobacco tax policies have been characterized by a relative inconsistency. This research aims to understand why, by analyzing the arguments of French policymakers (MPs and government) between 2000 and 2020 in favor or against tax increases. METHODS: To capture parliamentary debates, we performed an advanced term search on the French National Assembly website, using the keyword 'tobacco'. The search returned 5126 available documents out of which 1106 (12.6%, 645 questions, 461 responses) covered price and taxation and were included. They were analyzed using descriptive statistics and thematic content analysis (NVivo) and were compared, when relevant, to arguments raised in the international literature on TI lobbying against taxation increases. RESULTS: We found 3176 arguments on tobacco taxation: 77.2% were against tobacco tax increases and 22.7% were in favor of tax policies. Arguments varied depending on the source: 92.4% of MPs' arguments were against tax increases, while 52.1% of arguments from government responses were in favor. The anti-tax arguments were similar to those identified in the international literature that singled out negative economic and social consequences (illicit trade, penalizing tobacconists). Other arguments that were more specific to the French context, highlighted the key economic and social role played by tobacconists in France. Pro-tax arguments highlighted the health, economic and social benefits of tax policies. CONCLUSIONS: This is the first French tobacco research on parliamentary documents, although Parliament is a place of direct TI lobbying. It will enable public health actors to better understand the arguments used by the TI in order to counter them in front of MPs, and to better monitor debates in Parliament.

Youth behavioural responses to regulated alcohol advertising content: Results from a mixed-methods study in France.

OBJECTIVES: The World Health Organization advocates measures regulating alcohol advertising content, as illustrated by the French Évin law. However, how people react to such regulation has been under-investigated. The research reported here has two objectives: to analyze how different advertising contents (regulated or not) affect the persuasion process from attention to behavioural responses, and whether young people are protected; to examine how alcohol warnings perform depending on their salience and the advertising content displayed (regulated or not). MATERIALS AND METHODS: This study surveyed French people aged 15-30 using a mixed-methods design. In-depth interviews were conducted on 26 respondents to understand how non-regulated (NRA) and regulated (RA) alcohol advertising influence the persuasion process. An experiment on 696 people assessed the influence of RA vs. NRA on intentions to buy and drink alcohol, and whether less vs. more salient warnings displayed in the RA or NRA setting have differential effects on behavioural responses. RESULTS: NRA (vs. RA) had a greater influence on young people's desire to buy and drink alcohol, which we explain by different psychological processes. NRA appeared to trigger a heuristic process that involves affective reactions (e.g. image, symbolism) and product-oriented responses (e.g. quality), whereas RA appeared to trigger a more systematic process that had less influence. The protective effect of content regulations was strong for the youngest participants but fades as age increases, reaching its limits at age 22 years. Salience of the warnings had no influence on desire to buy and drink alcohol, whatever the ad content. CONCLUSION: Advertising content regulations need to be implemented to protect young people, particularly the youngest. Our results on alcohol health warnings highlighted that text-only labels similar to those adopted in many countries are ineffective at decreasing young people's intentions to buy and drink alcohol.

What are the effects of smoke-free and tobacco-free university campus policies, and how can they be assessed? A systematic review.

OBJECTIVE: This article looks at the evaluation of smoke-free (SF) and tobacco-free (TF) university campus policies that ban smoking (and often vaping) both indoors and outdoors. To assess the effectiveness of these policies, we performed a systematic literature review to answer the following questions: what is the effect of SF/TF policies on campus users' behaviors/norms/perceptions around smoking? Are the SF/TF policies an effective measure for reducing smoking among young adults? What methods and indicators can we use to assess the impact of SF/TF campus policies? What is the theoretical model underpinning the influence of SF/TF policies on the behavior of campus users? METHODS: Three databases (PubMed, Scopus, and Web of Science) were searched over the period from January 2005 to December 2022. The article selection process included 54 articles published in scientific journals that analyzed the post-implementation impact of SF/TF campus policies. The quality of these articles was analyzed using six ad hoc indicators based on the Critical Appraisal Skills Program checklist and Joanna Briggs Institute scoping tools. RESULTS: Most of the research on SF/TF campus policies has been conducted in the United States using quantitative methodologies. Most of these studies show that SF/TF policies reduce positive beliefs about smoking and its acceptability, influence smoking behavior (reducing smoking initiation and increasing the number of quits and quit attempts), and reduce exposure to passive smoking and pollution from cigarette butts. User acceptability of SF/TF policies is generally high. Limitations of SF/TF campus policies include difficulty for smokers to comply with them, persistence of passive smoking around campuses, and limited uptake of on-campus cessation support services provided to smokers. DISCUSSION: The various mediating and moderating variables identified in the literature have made it possible to propose a model of the potential influence of SF/TF policy on campus users, based on the theory of planned behavior. Based on this review, we provide health professionals and higher education institutions wishing to implement a SF/TF campus policy with a set of indicators that can serve to assess the impact of a SF/TF campus policy (attitudes, acceptability, beliefs, norms, exposure to passive smoking and pollution, changes in smoking behavior). CONCLUSION: Based on scientific evidence, the implementation of SF/TF campus policies in France is an important measure to help combat smoking in young adults.

Restricting the content of alcohol advertising and including text health warnings: A between-group online experiment with a non-probability adult sample in the United Kingdom.

BACKGROUND: Statutory options for restricting alcohol advertising include limiting it to product-orientated information and requiring health warnings. We assess the impact of removing positive contextual factors from alcohol advertising and including a health warning among adults in the United Kingdom (UK). METHODS: We conducted a 2 × 2 online between-group experiment with adults (18+) (n = 2421) recruited from a non-probability research panel in the United Kingdom. Participants were randomized to see an alcohol (vodka) advertisement (advert) which varied by context (no context vs. imagery depicting positive social interactions around alcohol) and message (multiple text health warning vs. "drink responsibly"). The multiple text health warning, based on recent legislation in Ireland, comprised three separate warnings (liver disease, cancers, drinking during pregnancy) and a web address for alcohol-related information and support. The "drink responsibly" control reflected the self-regulatory messages commonly used by alcohol companies. Participants rated the advert on 7-point scales for advert attractiveness, product appeal, trial intentions, perceived harm, and whether it made drinking alcohol seem enjoyable. RESULTS: Removing the positive social context reduced positive advert and product reactions (difference in estimated marginal means [EMM]: -1.57 [makes drinking alcohol seem enjoyable] to -0.23 [intention to try]). Including the multiple text health warning also reduced positive advert and product reactions (difference in EMM: -0.55 [advert attractiveness] to -0.25 [intention to try]) and increased perceived product harm (difference in EMM: +0.25). There were no interactions between advert context and message for any outcome. CONCLUSIONS: Restricting content and including a multiple text health warning (compared to a "drink responsibly" message) may attenuate the persuasive impact of alcohol advertising and increase perceived product harm. Further research is needed to examine different degrees of content restrictions, alternative warning content and design, generalizability to different alcohol products and advert formats, and whether the impact of content controls varies among population subgroups.

Tobacco-free university campus policies: A systematic review.

Objective: This systematic review aims to provide an update of the scientific evidence regarding tobacco-free/smoke-free campus policies (TFC/SFC), using a complex interventions approach. PARTICIPANTS/METHODS: We searched the PubMed, Scopus and Web of Science databases using a combination of 'tobacco-free' or 'smoke-free', 'campus', 'university or college' and 'policy' search terms on all indexed articles published up until June 2023. Studies were included if they presented research on pre-/post-implementation of TFC/SFC or policy components. Two coders extracted and synthesized the data and assessed the risk of bias. RESULTS: A total of 113 studies were included, reporting data from 2005 to 2023 across 17 countries. The data was categorized into three of the four phases of the Medical Research Council (MRC) framework, i.e. "feasibility (n=24), "implementation" (n=34), and "evaluation" (n=69). This review finds that a policy draft, communication, enforcement strategies, and cessation services are critical policy components. TCF/SFC are effective for reducing tobacco use and secondhand smoke exposure, but they also increase vaping. Little research has investigated the effect of TFC/SFC on smokeless tobacco use. CONCLUSION: This review addresses remaining uncertainties in evidence on the TFC/SFC implementation process. We go on to provide a series of recommendations for university administrators.