Identifying best practices in adoption, implementation and enforcement of flavoured tobacco product restrictions and bans: lessons from experts.

OBJECTIVE: To identify recommended components for adopting, implementing and enforcing bans or restrictions targeting flavoured tobacco products. METHODS: Between April and June 2019, semistructured interviews were conducted with 17 high-level experts across the USA and Canada with expertise in flavoured tobacco product policies. Participants included health department staff, researchers, legal professionals and local government officials. Interviews were recorded, transcribed and analysed for key themes. RESULTS: Major findings were organised into four categories: programme planning and legislative preparations; education and community outreach; implementation and enforcement; and policy impact. Critical pre-implementation elements included using comprehensive policy language, identifying enforcement agents, examining potential economic costs, deploying media campaigns and engaging community partners and retailers. Recommended implementation processes included a 6-month preparation timeline, focus on retailer education and clearly outlined enforcement procedures, particularly for concept flavours. CONCLUSIONS: Flavoured tobacco policies have successfully limited sales, withstood legal challenges and become more comprehensive over time, providing useful lessons to inform ongoing and future legislative and programmatic efforts. Identifying and sharing best practices can improve passage, implementation, efficacy and evaluation of flavoured tobacco policies.

Insights in Public Health: Data Highlights from the Hawai'i Youth Risk Behavior Survey: Links Between Academic Achievement and Health Behaviors.

The Youth Risk Behavior Survey is administered biennially in odd years to public middle and high school students in Hawai'i. Data highlights are presented from Hawaii's 2017 high school survey results to enhance understanding of the relationship between health and academic achievement. This article reviews a select set of health-risk behaviors and their association with academic grades for Hawai'i public school students. The findings demonstrate that students who self-reported engaging in health protective behaviors also reported higher academic grades in school, while those who engaged in health-risk behaviors were more likely to report lower grades in school. This discussion can provide useful background information and benchmarks for research, policy, and local initiatives. It also supports the need for continued collaboration and a synergistic approach between education and health partners in Hawai'i in order to improve the health and academic achievement of our youth.

Psychophysiological arousal and craving in smokers, deprived smokers, former smokers, and non-smokers.

This study investigates the biometric signature associated with tobacco craving and stress elicitation using principles of cue reactivity. Seventy-five non-smokers and smokers (half of whom were tobacco-deprived for 6 hours) took part in a standardized laboratory session during which they were presented with a series of film clips designed to arouse fear, amusement, or craving. Participants self-reported their emotional response to each film clip and wore non-invasive biosensors to collect physiologic data. Findings indicate different patterns of physiologic arousal for smokers than non-smokers; and that among smokers, deprived smokers had significantly different arousal patterns than non-deprived smokers. This article describes how the elicitation of stress and craving can contribute to the prediction of arousal patterns associated with tobacco craving and how this can create new opportunities for smoking cessation intervention. A comparison of each group's patterns of arousal and physiologic activity is presented, with particular focus on the differences between smokers and deprived smokers.