Who's still smoking? Disparities in adult cigarette smoking prevalence in the United States.

The continuing high prevalence of cigarette smoking among specific subpopulations, many of them vulnerable, is one of the most pressing challenges facing the tobacco control community. These populations include individuals in lower education and/or socioeconomic groups; from certain racial/ethnic groups; in the lesbian, gay, bisexual, and transgender community; with mental illness; and in the military, particularly among those in the lowest pay grades. Although traditional tobacco control measures are having positive health effects for most groups, the effects are not sufficient for others. More attention to and support for promising novel interventions, in addition to new attempts at reaching these populations through conventional interventions that have proven to be effective, are crucial going forward to find new ways to address these disparities. CA Cancer J Clin 2018;68:106-115. © 2018 American Cancer Society.

Key issues surrounding the health impacts of electronic nicotine delivery systems (ENDS) and other sources of nicotine.

Answer questions and earn CME/CNE Over the last decade, the use of electronic nicotine delivery systems (ENDS), including the electronic cigarette or e-cigarette, has grown rapidly. More youth now use ENDS than any tobacco product. This extensive research review shows that there are scientifically sound, sometimes competing arguments about ENDS that are not immediately and/or completely resolvable. However, the preponderance of the scientific evidence to date suggests that current-generation ENDS products are demonstrably less harmful than combustible tobacco products such as conventional cigarettes in several key ways, including by generating far lower levels of carcinogens and other toxic compounds than combustible products or those that contain tobacco. To place ENDS in context, the authors begin by reviewing the trends in use of major nicotine-containing products. Because nicotine is the common core-and highly addictive-constituent across all tobacco products, its toxicology is examined. With its long history as the only nicotine product widely accepted as being relatively safe, nicotine-replacement therapy (NRT) is also examined. A section is also included that examines snus, the most debated potential harm-reduction product before ENDS. Between discussions of NRT and snus, ENDS are extensively examined: what they are, knowledge about their level of "harm," their relationship to smoking cessation, the so-called gateway effect, and dual use/poly-use. CA Cancer J Clin 2017;67:449-471. © 2017 American Cancer Society.

Advocacy, communication, and partnerships: Mobilizing for effective, widespread cervical cancer prevention.

Both human papillomavirus (HPV) vaccination and screening/treatment are relatively simple and inexpensive to implement at all resource levels, and cervical cancer screening has been acknowledged as a "best buy" by the WHO. However, coverage with these interventions is low where they are needed most. Failure to launch or expand cervical cancer prevention programs is by and large due to the absence of dedicated funding, along with a lack of recognition of the urgent need to update policies that can hinder access to services. Clear and sustained communication, robust advocacy, and strategic partnerships are needed to inspire national governments and international bodies to action, including identifying and allocating sustainable program resources. There is significant momentum for expanding coverage of HPV vaccination and screening/preventive treatment in low-resource settings as evidenced by new global partnerships espousing this goal, and the participation of groups that previously had not focused on this critical health issue.

Comprehensive evaluation of an online tobacco control continuing education course in Canada.

INTRODUCTION: To respond to the increasing need to build capacity for planning, implementing, and supporting tobacco control strategies, an evidence-based, online continuing education (CE) course aimed at Canadian public health professionals was developed. The purpose of this study was to comprehensively evaluate the course, Tobacco and Public Health: From Theory to Practice (http://tobaccocourse.otru.org). METHODS: Rossett and McDonald's revision of Kirkpatrick's four-level evaluation model for training programs guided the evaluation design. A pre-, post-, and follow-up single group design assessed immediate reactions to course modules, knowledge change and retention, practice change, and overall perceived value of the course. Six external peer reviewers evaluated course module content. RESULTS: Fifty-nine participants completed all three course modules and the final online questionnaire at time 3, representing a response rate of 78%. Significant knowledge gains occurred between times 1 and 2 (p < 0.001). Although time 3 scores remained higher than time 1 scores for each module (p < 0.001), they decreased significantly between times 2 and 3 (p < 0.001). The majority of participants (93%) felt the topics covered were useful to their daily work. All but one participant felt the course was a good investment of their time, and nearly all participants (97%) stated they would recommend the course to others. Peer reviewers found that module content flowed well and was comprehensive. DISCUSSION: This comprehensive evaluation was valuable both for assessing whether course goals were achieved and for identifying areas for course improvement. We expect this design would be a useful model to evaluate other online continuing education courses.