Content analysis of email marketing communications among online e-cigarette retailers.

INTRODUCTION: Online e-cigarette retailers use email communications to promote products directly to consumers, which may facilitate e-cigarette use. Little is known about the content of these emails. As such, this study collected emails from online e-cigarette retailers in California to conduct a content analysis. METHODS: This study included 13 online e-cigarette retailers in California using Yelp. To be included in the study, e-cigarette retailers needed a live website, physical retail location (i.e., vape shop), and e-cigarettes available for purchase online. The research team entered each website and signed up (if possible) for an email newsletter. Data were collected from the Gmail Application Programming Interface over a 1-year study period (11/01/21-11/01/22). Members of the research team coded emails for the presence of e-cigarettes, other products, flavors, marketing categories, and promotional activities, among other variables. RESULTS: 749 promotional emails (2.1 avg/per day) were received over the 1-year study period. Second-generation e-cigarettes (n=581, 77.6%) were the most observed product in emails followed by disposable e-cigarettes (n=391, 52.2%). The most common flavor profile was fruit/sweet/liquor (n=424, 56.6%). Emails included links to social media pages (n=366, 48.9%). Online coupons were found in 53.1% (n=398) of the emails. Age warnings were displayed in 8.0% (n=60) of the emails. CONCLUSIONS: E-cigarette retailers' emails promoted new products, flavors, and contained promotional discounts. Future research should examine the impact of exposure to such emails on e-cigarette-related attitudes and behaviors. IMPLICATIONS: Findings from this study may help inform prevention programs and interventions focused on increasing tobacco-related digital media literacy (i.e., evaluate tobacco advertising messages on digital media) among gender and ethnic minorities. Future research should examine if exposure to email marketing is causally linked with e-cigarette use among gender and ethnic minorities.

Online Purchase Attempts of Flavored E-Cigarettes to Minors in California Before and After Senate Bill 793.

This survey study assesses whether the online purchase attempt completion rate of e-cigarettes changed after passage of California Senate Bill 793.

Mentoring for Success in Tobacco Regulatory Science: A Qualitative Study.

OBJECTIVES: Our study explores the experiences of early career and senior scientists regarding mentorship and career trajectories in tobacco regulatory science (TRS). METHODS: We conducted 22 phone interviews with early career and senior tobacco regulatory scientists from July 2015 to January 2016. All interviews were conducted using a structured interview guide and analyzed using a thematic approach by 2 independent coders. RESULTS: TRS presents specific opportunities and challenges to scientists due to its focused goal of informing tobacco regulation. An understanding of US Food and Drug Administration (FDA) research priorities and how science can inform tobacco regulation are essential for effective mentorship in TRS. Careers in TRS can be pursued in various academic and non-academic professional roles; both offer the distinct ability to conduct science that impacts public policy. Early career and senior scientists identified the importance and challenge of providing broad training across the diverse disciplines of TRS. CONCLUSIONS: Effective mentorship in TRS requires that mentors possess an in-depth understanding of the scientific, regulatory, and legislative processes inherent to tobacco regulatory policy-making. A training program for mentors specific to TRS has the potential to meet diverse professional needs of mentors and mentees aiming to impact tobacco policy.

Defining Tobacco Regulatory Science Competencies.

INTRODUCTION: In 2013, the National Institutes of Health and the Food and Drug Administration funded a network of 14 Tobacco Centers of Regulatory Science (TCORS) with a mission that included research and training. A cross-TCORS Panel was established to define tobacco regulatory science (TRS) competencies to help harmonize and guide their emerging educational programs. The purpose of this paper is to describe the Panel's work to develop core TRS domains and competencies. METHODS: The Panel developed the list of domains and competencies using a semistructured Delphi method divided into four phases occurring between November 2013 and August 2015. RESULTS: The final proposed list included a total of 51 competencies across six core domains and 28 competencies across five specialized domains. CONCLUSIONS: There is a need for continued discussion to establish the utility of the proposed set of competencies for emerging TRS curricula and to identify the best strategies for incorporating these competencies into TRS training programs. Given the field's broad multidisciplinary nature, further experience is needed to refine the core domains that should be covered in TRS training programs versus knowledge obtained in more specialized programs. IMPLICATIONS: Regulatory science to inform the regulation of tobacco products is an emerging field. The paper provides an initial list of core and specialized domains and competencies to be used in developing curricula for new and emerging training programs aimed at preparing a new cohort of scientists to conduct critical TRS research.

The Tsao Fellowship in Global Health: A Model for International Fellowships in a Surgery Residency.

OBJECTIVE: To present a model for integrated global health fellowships in plastic surgical residency training. BACKGROUND: National surveys have found that North American surgical residents have significant interest in international training. While global health training opportunities exist, less than a third of these are housed within surgical residency programs; even fewer are designed specifically for plastic surgery residents. METHODS: The Tsao Fellowship was created through a partnership between Operation Smile, Children's Hospital Los Angeles, Shriners Hospital for Children, and the University of Southern California. Designed for Accreditation Council for Graduate Medical Education accredited plastic surgery residents between their third and fourth years of residency, the fellowship curriculum is completed over 24 months and divided into 3 areas: clinical research, international reconstructive surgery fieldwork, and the completion of a Master of Science in Clinical and Biomedical Investigations. RESULTS: The Tsao Fellowship has matriculated 4 fellows: 3 have graduated from the program and 1 is in the current cycle. Fellows completed 4 to 7 international missions each cycle and have performed an aggregate total of 684 surgical procedures. Each fellow also conducted 2 to 6 research projects and authored several publications. All fellows continue to assume leadership roles within the field of global reconstructive surgery. CONCLUSIONS: Comprehensive global health fellowships provide invaluable opportunities beyond surgical residency. The Tsao Fellowship is a model for integrating international surgical training with global health research in plastic surgical residency that can be applied to other residency programs and different surgical specialties.

Framing Progress In Global Tobacco Control To Inform Action On Noncommunicable Diseases.

Much has been learned about the tobacco epidemic, including its consequences, effective measures to control it, and the actors involved. This article identifies lessons learned that are applicable to the other principal external causes of noncommunicable diseases: alcohol abuse, poor nutrition, and physical inactivity. Among these lessons are the development of evidence-based strategies such as proven cessation methods, tax increases, and smoke-free policies; the role of multinational corporations in maintaining markets and undermining control measures; and the need for strategies that reach across the life course and that begin with individuals and extend to higher levels of societal organization. Differences are also clear. Tobacco products are relatively homogeneous and have no direct benefit to consumers, whereas food and alcohol consumed in moderation are not inherently dangerous. Some tobacco-related diseases have the singular predominant cause of smoking, while many noncommunicable diseases have multiple interlocking causes such as poor diet, excess alcohol consumption, insufficient physical activity, and smoking, along with genetics. Thus, the tobacco control model of comprehensive multilevel strategies is applicable to the control of noncommunicable diseases, but the focus must be on multiple risk factors.

Perceptions of foreign health aid in East Africa: an exploratory baseline study.

BACKGROUND: There is insufficient literature on the perceptions of aid recipients with respect to foreign health aid administration and impact. This study sought to identify perceptions of foreign health aid among individuals, health care workers (HCWs), and policymakers in three East African countries: Kenya, Uganda, and Ethiopia. Each country receives substantial foreign aid and shares regional proximity. METHODS: A qualitative exploratory study design was adopted and 81 questionnaires were administered to individuals, HCWs and policymakers. Questionnaires ascertained perceptions of foreign aid, health aid and the USA. Responses were compared between groups and across countries. RESULTS: Perceptions of how much foreign aid a community receives varied between individuals ('a little'), HCWs ('some') and policymakers ('a lot'). Respondents were positive towards the USA irrespective of the level of aid they perceived came from the USA. Opinions regarding the impact of aid varied by country and by profession. Aid priorities were similar among all countries and participants, with health care, education and economic development among the primary sectors reported. CONCLUSIONS: More research is needed on perceptions of aid recipients. The findings of this pilot study highlight the need for inclusion of these stakeholders in order to better inform decisions regarding foreign aid.

Banning the hiring of tobacco users: where's the fire?

This commentary addresses the article in this issue by Huddle and colleagues concerning the implementation of policies by the University of Alabama at Birmingham (UAB) School of Medicine and other academic health centers to not hire users of tobacco products. Huddle and colleagues explore the basis for such policies and find that even though institutions may be within their rights to implement such policies, the policies are inconsistent with the societal role of an academic health center as a caregiving institution. They see a potential for discrimination, as contemporary users of tobacco are more likely to have less education and lower incomes than nonusers.The authors of this commentary review the arguments for and against such policies and explore the complexities of the implementation of such a policy by a state institution. They express concern that a state institution has chosen not to hire state residents who use tobacco products, which are legal. The authors also explore the potentially discriminatory aspects of such policies and possible implications of these policies in the context of rights and legal frameworks.The academic medicine community must learn from the experience that will follow from such policies as well as from other state and nonstate institutions that have implemented similar employment policies. Huddle and colleagues have provided a thoughtful contribution to a complex and inevitably continuing discussion.

Global tobacco control diffusion: the case of the framework convention on tobacco control.

OBJECTIVES: We analyzed demographic and social network variables associated with the timing of ratification of the Framework Convention on Tobacco Control (FCTC). METHODS: We compiled a 2-mode data set that recorded country participation in FCTC negotiations, as well as the number of individuals per country per year who joined an online tobacco control network. We used logistic regression analysis of these 2 data sets along with geographic location to determine whether exposure to prior FCTC adoptions was associated with a country's likelihood of adoption. RESULTS: In the logistic regression analysis, higher income and more nongovernmental organizations (NGOs) involved in the Framework Convention Alliance (a network dedicated to the FCTC) were associated with being among the earliest adopters (for income, adjusted odds ratio [AOR] = 2.41; 95% confidence interval [CI] = 1.55; for NGOs, AOR = 1.66; 95% CI = 1.26, 2.17) or among early adopters (for income, AOR = 1.42; 95% CI = 1.09, 1.84; for NGOs, AOR = 1.23; 95% CI = 1.03, 1.45). Network exposure and event history analysis showed that in addition to income, the likelihood of adoption increased with increasing affiliation exposure to FCTC adopters through GLOBALink (an online network facilitating communication between tobacco control advocates). CONCLUSIONS: Public health programs should include a plan for creating opportunities for network interaction; otherwise, adoption and diffusion will be delayed and the investments in public health policy greatly diminished.

Building capacity for international tobacco control research: the global tobacco research network.

The Global Tobacco Research Network (GTRN) was developed to enhance global tobacco control research through information sharing and collaboration among researchers. The formation of the GTRN is timely because of the need to ratify, implement, and track the Framework Convention on Tobacco Control. While the spectrum of international tobacco control research continues to expand, resources to support these efforts are still quite limited. As an issue-specific network focused on information sharing and capacity building associated with tobacco control research, the GTRN will provide an opportunity for enhancing the effectiveness of tobacco control initiatives.