A mixed-methods evaluation of the Tobacco Retailer Advanced Compliance (TRAC) online training (e-learning) program.

INTRODUCTION: Tobacco vendor training is recognized as an essential element to reduce youth access to tobacco. The TRAC training program was developed utilizing best-practices in tobacco retailer training, adult instruction, and e-learning. The objective of this mixed-methods study is to evaluate the acceptability, usability and knowledge impact of an online tobacco retailer program. METHODS: An interview guide and evaluation questionnaire were used to collect data on usability and acceptability. To test learner knowledge, each module included a final set of 15 questions randomly chosen and posed to participants before and after the training. Content analysis, chi-squared tests, Student's t-tests, and paired tests were utilized for data analysis. The evaluation was conducted in Alberta, Canada in 2020. RESULTS: A total of 128 participants enrolled in the study. The main themes revealed in the qualitative aspect of the evaluation were: the training was easy to navigate, engaging, informative, and beneficial to the staff's daily work. Compared with the pre-training test, a significantly higher post-training test score, mean and (SD), was recorded for clerks who completed the clerk training module [59.1 (12.8) vs 75.5 (11.1), t=8.6378, p<0.001], and managers who completed the managers training module [51.5 (11.1) vs 73.1 (12.3), t=7.6446, p<0.001]. Similarly, a higher number of participants achieved the passing score of 80% in the post-training test in all three groups. CONCLUSIONS: The online training was found to be acceptable and effective in increasing the mean individual score in the knowledge test and in increasing the percentage of participants achieving the passing score. The TRAC training is the first known tobacco retailer training course to employ best practices in tobacco retailer training, adult instruction, and e-learning. Further evaluation of long-term outcomes on employee behavior and on overall compliance with tobacco legislation is recommended.

Perspective on Cancer Control: Whither the Tobacco Endgame for Canada?

Aims: In 2014, in response to evidence that Canada's tobacco use would lead, inexorably, to substantial morbidity and mortality for the foreseeable future, a group of experts convened to consider the development of a "Tobacco Endgame" for Canada. The "Tobacco Endgame" defines a time frame in which to eliminate structural, political, and social dynamics that sustain tobacco use, leading to improved population health. Strategies: A series of Background Papers describing possible measures that could contribute to the creation of a comprehensive endgame strategy for Canada was prepared in advance of the National Tobacco Endgame Summit hosted at Queen's University in 2016. At the summit, agreement was reached to work together to achieve <5% tobacco use by 2035 (<5 by '35). A report of the proceedings was shared widely. Achievements: Progress since 2016 has been mixed. The Summit report was followed by a national forum convened by Health Canada in March 2017, and in 2018, the Canadian Government adopted "<5 × '35" tobacco use target in a renewed Canadian tobacco reduction strategy. Tobacco use has declined in the last 5 years, but at a rate slower than that which will be needed to achieve the <5 by '35 goal. There remain > 5 million smokers in Canada, signaling that smoking-related diseases will continue to be an enormous health burden. Furthermore, the landscape of new products (e-cigarettes and cannabis) has created additional risks and opportunities. Future directions: A bold, reinvigorated tobacco control strategy is needed that significantly advances ongoing policy developments, including full implementation of the key demand-reduction policies of the WHO Framework Convention on Tobacco Control. Formidable, new disruptive policies and regulations will be needed to achieve Canada's Endgame goal.

Taking global leadership in banning menthol and other flavours in tobacco: Canada's experience.

Measures to ban or restrict menthol and other flavours in tobacco products are under consideration or newly implemented in an increasing number of jurisdictions across the world. As one of the world leaders, Canada's experience in successfully developing and implementing such measures can be instructive for other jurisdictions. This paper explores the history of how Canada was able to implement tobacco flavour bans including menthol, examines some of the challenges and presents lessons learnt for other jurisdictions. The crucial motivation for these bans emerged from surveillance data showing high rates of flavoured tobacco use by youth, including menthol cigarette smoking, that was publicised by non-governmental organisations. Further data showed that early legislation in 2009 contained loopholes (cigar size exemptions and menthol exemptions) that limited the benefits of the legislation. Leadership by the provinces created an environment in which the federal ban on menthol ingredients in 2017 was a clear and obvious step to ensure implementation across the country. The Canadian measures have been successful at reducing the use of flavoured tobacco including menthol cigarettes and facilitating smoking cessation. Lessons learnt include the downsides of exemptions, the lack of a contraband issue (despite an existing supply in Canada), the benefits of availability of youth flavour prevalence data and the success of subnational regulations to advance national regulation.

Cigarette affordability in Canadian provinces: a 10-year review. / Abordabilité des cigarettes dans les provinces canadiennes : revue sur 10 ans.

The association between pricing and cigarette consumption is long-established. However, the effects of taxation alone can be diminished if relative income increases. Therefore, affordability is seen as a key determinant of demand for cigarettes, as it combines the impact of changing prices with economic growth or wage increases. This brief analysis employs methods used by the World Health Organization in examining cigarette affordability, and explores the trend in affordability across Canadian provinces over a 10-year period, from 2009 to 2019. The discussion illustrates how monitoring affordability over time can help policy makers in Canadian provinces design tobacco taxation for maximum impact.

This paper reports on the comparative analysis of the trend in cigarette affordability rates across Canadian provinces over a 10-year period, from 2009 to 2019. This paper discusses the importance of examining affordability as an effective measure of the impact of tobacco taxation on tobacco consumption.

Cet article porte sur une analyse comparative de l'évolution des taux d'abordabilité des cigarettes dans les provinces canadiennes sur 10 ans, soit entre 2009 et 2019. Cet article explique l'importance de prendre en compte l'abordabilité à titre de mesure efficace de l'impact de la taxation du tabac sur la consommation de tabac.

Empowering Students and Influencing Policy Change Through Experiential Public Health Advocacy Education.

BACKGROUND: Public health advocacy is central to the work of many health professionals, including nurses. Although deemed to be a core competency for public health practitioners, courses described in the literature often lack a focus on experiential learning, which is an essential component to acquiring public health advocacy skills. METHOD: This article describes an innovative, 12-week graduate course that provides students with a combination of theory and experiential learning through an opportunity to engage in political advocacy, community mobilization, and media engagement on a current public health issue. RESULTS: An advocacy campaign undertaken by students to increase community access to the overdose reversal medication naloxone is described in light of the current North American overdose epidemic. Key considerations for teaching public health advocacy to facilitate development of nursing courses elsewhere are highlighted. CONCLUSION: Public health advocacy education is important and needs to be expanded both within the nursing profession and across all disciplines. [J Nurs Educ. 2019;58(12):698-703.].