Commercial tobacco endgame themes in the Australian media from 2000 to 2021.

BACKGROUND: Conventional tobacco control is dominated by demand-reduction measures, whereas commercial tobacco endgame (endgame) policies address the key drivers that maintain the tobacco epidemic, such as Tobacco Industry interference in policymaking, the addictiveness of commercial tobacco products and their widespread availability via retail outlets. While Australia has been a pioneer in tobacco control, Australian Governments are yet to commit to endgame policies. The media play an important role reflecting and influencing public opinion and policymaker positions, and can help set the agenda for policy innovation. METHOD: Media articles mentioning tobacco endgame goals and policies published between 2000 and 2021 were identified by searching Factiva and Google (News). We used reflexive thematic analysis (RTA) to identify themes in the articles, supported by content analysis, to describe elements of the data and sentiment analysis to categorise the article sentiment. A deductive-inductive approach was applied in the RTA, coding text from the articles against predefined codes, while also generating new codes where novel themes were identified. Codes were then grouped and summarised. RESULTS: One hundred and ninety-three articles were included for analysis. The media discourse focused on three policies: tobacco-free generation; banning or phasing out retail supply of tobacco; and mandating a very low nicotine content standard for cigarettes. A broad range of themes in the articles supported endgame policies, including the large health toll from tobacco, government responsibility to act and the total social costs far outweighing any economic benefit from the tobacco market. Opposing themes included the purported failures of 'prohibition', illicit trade, 'nanny statism' and impact on retail trade. Equity themes were scarce. The benefits of a smoke-free society were described at a societal level, rather than the personal benefits for individuals. CONCLUSION: Media articles on the tobacco endgame in Australia generally contained positive sentiment about endgame policies. When engaging with the media, endgame advocates should be aware of, and ready to counter, opposing themes such as the purported failures of 'prohibition', 'nanny state' rhetoric or a growth in illicit tobacco trade.

Closing the gaps in tobacco endgame evidence: a scoping review.

OBJECTIVE: Tobacco endgame policies aim to rapidly and permanently reduce smoking to minimal levels. We reviewed evidence syntheses for: (1) endgame policies, (2) evidence gaps, and (3) future research priorities. DATA SOURCES: Guided by JBI scoping review methodology, we searched five databases (PubMed, CINAHL, Scopus, Embase and Web of Science) for evidence syntheses published in English since 1990 on 12 policies, and Google for publications from key national and international organisations. Reference lists of included publications were hand searched. STUDY SELECTION: Two reviewers independently screened titles and abstracts. Inclusion criteria were broad to capture policy impacts (including unintended), feasibility, public and stakeholder acceptability and other aspects of policy implementation. DATA EXTRACTION: We report the results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. DATA SYNTHESIS: Eight policies have progressed to evidence synthesis stage (49 publications): mandatory very low nicotine content (VLNC) standard (n=26); product standards to substantially reduce consumer appeal or remove the most toxic products from the market (n=1); moving consumers to reduced risk products (n=8); tobacco-free generation (n=4); ending sales (n=2); sinking lid (n=2); tax increases (n=7); and restrictions on tobacco retailers (n=10). Based on published evidence syntheses, the evidence base was most developed for a VLNC standard, with a wide range of evidence synthesised. CONCLUSIONS: VLNC cigarettes have attracted the most attention, in terms of synthesised evidence. Additional focus on policies that reduce the availability of tobacco is warranted given these measures are being implemented in some jurisdictions.

Evaluation of a comprehensive tobacco control project targeting Arabic-speakers residing in south west Sydney, Australia.

Tobacco control is a health promotion priority, but there is limited evidence on the effectiveness of campaigns targeting culturally and linguistically diverse (CALD) populations. Being the largest population of non-English-speaking smokers residing in New South Wales (NSW), Australia, Arabic-speakers are a priority population for tobacco control. We report findings from baseline and post-intervention cross-sectional telephone surveys evaluating a comprehensive social marketing campaign (SMC) specifically targeting Arabic-speakers residing in south west Sydney, NSW. The project was associated with a decline in self-reported smoking prevalence from 26% at baseline to 20.7% at post (p < 0.05) and an increase in self-reported smoke-free households from 67.1% at baseline to 74.9% at post (p < 0.05). This paper contributes evidence that comprehensive SMCs targeting CALD populations can reduce smoking prevalence and influence smoking norms in CALD populations.

Tobacco control priorities for Arabic speakers: key findings from a baseline telephone survey of Arabic speakers residing in Sydney's south-west.

ISSUE ADDRESSED: The Arabic-speaking population is a priority for tobacco control in Sydney's south-west. Current smoking prevalence and smokers' preferences for evidence-based cessation therapies are reported for this population. METHODS: A telephone survey of Arabic speakers conducted in Sydney's south-west between August and November 2004 included: utilisation of tobacco products, tobacco and health knowledge, quit attempts and likelihood to use evidence-based cessation strategies. RESULTS: A 70% response rate was achieved (n=1,102). Twenty-six per cent of respondents (95% CI 23.5-28.7) self-reported being current smokers. Logistic regression analysis demonstrated that poor knowledge of the harms of smoking (AOR=7.50, 95% CI 3.20-17.59), being male (AOR=2.63, 95% CI 1.89-3.65), being aged between 40 and 59 (AOR=1.44, 95% CI 1.06-1.96) and non-tertiary educated (AOR=1.44, 95% CI 1.06-1.97) were independent predictors of self-reported smoking. Smokers' preferences for evidence-based cessation strategies included: vouchers for discounted nicotine replacement therapy (NRT) (58.8%, 95% CI 52.9-64.6), standard self-help booklet (56.6%, 95% CI 50.7-62.4) and tailored self-help written materials (mailed) (54.0%, 95% CI 48.1- 59.9). More than one-third of all current cigarette smokers (39.4%, n=108, 95% CI 33.6-45.2) indicated they had made a quit attempt in the past 12 months. CONCLUSIONS: Well-designed trials of efficacy for preferred evidence-based strategies, particularly among middle-aged male Arabic-speaking smokers, appear warranted prior to policy development and implementation.

Subsidised nicotine replacement therapy in a community pharmacy setting.

ISSUES ADDRESSED: Nicotine replacement therapies are effective, but are mostly under-utilised and often not used for an appropriate duration. The paper reports on a pilot project that used subsidies for NRT as a means to engage community pharmacists to deliver tobacco cessation to the Arabic-speaking community. METHOD: Arabic-speaking community pharmacists were recruited through direct mail-outs and trained in tobacco cessation brief intervention. Fifteen selected pharmacies recruited Arabic smokers through their pharmacies. Pharmacy follow-up was conducted three months after the program was implemented. RESULTS: A total of 65 participants attended the seminar. A total of 31 pharmacy customers received at least one packet of subsidised NRT patches. Twenty (64.5%) clients received both the first and second subsidised pack. Fifteen clients continued to use patches after the third packet, however only three clients continued the patches to the eighth pack. CONCLUSION: The pilot was successful in improving recruitment of pharmacies into training for smoking cessation counselling as well as engaging community pharmacists to deliver tobacco cessation intervention with small incentive.