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1.
Int J Health Policy Manag ; 8(12): 727-731, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31779301

RESUMO

In their editorial, Tangcharoensathien et al1 describe the challenges of industry market promotion and policy interference from Big Tobacco, Alcohol, and Food in addressing non-communicable diseases (NCDs). They provide an overview of the increasing influence of corporate interest in emerging economies and government attempts to implement the World Health Organization (WHO) 'best buy' interventions. The authors largely draw on examples from Asia and a few selected countries, but provide little detail as to how aggressive marketing and policy interference plays out in a context of poor legislation and regulation in many low- and middleincome countries (LMICs), where the burden of NCDs is increasing at an alarming rate and governments face a high burden of disease with a limited budget for countering industry interference. This commentary provides some poignant examples of the influence of Big Tobacco, Alcohol, and Food on market regulation and policy interference in LMICs and argues for more policy coherence and accountability in terms of multisectoral action and civil society activism. Securing funds for health promotion and establishing health promotion foundations could help achieve that goal.


Assuntos
Doenças não Transmissíveis , Ásia , Países em Desenvolvimento , Política de Saúde , Humanos , Tabaco
2.
Artigo em Inglês | MEDLINE | ID: mdl-31752132

RESUMO

Australia has maintained a highly restrictive regulatory framework for nicotine vaping products (NVPs) and the regulatory approach differs from most other high income countries. This paper employed a thematic analysis to assess policy consultation submissions made to a government inquiry regarding use and marketing of NVPs. We included in the analysis submissions (n = 40) made by Australian institutions that influence or contribute to health policy-making including government agencies, health bodies and charities (n = 23), and public health academics and healthcare professionals (n = 18). Submissions from commercial entities and consumers were excluded. The majority of submissions from representatives of government agencies, health bodies and charities recommended maintaining current restrictions on NVPs. Arguments against widening access to NVPs included the demand for long-term evidence on safety and efficacy of an unusually high standard. There was widespread support for restrictions on sales, advertising and promotion, with most submissions supporting similar controls as for tobacco products. In contrast, the majority of individual submissions from healthcare professionals and public health academics advocated for widening access to NVPs for smokers and emphasized the potential benefits of smokers switching to vaping and the policy incoherence of regulating less harmful nicotine products more strictly than tobacco cigarettes. Progress in resolving the policy debate concerning NVP regulation in Australia will require policy makers, clinicians and the public health community to engage in a meaningful dialogue which gives due consideration to both intended and unintended consequences of proposed policies.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Política de Saúde/legislação & jurisprudência , Nicotina , Formulação de Políticas , Saúde Pública/legislação & jurisprudência , Vaping/legislação & jurisprudência , Austrália , Humanos
3.
Washington, D.C.; PAHO; 2019-11. (PAHO/NMH/19-018).
em Inglês | PAHO-IRIS | ID: phr-51715

RESUMO

[Executive summary]. Noncommunicable diseases (NCDs) are a major driver of morbidity and mortality in the Region of the Americas. They represent a major public health challenge that undermines social and economic development. The WHO Global Action Plan for Prevention and Control of Noncommunicable Diseases 2013-2020, endorsed by the 66th World Health Assembly, provides a road map and a menu of policy options. It recognizes implementing taxes on unhealthy products associated with NCDs—namely tobacco, alcoholic beverages, and sugar-sweetened beverages (SSBs)—as one of the most cost-effective regulatory policies to prevent NCDs. Although, the World Health Organization (WHO) does calculate and publish biennially a standardized and comparable indicator on tobacco taxation for all Member States, it does not count with comparable measurements of taxation on alcoholic beverages and SSBs. Such measurements are necessary to monitor tax policies, analyze trends and establish best practices in using taxation for NCD prevention. Since 2016, the Department of Noncommunicable Diseases and Mental Health (NMH) of the Pan American Health Organization/World Health Organization (PAHO/WHO) has worked towards addressing the gap measuring progress on alcoholic beverages and SSBs taxation in the Americas. NMH collected country-level information on prices as well as tax legislation and developed a methodology for calculating a tax share indicator. This indicator, estimating the share of total and excise taxes in the price of alcoholic beverages and SSBs, was calculated for ten countries. In order to receive feedbacks on its proposed methodology, discuss the progress and challenges in monitoring and evaluating taxation policies, and establish a roadmap to periodically collect tax legislation and prices and calculate the tax share for alcoholic beverages and SSBs in the Americas, NMH convened researchers and ministries of finance personnel for a two-day meeting in July 2018, in Washington D.C. The participants provided inputs on how to strengthen the proposed tax share indicator to adequately capture the intricacies, unique characteristics, and regional consumption patterns of these products. These valuable inputs will help to improve the methodology and facilitate future efforts to develop a standardized and comparable tax share indicator for alcoholic beverages and SSBs.


Assuntos
Doença Crônica , Bebidas Alcoólicas , Alimentos e Bebidas , Planos e Programas de Saúde
4.
Rev Prat ; 69(6): 653-657, 2019 Jun.
Artigo em Francês | MEDLINE | ID: mdl-31626428

RESUMO

French governments only very recently introduced comprehensive tobacco control policies including several measures recommended by WHO Framework Convention on Tobacco Control, leading to a speeding-up of tobacco smoking decrease, but still with a high current level of use. In the meantime, research confirms that nicotine is highly addictive, that smoking just a cigarette a day is highly detrimental for health, and that health professionals are efficient in helping smokers to give up. These measures are such diverse as tobacco taxes increases, introducing plain packs, promoting November as month without tobacco, getting tobacco cessation medications paid for by health insurances, implementing a comprehensive advertising ban of tobacco products in retailor shops, and increasing protection of public health policies from tobacco industry intrusion. This industry via frenzied marketing reacts by promoting "heat not burn tobacco" as a harm reduction mean, which it is not, and invests in e-cigarettes, whose most recent ones are as addictive as classic tobacco cigarettes.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Indústria do Tabaco , Produtos do Tabaco , Tabaco/efeitos adversos , França , Humanos , Prevenção do Hábito de Fumar , Políticas de Controle Social , Indústria do Tabaco/legislação & jurisprudência , Produtos do Tabaco/efeitos adversos
5.
Cancer Res ; 79(24): 6079-6083, 2019 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-31658978

RESUMO

E-cigarettes have the ability to deliver nicotine in a manner that is similar to, and, theoretically, safer than, combusted tobacco. However, these devices are extremely heterogeneous and regulation has struggled to keep up with their rapid evolution. A compilation of early data suggest that e-cigarettes may contain numerous toxic substances, including known carcinogens. However, there are few data available on the short- and long-term health effects of e-cigarettes, including any potential effect on cancer risk. Until more is known, e-cigarettes should not be considered a safe alternative to combusted tobacco use.


Assuntos
Carcinógenos/toxicidade , Sistemas Eletrônicos de Liberação de Nicotina/normas , Neoplasias/etiologia , Nicotina/toxicidade , Fumar/efeitos adversos , Humanos , Fumar/legislação & jurisprudência
6.
Pediatrics ; 144(5)2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31659004

RESUMO

OBJECTIVES: Electronic cigarettes (e-cigarettes) are available in nontraditional flavors (eg, fruit and candy) that are banned in combustible cigarettes in the United States. Whether adolescent use of e-cigarettes in nontraditional flavors prospectively predicts continuation of vaping and progression to more frequent vaping is unknown. METHODS: High school students in Los Angeles, California, completed 5 semiannual surveys (2014-2017 [10th grade to 12th grade]). Among past-6-month e-cigarette users at survey waves 1 to 4 (N = 478), e-cigarette flavor (or flavors) used was coded into 2 mutually exclusive categories at each wave (use of ≥1 nontraditional flavors [fruit, candy, sweet or dessert, buttery, blends or combinations, and other] versus exclusive use of tobacco, menthol or mint, or flavorless). Flavor used during waves 1 to 4 was modeled as a time-varying, time-lagged regressor of vaping status and frequency outcomes 6 months later at waves 2 to 5. RESULTS: Across waves 1 to 4, there were 739 (93.8%) observations of nontraditional-flavor use and 49 (6.2%) observations of exclusive use of tobacco, mint or menthol, or flavorless e-cigarettes. Use of e-cigarettes in nontraditional flavors (versus only tobacco, mint or menthol, or flavorless) was positively associated with vaping continuation (64.3% vs 42.9%; adjusted odds ratio = 3.76 [95% confidence interval 1.20 to 10.31]) and past-30-day number of puffs per nicotine vaping episode (mean: 3.1 [SD 5.5] vs 1.5 [SD 3.8]; adjusted rate ratio = 2.41 [95% confidence interval 1.08 to 5.92]) 6 months later. Flavor used was not associated with the subsequent number of past-30-day vaping days or episodes per day. CONCLUSIONS: Adolescents who vaped e-cigarettes in nontraditional flavors, compared with those who exclusively vaped tobacco-flavored, mint- or menthol-flavored, or flavorless e-cigarettes, were more likely to continue vaping and take more puffs per vaping occasion 6 months later.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Aromatizantes , Regulamentação Governamental , Vaping/epidemiologia , Adolescente , Feminino , Humanos , Masculino , Modelos Estatísticos , Distribuição por Sexo , Inquéritos e Questionários , Estados Unidos/epidemiologia , United States Food and Drug Administration , Vaping/legislação & jurisprudência , Vaping/prevenção & controle
8.
Public Health Res Pract ; 29(3)2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31569205

RESUMO

Objectives and importance of study: News media portrayal of public health issues influences public opinion, policy action and decision making. This study aimed to analyse the use of 'nanny state' frames in Australian news media coverage; identify the stakeholders invoking this frame; determine which public health-related policies attract such framing; and investigate whether 'nanny state' framing is directly challenged in news coverage. STUDY TYPE: A qualitative framing analysis. METHODS: Articles featuring the term 'nanny state' that were published in Australian print newspapers during matched periods between March and September in 2017 and 2018 were sourced through Factiva, coded and analysed for content and 'nanny state' framing. Content analysis was used to identify any public health-related issues that the terminology nanny state was applied to, and who was portrayed as imposing the nanny state. Frame analysis was used to analyse what meanings are co-presented with the phrase nanny state. RESULTS: Out of 81 print newspaper articles that included the term 'nanny state', 19% linked the term to restricting personal choice or creating dissatisfaction with too many health-related rules and regulations broadly, across a range of issues, including: bike helmets, e-cigarettes, firearm restrictions, seatbelts, pool fences and smoking bans. The next most frequent links were to regulations on alcohol (17%), road safety (14%), obesity-related issues (7%) and tobacco control (6%). Of the 81 articles, 53% appeared in news publications owned by News Corporation Australia, 20% in Fairfax Media (Nine Entertainment) publications, 17% in Daily Mail and General Trust and 10% in publications owned by other organisations. Governments were the entity most frequently framed as imposing the nanny state. Most nanny state framings (73%) were negative towards public health controls and focused on policies and regulations. Nanny state was portrayed as an assault on freedom and choice (14%) and used to attack proponents of nanny state controls (11%), while few articles framed the nanny state (7%) in a favourable light. CONCLUSIONS: 'Nanny state' is a rhetorical device commonly used in Australian news media that may contribute to discrediting of the regulation of a range of health-related issues. News Corp publications are a major propagator of nanny state rhetoric in Australian newspaper media. Public health advocates are not commonly represented within nanny state debates within the news media.


Assuntos
Meios de Comunicação/estatística & dados numéricos , Política de Saúde/legislação & jurisprudência , Saúde Pública/legislação & jurisprudência , Saúde Pública/estatística & dados numéricos , Opinião Pública , Austrália , Humanos
9.
MMWR Morb Mortal Wkly Rep ; 68(39): 839-844, 2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31581163

RESUMO

The 2009 Family Smoking Prevention and Tobacco Control Act prohibits the inclusion of characterizing flavors (e.g., candy or fruit) other than tobacco and menthol in cigarettes; however, characterizing flavors are not currently prohibited in other tobacco products at the federal level.* Flavored tobacco products can appeal to youths and young adults and influence initiation and establishment of tobacco-use patterns (1). The Food and Drug Administration (FDA) and CDC analyzed data from the 2014-2018 National Youth Tobacco Surveys (NYTS) to determine prevalence of current (past 30-day) use of flavored tobacco products, including electronic cigarettes (e-cigarettes), hookah tobacco, cigars, pipe tobacco, smokeless tobacco, bidis, and menthol cigarettes among U.S. middle school (grades 6-8) and high school (grades 9-12) students. In 2018, an estimated 3.15 million (64.1%) youth tobacco product users currently used one or more flavored tobacco products, compared with 3.26 million (70.0%) in 2014. Despite this overall decrease in use of flavored tobacco products, current use of flavored e-cigarettes increased among high school students during 2014-2018; among middle school students, current use of flavored e-cigarettes increased during 2015-2018, following a decrease during 2014-2015. During 2014-2018, current use of flavored hookah tobacco decreased among middle and high school students; current use of flavored smokeless tobacco, cigars, pipe tobacco, and menthol cigarettes decreased among high school students. Full implementation of comprehensive tobacco prevention and control strategies, coupled with regulation of tobacco products by FDA, can help prevent and reduce use of tobacco products, including flavored tobacco products, among U.S. youths (2,3).


Assuntos
Aromatizantes , Estudantes/psicologia , Produtos do Tabaco/estatística & dados numéricos , Uso de Tabaco/epidemiologia , Adolescente , Criança , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência , Instituições Acadêmicas/estatística & dados numéricos , Prevenção do Hábito de Fumar/legislação & jurisprudência , Estudantes/estatística & dados numéricos , Produtos do Tabaco/legislação & jurisprudência , Uso de Tabaco/legislação & jurisprudência , Uso de Tabaco/prevenção & controle , Tabaco sem Fumaça/estatística & dados numéricos , Estados Unidos/epidemiologia , United States Food and Drug Administration
10.
Gac. sanit. (Barc., Ed. impr.) ; 33(5): 401-407, sept.-oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-189012

RESUMO

Objetivo: Explorar la percepción de profesionales y pacientes sobre las cuestiones éticas que entraña la atención al tabaquismo en las consultas de atención primaria. Método: Se diseñó un estudio cualitativo. Se realizaron entrevistas semiestructuradas a 12 profesionales y 7 pacientes, y dos grupos focales con 6 profesionales y 7 pacientes de atención primaria (32 participantes en total). Se realizó un muestreo intencional buscando perfiles de profesionales y pacientes de ambos sexos, distintas edades y experiencia en relación con el tabaquismo. El análisis de contenido siguió una estrategia analítica inductiva desde los datos hasta la creación de categorías teóricas. Resultados: Se identificaron cuatro categorías principales: 1) cuestiones éticas relativas a la responsabilidad del/de la profesional con el/la paciente fumador/a; 2) cuestiones relacionadas con la actitud que debe mostrar el/la profesional ante el/la paciente; 3) aspectos relacionados con la justicia en la distribución de recursos y con el papel de la Administración pública en el control del tabaquismo; y 4) cuestiones relativas a la autonomía de la persona fumadora con respecto al consumo y al cese del tabaquismo. Conclusiones: Es necesaria una alianza entre la ética que favorece la auténtica autonomía de la persona fumadora y la regulación heterónoma del consumo de tabaco. Sería conveniente incluir estas cuestiones en los programas de formación para el manejo del tabaquismo por parte de los/las profesionales


Objective: To explore the perception of professionals and patients with regard to ethical issues involved in addressing the habit of smoking in primary care consultations. Method: A qualitative study was designed, consisting of 12 semi-structured interviews with professionals, 7 interviews with patients and 2 focus groups with 6 professionals and 7 primary care patients (a total of 32 participants). An intentional sampling was conducted, including profiles of professionals and patients of both sexes, different ages and experience in relation to smoking. A content analysis was performed with an inductive analytical approach from data to the creation of theoretical categories. Results: Four main categories were identified: 1) ethical issues related to the responsibility of the professional when treating patients who smoke; 2) issues related to attitude to patients who smoke; 3) issues related to fair and equitable distribution of resources and to the role of the different levels of government in relation to the control of smoking; and 4) issues related to smokers' autonomy regarding their habit and smoking cessation. Conclusions: An alliance is needed between the ethics that support the autonomy of patients who smoke and the regulation of tobacco consumption. This approach should be included in clinical training programmes dealing with tobacco use, dependence and cessation


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Tabagismo/epidemiologia , Prevenção do Hábito de Fumar/ética , Abandono do Hábito de Fumar/legislação & jurisprudência , Autonomia Pessoal , Dominação-Subordinação , Tabagismo/prevenção & controle , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Atenção Primária à Saúde/ética , Legislação Médica/tendências , Pesquisa Qualitativa
11.
Artigo em Inglês | MEDLINE | ID: mdl-31547517

RESUMO

This research examined the influence of natural cigarette advertising on tobacco control policy support, and the potential for misbeliefs arising from exposure to cigarette marketing to affect such support. Ample research indicates that natural cigarettes such as Natural American Spirit (NAS) are widely and erroneously perceived as safer than their traditional counterparts because of their marketed "natural" composition. Yet regulatory action regarding natural cigarette marketing has been limited in scope, and little research has examined whether misleading product advertising affects support for related policy, an important component of the policy process. Here, we administered a large-scale randomized experiment (n = 1128), assigning current and former smokers in the United States to an NAS advertising condition or a control group and assessing their support for tobacco industry regulation. Results show that exposure to NAS advertising reduces support for policies to ban potentially misleading terminology from cigarette advertising, and these effects are stronger for daily smokers. Further, misinformed beliefs about the healthy composition of NAS partially mediate effects on policy support. Yet interestingly, exposure to NAS marketing does not reduce support for policies to establish standards for when certain terms are permissible in cigarette advertising. The results of this analysis indicate potential spillover effects from exposure to NAS advertising in the realm of support for regulatory action pertaining to tobacco industry marketing.


Assuntos
Publicidade/legislação & jurisprudência , Regulamentação Governamental , Fumantes/psicologia , Indústria do Tabaco/legislação & jurisprudência , Produtos do Tabaco/legislação & jurisprudência , Adulto , Comunicação , Feminino , Política de Saúde , Humanos , Masculino , Estados Unidos
12.
Adv Dent Res ; 30(1): 22-25, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31538803

RESUMO

Regulatory policy toward tobacco significantly affects oral health because tobacco use is a driver of diseases that manifest themselves in or near the oral cavity. Tobacco use in the United States has been associated with millions of cases of periodontal disease. Researchers have identified the role of combusted and noncombusted tobacco products in promoting cancers of the head and neck, leading to disease and premature death. Tobacco companies have moved increasingly toward so-called next-generation products (NGPs)-products that may emit fewer toxins than combustible forms of tobacco. Although NGPs may negatively affect the lungs and other bodily systems, they shift the injection site of nicotine from the lungs to the oral cavity and oral tissues. Because the long-term effects of NGPs are unknown, this tobacco marketing development has profound implications for oral disease. The US Food and Drug Administration exercises regulatory authority over tobacco products. The tobacco industry has avoided meaningful regulation of its products, especially smokeless forms. By publishing new research, oral health scientists can meaningfully shape the climate in which the administration's policy making occurs.


Assuntos
Indústria do Tabaco , Produtos do Tabaco , Humanos , Nicotina , Indústria do Tabaco/legislação & jurisprudência , Indústria do Tabaco/tendências , Produtos do Tabaco/legislação & jurisprudência , Estados Unidos , United States Food and Drug Administration
13.
Lancet Public Health ; 4(12): e607-e617, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31530472

RESUMO

BACKGROUND: Comprehensive tobacco control policies can help to protect children from tobacco smoke exposure and associated adverse respiratory health consequences. We investigated the impact of England's 2015 regulation that prohibits smoking in a private vehicle with children present on changes in environmental tobacco smoke exposure and respiratory health in children. METHODS: In this quasi-experimental study, we used repeated cross-sectional, nationally representative data from the Health Survey for England from Jan 1, 2008, to Dec 31, 2017, of children aged up to 15 years. We did interrupted time series logistic or ordinal regression analyses to assess changes in prevalence of self-reported respiratory conditions, prevalence of self-reported childhood tobacco smoke exposure (children aged 8-15 years only), and salivary cotinine levels (children aged 2 years or older) before and after implementation of the smoke-free private vehicle regulation on Oct 1, 2015. Children who were considered active smokers were excluded from the analyses of salivary cotinine levels. Our primary outcome of interest was self-reported current wheezing or asthma, defined as having medicines prescribed for these conditions. Analyses were adjusted for underlying time trends, quarter of year, sex, age, Index of Multiple Deprivation quintile, and urbanisation level. FINDINGS: 21 096 children aged 0-15 years were included in our dataset. Implementation of the smoke-free private vehicle regulation was not associated with a demonstrable change in self-reported current wheezing or asthma (adjusted odds ratio 0·81, 95% CI 0·62-1·05; p=0·108; assessed in 13 369 children), respiratory conditions (1·02, 0·80-1·29; p=0·892; assessed in 17 006 children), or respiratory conditions probably affecting stamina, breathing, or fatigue (0·75, 0·47-1·19; p=0·220; assessed in 12 386 children). Self-reported tobacco smoke exposure and salivary cotinine levels generally decreased over the study period. There was no additional change in self-reported tobacco smoke exposure in cars among children aged 8-15 years following the legislation (0·77, 0·51-1·17; p=0·222; assessed in 5399 children). We observed a relative increase in the odds of children having detectable salivary cotinine levels post legislation (1·36, 1·09-1·71; p=0·0074; assessed in 7858 children) and levels were also higher (1·30, 1·04-1·62; p=0·020; ordinal variable). Despite introduction of the regulation, one in 20 children still reported being regularly exposed to tobacco smoke in cars and one in three still had detectable salivary cotinine levels. INTERPRETATION: We found no demonstrable association between the implementation of England's smoke-free private vehicle regulation and changes in children's self-reported tobacco smoke exposure or respiratory health. There is an urgent need to develop more effective approaches to protect children from tobacco smoke in various places, including in private vehicles. FUNDING: Netherlands Lung Foundation, Erasmus MC, Farr Institute, Health Data Research UK, Asthma UK Centre for Applied Research, Academy of Medical Sciences, and Newton Fund.


Assuntos
Doenças Respiratórias/epidemiologia , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Adolescente , Automóveis , Criança , Pré-Escolar , Cotinina/análise , Estudos Transversais , Inglaterra/epidemiologia , Feminino , Humanos , Lactente , Análise de Séries Temporais Interrompida , Masculino , Prevalência
14.
Artigo em Inglês | MEDLINE | ID: mdl-31455009

RESUMO

Concerns have been raised that the divisions emerging within public health in response to electronic cigarettes are weakening tobacco control. This paper employed thematic and network analysis to assess 90 policy consultation submissions and 18 interviews with political actors to examine the extent of, and basis for, divisions between health-focused actors with regard to the harms and benefits of e-cigarettes and appropriate approaches to regulation in Scotland. The results demonstrated considerable engagement in e-cigarette policy development by health-focused actors and a widely held perception of strong disagreement. They show that actors agreed on substantive policy issues, such as age-of-sale restrictions and, in part, the regulation of advertising. Points of contestation were related to the harms and benefits of e-cigarettes and the regulation of vaping in public places. The topicality, limitations of the evidence base and underlying values may help explain the heightened sense of division. While suggesting that some opportunities for joint advocacy might have been missed, this analysis shows that debates on e-cigarette regulation cast a light upon differences in thinking about appropriate approaches to health policy development within the public health community. Constructive debates on these divisive issues among health-focused actors will be a crucial step toward advancing public health.


Assuntos
Fumar Cigarros/legislação & jurisprudência , Sistemas Eletrônicos de Liberação de Nicotina , Política de Saúde , Saúde Pública/legislação & jurisprudência , Vaping/legislação & jurisprudência , Adulto , Idoso , Idoso de 80 Anos ou mais , Tecnologia Disruptiva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escócia
15.
Pediatrics ; 144(3)2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31451608

RESUMO

BACKGROUND AND OBJECTIVES: Electronic nicotine delivery systems (ENDS) have become the most popular tobacco products among young people, yet ENDS marketing remains unregulated, and its effects on ENDS use behavior across age groups is poorly understood. In this study, using a longitudinal design, we examined how recall of ENDS marketing through 5 different channels predicted subsequent ENDS initiation up to 2.5 years later among youth (ages 12-17 years) and young adults (ages 18-29 years). METHODS: Data were drawn from 2 large cohort studies in Texas. The analysis included school-going youth (n = 2288) and college-going young adults (n = 2423) who reported never having used ENDS at baseline in 2014. Logistic regression was used to assess the influence of recalled ENDS marketing exposure via television (TV), radio or Internet radio, billboards, retail stores, and the Internet on subsequent ENDS initiation, with adjustment for these channels, baseline sociodemographics, other past-30-day tobacco use, sensation seeking, and peer ENDS use. RESULTS: Recall of retail store-based ENDS marketing at baseline was associated with significantly higher odds of subsequent ENDS initiation among youth (adjusted odds ratio [aOR] = 1.99; 95% confidence interval [CI]: 1.25-3.17) and young adults (aOR = 1.30; 95% CI: 1.05-1.61) up to 2.5 years later. Young adult initiation was also associated with recalled ENDS marketing on TV at baseline (aOR = 1.29; 95% CI: 1.03-1.63). CONCLUSIONS: Marketing of ENDS at retail stores predicts youth and young adult ENDS initiation, and marketing on TV predicts young adult initiation. Future research and regulation should be used to address the most influential marketing channels.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Comportamentos de Risco à Saúde , Marketing , Adolescente , Comportamento do Adolescente , Adulto , Criança , Humanos , Modelos Logísticos , Estudos Longitudinais , Marketing/legislação & jurisprudência , Texas , Fatores de Tempo , Adulto Jovem
16.
Salud Publica Mex ; 61(4): 436-447, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31430086

RESUMO

OBJECTIVE: To review the implementation of the WHO Framework Convention onTobacco Control in theAmericas, describe two national case studies and analyze the evidence on electronic cigarettes from a public health perspective. MATERIALS AND METHODS: Revision of the tobacco control legislation and the scientific evidence regarding electronic cigarettes. RESULTS: Implementation of tobacco control policies is not homogeneous, with important advances in smoke-free environments, pictorial health warnings, and epidemiological surveillance, but challenges that remain for the implementation of a total ban of tobacco advertising, increases in tobacco taxes, and tobacco cessation programs. Tobacco industry interference is one of the main obstacles for advancing and novel products create uncertainty about their regulation. CONCLUSIONS: There is a need for political will for a comprehensive implementation of the Convention, with evidence-based decisions to confront challenges and to defend the achievements from tobacco industry interference.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Prevenção do Hábito de Fumar/legislação & jurisprudência , Produtos do Tabaco/legislação & jurisprudência , Publicidade , Prática Clínica Baseada em Evidências , Implementação de Plano de Saúde , Promoção da Saúde/métodos , Humanos , Cooperação Internacional , Manobras Políticas , México , Panamá , Política Antifumo , Prevenção do Hábito de Fumar/tendências , Impostos , Indústria do Tabaco/economia , Indústria do Tabaco/legislação & jurisprudência , Produtos do Tabaco/provisão & distribuição , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Poluição por Fumaça de Tabaco/prevenção & controle , Organização Mundial da Saúde
17.
Nutrients ; 11(8)2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31370182

RESUMO

When it comes to nutrition, nearly everyone has an opinion. In the past, nutrition was considered to be an individual's responsibility, however, more recently governments have been expected (by some) to share that responsibility by helping to ensure that marketing is responsible, and that food chains offer healthy meal choices in addition to their standard fare, for example. In some countries, governments have gone as far as to remove tax from unprocessed foods or to introduce taxes, such as that imposed on sugary soft drinks in the UK, Mexico, France and Norway. Following on from the sugar tax, chocolate might be next! Is this the answer to our burgeoning calorie intake and increasing poor nutritional status, or is there another approach? In this narrative we will focus on some of the approaches taken by communities and governments to address excess calorie intake and improve nutritional status, as well as some of the conflicts of interest and challenges faced with implementation. It is clear that in order to achieve meaningful change in the quality of nutritional intake and to reduce the long-term prevalence of obesity, a comprehensive approach is required wherein governments and communities work in genuine partnership. To take no or little action will doom much of today's youth to a poor quality of life in later years, and a shorter life expectancy than their grandparents.


Assuntos
Saúde Global , Política de Saúde , Legislação sobre Alimentos , Política Nutricional , Estado Nutricional , Serviços de Saúde Comunitária , Carboidratos da Dieta/efeitos adversos , Carboidratos da Dieta/economia , Humanos , Instituições Acadêmicas , Cloreto de Sódio na Dieta/efeitos adversos , Cloreto de Sódio na Dieta/economia , Impostos , Produtos do Tabaco/efeitos adversos , Produtos do Tabaco/economia
18.
Rev Esp Salud Publica ; 932019 Jul 15.
Artigo em Espanhol | MEDLINE | ID: mdl-31298227

RESUMO

This paper presents a strategic analysis of the prevention of smoking in Spain. After a review of the situation of the epidemic and of the current prevention policies with the data available in 2019, it identifies the main problems to improve the prevention of smoking, while proposing strategies and key actions for the future. Considering as major objectives reducing the initiation of smoking and helping smokers quit, the different strategies of action and the key actions to be developed. In addition to helping smokers to stop smoking from the health services, key preventive actions include several public policies including taxation, banning advertising and other forms of promotion, the regulation of tobacco packaging, the expansion of smoke-free spaces, and information to the public on its effects. Some of them have followed a positive path for prevention in Spain but for others there is wide room for improvement. The MPOWER strategy of the WHO offers a guide for the development of the most effective tobacco control policies. In its light it is recommended to put emphasis on actions related to expanding smoke-free areas, to develop distance support services to stop smoking, to periodically carry out advertising campaigns of wide coverage to encourage quitting, to reinforce support for quitting in health care services, to finance pharmacological treatments, to expand the advertising ban to electronic devices that release nicotine, and to increase the tax burden on tobacco and other products delivering nicotine.


Assuntos
Abandono do Hábito de Fumar/métodos , Tabagismo/epidemiologia , Tabagismo/prevenção & controle , Política de Saúde , Promoção da Saúde/métodos , Promoção da Saúde/organização & administração , Humanos , Política Pública , Fumar/economia , Fumar/legislação & jurisprudência , Espanha/epidemiologia , Organização Mundial da Saúde
19.
Rev Esp Salud Publica ; 932019 Jul 24.
Artigo em Espanhol | MEDLINE | ID: mdl-31337747

RESUMO

OBJECTIVE: To know the support of tobacco regulation is a very important issue to advance in the tobacco control policies and reduce the passive exposure to tobacco. The aim of this study was to describe the attitudes towards forbidding smoking in private vehicles and public outdoor spaces. METHODS: This is a cross-sectional study of a representative sample (n=736) of the adult population (24+ years old) from Barcelona, Spain in 2013-2014. We calculated the percentages of individuals who had a favourable attitude towards smoking regulation in private vehicles and public outdoor spaces, their adjusted Odds ratios (aOR) and their 95% confidence intervals (95%CI) according to sex, age, educational level and smoking status through logistic regression. We used weighted data for all analyses in order to keep the representativeness of the population of Barcelona in 2013-2014. RESULTS: 61.7% of participants supported forbidding smoking in private vehicles and 89.5% supported forbidding it only in the presence of minors. The support to smoking regulation in public outdoor spaces varied from 42.5% to 84.7% in different settings. Smokers showed a less favourable attitude towards an extension of the smoking regulation to other settings: outdoor areas of university centres, outdoor areas of shopping centres and beaches and outdoor pools. CONCLUSIONS: A wide support exists to extend the smoking regulation to private vehicles, especially in the presence of children, and public outdoor spaces. This wide support could favour the extension of smoking regulation to these places to improve the population's health and to contribute to denormalise tobacco use among the population.


Assuntos
Atitude Frente a Saúde , Veículos Automotores/legislação & jurisprudência , Prevenção do Hábito de Fumar/legislação & jurisprudência , Fumar/legislação & jurisprudência , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Poluição por Fumaça de Tabaco/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espanha
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