Perspectives of push-pull-mooring effects on a desire for switching to alternative crops among tobacco farmers in Thailand: A qualitative study.

INTRODUCTION: Tobacco use contributes significantly to premature deaths worldwide. A key strategy to curb tobacco consumption involves limiting the tobacco supply through the transition to substitute crops. This study aims to provide insight into why tobacco farmers desire to switch to alternative crops and the support required for a successful transition. METHODS: Semi-structured interviews were conducted with 34 tobacco farmers expressing a desire to transition to other crops in two communities in Thailand. Data were recorded and transcribed verbatim in Thai and subsequently translated into English. A deductive content analysis applied the Push-Pull-Mooring (PPM) framework, contextualizing factors for the transition among tobacco farmers. RESULTS: Four main categories emerged: 1) push factors, encompassing negative experiences in growing tobacco, such as poverty, health problems, and hopelessness; 2) pull factors, representing positive experiences in transitioning to alternative crops, particularly having a role model; and 3) mooring factors, highlighting characteristic disadvantages of tobacco farmers, particularly the receipt of small tobacco growing quotas. The fourth category focused on the support needed for a successful transition, including the suspension of tobacco debt payments, access to low-interest loans, and the development of marketing capabilities. CONCLUSIONS: The study provides a comprehensive understanding of farmers' motivations to switch from tobacco to alternative crops and outlines the necessary support for a successful transition. Offering financial assistance and enhancing the production and marketing capabilities of alternative crops are essential steps toward facilitating a successful switch for farmers and ensuring a secure livelihood beyond tobacco farming.

Perception of and legal compliance with the law prohibiting cigarette sales to minors in Thailand following the raising of the minimum selling age to 20 years: a cross-sectional survey.

OBJECTIVES: The minimum age for cigarette sales in Thailand was increased from 18 to 20 years, as stipulated in the Tobacco Products Control Act B.E. 2017. This study investigated tobacco retailers' perceptions, cigarette sales behaviour and other factors relevant to selling cigarettes to people younger than 20 years in areas surrounding schools in Thailand. DESIGN: Cross-sectional survey. SETTING: Tobacco shops within a radius of 500 m of secondary schools across four regions of Thailand. Data collection took place between May and August 2019. PARTICIPANTS: 1440 tobacco retailers (grocery or convenience stores) were sampled via a stratified, two-stage cluster sampling method. 1021 retailers completed the self-administered questionnaire. OUTCOME MEASURES: Tobacco sales to people younger than 20 years. RESULTS: The prevalence of the retailers' cigarette sales to youth younger than 20 years was 38.20% (95% CI 35.2% to 41.3%). Multivariable logistic regression analysis revealed associations with sale of single cigarettes (adjusted OR (AOR) 23.14, 95% CI 15.13 to 35.39), self-service sale of cigarettes (4.21, 2.59 to 6.86) and display of cigarettes at the point of sale (2.39, 1.47 to 3.89). Cigarette sales to underage youth were higher among retailers located in the northeast region (AOR 2.09, 95% CI 1.20 to 3.64) and among those who did not perceive the prosecution of violators in the past year (1.85, 1.16 to 2.96). CONCLUSION: A large percentage of cigarette retailers violated the laws related to underage cigarette sales. Measures to minimise retailers' legally non-compliant sales behaviours should be implemented along with improved legal enforcement.

Susceptibility to smoking and determinants among never-smoking high school students in Thailand.

INTRODUCTION: To prevent youth from becoming smokers, it is essential to understand factors contributing to them becoming susceptible to smoking. The aim of this study was thus to estimate the prevalence of smoking susceptibility among neversmoking youth in Thailand and to identify determinants associated with such behavior. METHODS: Cross-sectional data for 4572 eighth-grade students (aged 13-15 years) from 120 secondary schools were obtained from a classroom-based survey using a self-administered questionnaire. Using data from never-smoking students (n=3180), simple and multiple logistic regression analyses were performed to identify factors associated with smoking susceptibility. Frequencies and proportions for descriptive statistics are reported along with adjusted odds ratios and 95% confidence intervals for logistic regression models. RESULTS: A total of 16.4% of Thai never-smoking youth were susceptible to smoking. Several variables of interest were identified in multivariable analysis as significantly associated with increased susceptibility to smoking: being male (AOR=3.16; 95% CI: 25.4-3.92), having a positive attitude toward smoking - agreeing that smoking displays maturity (AOR=1.49; 95% CI: 1.07-2.09), the perception that smoking helps relieve stress (AOR=1.57; 95% CI: 1.14-2.15), the presence of current smoking peers (AOR=2.04; 95% CI: 1.57-2.66), exposure to secondhand smoking in public (AOR=1.51; 95% CI: 1.17-1.94), exposure to online cigarette and smoking-related advertising occasionally (AOR=1.98; 95% CI: 1.49-2.65), attendance at schools where there are sometimes anti-smoking education activities (AOR=1.57; 95% CI: 1.18-2.07); as well as exposure to anti-tobacco messages rarely (AOR=1.40; 95% CI: 1.05-1.87), occasionally (AOR=1.48; 95% CI: 1.12-1.96) and infrequently (AOR=1.41; 95% CI : 1.07-1.87). CONCLUSIONS: Approximately one in six Thai never-smoking youth was found to be susceptible to smoking. Findings suggest it should be useful to supplement relevant tobacco prevention and control efforts by considering such interpersonal and socio-environmental determinants, among vulnerable people to smoke.

Deteriorating Quality of Life and a Desire to Stop Growing Tobacco Among Virginia and Burley Tobacco Farmers in Thailand.

PURPOSE: This study aimed to examine the quality of life of tobacco farmers and their desire to stop growing tobacco. METHODS: A cross-sectional home-based survey was conducted between October 2021 and January 2022 among 2,970 Virginia and Burley tobacco farmers in Northern Thailand. Multivariate logistic regression models were used to determine the association between farmers' characteristics and their quality of life and a desire to stop planting tobacco. RESULTS: In total, 58.5% of the participants wanted to stop growing tobacco, and most had a lower quality of life than the mean. Nine independent variables were associated with a desire to stop tobacco farming: having a low level of economic quality of life (adjusted odds ratio [ORAdj], 5.42; 95% CI, 3.8 to 7.8); having a high environmental quality of life (ORAdj, 4.60; 95% CI, 3.3 to 6.5); belonging to the Tobacco Farmers' Association (ORAdj, 3.04; 95% CI, 2.1 to 4.5); growing tobacco on their own land (ORAdj, 2.12; 95% CI, 1.8 to 2.6); having a low social quality of life (ORAdj, 1.69; 95% CI, 1.4 to 2.1); having a low health quality of life (ORAdj, 1.69; 95% CI, 1.4 to 2.1); having a low spiritual quality of life (ORAdj, 1.41; 95% CI, 1.2 to 1.7); being Burley tobacco farmers (ORAdj, 1.33; 95% CI, 1.0 to 1.8); and having a low family quality of life (ORAdj, 0.49; 95% CI, 0.4 to 0.6). CONCLUSION: The majority of the tobacco farmers had a declining quality of life, particularly economic and environmental quality of life, resulting in reducing growing tobacco. National and regional support are needed to help these farmers effectively grow alternative crops, and financial support to make such conversions.

Communication intervention to improve perceived threat of smoking-related COVID-19 and intentions to quit smoking during the COVID-19 pandemic in Thailand.

INTRODUCTION: Smokers are more likely to be at risk of developing severe COVID-19. This study aimed to develop and evaluate the effect of a communication intervention for enhancing perceived threat of coronavirus 19 (COVID-19) infection associated with smoking and examine intentions to quit smoking among smokers during the COVID-19 pandemic in Thailand. METHODS: This study was of experimental design. The sample was 427 eligible smokers who were living in Kosumphi Nakhon district. They were either assigned to the intervention group (233) or control group (194). The intervention group received the communication intervention, developed based on the Health Belief Model (HBM), including education online, motivation via social networks, and communication through local mass media. The difference in mean scores between the two groups was examined using an independent t-test. Regression models were fitted to explore the factors associated with the improvement score of intention to quit smoking. RESULTS: The participants in the intervention group who received the communication intervention had a significantly higher mean score of perceived threats of smoking-induced COVID-19 (effect size=0.518, p<0.001) and had a significantly higher mean score of intentions to quit smoking (effect size=0.717, p<0.001) than in the control group. However, the number of e-cigarettes smoked per day between-groups was not significantly different (p=0.532). In the regression analysis, factors that significantly associated with the improvement score of intentions to quit smoking, included female gender (p=0.002), addicted to nicotine score (p<0.001), intervention group (p=0.010), and the improvement score of perceived threats (p=0.026). CONCLUSIONS: This community-based communication intervention could enhance the perceived threats of smoking-induced COVID-19 and increased the intentions to quit smoking among the smokers. However, further research to track the success rate of smoking cessation is still needed.

Personal and perceptual factors associated with the use of electronic cigarettes among university students in northern Thailand.

INTRODUCTION: Although Thailand has banned the import of electronic cigarettes (e-cigarettes) into the kingdom, a range of evidence has revealed the widespread use of these illegal products, especially among university students. Too little is known about personal and perceptual factors for such behavior. This study aimed to investigate the prevalence and factors associated with the use of e-cigarettes among university students in Northern Thailand. METHODS: A cross-sectional study was conducted with 792 university students in Northern Thailand between June and July 2020. An anonymous, self-administered questionnaire was implemented to collect relevant information. Bivariate and multivariate logistic regression analyses were applied to identify factors associated with the use of e-cigarettes in the last 30 days. RESULTS: The study revealed that 18.1% of the participants used e-cigarettes in the past 30 days. The personal factors associated with e-cigarette use among Thai university students included: studying in non-health related faculties (AOR=11.21; 95% CI: 4.88-25.71); having a friend using e-cigarettes (AOR=10.48; 95% CI: 5.96-18.41); having a lower GPA than the mean (AOR=1.93; 95% CI: 1.14- 3.28); and having a monthly income higher than the mean (AOR=1.74; 95% CI: 1.09-2.78). Regarding perceptual factors, there was a significant link between e-cigarette use and the perception that these modern cigarettes are less harmful than conventional cigarettes (AOR=2.47; 95% CI: 1.50-4.07), and perception that using e-cigarettes in public is not illegal (AOR=1.93; 95% CI: 1.19-3.15). CONCLUSIONS: E-cigarette use is widespread among Thai university students. Maintaining the enforcement policy on banning the importation of e-cigarettes into the country is thus needed. Also, further communication and public relations on the risks and legal prohibitions of e-cigarette use are needed among university students in the Northern Thailand.