From the tobacco industry's uses of science for public relations purposes to the alcohol industry: Tobacco industry documents study.

INTRODUCTION: Associates for Research in Substances of Enjoyment (ARISE) was formed by tobacco companies in the late 1980s designed to counter public health policy development. This study examines the alcohol content of ARISE and the contribution of ARISE to alcohol industry activities in a key period in the globalisation of the alcohol industry, generating insights into the inter-relationships between the tobacco and alcohol industries in their involvements in policy-oriented science. METHODS: We systematically searched the UCSF Truth Tobacco Documents Library for information about ARISE, alcohol and the alcohol industry. This material was supplemented with an analysis of the contributions by ARISE associates to one volume in the International Center for Alcohol Policies (ICAP) book series on alcohol and pleasure. RESULTS: ARISE placed nicotine alongside caffeine, chocolate and other foods, and alcohol as treats which brought pleasure and other benefits. Alcohol was thus intrinsic to the ARISE project for the tobacco industry. This study shows that at a formative moment in the mid-1990s the major alcohol companies took advantage of the intellectual inheritance and personnel provided by the tobacco industry when establishing ICAP. Key to this was an ICAP conference that resulted in Alcohol and pleasure: A health perspective (1999). DISCUSSION AND CONCLUSIONS: Not only did ARISE use alcohol to play a supporting role in a sophisticated tobacco industry strategy, the alcohol industry engaged with ARISE as part of its own strategy. This shows the importance of careful attention to corporate activities on the fringes of peer-reviewed science.

Uncovering the advertising and promotional strategies of tobacco companies in Cambodia: recall of below-the-line marketing among young male smokers.

INTRODUCTION: Tobacco companies have used below-the-line marketing in novel ways to promote their brands to youth in low/middle-income countries in Southeast Asia. This study explores how young male smokers in Cambodia experience below-the-line marketing strategies. METHODS: Convenience sampling was used to recruit 147 young male smokers (18-24 years) in Cambodia in early 2020. Local research assistants conducted mixed-methods interviews with participants in Khmer or English. Participants recalled exposure to below-the-line marketing strategies and provided in-depth descriptions about their experiences with individual sales promotions. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using thematic analysis. RESULTS: 54% of participants recalled exposure to at least one below-the-line marketing strategy, including point-of-sale promotions (32.7%), individual sales promotions (27.9%) and online advertising (14.3%). Participants described individual sales promotions in public settings, and recalled that promoters were mostly female, attractive and targeted young males. Tactics used to encourage young people to accept promotional offers included free cigarettes and sample packets, swapping current cigarettes for new brands and collecting consumer details after interviewing. The brands and product features of cigarettes being promoted were readily described by participants. CONCLUSION: This study provides evidence that illegal below-the-line marketing is still occurring in Cambodia, and increased monitoring and enforcement of advertising restrictions is needed.

Oral nicotine marketing claims in direct-mail advertising.

BACKGROUND: Little is known regarding how oral nicotine products (eg, nicotine pouches, lozenges) are marketed to consumers, including whether potential implicit reduced harm claims are used. In the current study, we explored the marketing claims present in a sample of direct-mail oral nicotine advertisements sent to US consumers (March 2018-August 2020). METHODS: Direct-mail ads (n=50) were acquired from Mintel and dual-coded for the following claims: alternative to other tobacco products, ability to use anywhere, spit-free, smoke-free and product does not contain tobacco leaf. We merged the coded data with Mintel's volume estimate (number of mail pieces sent to consumers) and calculated the proportion of oral nicotine advertisements containing claims by category. RESULTS: Of the 38 million pieces of oral nicotine direct-mail sent to US consumers, most featured claims that the product could be used anywhere (84%, 31.8 million pieces); was an alternative to other tobacco products (69%, 26.1 million pieces); and did not contain tobacco leaf (eg, 'tobacco leaf-free', 'simple' approach of extracting nicotine from tobacco; 55%, 20.7 million pieces). A slightly smaller proportion contained claims that oral nicotine was 'spit-free' (52%, 19.8 million pieces) or 'smoke-free' (31%, 11.7 million pieces). CONCLUSION: Our results provide an early indication of marketing claims used to promote oral nicotine. The strategies documented, particularly the use of language to highlight oral nicotine is tobacco-free, may covey these products as lower-risk to consumers despite the lack of evidence or proper federal authorisation that oral nicotine products are a modified-risk tobacco product. Future research is needed to examine consumer perceptions of such claims.

Exploring the Twitter activity around the eighth meeting of the Conference of the Parties to the WHO Framework Convention on Tobacco Control.

BACKGROUND: Tobacco companies' intentions to influence the WHO Framework Convention on Tobacco Control (FCTC) via the Conference of Parties (COP; the official biannual meeting where Parties review the Convention) are well documented. We aimed to analyse Twitter data to gain insights into tobacco industry tactics, arguments and allies. METHODS: We retrieved 9089 tweets that included #COP8FCTC between 1 and 9 October 2018. We categorised the tweets' content and sentiment through manual coding and machine learning. We used an investigative procedure using publicly available information to categorise the most active Twitter users and investigate tobacco industry links. Network analysis was used to visualise interactions and detect communities. RESULTS: Most tweets were about next-generation products (NGPs) or 'harm reduction' (54%) and tended to argue in support of NGPs; around one-quarter were critical of tobacco control (24%). The largest proportion of most active tweeters were NGP advocates, and slightly over half of those had either links to the Philip Morris International (PMI) funded Foundation for a Smoke-Free World (FSFW) and/or to the International Network of Nicotine Consumer Organisations, a network to whom the FSFW granted US$100 300 in 2018. PMI was the most active transnational tobacco company during COP8. CONCLUSIONS: The nature of the activity on Twitter around COP8, including a substantial online presence by PMI executives and NGP advocates with links to organisations funded directly and indirectly by PMI, is highly consistent with PMI's 2014 corporate affairs strategy, which described engaging tobacco harm reduction advocates to 'amplify and leverage the debate on harm reduction' around events such as the COP.

Tobacco industry marketing adaptations to Singapore plain packaging.

BACKGROUND: Singapore has implemented plain packaging, a measure that strips all colours, logos and branding elements from tobacco packs. In other countries, tobacco companies responded to plain packaging with a variety of marketing tactics. Our goal was to describe the tobacco industry's marketing adaptations to Singapore plain packaging. METHODS: Qualitative analysis of 378 cigarette packs sampled from Singapore retailers in March 2019, March 2020 and January 2021, 12 months prior to, 2 weeks prior to and 6 months after plain packaging phase-in, respectively. For each pack, we collected descriptive information on the brand and variant name, pack and stick dimensions, pack shape, differentiating features and distinctive scents, as well as photographic data of the pack, cigarette sticks and any distinct features. We used the March 2019 collection as our baseline dataset, and March 2020 and January 2021 collections as comparison datasets to examine changes in tobacco marketing strategies just before and after plain packaging phase-in. RESULTS: Around Singapore's plain packaging phase-in, tobacco companies launched variants with flavour capsules, novelty filter features and new flavours and used more descriptive variant names reflecting the variant's colour coding or market positioning. Tobacco companies revamped some existing variants, often with Japanese marketing themes to convey a more premium product image. After plain packaging, tobacco companies used longer packs and variations in stick length, filter length and foil texture to further differentiate products. CONCLUSIONS: Following plain packaging in Singapore, tobacco companies rely increasingly on nomenclature and the cigarette stick itself to market and differentiate products.

Size matters: An analysis of cigarette pack sizes across 23 European Union countries using Euromonitor data, 2006 to 2017.

INTRODUCTION: The tobacco industry (TI) has used small cigarette pack sizes to encourage brand-switching and consumption, and to mitigate the impacts of tobacco tax increases. Since 2016, the European Union (EU) Tobacco Products Directive (TPD) specifies a minimum pack size of 20 cigarettes. We examined cigarette pack sizes in the EU and whether pack size composition differed between cheap and expensive price segments, as well as the impact of the revised TPD. METHODS: We conducted a longitudinal analysis of pricing data from 23 EU countries between 2006-2017. We examined pack sizes over time to assess the impact of the TPD, differences in pack size composition between cheap and expensive price segments, and compared gaps in median prices between products using actual and 'expected' prices (price if all packs contained 20 sticks). RESULTS: Cigarette pack sizes changed over time, across the EU. The distribution of pack sizes varied between price segments, with small pack sizes especially frequent in the cheap segment of the cigarette market, but this varied over time and across countries. Packs of <20 cigarettes almost disappeared from the data samples after implementation of the TPD. CONCLUSION: Implementation of the TPD appears to have virtually eliminated packs with <20 cigarettes, restricting their use by the TI. Our analysis suggests pack sizes have been used differentially across the EU. Country-level analyses on the industry's use of pack sizes, consumer responses, and evaluations of restricting certain pack sizes are needed to confirm our findings and strengthen policy.

Association of Exposure to Court-Ordered Tobacco Industry Antismoking Advertisements With Intentions and Attempts to Quit Smoking Among US Adults.

Importance: In 2006, a US district court judge ordered tobacco companies to sponsor nationwide antismoking advertising campaigns. This landmark ruling and its subsequent execution represent an unprecedented tobacco control event; however, the association of this campaign with intentions and/or attempts to quit smoking is unknown. Objectives: To assess the reach of the expanded court-ordered tobacco industry antismoking advertisements (via television, newspapers, tobacco company websites, and/or cigarette packages), to examine associations between exposure to industry antismoking advertisements and intentions and/or attempts to quit smoking among cigarette smokers, and to calculate the numbers of US smokers who would have quit intentions associated with exposure to multiple advertisements. Design, Setting, and Participants: Data for this study were obtained from 5309 US adults, including 610 smokers, who responded to the Health Information National Trends Survey, a nationally representative cross-sectional survey conducted from January 22 to April 30, 2019. Respondents were representatives of households selected by equal-probability sampling of a database of US residential addresses. Exposure: Reported exposure to antismoking messages. Main Outcomes and Measures: Cigarette smoking cessation attempt in the past 12 months and intentions to quit cigarette smoking in the next 6 months. Covariates were age, sex, household annual income, race/ethnicity, educational level, and geographical residence. Data were weighted to be nationally representative after applying survey weights specified for the survey cycle. Results: The overall sample of 5309 respondents were a mean (SD) age of 55.6 (19.1) years and included 3073 women (51.2%), 3037 non-Hispanic white respondents (59.1%), 4645 respondents who lived in urban US areas (84.7%), and 610 current smokers (12.5%). Findings indicate that 2464 US adults (45.8%; 95% CI, 43.2%-48.5%) and 410 current smokers (66.8%; 95% CI, 61.1%-72.4%) were exposed to antismoking advertisements. Exposure to multiple antismoking messages was associated with 2.19 (95% CI, 1.10-4.34) greater odds of having intentions to quit cigarette smoking but was not associated with attempts to quit (adjusted odds ratio, 1.31; 95% CI, 0.69-2.52). Furthermore, an examination of the association of cumulative exposure to antismoking messages with cessation intentions revealed that, with each additional exposure to an antismoking message, the odds of smoking cessation intentions increased by 1.21 (95% CI, 1.02-1.44). If all smokers were to be exposed to multiple antitobacco messages, there could be an estimated 3.98 million (95% CI, 492 480-7 223 040) current smokers in the United States with intentions to quit. Conclusions and Relevance: Although the reach of court-ordered industry advertisements increased among smokers, the reach of these advertisements within the general population remains suboptimal. The finding that industry advertisements helped smokers consider quitting highlights their potential to aid smoking cessation. However, the lack of association with actual attempts to quit suggests that the industry antismoking advertisement campaigns were inadequate. The design and content of industry antismoking advertisement campaigns should be enhanced to help smokers quit.

Impact of tobacco industry pricing and marketing strategy on brand choice, loyalty and cessation in global south countries: a systematic review.

OBJECTIVES: We undertook this review to assess the impact of pricing strategies on brand choice, loyalty and quitting behaviour in Global South countries. METHODS: We systematically retrieved articles from Medline, CENTRAL, ScienceDirect, Google Scholar from inception up to January 2020. Studies which reported tobacco industry's pricing strategies were eligible. We summarized the data as themes and codes using the principles of inductive qualitative thematic analysis within structured rational constructivist framework. RESULTS: In total, 13 studies met inclusion criteria were included. Major strategies adopted by tobacco industries to tackle the pricing and taxation changes were increased tax absorption, differential taxation based on price, cigarette length/size which ensures modest increase in the net price of cigarettes. This in turn influences the tobacco users in terms of brand loyalty and switching as they prefer to stay with factory-made cigarettes or shift to a cheaper alternative or illegal product rather than decreasing/quitting tobacco use. CONCLUSIONS: Absorption of excise tax and differential taxation are the common pricing strategies adopted by tobacco industries in Global South. These strategies together with external determinants impact the price-related tobacco control interventions.

Cigarette Packs With URLs Leading to Tobacco Company Websites: Content Analysis.

BACKGROUND: Tobacco companies include on the packaging of their products URLs directing consumers to websites that contain protobacco messages. Online media tend to be underregulated and provide the industry with an opportunity to present users with protobacco communication. OBJECTIVE: The objective of our study was to document the content of websites that were advertised on tobacco packs in 14 low- and middle-income countries. METHODS: We purchased tobacco packs from 14 low- and middle-income countries in 2013 and examined them for the presence of URLs. We visited unique URLs on multiple occasions between October 1, 2016 and August 9, 2017. We developed a coding checklist and used it to conduct a content analysis of active corporate websites to identify types of protobacco communication. The coding checklist included the presence of regulatory controls and warnings, engagement strategies, marketing appeals (eg, description of product popularity, luxury/quality, taste), corporate social responsibility programs, and image management. We coded brand websites separately and also described social media and other website types. RESULTS: We identified 89 unique URLs, of which 54 were active during the search period. We assessed 26 corporate websites, 21 brand websites, 2 nontobacco websites, and 5 social media pages. We excluded 2 corporate websites and 14 brand websites due to limited accessible content or incomplete content. Corporate social responsibility was discussed on all corporate websites, and marketing appeals were also common. Corporate websites were also more likely to include more nonspecific (12/24, 50%) than specific (7/24, 29%) health warnings. Promotions (6/7, 86%) and sociability appeals (3/7, 43%) were common on brand websites. The small number of social media webpages in our sample used gendered marketing. CONCLUSIONS: URLs appearing on tobacco packs direct consumers to websites where users are exposed to marketing that highlights the "positive" contributions of tobacco companies on corporate websites, and extensive promotions and marketing appeals on brand websites and social media pages. It is essential that marketing regulations become more comprehensive and ban all protobacco communication, a policy that is in line with articles 5.3 and 13 of the World Health Organization Framework Convention on Tobacco Control. For countries that already ban internet tobacco advertising, enforcement efforts should be strengthened. Tobacco companies' use of URLs on packs may also be compelling for plain packaging advocacy, where all branding is removed from the pack and large graphic health warning labels are the only communication on the tobacco packaging. Future research should consider including tobacco websites in marketing surveillance.

Transferring Racial/Ethnic Marketing Strategies From Tobacco to Food Corporations: Philip Morris and Kraft General Foods.

Objectives. To investigate the transfer of marketing knowledge and infrastructure for targeting racial/ethnic minorities from the tobacco to the food and beverage industry in the United States.Methods. We analyzed internal industry documents between April 2018 and April 2019 from the University of California San Francisco Truth Tobacco Industry Documents Library, triangulated with other sources.Results. In the 1980s, Philip Morris Companies purchased General Foods and Kraft Foods and created Kraft General Foods. Through centralized marketing initiatives, Philip Morris Companies directly transferred expertise, personnel, and resources from its tobacco to its food subsidiaries, creating a racial/ethnic minority-targeted food and beverage marketing program modeled on its successful cigarette program. When Philip Morris Companies sold Kraft General Foods in 2007, Kraft General Foods had a "fully integrated" minority marketing program that combined target marketing with racial/ethnic events promotion, racial/ethnic media outreach, and corporate donations to racial/ethnic leadership groups, making it a food industry leader.Conclusions. The tobacco industry directly transferred racial/ethnic minority marketing knowledge and infrastructure to food and beverage companies. Given the substantial growth of food and beverage corporations, their targeting of vulnerable populations, and obesity-related disparities, public policy and community action is needed to address corporate target marketing.

Is Smoking Cessation in Young Adults Associated With Tobacco Retailer Availability in Their Activity Space?

INTRODUCTION: The presence of tobacco retailers in residential neighborhoods has been inversely associated with residents' likelihood of quitting smoking. Few studies have yet explored whether this association holds when accounting for tobacco retailers found in the multiple environments where people conduct their daily activities, that is, their activity space. METHODS: We analyzed cross-sectional data from 921 young adults (18- to 25-years old) participating in the Interdisciplinary Study of Inequalities in Smoking (Montreal, Canada). Respondents self-reported sociodemographic, smoking, and activity location data. Log-binomial regression was used to estimate prevalence ratios (PRs) for the association between smoking cessation and (1) the number of tobacco retailers (counts), and (2) the distance to the closest retailer (proximity) in participants' residential neighborhood and activity space. RESULTS: Smoking cessation was positively associated with low and intermediate tertile levels of tobacco retailer counts in both the residential neighborhood and activity space, and with the furthest distance level in the activity space [PR (95% CI) = 1.21 (1.02 to 1.43)]. CONCLUSIONS: Individuals encounter resources in the course of their regular daily activities that may hamper smoking cessation. This study highlights the relevance of considering the tobacco retail environment of both individuals' residential neighborhood and activity space to understand its association with smoking cessation. IMPLICATIONS: This article contributes to the literature on the association between the tobacco retail environment and smoking cessation in young adults by moving beyond the residential neighborhood to also assess individuals' access to tobacco retailers in the multiple areas where they regularly spend time, that is, their activity space. Findings suggest that lower numbers of tobacco retailers in both the residential neighborhood and activity space, and further distance to tobacco retailers in the activity space are associated with increased smoking cessation.

Changes in roll-your-own tobacco and cigarette sales volume and prices before, during and after plain packaging legislation in the UK.

BACKGROUND: Plain packaging and minimum pack size legislation for tobacco products was introduced in the UK in May 2016, with a 1-year sell-off period until May 2017, during which both fully branded and plain packs of various sizes were legally available. This study investigates trends in prices of roll-your-own tobacco (RYO) before, during and after implementation of this legislation, and compares trends with those observed in the cigarette market. METHODS: We used Nielsen Scantrack data for the period from March 2013 to June 2018 to describe trends in UK inflation-adjusted prices and volumes of both RYO and cigarettes, and linear regression to estimate changes in prices associated with the introduction of plain packaging and the minimum pack sizes of 30 g RYO and 20 cigarettes. RESULTS: In contrast to a downward trend in cigarette sales volumes, RYO volumes rose throughout the study period. By the time plain packs accounted for 75% or more of sales, the average price of products sold in equivalent pack sizes had increased, relative to average prices in the year before implementation and with adjustment for tax changes, from 34.9 to 38.8 pence per gram for RYO (mean difference 4.26, 95% CI 3.99 to 4.53 pence, 12% increase), and from 38.6 to 41.13 pence for cigarettes (mean difference 2.53, 95% CI 2.24 to 2.83 pence, 7% increase) per cigarette. CONCLUSIONS: New legislation resulted in higher prices for RYO and manufactured cigarettes. However, sales volumes of RYO continued to increase throughout the study period, perhaps because RYO remains a less expensive means of smoking tobacco.

Effects of Current and Enhanced Tobacco Corrective Messages on Smokers' Intention to Quit Smoking and Intention to Purchase Cigarettes.

INTRODUCTION: A federal court has ordered tobacco companies to issue corrective messages to address tobacco-related misperceptions. This study examined the effects of viewing current versus two enhanced versions of tobacco corrective messages on smokers' intention to quit smoking and intention to purchase cigarettes. METHODS: US adult smokers (N = 803) were randomly assigned to view (1) two current tobacco corrective messages (Current), (2) two corrective messages that include an industry deception statement (Industry Deception), or (3) two corrective messages with an industry deception statement and testimonials of people harmed by smoking (Industry Deception + Testimonial). Outcomes were pretest-posttest change in intentions to quit smoking and posttest intention to purchase cigarette measures. RESULTS: Intention to quit smoking increased significantly after viewing the Current corrective messages versus baseline. In addition, viewing the Industry Deception + Testimonial messages increased intention to quit smoking compared with the Current corrective condition and the Industry Deception condition. Hispanic smokers had increased intention to quit smoking and decreased intention to purchase cigarettes to a greater degree than non-Hispanic smokers in response to Industry Deception + Testimonial messages. There was no significant difference in intention to purchase cigarettes across conditions. CONCLUSIONS: Enhancing the current corrective statements by including an industry deception statement and testimonials may strengthen effects and contribute to remedying the effects of tobacco misinformation. IMPLICATIONS: Previous research has found that draft or proposed versions of tobacco industry corrective messages are effective in correcting beliefs and knowledge. However, studies have not examined how the current court-ordered corrective messages could change intention to quit smoking and intention to purchase cigarettes nor whether enhanced messages could perform better. Study findings suggest that the current corrective messages can increase smokers' intention to quit smoking beyond their baseline intention. More importantly, enhancing corrective messages by including an industry deception statement and testimonial was found to be more effective than current corrective messages. Findings can inform future iterations of tobacco correctives and strategies to reverse the effects of tobacco misinformation.

Socio-environmental risks associated with the green tobacco sickness in farmers: a case-control study / Riesgos socioambientales asociados a la enfermedad del tabaco verde en agricultores: un estudio caso-control / Riscos socioambientais associados à doença da folha verde do tabaco em agricultores: um estudo caso-controle

ABSTRACT Objective: to determine the presence of socio-environmental risk factors for the development of Green Tobacco Sickness in workers who grow Burley tobacco. Method: matched case-control study. The data collection took place in two moments: from December 2016 to January 2017 and December 2017, when the Burley tobacco was collected, through a household survey with interview application and urine collection for urinary cotinine. Results: the socio-environmental risk factors that remained associated with the disease were: bundling tobacco (p=0.047) and wearing socks (p=0.011); with protective effect were found sticking tobacco seeding of the day (p=0.006) and number of tobacco harvested per day (p=0.021). Conclusion: the steps in the Burley tobacco work process increase the exposure and risk of developing the disease. By identifying these factors, it is possible to address interdisciplinary control and prevention measures.

RESUMEN Objetivo: determinar la presencia de factores de riesgo socioambientales para el desarrollo de la Enfermedad del Tabaco Verde en trabajadores que cultivan el tabaco Burley. Método: estudio del tipo caso-control pareado. La recolección de datos ocurrió en dos momentos: de diciembre de 2016 a enero de 2017 y diciembre de 2017, período en que ocurrió la recolección del tabaco Burley, por medio de encuesta domiciliaria con aplicación de entrevista y recolección de orina para el examen de cotinina urinaria. Resultados: los factores de riesgo socioambientales que permanecieron asociados a la enfermedad fueron aferrar tabaco (p=0,047) y usar medias (p=0,011); con efecto protector fueron encontrados espetar los pies de tabaco del día (p=0,006) y el número de pies de tabaco cosechados por día (p=0,021). Conclusión: las etapas del proceso de trabajo con tabaco Burley aumentan la exposición y el riesgo de desarrollar la enfermedad. Al identificar estos factores, es posible dirigir, de forma interdisciplinaria, medidas de control y prevención.

RESUMO Objetivo: determinar a presença de fatores de riscos socioambientais para o desenvolvimento da Doença da Folha Verde do Tabaco em trabalhadores que cultivam o tabaco Burley. Método: estudo do tipo caso-controle pareado. A coleta de dados ocorreu em dois momentos: de dezembro de 2016 a janeiro de 2017 e dezembro de 2017, período em que ocorreu a colheita do tabaco Burley, por meio de inquérito domiciliar com aplicação de entrevista e coleta de urina para exame de cotinina urinária. Resultados: os fatores de riscos socioambientais que permaneceram associados à doença foram enfeixar tabaco (p=0,047) e usar meias (p=0,011); com efeito protetor foram encontrados espetar pés de tabaco do dia (p=0,006) e número de pés de tabaco colhido por dia (p=0,021). Conclusão: as etapas do processo de trabalho com tabaco Burley aumentam a exposição e o risco de desenvolver a doença. Ao identificar esses fatores, é possível direcionar, de forma interdisciplinar, medidas de controle e prevenção.

Socio-environmental risks associated with the green tobacco sickness in farmers: a case-control study.

OBJECTIVE: to determine the presence of socio-environmental risk factors for the development of Green Tobacco Sickness in workers who grow Burley tobacco. METHOD: matched case-control study. The data collection took place in two moments: from December 2016 to January 2017 and December 2017, when the Burley tobacco was collected, through a household survey with interview application and urine collection for urinary cotinine. RESULTS: the socio-environmental risk factors that remained associated with the disease were: bundling tobacco (p=0.047) and wearing socks (p=0.011); with protective effect were found sticking tobacco seeding of the day (p=0.006) and number of tobacco harvested per day (p=0.021). CONCLUSION: the steps in the Burley tobacco work process increase the exposure and risk of developing the disease. By identifying these factors, it is possible to address interdisciplinary control and prevention measures.

Exploiting the "video game craze": A case study of the tobacco industry's use of video games as a marketing tool.

BACKGROUND: Video games have grown in popularity since the 1970s, and tobacco imagery is present in a substantial subset of games, including those oriented to youth. Much like exposure to tobacco content in films, exposure to tobacco content in video games may influence smoking uptake and use; however, the tobacco industry's role in facilitating or promoting the use of tobacco imagery in video games is unclear. We explored the industry's interest in and use of video games to market their products to youth and young adults. METHODS: We retrieved and analyzed archival tobacco industry documents. We supplemented information from the documents with current and archived versions of several brand and corporate websites and one website containing user-supplied information on video games. RESULTS: Tobacco companies recognized the youth appeal and marketing potential of video games as early as 1980. Initial marketing ideas included incorporating video game themes into product packaging and design. More fully realized plans focused on incorporating video games into product promotions in bars, as a high visibility way to attract younger patrons and increase long-term marketing opportunities by generating names for tobacco company direct-marketing databases. Tobacco companies also incorporated video games into in-home product promotions, primarily as components of brand websites, in order to enhance brand image and generate repeat website traffic. A similar desire to attract and keep visitors led to discussions about the inclusion of video games on corporate youth smoking prevention websites, although only one company, Lorillard, followed through. CONCLUSIONS: Video game players are an attractive target market for tobacco companies. Video games, as used by these companies, facilitate consumer engagement with particular tobacco brands or particular corporate messages. Eliminating the use of video games as a promotional vehicle may require limiting tobacco marketing in both physical and online environments.

Tapping Into Multiple Data "Springs" to Strengthen Policy Streams: A Guide to the Types of Data Needed to Formulate Local Retail Tobacco Control Policy.

In 2015, the tobacco industry spent $8.24 billion to market tobacco products in convenience stores, supermarkets, pharmacies, and other retail or point-of-sale settings. Community tobacco control partnerships have numerous evidence-based policies (eg, tobacco retailer licensing and compliance, tobacco-free-school buffer zones, eliminating price discounts) to counter point-of-sale tobacco marketing. However, deciding which point-of-sale policies to implement - and when and in what order to implement them - is challenging. The objective of this article was to describe tools and other resources that local-level tobacco use prevention and control leaders can use to assemble the data they need to formulate point-of-sale tobacco policies that fit the needs of their communities, have potential for public health impact, and are feasible in the local policy environment. We were guided by Kingdon's theory of policy change, which contends that windows of policy opportunity open when 3 streams align: a clear problem, a solution to the problem, and the political will to work for change. Community partnerships can draw on 7 data "springs" to activate Kingdon's streams: 1) epidemiologic and surveillance data, 2) macro retail environment data, 3) micro retail environment data, 4) the current policy context, 5) local legal feasibility of policy options, 6) the potential for public health impact, and 7) political will.