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1.
Asian Pac J Cancer Prev ; 22(S2): 51-57, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780138

RESUMO

BACKGROUND: Sale of single cigarettes (also known as singles or loosies) is a key driver for early initiation of smoking and is a leading contributor to the smoking epidemic in India. Sale of singles additionally deter implementation of tobacco control strategies of pictorial health warnings including plain packaging and defeat effective taxation and promote illicit trade. We review India's tobacco control policy responses towards banning singles and other products sold as loose tobacco and identify opportunities for future policy intervention especially in the context of the ongoing COVID-19 pandemic. METHODS: Existing national and sub-national policy documents were analyzed for their content since the inception of the tobacco control laws in the country. RESULTS: There are no effective provisions at national level to ban loose tobacco products in India. However, the implementation of multiple legislative and regulatory measures (Acts/circulars/letters/notifications/orders/court judgements) in 16 Indian states and jurisdictions provide sufficient legal framework to substantiate its complete ban pan India. While the majority of state governments have adopted state level measures, Rajasthan had issued specific directive to all the 33 districts banning loose cigarettes and other tobacco products. Himachal Pradesh introduced the most unique and comprehensive legislation, for banning the sale of cigarettes and beedis (Dated November 7, 2016). The most recent notification in the state of Maharashtra (September 24, 2020) is the first to leverage powers using a mix of national and state legislations including the legislation addressing the rapidly emerging challenge of managing COVID-19. CONCLUSION: A robust national policy which supports strong provision to deter tobacco companies, their distribution network and vendors from selling singles or loose tobacco products is urgently needed. Such policy should be backed by cautionary messaging for consumers as well. Eliminating singles and loose tobacco sale will help in blunting tobacco use prevalence besides curbing spread of infectious diseases like COVID-19 pandemic.


Assuntos
Política Pública/legislação & jurisprudência , Prevenção do Hábito de Fumar/legislação & jurisprudência , Fumar/economia , Fumar/epidemiologia , Indústria do Tabaco/economia , Produtos do Tabaco/economia , COVID-19/epidemiologia , Humanos , Índia/epidemiologia , Pandemias , SARS-CoV-2 , Governo Estadual , Impostos/legislação & jurisprudência , Indústria do Tabaco/legislação & jurisprudência
2.
PLoS One ; 16(10): e0257553, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34644338

RESUMO

BACKGROUND: California Proposition 56 increased cigarette excise tax by $2 per pack with equivalent increases on non-cigarette tobacco products. We estimated the changes in cigarette price, cigarette use, and non-cigarette use following the implementation of Proposition 56 in California in 2017. METHODS: Seven waves of Tobacco Use Supplements to the Current Population Survey (TUS-CPS) 2011-2019 data were used to obtain state-level aggregate self-reported outcomes, including cigarette price per pack, current and daily cigarette use, cigarette consumption per day, and current and daily use of non-cigarette tobacco products (hookah, pipe, cigar, and smokeless tobacco). A modified version of a synthetic control method was used to create a "synthetic" California that best resembled pre-policy sociodemographic characteristics and outcome trends in California while correcting time-invariant pre-policy differences. Various sensitivity analyses were also conducted. RESULTS: The implementation of Proposition 56 was associated with an increase in self-reported cigarette price per pack in California ($1.844, 95%CI: $0.153, $3.534; p = 0.032). No evidence suggested that Proposition 56 was associated with the changes in the prevalence of current or daily cigarette use, cigarette consumption per day, or the prevalence of current or daily use of non-cigarette tobacco products. CONCLUSION: Most of the cigarette tax increase following Proposition 56 in California was passed on to consumers. There is a lack of evidence that the implementation of Proposition 56 was associated with the changes in the use of cigarettes and other tobacco products such as hookah, pipe, cigar, and smokeless tobacco.


Assuntos
Produtos do Tabaco/economia , Uso de Tabaco/epidemiologia , California/epidemiologia , Humanos , Prevalência , Impostos/economia , Indústria do Tabaco/economia , Tabaco sem Fumaça/economia
3.
Am J Health Behav ; 45(4): 635-641, 2021 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-34340731

RESUMO

Objectives: This study investigated the smoking behavior and its association with the availability of tobacco products purchases among Korean adolescents. Methods: The data of the 2019 Korea Youth Risk Behavior Survey were used (N =57,303). This study assessed 3 tobacco products: cigarettes, e-cigarettes, and heated tobacco products. Smoking behavior including lifetime, current, daily, heavy smoking, and attempting to quit and its association with the availability of tobacco products for purchase was assessed. Results: Overall, 92.9% did not try to purchase tobacco products during the past 30 days, 2.2% found it impossible to purchase, 0.8% could buy with a lot of effort, 1.7% could buy with little effort, and 2.3% could buy easily without any effort. Lifetime smokers were 13.8% (12.7% for cigarettes, 7.4% for e-cigarettes, and 4.9% for heated tobacco products). Among lifetime smokers, the current smoking rates for cigarettes, e-cigarettes, and heated tobacco products were 48.5%, 22.9%, and 19.0%, and the rates were lower in adolescents who responded that it was impossible to buy tobacco products. Among current smokers, the daily smoking rates were lower in adolescents who were found it impossible to buy tobacco products. Conclusions: The ease of access to tobacco products was associated with higher use of cigarettes, e-cigarettes, and heated tobacco products and lower attempts to quit smoking in Korean adolescents.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Fumar , Produtos do Tabaco , Vaping/epidemiologia , Adolescente , Humanos , República da Coreia/epidemiologia , Fumantes , Fumar/epidemiologia , Produtos do Tabaco/economia
4.
Int J Public Health ; 66: 1604005, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34335142

RESUMO

Objectives: Compare the brand availability, pricing and presence of illicit products in semi-urban and rural areas in India across product types and states. Methods: In late 2017, 382 unique tobacco products were purchased from localities with populations under 50,000 in the states of Assam, Karnataka, Maharashtra, Rajasthan, and Uttar Pradesh. Brand, printed maximum retail price, price paid, tax, and health warning labels (HWLs) were used to compare the market for bidis, smokeless tobacco (SLT), and cigarettes. Results: Brand availability and pricing of SLT products was similar to cigarettes. Brand availability and pricing of bidis was consistent with having many small producers. Bidis and single serving SLT with spice mixtures were more affordable than cigarettes and SLT sold alone. 2% of SLT and 10% of cigarettes did not feature an India HWL. Conclusion: The elimination of single serving SLT packets and the removal of tax exemptions for small producers, often exploited by bidi producers, could reduce their respective affordability. State differences in illegal and illicit products could indicate a greater need for enforcement in some states.


Assuntos
Comércio , Produtos do Tabaco , Tabaco sem Fumaça , Comércio/estatística & dados numéricos , Custos e Análise de Custo , Humanos , Índia , População Rural , Produtos do Tabaco/economia , Tabaco sem Fumaça/economia , População Urbana
6.
Am J Health Behav ; 45(2): 205-215, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33888182

RESUMO

Objectives: The government of the Republic of Korea (ie, South Korea) drastically increased cigarette prices by 80% in 2015. The exogenous regulatory change provided us with an opportunity to examine the effects of the cigarette price increase on smoking behavior. Methods: Utilizing 2011-2016 balanced panel data from the Korea Health Panel (3693 participants each year), we divided the sample into smokers and non-smokers and traced each individual's smoking behavior. Results: Overall smoking prevalence (OR = 0.476, p < .01) and daily cigarette consumption (IRR = 0.737, p < .01) were reduced after the cigarette price increase. However, although the cigarette price increase was inversely related to smokers' cigarette consumption (OR = 0.799, p < .01), we found no statistically significant impact on smoking cessation among smokers. On the other hand, the cigarette price increase was associated with decreased smoking onset among non-smokers (OR = 0.172, p < .01) and reduced cigarette consumption after they started smoking (IRR = 0.279, p < .01). Conclusions: The reduction in smoking prevalence after the increase of the cigarette price resulted from the fact that non-smokers did not start smoking rather than from a decrease in the number of existing smokers.


Assuntos
não Fumantes , Fumantes , Fumar , Produtos do Tabaco , Comércio , Humanos , República da Coreia , Fumar/epidemiologia , Abandono do Hábito de Fumar , Impostos , Produtos do Tabaco/economia
7.
Am J Health Behav ; 45(2): 226-238, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33888184

RESUMO

Objectives: Our objective was to provide data contrasting commercial tobacco retailing in Tribal versus non-Tribal jurisdictions, in 3 states. These data may be relevant for US Food and Drug Administration regulation of Tribal retailing. Methods: With Tribal permission, observations were made on commercial tobacco advertising, product variety, pricing, and retail concept for stores within and just outside Tribal jurisdictions in areas of Arizona (AZ), California (CA), and Oklahoma (OK). Results: A total of 87 Tribal (20 AZ, 53 CA, 14 OK) and 67 (10, 43, 14) non-Tribal retailer visits were completed. There was substantial variation across tribes, with sales in AZ and most CA Tribal jurisdictions handled at convenience stores, whereas OK Tribal retailing was done mostly in specialized tobacco-specialty shops. Electronic cigarettes were ubiquitous across Tribal and non-Tribal outlets. Advertising and breadth of cigarette offerings was most extensive in the tobacco specialty retailers of Tribal OK. Surprisingly, Tribally manufactured cigarettes were found only at some CA Tribal retailers. Conclusions: Some Tribal commercial tobacco outlets actually price above their non-Tribal competitors and there is substantial variation in retailing strategy across Tribal jurisdictions. Tribal governments can continue to evaluate and reform commercial tobacco retailing so as to improve Tribal health.


Assuntos
Comércio , Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Nativos Estadunidenses , Arizona , California , Humanos , Marketing , Oklahoma , Produtos do Tabaco/economia
8.
Prev Med ; 148: 106526, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33745955

RESUMO

As a public health measure against COVID-19, South Africa restricted the sale of "tobacco, e-cigarettes and related products" for 5 months, ending on August 17, 2020. We examined marketing activities related to novel tobacco products (e-cigarettes and heated tobacco products) during this restriction. Using web scraping, we accessed data for 2661 e-cigarette liquids marketed online by South African vendors in June 2020. We also analyzed heated tobacco product volume sales (kits) using retail scanner data from Nielsen Company. The 2661 e-cigarette liquids assessed online comprised cannabidiol liquids, 28.8%[767/2661], nicotine salts, 10.4%[276/2661], e-cigarette juice concentrates, 14.1%[376/2661], nicotine-free e-liquid, 4.0%[107/2661], and nicotine-containing e-liquid, 42.6%[1135/2661]. Cannabidiol liquids had the highest percentage of fruit (78.4%[601/767]) and tobacco flavors (9.4%[72/767]). During the restriction, many online e-cigarette vendors actively promoted cannabidiol liquid in lieu of regular e-liquid. Nielsen retail scanner data showed that volume of heated tobacco product sales in February 2020, preceding the restriction (7.76 million kits), were higher than in February 2019 (4.52 million kits). The restriction saw decreased sales of heated tobacco products; mean weekly heated tobacco product sales in the 6 weeks following the restriction (772,585 kits/week) were dramatically lower versus the 6 weeks preceding the restriction (2.26 million kits/week). Lifting the restriction saw a 131% spike in sales between the latter half of August 2020 (825,638 kits) and mid-September 2020 sales (1.90 million kits), even though total sales in September 2020 were half of what was observed in the preceding year (3.81 million units in September 2020, vs 6.33 million units, September 2019). The marketing of cannabidiol and other novel products by e-cigarette manufacturers and the tobacco industry may encourage youth use; close monitoring is required.


Assuntos
COVID-19 , Comércio/estatística & dados numéricos , Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco/economia , Adolescente , Humanos , SARS-CoV-2 , África do Sul , Tabaco , Indústria do Tabaco
9.
Afr J Prim Health Care Fam Med ; 13(1): e1-e3, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33764140

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has spread throughout the world, with devastating effects of the virus as well as the repercussions of the resulting 'lockdowns'. South Africa went into a national lockdown in March 2020 to mitigate the impact of the virus. This included a ban on the sales of tobacco and electronic cigarette products. The ban has been a highly contentious issue in South Africa, discussed worldwide, which has drawn many criticisms. The prevalence rate of smoking in South Africa was around 21.5%, with the Western Cape province having a prevalence rate of 39%. We compared the number of chronic obstructive pulmonary disease (COPD) presentations at a large regional referral hospital in the Western Cape province from January to August 2019 with the same period in 2020. Electronic emergency centre data showed a reduction of 69.28% in COPD presentations. To control for some confounders for the same period, we also reviewed patients presenting with urinary tract infections, which showed only a 30.60% reduction. This notable reduction in COPD presentations reduced service pressure of emergency centre and most likely benefitted patients' health. Further research and policies are needed to ensure ongoing reduction in the prevalence of smoking.


Assuntos
COVID-19 , Fumar Cigarros/efeitos adversos , Serviço Hospitalar de Emergência , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/terapia , Produtos do Tabaco/legislação & jurisprudência , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/virologia , Fumar Cigarros/epidemiologia , Fumar Cigarros/legislação & jurisprudência , Fumar Cigarros/prevenção & controle , Comércio/legislação & jurisprudência , Controle de Doenças Transmissíveis/métodos , Humanos , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/epidemiologia , SARS-CoV-2 , África do Sul/epidemiologia , Exacerbação dos Sintomas , Produtos do Tabaco/efeitos adversos , Produtos do Tabaco/economia
11.
Rev Esp Salud Publica ; 952021 Feb 09.
Artigo em Espanhol | MEDLINE | ID: mdl-33559644

RESUMO

OBJECTIVE: The price elasticity of tobacco emerges as an instrument for minimizing tobacco consumption, sustained by the idea that although tobacco has an addictive nature, an increase in its price causes a decrease in its consumption. However, the price is not the only component of tobacco consumption studied in the literature. Some studies include income as an explanatory component of tobacco consumption. These studies conclude that income affects tobacco consumption positively. METHODS: In this paper, the factors that affect the consumption of cigarettes are measured for the Spanish market using time series data from 1957 to 2018 and by applying the Logarithmic Mean Divisia Index LMDI method. The novel application of this method to this body of literature allows us to verify how effective the price policies that the government has implemented against the consumption of cigarettes have been. RESULTS: Our results reveal that income is a determining factor that sometimes nullifies the effect of policies when governments increase the price of cigarettes by taxes. In order to reduce the prevalence of smokers, the increase in the price of tobacco must consider the effect of income on consumption, so that it does not cancel the effects of health policy. CONCLUSIONS: It is strongly recommended that tax authorities consider these results before applying anti-smoking policies. If the authorities do not do so, it is possible that they will not obtain the expected results in terms of minimized the cigarette consumption.


Assuntos
Comércio/estatística & dados numéricos , Produtos do Tabaco/economia , Uso de Tabaco/epidemiologia , Humanos , Espanha/epidemiologia , Impostos
12.
Drug Alcohol Depend ; 221: 108522, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33582490

RESUMO

INTRODUCTION: Cigarette demand, or relative value, can be assessed via analysis of performance on a hypothetical behavioral economic cigarette purchase task (CPT). Substance purchase tasks are highly amenable to manipulation, namely, external stimuli, instructional changes, or acute stressors. In this regard, the current secondary analysis evaluates the role a novel, computerized stress induction paradigm, the Contextual-Frustration Intolerance Typing Task (C-FiTT), plays in eliciting varying levels of stress and resulting demand. METHOD: Daily smokers (n = 484) completed the C-FiTT wherein they were randomly assigned to one of five distress conditions: combination of task difficulty (low or high difficulty) with neutral or withdrawal cues, and a neutral control group. Tobacco demand was assessed immediately following the distress task using the hypothetical CPT. RESULTS: The C-FiTT distress-induction task significantly increased key cigarette demand indices, including price at maximum expenditure (Pmax) and first price where consumption was suppressed to zero (breakpoint). Moreover, demand increased with severity of C-FiTT condition, with the high-difficulty condition resulting in significantly higher breakpoint and Pmax, compared to other conditions. C-FiTT condition was not related to a significant increase in Omax, intensity, or elasticity. DISCUSSION: The novel C-FiTT paradigm produced comparable effects on tobacco demand relative to in vivo withdrawal induction, indicating that the C-FiTT is a viable procedure by which to influence demand. Reduction of internal and external stressors may be effective in lowering motivation for tobacco. These results highlight the importance of state distress in tobacco demand, and offer a potential avenue for intervention.


Assuntos
Tabagismo/psicologia , Adulto , Comportamento do Consumidor , Sinais (Psicologia) , Economia Comportamental , Feminino , Humanos , Masculino , Motivação , Fumantes , Tabaco , Produtos do Tabaco/economia , Uso de Tabaco , Tabagismo/economia , Adulto Jovem
13.
PLoS One ; 16(2): e0246321, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33571218

RESUMO

Cigarette smoking patterns vary within the population, with some individuals remaining never smokers, some remaining occasional users, and others progressing to daily use or quitting. There is little research on how population-level tobacco control policy interventions affect individuals within different smoking trajectories. We identified associations between tobacco control policy interventions and changes across different smoking trajectories among adolescents and young adults. Using 15 annual waves of data drawn from the National Longitudinal Survey of Youth 1997 (NLSY97), we applied a group-based trajectory model to identify associations between days smoked per month, comprehensive smoke-free laws, cigarette tax rates, and known socio-demographic risk factors for membership in different smoking trajectories. Comprehensive smoke-free laws were associated with reduced risk of initiation and reductions in days smoked per month for all trajectories other than occasional users. Higher tax rates were associated with reduced risk of initiation and days smoked for all trajectories other than established users. Overall, population-based tobacco control policies, particularly comprehensive smoke-free laws, were associated with reduced smoking. Tobacco taxes primarily reduced risk of initiation and use among never smokers, experimenters, and quitters, consistent with previous research suggesting that tobacco manufacturers lower prices after tax increases to reduce the cost of continued smoking for established users. These results provide support for expanding smoke-free laws and establishing a minimum tobacco floor price, which could improve public health by reducing the risk of initiation as well as use among occasional and established smokers.


Assuntos
Política Antifumo , Fumar/epidemiologia , Impostos , Produtos do Tabaco/economia , Adolescente , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Fatores de Risco , Fatores Sexuais , Política Antifumo/legislação & jurisprudência , Prevenção do Hábito de Fumar/métodos , Adulto Jovem
14.
BMJ Open ; 11(1): e039211, 2021 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-33462095

RESUMO

OBJECTIVE: To examine the impact of cigarette price and smoking environment on allocation of household expenditure and its implication on nutrition consumption. DESIGN: A cross-sectional study was conducted using the 2014 National Socioeconomic Survey (SUSENAS), the 2014 Village Potential Survey (PODES) and the 2013 Basic National Health Survey (RISKESDAS). SUSENAS and PODES data were collected by the Central Bureau of Statistics. RISKESDAS was conducted by National Institute of Health Research and Development (Balitbangkes), Indonesian Ministry of Health (MOH). SETTING AND PARTICIPANTS: The sample covered all districts in Indonesia; with sample size of 285 400 households. These households are grouped into low, medium and high smoking prevalence districts. PRIMARY AND SECONDARY OUTCOME MEASURES: The impact of cigarette price and smoking environment on household consumption of cigarette, share of eight food groups, as well as calorie and protein intake. RESULT: 1% increase in cigarette price will increase the cigarette budget share by 0.0737 points and reduce the budget share for eggs/milk, prepared food, staple food, nuts, fish/meat and fruit, from 0.0200 points (eggs/milk) up to 0.0033 points (fruit). Reallocation of household expenditure brings changes in food composition, resulting in declining calorie and protein intake. A 1% cigarette price increase reduces calorie and protein intake as much as 0.0885% and 0.1052%, respectively. On the other hand, existence of smoke-free areas and low smoking prevalence areas reduces the household budget for cigarettes. CONCLUSION: A pricing policy must be accompanied by non-pricing policies to reduce cigarette budget share.


Assuntos
Comércio , Dietética/economia , Alimentos/economia , Fumar/economia , Impostos , Produtos do Tabaco/economia , Estudos Transversais , Ingestão de Alimentos , Abastecimento de Alimentos/economia , Humanos , Indonésia/epidemiologia , Política Pública , Fumar/efeitos adversos , Fumar/epidemiologia , Fatores Socioeconômicos
15.
J Vasc Surg ; 73(5): 1759-1768.e1, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33098941

RESUMO

OBJECTIVE: Active smoking among patients undergoing interventions for intermittent claudication (IC) is associated with poor outcomes. Notwithstanding, current levels of active smoking in these patients are high. State-level tobacco control policies have been shown to reduce smoking in the general US population. We evaluated whether state cigarette taxes and 100% smoke-free workplace legislation are associated with active smoking among patients undergoing interventions for IC. METHODS: We queried the Vascular Quality Initiative database for peripheral endovascular interventions, infrainguinal bypasses, and suprainguinal bypasses for IC. Active smoking at the time of intervention was defined as smoking within one month of intervention. We implemented difference-in-differences analysis to isolate changes in active smoking owing to cigarette taxes (adjusted for inflation) and implementation of smoke-free workplace legislation. The difference-in-differences models estimated the causal effects of tobacco policies by adjusting for concurrent temporal trends in active smoking unrelated to cigarette taxes or smoke-free workplace legislation. The models controlled for age, sex, race/ethnicity, insurance type, diabetes, chronic obstructive pulmonary disease, state, and year. We tested interactions of taxes with age and insurance. RESULTS: Data were available for 59,847 patients undergoing interventions for IC in 25 states from 2011 to 2019. Across the study period, active smoking at the time of intervention decreased from 48% to 40%. Every $1.00 cigarette tax increase was associated with a 6-percentage point decrease in active smoking (95% confidence interval, -10 to -1 percentage points; P = .02), representing an 11% decrease relative to the baseline proportion of patients actively smoking. The effect of cigarettes taxes was greater in older patients and those on Medicare. Among patients aged 60 to 69 and 70 to 79 years, every $1.00 tax increase resulted in 14% and 21% reductions in active smoking relative to baseline subgroup prevalences of 53% and 29%, respectively (P < .05 for both); however, younger age groups were not affected by tax increases. Among insurance groups, only patients on Medicare exhibited a significant change in active smoking with every $1.00 tax increase (an 18% decrease relative to a 33% baseline prevalence; P = .01). The number of states implementing smoke-free workplace legislation increased from 9 to 14 by 2019; however, this policy was not significantly associated with active smoking prevalence. At follow-up (median, 12.9 months), $1.00 tax increases were still associated with decreased smoking prevalence (a 25% decrease relative to a 33% baseline prevalence; P < .001). CONCLUSIONS: Cigarette tax increases seem to be an effective strategy to decrease active smoking among patients undergoing interventions for IC. Older patients and Medicare recipients are the most responsive to tax increases.


Assuntos
Claudicação Intermitente/terapia , Doença Arterial Periférica/terapia , Abandono do Hábito de Fumar , Prevenção do Hábito de Fumar , Fumar/efeitos adversos , Produtos do Tabaco/efeitos adversos , Local de Trabalho , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Regulamentação Governamental , Humanos , Claudicação Intermitente/diagnóstico , Claudicação Intermitente/epidemiologia , Masculino , Medicare , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/epidemiologia , Formulação de Políticas , Prevalência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Política Antifumo/economia , Política Antifumo/legislação & jurisprudência , Fumar/economia , Fumar/epidemiologia , Fumar/legislação & jurisprudência , Abandono do Hábito de Fumar/economia , Abandono do Hábito de Fumar/legislação & jurisprudência , Prevenção do Hábito de Fumar/economia , Prevenção do Hábito de Fumar/legislação & jurisprudência , Impostos , Produtos do Tabaco/economia , Produtos do Tabaco/legislação & jurisprudência , Estados Unidos/epidemiologia , Local de Trabalho/legislação & jurisprudência
16.
Rev Environ Health ; 36(3): 367-389, 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-33185581

RESUMO

India is the second country in tobacco production in the world. Smoking tobacco products included Hookah, Cohutta, Chillum, Chillum, ganja, Beedi, Mava, Cigarettes, and cigar etc. Various types of smokeless tobacco like betel quid, khaini, mishri, snuff, gutkha are used. Fifty percent of them are addicted to smokeless tobacco. Sixty eight smokeless tobacco products were available in 2010; most of them included the risk of cancer warning except for loose tobacco products. Women mostly prefer 8 out of 29 gutkha brands. Out of these 29 gutkha brands, 15 were loose tobacco packets. India is the second-largest tobacco consumer, comprises of 27.5 crore consumers which altogether greater than the population of Western Europe. From among these 27.5 crore consumers, 16.4 crore people are smokeless tobacco in takers, 6.9 crore people are exclusive smokers and 4.2 crore people are both tobacco in takers and exclusive smokers. If we take this data into consideration early mortality of 45 crore people is expected by 2050 worldwide. Female basically are prone to fewer cigarettes per day as compared to males. On the other hand, a cigarette that is consumed by females has lower nicotine content as compared to males. In developing countries, the female population has less prevalence of smoking because the level of employment is low, socio-cultural norms, and health and beauty concerns. According to the estimation by the South East Asia Region (SEAR) in the year 2000 basically from India, we encounter death of about 18% men and about 3% of women due to tobacco. Various policies have been set up to control the use of tobacco. So that threat to public health is reduced. Policies like tobacco control policy, pro-health policy are set up for this purpose. Talking about the effects on a longer-term usage of water pipe can add up to the risk of getting affected by cancers of lungs, mouth, bladders, atherosclerosis, cardiovascular and pulmonary diseases, tooth extraction, etc.


Assuntos
Produtos do Tabaco/efeitos adversos , Uso de Tabaco/epidemiologia , Arritmias Cardíacas/induzido quimicamente , Fatores Econômicos , Regulamentação Governamental , Humanos , Índia/epidemiologia , Nicotina/efeitos adversos , Política Pública , Produtos do Tabaco/economia , Uso de Tabaco/prevenção & controle
17.
Nicotine Tob Res ; 23(3): 557-565, 2021 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-32770216

RESUMO

INTRODUCTION: Behavioral economic demand provides a multidimensional understanding of reinforcement. Commodity purchase tasks are an efficient method for measuring demand in human participants. One challenge in translating these procedures to electronic nicotine delivery systems (ENDS or e-cigarettes) is defining commodity units given the lack of standardization in the e-cigarette marketplace. AIMS AND METHODS: The purpose of this study was to directly compare methods of operationalizinge-cigarette purchases, puffs, cartridges, and mLs liquid, using a within-subject design. Participants (N = 132) reporting past week e-cigarette use were recruited using crowdsourcing. Purchase tasks were completed operationalizing e-cigarette units as puffs or cartridges at baseline and puffs or mLs liquid at a 3-month follow-up. RESULTS: Bivariate associations supported convergent and discriminant validity with the largest effect size correlations for intensity and elasticity observed for the puff version. Interaction models suggested that product preferences moderated the relationship between time-to-first use and cartridge demand with larger effect size correlations among persons reporting a preference for JUULs, but weaker relationships among persons reporting other device preferences. Puff intensity (rxx = .61) and elasticity (rxx = .62) showed good test-retest reliability for participants reporting stable consumption, but poor test-retest reliability for individuals with changed consumption levels (intensity rxx = -.08; elasticity rxx = -.10). CONCLUSIONS: This study highlights the relevance of commodity definitions in the e-cigarette purchase task. Puffs as an experimental commodity may provide flexibility for studying e-cigarette demand in heterogenous or unknown populations, whereas more tailored or personalized approaches like cartridge or mL-based tasks will likely be helpful when studying known subgroups. IMPLICATIONS: The commodity purchase task procedure is widely used for understanding cigarette and e-cigarette demand in nicotine dependence research. This study evaluates the importance of operational definitions of e-cigarette commodities in the purchase task (ie, puffs, cartridges, or mLs liquid). Puffs may provide a more flexible commodity unit when evaluating e-cigarette demand in general or heterogenous populations, whereas device-specific units may prove more valuable when studying populations with consistent and known product use.


Assuntos
Comportamento de Escolha , Comportamento do Consumidor/economia , Economia Comportamental , Sistemas Eletrônicos de Liberação de Nicotina/economia , Reforço Psicológico , Produtos do Tabaco/economia , Tabagismo/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Adulto Jovem
18.
Nicotine Tob Res ; 23(4): 716-723, 2021 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-32936883

RESUMO

INTRODUCTION: Assessing long-term smoking cessation after tobacco price increases is more valuable than short-term cessation as smokers often relapse after temporary cessation. We investigated whether tobacco price increases were associated with long-term smoking cessation and whether the association differed according to demographic, socioeconomic, and behavioral factors, using a national longitudinal survey of middle-aged individual-level data from 10 waves, every November from 2005 to 2014. METHODS: Temporary and long-term at least 1 year (1y+) or 2 years (2y+) quitters were defined by smoking in any one wave and quitting in the subsequent two or three waves in a discrete-time design. November 2006 (after July 11% increase) and November 2010 (after October 37% increase) were used as proxy variables for price increases. Generalized estimating equation models adjusted for demographic, socioeconomic, and behavioral covariates, and analyses stratified by these covariates were performed to estimate the association between price increases and smoking cessation. RESULTS: Of 43 630 smokers aged 50-65, 7.7%, 5.6%, and 5.2% of smokers quit temporarily, for at least 1 year and at least 2 years, respectively. 2y+ quitters significantly increased in November 2005-November 2008 (adjusted odds ratio = 1.23, 95% confidence interval: 1.06-1.43) and November 2009-November 2012 (adjusted odds ratio = 1.85, 95% confidence interval = 1.57-2.16). In stratified analyses, higher prices were associated with 2y+ quitters in all subgroups with some exceptions, including participants who smoked 21-30 cigarettes per day and those aged 60-65. CONCLUSIONS: Increasing tobacco prices may be effective in promoting long-term smoking cessation in various subgroups among middle-aged Japanese adults. IMPLICATIONS: Few longitudinal studies have examined the effect of a tobacco price increase on long-term smoking cessation. In a national longitudinal survey of middle-aged Japanese from 10 waves, the 37% tobacco price increase was found to be a trigger for successful smoking cessation for two or more years. Price increases were significantly associated with 2y+ smoking cessation in most demographic, behavioral, and socioeconomic subgroups. Results indicate that higher tobacco prices may be effective for long-term smoking cessation in almost all subgroups. Raising tobacco taxes and prices may be one of the most effective strategies for promoting long-term smoking cessation.


Assuntos
Comércio/economia , Fumantes/psicologia , Abandono do Hábito de Fumar/economia , Fumar/economia , Adulto , Idoso , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Japão/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fumar/epidemiologia , Fumar/psicologia , Abandono do Hábito de Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Impostos/economia , Produtos do Tabaco/economia
19.
Nicotine Tob Res ; 23(2): 294-301, 2021 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-32805055

RESUMO

INTRODUCTION: About 28.6% of Indian adults use tobacco. This study estimates the economic burden of deaths and diseases attributable to smoking and smokeless tobacco (SLT) use for persons aged ≥35 years. METHODS: The National Sample Survey data on healthcare expenditures, the Global Adult Tobacco Survey data on tobacco use prevalence, and relative risks of all-cause mortality from tobacco use were used to estimate the economic burden of diseases and deaths attributable to tobacco use in India, using a prevalence-based attributable-risk approach. Costs are estimated under the following heads: (1) direct medical and nonmedical expenditures; (2) indirect morbidity costs; and (3) indirect mortality costs of premature deaths. RESULTS: Total economic costs attributable to tobacco use from all diseases and deaths in India in the year 2017-2018 for persons 35 years or older amount to INR 1773.4 billion (US $27.5 billion), of which 22% is direct and 78% is indirect cost. Men bear 91% of the total costs. Smoking contributed 74% and SLT use contributed 26% of the costs. CONCLUSIONS: The economic costs of tobacco use amount to approximately 1.04% of India's gross domestic product (GDP), while the excise tax revenue from tobacco in the previous year was only 12.2% of its economic costs. The direct medical costs alone amount to 5.3% of total health expenditure. The enormous costs imposed on the nation's health care system due to tobacco use could potentially stress the public health care system and strain the economy and it warrants massive scaling up of tobacco control efforts in India. IMPLICATIONS: The study finds that the economic burden from tobacco constitutes more than 1% of India's GDP, and the direct health expenditures on treating tobacco-related diseases alone accounts for 5.3% of the total private and public health expenditures in India in a year. It shows that, for every INR 100 that is received as excise taxes from tobacco products, INR 816 of costs is imposed on society through its consumption. It establishes that tobacco consumption is a major resource drain on the national exchequer, and its effective regulation through comprehensive fiscal and non-fiscal policies is highly warranted.


Assuntos
Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Gastos em Saúde , Fumar/economia , Fumar/mortalidade , Produtos do Tabaco/economia , Adulto , Idoso , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fumar/epidemiologia , África do Sul/epidemiologia , Inquéritos e Questionários , Taxa de Sobrevida , Fatores de Tempo
20.
Nicotine Tob Res ; 23(1): 48-56, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-32652522

RESUMO

INTRODUCTION: There is an agreement in the literature that tobacco price elasticity is around -0.4 for given location. Furthermore, works only focus separately, on the temporal dimension or the spatial dimension, however, there are studies that show the existence of spillovers between different geographical areas due to the spatial dependence in tobacco consumption. The novelty of this study is the measurement of the effect that neighboring regions have on the price elasticity of cigarettes. AIMS AND METHODS: This study simultaneously analyzed, first, a dynamic spatial model used to measure the price elasticity of cigarettes in the short term and long term of the 47 provinces that make up the Spanish territory, detailing the influence of neighbors. Second, given the spatial arrangement of the elasticities observed in the provinces, we can detect behaviors typical of large-scale illicit trade and cross-border purchasing since geographical location can be an important factor in smuggling, and politicians should take this into account when making price policies. RESULTS: Results reveal that the consumption of the regions is influenced by the consumption of the neighboring regions in the same period. The price elasticity of cigarettes in the long term exceeds in many cases, in absolute value, unity. This result is novel because tobacco has historically been treated as an inelastic demand good. Finally, we found that the regions that are most sensitive to price are those bordering France and Gibraltar or tourist regions, demonstrating the effect that smuggling has on the behavior of the regions. CONCLUSIONS: These results are important because the price in Spain is set by the central government and fiscal policies regarding the price of tobacco can have different effects in different regions. This study has shown that the consumption of cigarettes is influenced by the neighboring regions and also measured different sensitivities for each region. Regional cooperation in tobacco control policies may have better effects than the elaborated policies based on historical information. IMPLICATIONS: Policy makers should consider that tobacco could be an elastic good in the long term and that cooperation between countries in terms of price differential should be taken to avoid tobacco smuggling. The allocation of resources to control smoking should consider the special dependence shown in this report. Also, academics should account for spatial dependence to measure tobacco consumption instead of temporal analysis.


Assuntos
Comércio/economia , Comportamento do Consumidor/economia , Política Pública , Impostos/legislação & jurisprudência , Produtos do Tabaco/economia , Fumar Tabaco/economia , Elasticidade , França/epidemiologia , Humanos , Espanha/epidemiologia , Fumar Tabaco/epidemiologia
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