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Who is the target? Package health warnings and the role of market segmentation

April 19, 2018 - 7:20am

Guidelines for implementation of Article 11 of the WHO Framework Convention on Tobacco Control recognise that ‘it is important to assess the impact of packaging and labelling measures on the target populations,’ yet how target populations may be identified is largely unspecified.1 We have previously characterised that early tobacco control efforts are often implemented in a given jurisdiction with a mass market approach, where the total population is treated in its entirety and largely undivided, but market segmentation should be adopted over time.2 Indeed, marketing strategists normally recognise the human diversity of consumers they are attempting to influence and a segmentation strategy involves the identification of well-defined consumer subgroups who share certain common characteristics to facilitate marketing communication that is more efficient, customised and personally relevant. When people find a message personally relevant, they are more likely to pay attention and process the message more...

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Authors guardian angels: our 2017 Reviewers of the Year

April 19, 2018 - 7:20am

As Editor in Chief of Tobacco Control, I regularly speak to junior researchers and novice authors about the publication process and what editors look for in submitted papers. Many novice authors are intimidated by peer review, and lacking good mentorship, they may not showcase their work well in a cover letter, target a journal properly for the type of work they have done, or understand that at high-impact journals, the abstract and cover letter may be the only parts of their paper that are read before the initial screening cut. But they also may seriously misinterpret or underestimate the role of peer reviewers in making their work better.

Many beginning authors think of peer reviewers negatively, as though they have to run the gauntlet and reviewers are people ‘out to get’ them by finding flaws in their work. While it may feel that way to all of us sometimes, good...

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Worldwide news and comment

April 19, 2018 - 7:20am
Austria: government chooses tobacco industry interests over citizens’ health

Austria achieved a dismal milestone in March 2018, when its government overturned modest (and long overdue) legislation for smoke free hospitality venues. The new laws had been due to come into force in May 2018.

All articles written by Marita Hefler unless otherwise attributed. Ideas and items for News Analysis should be sent to: marita.hefler@menzies.edu.au

Among high income countries, Austria already stood as a grim example of woefully inadequate tobacco control. The country has long been the standout laggard in Europe, ranking last on the European tobacco control scale since 2007. The lack of smoke free public spaces to protect the non-smoking majority is a key factor in Austria languishing at the bottom of the scale, resolutely clinging to the last century while many other European countries have achieved considerable progress.

Even taking into account Austria’s appalling record...

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Factual text and emotional pictures: overcoming a false dichotomy of cigarette warning labels

April 19, 2018 - 7:20am
Background

In reviewing the first set of pictorial warning labels in the USA, the courts equated textual labels with facts and information, and images with emotion. This study tested the differences in perceived informativeness and emotion between textual and pictorial cigarette warning labels.

Methods

An online study with 1838 US adults who were non-smokers (n=764), transitioning smokers (quit smoking in the past 2 years or currently trying to quit, n=505) or current smokers (n=569). Each participant evaluated 9 out of 81 text and pictorial cigarette warning labels. Participants reported to what extent they perceived the label as informative and factual and the negative emotions they felt while looking at each label. We used linear mixed models to account for the nesting of multiple observations within each participant.

Results

There were no significant differences in perceived informativeness between textual (mean 6.15 on a 9-point scale) and pictorial labels (6.14, p=0.80, Cohen’s d=0.003). Textual labels evoked slightly less emotion (4.21 on a 9-point scale) than pictorial labels (4.42, p<0.001, Cohen’s d=0.08). Perceived informativeness and emotion were strongly correlated (Pearson r=0.53, p<0.001).

Conclusion

Our findings contradict courts’ conclusions that pictorial messages are emotional and not factual. Pictorial labels are rated as informative and factual, textual labels evoke emotion, and emotionality and informativeness are strongly correlated. These findings serve as evidence for the Food and Drug Administration (FDA) to counteract the claim that pictorial warning labels, by definition, are not ‘purely factual and uncontroversial’.

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Electronic cigarette use in restaurants and workplaces where combustible tobacco smoking is not allowed: an Internet survey in Japan

April 19, 2018 - 7:20am
Background

The present study aimed to examine the experience of actual electronic cigarette (e-cigarette) use in smoke-free areas of restaurants and workplaces and to explore the determinants associated with such use among Japanese adults who reported any experience using e-cigarettes (e-cigarette ever-users).

Methods

An Internet-based self-reported questionnaire survey was conducted in 2015 on Japanese e-cigarette ever-users. The proportion of the respondents who had ever used or frequently used e-cigarettes in smoke-free restaurants and/or workplaces was calculated. Potential factors associated with e-cigarette use in those smoke-free areas were also examined by using multivariable logistic regression analyses.

Results

In total, 1243 e-cigarette ever-users (662 current and 581 former e-cigarette users) were analysed. The majority of them (1020/1243, 82.1%) were male and their mean age ± SD was 47.0±10.4 years. The proportion of those who had ever used e-cigarettes in smoke-free restaurants was 28.8% (358/1243) and that in smoke-free workplaces was 25.5% (317/1243), respectively. The proportion of those who had frequently used e-cigarettes in smoke-free restaurants was 18.5% (230/1243) and that in smoke-free workplaces was 16.3% (202/1243), respectively. In general, the proportion of e-cigarette use in those smoke-free areas was higher among those having a higher educational level than those having a lower educational level.

Conclusion

Among adult Japanese e-cigarette ever-users, approximately 26%–29% had ever used and 16%–19% had frequently used e-cigarettes in restaurants and/or workplaces where combustible tobacco smoking is not allowed. Policy-makers may need to establish explicit rules as to e-cigarette use in smoke-free environments.

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The effects of tobacco control policies on retailer sales to minors in the USA, 2015

April 19, 2018 - 7:20am
Background

Under the 2009 Family Smoking Prevention and Tobacco Control Act, the Food and Drug Administration (FDA) has been routinely inspecting tobacco retailers' compliance with under-age sales laws. We seek to identify factors associated with Retail Violation Rate for sale to minors (RVRm).

Methods

We collected the tobacco retailer inspection data for 2015 from the FDA compliance check database. RVRm was calculated at the census tract level and overlaid with tobacco regulations and youth smoking prevalence at the state level. Multi-level spatial analysis was performed to examine the impacts of tobacco jurisdiction variations, youth smoking rates and neighbourhood social characteristics on RVRm.

Results

A total of 136 816 compliance checks involving minors conducted by the FDA in 2015 were analysed. A higher RVRm was associated with higher youth smoking prevalence (aRR=1.04, p<0.0001). Tobacco regulations show significant relationships with RVRm. For every one dollar increase in cigarette tax per pack, the likelihood of retail violations was reduced by 2% (aRR=0.98, p=0.03). For every 10% increase in tobacco prevention spending towards Centers for Disease Control recommended funding targets, the likelihood of retail violations was reduced by 1% (aRR=0.99, p=0.01). RVRm increased in states that enacted stronger smoke-free air policies (aRR=1.08, p<0.0001).

Conclusion

We observed associations of tobacco regulations and neighbourhood social characteristics with tobacco retailers’ compliance with under-age sales laws. This study provides evidence to support stronger tobacco regulations and control policies in reducing youth access to tobacco products.

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Evaluating the pictorial warnings on tobacco products in Arabian Gulf countries against other international pictorial warnings

April 19, 2018 - 7:20am
Background

Few assessments of pictorial warnings (PWs) on cigarette packs implemented in Gulf Cooperation Council (GCC) countries have been done.

Methods

This article includes two cross-sectional studies. In Study 1, convenience samples of adults from the Kingdom of Saudi Arabia (n=111) and USA (n=115) participated in a consumer survey to rate a total of nine PWs from the GCC, Australia and the UK. Outcome measures were affective responses to PWs and concerns about smoking. In Study 2, tobacco control experts (n=14) from multiple countries rated the same PWs on a potential efficacy scale and completed one open-ended question about each. The PWs were altered to mask their country of origin. Analyses compared ranking on multiple outcomes and examined ratings by country of origin and by smoking status.

Results

In the consumer survey, participants from both countries rated the PWs from GCC lower than PWs from other countries on the two measures. The mixed-model analysis showed significant differences between the PWs from Australia and those from the GCC and between the PWs from the UK and those from the GCC (p<0.001) in the consumer and expert samples. The experts’ comments about the PWs implemented in the GCC were negative overall and confirmed previously identified themes about effective PWs.

Conclusion

This study shows PWs originating from the GCC had significantly lower ratings than those implemented in Australia and the UK. The GCC countries may need to re-evaluate the currently implemented PWs and update them periodically.

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Effect of message congruency on attention and recall in pictorial health warning labels

April 19, 2018 - 7:20am
Objective

The nine pictorial health warning labels (PWLs) proposed by the US Food and Drug Administration vary in format and feature of visual and textual information. Congruency is the degree to which visual and textual features reflect a common theme. This characteristic can affect attention and recall of label content. This study investigates the effect of congruency in PWLs on smoker’s attention and recall of label content.

Methods

120 daily smokers were randomly assigned to view either congruent or incongruent PWLs, while having their eye movements recorded. Participants were asked to recall label content immediately after exposure and 5 days later.

Results

Overall, the image was viewed more and recalled better than the text. Smokers in the incongruent condition spent more time focusing on the text than smokers in the congruent condition (p=0.03), but dwell time of the image did not differ. Despite lower dwell time on the text, smokers in the congruent condition were more likely to correctly recall it on day 1 (p=0.02) and the risk message of the PWLs on both day 1 (p=0.01) and day 5 (p=0.006) than smokers in the incongruent condition.

Conclusions

This study identifies an important design feature of PWLs and demonstrates objective differences in how smokers process PWLs. Our results suggest that message congruency between visual and textual information is beneficial to recall of label content. Moreover, images captured and held smokers’ attention better than the text.

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Moving past the problematisation of tobacco farming: insights from South India

April 19, 2018 - 7:20am
Introduction

Tobacco control actors increasingly recognise the importance of supply-side issues in seeking to address the problem of global tobacco consumption. However, research in this field often depicts tobacco production as a problem for farmers and as a malaise of the global industry. This paper the case of chewing tobacco producers in South India to explore why tobacco remains so resilient in this region.

Methods

Semi-structured interviews with 68 tobacco farmers and traders in 38 villages across five districts of Tamil Nadu, triangulated with informal discussions with over 100 agrarian actors both connected and unconnected to tobacco, extensive ethnographic field notes, and interviews with state and NGO actors. Representative sampling was not possible due to a lack of data on what constituted the ’population'. Therefore interviews were based on snowballing methods, with the aim being to capture the general scenario across five districts where tobacco is produced.

Results

The case highlighted the lack of a clear ’industry' which was exploiting farmers. Instead, tobacco was favoured by producers due to its drought resistance in a region of water scarcity, and it offered high levels of remuneration in certain circumstances where farmers are able to cure the leaf. It also afforded increased bargaining power to farmers in relation to traders as it is able to be stored and sold in low seasons by some. Finally, where exploitation of farmers by traders was evident, this was not necessarily unique to tobacco.

Discussion

The paper ultimately advocates further research on locally specific settings to better understand why tobacco cash crop remains so resilient in the Global South today, and a move beyond problematisations of the tobacco industry alone when looking at production.

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Impact of five tobacco endgame strategies on future smoking prevalence, population health and health system costs: two modelling studies to inform the tobacco endgame

April 19, 2018 - 7:20am
Objective

There is growing international interest in advancing ‘the tobacco endgame’. We use New Zealand (Smokefree goal for 2025) as a case study to model the impacts on smoking prevalence (SP), health gains (quality-adjusted life-years (QALYs)) and cost savings of (1) 10% annual tobacco tax increases, (2) a tobacco-free generation (TFG), (3) a substantial outlet reduction strategy, (4) a sinking lid on tobacco supply and (5) a combination of 1, 2 and 3.

Methods

Two models were used: (1) a dynamic population forecasting model for SP and (2) a closed cohort (population alive in 2011) multistate life table model (including 16 tobacco-related diseases) for health gains and costs.

Results

All selected tobacco endgame strategies were associated with reductions in SP by 2025, down from 34.7%/14.1% for Māori (indigenous population)/non-Māori in 2011 to 16.0%/6.8% for tax increases; 11.2%/5.6% for the TFG; 17.8%/7.3% for the outlet reduction; 0% for the sinking lid; and 9.3%/4.8% for the combined strategy. Major health gains accrued over the remainder of the 2011 population’s lives ranging from 28 900 QALYs (95% Uncertainty Interval (UI)): 16 500 to 48 200; outlet reduction) to 282 000 QALYs (95%UI: 189 000 to 405 000; sinking lid) compared with business-as-usual (3% discounting). The timing of health gain and cost savings greatly differed for the various strategies (with accumulated health gain peaking in 2040 for the sinking lid and 2070 for the TFG).

Conclusions

Implementing endgame strategies is needed to achieve tobacco endgame targets and reduce inequalities in smoking. Given such strategies are new, modelling studies provide provisional information on what approaches may be best.

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Content analysis of age verification, purchase and delivery methods of internet e-cigarette vendors, 2013 and 2014

April 19, 2018 - 7:20am
Objective

Identify the population of internet e-cigarette vendors (IEVs) and conduct content analyses of their age verification, purchase and delivery methods in 2013 and 2014.

Methods

We used multiple sources to identify IEV websites, primarily complex search algorithms scanning more than 180 million websites. In 2013, we manually screened 32 446 websites, identifying 980 IEVs, selecting the 281 most popular for content analysis. This methodology yielded 31 239 websites for screening in 2014, identifying 3096 IEVs, with 283 selected for content analysis.

Results

The proportion of vendors that sold online-only, with no retail store, dropped significantly from 2013 (74.7%) to 2014 (64.3%) (p<0.01), with a corresponding significant decrease in US-based vendors (71.9% in 2013 and 65% in 2014). Most vendors did little to prevent youth access in either year, with 67.6% in 2013 and 63.2% in 2014 employing no age verification or relying exclusively on strategies that cannot effectively verify age. Effective age verification strategies such as online age verification services (7.1% in 2013 and 8.5% in 2014), driving licences (1.8% in 2013 and 7.4% in 2014, p<0.01) or age verification at delivery (6.4% in 2013 and 8.1% in 2104) were rarely advertised on IEV websites. Nearly all vendors advertised accepting credit cards, and about 3/4 shipping via United States Postal Service, similar to the internet cigarette industry prior to federal bans.

Conclusions

The number of IEVs grew sharply from 2013 to 2014, with poor age verification practices. New and expanded regulations for online e-cigarette sales are needed, including strict age and identity verification requirements.

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Alcohol-flavoured tobacco products

April 19, 2018 - 7:20am
Background

In 2009, the Food and Drug Administration (FDA) banned characterising flavours in cigarettes (except for menthol) due to their appeal to teen starter smokers. In August 2016, the agency deemed all tobacco products to be under its authority and a more comprehensive flavour ban is under consideration.

Objectives

To determine the scope and scale of alcohol-flavoured tobacco products among cigars & cigarillos, hookahs and electronic cigarettes (e-cigarettes).

Methods

Alcohol-flavoured tobacco products were identified by online search of tobacco purveyors’ product lines and via Google search cross-referencing the various tobacco product types versus a list of alcoholic beverage flavours (eg, wine, beer, appletini, margarita).

Results

48 types of alcohol-flavoured tobacco products marketed by 409 tobacco brands were identified. Alcohol flavours included mixed drinks (n=25), spirits (11), liqueurs (7) and wine/beer (5). Sweet and fruity tropical mixed drink flavours were marketed by the most brands: piña colada (96), mojito (66) and margarita (50). Wine flavours were common with 104 brands. Among the tobacco product categories, brands offering alcohol-flavoured e-cigarettes (280) were most numerous, but alcohol-flavoured products were also marketed by cigars & cigarillos (88) and hookah brands (41). Brands by major tobacco companies (eg, Philip Morris, Imperial Tobacco) were well represented among alcohol-flavoured cigars & cigarillos with five companies offering a total of 17 brands.

Conclusions

The widespread availability of alcohol-flavoured tobacco products illustrates the need to regulate characterising flavours on all tobacco products.

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Responsiveness to cigarette prices by different racial/ethnic groups of US adults

April 19, 2018 - 7:20am
Objective

To evaluate the impact of cigarette prices on adult smoking for four US racial/ethnic groups: whites, African–Americans, Asians and Hispanics.

Methods

We analysed pooled cross-sectional data from the 2006/2007 and 2010/2011 Tobacco Use Supplement to the Current Population Survey (n=339 921 adults aged 18+) and cigarette price data from the Tax Burden on Tobacco. Using a two-part econometric model of cigarette demand that controlled for sociodemographic characteristics, state-level antismoking sentiment, local-level smoke-free air laws and monthly indicator, we estimated for each racial/ethnic group the price elasticities of smoking participation, smoking intensity and total demand for cigarettes.

Results

Smoking prevalence for whites, African–Americans, Asians and Hispanics during the study period was 18.3%, 16.1%, 8.2% and 11.3%, respectively. The price elasticity of smoking participation was statistically significant for whites, African–Americans, Asians and Hispanics at –0.26, –0.10, –0.42 and –0.11, respectively. The price elasticity of smoking intensity was statistically significant among whites (–0.22) and African–Americans (–0.17). Overall, the total price elasticity of cigarette demand was statistically significant for all racial/ethnic groups: 0.48 for whites, –0.27 for African–Americans, –0.22 for Asians and –0.15 for Hispanics.

Conclusions

Our results suggest that raising cigarette prices, such as via tobacco tax increases, would result in reduced cigarette consumption for all racial/ethnic groups. The magnitude of the effect and the impact on cessation and reduced smoking intensity differ across these groups.

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Banning tobacco price promotions, smoking-related beliefs and behaviour: findings from the International Tobacco Control Four Country (ITC 4C) Survey

April 19, 2018 - 7:20am
Background

Ecological models emphasise multilevel influences on health behaviours. While studies show that exposure to price promotions is associated with smoking behaviour and its antecedents, less is known about whether these associations differ by macro-level factors such as national price promotion policies.

Methods

Current and former smokers (N=4698) from the International Tobacco Control Policy Evaluation Project four-country cohort were included in weighted multivariate logistic regression models to examine individual-level associations between exposure to price promotions at waves 7 and 8 (conducted in 2008–2009 and 2010–2011) and beliefs (social and injunctive norms, functional value of smoking, misconceptions around smoking and beliefs of tobacco industry and its regulations) and behaviour at wave 8, stratified by whether countries allow (Australia and USA) or ban (Canada and UK) price promotions.

Results

Associations between exposure to price promotions and smoking-related beliefs and behaviour differed by national price promotion policies. In countries that allow price promotions, participants repeatedly exposed to price promotions at waves 7 and 8 were more likely to associate functional values to smoking (ie, calms down when stressed (adjusted OR (AOR) 1.83) and to be current smokers at wave 8 (AOR 1.94). In countries that ban price promotions, participants repeatedly exposed to price promotions were less likely to hold misconceptions around smoking (ie, harsher smoke is more dangerous).

Conclusions

Differential associations emerged between exposure to price promotions, smoking-related beliefs and behaviour across countries with and without a price promotions ban. Adopting price promotion bans could ameliorate the associations between exposure to price promotions and smoking beliefs and behaviours.

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Comparison of a preferred versus non-preferred waterpipe tobacco flavour: subjective experience, smoking behaviour and toxicant exposure

April 19, 2018 - 7:20am
Introduction

One possible reason for the rapid proliferation of waterpipe (WP) smoking is the pervasive use of flavoured WP tobacco. To begin to understand the impact of WP tobacco flavours, the current study examined the impact of a preferred WP tobacco flavour compared with a non-preferred tobacco flavoured control on user’s smoking behaviour, toxicant exposure and subjective smoking experience.

Method

Thirty-six current WP smokers completed two, 45-minute ad libitum smoking sessions (preferred flavour vs non-preferred tobacco flavour control) in a randomised cross-over design. Participants completed survey questionnaires assessing subjective smoking experience, exhaled carbon monoxide (eCO) testing, and provided blood samples for monitoring plasma nicotine. WP smoking topography was measured continuously throughout the smoking session.

Results

While participants reported an enhanced subjective smoking experience including greater interest in continued use, greater pleasure derived from smoking, increased liking and enjoyment, and willingness to continue use after smoking their preferred WP tobacco flavour (p values <0.05), no significant differences were observed in nicotine and carbon monoxide boost between flavour preparations. Greater average puff volume (p=0.018) was observed during the non-preferred flavour session. While not significant, measures of flow rate, interpuff interval (IPI), and total number of puffs were trending towards significance (p values <0.10), with decreased IPI and greater total number of puffs during the preferred flavour session.

Discussion

The current study is the first to examine flavours in WP smoking by measuring preferred versus control preparations to understand the impact on subjective experience, smoking behaviour and toxicant exposure. The pattern of results suggests that even this relatively minor manipulation resulted in significant changes in subjective experience. These results indicate a possible need for regulations restricting flavours in WP tobacco as with combustible cigarettes.

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Comparing the cytotoxicity of electronic cigarette fluids, aerosols and solvents

April 19, 2018 - 7:20am
Background

As thousands of electronic cigarette (e-cigarette) refill fluids continue to be formulated and distributed, there is a growing need to understand the cytotoxicity of the flavouring chemicals and solvents used in these products to ensure they are safe. The purpose of this study was to compare the cytotoxicity of e-cigarette refill fluids/solvents and their corresponding aerosols using in vitro cultured cells.

Methods

E-cigarette refill fluids and do-it-yourself products were screened in liquid and aerosol form for cytotoxicity using the MTT (3-(4,5-dimethylthiazol-2-yl)–2,5-diphenyltetrazolium bromide) assay. The sensitivity of human pulmonary fibroblasts, lung epithelial cells (A549) and human embryonic stem cells to liquids and aerosols was compared. Aerosols were produced using Johnson Creek’s Vea cartomizer style e-cigarette.

Results

A hierarchy of potency was established for the aerosolised products. Our data show that (1) e-cigarette aerosols can produce cytotoxic effects in cultured cells, (2) four patterns of cytotoxicity were found when comparing refill fluids and their corresponding aerosols, (3) fluids accurately predicted aerosol cytotoxicity 74% of the time, (4) stem cells were often more sensitive to aerosols than differentiated cells and (5) 91% of the aerosols made from refill fluids containing only glycerin were cytotoxic, even when produced at a low voltage.

Conclusions

Our data show that various flavours/brands of e-cigarette refill fluids and their aerosols are cytotoxic and demonstrate the need for further evaluation of e-cigarette products to better understand their potential health effects.

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The proliferation of &#039;We Sell Tobacco Here signs at the point-of-sale of tobacco retailers in Melbourne, Australia

April 19, 2018 - 7:20am

Opportunities to promote tobacco persist even where the retail promotion of tobacco products is heavily regulated. In the Australian state of Victoria, tobacco advertising at the point-of-sale (POS) has been banned since 2002 and POS display of products prohibited since 2011.1 However, tobacco product boards—listing brands, prices and price specials—are permitted up to 1.5x1.5 m in size. Tobacco retailers are required to display health warning posters and sales to minors notices and are permitted to display an optional A4-size sign stating ‘We Sell Tobacco Here’.2 While exposure to antismoking signage at the POS has been associated with quitting interest,3 other POS features that signal the availability of tobacco when these products are otherwise concealed may undermine tobacco advertising and display bans. This study aimed to explore the prevalence of such features.

A panel of stores was derived from two prior observational studies of...

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Menthol levels in cigarettes from eight manufacturers

April 19, 2018 - 7:20am

Menthol-labelled cigarettes accounted for almost one-third of the US cigarette market in 2012.1 Menthol may be present in cigarettes not labelled to contain menthol, either by intentional addition in small quantities,2 as a contaminant in the manufacturing facilities which were used for menthol cigarettes production,3 or as a naturally occurring constituent in tobacco.4 We previously examined menthol amounts in 46 commercial cigarettes. The amount of menthol measured in the whole cigarettes ranged from 2.9 to 19.6 mg/cigarette for menthol-flavoured cigarettes and from 0.002 to 0.07 mg/cigarette for cigarettes without a detectable menthol flavour.5 In an effort to understand how menthol may be used by various cigarette manufacturers, here we present the repeated and additional measurements of menthol quantities in the cigarette rods, cigarette filters and whole cigarettes of these 46 cigarettes from the following manufacturers: Commonwealth Brands, Liggett Group, Lorillard Tobacco, Philip...

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Cigarette package colour is associated with level of filter ventilation

April 19, 2018 - 7:20am

The cigarette package is, in many markets, the primary means of marketing and advertising cigarette brands to consumers. While some countries have moved to implement plain packaging, most continue to allow product differentiation on the basis of packaging. Colour is often used to communicate implicit messages about taste, risk and quality, and evidence suggests that package colours are specifically chosen to manipulate consumer perceptions through ‘sensation transference’.1 Filter ventilation also has been shown to influence perceptions of harshness and perceived risk.2 3 Filter ventilation is also closely associated with machine-measured tar yield and is generally higher in brands previously marketed as ‘Light’. Light and similar words have in many cases been supplanted by colours or other descriptive terms.4 Bans appear to have had an effect in reducing false beliefs, but substantial levels of false beliefs persist, most likely due to other...

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Actual and potential use of Google Street View for studying tobacco issues: a brief review

April 19, 2018 - 7:20am
Background

Google Street View (GSV) is an increasingly used data collection method for objectively measuring observable features of the environment as detailed in a recent review.1 But as its overall potential for studying tobacco control-related issues to date has never been considered, we aimed to perform a brief review of this potential.

Methods

Searches were conducted using PubMed for articles using the term ‘Google Street View’ (to January 2017). From these articles, additional ones involving GSV were identified in bibliographies. Articles were excluded from further analysis if they focused on the non-human environment (n=3 excluded, ie, bird nests, insects with silk nests and invasive plants) or if they did not cover any of the following: signage/advertising, retail outlets/stores or bars/pubs, or tobacco content (n=15 excluded).

Results

We identified 23 relevant Medline-indexed studies relating to GSV and one review. A total of four...

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