Local sales restrictions significantly reduce the availability of menthol tobacco: findings from four Minnesota cities

BACKGROUND In 2017 and 2018, Minneapolis, St. Paul, Duluth and Falcon Heights, Minnesota were among the first US cities to restrict the sale of menthol tobacco to adult-only stores. The study examined changes in the availability and marketing of these products following policy implementation. METHODS Retail store audits were conducted approximately 2 months pre-policy and post-policy implementation. Tobacco retail stores (n=299) were sampled from tobacco licensing lists in Minneapolis, St. Paul, Duluth and Falcon Heights, as well as six comparison cities without menthol policies. The presence of menthol tobacco was assessed, along with the number of interior and exterior tobacco ads and promotions at each store. RESULTS The majority of policy intervention stores (grocery, convenience stores and pharmacies) were compliant (Minneapolis, 84.4%; Duluth, 97.5%; and St. Paul and Falcon Heights, 100.0%) and did not sell menthol tobacco. In contrast, menthol tobacco was available in all comparison city stores, and most (96.0%) exempted tobacco shops and liquor stores post-policy implementation. Two Minneapolis convenience stores added interior tobacco shops, allowing them to continue selling menthol tobacco. Significant decreases in menthol tobacco marketing post-policy were observed in the stores' interior in Minneapolis, St. Paul and Duluth (p<0.001) and on the stores' exterior in Duluth (p=0.023). CONCLUSIONS Findings demonstrate high rates of compliance, indicating that sales restrictions can significantly reduce the availability of menthol tobacco. However, challenges to policy adherence underscore the need for continued monitoring and enforcement action

Concurrent Use of Cigarettes and Smokeless Tobacco in Minnesota

Cigarette smokers are being encouraged to use smokeless tobacco (SLT) in locations where smoking is banned. We examined state-wide data from Minnesota to measure changes over time in the use of SLT and concurrent use of cigarettes and SLT. The Minnesota Adult Tobacco Survey was conducted four times between 1999 and 2010 and has provided state-wide estimates of cigarette smoking, SLT use and concurrent use of SLT by smokers. The prevalence of SLT was essentially unchanged through 2007, then increased significantly between 2007 and 2010 (3.1% versus 4.3%, P < 0.05). Similarly, the prevalence of cigarette smokers who reported using SLT was stable then increased between 2007 and 2010 (4.4% versus 9.6%, P < 0.05). The finding of higher SLT use by smokers could indicate that smokers in Minnesota are in an experimental phase of testing alternative products as they adjust to recent public policies restricting smoking in public places. The findings are suggestive that some Minnesota smokers are switching to concurrent use of cigarettes and SLT. Future surveillance reports will be necessary to confirm the results

Menthol Tobacco Sales Restrictions at the Local Level: Community Perceptions, Lessons Learned, and Policy Evaluation

Menthol cigarettes are a significant public health concern. While sales of regular cigarettes have declined in recent years, menthol cigarette sales are increasing. Known for their minty taste and cooling effects, menthol cigarettes are a starter product for youth. The tobacco industry has a long history of predatory marketing to African Americans, who are more likely to smoke menthol cigarettes, have lower quit rates, and experience higher tobacco-related mortality than white smokers. Because flavored cigarettes are appealing to youth, the 2009 Tobacco Control Act banned the sale of flavored cigarettes; however, menthol was exempted. Due to federal inaction on menthol, localities are enacting restrictions to address this social justice issue. In 2017, Minneapolis, Minnesota was among the first U.S. jurisdictions to restrict menthol sales to tobacco shops and liquor stores. Grounded in the Social Ecological Model, this dissertation utilized multiple methods to increase our understanding of the experience and impact of the Minneapolis menthol policy. Study 1 examined African American adult smoker perceptions and found that many menthol smokers perceived menthol to be as harmful or more harmful than non-menthol cigarettes and emphasized the role of tobacco industry targeting to African American communities and youth. Participants also indicated mixed support for menthol policy restrictions. Study 2 identified key factors that led to policy passage and included an in-depth assessment of critical steps in policy-making from policy formulation through adoption. The active engagement of youth and support of members of communities most impacted by menthol tobacco-related disparities were identified as critical to the policy’s successful adoption. Study 3 evaluated the impact of the menthol policy on the retail environment and found reduced menthol availability and decreased menthol marketing at the point-of-sale two months following policy implementation. Unintended consequences of the policy were also observed; two tobacco shops were added to convenience stores and continued to sell menthol tobacco. Results from these studies provide critical insights from several phases of the policy process. Findings can inform other jurisdictions around the country interested in pursuing menthol restrictions to reduce the burden of tobacco use and advance health equity for priority populations

Evaluation of a Tailored Approach for Tobacco Dependence Treatment for American Indians

Purpose. Evaluate a tailored approach for tobacco dependence treatment for American Indians. Design. A single-group design evaluation of a culturally specific curriculum for tobacco dependence treatment was implemented. Baseline assessment, program utilization, and 90-day follow-up interview data were analyzed. Setting. Fond du Lac Reservation in rural Minnesota and Mashkiki Waakaaigan Pharmacy in Minneapolis, Minnesota. Subjects. American Indian adults (N = 317). Intervention. Four 1-hour individual or group sessions of behavioral counseling paired with pharmacotherapy. Measures. Demographic variables, program satisfaction, and tobacco use behaviors. Analysis. Descriptive statistics; for abstinence, a smoking = missing analysis was used, assuming all nonrespondents were still smoking. Results. Sixty-three percent of participants completed the program. The 90-day follow-up response rate was 47%. Of those who completed, 47% reported abstinence at the 90-day follow-up. Missing = smoking analysis yielded a 21.8% quit rate. Continuing smokers cut their daily smoking by half from 17 to eight cigarettes, 88% reported an increase in self-efficacy for their next quit, and 44% planned to quit within 30 days. Conclusion. Evidence-based tobacco dependence treatment programs tailored to be culturally specific have the potential to significantly affect the burden of tobacco-related disparities among American Indian

Linking smokers to a quitline: randomized controlled effectiveness trial of a support person intervention that targets non-smokers.

Evidence-based treatments (e.g. quitlines) are greatly underutilized by smokers limiting their public health impact. A three-session phone intervention for nonsmoking family members and friends (i.e. support persons) was successful for increasing smoker quitline enrollment. To enhance the intervention's potential translatability, in this study, we delivered treatment for the non-smoker within ongoing quitline services and compared the efficacy of the three-call intervention to a streamlined version (one call). A total of 704 adult non-smokers (85% female, 95% White) wanting to help a smoker quit and recruited statewide in Minnesota participated in this randomized controlled trial with parallel groups. Non-smokers received mailed written materials and were randomly assigned to a control condition (no additional treatment, n = 235), or to a one- (n = 233) or three-call (n = 236) intervention delivered by quitline coaches. The main outcome was smoker quitline enrollment through 7-month follow-up. Smoker quitline enrollment was similar for those linked to non-smokers in the one- and three-call interventions (14.6% [34/233] and 14.8% [35/236]), and higher than for smokers linked to control participants (6.4% [15/235]), P = 0.006. Just one quitline coaching call delivered to non-smokers increased treatment enrollment among smokers. The reach of quitlines could be enhanced by targeting the social support network of smokers

Guidelines for the use of flow cytometry and cell sorting in immunological studies

International audienceThe classical model of hematopoiesis established in the mouse postulates that lymphoid cells originate from a founder population of common lymphoid progenitors. Here, using a modeling approach in humanized mice, we showed that human lymphoid development stemmed from distinct populations of CD127(-) and CD127(+) early lymphoid progenitors (ELPs). Combining molecular analyses with in vitro and in vivo functional assays, we demonstrated that CD127(-) and CD127(+) ELPs emerged independently from lympho-mono-dendritic progenitors, responded differently to Notch1 signals, underwent divergent modes of lineage restriction, and displayed both common and specific differentiation potentials. Whereas CD127(-) ELPs comprised precursors of T cells, marginal zone B cells, and natural killer (NK) and innate lymphoid cells (ILCs), CD127(+) ELPs supported production of all NK cell, ILC, and B cell populations but lacked T potential. On the basis of these results, we propose a "two-family" model of human lymphoid development that differs from the prevailing model of hematopoiesis