Effectiveness of Switching Smoking-Cessation Medications Following Relapse

Introduction—Nicotine dependence is a chronic disorder often characterized by multiple failed quit attempts (QAs). Yet, little is known about the sequence of methods used across multiple QAs or how this may impact future ability to abstain from smoking. This prospective cohort study examines the effectiveness of switching smoking-cessation medications (SCMs) across multiple QAs. Methods—Adult smokers (aged ≥ 18 years) participating in International Tobacco Control surveys in the United Kingdom, U.S., Canada, and Australia (N=795) who: (1) completed two consecutive surveys between 2006 and 2011; (2) initiated a QA at least 1 month before each survey; and (3) provided data for the primary predictor (SCM use during most recent QA), outcome (1-month point prevalence abstinence), and relevant covariates. Analyses were conducted in 2016. Results—Five SCM user classifications were identified: (1) non-users (43.5%); (2) early users (SCM used for initial, but not subsequent QA; 11.4%); (3) later users (SCM used for subsequent, but not initial QA; 18.4%); (4) repeaters (same SCM used for both QAs; 10.7%); and (5) switchers (different SCM used for each QA; 14.2%). Abstinence rates were lower for non-users (15.9%, OR=0.48, p=0.002), early users (16.6%, OR=0.27, p=0.03), and repeaters (12.4%, OR=0.36, p=0.004) relative to switchers (28.5%). Conclusions—Findings suggest smokers will be more successful if they use a SCM in QAs and vary the SCM they use across time. That smokers can increase their odds of quitting by switching SCMs is an important message that could be communicated to smokers

The association between exposure to point-of-sale anti-smoking warnings and smokers' interest in quitting and quit attempts:findings from the International Tobacco Control Four Country Survey

AIMS: This study aimed to examine the associations between reported exposure to anti-smoking warnings at the point-of-sale (POS) and smokers’ interest in quitting and their subsequent quit attempts by comparing reactions in Australia where warnings are prominent to smokers in other countries. DESIGN: A prospective multi-country cohort design was employed. SETTING: Australia, Canada, the UK and the US. PARTICIPANTS: 21,613 adult smokers who completed at least one of the seven waves (2002-2008) of the International Tobacco Control Four Country Survey were included in the analysis. MEASUREMENTS: Reported exposure to POS anti-smoking warnings and smokers’ interest in quitting at the same wave and quit attempts over the following year. FINDINGS: Compared to smokers in Canada, the UK and the US, Australian smokers reported higher levels of awareness of POS anti-smoking warnings, and this difference was consistent over the study period. Over waves in Australia (but not in the other three countries) there was a significantly positive association between reported exposure to POS anti-smoking warnings and interest in quitting (adjusted odds ratio = 1.139, 95% CI 1.039~1.249, p<0.01) and prospective quit attempts (adjusted odds ratio = 1.216, 95% CI 1.114~1.327, p<0.001) when controlling for demographics, smoking characteristics, overall salience of anti-smoking information, and awareness of anti-smoking material from channels other than POS. CONCLUSIONS: Point-of-sale health warnings about tobacco are more prominent in Australia than US, UK or Canada and appear to act as a prompt to quitting

Electronic Nicotine Delivery System (ENDS) Device Types and Flavors Used by Youth in the PATH Study, 2016&ndash;2019

The evolving electronic nicotine delivery system (ENDS) marketplace and recent regulatory actions may influence youth ENDS device preferences. Using data from Waves (W) 4, 4.5, and 5 (2016&ndash;2019) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study, this study estimated the prevalence of open and closed system primary ENDS use by youth (12&ndash;17 years) current (past 30-day) ENDS users, and compared demographics, tobacco use characteristics, and patterns of ENDS use, including flavors, by device type. Among current ENDS users, closed system use was significantly higher than open system use in W4.5 (68.3% vs. 31.7%) and W5 (60.5% vs. 39.5%). In W5, closed system users were more likely to have a regular ENDS brand, believe their ENDS had nicotine, and use tobacco and mint or menthol flavors in the past 30 days compared to open system users. In W5, users of closed systems were less likely to use fruit, non-alcoholic drink, and candy, desserts, or other sweets flavors in the past 30 days than users of open systems. Youth were more likely to use closed over open system ENDS in 2017&ndash;2019. Differences were observed between device types, particularly with flavor use, reflecting recent changes in flavored product availability

The effectiveness of tobacco marketing regulations on reducing smokers' exposure to advertising and promotion:findings from the International Tobacco Control (ITC) Four Country Survey

Exposure to tobacco product marketing promotes the initiation, continuation, and reuptake of cigarette smoking and as a result the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) has called upon member Parties to enact comprehensive bans on tobacco advertising and promotion. This study examines the immediate and long term effectiveness of advertising restrictions enacted in different countries on exposure to different forms of product marketing, and examines differences in exposure across different socioeconomic status (SES) groups. Nationally representative data from the United Kingdom, Canada, Australia, and the United States, collected from adult smokers between 2002 and 2008 using the International Tobacco Control Four Country Survey (ITC-4), were used in this study (N = 21,615). In light of the specific marketing regulation changes that occurred during the course of this study period, changes in awareness of tobacco marketing via various channels were assessed for each country, and for different SES groups within countries. Tobacco marketing regulations, once implemented, were associated with significant reductions in smokers’ reported awareness of pro-smoking cues, and the observed reductions were greatest immediately following the enactment of regulations. Changes in reported awareness were generally the same across different SES groups, although some exceptions were noted. While tobacco marketing regulations have been effective in reducing exposure to certain types of product marketing there still remain gaps, especially with regard to in-store marketing and price promotions