Abstract
Background
Appropriate increases in tobacco taxes and prices are an essential component of comprehensive tobacco control strategies. This study investigates factors related to the use, sale, ...and distribution of cigarettes in Iran, focusing on the relationship between cigarette price and its consumption.
Methods
This interview-based qualitative study was conducted among 20 participants, including cigarette smokers, retail shop owners, large-scale distributors, and an expert in tobacco control research.
Results
Seven themes were extracted from participant interviews, including the type and price of cigarette, the best time to sell cigarettes, profits from the sale of cigarette, affordability, rise in cigarette price and smokers’ reaction to it, lobbying and black-market sales of cigarettes, and the sale and distribution of cigarettes across the country. Although the price of cigarettes in Iran has shown some increases in the past decade, the timing of these increases are not predictable and the limited amount of these increases has not reduced the use of cigarettes. Following a price increase, consumers are more likely to switch from buying packets to single cigarettes, or buy a less expensive brand, then to quit. Moreover, increases in prices may encourage smokers and sellers to buy a large number of cigarettes and store them for a rainy day. Another adverse effect may be increased smuggling of illicit cigarettes to balance the pressure caused by rising prices.
Conclusions
Our findings highlight two important aspects concerning cigarette pricing in Iran. First is the change in the type of purchase from the whole box of cigarettes to the single stick cigarette or swapping to less expensive cigarettes. Second, increase in cigarette price (either through taxing or regular increases) could be offset by flooding smuggled cigarettes into the market. Therefore, in addition to raising cigarette prices, reducing cigarette consumption rates in Iran requires the development and effective implementation of regulatory policies to control cigarette smuggling, reduce purchasing, and subsequently curb the use of this leading cause of premature morbidity and mortality.
In their review paper, Kotnowski & Hammond 1 show tobacco industry attempts to undermine public health policies that would harm their commercial interests. I would like to draw attention to ...inadequacy in the policies and regulations around waterpipe (WP) promotion and product formulation. WP smoking shows signs of becoming a new epidemic, especially among adolescents and young adults 2-6. The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) Article 11, which regulates packaging and labeling purportedly on all tobacco products, is not well suited to WPs. Unlike cigarettes, WPs come in very different shapes and sizes and therefore issues such as labeling, packaging, textual and pictorial health warnings, as well as standard packaging, present significant challenges necessitating specific and creative policies to tackle them 2. Labeling and packaging of WP accessories and tobacco show low, if any, compliance with WHO FCTC Article 11 2, 7. Health warnings, if they exist, cover less than the minimum labeling area of 30% required by FCTC Article 11 7. Given the social nature of WP smoking and the variety of cafés and restaurants serving it, many consumers are unaware of the contents of the tobacco served or of the presence of any health warnings on WP tobacco and accessories 2. Misleading descriptors have also been reported on WP tobacco products and accessories 7.
The global epidemiology of waterpipe smoking Maziak, Wasim; Taleb, Ziyad Ben; Bahelah, Raed ...
Tobacco Control,
03/2015, Letnik:
24, Številka:
Suppl 1
Journal Article, Book Review
Recenzirano
Odprti dostop
Objectives In the past decade, waterpipe smoking (a.k.a. hookah, shisha, narghile) has become a global phenomenon. In this review, we provide an updated picture of the main epidemiological trends in ...waterpipe smoking globally. Data sources Peer-reviewed publications indexed in major biomedical databases between 2004 and 2014. Search keywords included a combination of: waterpipe, hookah, shisha along with epidemiology, patterns, prevalence and predictors. We also used different spellings of waterpipe terms commonly used. Study selection The focus was on studies with large representative samples, national data or high-quality reports that illuminated aspects of the epidemiology and trends in waterpipe smoking. Data extraction Multiple researchers extracted the data independently and collectively decided on the most important and pertinent studies to include in the review. Data synthesis Waterpipe smoking has become a global phenomenon among youth. The global waterpipe epidemic is likely driven by (1) the introduction of manufactured flavoured tobacco (Maassel); (2) the intersection between waterpipe's social dimension and thriving café culture; (3) the evolution of mass communication media; (4) the lack of regulatory/policy framework specific to the waterpipe. Waterpipe smoking is becoming the most popular tobacco use method among youth in the Middle East, and is quickly gaining popularity elsewhere. Important patterns of waterpipe smoking include the predominance among younger, male, high socioeconomic, and urban groups. Intermittent and social use are also noted patterns. Conclusions Waterpipe smoking has become a global public health problem. Developing surveillance, intervention and regulatory/policy frameworks specific to the waterpipe has become a public health priority.
Waterpipe smoking is harmful and addictive and can be a gateway to cigarette smoking. This study examined the association between curiosity and susceptibility to cigarette smoking among ...cigarette-naïve US youth who smoke waterpipe using cross-sectional data from the National Youth Tobacco Survey, 2014.
Susceptibility to cigarettes was assessed using a composite index of three questions: 'Do you think you will smoke a cigarette in the next year?', 'Do you think that you will try a cigarette soon?', and 'If one of your best friends were to offer you a cigarette, would you smoke it?'. Curiosity was assessed by one question: 'Have you ever been curious about smoking a cigarette?'.
Among current waterpipe smokers, 48.5% (95% CI: 43.1-53.9) were susceptible to cigarettes and 42.6% (95% CI: 36.5-48.9) were curious about cigarettes. Overall, 45.1% (95% CI: 38.9-51.4) and 46.5% (95% CI: 40.2-52.8) of those living with a waterpipe smoker were susceptible and curious about cigarettes, respectively. Current waterpipe smokers had significantly higher odds of susceptibility to cigarettes (aOR=1.5, 95% CI: 1.1-2.3, p<0.04), but not for curiosity about cigarettes (aOR=1.2, 95% CI: 0.83-1.70, p=0.3).
Initiation of cigarettes among adolescents who smoke waterpipe can be due to increasing susceptibility to cigarette smoking rather than increasing curiosity about cigarettes.
Objectives
More than 10 % of pregnant women in the United States (U.S.) suffer from depression, which has far-reaching consequences on maternal and fetal well-being. There is conflicting evidence ...regarding the prevalence of antenatal depression among different race and ethnic groups. This systematic review aimed to summarize the existing literature concerning racial/ethnic disparities in the prevalence and correlates of antenatal depression in the U.S.
Methods
PubMed, CINAHL and PsycINFO databases were searched online for research studies published in English in peer-reviewed journals until March 2015, using a pre-designed search strategy. Eligibility was determined using pre-specified criteria; and quality was assessed.
Results
Forty-one (41) articles met the criteria; 13 were cross-sectional, and 21 were longitudinal studies. Overall, the prevalence of antenatal depression was 10–30 %; it was higher among non-Hispanic blacks (NHBs) and Hispanics, compared to non-Hispanic whites (NHWs). Few studies looked at the correlates of depression by race/ethnicity. Among employed women, higher depression scores were observed among NHBs, compared to NHWs; while there was no racial difference among unemployed women. Racial difference and race-employment interaction disappeared once discrimination was accounted for. In another study, higher parity, higher stress, and lower self-esteem were significant correlates of depression among NHBs, while less satisfaction with social support, and higher stress predicted higher depression scores among NHWs and Hispanics respectively.
Conclusions
The findings of our review suggest that not only is antenatal depression a major public health issue that needs to be addressed, but different racial/ethnic groups seem to differ in their vulnerability and risk factors.
•Examined correlates of past 30-day poly-tobacco use among youth and young adults.•Data were from the Population Assessment of Tobacco and Health study, 2013–2014.•About 4% of youth, 22% younger- and ...16% older young adults report poly-tobacco use.•Most common combination of poly-tobacco was cigarettes and e-cigarettes.•Correlates of poly-tobacco use differed by age-groups.
Poly-tobacco use is common among youth and young adults. This study examined sociodemographic, tobacco-related, and substance use characteristics of poly-tobacco use compared to mono-tobacco use among youth and young adults (12–34 years) in the United States.
We conducted a descriptive analysis by age-group of 12898 youth (12–17 years), 8843 younger young adults (18–24 years), and 6081 older young adults (24–34 years) from the 2013–2014 Population Assessment of Tobacco and Health study. Multiple logistic regression modeling was conducted to assess the sociodemographic, tobacco-related, and substance use associations with current (past 30 days) tobacco use on a binary scale (poly- versus mono-tobacco use) among tobacco users.
Between 2013 and 2014, 3.6% of youth, 21.7% of younger young adults, and 15.8% of older young adults were current poly-tobacco users in the general population. In the regression analyses, among youth tobacco users, heavy drinking was the only factor associated with higher odds of poly-tobacco use. Factors associated with higher odds of poly-tobacco use among younger young adults included being male, having less than high school diploma or GED, residing in the South, having 2 and ≥3 quit attempts, heavy drinking, and marijuana use. Residing in the South, older ages of exposure to tobacco use, and marijuana use were associated with higher odds of poly-tobacco use among older young adults.
Regardless of tobacco product type, poly-tobacco use was common among youth and young adults. Interventions designed to address factors associated with poly-tobacco use among youth and young adults are warranted.
The Arab world is comprised of 22 countries with a combined population of ~360 million. The region is still at the initial stages of the tobacco epidemic, where it is expected to witness an increase ...in smoking levels and mounting tobacco-related morbidity and mortality in the future. Still, the bleak outlook of the tobacco epidemic in the Arab world continues to be faced with complacency in the form of underutilization of surveillance systems to monitor the tobacco epidemic and prioritize action, and failure to implement and enforce effective policies to curb the tobacco epidemic. Understandably, the focus on the Arab world carries the risk of trying to generalize to such a diverse group of countries at different level of economic and political development. Yet, tobacco control in the Arab world faces some shared patterns and common challenges that need to be addressed to advance its cause in this region. In addition, forces that promote tobacco use, such as the tobacco industry, and trends in tobacco use, such as the emerging waterpipe epidemic tend to coalesce around some shared cultural and socio-political features of this region. Generally, available data from Arab countries point at three major trends in the tobacco epidemic: (1) high prevalence of cigarette smoking among Arab men compared with women; (2) the re-emergence of waterpipe (also known as hookah, narghile, shisha, arghile) smoking as a major tobacco use method, especially among youth and (3) the failure of policy to provide an adequate response to the tobacco epidemic. In this review, we will discuss these trends, factors contributing to them, and the way forward for tobacco control in this unstable region.
•The SCTS-13 is the first waterpipe-specific nicotine dependence scale.•It has a stable factor structure and good reliability and convergent, discriminant, concurrent, and predictive ...validity.•Dependence features captured by the SCTS-13 include positively and negatively reinforced and social/sensory cues, and impaired control.•The SCTS-13 is a promising brief, self-report instrument to assess nicotine dependence among waterpipe smokers.
Waterpipe tobacco smoking (WTS) has surged globally among young people and causes nicotine dependence (ND). No existing ND instruments are sensitive to waterpipe-specific features of ND and early stages of use.
We conducted a psychometric scale evaluation among 192 current waterpipe smokers, initially averaging 15 years of age, recruited from schools in Beirut, Lebanon, and assessed 4 times, 6 months apart. Twenty eight self-report items tapping multiple features of ND were submitted to exploratory and confirmatory factor analyses (EFA and CFA) to reduce items and verify factor structure. Convergent validity was assessed with the Lebanese Waterpipe Dependence Scale and the Hooked on Nicotine Checklist, and discriminant validity with the Depressive Symptom Scale and Adolescent Life Events Stress Scale. Concurrent and predictive validity measures included smoking status and intensity (amount, frequency, session duration, and change in frequency), quitting interest and success, perceived addiction, and smoking alone.
The EFA yielded a single factor, 13 item solution (named the Syrian Center for Tobacco Studies SCTS-13) that explained 91% of variance in responses, was internally consistent (Cronbach’s alpha and McDonald’s omega = 0.87), and captured several positive reinforcement, negative reinforcement, and social/sensory-related features of ND. The CFA indicated good model fit. The SCTS-13 showed acceptable convergent and discriminant validity. Higher SCTS-13 scores predicted current waterpipe and dual (waterpipe and cigarette) smoking, greater intensity of use, less interest in quitting, shorter duration of abstinence, greater perceived addiction, and smoking alone (vs. socially).
The SCTS-13 is a promising brief, waterpipe-specific ND instrument.
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