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April 20th, 2016:

Health Canada looks at forcing tobacco companies to make cigarettes less addictive

Apr 20th, 2016
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http://news.nationalpost.com/news/canada/health-canada-looks-at-forcing-tobacco-companies-to-make-cigarettes-less-addictive

Health Canada is studying the possibility of forcing companies to make their cigarettes less addictive, a controversial anti-smoking strategy that no other country has implemented.

The department issued a tender recently calling for an outside researcher to add to the government’s own extensive analysis of the idea and how it would affect public health.

Though not mentioned specifically in the document, reducing the nicotine level of cigarettes is the most-discussed means of lessening their addictiveness. But experts are divided on whether that makes any sense.

Proponents say early evidence indicates that a cut in the chemical could help wean smokers off the habit.

Critics argue that a mandated nicotine reduction would only prompt people to smoke more to get their desired hit of the drug — and suck in more of tobacco’s carcinogens in the process.

“It’s so wrong-headed,” said David Sweanor, an Ottawa lawyer and long-time anti-smoking advocate. “The unintended consequences are screaming out on this. … People adjust the way they smoke to get the nicotine they need or want.”

While other components of smoke account for cigarettes being the single-biggest cause of cancer, nicotine is what makes them addictive. No rule currently dictates how much of the drug they may contain.

Regulating changes to the chemical make-up of tobacco is one of the ideas being debated as part of the so-called smoking “endgame” – tactics to push smoking rates below the stubborn 15-20% they’ve hovered around for years.

Health Canada’s request for proposals asks for independent experts to expand and validate a model created by the department to assess the health benefits of an “addictiveness-reduction standard” for tobacco.

Officials have already considered how a cut in addictiveness would affect the rate of people starting and quitting smoking, as well as such possible consequences as a jump in the sales of contraband tobacco and rates of “compensatory” smoking — consuming more cigarettes or inhaling more intensely.

Sean Upton, a spokesman for Health Canada, said the project is not necessarily about reducing nicotine levels but “will help guide policy and be used to test different things and potential benefits.”

“It’s a policy development tool,” he said.

However, the document discusses exclusively addictiveness-reduction.

And in academic circles recently, cutting nicotine levels has garnered most of the attention as a way to make tobacco less addictive.

It’s so wrong-headed. The unintended consequences are screaming out on this.

The idea had earned a bad name because of what one anti-smoking campaigner calls the “disaster” of light cigarettes, an industry-led concept that aimed to lessen levels of tar and nicotine through special filters. The filters are perforated to vent off some of the chemicals before they are inhaled.

Studies have shown, however, that smokers essentially override the feature by covering the holes with their mouth or fingers, or smoking more cigarettes.

Some tobacco-control experts say there is more promise in tobacco that has been specially treated or genetically modified to lower nicotine content before the smoker even lights up.

A study published in the New England Journal of Medicine last fall found that smokers in a trial who were given experimental, reduced-nicotine cigarettes were smoking about 25% fewer of them per day by the end of the six-week study — and without “compensating” to get more of the drug.

But not everyone is convinced by the research, with one critic pointing to evidence that some participants may have augmented the low-nicotine cigarettes with regular ones outside the study.

Regardless, for the idea to really work, there needs to be another, safer nicotine-delivery tool readily available as a fallback for smokers, like electronic cigarettes or “snus,” smokeless tobacco, says Lynn Kozlowski, a health-behaviour professor at the University of Buffalo.

Addictiveness-reduction is a more dramatic step than it might sound, he argues.

“If you diminish the nicotine levels to such a point that it’s not addictive, that seems to me very much like prohibition of traditional cigarettes,” said Kozlowski, “a little bit like alcohol prohibition.”

It’s good that Health Canada is trying to learn more about tobacco and its effects, given industry is always way ahead of regulators in its knowledge level, said Rob Cunningham, a policy analyst with the Canadian Cancer Society.

But he suggested there are higher priorities for government, such as addressing the manufacturers’ new methods of promoting cigarettes, and bringing back anti-smoking ad campaigns that once were ubiquitous.

Cigarette Smokers Can Now Quit Smoking Effectively By Doing One Thing; Learn More

Apr 20th, 2016
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Cigarette smoking is among the most addictive vices known to mankind. This new study done by scientists at the Oxford University would help smokers to finally quit smoking consistently.

http://www.universityherald.com/articles/29226/20160420/cigarette-smokers-now-quit-smoking-effectively-doing-one-thing-new.htm

There were smokers who attempted quitting, but would eventually go back doing it because the methods they tried were not that effective. This new study that can be found via the journal called Annals of Internal Medicine says that smokers can finally say goodbye to smoking forever as cited by The Inquisitr.

Scientists from Oxford University said, that going “cold turkey” is indeed the best way to quit smoking based on their recent survey. They used 700 smokers based in the United Kingdom who have always wanted to quit smoking cigarettes.

They were asked to participate for two weeks. Half of those smokers were told to go back to smoking after two weeks if they still feel the urge to. The other half was asked to completely stop it.

The researchers then observed the two groups and their behavior towards smoking after a month, which also was followed by another survey after six months. They found out that smokers who quit abruptly were more likely to quit smoking forever than those who did it gradually. But that was just for the first month. The success rate was also similar to that after six months.

One of the researchers of the said project, Nicole Lindson-Hawley, said that going “cold turkey” is the best strategy to quit smoking, but quitting gradually is still not a bad idea because at least the person is making an effort.

Gradually saying goodbye to smoking is still better than not doing anything at all to quit it.

If you are someone who is trying to quit smoking using the “cold turkey” style, then you should know that you’re on your way to a healthy lifestyle. Share this information to your friends and family who you think need to finally quit smoking, but are having a hard time.

Open Letter to Gary Johns

Apr 20th, 2016
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Download (PDF, 425KB)

Smoke without fire

Apr 20th, 2016
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http://www.chinadaily.com.cn/sunday/2014-04/20/content_17448095.htm

Are e-cigarettes fresh air or smoke and mirrors? Leanne Italie peers through the haze surrounding these devices. On the edge of the SoHo neighborhood in New York, The Henley Vaporium is an intimate hipster hangout with overstuffed chairs, exposed brick, friendly counter help – but no booze. Instead, the proprietors are peddling e-cigarettes, along with bottles of liquid nicotine ready to be plucked from behind a wooden bar and turned into flavorful vapor for a lung hit with a kick that is intended to simulate traditional smoking. A hint of banana nut bread e-juice lingered in the air one recent afternoon as patrons gathered around a low table to chat and vape or sidled up to the inviting bar for help from a knowledgeable “vapologist”. Places like The Henley are a rarity, even in New York. But “vaping” itself has had astonishing growth – in just eight years or so, the number of enthusiasts around the world has grown from a few thousand to millions. Believed by some to be the invention of a Chinese pharmacist, vaping now has its own YouTube gurus, trade associations, lobbyists, online forums and vapefests for meet-ups centered on what enthusiasts consider a safer alternative to the “analog”, their name for tobacco cigarettes. Vaping may be safer – there are differing opinions – but it isn’t necessarily cheap. Will Hopkins, a 21-year-old dog walker wearing a black leather jacket and skull ring, visits Henley four or five times a week. He smoked a pack of full-strength Marlboros a day for eight years, until he took up vaping. The same goes for his buddy, 20-year-old photographer Will Gallagher, who has been vaping for two years and is fond of his brass mod, a cylindrical device that’s larger than a cigarette and decorated with a tiger and Chinese lettering.

“I think both of us have poured in probably a little over a thousand” dollars, Gallagher says of their equipment. “I like the exclusivity of vaping. I like to keep changing up my stuff.” The Wills are into rebuilding tanks and rewiring coils, scouting new e-liquid flavors and adjusting their devices, which can cost up to $300 at Henley, to allow for more vapor, more flavor. But the co-owners of Henley count older smokers among their clientele as well. E-cigarettes are usually made of metal parts combined with plastic or glass and come in a variety of shapes and sizes. They heat the liquid nicotine solution, creating vapor that quickly dissipates when exhaled. The vapor looks like tobacco smoke and can feel like tobacco smoke when taken into the lungs at varying strengths, from no nicotine up to 24 milligrams or more. In 2006, sellers of all things vape worked primarily online or via kiosks in shopping malls. Now there are more than 250 brands and devices that can cost mere dollars for a case of “cigalikes”, which resemble the real thing, to a gold-and-diamond unit the size of a fountain pen that was reportedly made for a Russian oil tycoon and cost about $900,000. Whether vaping is cheaper than a cigarette habit is up to how much is spent on equipment and liquids and how often one vapes. A 15-milliliter bottle of liquid at Henley can go for $12 and may be roughly the equivalent of four packs of cigarettes, depending on the strength of both liquid and leaf cigarette, among other factors like how many puffs a smoker takes in. Rechargeable devices require batteries – another expense – and a starter kit for reuse that comes with a device can run around $66. By comparison, the cost of a 20-cigarette pack of regular cigarettes can range from about $5 to about $15, depending on state tax and the type of location where they’re purchased.

Critics believe e-cigs may serve as a tobacco gateway for uninitiated young people.

Proponents argue that vaping isn’t only safe but also is helping people quit smoking. The Henley has a white “wall of doom”, where it lists in big black letters the numerous tars and chemicals found in tobacco cigarettes but absent in e-cig use if one is careful about the liquids purchased. “What’s so beautiful about this product is we can take people from a high level of nicotine down to zero, down to nothing, so they’re just vaping basically water and flavoring,” says Henley co-owner Talia Eisenberg. She scoffs at the notion that child-friendly flavors of e-liquids – Watermelon Wave and Frozen Lime Drop, for instance – were created to lure teens. And she rejects the idea that e-cig companies should be banned from advertising on TV, as tobacco companies were more than 40 years ago. While e-liquids and vaping supplies lack oversight and long-term research, they are readily available to all ages online and at gas stations, bodegas and many drug stores.

But Henley doesn’t serve those under 18. Would it make more sense to help people give up nicotine – an addictive substance – altogether? “Sure, but how’s that workin’ for the country so far? How are they doin’ with that? We’re talking in terms of serious harm reduction,” says Eisenberg’s business partner, Peter Denholtz.

His mother died of lung cancer two years ago. He himself smoked cigarettes for 36 years but has been vaping for four years.

Some vapers, like Hopkins and Gallagher, find fun in tinkering with the paraphernalia. Denholtz likens them to older DIY enthusiasts who once whiled away their time on Heathkits, those all-inclusive boxes of parts that could be turned into TV receivers, amateur radios or stereo speakers. “There’s a whole subculture coming up. They’re very into all of the different devices. They rewire and rebuild and use different materials for drawing up the juice. It’s unbelievable what they’ve turned it into,” he says. Denholtz and others say vaping, to many, is merely a less harmful activity than tobacco smoking that duplicates the most pleasurable aspects and offers a communal feel like hookah use and cigar bars.

Xavier Armand, 25, has been vaping for a little more than three years and owns an advertising and marketing firm that is helping Henley put together a “liquid of the month club”, along the lines of mail-order fruit of the month. “I always kind of knew smoking was bad for me. My mom was a smoker, but I was never going to look into the patch or the gum or anything,” Armand says. “At the end of the day, the best part about smoking is the smoke part. And that oral fixation is kind of a big thing as well. I consider my agency the 2014 version of Mad Men. We all sit around there and instead of smoking cigarettes everyone is smoking e-cigs.” Much as movie stars made tobacco smoking seem glamorous in the 1930s and ’40s, celebrities have helped fuel interest in vaping. At the Golden Globes, Leonardo DiCaprio was shown vaping away in the audience. The actor told The Associated Press recently he vapes to “relieve the stress of life”. Other celebrities have signed on as paid e-cig endorsers, including co-host of The View Jenny McCarthy, and actor Stephen Dorff, both of whom push Blu, a big player in e-cigs that was recently bought by Big Tobacco’s Lorillard.

Dorff, who took up smoking 20 years ago, stuck to Blu’s talking points in a recent interview. He described how vaping offers him the freedom to smoke where regular cigarettes are frowned upon.

But wouldn’t his loved ones like to see him quit nicotine for good? “Ah, probably yeah,” Dorff says, laughing. “But there’s a lot of bad things in the world, you know. The one thing that I’ve always enjoyed is smoking. I consider myself a smoker.”

The Associated Press

Anti -smoking doctor calls for vaping to help hopeful quitters

Apr 20th, 2016
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Vaping experts have slammed the Hong Kong Government for turning a deaf ear to the potential to improve health outcomes. An European doctor-researcher believes vaping can help many to reduce the harm of using cigarettes and even quit.

http://harbourtimes.com/2016/04/20/anti-smoking-doctor-calls-for-vaping-to-help-hopeful-quitters/

Consumers and business owners alike have been consistent in their calls urging the Hong Kong Government to adopt a more open attitude towards vaping products, also known as e-cigarettes. Last week, a European doctor and scientist, Professor Riccardo Polosa, arrived in Hong Kong making the argument that is can be a boon to public health and even reduce smoking rates.

Professor Riccardo Polosa is a doctor turned scientist supporting the liberalisation of vaping products in order to lower the incidence of smoking and help people quit. He is the former president of the Italian Anti Smoking League (from 2003 to 2008) and founded the University of Catania’s Centre for Tobacco Research in 2003, making him an active member contributor to the European debate on vaping regulatory issues.

In his recent visit to Hong Kong, the smoking cessation expert stressed that vaping, given proper monitoring and regulation, can be a “gateway away from the harmful effects of smoking”, citing a widely endorsed report by Public Health England which concluded that e-cigarette is 95% less harmful than combustible cigarettes in terms of harmful constituents produced.

“By definition, smokers are already polluting themselves with more than 7,000 chemicals. What causes disease… is a synergistic action of these many thousands of chemicals. If you look at the component…of what is emitted by electronic cigarettes, it’s not thousands of chemicals, but a few, 95% less chemicals,” Professor Polosa explained.

“Brainwashed”

Commenting on the Hong Kong Government’s cool, if not dismissive, response towards market liberalisation of vaping products, the professor criticised it for being “brainwashed by ideological information.” “It seems to me that [the] Hong Kong [Government]…is trying to mimic what’s happening in Singapore..to follow steps without any scientific reason,” he said, calling it “nonsensical” and “irresponsible” for the Hong Kong Government, or any government, to deprive smokers of a lower risk alternative which can generate a “public health revolution.”

For Professor Polosa, what matters at the end of the day is the smoking prevalence. He draws upon findings of studies conducted by his team in the past three years over switching from smoking to vaping and its impact on tobacco-related diseases (here, here and here). “All people exclusively adopting the vaping lifestyle are improving all objective and subjective outcomes for all diseases under examination. So it’s a great public health gain that we are going to see if we embrace electronic cigarettes,” the professor said. “I would like to caution the Hong Kong Government to follow more beneficial examples, say in England, where e-cigarette [usage] has been very popular for the past five years and they have seen the largest decrease in smoking prevalence.”

“I understand [Hong Kong] has a flat rate for smoking for the last seven or eight years, so it is time for a change…We see in other countries where [vaping] had been liberalised, there were big changes in smoking prevalence and I don’t see why this is not going to happen in Hong Kong too,” the professor added.

Crusade for health

As such data is not yet available in Hong Kong, Professor Polosa urged the Hong Kong Government to build up its own smoking prevalence data, monitor it and formulate vaping policies accordingly. In his short trip to Hong Kong, he met with lawmakers Joseph Lee Kok-long (???), representative of the Health Services functional constituency, and Aron Kwok Wai-keung (???) for the Labour constituency and offered his expertise in designing a monitoring system and designing experimental protocol.

Speaking to HT, Lee was open to Professor Polosa’s ideas. “I think this is a good perspective that would allow Hong Kong smokers to have a better informed choice,” Lee says. “Right now there is no regulation over e-cigarettes in Hong Kong, so the Government should look into the regulatory lines drawn by other countries that have already legalised the product.”

The Federation of Trade Union lawmaker and social worker, meanwhile, is less open. “Whether examples in other places can be applied to Hong Kong remains unclear. It can be due to cultural difference, or difference in the perspectives over what e-cigarette can deliver. Indeed, the Baptist University of Hong Kong was commissioned to conduct a research and found that, used improperly, there are harmful chemicals in e-cigarette that can lead to cancerIf you can’t prove that . the substances in e-cigarette are 100% safe, it is hard for us to be convinced that there are other, positive functions of the product,” Kwok says. “That being said, I have always urged the Government to . Given current findings, I am provide more scientific evidence to support their propositionleaning towards stricter regulations [on e-cigarette], but it is still too early to conclude whether we should ban it completely. The Government should strive to provide a regulatory framework first, but if it insists that they don’t have the resources to provide such a supplement, banning the product may be the only way to go.”

As a general response, Professor Polosa slammed the papers generally embraced by the Hong Kong Government for not reflecting normal use, while noting a general misunderstanding in the general public towards nicotine.

“You stress the product so that it produces a much higher level of toxicants. This does not appear under regular use,” he said. “The dosage of nicotine normally absorbed by smokers is just a transmitter, or a psycho-stimulant. Nicotine doesn’t cause cancer. Nicotine doesn’t cause lung disease. Nicotine doesn’t cause serious cardiovascular problem. What causes these problems is the [chemicals arising from] combustion. So you need to quit combustion, not to quit tobacco nicotine.”

“E-cigarette should not be categorised as a drug, and in principle not as a tobacco product. In essence, it is currently included as a separate chapter under the tobacco category in Europe. Hong Kong may want to follow [Europe],” he says, suggesting an increase in tobacco tax in addition to other regulatory initiatives.

The ‘kids’ card

The two lawmakers also express concerns over teenagers picking up smoking habits if vaping is made available to them. In response, Professor Polosa drew upon a recent study by the Centers for Disease Control and Prevention (CDC), a leading national public health institute of the United States, which found that e-cigarette use among middle and high school students in the US is skyrocketing.

“Data in CDC shows clearly that even though there is a high adoption rate in experimentation of e-cigarette, smoking prevalence in the same age group is going down for the first time in ten years,” he said, “In fact, the CDC lied as it released the two sets of data months apart, making people think that the two are unconnected.” In other words, teenagers may be smoking less because they are vaping instead.

“It’s never been shown that this is going to cause an increase in smoking prevalence…30-50% of kids have a risk-seeking profile. That’s normal. But the large picture is not the few kids that are trying e-cigarettes, the large picture is billion of smokers that need a safer alternative,” the professor added. “I find it very irritating to use kids for their campaigns.”

Train the shoppers!

Back in his country, Professor Polosa has launched a collaborative project to provide training for vape shop owners and salespersons on smoking cessation counselling. “I prefer to have professionals in vape shops. Probably in the future we need to regulate vape shop owners and salespersons in the way we regulate pharmacists. They should have a minimal training, because after all they are helping people to quit smoking,” he says. “I don’t see anyone in Hong Kong who is in charge of smoking cessation.” There is much to be done Expect the professor to be in Hong Kong more often as part of his lifelong mission to help people quit smoking.

How might Big Tobacco react to a rise in cigarette excise?

Apr 20th, 2016
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http://theconversation.com/how-might-big-tobacco-react-to-a-rise-in-cigarette-excise-57895

There now appears to be bipartisan recognition in Australia of the political stench of cigarettes. Labor governments have taken a dim view of smoking for at least a decade, but now even the Liberal Party is joining the attack.

As the campaign donations from the tobacco industry dry up, the Turnbull government has set its sights on a product that, thanks to its unfortunate tendency to kill off its natural constituency, makes for an obvious target. The government is expected to announce a rise in tobacco excise in the coming federal budget.

The current taxation debate is just a small part of a much wider effort to curb smoking rates. And with every successful legislative change in Australia, other nations are increasingly emboldened to take on an industry once considered too politically powerful and dangerous.

Australia’s plain-packaging laws are already viewed as a model for Ireland, the UK and France. Its taxes – among the highest in the world – have routinely been shown to cut smoking rates to historic lows. Its citizens now overwhelmingly accept bans on passive smoking.

Still, Big Tobacco will never give up its fight against regulation and taxes. It knows that for every day it delays change, it saves millions in profits. As such, it relies on tactics of deceit, delay and frustration, which it has developed and refined over half a century.

But it also knows that it can’t make its argument directly. Instead, it relies on rhetorically gifted proxies. To that end, Big Tobacco has collaborated with a global web of friendly lobby groups, researchers and free-market think-tanks, such as the Institute of Public Affairs (IPA). Each proxy is expected to push an agenda, such as suggesting that research on tobacco smoke is “junk science” and critics of tobacco are “biased”.

Once the research has been completed, there are always media outlets willing to dutifully repeat the industry’s claims, which are used to build a narrative of the “nanny” state repeatedly kicking the mature and informed smoker.

Capitalism and freedom – for smokers

In the West, the freedom-of-choice argument has been at the heart of most of Big Tobacco’s campaigns since the 1970s. It’s a powerful idea, but it deliberately ignores the issue of child and passive smoking.

As such, Big Tobacco primarily relies on the argument that the state is trampling on personal liberty. When plain-packaging laws were being debated in Australia in 2010 – the first such laws in the world – the industry and its allies leapt into action.

The resultant advertising campaign was designed to portray the government and anti-smoking campaigners as part of a “nanny state” that was determined to tell adults how to live their lives.

An anti-plain-packaging advertisement.

(Stuck in) Nineteen Eighty-Four

The liberty argument may be a legitimate point of debate. But Big Tobacco also contended that plain-packaging laws would fail to deter people from smoking.

The IPA pointed out the tremendous monetary value of packaging, and Australia’s vulnerability to legal challenges that would cost billions of taxpayer dollars.

But, later, a senior IPA member released a study that showed spending on tobacco products had – controlling for other factors – increased following the plain-packaging laws’ passage.

Writers in the Murdoch press reported both stories, unaware of their contradictory nature.

Media Watch on how the plain-packaging studies were reported.

(Big Tobacco’s) crime and punishment

Another line of attack suggests that high taxes on cigarettes cause crime.

In 2015, the tobacco industry commissioned KPMG to study the effects of cigarette taxes on smuggling and black market sales. Unsurprisingly, the report said exactly what the tobacco industry wanted it to – going so far as to suggest that one in seven cigarettes smoked in Australia were smuggled.

As with all industry-funded “research”, government critics were keen to regurgitate the findings.

This is a distraction tactic. It is true that very high taxes, or a prohibition, will create a black market. It is also beside the point of plain packaging – which is to reduce smoking, while allowing for some free choice, provided it is informed and adult. Such laws have proved successful to that end.

The tobacco industry, insisting that we look anywhere but at them, wants to repaint a health issue as a law-enforcement one.

However, the tobacco industry is deeply hypocritical on smuggling. It systematically floods key foreign markets with its product, in turn facilitating smuggling in Western markets. The tactic allows it to claim plain-packaging laws and taxes cause the same crime it creates.

The heart of darkness

Big Tobacco fights in this way because of what it stands to lose.

So, the industry of death continues to exact its toll. It knew that people died from smoking and passive inhalation decades before it conceded the point. It knew of children taking up smoking – it even helped them do so. It complains of smuggling while being the biggest source of the problem.

Big Tobacco does these things because it is afraid. Imagine the profits lost should other countries adopt similar messages. Tens of billions every year are at stake.

In the tobacco wars, the strategic importance of Australia is critical. Big Tobacco will go to extraordinary lengths to ensure moves to quell smoking fail.

Smoking status and subjective well-being

Apr 20th, 2016
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http://tobaccocontrol.bmj.com/content/early/2016/04/20/tobaccocontrol-2015-052601.short?g=w_tobaccocontrol_ahead_tab

Abstract

Background/aims

A debate is currently underway about the Food and Drug Administration’s (FDA’s) methods for evaluating antitobacco regulation. In particular, the US government requires a cost-benefit analysis for significant new regulations, which has led the FDA to consider potential lost subjective well-being (SWB) of ex-smokers as a cost of any proposed antitobacco policy. This practice, which significantly limits regulatory capacity, is premised on the assumption that there is in fact a loss in SWB among ex-smokers.

Methods

We analyse the relationship between SWB and smoking status using a longitudinal internet survey of over 5000 Dutch adults across 5 years. We control for socioeconomic, demographic and health characteristics, and in a contribution to the literature, we additionally control for two potential confounding personality characteristics, habitual use of external substances and sensitivity to stress. In another contribution, we estimate panel fixed effects models that additionally control for unobservable time-invariant characteristics.

Results

We find strong suggestive evidence that ex-smokers do not suffer a net loss in SWB. We also find no evidence that the change in SWB of those who quit smoking under stricter tobacco control policies is different from those who quit under a more relaxed regulatory environment. Furthermore, our cross-sectional estimates suggest that the increase in SWB from quitting smoking is statistically significant and also of a meaningful magnitude.

Conclusions

In sum, we find no empirical support for the proposition that ex-smokers suffer lower net SWB compared to when they were smoking.

Index of tobacco control sustainability (ITCS)

Apr 20th, 2016
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A tool to measure the sustainability of national tobacco control programmes

http://tobaccocontrol.bmj.com/content/early/2016/04/18/tobaccocontrol-2015-052799.short?g=w_tobaccocontrol_ahead_tab

Abstract

Objective

To produce a tool to assess and guide sustainability of national tobacco control programmes.

Method

A two-stage process adapting the Delphi and Nominal group techniques. A series of indicators of tobacco control sustainability were identified in grantee/country advisor reports to The International Union Against Tuberculosis and Lung Disease under the Bloomberg Initiative to Reduce Tobacco Control (2007–2015). Focus groups and key informant interviews in seven low and middle-income countries (52 government and civil society participants) provided consensus ratings of the indicators’ relative importance. Data were reviewed and the indicators were accorded relative weightings to produce the ‘Index of Tobacco Control Sustainability’ (ITCS).

Results

All 31 indicators were considered ‘Critical’ or ‘Important’ by the great majority of participants. There was consensus that a tool to measure progress towards tobacco control sustainability was important. The most critical indicators related to financial policies and allocations, a national law, a dedicated national tobacco control unit and civil society tobacco control network, a national policy against tobacco industry ‘Corporate Social Responsibility’ (CSR), national mortality and morbidity data, and national policy evaluation mechanisms.

Conclusions

The 31 indicators were agreed to be ‘critical’ or ‘important’ factors for tobacco control sustainability. The Index comprises the weighted indicators as a tool to identify aspects of national tobacco control programmes requiring further development to augment their sustainability and to measure and compare progress over time. The next step is to apply the ITCS and produce tobacco control sustainability assessments.

Index of tobacco control sustainability (ITCS): a tool to measure the sustainability of national tobacco control programmes

Apr 20th, 2016
by Editor.
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http://tobaccocontrol.bmj.com/content/early/2016/04/18/tobaccocontrol-2015-052799.short?g=w_tobaccocontrol_ahead_tab

Abstract

Objective

To produce a tool to assess and guide sustainability of national tobacco control programmes.

Method

A two-stage process adapting the Delphi and Nominal group techniques. A series of indicators of tobacco control sustainability were identified in grantee/country advisor reports to The International Union Against Tuberculosis and Lung Disease under the Bloomberg Initiative to Reduce Tobacco Control (2007–2015). Focus groups and key informant interviews in seven low and middle-income countries (52 government and civil society participants) provided consensus ratings of the indicators’ relative importance. Data were reviewed and the indicators were accorded relative weightings to produce the ‘Index of Tobacco Control Sustainability’ (ITCS).

Results

All 31 indicators were considered ‘Critical’ or ‘Important’ by the great majority of participants. There was consensus that a tool to measure progress towards tobacco control sustainability was important. The most critical indicators related to financial policies and allocations, a national law, a dedicated national tobacco control unit and civil society tobacco control network, a national policy against tobacco industry ‘Corporate Social Responsibility’ (CSR), national mortality and morbidity data, and national policy evaluation mechanisms.

Conclusions

The 31 indicators were agreed to be ‘critical’ or ‘important’ factors for tobacco control sustainability. The Index comprises the weighted indicators as a tool to identify aspects of national tobacco control programmes requiring further development to augment their sustainability and to measure and compare progress over time. The next step is to apply the ITCS and produce tobacco control sustainability assessments.