Tobacco Info

From Tobacco Info No. 10 - August 2012
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Review of new studies by the Ontario Tobacco Research Unit

The Ontario Tobacco Research Unit (OTRU) is recognized as a Canadian leader in tobacco control research and training, and as a respected source of science-based information on tobacco control. In each issue of Tobacco Info, OTRU’s Michael Chaiton reviews the latest groundbreaking tobacco studies around the world. For more information, visit

Tobacco and substance use

The results of a Youth Smoking Survey revealed that it is rare to find youth who had used tobacco or drugs without also using alcohol. Out of 45,425 Canadian youth who were surveyed, alcohol was the most prevalent substance used. The study was published in the journal Addictive Behaviors by Leatherdale and Burkhalter. The researchers found that by grade 12, the majority of students were current users of alcohol, tobacco or drugs. Future research should consider developing a better understanding of how to prevent substance use among this population.

Patio smoking

A study in Athens, Georgia looked at whether exposure to secondhand smoke on bar patios can lead to measurable increases in biomarkers of tobacco exposure. The study, published in Environmental Health Perspectives, tested urinary and salivary cotinine (a biomarker that reveals exposure levels to tobacco smoke) of non-smokers assigned to sit either outside a bar or restaurant, or an open-air site with no smokers, collecting samples before and after the visit. Non-smokers who sat outside the bar had elevated levels of salivary and urinary cotinine. The authors conclude that such exposures may increase risks of health effects associated with tobacco carcinogens.

U.S. warnings

David Hammond and colleagues evaluated the 36 specific health warnings proposed by the U.S. Food and Drug Administration in 2010 in the journal Nicotine and Tobacco Research. They used web-based surveys of 783 adult smokers and 510 youth in the United States. Participants were randomized to view and rate two sets of six to seven warnings, each set corresponding to one of nine health effect statements required under the Tobacco Control Act. Comparisons between specific elements indicated that warnings were perceived as more effective if they were: full colour (vs. black and white), featured real people (vs. comic book style), contained graphic images (vs. non-graphic), and included the number for a quitline, or personal information. Generally, smokers of all demographics rated the warnings similarly, although youth tended to rate warnings as more effective.

Smoking Cessation

The effectiveness of STOP (Smoking Treatment for Ontario Patients) and nicotine replacement therapies (NRT) for smoking cessation at the population level were analyzed by the Centre for Addiction and Mental Health and OTRU. Published in Tobacco Control, the authors compared the quit rates of 13,143 smokers enrolled in an Ontario program to distribute free NRT, brief advice, and self-help materials via a toll-free number with a concurrent non-intervention cohort of Ontario smokers matched for eligibility. The program was found to be very effective as smokers who called the quitline were nearly twice as likely to be abstinent at six months.


Wealthier men are less likely to be smokers in all regions across the globe according to a major study examining the relationship of tobacco to socioeconomic status worldwide.  Harper and McKinnon in Cancer Causes and Control used data from 50 countries that participated in World Health Surveys in 2002-2003.  In some countries, however (Georgia, Mexico, Mauritania), current smoking was greater among the more advantaged. For women, smoking was more prevalent among the poor in Europe, but more common among richer women in Southeast Asia and the Western Pacific. The authors conclude that the relationship between socioeconomic position and smoking in poorer countries is dynamic and may not reflect the historical pattern in wealthier countries.