From Tobacco Info No. 8 -
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Abstracts review by the Ontario Tobacco Research Unit
The Ontario Tobacco Research Unit (OTRU) is a research network that is recognized as a Canadian leader in tobacco control research, monitoring and evaluation. At www.otru.org, browse Current Abstracts on Tobacco Control, a monthly list of selected journal articles and reports on tobacco topics, or visit the online library catalogue to search thousands of citations related to smoking and tobacco.
Advertising and promotion
Even among smokers, the public supports display bans. Brown and other co-authors involved in the International Tobacco Control (ITC) Survey analyzed three years of surveys from 10 Canadian provinces to assess smoker support for a ban on tobacco advertising and displays in stores. Writing in Tobacco Control, the authors found that smokers strongly supported such a ban in all provinces irrespective of whether a ban was in place. However, smokers who noticed displays and advertising in stores and smokers with no intention to quit were less likely to support a ban.
In a major systematic review, Chris Lovato and colleagues synthesize the evidence for the impact of tobacco advertising and promotion on increasing adolescent smoking behaviours. Published in the Cochrane Database of Systematic Reviews, the study summarized 19 longitudinal cohort studies that examined tobacco advertising and smoking initiation. In 18 of the 19 studies, the nonsmoking adolescents who were more aware of tobacco advertising or receptive to it, were more likely to have experimented with cigarettes or become smokers at follow up. The authors conclude that the evidence is sufficient to claim a causal relationship between tobacco advertising and promotion and the likelihood of starting smoking.
Cessation and quit attempts
David Ip et al., in Addiction, examined the relative predictive ability of various ‘hardcore’ components (high daily cigarette consumption, high nicotine dependence, being a daily smoker, history of long-term smoking, no quit intention, and no lifetime quit attempt) on quit attempts and successful quitting. Analyzing 4,130 smokers from the Ontario Tobacco Survey, the study found components that were thought to contribute to being a ‘hardcore smoker’ were associated with not trying to quit smoking over a one year period. However, if a quit attempt was made, only the components associated with addiction such as high nicotine dependence and cigarette consumption were associated with quit success. The results suggest that those who ‘can’t quit’ should be distinguished from those who aren’t interested in quitting.
The four country ITC survey was used to examine the rate and frequency of quit intentions and failed quit attempts among smokers over a seven year period. In Addiction, Borland and colleagues found that around 40% of smokers report attempts to quit in a given year. On average, every smoker attempted to quit once per year. The results suggest that relapse and failed quit attempts are very common and more attention on translating quit attempts into longer successes is needed.
Social environmental influences
In Addictive Behaviors, French researchers lead by Mayet examined the relationship between tobacco and cannabis onset and daily use in a large survey. Using Markov models to assess transitions among a representative sample of 29,393 teenagers in France, the authors found that the initiation of tobacco first was 17 times as likely as trying cannabis first. Once the teenager had started using either substance, they were significantly more likely to try the other. While the study design could not test whether there was a common liability to addiction among users, the results highlight the importance of contextualizing tobacco use with other substances.
Rahmati, Nourian, and Okoli, in Public Health Nursing, investigated how the family structure is associated with smoking among youth in Canada. Using the Canadian Community Health Survey, the study found that smoking was nearly twice as common among youth who lived in a household with either one or no parents compared to youth with two parents while controlling for age, sex, household education and exposure to secondhand smoking.
Context was also found to be important in a study of neighbourhood factors
published in Health and Place.
A Montreal research team lead by Généreux examined data from cross-sectional surveys of over 12,000 residents of Montreal over the period from 2003 to 2009. They found that the prevalence of smoking increased among those with low education, and decreased among those with higher levels of education, leading to increased inequalities in smoking. Smoking prevalence was also clustered in the south central areas of Montreal.
By Michael Chaiton