ObjectiveTo identify recommended components for adopting, implementing and enforcing bans or restrictions targeting flavoured tobacco products.MethodsBetween April and June 2019, semistructured interviews were conducted with 17 high-level experts across the USA and Canada with expertise in flavoured tobacco product policies. Participants included health department staff, researchers, legal professionals and local government officials. Interviews were recorded, transcribed and analysed for key themes.ResultsMajor findings were organised into four categories: programme planning and legislative preparations; education and community outreach; implementation and enforcement; and policy impact. Critical pre-implementation elements included using comprehensive policy language, identifying enforcement agents, examining potential economic costs, deploying media campaigns and engaging community partners and retailers. Recommended implementation processes included a 6-month preparation timeline, focus on retailer education and clearly outlined enforcement procedures, particularly for concept flavours.ConclusionsFlavoured tobacco policies have successfully limited sales, withstood legal challenges and become more comprehensive over time, providing useful lessons to inform ongoing and future legislative and programmatic efforts. Identifying and sharing best practices can improve passage, implementation, efficacy and evaluation of flavoured tobacco policies.

No abstract

ObjectivesAdolescent childbirth is associated with older adult adverse health outcomes that negatively affect mobility function, but these associations have not been studied globally in large samples of reproductive-age women. This study examines the association between age at first childbirth and mobility disability in national surveys from low-income and middle-income countries, and hypotheses that adolescent childbirth is associated with mobility disability.DesignCross-sectional analysis.SettingPopulation health surveys from 2013 to 2018 containing mobility disability measures among ever-pregnant women ages 15–49. These included 13 Demographic Health Surveys from Haiti, Pakistan, Uganda, Cambodia, Colombia, South Africa, Timor-Leste, Albania, Gambia, Maldives, Peru, Senegal and Yemen and 1 Maternal Health Survey from Ghana.ParticipantsThe sample included 157 988 women ages 15–49 years.Primary outcome measureAdolescent childbirth was defined as 10–19 years of age. Poisson regression models were used to estimate prevalence ratios (PRs) of mobility disability among women who first gave birth during adolescence and in adult life (ages 20–45 years) in each country and across the whole sample. Countries were also analysed according to the use of standard and non-standard mobility disability measures. Covariates included current age, urban/rural residence, education and household wealth.ResultsPrevalence of adolescent childbirth (17.5%–66.2%) and mobility disability (0.32%–21.45%) varied widely across countries. Adolescent childbirth was significantly (p<0.05) associated with greater mobility disability in six of eight countries using standard disability measures. Among the six countries that did not use standard disability measures, none showed a statistically significant association between adolescent childbirth and mobility disability. Considering the whole sample and adjusting for all covariates, women who gave birth during adolescence had greater prevalence of mobility disability (pooled PR 1.19, 95% CI 1.06–1.31).ConclusionsThis analysis suggests a moderate and consistent association of adolescent childbearing with subsequent mobility disability.