Perceptions and impact of plain packaging of tobacco products in low and middle income countries, middle to upper income countries and low-income settings in high-income countries: a systematic review of the literature

Hughes, Nicole; Arora, Monika; Grills, Nathan

doi:10.1136/bmjopen-2015-010391

Cited by 33 publications

(28 citation statements)

References 46 publications

(78 reference statements)

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“…A change, of course, could be accelerated by implementing interventions known to be effective, such as an increase in cigarette prices, which is known to be especially effective in young people 26 , and plain packaging. 27 …”

Section: Discussionmentioning

confidence: 99%

Trends in smoking and smokeless tobacco use among Danish Adolescents, 1997-2014

Tolstrup

Pisinger

Egan

et al. 2018

Tob. Prev. Cessation

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INTRODUCTION High rates of smoking among adolescents remain a public health concern. This study investigates smoking behavior and use of smokeless tobacco among Danish high-school students and assesses how smoking and use of smokeless tobacco cluster in schools and school classes. We estimate the trend in cigarette smoking from 1997 to 2014. METHODS We used data on 70 243 students, from 3 214 school classes in 119 high schools, who participated in the Danish National Youth Study from 2014. We had information on 87% of all Danish high schools and 85% of eligible students. We also used data from 1997 on 26 644 high-school students from a similar data set to assess the chronological trend in smoking. We calculated prevalences and intraclass correlation coefficients (ICCs) to estimate between-school and between-school class clustering in smoking and use of smokeless tobacco. RESULTS In all, 14% of boys and 11% of girls were daily smokers. A large fraction of the variation in smoking and the use of smokeless tobacco was attributable to the school and school-class level (ICC of 0.19, 0.12, 0.16 and 0.27, for daily smoking, waterpipe smoking, use of electronic cigarettes and snuff/chewing tobacco, respectively). Daily smoking decreased from 15% in 1997 to 12% in 2014, while more students were occasional smokers in 2014 than in 1997 (30% vs 18%). CONCLUSIONS The prevalence of smoking was high among Danish high-school students and had changed little since 1997. The school and class environment accounted for a large part of the variation in smoking behavior. INTRODUCTIONDespite the solid evidence of smoking's addictive properties and the comprehensive associated harms, high rates of smoking among adolescents remain a global public health concern. In 2015, 18 countries in western and central Europe had a smoking prevalence among girls, aged between 15 and 19 years, higher than 15%, and only three countries worldwide had significant decreases in adolescent smoking in the period from 2005 to 2015 1 . During the last decade, alternative smoke and smokeless products have become available and are being increasingly used; most popular are electronic cigarettes (e-cigarettes) and waterpipe, and also smokeless products such as snuff and chewing tobacco [2][3][4][5] . While there is little doubt that these products in themselves are less dangerous than cigarettes 6,7 , they are not harmless and there is concern that their use is associated with an increased risk of smoking initiation 3,[8][9][10] . High school constitutes a time of transition characterized by physical, psychological and social changes during which environment and opinions of peers become increasingly important to young people while parents' influence declines [11][12][13] . The school is an important setting that influences young people as they spend a large part of their day interacting with the school environment and other students. Research

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Section: Discussionmentioning

confidence: 99%

Trends in smoking and smokeless tobacco use among Danish Adolescents, 1997-2014

Tolstrup

Pisinger

Egan

et al. 2018

Tob. Prev. Cessation

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“…[20][21][22] A last point of interest involves 2 WHO-supported strategies for tobacco control that have proven effective in >75 countries: graphic health warnings and plain packaging. 23,24 A recent RCT emphasizes the effectiveness of graphic warnings in smoking cessation. 25 Despite recent legal rulings, FDA is encouraged to redouble efforts to use meaningful graphical information to assist tobacco cessation efforts.…”

Section: Tobacco Regulationmentioning

confidence: 99%

The FDA and the State of Chronic Diseases: Cardiovascular, Endocrine, Pulmonary, and Renal Diseases

Fiuzat¹,

Mp²,

Gad³

et al. 2018

Preprint

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Despite needs for new therapies and improvements in existing approaches in cardiovascular, pulmonary, endocrine, and renal disease, investment in these areas is lagging relative to other specialties. This article summarizes a meeting of key stakeholders of U.S. Food and Drug Administration (FDA) officials, representatives from academia, national organizations, and patients and caregivers. The purpose was to identify and discuss high-priority issues, establish areas of common interest, and explore opportunities for collaboration. During the meeting (September 2016), the construct of a “multimorbidity continuum” emerged, in which chronic diseases are understood as their effects on the whole rather than individual organ systems. Cross-disciplinary priorities included: 1) the need to generate greater high-quality evidence at lower cost; 2) the imperative to develop and implement patient-centered approaches to clinical investigations; 3) the importance of trial participation in under-represented populations, particularly with comorbid conditions, and 4) the need for progress in tobacco regulation. Representatives from each therapeutic area reported on their consensus priorities, and FDA representatives discussed the agency’s role in facilitating broader approaches to therapeutic development and evaluation of disease as linked across organ systems rather than in isolation, and emphasized the importance of patient engagement, collaboration and communication across stakeholders.

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“…Plain packaging, which removes company branding and employs standard packaging and lettering, effectively strips tobacco companies of their proprietary marketing. From limited evidence, plain packaging appears to increase the salience of health warnings and decrease the appeal of cigarettes, particularly in LMICs (Hughes et al, 2016; Munafo et al, 2011; Stead et al, 2013a). Plain packaging was first implemented in Australia in 2012, is scheduled to be implemented in Ireland and England in 2016, and is under consideration in 10 other countries.…”

Section: Successes In Global Tobacco Control: “Best Buys”mentioning

confidence: 99%

Global tobacco prevention and control in relation to a cardiovascular health promotion and disease prevention framework: A narrative review

Carroll

Huffman

Hitsman

2016

Preventive Medicine

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The purpose of this review is to emphasize the role of tobacco prevention and control in cardiovascular health (CVH) promotion and cardiovascular disease (CVD) prevention, including the importance of these endpoints for measuring the full impact of tobacco-related policies, programs, and practices. In this review, we describe an overview of tobacco control interventions that have led to substantial declines in tobacco use and the relationship between these declines with CVH and CVD. We review interventions that have had success in high-income countries (HICs) as well as those that are gaining traction in low- and middle-income countries (LMICs). We emphasize the challenges to comprehensive tobacco prevention and control strategies faced by LMICs, and highlight the special role of cardiovascular health professionals in achieving CVH promotion and CVD prevention endpoints through tobacco control. Tobacco prevention and control strategies have a strong scientific basis, yet a distinct gap remains between this evidence and implementation of tobacco control policies, particularly in LMICs. Health professionals can contribute to tobacco control efforts, especially through patient-level clinical interventions, when supported by a health care system and government that recognize and support tobacco control as a critical strategy for CVH promotion and CVD prevention. Understanding, supporting, and applying current and evolving policies, programs, and practices in tobacco prevention and control is the province of all health professionals, especially those concerned with CVH promotion and CVD prevention. A new tobacco control roadmap from the World Heart Federation provides a strong impetus to the needed interdisciplinary collaboration.

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Perceptions and impact of plain packaging of tobacco products in low and middle income countries, middle to upper income countries and low-income settings in high-income countries: a systematic review of the literature

Cited by 33 publications

References 46 publications

Trends in smoking and smokeless tobacco use among Danish Adolescents, 1997-2014

Trends in smoking and smokeless tobacco use among Danish Adolescents, 1997-2014

The FDA and the State of Chronic Diseases: Cardiovascular, Endocrine, Pulmonary, and Renal Diseases

Global tobacco prevention and control in relation to a cardiovascular health promotion and disease prevention framework: A narrative review

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