Tobacco endgame and priority populations: a scoping review

Abstract

AimTo summarise the research literature on the impacts or perceptions of policies to end tobacco use at a population level (ie, tobacco endgame policies) among people from eight priority population groups (experiencing mental illness, substance use disorders, HIV, homelessness, unemployment or low incomes, who identify as lesbian, gay, bisexual, transgender, queer or intersex (LGBTQI+) or who have experienced incarceration).MethodsGuided by JBI Scoping Review Methodology, we searched six databases for original research examining the impacts or perceptions of 12 tobacco endgame policies among eight priority populations published since 2000. We report the results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.ResultsOf the 18 included studies, one described perceptions of five endgame policies among people on low incomes in Aotearoa (New Zealand), and 17 focused on the effectiveness or impacts of a very low nicotine content (VLNC) cigarette standard among people experiencing mental illness (n=14), substance use disorders (n=8), low incomes (n=6), unemployment (n=1) or who identify as LGBTQI+ (n=1) in the USA. These studies provide evidence that VLNC cigarettes can reduce tobacco smoking, cigarette cravings, nicotine withdrawal and nicotine dependence among these populations.ConclusionsMost of the tobacco endgame literature related to these priority populations focuses on VLNC cigarettes. Identified research gaps include the effectiveness of endgame policies for reducing smoking, impacts (both expected and unexpected) and policy perceptions among these priority populations.

Public Support for Tobacco Endgame Policies: A Systematic Review and Meta-analysis

“…[53] The support estimates for mandating VLNC policy also remained consistent even when the question was posed without any additional explanation,[26 61] suggesting that the findings are robust even when reasons for implementing are not provided. High support for the VLNC policy and its potential effect on reducing smoking prevalence[1] and improving equity,[3] suggests that it is an option that should be given strong consideration by countries seeking implementable endgame policies. Nevertheless, clear communication strategies must be developed as some studies show understanding of the policy is limited.…”

“…A growing number of tobacco control research activities are directed towards tobacco endgame policies. [1][2][3] The concept of the tobacco endgame refers to achieving near-zero smoking prevalence within a defined (proximate) timeframe This may require innovative policies [1] that complement conventional demand reduction measures, such as those included in the MPOWER package. Rather than the typical incremental intensification of existing measures, endgame policies address the fundamental factors that sustain the commercial tobacco market, such as the addictiveness of tobacco products (e.g., by mandating a very low nicotine content (VLNC) standard for smoked tobacco), the availability of tobacco products (e.g., by substantially reducing the number or types of tobacco retailers), or the tobacco industry's commercial activities (e.g., by implementing a regulated market model).…”

South Australia's tobacco retail landscape and its intersection with socioeconomic factors and smoking prevalence

“…19,40 However, it is not yet clear how such strategies will impact priority groups. 41 Specific research examining the effects of tobacco endgame strategies on specific priority populations is required to mitigate possible negative consequences.…”

“…Other control strategies may include restricting the number of retailers relative to population size, implementing proximity limits between retailers, and prohibiting tobacco retail near schools 19,40 . However, it is not yet clear how such strategies will impact priority groups 41 . Specific research examining the effects of tobacco endgame strategies on specific priority populations is required to mitigate possible negative consequences.…”