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  • 1
    Keywords: HEALTH ; NETHERLANDS ; smoking cessation ; survey ; Country differences ; DEPENDENCE TREATMENT ; NATIONAL QUITLINE ; PROJECT NEW-ZEALAND ; quitting activity ; quitting aids ; quitting medications
    Abstract: AIMS: To describe some of the variability across the world in levels of quit smoking attempts and use of various forms of cessation support. DESIGN: Use of the International Tobacco Control Policy Evaluation Project surveys of smokers, using the 2007 survey wave (or later, where necessary). SETTINGS: Australia, Canada, China, France, Germany, Ireland, Malaysia, Mexico, the Netherlands, New Zealand, South Korea, Thailand, United Kingdom, Uruguay and United States. PARTICIPANTS: Samples of smokers from 15 countries. MEASUREMENTS: Self-report on use of cessation aids and on visits to health professionals and provision of cessation advice during the visits. FINDINGS: Prevalence of quit attempts in the last year varied from less than 20% to more than 50% across countries. Similarly, smokers varied greatly in reporting visiting health professionals in the last year (〈20% to over 70%), and among those who did, provision of advice to quit also varied greatly. There was also marked variability in the levels and types of help reported. Use of medication was generally more common than use of behavioural support, except where medications are not readily available. CONCLUSIONS: There is wide variation across countries in rates of attempts to stop smoking and use of assistance with higher overall use of medication than behavioural support. There is also wide variation in the provision of brief advice to stop by health professionals.
    Type of Publication: Journal article published
    PubMed ID: 21883605
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  • 2
    Keywords: IMPLEMENTATION ; SECONDHAND SMOKE ; 4 COUNTRY SURVEY ; IRELAND ; RESTRICTIONS ; CROSS-SECTIONAL SURVEY ; CHILD EXPOSURE ; SCOTLAND ; LAW ; HOUSEHOLDS
    Abstract: ObjectivesTo measure changes in prevalence and predictors of home smoking bans (HSBs) among smokers in four European countries after the implementation of national smoke-free legislation.DesignTwo waves of the International Tobacco Control Policy Evaluation Project Europe Surveys, which is a prospective panel study. Pre- and post-legislation data were used from Ireland, France, Germany and the Netherlands. Two pre-legislation waves from the UK were used as control.Participants4634 respondents from the intervention countries and 1080 from the control country completed both baseline and follow-up and were included in the present analyses.MethodsMultiple logistic regression models to identify predictors of having or of adopting a total HSB, and Generalised Estimating Equation models to compare patterns of change after implementation of smoke-free legislation to a control country without such legislation.ResultsMost smokers had at least partial smoking restrictions in their home, but the proportions varied significantly between countries. After implementation of national smoke-free legislation, the proportion of smokers with a total HSB increased significantly in all four countries. Among continuing smokers, the number of cigarettes smoked per day either remained stable or decreased significantly. Multiple logistic regression models indicated that having a young child in the household and supporting smoking bans in bars were important correlates of having a pre-legislation HSB. Prospective predictors of imposing a HSB between survey waves were planning to quit smoking, supporting a total smoking ban in bars and the birth of a child. Generalised Estimating Equation models indicated that the change in total HSB in the intervention countries was greater than that in the control country.ConclusionsThe findings suggest that smoke-free legislation does not lead to more smoking in smokers homes. On the contrary, our findings demonstrate that smoke-free legislation may stimulate smokers to establish total smoking bans in their homes.
    Type of Publication: Journal article published
    PubMed ID: 22331456
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  • 3
    Keywords: HEALTH ; smoking ; CESSATION ; PRICE
    Abstract: Background Legal tobacco tax avoidance strategies such as cross-border cigarette purchasing may attenuate the impact of tax increases on tobacco consumption. Little is known about socioeconomic and country variations in cross-border purchasing. Objective To describe socioeconomic and country variations in cross-border cigarette purchasing in six European countries. Methods Cross-sectional data from adult smokers (n=7873) from the International Tobacco Control (ITC) Surveys in France (2006/2007), Germany (2007), Ireland (2006), The Netherlands (2008), Scotland (2006) and the rest of the UK (2007/2008) were used. Respondents were asked whether they had bought cigarettes outside their country in the last 6 months and how often. Findings In French and German provinces/states bordering countries with lower cigarette prices, 24% and 13% of smokers, respectively, reported purchasing cigarettes frequently outside their country. In non-border regions of France and Germany, and in Ireland, Scotland, the rest of the UK and The Netherlands, frequent purchasing of cigarettes outside the country was reported by 2-7% of smokers. Smokers with higher levels of education or income, younger smokers, daily smokers, heavier smokers and smokers not planning to quit smoking were more likely to purchase cigarettes outside their country. Conclusions Cross-border cigarette purchasing is more common in European regions bordering countries with lower cigarette prices and is more often reported by smokers with higher education and income. Increasing taxes in countries with lower cigarette prices, and reducing the number of cigarettes that can be legally imported across borders could help to avoid cross-border purchasing.
    Type of Publication: Journal article published
    PubMed ID: 23644287
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  • 4
    Keywords: COUNTRIES ; SMOKERS ; INEQUALITIES ; ADULTS ; CESSATION ; INTERVENTIONS ; PRICE ; CIGARETTE WARNING LABELS ; REDUCE SMOKING ; EQUITY IMPACT
    Abstract: Introduction: The aim of the current study is to investigate trends and socioeconomic differences in policy triggers for thinking about quitting in six European countries. Methods: Data were derived from all available survey waves of the International Tobacco Control (ITC) Europe Surveys (2003-2013). France conducted three survey waves (n = 1420-1735), Germany three waves (n = 515-1515), The Netherlands seven waves (n = 1420-1668), Ireland three waves (n = 582-1071), Scotland two waves (n = 461-507), and the rest of the United Kingdom conducted seven survey waves (n = 861-1737). Smokers were asked whether four different policies (cigarette price, smoking restrictions in public places, free or lower cost medication, and warning labels on cigarette packs) influenced them to think about quitting. Generalized Estimating Equation (GEE) models were estimated for each country. Results: Cigarette price was mentioned most often in all countries and across all waves as trigger for thinking about quitting. Mentioning cigarette price and warning labels increased after the implementation of price increases and warning labels in some countries, while mentioning smoking restrictions decreased after their implementation in four countries. All studied policy triggers were mentioned more often by smokers with low and/or moderate education and income than smokers with high education and income. The education and income differences did not change significantly over time for most policies and in most countries. Conclusions: Tobacco control policies work as a trigger to increase thoughts about quitting, particularly in smokers with low education and low income and therefore have the potential to reduce health inequalities in smoking.
    Type of Publication: Journal article published
    PubMed ID: 26282108
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  • 5
    Keywords: DISEASE ; EXPOSURE ; CHILDREN ; DETERMINANTS ; ENVIRONMENTAL TOBACCO-SMOKE ; PASSIVE SMOKING ; SECONDHAND SMOKE ; 4 COUNTRY SURVEY ; 2ND-HAND SMOKE ; MOTOR-VEHICLES ; POLLUTION
    Abstract: BACKGROUND: As exposure to tobacco smoke pollution (TSP) has been identified as a cause of premature death and disease in non-smokers, and studies have demonstrated that smoking in cars produces high levels of TSP, this study will investigate smokers' rules for smoking in their cars, and predictors of car smoking rules, including potentially modifiable correlates. METHODS: Data were drawn from nationally representative samples of current smokers from the International Tobacco Control Policy Evaluation Project surveys in France (2007), Germany (2007), and the Netherlands (2008). Smokers in France and Germany were asked about smoking rules in their cars, and smokers in the Netherlands were asked about smoking rules in cars carrying children. RESULTS: In France and Germany, 59% and 52% of smokers respectively, allowed smoking in their cars. In the Netherlands, 36% of smokers allowed smoking in cars carrying children. Predictors of allowing smoking in cars included: being a daily vs. non-daily smoker, being younger vs. older age, having no (young) children in the home, being a heavier smoker, and allowing smoking in the home. In the Netherlands, smokers who agreed that TSP is dangerous to non-smokers were less likely to allow smoking in cars carrying children. CONCLUSION: Overall, a sizeable proportion of smokers allowed smoking in their cars across the three countries. Media campaigns with information about the dangers of TSP may increase the adoption of smoke-free cars. These media campaigns could target smokers who are most likely to allow smoking in cars.
    Type of Publication: Journal article published
    PubMed ID: 22294780
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  • 6
    Keywords: IMPACT ; TOBACCO ; SMOKERS ; SMOKING-BEHAVIOR ; QUIT ; LABELS ; PACKAGES
    Abstract: BACKGROUND: The European Commission requires tobacco products sold in the European Union to display standardized text health warnings. This article examines the effectiveness of the text health warnings among daily cigarette smokers in four Member States. METHODS: Data were drawn from nationally representative samples of smokers from the International Tobacco Control Policy Evaluation Project surveys in France (2007), Germany (2007), the Netherlands (2008) and the UK (2006). We examined: (i) smokers' ratings of the health warnings on warning salience, thoughts of harm and quitting and forgoing of cigarettes; (ii) impact of the warnings using a Labels Impact Index (LII), with higher scores signifying greater impact; and (iii) differences on the LII by demographic characteristics and smoking behaviour. RESULTS: Scores on the LII differed significantly across countries. Scores were highest in France, lower in the UK, and lowest in Germany and the Netherlands. Across all countries, scores were significantly higher among low-income smokers, smokers who had made a quit attempt in the past year and smokers who smoked fewer cigarettes per day. CONCLUSION: The impact of the health warnings varies greatly across countries. Impact tended to be highest in countries with more comprehensive tobacco control programmes. Because the impact of the warnings was highest among smokers with the lowest socioeconomic status (SES), this research suggests that health warnings could be more effective among smokers from lower SES groups. Differences in warning label impact by SES should be further investigated.
    Type of Publication: Journal article published
    PubMed ID: 21920847
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  • 7
    Keywords: MORTALITY ; SMOKERS ; PHYSICAL-ACTIVITY ; YOUNG-ADULTS ; INDIVIDUAL-DIFFERENCES ; FUTURE CONSEQUENCES ; ADOLESCENT SMOKING ; SENSATION-SEEKING ; SUBSTANCE USE ; IMMEDIATE
    Abstract: BACKGROUND: Prior studies have demonstrated that time perspective-the propensity to consider short-versus long-term consequences of one's actions-is a potentially important predictor of health-related behaviors, including smoking. However, most prior studies have been conducted within single high-income countries. The aim of this study was to examine whether time perspective was associated with the likelihood of being a smoker or non-smoker across five countries that vary in smoking behavior and strength of tobacco control policies. METHODS: The data were from the International Tobacco Control (ITC) Surveys in five countries with large probability samples of both smokers (N=10,341) and non-smokers (N=4,955): Scotland, France, Germany, China, and Malaysia. The surveys were conducted between 2005-2008. Survey respondents indicated their smoking status (smoker vs. non-smoker) and time perspective (future oriented vs. not future-oriented) and provided demographic information. RESULTS: Across all five countries, non-smokers were significantly more likely to be future-oriented (66%) than were smokers (57%), chi2(1, N = 15,244) = 120.64, p 〈 .001. This bivariate relationship between time perspective and smoking status held in a multivariate analysis. After controlling for country, age, sex, income, education, and ethnicity (language in France), those who were future-oriented had 36% greater odds of being a non-smoker than a smoker (95% CI: 1.22 to 1.51, p〈.001). CONCLUSION: These findings establish time perspective as an important predictor of smoking status across multiple countries and suggest the potential value of incorporating material to enhance future orientation in smoking cessation interventions.
    Type of Publication: Journal article published
    PubMed ID: 23587205
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