Andrew B. Seidenberg

Storefront Cigarette Advertising Differs by Community Demographic Profile

Purpose. Tobacco manufacturers have targeted youth and ethnic/racial minorities with tailored advertising. Less is known about how characteristics of storefront tobacco advertisements, such as location, position, size, and content, are used to appeal to demographic subgroups. Design. The occurrence and characteristics of storefront cigarette advertising were observed for all licensed tobacco retailers in two defined communities. Setting. Measures were taken in two Boston, Massachusetts, area urban communities: a low-income, minority community and a high-income, nonminority community. Subjects. No human subjects were involved in this study. Measures. Advertisement position (attached or separated from storefront), size (small, medium, or large), mentholation, and price were recorded. Geographic coordinates of tobacco retailers and schools were mapped using ArcGIS 9.2. Analysis. Differences between the communities in advertisement number and characteristics were assessed using bivariate analyses. Logistic regression was used to ascertain the odds of specific advertising features occurring in the low-income/minority community. Results. The low-income/minority community had more tobacco retailers, and advertisements were more likely to be larger, promote menthol products, have a lower mean advertised price, and occur within 1000 feet of a school. Conclusion. Storefront cigarette advertising characteristics that increase exposure and promote youth initiation were more prominent in a low-income/minority community. The findings emphasize the need for more effective regulation of storefront tobacco advertising.

Strategies to Reduce Indoor Tanning: Current Research Gaps and Future Opportunities for Prevention

Exposure to ultraviolet radiation from indoor tanning device use is associated with an increased risk of skin cancer, including risk of malignant melanoma, and is an urgent public health problem. By reducing indoor tanning, future cases of skin cancer could be prevented, along with the associated morbidity, mortality, and healthcare costs. On August 20, 2012, the CDC hosted a meeting to discuss the current body of evidence on strategies to reduce indoor tanning as well as research gaps. Using the Action Model to Achieve Healthy People 2020 Overarching Goals as a framework, the current paper provides highlights on the topics that were discussed, including (1) the state of the evidence on strategies to reduce indoor tanning; (2) the tools necessary to effectively assess, monitor, and evaluate the short- and long-term impact of interventions designed to reduce indoor tanning; and (3) strategies to align efforts at the national, state, and local levels through transdisciplinary collaboration and coordination across multiple sectors. Although many challenges and barriers exist, a coordinated, multilevel, transdisciplinary approach has the potential to reduce indoor tanning and prevent future cases of skin cancer.

Preventing skin cancer through reduction of indoor tanning: current evidence.

Exposure to ultraviolet radiation from indoor tanning devices (tanning beds, booths, and sun lamps) or from the sun contributes to the risk of skin cancer, including melanoma, which is the type of skin cancer responsible for most deaths. Indoor tanning is common among certain groups, especially among older adolescents and young adults, adolescent girls and young women, and non-Hispanic whites. Increased understanding of the health risks associated with indoor tanning has led to many efforts to reduce use. Most environmental and systems efforts in the U.S. (e.g., age limits or requiring parental consent/accompaniment) have occurred at the state level. At the national level, the U.S. Food and Drug Administration and the Federal Trade Commission regulate indoor tanning devices and advertising, respectively. The current paper provides a brief review of (1) the evidence on indoor tanning as a risk factor for skin cancer; (2) factors that may influence use of indoor tanning devices at the population level; and (3) various environmental and systems options available for consideration when developing strategies to reduce indoor tanning. This information provides the context and background for the companion paper in this issue of the American Journal of Preventive Medicine, which summarizes highlights from an informal expert meeting convened by the CDC in August 2012 to identify opportunities to prevent skin cancer by reducing use of indoor tanning devices.

Twitter: an opportunity for public health campaigns

www.thelancet.com Vol 384 July 12, 2014 131 F i n a l l y, L a b r o p o u l o s a n d colleagues seem to be dismayed that the SOX trial does not confi rm the assumed benefit of elastic compression stockings suggested by smaller trials. There are many examples of large, properly designed multicenter trials refuting results of earlier smaller trials or cohort studies. The SOX trial is the largest randomised trial so far of elastic compression stockings, overcomes the potential for bias inherent in any open trial by using placebo and double blinding, uses outcome measures used in other clinical trials of post-thrombotic syndrome, and is generalisable because of the large number of centres involved. Further, the estimated compliance rates are consistent with our clinical experience. Many patients find elastic compression stockings intolerable for aesthetic reasons, because they have the potential to cause discomfort, and can be difficult to put on. Although some might find the negative results of the SOX trial disappointing, patients might be relieved to fi nd that they do not routinely need to wear elastic compression stockings for 2 years after deep-vein thrombosis.

Cigarette sales in pharmacies in the USA (2005–2009)

Background Several US jurisdictions have adopted policies prohibiting pharmacies from selling tobacco products. Little is known about how pharmacies contribute to total cigarette sales. Methods Pharmacy and total cigarette sales in the USA were tabulated from AC Nielsen and Euromonitor, respectively, for the years 2005–2009. Linear regression was used to characterise trends over time, with observed trends extrapolated to 2020. Results Between 2005 and 2009, pharmacy cigarette sales increased 22.72% (p=0.004), while total cigarette sales decreased 17.43% (p=0.015). In 2005, pharmacy cigarette sales represented 3.05% of total cigarette sales, increasing to 4.54% by 2009. Extrapolation of these findings resulted in estimated pharmacy cigarette sales of 14.59% of total US cigarette sales by 2020. Conclusions Cigarette sales in American pharmacies have risen in recent years, while cigarette sales nationally have declined. If current trends continue, pharmacy cigarette market share will, by 2020, increase to more than four times the 2005 share.

Indoor secondhand tobacco smoke emission levels in six Lebanese cities

Background To date, Lebanon has failed to enact comprehensive clean indoor air laws despite ratification of the Framework Convention on Tobacco Control (FCTC), which calls for the protection of non-smokers from exposure to secondhand tobacco smoke (SHS). Complicating the problem of SHS exposure in Lebanon is the widespread use of the tobacco water-pipe. While most research on SHS has involved cigarette smoking as a source of emissions, other sources, including tobacco water-pipes, may be an important contributor. Methods PM2.5 concentrations (μg/m3) were measured in a sample of 28 public venues located in six major Lebanese cities. Active smoker density (number of smokers/100 m3) was calculated for both water-pipe and cigarette smokers. Venues were then categorised as having higher density of water-pipe smokers or higher density of cigarette smokers, and resultant emission levels were compared between the two groups. Results Cigarette and water-pipe smoking was observed in 14 venues, while cigarette smoking only and water-pipe smoking only were found in 12 venues and one venue, respectively. Among all smoking-permitted venues, the mean PM2.5 concentration was 342 μg/m3. Venues with a higher density of water-pipe smokers (n =14) showed a similar median PM2.5 concentration (349 μg/m3) compared with venues with a higher density of cigarette smokers (n =13; 241 μg/m3; p=0.159). The mean PM2.5 concentration in the single venue with a voluntary smoke-free policy was 6 μg/m3. Conclusions Despite ratification of the FCTC in 2005, both cigarette and water-pipe smoking are commonly practised in enclosed public places throughout Lebanon, leading to unsafe levels of indoor particulate pollution. Smoke-free policies are needed in Lebanon to protect the publics health, and should apply to all forms of tobacco smoking.

Differences in the design and sale of e-cigarettes by cigarette manufacturers and non-cigarette manufacturers in the USA

Background Three categories of e-cigarette brands have emerged within the US market: e-cigarette brands developed by cigarette manufacturers, brands acquired by cigarette manufacturers and brands with no cigarette manufacturer affiliation. In the absence of federal regulatory oversight of e-cigarettes, we assessed differences in e-cigarette products and sales practices across these categories. Methods Brand websites for top-selling e-cigarette brands from each of these categories were examined in October of 2015 to compare website access restrictions, online sales practices and products sold, including e-cigarette model type (eg, ‘cigalike’ vs advanced systems) and options available (eg, flavoured, nicotine free). Results Website access to brands developed by cigarette manufacturers was restricted to users aged 21 years or older, and one website required user registration. In addition, these brands were exclusively reusable/rechargeable ‘cigalikes.’ Limited flavour options were available for these products, and nicotine-free options were not sold. In contrast, brands acquired by cigarette manufacturers and brands with no cigarette manufacturer affiliation generally required website visitors to be 18, offered a nicotine-free option, and most offered disposable products and an array of flavoured products (eg, fruit/candy flavours). Conclusions This exploratory study finds differences in e-cigarette products and sales practices across these three e-cigarette brand categories, with brands developed by cigarette manufacturers adopting a particularly distinctive product and sales strategy. Anticipated regulation of e-cigarettes in the USA may be influencing these product and sales decisions.

Youth Indoor Tanning and Skin Cancer Prevention Lessons from Tobacco Control

Youth use of ultraviolet-emitting indoor tanning beds represents a present and emerging public health crisis. Nearly 30% of white female high school students report tanning indoors, and a quarter of high school tanners have used a tanning bed more than 20 times in the past year. Despite the significant health risks of tanning beds, including potentially deadly melanoma and eye problems, limited actions have been taken in the U.S. to protect youth. Tobacco control policies and campaigns, which have sharply reduced youth smoking, may provide a useful framework to control indoor tanning among young people. This article describes several evidence-based tobacco control strategies with potential applicability to indoor tanning within the context of the U.S. Further, current tobacco control policies and current indoor tanning policies in the U.S. are compared, and recommendations on how to curtail youth indoor tanning are discussed.

Availability and range of tobacco products for sale in Massachusetts pharmacies

Objective New tobacco control policies have been introduced in Massachusetts which restrict tobacco product sales in pharmacies. The purpose of this investigation was to outline the scope of pharmacy involvement in the tobacco market by assessing the availability and range of tobacco products sold in Massachusetts pharmacies. Methods Public listings of licenced pharmacies and tobacco retailers in Massachusetts were examined to determine the proportion of pharmacies licenced to sell tobacco, and the proportion of tobacco retailers possessing a pharmacy licence. Telephone interviews were conducted with a random sample (n=70) of pharmacies possessing a tobacco licence to assess the availability and range of tobacco products for sale. The availability of nicotine replacement therapy (NRT) products was assessed as a comparison. Results The majority of pharmacies in Massachusetts possessed a tobacco licence (69%), and pharmacies made up 9% of licenced tobacco retailers. Among pharmacies surveyed that reported selling tobacco (90%), cigarettes were the most available tobacco product for sale (100%), followed by cigars (69%), little cigars/cigarillos (66%), moist snuff (53%), pipe tobacco (49%), roll-your-own tobacco (34%), snus (14%), dissolvable tobacco (11%) and electronic cigarettes (2%). Nearly all pharmacies selling tobacco offered the nicotine patch (100%), gum (100%) and lozenge (98%). Conclusions Tobacco-free pharmacy policies would affect a majority of Massachusetts pharmacies and remove a variety of tobacco products from their store shelves. Further, nearly one in ten tobacco retailers would be eliminated by prohibiting tobacco sales in Massachusetts pharmacies statewide.

Swedish Match marketing on YouTube

In a press release dated April 6, 2009, Swedish Match North America announced the launch of a new website promoting its General Snus brand.1 Included with this release was a link to a professionally made video hosted on the YouTube website. Entitled ‘General Snus Is The Less Harmful Alternative. Do You SNUS,’ the video described General Snus flavours, features of the new website and directed viewers to the website with an offer of free samples.2 …