The Cancer Council Victoria

Melbourne, Australia

The Cancer Council Victoria

Melbourne, Australia
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Yong H.-H.,The Cancer Council Victoria | Borland R.,The Cancer Council Victoria | Cummings K.M.,Roswell Park Cancer Institute | Hammond D.,University of Waterloo | And 3 more authors.
Addiction | Year: 2011

Aim This paper examines how smokers' beliefs about 'light/mild' cigarettes in Australia, Canada and the United Kingdom were affected by the removal of misleading 'light/mild' terms from packs. Design, setting and participants The data come from the first seven waves (2002-09) of the International Tobacco Control Policy Evaluation (ITC) Four-Country Survey, an annual cohort telephone survey of adult smokers in Canada, the United States, the United Kingdom and Australia (21613 individual cases). 'Light' and 'mild' descriptors were removed in 2003 in the United Kingdom, in 2006 in Australia and in 2007 in Canada. We compare beliefs about 'light' cigarettes both before and after the bans, with those of smokers in the United States serving as the control condition. Measures Smokers' beliefs about 'light' cigarettes were assessed using a set of statements rated on a five-point 'agree'-'disagree' scale. Findings The proportions of respondents reporting misperceptions about light cigarettes declined between 2002 and 2009 in all four countries. There were marked temporary reductions in reported misperceptions in the United Kingdom and Australia, but not in Canada, following the removal of 'light/mild' descriptors. Conclusions Removal of 'light/mild' descriptors and tar, nicotine and carbon monoxide yield information from cigarette packs is insufficient to effectively eliminate false beliefs. The combination of alternative descriptors and design features that produce differences in taste strength and harshness, independent of actual intakes, are sufficient to produce or sustain the same misbeliefs. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.


Borland R.,The Cancer Council Victoria | Partos T.R.,The Cancer Council Victoria | Yong H.-H.,The Cancer Council Victoria | Cummings K.M.,Roswell Park Cancer Institute | Hyland A.,Roswell Park Cancer Institute
Addiction | Year: 2012

Aims To document accurately the amount of quitting, length of quit attempts and prevalence of plans and serious thought about quitting among smokers. Design We used longitudinal data from 7 waves of the International Tobacco Control Policy Evaluation Four Country Survey (ITC-4). We considered point-prevalence data and cumulative prevalence over the 7 years of the study. We also derived annual estimates of quit activity from reports of quit attempts starting only within more recent time-frames, to control for biased recall. Setting Australia, Canada, the United Kingdom and the United States. Participants A total of 21613 smokers recruited across seven waves. Measurements Reported life-time quit attempts, annual quit attempts, length of attempts, time since last attempt started, frequency of aborted attempts, plans to quit and serious thought about quitting. Findings Around 40.1% (95% CI: 39.6-40.6) of smokers report attempts to quit in a given year and report an average of 2.1 attempts. Based on free recall, this translates to an average annual quit attempt rate of 0.82 attempts per smoker. Estimates derived only from the preceding month to adjust for recall bias indicate an annual rate of approximately one attempt per smoker. There is a high prevalence of quit-related activity, with more than a third of smokers reporting thoughts or actions related to quitting in a given month. More than half the surveyed smokers eventually succeeded in quitting for at least 1 month, and a majority of these for over 6 months. Conclusions Smokers think a great deal about stopping and make many unsuccessful quit attempts. Many have been able to last for extended periods and yet they still relapsed. More attention needs to be focused on translating quit-related activity into long-term abstinence. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.


Borland R.,The Cancer Council Victoria | Yong H.-H.,The Cancer Council Victoria | O'Connor R.J.,Roswell Park Cancer Institute | Hyland A.,Roswell Park Cancer Institute | Thompson M.E.,University of Waterloo
Nicotine and Tobacco Research | Year: 2010

Background: There is increasing recognition that the two measures in the Heaviness of Smoking Index (HSI), time to first cigarette of the day (TTFC) and daily consumption (cigarettes per day [CPD]), are strong predictors of quitting behavior. Methods: Use of Waves 1-4 of International Tobacco Control cohort with around 8,000 respondents per wave and 6,000 for prediction of quit outcomes at the next wave. We measured TTFC and CPD at each wave and quit outcomes at the next wave. We also looked at the relative utility of the standard categorical scoring compared with a continuous score using the square root of CPD minus the natural log of TTFC in minutes. Results: We found considerable consistency of the measures across years with a small decrease as duration between measurements increased. For a 3-year gap, the correlations were .72 and .70 for the continuous and categorical composite HSI measures, respectively, and were at least .63 for the individual components. Both TTFC and CPD independently predicted maintenance of quit attempts (for at least 1 month) in each of the three wave-to-wave replications, and these effects were maintained when controlling for demographic factors. CPD also predicted making attempts consistently, but the results for TTFC was not consistently significant. Discussion: Both TTFC and CPD are fairly reliable over time and are important predictors of quitting. There are only small effects of mode of computing the scores, and the two items can be used either individually or combined as the HSI. © The Author 2010. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.


Siahpush M.,University of Nebraska Medical Center | Yong H.,The Cancer Council Victoria | Borland R.,The Cancer Council Victoria | Reid J.L.,University of Waterloo
Nicotine and Tobacco Research | Year: 2010

Introduction: Our aim was to investigate the association between socioeconomic position (income and education) and abrupt versus gradual method of smoking cessation. Methods: The analysis used data (n = 5,629) from Waves 1 through 6 (2002-2008) of the International Tobacco Control Four-Country Survey, a prospective study of a cohort of smokers in the United States, Canada, the United Kingdom, and Australia. Results: Logistic regression analyses using generalized estimating equations showed that higher income (p < .001) and higher education (p = .011) were associated with a higher probability of abrupt versus gradual quitting. The odds of adopting abrupt versus gradual quitting were about 40% higher among respondents with high income ($60,000 and more in the United States/Canada/Australia and £30,000 and more in the United Kingdom) compared with those with low income (less than $30,000 in the United States/Canada/Australia; £15,000 and less in the United Kingdom). Similarly, the odds of abrupt versus gradual quitting were about 30% higher among respondents with a high level of education (university degree) compared with those with a low level of education (high school diploma or lower). Discussion: Higher socioeconomic position is associated with a higher probability of quitting abruptly rather than gradually reducing smoking before quitting. © The Author 2010. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.


Partos T.R.,The Cancer Council Victoria | Borland R.,The Cancer Council Victoria | Siahpush M.,University of Nebraska Medical Center
Drug and Alcohol Review | Year: 2012

Introduction. Area-level indicators of socio-economic variation are frequently included in models of individual health outcomes. Area disadvantage is linearly related to smoking prevalence, but its relation to cessation outcomes is less well understood. Aims. To explore the relationship between area-level disadvantage and prospective data on smoking cessation. Design and Methods. The Australian cohort of the International Tobacco Control Four-Country Survey (N=3503) was used to prospectively examine the contribution of area-level socio-economic disadvantage to predicting three important smoking-cessation outcomes: making a quit attempt, achieving 1month abstinence and achieving 6month abstinence from smoking, while controlling for individual-level socio-economic indicators and other individual-level covariates related to smoking cessation. Results. Only two independent associations were observed between socio-economic disadvantage and cessation outcomes. Area-level disadvantage was related to 1month abstinence in a non-linear fashion, and the individual experience of smoking-induced deprivation was associated with a lower likelihood of making quit attempts. Discussion. Despite the documented higher prevalence of smoking among the more disadvantaged and in more disadvantaged areas, socio-economic disadvantage was not consistently related to making quit attempts, nor to medium-term success. Nevertheless, indirect effects of disadvantage, like its impact on psychological distress, cannot be ruled out, and considering smokers' individual psychosocial circumstances is likely to aid cessation efforts. Conclusion. Socio-economic disadvantage, particularly at the area level, poses few direct barriers to smoking cessation.[Partos TR, Borland R, Siahpush M. Socio-economic disadvantage at the area level poses few direct barriers to smoking cessation for Australian smokers: Findings from the International Tobacco Control Australian cohort survey. Drug Alcohol Rev 2012;31:653-663] © 2012 Australasian Professional Society on Alcohol and other Drugs.


Dixon H.G.,The Cancer Council Victoria | Warne C.D.,The Cancer Council Victoria | Scully M.L.,The Cancer Council Victoria | Wakefield M.A.,The Cancer Council Victoria | Dobbinson S.J.,The Cancer Council Victoria
Health Education and Behavior | Year: 2011

Content analysis data on the tans of 4,422 female Caucasian models sampled from spring and summer magazine issues were combined with readership data to generate indices of potential exposure to social modeling of tanning via popular women's magazines over a 15-year period (1987 to 2002). Associations between these indices and cross-sectional telephone survey data from the same period on 5,675 female teenagers' and adults' tanning attitudes, beliefs, and behavior were examined using logistic regression models. Among young women, greater exposure to tanning in young women's magazines was associated with increased likelihood of endorsing pro-tan attitudes and beliefs. Among women of all ages, greater exposure to tanned models via the most popular women's magazines was associated with increased likelihood of attempting to get a tan but lower likelihood of endorsing pro-tan attitudes. Popular women's magazines may promote and reflect real women's tanning beliefs and behavior.© 2011 by SOPHE.


Fotuhi O.,University of Waterloo | Fong G.T.,University of Waterloo | Fong G.T.,Ontario Cancer Institute | Zanna M.P.,University of Waterloo | And 3 more authors.
Tobacco Control | Year: 2013

Objective The purpose of this paper is to assess whether smokers adjust their beliefs in a pattern that is consistent with Cognitive Dissonance Theory. This is accomplished by examining the longitudinal pattern of belief change among smokers as their smoking behaviours change. Methods A telephone survey was conducted of nationally representative samples of adult smokers from Canada, the USA, the UK and Australia from the International Tobacco Control Four Country Survey. Smokers were followed across three waves (October 2002 to December 2004), during which they were asked to report on their smoking-related beliefs and their quitting behaviour. Findings Smokers with no history of quitting across the three waves exhibited the highest levels of rationalisations for smoking. When smokers quit smoking, they reported having fewer rationalisations for smoking compared with when they had previously been smoking. However, among those who attempted to quit but then relapsed, there was once again a renewed tendency to rationalise their smoking. This rebound in the use of rationalisations was higher for functional beliefs than for risk-minimising beliefs, as predicted by social psychological theory. Conclusions Smokers are motivated to rationalise their behaviour through the endorsement of more positive beliefs about smoking, and these beliefs change systematically with changes in smoking status. More work is needed to determine if this cognitive dissonancereducing function has an inhibiting effect on any subsequent intentions to quit.


Borland R.,The Cancer Council Victoria | Savvas S.,The Cancer Council Victoria
Tobacco Control | Year: 2014

Objectives: To examine the effects that variant descriptor labels on cigarette packs have on smokers' perceptions of those packs and the cigarettes contained within. Method: As part of two larger web-based studies (each involved 160 young adult ever-smokers 18-29 years old), respondents were shown a computer image of a plain cigarette pack and sets of related variant descriptors. The sets included terms that varied in terms of descriptors of colours as names, flavour strength, degrees of filter venting, filter types, quality, type of cigarette and numbers. For each set, respondents rated the highest and lowest of two or three of the following four characteristics: quality, strongest or weakest in taste, delivers most or least tar/nicotine, and most or least level of harm. Results: There were significant differences on all four ratings. Quality ratings were the least differentiated. Except for colour descriptors, where 'Gold' rated high in quality but medium in other ratings, ratings of quality, harm, strength and delivery were all positively associated when rated on the same descriptors. Conclusions: Descriptor labels on cigarette packs, can affect smokers' perceptions of the characteristics of the cigarettes contained within. Therefore, they are a potential means by which product differentiation can occur. In particular, having variants differing in perceived strength while not differing in deliveries of harmful ingredients is particularly problematic. Any packaging policy should take into account the possibility that variant descriptors can mislead smokers into making inappropriate product attributions.


Johnson G.,Diabetes Australia | Martin J.E.,The Cancer Council Victoria
Medical Journal of Australia | Year: 2015

Strong evidence from randomised controlled trials shows type 2 diabetes can be prevented in up to 58% of people at high risk, through structured lifestyle intervention.Good evidence and experience obtained from translational studies in Australia shows we can deliver effective community-based prevention programs.To be effective, a national strategy for prevention of type 2 diabetes should involve two concurrent approaches — a targeted approach aimed at those most at risk (ie, with prediabetes) combined with an environments, systems and behaviour approach for the entire population.Australia’s current efforts in both these areas are not nationwide, not large scale and often not sustained.About 2 million Australians have prediabetes and are at high risk of developing type 2 diabetes.Type 2 diabetes is a fast-growing epidemic and the economic costs are estimated to be $14.6 billion per year in Australia.


Mutti S.,University of Waterloo | Hammond D.,University of Waterloo | Borland R.,The Cancer Council Victoria | Cummings M.K.,Roswell Park Cancer Institute | And 3 more authors.
Addiction | Year: 2011

Aims To examine perceptions of risk related to type of cigarette brand. Design and setting Cross-sectional findings from wave 5 of the ITC Four Country Survey, conducted with nationally representative samples of smokers in 2006. Participants A total of 8243 current and former adult (≥18 years) smokers from Canada (n=2022), the United States (n=2034), the United Kingdom (n=2019) and Australia (n=2168). Measurements Outcomes included beliefs about the relative risks of cigarettes, including perceptions of 'own' brand. Correlates included socio-demographic, smoking-related covariates and brand characteristics. Findings One-fifth of smokers believed incorrectly that 'some cigarette brands could be less harmful' than others. False beliefs were higher in both the United States and United Kingdom compared to Canada and Australia. Smokers of 'light/mild', 'slim' and 100mm/120mm cigarettes were more likely to believe that some cigarettes could be less harmful [odds ratio (OR)=1.29, 95% confidence interval (CI)=1.12-1.48 and that their own brand might be a little less harmful (OR=2.61, 95% CI=2.01-3.41). Smokers of 'gold', 'silver', 'blue' or 'purple' brands were more likely to believe that their 'own brand might be a little less harmful' compared to smokers of 'red' or 'black' brands (OR=12.48, 95% CI=1.45-107.31). Conclusions Despite current prohibitions on the words 'light' and 'mild', smokers in western countries continue to falsely believe that some cigarette brands may be less harmful than others. These beliefs are associated with descriptive words and elements of package design that have yet to be prohibited, including the names of colours and long, slim cigarettes. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

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