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Gruer L.,NHS Health Scotland | Tursan d'Espaignet E.,Tobacco free Initiative | Haw S.,University of Stirling | Fernandez E.,Tobacco Control Unit | Mackay J.,World Lung Foundation
Public Health | Year: 2012

Article 8 of the World Health Organization Framework Convention on Tobacco Control (2005) requires all signatory countries to adopt measures to protect people from tobacco smoke in indoor workplaces, indoor public places, public transport and other public places as appropriate. The aims of this symposium were to review progress across the world, to assess the evidence for the impact of legislation on health, and to identify the continuing challenges in making universal protection a reality. There was agreement that even in countries where strict legislation is enforced, many children continue to be dangerously exposed to parental second-hand smoke in the womb, the home and private cars. The importance of using accurate estimates of the burden of disease caused by second-hand smoke was agreed, in order to present an unassailable case for legislation and enforcement. © 2012 The Royal Society for Public Health. Source

Wilson N.,University of Otago | Weerasekera D.,University of Otago | Borland R.,Tobacco Control Unit | Edwards R.,University of Otago | And 2 more authors.
Nicotine and Tobacco Research | Year: 2010

Introduction: We aimed to describe use of a national quitline service and the variation in its use by smoker characteristics (particularly ethnicity and deprivation). The setting was New Zealand (NZ), which takes proactive measures to attract disadvantaged smokers to this service. Methods: The NZ arm of the International Tobacco Control Policy Evaluation Survey (ITC Project) utilizes the New Zealand Health Survey (a national sample) from which we surveyed adult smokers in two waves (N = 1,376 and N = 923) 1 year apart. Results: Quitline use in the last 12 months rose from 8.1% (95% CI = 6.3%-9.8%) in Wave 1 to 11.2% (95% CI = 8.4%-14.0%) at Wave 2. Māori (the indigenous people of NZ) were significantly more likely to call the Quitline than were European/other smokers. Relatively higher call rates also occurred among those reporting higher deprivation, financial stress, a past mental health disorder, a past drug-related disorder, and higher psychological distress (Kessler 10-item index). Independent associations in the multivariate analyses of Quitline use were being Māori, reporting financial stress, and ever having been diagnosed with a mental health disorder. Discussion: This national Quitline service is successfully stimulating disproportionately more calls by Māori smokers and those with some measures of disadvantage. It may therefore be contributing to reducing health inequalities. It appears possible to target quitlines to reach those smokers in greatest need. © The Author 2010. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. Source

Gartner C.,University of Queensland | Scollo M.,Tobacco Control Unit | Marquart L.,Queensland Institute of Medical Research | Mathews R.,University of Queensland | Hall W.,University of Queensland
Australian and New Zealand Journal of Public Health | Year: 2012

Objective: According to the 'hardening hypothesis', the proportion of smokers that are 'low-probability quitters' will increase as societal disapproval of smoking increases. This paper examines whether there has been increased hardening in Australian smokers over the past decade as reflected in an increased prevalence of psychological distress and social disadvantage among current smokers. Methods: The relationship between psychological distress, living in a disadvantaged area and level of education was determined using logistic regression at two time points 7 to 10 years apart in three cross-sectional household survey series: National Drug Strategy Household Survey (NDSHS), National Health Survey (NHS) and National Survey of Mental Health and Well-being (NSMHW). Results: The relationships between smoking and living in the most disadvantaged areas and having completed less than 12 years of schooling strengthened between 2001 and 2010 in the NDSHS, but there were no significant changes between survey years in the NHS and NSMHW. There was no significant change in the relationship between smoking and psychological distress between survey years in any of the survey series. Conclusion: Social disadvantage may be increasing among current smokers, but the results were inconsistent between survey series, presenting weak evidence that the population of Australian smokers hardened as smoking prevalence declined by approximately 4% over the last decade. Implications: A greater focus on intensive individual-level tobacco cessation interventions does not appear warranted at this time. © 2012 The Authors. Source

Young D.,Tobacco Control Unit | Yong H.-H.,Tobacco Control Unit | Borland R.,Tobacco Control Unit | Shahab L.,University College London | And 3 more authors.
Journal of Environmental and Public Health | Year: 2012

Objective. To establish the trends in prevalence, and correlates, of roll-your-own (RYO) use in Canada, USA, UK and Australia, 2002-2008. Methods. Participants were 19,456 cigarette smokers interviewed during the longitudinal International Tobacco Control (ITC) Four-Country Survey in Canada, USA, UK, and Australia. Results. Predominant RYO use (i.e., 50 of cigarettes smoked) increased significantly in the UK and USA as a proportion of all cigarette use (both P <.001) and in all countries as a proportion of any RYO use (all P <.010). Younger, financially stressed smokers are disproportionately contributing to some use (i.e., 50 of cigarettes smoked). Relative cost was the major reason given for using RYO, and predominant RYO use is consistently and significantly associated with low income. Conclusions. RYO market trends reflect the price advantages accruing to RYO (a product of favourable taxation regimes in some jurisdictions reinforced by the enhanced control over the amount of tobacco used), especially following the impact of the Global Financial Crisis; the availability of competing low-cost alternatives to RYO; accessibility of duty-free RYO tobacco; and tobacco industry niche marketing strategies. If policy makers want to ensure that the RYO option does not inhibit the fight to end the tobacco epidemic, especially amongst the disadvantaged, they need to reduce the price advantage, target additional health messages at (young) RYO users, and challenge niche marketing of RYO by the industry. Copyright © 2012 David Young et al. Source

Pastorino U.,Thoracic Surgery Unit | Boffi R.,Tobacco Control Unit | Marchiano A.,Radiology Unit | Sestini S.,Thoracic Surgery Unit | And 11 more authors.
Journal of Thoracic Oncology | Year: 2016

Introduction: The National Lung Screening Trial has achieved a 7% reduction in total mortality with low-dose computed tomography (LDCT) screening as compared with in the chest radiography arm. Other randomized trials are under way, comparing LDCT screening with no intervention. None of these studies was designed to investigate the impact of smoking habits on screening outcome. In the present study, we tested the effect of stopping smoking on the overall mortality of participants undergoing repeated LDCT screening for many years. Methods: Between 2000 and 2010, 3381 smokers aged 50 years or older were enrolled in two LDCT screening programs. On the basis of the last follow-up information, subjects were divided into two groups: current smokers throughout the screening period and former smokers. Results: With a median follow-up time of 9.7 years and a total of 32,857 person-years (PYs) of follow-up, a total of 151 deaths were observed in the group of 1797 current smokers (17,846 PYs) versus 109 among 1584 former smokers (15,011 PYs), corresponding to mortality rates of 8.46 and 7.26 for every 1000 PYs, respectively. Compared with current smokers, former smokers had an adjusted mortality hazard ratio of 0.61 (95% confidence interval: 0.44-0.83), with a 39% reduction in mortality. A similar reduction in mortality was observed in the subset of 712 late quitters, with a hazard ratio of 0.65 (95% confidence interval: 0.44-0.96). Conclusions: Stopping smoking significantly reduces the overall mortality of smokers enrolled in LDCT screening programs. The beneficial effect of stopping smoking on total mortality appears to be threefold to fivefold greater than the one achieved by earlier detection in the National Lung Screening Trial. © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved. Source

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