VicHealth Center for Tobacco Control

Carlton, Australia

VicHealth Center for Tobacco Control

Carlton, Australia
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Borland R.,VicHealth Center for Tobacco Control | Savvas S.,VicHealth Center for Tobacco Control | Sharkie F.,VicHealth Center for Tobacco Control | Moore K.,Monash University
Tobacco Control | Year: 2013

Objectives To examine the extent that novel cigarette pack shapes and openings have on smokers' perceptions of those packs and the cigarettes contained within. Method Using a web-based survey, 160 young adult ever-smokers (18-29 years) were shown computer images of plain packaged cigarette packs in five different shapes. This was followed by packs illustrating five different methods of opening. Brand (prestige or budget) and size of the health warnings (30% or 70% warning size) were between-subject conditions. Respondents ranked packs on attractiveness, perceived quality of the cigarettes contained within and extent that the pack distracted from health warnings. Results Ratings of attractiveness and perceived quality were significantly associated in both substudies, but tendency to distract from warnings was more independent. Significant differences were found between the pack shapes on attractiveness, perceived quality and distraction from warnings. Standard, 2×10 and 4×5 packs were ranked less attractive than Bevelled and Rounded packs. 2×10 and 4×5 packs were also perceived as lower quality than Bevelled and Rounded packs. The Standard pack was less distracting to health warnings than all other shapes except the 2×10 pack. Pack openings were perceived as different on quality of cigarettes contained and extent of distraction to warnings. The Standard Flip-top was rated significantly lower in distracting from warnings than all other openings. Conclusions Pack shape and pack opening affect ever-smokers' perceptions of the packs and the cigarettes they contain. This means that they have the potential to create appeal and differentiate products and thus should be regulated.


Vangeli E.,University College London | Stapleton J.,University College London | Smit E.S.,Maastricht University | Borland R.,VicHealth Center for Tobacco Control | West R.,University College London
Addiction | Year: 2011

Aims To identify the predictors of attempts to stop smoking and the predictors of quit attempt success in adult general population samples. Methods We performed an electronic search of EMBASE, Pubmed, Web of Science, PsychINFO and the Cochrane Tobacco Addiction Group specialized register for articles that examined, in prospective adult general population samples, predictors of quit attempts and the success of quit attempts. Experts were contacted for knowledge of other relevant studies. Eight studies met the inclusion criteria and results were extracted independently by two researchers. Results There was considerable methodological heterogeneity between studies. Motivational factors dominated the prediction of quit attempts, whereas only cigarette dependence consistently predicted success after an attempt had been made. Social grade also appeared to predict success but was only examined in two studies. None of the other socio-demographic factors consistently predicted making a quit attempt or success. Conclusions Population-level studies from a number of countries show that past quit attempts and measures of motivation to stop are highly predictive of quit attempts, whereas only measures of dependence are consistently predictive of success of those attempts. Gender, age and marital status and educational level are not related consistently to quit attempts or quit success across countries. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.


Balmford J.,VicHealth Center for Tobacco Control | Borland R.,VicHealth Center for Tobacco Control | Hammond D.,University of Waterloo | Cummings K.M.,Roswell Park Cancer Institute
Nicotine and Tobacco Research | Year: 2011

Introduction: Nicotine replacement therapies (NRTs) have been demonstrated to be effective in clinical trials but may have lower efficacy when purchased over-the-counter (OTC). Premature discontinuation and insufficient dosing have been offered as possible explanations. The aims are to (a) investigate the prevalence of and reasons for premature discontinuation of stop-smoking medications (including prescription only) and (b) how these differ by type, duration of use, and source (prescription or OTC). Methods: The sample includes 1,219 smokers or recent quitters who had used medication in the last year (80.5% NRT, 19.5% prescription only). Data were from Waves 5 and 6 of the International Tobacco Control (ITC) Four-Country Survey. Results: Most of the sample (69.1%) discontinued medication use prematurely. This was more common among NRT users (71.4%) than in users of bupropion and varenicline (59.6%). OTC NRT users were particularly likely to discontinue (76.3%). Relapse back to smoking was the most common reason for discontinuation of medication reported by 41.6% of respondents. Side effects (18.3%) and believing that the medication was no longer needed (17.1%) were also commonly reported. Of those who completed treatment, 37.9% achieved 6-month continuous abstinence compared with 15.6% who discontinued prematurely. Notably, 65.6% who discontinued because they believed the medication had worked were abstinent. Conclusions: Premature discontinuation of stop-smoking medications is common but is not a plausible reason for poorer quit outcomes for most people. Encouraging persistence of medication use after relapse or in the face of minor side effects may help increase long-term cessation outcomes. © The Author 2010. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.


Borland R.,VicHealth Center for Tobacco Control
Tobacco Control | Year: 2016

This commentary argues that a nicotine reduction strategy for tobacco control is a secondary strategy to the wider availability of low toxin forms of nicotine to give smokers a viable alternative to cigarettes. Failure to confront the likely reality of continued nicotine use and to make it as low in harm as possible may prolong the tobacco epidemic. © 2016 by the BMJ Publishing Group Ltd.


To investigate the links between health warning labels (WLs) on cigarette packets and relapse among recently quit smokers. Prospective longitudinal cohort survey. Australia, Canada, the UK and the USA. 1936 recent ex-smokers (44.4% male) from one of the first six waves (2002-2007) of the International Tobacco Control 4-Country policy evaluation survey, who were followed up in the next wave. Whether participants had relapsed at follow-up (approximately 1 year later). In multivariate analysis, very frequent noticing of WLs among ex-smokers was associated with greater relapse 1 year later (OR: 1.52, 95% CI 1.11 to 2.09, p<0.01), but this effect disappeared after controlling for urges to smoke and self-efficacy (OR: 1.29, 95% CI 0.92 to 1.80, p=0.135). In contrast, reporting that WLs make staying quit 'a lot' more likely (compared with 'not at all' likely) was associated with a lower likelihood of relapse 1 year later (OR: 0.65, 95% CI 0.49 to 0.86, p<0.01) and this effect remained robust across all models tested, increasing in some. This study provides the first longitudinal evidence that health warnings can help ex-smokers stay quit. Once the authors control for greater exposure to cigarettes, which is understandably predictive of relapse, WL effects are positive. However, it may be that ex-smokers need to actively use the health consequences that WLs highlight to remind them of their reasons for quitting, rather than it being something that happens automatically. Ex-smokers should be encouraged to use pack warnings to counter urges to resume smoking. Novel warnings may be more likely to facilitate this.


Balmford J.,VicHealth Center for Tobacco Control | Borland R.,VicHealth Center for Tobacco Control | Benda P.,University of Melbourne | Howard S.,University of Melbourne
Health Education Research | Year: 2013

The aim was to better understand structural factors associated with uptake of automated tailored interventions for smoking cessation. In a prospective randomized controlled trial with interventions only offered, not mandated, participants were randomized based on the following: web-based expert system (QuitCoach); text messaging program (onQ); both as an integrated package; the choice of using either or both; or a control condition informed of a static website (not considered here). Participants were 3530 smokers or recent quitters recruited from two sources; those seeking smoking cessation information, mostly recruited over the phone, and a cold-contacted group recruited from an Internet panel. More participants (60.1) initially accepted the intervention they had been offered than used it (42.5). Uptake of each intervention differed substantially by both recruitment source and modality (phone or web). onQ was a little more popular overall, especially in the information seeker sample. Highest overall intervention uptake occurred in the choice condition. A web-based intervention is most attractive if the offer to use is made by web, whereas a phone-based intervention is more likely to be used if the offer is made over the phone. Providing automated interventions on multiple platforms allows for maximal choice and greatest overall use of some form of help. © The Author 2012.


Borland R.,VicHealth Center for Tobacco Control | Savvas S.,National Ageing Research Institute
Tobacco Control | Year: 2013

Objective To examine the extent (if any) that cigarette stick dimension, tipping paper design and other decorative design/branding have on Australian smokers' perceptions of those cigarettes. Methods An internet survey of 160 young Australian adult ever-smokers who were shown computer images of three sets of cigarette sticksdfive sticks of different lengths and diameters (set A), five sticks with different tipping paper design (set B) and four sticks of different decorative design (set C). Branding was a between-subjects randomised condition for set C. For each set, respondents ranked sticks on most and least attractive, highest and lowest quality and strongest and weakest taste. Results Cigarette sticks were perceived as different on attractiveness, quality and strength of taste. Standard stick length/diameter was perceived as the most attractive and highest quality stick, with men more inclined to rate a slim stick as less attractive. A stick with a cork-patterned tipping paper and a gold band was seen as most attractive, of highest quality and strongest in taste compared to other tipping designs. Branded sticks were seen as more attractive, higher in quality and stronger tasting than non-branded designs, regardless of brand, although the effects were stronger for a prestige compared with a budget brand. Conclusions Characteristics of the cigarette stick affect smokers' perceptions of the attributes of those cigarettes and thus are a potential means by which product differentiation can occur. A comprehensive policy to eliminate promotional aspects of cigarette design and packaging needs to include rules about stick design.


Balmford J.,VicHealth Center for Tobacco Control | Borland R.,VicHealth Center for Tobacco Control
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco | Year: 2014

INTRODUCTION: Mobile-phone-based text (SMS) messaging is an effective method for delivering smoking cessation assistance; however, little is known about optimal program use. This paper reports on the use of 2 forms of interaction (reporting changes in quit status and emergency help) among users of QuitTxt, an interactive, automated text messaging advice program. We examined preferences for messaging intensity, duration of use, and their associations with short-term cessation outcome or perceived helpfulness.METHODS: QuitTxt was offered during participation in a previously reported randomized controlled trial and was activated by 924 smokers or recent quitters, of whom 862 used it to a criterion level. Outcome data (quit attempts, 7-day point prevalence abstinence, and perceived helpfulness) were collected 1 month after first use.RESULTS: Most (68.9%) accepted the default of 4-8 messages per day, and median use duration was 27 days. Half (49.1%) appeared to miss reporting at least 1 status change, with relapses less likely to be reported than quit progression. Emergency help was used by 27.0% of those eligible for it; emergency help was used more frequently among those with recent quit experience and lower nicotine dependence. Use of emergency help was unrelated to short-term cessation outcome.CONCLUSIONS: The most notable finding is the variability in use. Some users complied fully with the requirement to report status changes, while even among those who did not, many found QuitTxt to be very helpful, suggesting that perfect congruence between message content and quit status is not essential. The use of emergency help functionality was relatively rare but was appreciated. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.


King B.,VicHealth Center for Tobacco Control
Tobacco control | Year: 2010

This study explored the extent to which Malaysian and Thai smokers believe "light" and menthol cigarettes are less harmful than "regular" cigarettes and the correlates of these beliefs. The study used data from wave 1 of the International Tobacco Control Southeast Asia Survey. 2006 adult smokers (95.3% male) from Malaysia and 2000 adult smokers (94.5% male) from Thailand were interviewed face to face in 2005. 29% of Malaysian respondents reported currently smoking light cigarettes and 14% menthols, with 19% agreeing that lights are less harmful and 16% agreeing that menthols are less harmful. 38% of Thai respondents reported currently smoking light cigarettes and 19% menthols, with 46% agreeing that lights are less harmful and 35% agreeing that menthols are less harmful. Malaysian smokers reporting current use of light or menthol cigarettes were more likely to believe that they are less harmful. Reported use of lights did not relate to beliefs for Thai respondents. The belief that light and/or menthol cigarettes are less harmful was strongly related to the belief that they have smoother smoke. The experience of smoother smoke is likely to produce some level of belief in reduced harm, regardless of how brands are labelled and whether or not Federal Trade Commission FTC/International Organisation for Standardisation tar, nicotine and carbon monoxide yield figures are used.


Borland R.,VicHealth Center for Tobacco Control | Partos T.R.,VicHealth Center for Tobacco Control | Cummings K.M.,Roswell Park Cancer Institute
Nicotine and Tobacco Research | Year: 2012

Introduction: Randomized, controlled trials typically indicate stop-smoking medications (SSMs: e.g., Varenicline, Bupropion, and over-the-counter nicotine replacement therapies) to be effective, whereas cross-sectional community-based studies have found them to be less effective, ineffective, or even associated with higher risk of relapse. Consequently, some critics have suggested SSMs have no useful applications in "real-world"settings. This discrepancy may, however, be due to systematic biases affecting cross-sectional survey outcomes. Namely, failed quit attempts where SSMs were used may be better recalled than failed unassisted attempts. Moreover, smokers who choose to quit using SSMs may be more addicted and thus less likely to succeed. Either of these factors would lead to an over-representation of failed quit attempts among SSM users in cross-sectional surveys even if there were real benefits. Methods: We report on data from the International Tobacco Control 4-country cohort study to examine the relationship between SSM use, level of nicotine addiction, and the reported date since the start of participants' (N = 1,101) most recent quit attempt. Results: The last quit attempt was reported to have begun longer ago among participants who used SSMs than those who did not. Scores on the Heaviness of Smoking Index, measuring addiction severity, were also higher among SSM users, with no interactions. Conclusion: Better recall of quit attempts and stronger addiction to nicotine are two characteristics found more often among smokers using SSMs compared with self-quitters, which could potentially bias the assessed effects of SSMs on cessation outcomes in cross-sectional surveys. © The Author 2012.

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