Objective: The main objective was to examine characteristics associated with cigarette access behaviours among underage current youth smokers. Methods: This cross-sectional study used self-reported data collected from 29,296 students in Grades 9 to 12 who participated in the 2008-09 Youth Smoking Survey (YSS), and data from the 2008-09 DMTI-EPOI (Enhanced Points of Interest) data file. Multilevel logistic regression analyses were used to jointly examine whether student characteristics and the number of tobacco retailers surrounding schools were associated with the odds of a current youth smoker accessing cigarettes from: (a) a retailer source, (b) a family member, and (c) a friend or someone else. Results: Among underage current smokers, the majority reported usually buying their own cigarettes from a retailer (44.1%), and getting cigarettes from a friend or someone else (42.2%). Significant between-school random variation was identified for youth cigarette access from a retailer source, and from a friend or stranger. Males were more likely to buy their own cigarettes from a retailer (OR 2.08, 95% CI 1.74-2.48), whereas females were more likely to access cigarettes from a family member (OR 0.68, 95% CI 0.53-0.88), or a friend or someone else (OR 0.52, 95% CI 0.44-0.61). Binge smoking was associated with buying cigarettes from a retailer (OR 0.65, 95% CI 0.48-0.86). Youth with a smoking parent or guardian (OR 2.95, 95% CI 2.02-4.31) were more likely to get cigarettes from a family member. Youth who reported that they sometimes (OR 2.80, 95% CI 1.94-4.04), or usually or always (OR 3.15, 95% CI 2.17-4.58) share cigarettes with others was associated with accessing cigarettes from a friend or someone else. Each additional tobacco retailer surrounding a school was associated with an increased likelihood of youth purchasing their own cigarettes from a retailer (OR 1.04, 95% CI 1.01-1.07). Conclusion: Tobacco point-of-sale restrictions are inadequate as youth can still procure cigarettes from both retailers and social sources. Future studies should explore beyond individual-level factors and examine what influences cigarette access behaviours in the broader school context. Such insight will inform the development of new school-level tobacco control initiatives that can more effectively prevent youth from acquiring cigarettes.

Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, Biyokimya ve Klinik Biyokimya Anabilim Dalı, 2001. / Bibliyografya var.

This thesis deals with the issue of smoking. It is a serious global problem. Illnesses and death associated with smoking are among the most important problems of Public health in most countries. The risk of damage threatens not only to active smokers but also those who are exposed to passive smoking. Abuse of tobacco is clearly linked to cardiovascular diseases, cancer and other serious diseases. Most smokers begin to smoke no longer in secondary schools. According to Kalina (2003) is modus 14 years. Therefore, preventive activities must be realized before this period. School (outside of family and peers) affects education, attitudes and values of the student. Compulsory school attendance does from primary schools ideal environment for implementation preventive activities. That is reason why I wanted to know if and how well schools use an education as a means of primary prevention. Theoretical part contains the terminology associated with tobacco issues, further a history of tobacco and methods of tobacco and nicotine use. The following chapters provide information of substances contained in cigarettes, selected diseases, prevention, legislation, cessation and withdrawal symptoms and methods of quitting. I used a quantitative method for research in the practical part. Respondents were selected from among pupils from primary schools of Strakonice. At each of the schools in Strakonice I addressed to 50 pupils. First half of them were educated and second half were not. Two hundred of students were interviewed together. I discarded two questionnaires. Total quantity of respondents was 198 students. Questionnaire contained 20 questions, which was designed for students of second grade of elementary school. I set three targets. The main target was to map the problem of smoking among pupils of primary schools in Strakonice, evaluate the impact of education on the knowledge of the respondents and ascertain the views of students on the quality of education. Research has shown that the prevalence of smokers among students of second grade of elementary school in Strakonice is lower than prevalence by GYTS. Older pupils (who were educated) smoke to the greater extent (15.3 %) than younger (uneducated) pupils (6 % smokers). More than 70 % of smokers want to quit the smoking. Almost 26 % of respondents tolerate smoking of other people. Impact of education was assessed by the knowledge part of the questionnaire. It contained eight questions with a choice of four answers, only one was correct. The quality of information obtained in the school, most pupils assessed as good or marginal. These three hypotheses were created: the prevalence of smokers among respondents is higher with higher age, there is a statistically significant difference in knowledge of the issue of smoking between educated and uneducated pupils, and school provides respondents more information than other sources. For statistical verification was used the chi-square test at a significance level of 5 %. The first and second hypothesis was confirmed. A third hypothesis was refuted. Most pupils answered: media (television, internet...), school and family. The quantity of answers was balanced and so we can't talk about a statistically significant difference. Survey has enabled me to become a teacher for two hours. I was able teach sixth grade pupils in the issue of smoking. I have gotten so complex idea about the role of education in primary prevention. I was also convinced that it is necessary to grasp the issue from the perspective of pupil, not teacher. The theoretical part of the thesis can serve as educational material for students, teachers and the public. The practical part can be used to compare the results with other works or to monitor trends of smoking in Strakonice.

E-cigarette use has been increasing in recent years, and its ultimate public health impact is still unknown. In order to assess the addictive liability of these products, research is needed to investigate the roles of nicotine and other factors on psychological and physical effects of “vaping.” The goal of the current study was to investigate the role of expectancies, nicotine delivery, and their interactions on the effects of e-cigarette use via a balanced-placebo experiment. In this design, drug dosage (contains nicotine or not) was crossed with instructions (told nicotine or non-nicotine) during ad-lib e-cigarette use sessions by 128 current e-cigarette users. This design allows for parsing of the causal role of expectancies and pharmacology, as well as their interaction. Dependent variables included both psychological outcomes (cravings for cigarettes and e-cigarettes, mood, satisfaction, reward) and physiological variables (hunger, attention, aversion, respiratory tract sensations). Among cigarette smokers (n=52), a significant main effect of instruction emerged on reductions in craving to smoke, although moderation analyses revealed that this effect was limited to males. Overall, significant drug X instruction interactions were found on craving to vape, psychological reward, and enjoyment of respiratory tract sensations, indicating synergistic causal influences of both expectancies and nicotine. Expectancies, smoking status, and gender moderated some of these effects. The results of this study identified effects of e-cigarettes that were driven by either nicotine, cognitive drug expectancies, or both. Results should be considered in the context of methodological and theoretical limitations. This study contributes to the understanding of motivational influences that may affect the initiation and maintenance of e-cigarette use, which may guide the development of public health and clinical interventions.

Prior research found that female smokers with elevated dietary restraint (“high-restrainers”) smoked more after a disinhibiting food event (Kovacs, Correa, & Brandon, 2014). The current study aimed to determine if high-restrainers smoked merely to distract themselves from eating, or if the appetite/weight-control aspects of smoking played a role. Female smokers (N = 128) attended a laboratory session and were randomized to receive a milkshake prime (Prime condition) or not (No-Prime condition). All participants then received ad-lib access to tempting foods, cigarettes, and a computer tablet with internet access. Our main aims were to test the effect of the prime on smoking and eating behavior in the presence of an alternative distractor (i.e. the tablet). We expected high-restrainers in the Prime condition to demonstrate preference for cigarettes even in the presence of an alternative distractor. Primary analyses utilized hierarchical regression models with condition and several moderators as predictors of consumption behavior. Condition was predictive of total cigarette smoked (p’s<.02), indicating that those in the Prime condition smoked more. Regardless of condition, several expectancy measures predicted cigarette consumption (p’s < .05), and higher level of dietary restraint predicted shorter latency to smoke (p= .017). Additionally, lower levels of trait mindfulness were associated with elevated dietary restraint, cigarette craving at baseline and expectancies about cigarettes’ weight control properties. Importantly, latency to use the tablet was not predicted by level of dietary restraint or expectancies. Although dietary restraint and expectancies did not interact with condition to predict levels of smoking, the overall findings suggest that :1. The traditional priming effect was apparently mitigated in the presence of appealing distracting stimuli ;and 2. Dietary restrainers attempt to prevent food consumption by turning to cigarettes, choosing to utilize cigarettes above and beyond preference for other salient distracting stimuli. Therefore, smoking appears to be more than just a distractor from eating, and is also associated with strong beliefs about weight and appetite control. These findings may inform interventions aimed at the high-risk population of young adult female smokers, and mindfulness-based strategies may prove especially useful.

The paper addresses the impact of smoking in the Czech Republic in 2009. The aim is to describe the current facts and trends of tobacco consumption, assess the mortality attributable to smoking, compute its financial impact on the Czech state budget, evaluate the transmission of tax changes into the retail price of cigarettes, assess consumer price elasticity for cigarettes, and compute a fair excise tax on cigarettes for the Czech Republic as well as the tax which would maximise the benefits of smoking for the state budget. For our purposes, we define fairness as a situation in which there is no net redistribution of state budget funds between two groups of citizens: non-smokers and smokers. Smokers create benefits (for example, savings on pensions due to their earlier deaths) and costs (for instance, increased health care costs) for the state budget. We search for a tax rate that would balance smoking-associated costs and benefits. Furthermore, we also compute the tax which would maximise net revenues from smoking to the government. We realised these findings for the Czech Republic, 2009: we observed that there were 22,013 deaths attributable to smoking. About 2.281 billion cigarettes were sold illegally. The costs to the state budget caused by smoking were estimated to 30,547 million CZK,...

INTRODUCTION: Smoking is the leading cause of preventable death in the United States and has been shown to be harmful to human health. Among alternative tobacco products, e-cigarettes have been widely regarded as the safest substitute to the traditional cigarette. However, debate remains about their safety and possible ill effects. AIM: The purpose of this study was to assess characteristics associated with e-cigarette use (everyday/some days/no use) and examine factors related to former smokers replacing a traditional smoking habit with e-cigarette use (yes/no). METHODS: A secondary data analysis was conducted with the Public Use Files (PUFs) for the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative, longitudinal cohort study of tobacco use. Bivariate and multivariable unweighted and weighted generalized linear models were developed for value and comparative purposes, as well as multilevel models to account for within geographical region clustering. Ordinal logistic regression was used to analyze the ordinal e-cigarette use outcome, and logistic regression with the e-cigarette smoking status of former smokers outcome. RESULTS: Covariates associated with e-cigarette use included having rules that allowed smoking non-combustible tobacco inside the home (everyday vs no use: OR = 0.33, CI = 0.27-0.41; somedays vs no use: OR = 0.58, CI = 0.53-0.64), older than 35 years old (everyday vs no use: OR = 0.63, CI = 0.52-0.75; somedays vs no use: OR = 0.86, CI = 0.76-0.96), and positive or neutral self-opinion on tobacco (everyday vs no use: OR = 0.88, CI = 0.73-1.05; somedays vs no use: OR = 1.38, CI = 1.22-1.55). Factors related to e-cigarette use in former smokers included rules allowing non-combustible tobacco products inside the home (Weighted: OR = 0.19, CI = 0.15-0.24; Unweighted: OR = 0.15, CI = 0.12-0.19; Mixed: OR = 0.19, CI = 0.15-0.24), aged 18-35 years (Weighted: OR = 1.45, CI = 1.16-1.80; Unweighted: OR = 2.91, CI = 2.27-3.72; Mixed: OR = 1.45, CI = 1.16-1.80), and not having any health insurance (Weighted: OR = 0.57, CI = 0.44-0.75; Unweighted: OR = 0.47, CI = 0.34-0.64; Mixed: OR = 0.57, CI = 0.44-0.75). DISCUSSION: Family tolerance of smoking and one’s self-opinion on tobacco were factors found to be strongly associated with e-cigarette use. The prevalence of e-cigarette use among young adults raises concerns and necessitates a multi-disciplinary approach to monitor and intervene. Further study is needed to better understand e-cigarette smoking consumption behavior and effects.

With the entry into force of the Second Tobacco Products Directive1 (hereinafter TPD), new labelling requirements for tobacco products are being introduced for ensuring greater protection of public health. Notably, the TPD harmonises minimum requirements of the WHO’s Framework Convention on Tobacco Control and its Guidelines, consisting of pictorial warnings and information about the harmful effects of smoking (Article 9 and 10 TPD), covering 65% of the tobacco package2, but also provides the possibility for Member States to introduce further more stringent measures (Article 24(2) TPD). Only brand names in a standard font are allowed to be displayed on a package with neutral colour without any trademarks.3 This thesis is specifically concerned with the effect of the TPD’s new labelling requirements (plain packaging) on the intellectual property rights (trademark rights) of the tobacco manufacturers. The justifications for the new limitations are considered from a broader EU perspective and from an Intellectual Property law one. The paper reflects on the character of protection that there is no deprivation nor expropriation of property, but a mere control of use and that the right conferred upon registration of a mark is ius excludenti alios and not a right to use. These justifications are based on examination of case law, legislation provisions and it is relied on the surveys approved by the WHO and made post-implementation of plain packaging in Australia. However, it is suggested that the use of trademarks has become an indispensable part of the economic reality and through plain packaging the trademark proprietors’ interests are being undermined. Consequently, it is argued that the new regime is oppressive towards the interests of the trademark proprietors and is not the most effective for attaining the public health objective, by drawing upon sociological and economical research. Finally, the thesis criticises a plain packaging regime as being detrimental to trademark owners and its potential spillover effect to other industries, the risk of increase of illicit trade and counterfeits, which will cause a whole area of intellectual property to become redundant.

This Practice-Based Ph.D. thesis is in two sections, the written element presented as a sequence of eight Fascicles, and the practical element presented as an inter-related set of nine Artist’s Books and Multiples. This thesis presents a series of Artist’s Books and Multiples of graphic expressions of anxiety, each informed by a comparative study presented as a sequence of Fascicles of the visual strategies used to advertise cigarettes in America in mass-circulation magazines between 1945 and 1964. The thesis is presented as a boxed object containing the eight Fascicles (each containing a Gatefold Image) and the nine Artist’s Books and Multiples. The thesis identifies specific design and illustration solutions in cigarette advertising such as considerations of artwork, photography, layout, typography, characterisation, and diagrammatic representation of process. The conclusions are then used as the basis for 9 books and multiples in which I explore, within my own artwork, the dynamics of visual instruction, and the devices for reassuring the anxious consumer using irony and humour throughout. Each Fascicle has a Gatefold visual montage with juxtaposed imagery central to the theme. The thesis combines visual analysis and the making of imagery in equal measure. The vast proportion of original visual examples used in the Fascicles are reproduced for the first time in colour from a wide range of contemporary magazines. Particular emphasis is placed on the professional manuals generated by the advertising profession itself. A brief study of the cigarette market in the pre-1945 period identifies early anxieties about the product and how the tobacco industry and the advertising industry sought to address them. The thesis identifies the industries’ invention of the 'Safe Cigarette' and then explores the anxieties implicit in that concept, presenting visual means by which anxiety is depicted. Visual strategies of reassurance in the form of personifiers are compared - ranging from people in socially esteemed professions through to the use of animals (dogs) and visual fictions (Santa Claus). Two factors in particular have been identified to distract consumers from the gathering sense of unease in the safety of the product that culminated in the report of the American Surgeon General in 1964 - the appeal to the consumption of the cigarette in the outdoors and the corresponding success of menthol cigarettes, and the appeal to the reassurance that technology can impart - in the success of the Filter-Tip market. The twin polarities are reflected in the Artist’s books, 'Which Filter Works?' and 'Menthol Daze'. In the last Fascicle the techniques of persuasion after 1945 are compared with those used by the American Huckster of the early twentieth century and the thesis concludes with an assertion of the role that visual humour can play in exposing fallacious marketing.

Over the last decade, electronic cigarettes (e-cigarettes) have emerged as novel and popular nicotine delivery devices. Although many smokers use e-cigarettes, evidence suggests these products are also growing in popularity among young adult non-smokers. It is therefore important to examine factors that may contribute to onset of electronic cigarette use among young adult non-smokers. Critics and supporters of electronic cigarettes have been disseminating anti and pro e-cigarette messages (respectively) and it is currently unclear what effect, if any, these messages exert on young adult non-smokers. Critics of electronic cigarettes advocate caution towards these products, while supporters of electronic cigarettes argue these products can serve as healthier replacements for conventional cigarettes. The present study sought to investigate the influence of caution and replacement messages on young adult non-smokers’ dispositions towards future e-cigarette use. Two hundred and four young-adult non-smokers participated in a between subjects single session design where they viewed one of three possible audiovisual presentations (a caution message, replacement message or control message). After viewing the presentation, participants completed measures and tasks assessing their likelihood of future e-cigarette use, including willingness and intention to try e-cigarettes, as well as a measure of e-cigarette outcome expectancies. Results indicated the caution message decreased self-reported willingness to use e-cigarettes and was associated with higher negative and lower positive e-cigarette expectancies. The replacement message did not influence self-reported willingness and intention to use e-cigarettes but was associated with decreases in negative e-cigarette expectancies. These findings suggest that public health e-cigarette messages could be developed to simultaneously advocate using e-cigarettes as a smoking alternative and caution against e-cigarette use for individuals not already dependent on nicotine.