The effect of pack warning labels on quitting and related thoughts and behaviours in a national cohort of Aboriginal and Torres Strait Islander smokers

Nicholson, Anna; Borland, Ron; Bennet, Pele T; Davey, Maureen; Sarin, Jasmine; Sterren, Anke E van der; Stevens, Matthew; Thomas, D.

doi:10.1093/ntr/ntw396

Cited by 7 publications

(14 citation statements)

References 33 publications

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“…Nationwide programmes that are aimed at preventing tobacco use by means of taxation, introduction of smoke free workplaces, and prohibition of tobacco advertising were also found to be effective in Indigenous populations in the USA, Australia, and New Zealand, and were generally well accepted by the communities involved (appendix). [162][163][164][165][166][167]…”

Section: Western Pacificmentioning

confidence: 99%

Proximate determinants of tuberculosis in Indigenous peoples worldwide: a systematic review

Cormier

Schwartzman

Ndiaye

et al. 2019

The Lancet Global Health

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Background Indigenous peoples worldwide carry a disproportionate tuberculosis burden. There is an increasing awareness of the effect of social determinants and proximate determinants such as alcohol use, overcrowding, type 1 and type 2 diabetes, substance misuse, HIV, food insecurity and malnutrition, and smoking on the burden of tuberculosis. We aimed to understand the potential contribution of such determinants to tuberculosis in Indigenous peoples and to document steps taken to address them. MethodsWe did a systematic review using seven databases (MEDLINE, Embase, CINAHL, Global Health, BIOSIS Previews, Web of Science, and the Cochrane Library). We identified English language articles published from Jan 1, 1980, to Dec 20, 2017, reporting the prevalence of proximate determinants of tuberculosis and preventive programmes targeting these determinants in Indigenous communities worldwide. We included any randomised controlled trials, controlled studies, cohort studies, cross-sectional studies, case reports, and qualitative research. Exclusion criteria were articles in languages other than English, full text not available, population was not Indigenous, focused exclusively on children or older people, and studies that focused on pharmacological interventions.Findings Of 34 255 articles identified, 475 were eligible for inclusion. Most studies confirmed a higher prevalence of proximate determinants in Indigenous communities than in the general population. Diabetes was more frequent in Indigenous communities within high-income countries versus in low-income countries. The prevalence of alcohol use was generally similar to that among non-Indigenous groups, although patterns of drinking often differed. Smoking prevalence and smokeless tobacco consumption were commonly higher in Indigenous groups than in non-Indigenous groups. Food insecurity was highly prevalent in most Indigenous communities evaluated. Substance use was more frequent in Indigenous inhabitants of high-income countries than of low-income countries, with wide variation across Indigenous communities. The literature pertaining to HIV, crowding, and housing conditions among Indigenous peoples was too scant to draw firm conclusions. Preventive programmes that are culturally appropriate targeting these determinants appear feasible, although their effectiveness is largely unproven.Interpretation Indigenous peoples were generally reported to have a higher prevalence of several proximate determinants of tuberculosis than non-Indigenous peoples, with wide variation across Indigenous communities. These findings emphasise the need for community-led, culturally appropriate strategies to address smoking, food insecurity, and diabetes in Indigenous populations as important public health goals in their own right, and also to reduce the burden of tuberculosis.

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Section: Western Pacificmentioning

confidence: 99%

Proximate determinants of tuberculosis in Indigenous peoples worldwide: a systematic review

Cormier

Schwartzman

Ndiaye

et al. 2019

The Lancet Global Health

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“…Confounding was predominately due to introduction of enhanced pictorial health warnings [ 3 , 35 ], other marketing campaigns and smoking policies (e.g. price increases) during the course of the longitudinal study [ 34 , 48 ], or due to variance in smoking quantity amongst participants [ 32 , 38 , 51 ]. One study was found to be serious in at least one domain [ 1 ].…”

Section: Resultsmentioning

confidence: 99%

The effectiveness of graphic health warnings on tobacco products: a systematic review on perceived harm and quit intentions

et al. 2021

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Background Examination of the format and framing of the graphic health warnings (GHWs) on tobacco products and their impact on tobacco cessation has received increasing attention. This review focused on systematically identifying and synthesizing evidence of longitudinal studies that evaluate different GHW formats and specifically considered GHW influence on perceived risk of tobacco use and quit intentions. Methods Ten databases were systematically searched for relevant records in December 2017 and again in September 2019. Thirty-five longitudinal studies were identified and analyzed in terms of the formatting of GHWs and the outcomes of perceived risk and quit intentions. Quality assessment of all studies was conducted. Results This review found graphics exceeding 50% of packs were the most common ratio for GHWs, and identified an ongoing reliance on negatively framed messages and limited source attribution. Perceived harms and quit intentions were increased by GHWs. However, wear-out effects were observed regardless of GHW format indicating the length of time warnings are present in market warrants ongoing research attention to identify wear out points. Quit intentions and perceived harm were also combined into a cognitive response measure, limiting the evaluation of the effects of each GHW format variables in those cases. In addition, alternative GHW package inserts were found to be a complimentary approach to traditional GHWs. Conclusions This review demonstrated the role of GHWs on increasing quit intentions and perceptions of health risks by evaluating quality-assessed longitudinal research designs. The findings of this study recommend testing alternate GHW formats that communicate quit benefits and objective methodologies to extend beyond self-report.

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“…Some key examples are initiatives that address tobacco use, heavy drinking and diabetes in Aboriginal peoples and Torres Strait Islanders in Australia [80][81][82][83].…”

Section: Discussionmentioning

confidence: 99%

Social and behavioral risk reduction strategies for tuberculosis prevention in Canadian Inuit communities: a cost-effectiveness analysis

et al. 2021

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Background Tuberculosis (TB) is an important public health problem in Inuit communities across Canada, with an annual incidence rate in 2017 that was nearly 300 times higher than in Canadian-born non-Indigenous individuals. Social and behavioral factors that are prevalent in the North, such as commercial tobacco use, excessive alcohol use, food insecurity and overcrowded housing put individuals at higher risk for TB morbidity and mortality. We examined the potential impact of mitigation strategies for these risk factors, in reducing TB burden in this setting. Methods We created a transmission model to simulate the epidemiology of TB in Nunavut, Canada. We then used a decision analysis model to assess the potential impact of several evidence-based strategies targeting tobacco use, excessive alcohol use, food insecurity and overcrowded housing. We predicted TB incidence, TB-related deaths, quality adjusted life years (QALYs), and associated costs and cost-effectiveness over 20 years. All costs were expressed in 2018 Canadian dollars. Results Compared to a status quo scenario with no new interventions for these risk factors, the reduction strategy for tobacco use was most effective and cost-effective, reducing TB incidence by 5.5% (95% uncertainty range: 2.7–11%) over 20 years, with an estimated cost of $95,835 per TB case prevented and $49,671 per QALY gained. The addition of the food insecurity reduction strategy reduced incidence by a further 2% (0.5–3%) compared to the tobacco cessation strategy alone, but at significant cost. Conclusions Strategies that aim to reduce commercial tobacco use and improve food security will likely lead to modest reductions in TB morbidity and mortality. Although important for the communities, strategies that address excess alcohol use and overcrowding will likely have a more limited impact on TB-related outcomes at current scale, and are associated with much higher cost. Their benefits will be more substantial with scale up, which will also likely have important downstream impacts such as improved mental health, educational attainment and food security.

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The effect of pack warning labels on quitting and related thoughts and behaviours in a national cohort of Aboriginal and Torres Strait Islander smokers

Abstract: Graphic warning labels are likely to be effective for Aboriginal and Torres Strait Islander smokers as they are for the broader Australian population.

Cited by 7 publications

References 33 publications

Proximate determinants of tuberculosis in Indigenous peoples worldwide: a systematic review

Proximate determinants of tuberculosis in Indigenous peoples worldwide: a systematic review

The effectiveness of graphic health warnings on tobacco products: a systematic review on perceived harm and quit intentions

Social and behavioral risk reduction strategies for tuberculosis prevention in Canadian Inuit communities: a cost-effectiveness analysis

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