RESUMEN
AIMS: This paper presents updated prevalence estimates of awareness, ever-use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: A cross-sectional analysis of adult (≥ 18 years) current smokers and ex-smokers from 14 countries participating in the ITC Project. Data from the most recent survey questionnaire for each country were included, which spanned the period 2013-17. Countries were categorized into four groups based on regulations governing NVP sales and marketing (allowable or not), and level of enforcement (strict or weak where NVPs are not permitted to be sold): (1) most restrictive policies (MRPs), not legal to be sold or marketed with strict enforcement: Australia, Brazil, Uruguay; (2) restrictive policies (RPs), not approved for sale or marketing with weak enforcement: Canada, Malaysia, Mexico, New Zealand; (3) less restrictive policies (LRPs), legal to be sold and marketed with regulations: England, the Netherlands, Republic of Korea, United States; and (4) no regulatory policies (NRPs), Bangladesh, China, Zambia. Countries were also grouped by World Bank Income Classifications. Country-specific weighted logistic regression models estimated adjusted NVP prevalence estimates for: awareness, ever/current use, and frequency of use (daily versus non-daily). FINDINGS: NVP awareness and use were lowest in NRP countries. Generally, ever- and current use of NVPs were lower in MRP countries (ever-use = 7.1-48.9%; current use = 0.3-3.5%) relative to LRP countries (ever-use = 38.9-66.6%; current use = 5.5-17.2%) and RP countries (ever-use = 10.0-62.4%; current use = 1.4-15.5%). NVP use was highest among high-income countries, followed by upper-middle-income countries, and then by lower-middle-income countries. CONCLUSIONS: With a few exceptions, awareness and use of nicotine vaping products varied by the strength of national regulations governing nicotine vaping product sales/marketing, and by country income. In countries with no regulatory policies, use rates were very low, suggesting that there was little availability, marketing and/or interest in nicotine vaping products in these countries where smoking populations are predominantly poorer. The higher awareness and use of nicotine vaping products in high income countries with moderately (e.g. Canada, New Zealand) and less (e.g. England, United States) restrictive policies, is likely due to the greater availability and affordability of nicotine vaping products.
Asunto(s)
Comercio/legislación & jurisprudencia , Sistemas Electrónicos de Liberación de Nicotina , Ex-Fumadores/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Política Pública/legislación & jurisprudencia , Fumadores/estadística & datos numéricos , Vapeo/epidemiología , Adulto , Australia/epidemiología , Bangladesh/epidemiología , Brasil/epidemiología , Canadá/epidemiología , China/epidemiología , Estudios Transversales , Inglaterra/epidemiología , Femenino , Humanos , Modelos Logísticos , Malasia/epidemiología , Masculino , Mercadotecnía/legislación & jurisprudencia , México/epidemiología , Persona de Mediana Edad , Países Bajos/epidemiología , Nueva Zelanda/epidemiología , Prevalencia , República de Corea/epidemiología , Estados Unidos/epidemiología , Uruguay/epidemiología , Zambia/epidemiologíaRESUMEN
AIMS: To describe some of the variability across the world in levels of quit smoking attempts and use of various forms of cessation support. DESIGN: Use of the International Tobacco Control Policy Evaluation Project surveys of smokers, using the 2007 survey wave (or later, where necessary). SETTINGS: Australia, Canada, China, France, Germany, Ireland, Malaysia, Mexico, the Netherlands, New Zealand, South Korea, Thailand, United Kingdom, Uruguay and United States. PARTICIPANTS: Samples of smokers from 15 countries. MEASUREMENTS: Self-report on use of cessation aids and on visits to health professionals and provision of cessation advice during the visits. FINDINGS: Prevalence of quit attempts in the last year varied from less than 20% to more than 50% across countries. Similarly, smokers varied greatly in reporting visiting health professionals in the last year (<20% to over 70%), and among those who did, provision of advice to quit also varied greatly. There was also marked variability in the levels and types of help reported. Use of medication was generally more common than use of behavioural support, except where medications are not readily available. CONCLUSIONS: There is wide variation across countries in rates of attempts to stop smoking and use of assistance with higher overall use of medication than behavioural support. There is also wide variation in the provision of brief advice to stop by health professionals.
Asunto(s)
Líneas Directas/estadística & datos numéricos , Internet/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Cese del Hábito de Fumar/estadística & datos numéricos , Prevención del Hábito de Fumar , Dispositivos para Dejar de Fumar Tabaco/estadística & datos numéricos , Asia/epidemiología , Australasia/epidemiología , Comparación Transcultural , Europa (Continente)/epidemiología , Encuestas de Atención de la Salud , Accesibilidad a los Servicios de Salud , Humanos , Renta , América del Norte/epidemiología , Prevalencia , Evaluación de Programas y Proyectos de Salud , Política Pública , Autoinforme , Fumar/epidemiología , Cese del Hábito de Fumar/métodos , Uruguay/epidemiologíaRESUMEN
AIMS: The aims of this study are to describe the tobacco dependence treatment systems in five countries at different stages of development of their systems, and from different income levels and regions of the world, and to draw some lessons from their experiences that might be useful to other countries. METHODS AND DATA SOURSES: Data were drawn from an earlier survey of treatment services led by M.R. and A.M., from Party reports to the Secretariat of the Framework Convention on Tobacco Control, and from correspondents in the five countries. These data were entered onto a standard template by the authors, discussed with the correspondents to ensure they were accurate and to help us interpret them, and then the templates were used as a basis to write prose descriptions of the countries' treatment systems, with additional summary data presented in tables. RESULTS: Two of the middle-income countries have based their treatment on specialist support and both consequently have very low population coverage for treatment. Two countries have integrated broad-reach approaches, such as brief advice with intensive specialist support; these countries are focusing currently upon monitoring performance and guaranteeing quality. Cost is a significant barrier to improving treatment coverage and highlights the importance of using existing infrastucture as much as possible. CONCLUSIONS: Perhaps not surprisingly the greatest challenges appear to be faced by large, lower-income countries that have prioritized more intensive but low-reach approaches to treatment, rather than developing basic infrastructure, including brief advice in primary care and quitlines.