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Introduction: Globally, tobacco is the number one preventable cause of death, killing 1 in 10 adults. By 2030, 80% of all tobacco deaths will occur in developing countries. Social factors drive the adoption and cessation of smoking in high-income countries, but few studies have examined the socioeconomic patterning of smoking in developing countries. Methods: Using data from the 2005 National Survey of Risk Factors for Non-communicable Diseases in Argentina, we investigated gender-specific socioeconomic patterning of current, former, and never-smoking status; the intensity of smoking; and smokers’ readiness for cessation using multinomial logistic and ordinary least squares regression. We also investigated heterogeneity in the patterning by age. Results: Higher socioeconomic position (SEP) was associated with less smoking for men in all age groups, although the results were most pronounced for men at younger ages (odds ratio [OR] of current vs. never smoking = 0.57, 95% CI 0.51–0.63 for higher vs. lower education at ages 18–24 years). For women, higher SEP was associated with more smoking in older age groups but less smoking in younger age groups (OR = 1.51, CI 1.41–1.62 and OR = 0.86, CI 0.78–0.96 for higher vs. lower education at ages 50–64 and 18–24 years, respectively). Higher SEP was also associated with higher odds of recently quitting compared to not considering quitting for men regardless of age group but for women only in younger age groups. Discussion: The higher burden of smoking among those of lower SEP, especially in younger age groups, is a troubling pattern that is certain to impact future disparities in chronic disease outcomes unless interventions are undertaken. [ABSTRACT FROM AUTHOR]

Background Flavorings in cigars increase their appeal, mask the harsh taste of tobacco, and may hinder successful cigar smoking cessation; however, limited evidence has examined whether flavors are associated with short- or long-term cigar smoking cessation. Aims and Methods Using restricted data from the Population Assessment of Tobacco and Health Study Waves 1–5, we examined whether flavored cigar use was associated with 30-day-plus and 1-year-plus cigar smoking cessation among US adults. Multivariable discrete-time survival models were fit to a nationally representative sample of US adult (18+) respondents who had a current, established cigar use, smoked five or more days in the past 30 days, and did not exclusively smoke traditional premium cigars at baseline. Models adjusted for age, sex, race and ethnicity, income, cigar and cigarette smoking intensity, and blunt use. Results At baseline, 44.6% of respondents (n = 674) were 18–34 years old, 75.0% were male, 56.7% were non-Hispanic White, 78.9% had household incomes of <$50,000, and 56.2% smoked flavored cigars. In fully adjusted models, flavored cigar use was associated with a lower risk of 30-day-plus (HR = 0.76, 95% CI = 0.60, 0.97) but not 1-year-plus cigar smoking cessation (HR = 0.81, 95% = 0.62, 1.05). Conclusions We found that flavored cigar use was associated with a lower risk of short-term but not long-term cigar smoking cessation. More work is needed to understand the dynamics of cigar smoking transitions, including initiation, cessation, and relapse, particularly in larger cohorts and among those who exclusively use cigars or dual-use cigars and cigarettes. Implications As local and some state jurisdictions continue to adopt partial or complete bans of flavored cigar products and the United States Food and Drug Administration considers a national ban of all characterizing flavors in cigars, there is a need for more longitudinal work examining the associations between flavorings in cigars and short and long-term cigar-smoking behaviors, including but not limited to initiation, cessation, intensity of use, and relapse, particularly in diverse cohorts. [ABSTRACT FROM AUTHOR]

Introduction: To help offset the increased price of cigarettes and promote brand loyalty, tobacco companies distribute coupons, particularly to price-sensitive consumers. Few studies, however, have examined the longitudinal association between coupon receipt and smoking cessation.Methods: Using adult data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study, we examined the longitudinal association between coupon receipt and short-term smoking cessation. Multivariable discrete time survival models were fit to an unbalanced person-period dataset for adult respondents (18+) with current established smoking status at baseline (person n=9472, risk period n=29,784). Short-term smoking cessation was measured as discontinued cigarette use (no past 30-day cigarette use at follow-up) and self-reported complete quitting. Coupon receipt was measured as a time-varying exposure, measured in the wave preceding the outcome. Tobacco dependence and time-varying cigarette use intensity were controlled as potential confounders. Effect modification by age, sex, race/ethnicity, and education was assessed by examining interaction terms.Results: We found that adults who received a coupon were 19% less likely to quit smoking compared to adults who did not receive a coupon, adjusting for covariates (adjusted hazard rate (aHR): 0.81, 95% CI: 0.74-0.89). None of the interaction terms were statistically significant, suggesting that the association between coupon receipt and short-term smoking cessation may not differ across the sociodemographic groups that we examined.Conclusions: Taken together, our results reveal that coupon receipt reduces the likelihood of short-term smoking cessation, and that this association does not differ by age, sex, race/ethnicity, or education.Implications: Tobacco companies distribute coupons for tobacco products to price-sensitive customers in the US, and these coupons can be particularly effective in partly offsetting the impact of a tax increases and promoting brand loyalty. This study provides longitudinal evidence that coupon receipt is associated with a decrease in short-term smoking cessation among US adults who smoke cigarettes after adjusting for covariates and tobacco-related confounders. The findings from this study suggest that coupons are an effective tool for tobacco companies to prevent adults who smoke from quitting, and a national ban on coupons may help to facilitate smoking cessation. [ABSTRACT FROM AUTHOR]

Background: Tobacco control policies and other denormalization strategies may reduce tobacco use by stigmatizing smoking. This raises an important question: Does perceived smoking-related stigma contribute to a smoker's decision to quit? The aim of this study was to evaluate if perceived smoking-related stigma was associated with smoking cessation outcomes among smokers in Mexico and Uruguay.Methods: We analyzed prospective data from a panel of adult smokers who participated in the 2008-2012 administrations of the International Tobacco Control Policy Evaluation Surveys in Mexico and Uruguay. We defined two analytic samples of participants: the quit behavior sample (n = 3896 Mexico; n = 1525 Uruguay) and the relapse sample (n = 596 Mexico). Generalized estimating equations were used to evaluate if different aspects of perceived stigma (ie, discomfort, marginalization, and negative stereotype) at baseline were associated with smoking cessation outcomes at follow-up.Results: We found that perceived smoking-related stigma was associated with a higher likelihood of making a quit attempt in Uruguay but with a lower likelihood of successful quitting in Mexico.Conclusions: This study suggests that perceived smoking-related stigma may be associated with more quit attempts, but less successful quitting among smokers. It is possible that once stigma is internalized by smokers, it may function as a damaging force. Future studies should evaluate the influence of internalized stigma on smoking behavior.Implications: Although perceived smoking-related stigma may prompt smokers to quit smoking, smoking stigma may also serve as a damaging force for some individuals, making quitting more difficult. This study found that perceived smoking-related stigma was associated with a higher likelihood of making a quit attempt in Uruguay but with a lower likelihood of successful quitting in Mexico. [ABSTRACT FROM AUTHOR]