Transitions in product use during the implementation of the European Tobacco Products Directive: cohort study findings from the EUREST-PLUS ITC Europe Surveys
Author:
Vardavas Constantine I123, Kyriakos Christina N12, Driezen Pete4, Girvalaki Charis12, Nikitara Katerina2, Filippidis Filippos T356, Fernández Esteve78910, Mons Ute11, Przewoźniak Krzysztof121314, Trofor Antigona C1516, Demjén Tibor17, Katsaounou Paraskevi A3618, Zatoński Witold1219, Willemsen Marc20, Fong Geoffrey T421, Vardavas Constantine I, Glahn Andrea, Kyriakos Christina N, Nguyen Dominick, Nikitara Katerina, Radu-Loghin Cornel, Tsatsakis Aristidis, Girvalaki Charis, Igoumenaki Chryssi, Papadakis Sophia, Papathanasaki Aikaterini, Tzatzarakis Manolis, Vardavas Alexander I, Bécuwe Nicolas, Deaconu Lavinia, Goudet Sophie, Hanley Christopher, Rivière Oscar, Demjén Tibor, Kiss Judit, Kovacs Anna Piroska, Fernández Esteve, Castellano Yolanda, Fu Marcela, Nogueira Sarah O, Tigova Olena, McNeill Ann, East Katherine, Hitchman Sara C, Mons Ute, Kahnert Sarah, Tountas Yannis, Behrakis Panagiotis, Filippidis Filippos T, Gratziou Christina, Katsaounou Paraskevi, Peleki Theodosia, Petroulia Ioanna, Tzavara Chara, Trofor Antigona Carmen, Eremia Marius, Lotrean Lucia, Mihaltan Florin, Rohde Gernot, Asano Tamaki, Cichon Claudia, Far Amy, Genton Céline, Jessner Melanie, Hedman Linnea, Janson Christer, Lindberg Ann, Maguire Beth, Ravara Sofia, Vaccaro Valérie, Ward Brian, Willemsen Marc, de Vries Hein, Hummel Karin, Nagelhout Gera E, Zatoński Witold A, Herbeć Aleksandra, Janik-Koncewicz Kinga, Przewoźniak Krzysztof, Zatoński Mateusz, Fong Geoffrey T, Agar Thomas K, Driezen Pete, Gravely Shannon, Quah Anne C K, Thompson Mary E,
Affiliation:
1. Laboratory of Toxicology, School of Medicine, University of Crete, Heraklion, Greece 2. European Network for Smoking and Tobacco Prevention, Brussels, Belgium 3. European Respiratory Society, Lausanne, Switzerland 4. Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada 5. Department of Primary Care and Public Health, Imperial College, London, UK 6. Center for Health Services Research, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece 7. Tobacco Control Unit, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat (Barcelona), Catalonia, Spain 8. Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Catalonia, Spain 9. School of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, L’Hospitalet de Llobregat, Catalonia, Spain 10. Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain 11. German Cancer Research Center (DKFZ), Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, Heidelberg, Germany 12. Health Promotion Foundation, Warsaw, Poland 13. Maria Skłodowska-Curie Institute-Oncology Center (MSCI), Warsaw, Poland 14. Collegium Civitas, Warsaw, Poland 15. University of Medicine and Pharmacy ‘Grigore T. Popa’ Iasi, Iasi, Romania 16. Aer Pur Romania, Bucharest, Romania 17. Smoking or Health Hungarian Foundation, Budapest, Hungary 18. First ICU Evaggelismos Hospital Athens, National and Kapodistrian University of Athens, Athens, Greece 19. European Observatory of Health Inequalities, President Stanisław Wojciechowski State University of Applied Sciences, Kalisz, Poland 20. Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands 21. Ontario Institute for Cancer Research, Toronto, Canada
Abstract
AbstractBackgroundThe emergence of new types of tobacco and tobacco-related products on the European Union (EU) market has precipitated the possibility for both poly-tobacco use and transitions between products. In the EU, the regulatory environment has shifted with the implementation of the European Tobacco Products Directive (TPD) in May 2016, which may influence consumer transitions between products.MethodsThe aim of this paper was to examine trends and transitions in tobacco products from 2016 to 2018 -before and after implementation of the TPD in the EU. Data come from Wave 1 (pre-TPD) and Wave 2 (post-TPD) of the EUREST-PLUS ITC Six European Country Survey, a cohort study of adults who at the time of recruitment were smokers from six EU countries- Germany, Greece, Hungary, Poland, Romania, and Spain. D (N = 3195). Bivariate and logistic regression analyses of weighted data was conducted using SAS-callable SUDAANResultsOverall, among those who smoked factory-made cigarettes (FM) only at Wave 1, 4.3% switched to roll-your-own tobacco (RYO) only. Among RYO only users at Wave 1, 17.0% switched to FM only, however compared to all other countries, respondents from Hungary had the highest percentage of FM only users at Wave 1 switch to RYO only at Wave 2 (18.0%).ConclusionsThe most prominent transition overall was from smoking RYO exclusively at Wave 1 to smoking FM tobacco exclusively at Wave 2, however this varied across countries. As the tobacco control regulatory environment of the EU develops, it is important to continue to monitor transitions between types of products, as well as trends in cessation.
Funder
European Union’s Horizon 2020 University of Waterloo GTF Canadian Institutes of Health Research Ontario Institute for Cancer Research Ministry of Universities and Research, Government of Catalonia Instituto Carlos III European Regional Development Fund FEDER
Publisher
Oxford University Press (OUP)
Subject
Public Health, Environmental and Occupational Health
Cited by
4 articles.
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