Objective Tobacco endgame policies aim to rapidly and permanently reduce smoking to minimal levels. We reviewed evidence syntheses for: (1) endgame policies, (2) evidence gaps, and (3) future research priorities. Data sources Guided by JBI scoping review methodology, we searched five databases (PubMed, CINAHL, Scopus, Embase and Web of Science) for evidence syntheses published in English since 1990 on 12 policies, and Google for publications from key national and international organisations. Reference lists of included publications were hand searched. Study selection Two reviewers independently screened titles and abstracts. Inclusion criteria were broad to capture policy impacts (including unintended), feasibility, public and stakeholder acceptability and other aspects of policy implementation. Data extraction We report the results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Data synthesis Eight policies have progressed to evidence synthesis stage (49 publications): mandatory very low nicotine content (VLNC) standard (n=26); product standards to substantially reduce consumer appeal or remove the most toxic products from the market (n=1); moving consumers to reduced risk products (n=8); tobacco-free generation (n=4); ending sales (n=2); sinking lid (n=2); tax increases (n=7); and restrictions on tobacco retailers (n=10). Based on published evidence syntheses, the evidence base was most developed for a VLNC standard, with a wide range of evidence synthesised. Conclusions VLNC cigarettes have attracted the most attention, in terms of synthesised evidence. Additional focus on policies that reduce the availability of tobacco is warranted given these measures are being implemented in some jurisdictions.

The development of prescription medication for smoking cessation and the introduction of evidence-based guidelines for health professionals has increasingly medicalised smoking cessation. There are debates about whether medicalisation is a positive development, or whether it has devalued unassisted quitting. In this debate the views of smokers have been neglected. This study explored the attitudes of smokers towards a range of quitting methods, and their considerations when judging their value. We conducted semi-structured interviews with 29 smokers and analysed data using thematic analysis. The results show that the perceived nature of an individual smoker’s addiction was central to judgments about the value of pharmacological cessation aids, as was personal experience with a method, and how well it was judged to align with an individual’s situation and personality. Unassisted quitting was often described as the best method. Negative views of pharmacological cessation aids were frequently expressed, particularly concerns about side effects from prescription medications. Smokers’ views about the value of different methods were not independent: attitudes about cessation aids were shaped by positive attitudes towards unassisted quitting. Examining smokers’ attitudes towards either assisted or unassisted quitting in isolation provides incomplete information on quitting preferences.

The differential diagnosis of Alzheimer's disease (AD) and frontotemporal dementia (FTD) remains a difficult clinical issue. A recent meta-analysis by Hutchinson and Mathias (2007 Hutchinson, A. D. and Mathias, J. L. 2007. Neuropsychological deficits in frontotemporal dementia and Alzheimer's disease: A meta-analytic review. Journal of Neurology, Neurosurgery, and Psychiatry, 78: 917–928. [Crossref], [PubMed], [Web of Science ®] [Google Scholar] ) found that many cognitive tests do not adequately differentiate between these types of dementia. However, their study did not examine the ability of neurobehavioral scales to distinguish between AD and FTD. The data from 33 studies, published between January 1994 and December 2008, examining the neurobehavioral symptoms of persons with AD (N = 2,305) and FTD (N = 971) were therefore analyzed. Weighted Cohen's d effect sizes, percentage overlap statistics, confidence intervals, and fail-safe Ns were calculated for each scale. The most discriminating measures were the Schedules for Clinical Assessment in Neuropsychiatry and the Scale for Emotional Blunting. The Middelheim Frontality Score and the Frontal Behavior Inventory also had excellent discriminative ability, surpassing the cognitive tests examined previously. Numerous other scales additionally showed large and significant differences between the AD and FTD groups, highlighting the importance of assessing neurobehavioral symptoms in this context. While these latter measures may be useful in providing a clinical profile of patients with dementia, greater overlap in the scores of patients with AD and FTD limits their usefulness in the context of differential diagnosis.

Aims: To systematically review the literature on (i) whether and how various risk messages about nicotine vaping products (NVPs) alter harm perception and behavioural intentions of smokers and non‐smokers and (ii) how trust in sources of NVP risk communication affects message reception and behavioural intentions.Methods: Seven electronic databases and reference lists of relevant articles were searched for articles published up to April 2020. Experimental and quasi‐experimental studies on message effects and cross‐sectional studies on source credibility were included. The Newcastle–Ottawa Scale and the Evidence Project Risk of Bias Tool were used to assess the quality of observational and intervention studies, respectively. For each outcome variable, we indicated whether there was an effect (as a ‘yes’ or ‘no’) and used effect direction plots to display information on the direction of effects.Results: Nicotine addiction messages resulted in greater health and addiction risk perceptions, relative risk messages comparing the health risks of NVPs to cigarette smoking increased the perception that NVPs are less harmful than combustible cigarettes, and a nicotine fact sheet corrected misperceptions of nicotine and NVPs. Smokers’ intention to purchase, try or switch to NVPs was higher when exposed to a relative risk message and lower when exposed to nicotine addiction warnings. Trust in NVP risk information from public health agencies was associated with lower odds of; (i) NVP use and (ii) perceiving NVPs as less harmful, whereas those who trusted information from NVP companies were more likely to perceive NVPs as less harmful than combustible cigarettes.Conclusions: Relative risk messages may help improve the accuracy of harm perceptions of nicotine vaping products and increase smokers’ intentions to quit smoking and/or to switch to vaping, although the literature is nascent.

Background and Aims: Cytisine (also known as cytisinicline) is a low‐cost partial agonist of nicotinic acetylcholine receptors used to assist tobacco cessation. We aimed to review the effectiveness of cytisine for tobacco cessation and the effects of dose and co‐use of behavioural or other pharmacological interventions on cessation outcomes.Methods: We searched seven databases, Google Scholar, and reference lists of included publications for randomised controlled trials investigating use of cytisine as a tobacco cessation aid. Studies were eligible if participants were ≥15 years old and used tobacco upon study enrolment. We conducted four random effects meta‐analyses and sensitivity analyses with fixed effects models. We used the Cochrane risk‐of‐bias tool for randomised trials version 2 to assess risk of bias in included studies, with adjustments recommended by the Cochrane Tobacco Addiction Group.Results: Participants using cytisine were significantly more likely to quit tobacco than participants who received placebo/no intervention/usual care (risk ratio [RR] = 2.65, 95% confidence interval [CI] = 1.50–4.67, 6 trials, 5194 participants) or nicotine replacement therapy (RR = 1.36, 95% CI = 1.06–1.73, p = 0.0152, 2 trials, 1511 participants). The difference in cessation rates among participants receiving cytisine versus varenicline was not statistically significant (RR = 0.96, 95% CI 0.63–1.45, P = 0.8464, 3 trials, 2508 participants). Two trials examined longer versus shorter treatment duration, finding higher abstinence rates with longer treatment (RR = 1.29, 95% CI = 1.02–1.63, 2 trials, 1009 participants). The differences in the number of adverse events reported by participants who received cytisine versus placebo (RR = 1.19, 95% CI = 0.99–1.41, P = 0.0624; 6 trials; 4578 participants) or cytisine versus varenicline (RR = 1.37, 95% CI = 0.57–3.33, P = 0.4835; 2 trials; 1345 participants) were not statistically significant. Most adverse events were mild (e.g. abnormal dreams, nausea, headaches).Conclusions: Cytisine is an effective aid for tobacco cessation and appears to be more effective for tobacco cessation than placebo, no intervention, usual care and nicotine replacement therapy.