Tobacco promotion increases the likelihood that adolescents will start smoking. Much of the tobacco industry's promotional budget is spent on point of sale (PoS) promotion in many jurisdictions. Consequently, tobacco is an eye-catching feature at the PoS in many places. We reviewed the evidence that PoS tobacco promotion influences key smoking-related behaviors and beliefs, increases susceptibility to smoking in youth, undermines smokers' quit attempts, and promotes relapse among ex-smokers. We found 12 peer-reviewed studies, 10 of which were focused on children. Seven of 8 observational studies found statistically significant associations between exposure to tobacco promotion at the PoS and smoking initiation or susceptibility to smoking. Two experimental studies of children found statistically significant associations between exposure to PoS tobacco promotions and beliefs about ease of getting tobacco and smoking prevalence among their peers. An experimental study with adults found that a picture of collected tobacco pack elicited cravings for cigarettes among smokers. A cross-sectional study found that 25% of adult smokers reported impulse purchasing and a third of recent ex-smokers reported urges to start smoking after seeing tobacco displayed. More prospective studies are needed to clarify the temporal relationship between exposure to PoS tobacco and outcome. However, given the addictiveness of tobacco, the severity of the health hazards posed by smoking, the evidence that tobacco promotion encourages children to start smoking, and the consistency of the evidence that PoS promotion influences children's smoking, we believe that ample justification exists for banning PoS advertising and displays of smoked tobacco products.

Cigarette smoking is the single biggest avoidable cause of death and disability in developed countries. Smoking is now increasing rapidly throughout the developing world and is one of the biggest threats to current and future world health. For most smokers, quitting smoking is the single most important thing they can do to improve their health. Encouraging smoking cessation is one of the most effective and cost effective things that doctors and other health professionals can do to improve health and prolong their patients' lives. This series will explore the reasons why smokers smoke, how to help them to quit, and how to reduce the prevalence of smoking more generally. Stages of worldwide tobacco epidemic. Adapted from Lopez et al. A descriptive model of the cigarette epidemic in developed countries. Tobacco Control 1994;3: 242-7 Cigarette smoking first became a mass phenomenon in the United Kingdom and other more affluent countries in the early 20th century after the introduction of cheap, mass produced, manufactured cigarettes. Typically, a “smoking epidemic” in a population develops in four stages: a rise and then decline in smoking prevalence, followed two to three decades later by a similar trend in smoking related diseases. Usually, the uptake and consequent adverse effects of smoking occur earlier and to a greater degree among men. In the United Kingdom there are about 13 million smokers, and worldwide an estimated 1.2 billion. Half of these smokers will die prematurely of a disease caused by their smoking, losing an average of eight years of life; this currently represents four million smokers each year worldwide. Deaths from smoking are projected to increase to more than 10 million a year by 2030, by which time 70% of deaths will be in developing countries. Prevalence of smoking of manufactured cigarettes in Great Britain. Data from Tobacco …

Background: The New Zealand 2003 Smoke-free Environments Amendment Act (SEAA) extended existing restrictions on smoking in office and retail workplaces by introducing smoking bans in bars, casinos, members’ clubs, restaurants and nearly all other workplaces from 10 December 2004. Objective: To evaluate the implementation and outcomes of aspects of the SEAA relating to smoke-free indoor workplaces and public places, excluding schools and early learning centres. Methods: Data were gathered on public and stakeholder attitudes and support for smoke-free policies; dissemination of information, enforcement activities and compliance; exposure to secondhand smoke (SHS) in the workplace; changes in health outcomes linked to SHS exposure; exposure to SHS in homes; smoking prevalence and smoking related behaviours; and economic impacts. Results: Surveys suggested growing majority support for the SEAA and its underlying principles among the public and bar managers. There was evidence of high compliance in bars and pubs, where most enforcement problems were expected. Self reported data suggested that SHS exposure in the workplace, the primary objective of the SEAA, decreased significantly from around 20% in 2003, to 8% in 2006. Air quality improved greatly in hospitality venues. Reported SHS exposure in homes also reduced significantly. There was no clear evidence of a short term effect on health or on adult smoking prevalence, although calls to the smoking cessation quitline increased despite reduced expenditure on smoking cessation advertising. Available data suggested a broadly neutral economic impact, including in the tourist and hospitality sectors. Conclusion: The effects of the legislation change were favourable from a public health perspective. Areas for further investigation and possible regulation were identified such as SHS related pollution in semi-enclosed outdoor areas. The study adds to a growing body of literature documenting the positive impact of comprehensive smoke-free legislation. The scientific and public health case for introducing comprehensive smoke-free legislation that covers all indoor public places and workplaces is now overwhelming, and should be a public health priority for legislators across the world as part of the globalisation of effective public health policy to control the tobacco epidemic.

The objective of the study was to provide baseline and reference data on the prevalence and distribution of overweight and obesity, using different anthropometric measurements in adult urban populations in Cameroon. The Cameroon Burden of Diabetes Baseline Survey was a cross-sectional study, conducted in 4 urban districts (Yaoundé, Douala, Garoua and Bamenda) of Cameroon, using the WHO Step approach for population-based assessment of cardiovascular risk factors. Body mass index, waist circumference and waist-to-hip ratio were measured using standardized methods. Overall, 10,011 individuals, 6,004 women and 4,007 men, from 4,189 households, aged 15 years and above participated. Based on body mass index, more than 25% of urban men and almost half of urban women were either overweight or obese with 6.5% of men and 19.5% of women being obese. The prevalence of obesity showed considerable variation with age in both genders. Using body mass index provided the highest prevalence of obesity in men (6.5%) and waist-to-hip ratio the lowest prevalence (3.2%). Among women, using waist-to-hip ratio and waist circumference yielded the highest prevalence of obesity (28%) and body mass index the lowest (19.5%). There was a trend towards an increase in age-adjusted odd ratios of being overweight or obese with duration of education in both sexes. The study provides current data on anthropometric measurements and obesity in urban Cameroonian populations, and found high prevalences of overweight and obesity particularly over 35 years of age, and among women. Prevalence varied according to the measure used. Our findings highlight the need to carry out further studies in Cameroonian and other Sub-Saharan African populations to provide appropriate cut-off points for the identification of people at risk of obesity-related disorders, and indicate the need to implement interventions to reverse increasing levels of obesity.

Aim To evaluate the short-term impacts of removing point-of-sale tobacco displays in Ireland, implemented in July 2009. Methods Retailer compliance was assessed using audit surveys in 2007, 2008 and 2009. Using a monthly survey of 1000 adults carried out since 2002, changes in smoking prevalence were assessed; attitudes were measured using extra questions added for a 10-month period before and after the law. Youth responses were assessed using a cohort of 180 13–15 year olds, interviewed in June and August 2009. Results Immediately following implementation, compliance was 97%. Support for the law increased among adults after implementation (58% Apr-Jun vs 66% Jul-Dec, p<0.001). Recall of displays decreased significantly for adults (49% to 22%; p<0.001), more so among teenagers (81% to 22%; p<0.001). There were no significant short-term changes in prevalence among youths or adults. The proportion of youths believing more than a fifth of children their age smoked decreased from 62% to 46%, p<0.001). Post-legislation, 14% of adult smokers thought the law had made it easier to quit smoking and 38% of teenagers thought it would make it easier for children not to smoke. Conclusions Compliance was very high and the law was well supported. Recall of displays dropped significantly among adults and teenagers post-legislation and there were encouraging signs that the law helped de-normalise smoking.