Banning tobacco price promotions, smoking-related beliefs and behaviour: findings from the International Tobacco Control Four Country (ITC 4C) Survey.
Banning tobacco price promotions, smoking-related beliefs and behaviour: findings from the International Tobacco Control Four Country (ITC 4C) Survey.
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DOI：
10.1136/tobaccocontrol-2017-053648
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发表时间：
2018-05
期刊：
影响因子：
5.2
通讯作者：
Shang C
中科院分区：
文献类型：
--
作者：
El-Toukhy S;Choi K;Hitchman SC;Bansal-Travers M;Thrasher JF;Yong HH;O'Connor RJ;Shang C
生态模型强调对健康行为的多层次影响。虽然研究表明，价格促销与吸烟行为及其前因有关，但人们对这些关联是否因国家价格促销政策等宏观因素而有所不同，知之甚少。来自国际烟草控制政策评估项目四国队列的当前和前吸烟者（N = 4,698）被纳入加权多元逻辑回归模型，以检验第 7 波和第 8 波（2008-2009 年和 2010-2011 年进行）的价格促销活动与信念（社会和禁令规范、吸烟的功能价值、对吸烟的误解以及吸烟信念）之间个人层面的关联。烟草业及其法规）以及第 8 波的行为，按国家是否允许（澳大利亚、美国）或禁止（加拿大、英国）价格促销进行分层。价格促销与吸烟相关信念和行为之间的关联因国家价格促销政策而异。在允许价格促销的国家，在第 7 波和第 8 波中反复接触价格促销的参与者更有可能将功能价值与吸烟联系起来（即在压力下平静下来，AOR 1.83），并且在第 8 波中成为当前吸烟者（AOR 1.94）。在禁止价格促销的国家，反复接触价格促销的参与者不太可能对吸烟产生误解（即，烟雾越浓越危险）。在有或没有禁止价格促销的国家中，价格促销、与吸烟相关的信念和行为之间存在着不同的关联。采取价格促销禁令可以改善价格促销与吸烟信念和行为之间的关联。
Ecological models emphasize multi-level influences on health behaviors. While studies show that exposure to price promotions is associated with smoking behavior and its antecedents, less is known about whether these associations differ by macro-level factors such as national price-promotion policies. Current and former smokers (N= 4,698) from the International Tobacco Control Policy Evaluation Project four-country cohort were included in weighted multivariate logistic regression models to examine individual-level associations between exposure to price promotions at Waves 7 and 8 (conducted in 2008–2009 and 2010–2011) and beliefs (social and injunctive norms, functional value of smoking, misconceptions around smoking, and beliefs of tobacco industry and its regulations) and behavior at Wave 8, stratified by whether countries allow (Australia, United States) or ban (Canada, United Kingdom) price promotions. Associations between exposure to price promotions and smoking-related beliefs and behavior differed by national price-promotion policies. In countries that allow price promotions, participants repeatedly exposed to price promotions at Waves 7 and 8 were more likely to associate functional values to smoking (i.e., calms down when stressed, AOR 1.83) and to be current smokers at Wave 8 (AOR 1.94). In countries that ban price promotions, participants repeatedly exposed to price promotions were less likely to hold misconceptions around smoking (i.e., harsher smoke is more dangerous). Differential associations emerged between exposure to price promotions, smoking-related beliefs, and behavior across countries with and without a price-promotions ban. Adopting price-promotion bans could ameliorate the associations between exposure to price promotions and smoking beliefs and behaviors.
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