Tobacco control policies and the health of Adolescents in Pakistan (TAP): a multi-method study

巴基斯坦烟草控制政策和青少年健康（TAP）：一项多方法研究

• 批准号: MR/X004228/1
• 负责人: Kamran Siddiqi
• 金额: $ 101.56万
• 依托单位: University of York
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FX004228%2F1
• 关键词: Tobacco; control; policies; health; Adolescents

Globally, tobacco is responsible for over 8 million deaths each year. Most people start using tobacco during adolescence. Doing so increases their chances of developing health problems, such as asthma, and continuing to do so into adulthood increases their risk of cancers, cardiovascular and respiratory problems, and premature death. Therefore, preventing tobacco uptake is a public health priority. Robust policies have resulted in a steep decline in youth uptake in high-income countries. However, most low and middle-income countries (LMIC) lag behind. For example, one in 10 adolescents use tobacco in Pakistan compared to one in 40 in the UK. Such differences highlight a lack of robust policies to protect adolescents from cheap tobacco and aggressive tobacco industry marketing. Pakistan is heavily burdened by tobacco-related diseases, with over 160,000 tobacco deaths per year, yet it is one of the world's cheapest and most unregulated tobacco markets. Pakistan's government has reinvigorated its commitment to fulfil its obligation to protect adolescents from tobacco. A tobacco control policy roadmap includes plans to raise taxes and introduce plain packaging. Following a request from Pakistan's National Tobacco Control Cell, established by the government to enhance tobacco control efforts in Pakistan, we propose a research programme that aims to inform plain packaging policy and future tax reforms in order to reduce tobacco uptake and use among adolescents. Based on established methods in policy research, we will conduct five complementary studies. For the first three studies we will: conduct a pack collection exercise to explore how the packaging is being used to promote tobacco products, and to assess compliance with current health warning regulations (Study 1); interview those who advise, inform, legislate and advocate for tobacco control policies to gauge their level of support for and views on plain packaging and tax rises (Study 2); and explore adolescent's exposure to, and perceptions of, tobacco packaging, and response to plain packaging, and tobacco prices in focus group discussions (Study 3). For Study 3, to ensure the inclusion of adolescents who attend school and adolescents who do not, a significant issue in Pakistan, we will conduct eight focus groups with school attenders and eight with those out of school.Building on the earlier studies, in Study 4 we will conduct a survey with adolescents aged 10-16 years-old. We aim to recruit 5,670 in secondary schools and 2,880 in community settings. We will collect data on tobacco-related attitudes and behaviours. We will also assess perceptions of a range of tobacco packs on sale in Pakistan, and response to the health warnings that are on packs, and to plain packaging. Data on tobacco purchase behaviours, including product substitution and brand switching, will be collected. In addition to collecting data that will be crucial for informing policies, the survey will also provide a baseline for the future evaluation of any regulations and tax reforms. In parallel with the survey, in Study 5 we will estimate the predicted fall in tobacco use in adolescents as a result of a tobacco price increase to inform tobacco tax policies in Pakistan. To deliver this work, our team includes epidemiologists, statisticians, clinicians, health economists, behavioural and political scientists. Our expertise is in policy research, tobacco control, research translation, capacity strengthening and leading research consortia. In addition to the Ministry of Health, we are partnering with civil society advocates, clinicians, academics and legislators through a policy forum and with adolescents through youth advisory panels. With the help of our stakeholders and dissemination channels, we plan to inform tobacco control policies in Pakistan and beyond. By helping to prevent uptake among youth, our research will contribute to reducing the tobacco-related disease burden in LMIC.

在全球范围内，烟草每年造成超过800万人死亡。大多数人在青春期开始使用烟草。这样做增加了他们出现健康问题的机会，例如哮喘，并继续成年后，增加了他们患癌症，心血管和呼吸系统疾病的风险以及过早死亡。因此，防止烟草摄取是公共卫生的重点。强大的政策导致高收入国家的青年吸收急剧下降。但是，大多数低收入和中等收入国家（LMIC）落后。例如，十分之一的青少年在巴基斯坦使用烟草，而英国有40名。这种差异凸显了缺乏强大的政策来保护青少年免受廉价烟草和积极的烟草行业营销。 巴基斯坦受到与烟草有关的疾病的负担，每年有超过160,000个烟草死亡，但它是世界上最便宜，最不受监管的烟草市场之一。巴基斯坦政府振兴了其履行其保护青少年免受烟草义务的义务的承诺。烟草控制政策路线图包括增加税收并引入普通包装的计划。在巴基斯坦国家烟草控制细胞的要求下，政府建立了为加强巴基斯坦烟草控制工作的要求，我们提出了一项研究计划，旨在为纯粹的包装政策和未来的税收改革提供信息，以减少青少年烟草的吸收和使用。 基于政策研究中既定的方法，我们将进行五项互补研究。对于前三项研究，我们将：进行包装收集练习，以探讨如何使用包装来促进烟草产品，并评估遵守当前的健康警告法规（研究1）；访谈那些建议，告知，立法和倡导烟草控制政策的人，以评估他们对普通包装和税收上升的支持和观点（研究2）；并探索青少年对烟草包装的接触和感知，以及对普通包装的反应以及焦点小组讨论中的烟草价格（研究3）。对于研究3，为了确保包括上学和不参加的青少年的青少年，在巴基斯坦，这是一个重大问题，我们将与学校客人一起举办八个焦点小组，并与八名群落一起进行培训。在较早的研究中，我们将在研究4中与年龄10-16岁的青少年进行一项调查。我们的目标是在中学招募5,670名，在社区环境中招募2,880名。我们将收集有关烟草相关态度和行为的数据。我们还将评估对巴基斯坦出售一系列烟草包的看法，以及对包装中的健康警告以及对普通包装的反应。将收集有关烟草购买行为的数据，包括产品替代和品牌转换。除了收集对政策至关重要的数据外，该调查还将为对任何法规和税收改革的未来评估提供基准。与调查同时，在研究5中，我们将估计，由于烟草价格上涨，在巴基斯坦的烟草税收政策中提高了预测的青少年烟草使用情况。 为了提供这项工作，我们的团队包括流行病学家，统计学家，临床医生，卫生经济学家，行为和政治科学家。我们的专业知识是政策研究，烟草控制，研究翻译，能力增强和领先的研究联盟。除卫生部外，我们还通过一个政策论坛与民间社会倡导者，临床医生，学者和立法者合作，并通过青年咨询小组与青少年合作。在我们的利益相关者和传播渠道的帮助下，我们计划告知巴基斯坦及其他地区的烟草控制政策。通过帮助防止青年人吸收，我们的研究将有助于减轻LMIC中与烟草相关的疾病负担。

项目成果

Common assumptions in tobacco control that may not hold true for South-East Asia.

• DOI: 10.1016/j.lansea.2022.100088
• 发表时间: 2023-01
• 期刊: LANCET REGIONAL HEALTH - SOUTHEAST ASIA
• 作者: Siddiqi, Kamran;Arora, Monika;Gupta, Prakash C.
• 通讯作者: Gupta, Prakash C.

Tobacco Dependence in Adolescents: What Lies Ahead?

青少年的烟草依赖：未来会怎样？

• DOI: 10.2105/ajph.2023.307342
• 发表时间: 2023
• 期刊: American journal of public health
• 影响因子: 12.7
• 作者: Mehrotra R

Is Tobacco Use Associated With Risk of Recurrence and Mortality Among People With TB?: A Systematic Review and Meta-Analysis.

• DOI: 10.1016/j.chest.2023.08.021
• 发表时间: 2024-01
• 期刊: Chest
• 影响因子: 9.6
• 作者: Vidyasagaran AL;Readshaw A;Boeckmann M;Jarde A;Siddiqui F;Marshall AM;Akram J;Golub JE;Siddiqi K;Dogar O
• 通讯作者: Dogar O