American journal of preventive medicine
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Review Comparative Study
Epidemiologic perspectives on smokeless tobacco marketing and population harm.
Moist snuff is the most popular form of orally-used smokeless tobacco in North America and parts of Europe. Because moist snuff use conveys lower risks for morbidity or mortality than does cigarette smoking, its use has been proposed as a tobacco harm-reduction strategy. This article critically reviews new and published epidemiologic evidence on health effects of moist snuff and its patterns of use relative to smoking in the United States, Sweden, and Norway. ⋯ S. and an inconsistent role in Sweden, (6) U. S. states with the lowest smoking prevalence also tend to have the lowest prevalence of snuff use, (7) there are no data on the efficacy of snuff as a smoking-cessation method, (8) the prevalence of cigarette smoking is relatively high among people who use snuff, and (9) snuff use is more consistently associated with partial substitution for smoking than with complete substitution. The evidence base for promotion of snuff use as a public health strategy is weak and inconsistent.
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Tobacco use, primarily in the form of cigarettes and exposure to tobacco smoke pollution, has caused the premature deaths of more than 14 million Americans since 1964. The major diseases caused by tobacco and tobacco smoke include lung cancer, other cancers, coronary heart disease, other cardiovascular diseases, chronic respiratory diseases, pregnancy complications, and respiratory diseases in children. Per capita consumption of various tobacco products has declined substantially since 1950, with current consumption at approximately 3.7 pounds per capita. ⋯ Efforts to prevent initiation, promote quitting, and protect nonsmokers should reduce exposure to pro-tobacco marketing and increase (1) the price of tobacco products, (2) protection from tobacco smoke pollution, (3) effective mass media strategies, (4) provision of effective cessation support, (5) effective regulation, and (6) litigation that holds the industry responsible for its misdeeds. Adequate implementation of effective tobacco-control strategies and useful scientific advances will help to ensure that per capita consumption decreases to the lowest level possible. The economic benefits of tobacco in our society are replaceable and they pale in comparison to the extent of human life lost.
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Quitlines in the United States have grown dramatically over the past 15 years, from one state and a handful of health plans to all 50 states and over 200 health plans and employers. Over half a million tobacco users received help from state quitlines alone in 2005. ⋯ Quitlines have the capacity to serve a larger fraction of the population than they currently serve. Accomplishing this is dependent on creating ambitious, multi-institution funding and delivery mechanisms, as well as further research and development to improve reach, effectiveness, and efficiency.
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The purpose of the current study was to assess whether men who have sex with men (MSM) who limit their unprotected anal sexual partners to those who are of the same HIV status (serosort) differ in their risk for HIV transmission than MSM who do not serosort. ⋯ Men who identify as HIV-negative and serosort are no more likely to know their HIV status than men who do not serosort and are at higher risk for exposure to HIV. Interventions targeting MSM must address the limitations of serosorting.