Displaying publications 1 - 20 of 83 in total

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  1. Tan YL, Foong K
    Tob Control, 2014 Jan;23(1):84-7.
    PMID: 23872424 DOI: 10.1136/tobaccocontrol-2013-050977
    Matched MeSH terms: Tobacco Products*
  2. Cui T, Lu R, Liu C, Wu Z, Jiang X, Liu Y, et al.
    Sci Total Environ, 2024 May 20;926:171829.
    PMID: 38537812 DOI: 10.1016/j.scitotenv.2024.171829
    In recent years, the use of electronic vaping products (also named e-cigarettes) has increased due to their appealing flavors and nicotine delivery without the combustion of tobacco. Although the hazardous substances emitted by e-cigarettes are largely found to be much lower than combustible cigarettes, second-hand exposure to e-cigarette aerosols is not completely benign for bystanders. This work reviewed and synthesized findings on the second-hand exposure of aerosols from e-cigarettes and compared the results with those of the combustible cigarettes. In this review, different results were integrated based upon sampling locations such as residences, vehicles, offices, public places, and experimental exposure chambers. In addition, the factors that influence the second-hand exposure levels were identified by objectively reviewing and integrating the impacts of combustible cigarettes and e-cigarettes on the environment. It is a challenge to compare the literature data directly to assess the effect of smoking/vaping on the indoor environment. The room volume, indoor air exchange rate, puffing duration, and puffing numbers should be considered, which are important factors in determining the degree of pollution. Therefore, it is necessary to calculate the "emission rate" to normalize the concentration of pollutants emitted under various experimental conditions and make the results comparable. This review aims to increase the awareness regarding the harmful effects of the second-hand exposure to aerosols coming from the use of cigarettes and e-cigarettes, identify knowledge gaps, and provide a scientific basis for future policy interventions with regard to the regulation of smoking and vaping.
    Matched MeSH terms: Tobacco Products*
  3. Nga JDL, Hakim SL, Bilal S
    Subst Use Misuse, 2020;55(12):1943-1948.
    PMID: 32552152 DOI: 10.1080/10826084.2020.1781180
    BACKGROUND: Electronic nicotine delivery systems (ENDS) and heated tobacco products (HTPs) are noncombustible tobacco products which have been found to generate aerosols containing lower levels of Harmful and Potentially Harmful Constituents (HPHCs) in comparison to conventional cigarettes. Objective: This quasi experimental study measured and compared the end tidal carbon monoxide (eCO) levels of participants after use of ENDS, HTPs and conventional cigarettes. Methods: In total 45 smokers, each smoking at least 10 conventional cigarettes per day for 5 years participated in the study. Based on their preference, participants used only one of the tobacco products (ENDS, HTPs, or conventional cigarette) and were briefed about the product use based on manufacturer's instructions. The eCO levels were obtained at baseline, followed by 5, 10, 15, 30 and 45 min respectively after the product use. Results: There was significant increase in eCO levels for conventional cigarettes as compared to other modes. Peak eCO levels of 20.2 ± 0.86 ppm, 8.8 ± 1.56 ppm and 6.0 ± 1.36 ppm was achieved at 30 min, 15 min and 10 min for conventional cigarettes, ENDS and HTPs respectively. However, the levels were significantly lower in ENDS and HTPs. Conclusion: Even though ENDS and HTPs may have produced significantly lower eCO than conventional cigarettes, the significantly increasing levels over time from baseline which was not shown before is a cause of concern. As of now, their use as an alternate to cigarettes needs to be considered under regulatory framework.
    Matched MeSH terms: Tobacco Products*
  4. Ali D, Al-Yahya QM, Baskaradoss JK
    Int Dent J, 2023 Oct;73(5):717-723.
    PMID: 37037698 DOI: 10.1016/j.identj.2023.03.005
    OBJECTIVE: The aim of this study was to compare peri-implant clinical and radiographic status and levels of advanced glycation endproducts (AGEs) in peri-implant sulcular fluid (PISF) in waterpipe users and cigarette smokers.

    METHODS: Waterpipe users, cigarette smokers, and never smokers were included. Demographic details were collected using a questionnaire. Characteristics of implants (dimensions, jaw location, depth of placement, insertion torque, and duration in function) were recorded. Peri-implant modified plaque and gingival indices (mPI and mGI), probing depth (PD), and crestal bone loss (CBL) were recorded in all groups. Volume of PISF and levels of AGEs were determined using standard techniques. Sample-size estimation was done on data from a pilot investigation, and correlation between clinicoradiographic and immunoinflammatory parameters was assessed using logistic regression models. Probability values tobacco products on oral health.

    Matched MeSH terms: Tobacco Products*
  5. Sreeramareddy CT, Acharya K, Manoharan A, Oo PS
    Nicotine Tob Res, 2024 Jan 22;26(2):142-150.
    PMID: 37466212 DOI: 10.1093/ntr/ntad124
    INTRODUCTION: The increasing use of e-cigarettes among the youth is a public health problem that needs surveillance. We report changes in e-cigarette use, cigarette smoking, and "dual use" among youth in 10 countries.

    AIMS AND METHODS: Global Youth Tobacco Survey (GYTS)s from Georgia, Iraq, Italy, Latvia, Montenegro, Paraguay, Peru, Qatar, Romania, and San Marino were analyzed. Changes in prevalence of "awareness of e-cigarettes," "ever use" (even tried a few puffs) and "current use" (during last 30 days) of e-cigarettes and cigarette smoking, and "dual use" (both e-cigarette and cigarette smoking) between baseline (2013 and 2014) and most recent (2017-2019) surveys were estimated.

    RESULTS: "Awareness of e-cigarettes" and "ever e-cigarette use" significantly increased (p  50% in most countries. During the most recent surveys, "current e-cigarette" use was > 10% in five countries Italy (18.3%) and Latvia (18.5%) being the highest. Cigarette smoking significantly declined in Italy, Latvia, Peru, and San Marino (p tobacco use among youths and comprehensive tobacco control policies inclusive of e-cigarettes are needed.

    IMPLICATIONS: Secondary data analyses of serial GYTSs in 10 countries showed that both awareness of e-cigarette and e-cigarette use has increased among school-going youth aged 13-15 years. A concurrent increase in "dual use" of e-cigarettes and cigarette smoking during the last 30 days in all 10 countries indicates continued cigarette smoking in the absence of e-cigarettes because of the common risk construct of tobacco product use. Results call for continued surveillance of both e-cigarettes and cigarette smoking among school-going youth. Comprehensive tobacco control measures inclusive of e-cigarettes should be implemented to reduce tobacco use among the youth.

    Matched MeSH terms: Tobacco Products*
  6. Mat Rifin H, Rodzlan Hasani WS, Ling MYJ, Robert Lourdes TG, Saminathan TA, Ab Majid NL, et al.
    Syst Rev, 2020 01 13;9(1):13.
    PMID: 31931868 DOI: 10.1186/s13643-019-1263-6
    BACKGROUND: Small/kiddie cigarette packs consist of less than 20 cigarette sticks. Kiddie packs were recently proposed to be reintroduced by the tobacco industry with an excuse to prevent consumers from buying illicit cigarettes. By reintroducing kiddie packs, cigarettes will inevitably be more affordable and this would appeal to lower-income consumers especially teens. In this systematic review, we aimed to identify the impact of kiddie packs on smoking, specifically on smoking initiation, the urge/tendency to buy cigarettes and attempts to reduce cigarette consumption.

    METHODS: This systematic review will be based on the review of original articles on the impact of kiddie packs on smoking. There is no restriction on the publication dates. The Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Web of Science and Scopus will be searched to retrieve potential original articles. Additional records identified through other sources: Google Scholar, as well as Journal of Substance Use and Tobacco Control, are also to be searched. These will include original articles in any language which included all study designs (randomised controlled trials, quasi experimental and experimental studies, observational cross-sectional and cohort studies) comparing kiddie packs with regular cigarette packs. The primary outcomes of interest will be initiation of smoking and urge/tendency to buy cigarettes in the general population and attempts to reduce cigarette consumption among current smokers. Secondary outcomes will be the prevalence of smoking using kiddie packs among the current smokers.

    DISCUSSION: This systematic review will provide evidence to support the impact of kiddie packs on smoking in terms of smoking initiation, smoking prevalence, urge/tendency to purchase cigarettes and attempts to reduce cigarette consumption. The findings from this review could be helpful to policymakers in regulating kiddie packs to control the consumption of tobacco.

    SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018102325.

    Matched MeSH terms: Tobacco Products/economics; Tobacco Products/supply & distribution*
  7. Mohajerani A, Kadir AA, Larobina L
    Waste Manag, 2016 Jun;52:228-44.
    PMID: 26975623 DOI: 10.1016/j.wasman.2016.03.012
    The disposal and littering of cigarette butts (CBs) is a serious environmental problem. Trillions of cigarettes are produced every year worldwide, resulting in millions of tonnes of toxic waste being dumped into the environment in the form of cigarette butts. As CBs have poor biodegradability, it can take many years for them to break down. This paper reviews and presents some of the results of a study on the recycling of CBs into fired clay bricks. Bricks with 2.5%, 5%, 7.5%, and 10% CB content by weight were manufactured and tested, and then compared against control clay bricks with 0% CB content. The results showed that the dry density decreased by up to 30% and the compressive strength decreased by 88% in bricks with 10% CBs. The calculated compressive strength of bricks with 1% CBs was determined to be 19.53Mpa. To investigate the effect of mixing time, bricks with 7.5% CB content were manufactured with different mixing times of 5, 10, and 15min. To test the effect of heating time on the properties of CB bricks, the heating rate used during manufacturing was changed to 0.7, 2, 5, and 10°Cmin(-1). Bricks with 0% and 5% CB content were fired with these heating rates. Leachate tests were carried out for bricks with 0%, 2.5%, 5%, and 10% CB content. The emissions released during firing were tested for bricks with 0% and 5% CB content using heating rates of 0.7, 2, 5, and 10°Cmin(-1). The gases tested were carbon monoxide (CO), carbon dioxide (CO2), chlorine (Cl2), nitrogen oxide (NO), and hydrogen cyanide (HCN). Finally, estimations were made for the energy that could be saved by firing bricks incorporating CBs. Calculations showed that up to 58% of the firing energy could potentially be saved. Bricks were shown to be a viable solution for the disposal of CBs. They can reduce contamination caused by cigarette butts and provide a masonry construction material that can be either loadbearing or non-loadbearing, depending on the quantity of CBs incorporated. This paper proposes the use of bricks with 1% CB content throughout the brick-manufacturing industry. If bricks contained as little as 1% CB content, they would still provide a solution for the issue of CB recycling while maintaining properties very similar to those of a non-CB brick. Our calculations show that, theoretically, only 2.5% of the world's annual brick production is necessary to completely offset the worldwide, annual cigarette production.
    Matched MeSH terms: Tobacco Products*
  8. Sreeramareddy CT, Acharya K, Manoharan A
    Sci Rep, 2022 Dec 05;12(1):20967.
    PMID: 36470977 DOI: 10.1038/s41598-022-25594-4
    We report the country-level prevalence of awareness about electronic cigarette use, and 'dual use' and its association with age, sex, country income, and e-cigarette regulatory status. We analyzed the most recent Global Youth Tobacco Surveys done on nationally representative samples of school-going youth aged 13-15 years in 75 countries/territories. The weighted prevalence of 'awareness' (heard about e-cigarettes), 'ever use' (even tried a few puffs), 'current use' (during the last 30 days), and 'dual use' (e-cigarette use and cigarette smoking during the last 30 days) were estimated. Awareness was > 80% in 13 countries mostly from Europe Poland being the highest at 95.8% (95% CI 94.8- 96.6). In seven countries, 30-50% of the youth had ever used an e-cigarette, Italy was the highest at 55.1% (95%CI 51-3,58.9). In 30 countries, current e-cigarette use was > 10%, the highest of 35.1% (95%CI 32.4-38.0) in Guam. Awareness and use were highest in the European region (74.6% and 34.5%) and HIC (83.6% and 39.4%). Youth from HIC (compared to lMIC) and countries having restrictive e-cigarette regulations (compared to NRP) had 2.4 times (aOR 2.2.4, 95% CI 2.2, 2.7) and 1.8 times (aOR 1.8, 95% CI 1.6, 2.0) higher odds of being current e-cigarette users respectively. Youth in countries with the most restrictive e-cigarette regulations (compared to NRP) had 0.6 times lower odds of being current e-cigarette users (aOR 0.6, 95% CI 0.6, 0.7). Awareness and e-cigarette use varied by sex, country income level, and region. Continued global surveillance of youth e-cigarette use is needed for the formulation of e-cigarette regulatory policy. Awareness and use of e-cigarettes were higher among boys, in countries in Europe and America regions, and among those with higher income and restrictive policies, whereas it was lower in countries having the most restrictive policies. Higher awareness is strongly correlated with a trial and current use of e-cigarettes. E-cigarette marketing should be restricted, and continued surveillance of e-cigarette use is needed. Most restrictive policies such as the ban on e-cigarettes appear to reduce e-cigarette use among the youth.
    Matched MeSH terms: Tobacco Products*
  9. van der Eijk Y, Tan Ping Ping G, Ong SE, Tan Li Xin G, Li D, Zhang D, et al.
    Int J Health Policy Manag, 2022 Sep 01;11(9):1616-1624.
    PMID: 33906338 DOI: 10.34172/ijhpm.2021.25
    BACKGROUND: The global e-cigarette market has proliferated and is increasingly dominated by transnational tobacco companies. While Southeast Asian countries have received relatively little attention in e-cigarette research, the region represents an area of potentially untapped growth for the industry. We review the e-cigarette situation in Southeast Asia in terms of the e-cigarette markets, advertising and promotion of e-cigarettes, reported health impacts of e-cigarette use, and policy responses in the region.

    METHODS: We examined e-cigarette market data from the Euromonitor Global Market Information Database (GMID) Passport database, searched in the academic literature, grey literature and news archives for any reports or studies of e-cigarette related diseases or injuries, e-cigarette marketing, and e-cigarette policy responses in Southeast Asian countries, and browsed the websites of online e-cigarette retailers catering to the region's active e-cigarette markets.

    RESULTS: In 2019, e-cigarettes were sold in six Southeast Asian markets with a total market value of $595 million, projected to grow to $766 million by 2023. E-commerce is a significant and growing sales channel in the region, with most of the popular or featured brands in online shops originating from China. Southeast Asian youth are targeted with a wide variety of flavours, trendy designs and point of sale promotions, and several e-cigarette related injuries and diseases have been reported in the region. Policy responses vary considerably between countries, ranging from strict bans to no or partial regulations.

    CONCLUSION: Although Southeast Asia's e-cigarette market is relatively nascent, this is likely to change if transnationals invest more heavily in the region. Populous countries with weak e-cigarette regulations, notably Indonesia, Malaysia, Vietnam and the Philippines, are desirable targets for the transnationals. Regulatory action is needed to prevent e-cigarette use from becoming entrenched into these societies, especially among young people.

    Matched MeSH terms: Tobacco Products*
  10. Cheah YK
    Int J Adolesc Med Health, 2024 Feb 01;36(1):95-103.
    PMID: 38347679 DOI: 10.1515/ijamh-2023-0175
    OBJECTIVES: Knowledge of smoking is a protective factor for adolescent smoking. This study is the first to examine sociodemographic and lifestyle factors associated with adolescents' knowledge of smoking in Timor-Leste. It is also a pioneering investigation into the ways in which exposure to anti-tobacco messages and health warnings on cigarette packages, and involvement in smoking-related education at schools and home mediate the relationship between school grade levels and smoking knowledge.

    METHODS: Data were obtained from the Global Youth Tobacco Survey Timor-Leste. Ordered logistic regressions were used to examine the associations between knowledge of smoking and sociodemographic, and lifestyle factors. Structural equation modelling was utilized to explore the mediating effects.

    RESULTS: Adolescents were less likely to have high knowledge of smoking if they were lower-secondary students, were males, had unemployed parents and had no closest friends who smoked. The relationship between grade levels and smoking knowledge was partly mediated by awareness of anti-tobacco messages on mass media, school education about the dangers of smoking and family discussion about smoking.

    CONCLUSIONS: Sociodemographic and lifestyle factors play an important role in determining knowledge of smoking among adolescents. To some extent, awareness-, education- and family-related variables explain how grade levels affect smoking knowledge.

    Matched MeSH terms: Tobacco Products*
  11. Bui WKT, Ross H, Mohamed Nor N
    Tob Control, 2024 Apr 19;33(3):341-345.
    PMID: 36207128 DOI: 10.1136/tc-2021-057210
    BACKGROUND: The tobacco industry contends that the illicit market in Malaysia occupies 62.3% of the total cigarette market. If this is true, Malaysia has one of the largest shares of illicit cigarettes in the world.

    METHODS: This study employs a rigorous gap analysis to measure the size of the illicit cigarette trade in Malaysia and compare it with the industry estimates.

    FINDINGS: We found that in 2019, the illicit cigarette market share ranged from 38.2% to 52.5%, depending on assumptions with respect to consumption under-reporting, which is substantially less than the industry estimates. We found that the size of the illicit cigarette market was not driven by higher excise tax: doubling the excise tax rate from RM0.20 to RM0.40 per stick in November 2015 resulted in only a slight increase in the illicit cigarette market share and no increase in the number of illicit cigarettes in the market.

    CONCLUSIONS: Therefore, a reduction in cigarette excise taxes, as suggested by the industry, will not solve the problem of illicit cigarette trade in Malaysia. Instead, the government should ratify the Framework Convention on Tobacco Control's Protocol to Eliminate Illicit Trade in Tobacco Products and implement the strategies outlined in the protocol.

    Matched MeSH terms: Tobacco Products*
  12. Lim, Lee Min
    MyJurnal
    Tobacco products can be classified into combustible and smokeless types. It kills up to half of the users and globally around 5 million deaths every year. There are strong associations between smoking and health-related quality of life (HRQOL) measures.
    Matched MeSH terms: Tobacco Products
  13. Nordin AS, Bullen C
    Tob Control, 2014 Jan;23(1):4-5.
    PMID: 24479154
    Matched MeSH terms: Tobacco Products*
  14. Dieng H, Rajasaygar S, Ahmad AH, Ahmad H, Rawi CS, Zuharah WF, et al.
    Acta Trop, 2013 Dec;128(3):584-90.
    PMID: 23999373 DOI: 10.1016/j.actatropica.2013.08.013
    Annually, 4.5 trillion cigarette butts (CBs) are flicked into our environment. Evidence exists that CB waste is deadly to aquatic life, but their lethality to the aquatic life of the main dengue vector is unknown. CBs are full of toxicants that occur naturally, during planting and manufacturing, which may act as larvicidal agents. We assessed Aedes aegypti vulnerability to Marlboro butts during its development. Overall, CBs showed insecticidal activities against larvae. At early phases of development, mortality rates were much higher in two CBs solution (2CBSol) and 3CBSol microcosms (MICRs). Larval survival gradually decreased with development in 1CBSol-MICRs. However, in great presence of CBs, mortality was high even for the late developmental stages. These results suggest that A. aegypti larvae are vulnerable to CB presence in their habitats, but this effect was seen most during the early developmental phases and in the presence of increased amounts of cigarette remnants. CB filters are being used as raw material in many sectors, i.e., brick, art, fashion, plastic industries, as a practical solution to the pollution problem, the observed butt waste toxicity to mosquito larvae open new avenues for the identification of novel insecticide products.
    Matched MeSH terms: Tobacco Products/toxicity*
  15. Liber AC, Ross H, Omar M, Chaloupka FJ
    Tob Control, 2015 Jul;24 Suppl 3:iii83-iii87.
    PMID: 25808666 DOI: 10.1136/tobaccocontrol-2014-052028
    Study the effects of the 2011 Malaysian minimum price law (MPL) on prices of licit and illicit cigarette brands. Identify barriers to the MPL achieving positive public health effects.
    Matched MeSH terms: Tobacco Products/economics*
  16. Janaydeh M, Ismail A, Zulkifli SZ, Omar H
    Environ Monit Assess, 2019 Sep 16;191(10):637.
    PMID: 31529162 DOI: 10.1007/s10661-019-7755-y
    Cadmium (Cd) and lead (Pb) are ubiquitous metals widely distributed in the environment, resulting in toxic health effects. This project aims to evaluate Pb and Cd as toxic elements in 15 different tobacco cigarette brands produced and/or sold in Selangor state, Peninsular Malaysia. The concentrations of Pb and Cd in all tobacco brands tested in this study were determined using the air-acetylene flame atomic absorption spectrophotometer (AAS). On average, the concentrations of Pb and Cd in different tobacco brand samples ranged from 3.05 and 0.80 μg/g dw, respectively. The results indicate that assessment mean values of Pb inhaled from smoking one packet of 20 cigarettes were in the range of 1.55-3.51 μg. Furthermore, the concentration of Cd inhaled per packet of cigarettes (20 sticks) is estimated to be 0.04-0.36 μg. However, there was a significant difference in the concentrations of Pb and Cd between the different brands of tobacco cigarettes, among cigarette prices (cheap versus expensive) of tobacco brands. In conclusion, cigarette smokers in Selangor, Malaysia, are heavily exposed to Pb and Cd, and such exposure could adversely affect their health in the long term. The impact of toxic heavy metals on smokers in this state would be an area for future research.
    Matched MeSH terms: Tobacco Products/analysis*
  17. Nath S, Prakash J, Prajapati VK, Sharma N, Pulikkotil SJ
    Indian J Dent Res, 2020 8 10;31(3):433-438.
    PMID: 32769279 DOI: 10.4103/ijdr.IJDR_783_17
    Introduction: Bidi, a leaf rolled cigarette, is the most popular form of smoking in India. Bidi cigarette contains higher tar, ammonia, and nicotine content than a conventional cigarette and is more hazardous.

    Aim of Study: The aim of this study was to determine the effect of bidi smoking on periodontitis by assessing the interleukin (IL)-1β and IL-8 from a gingival crevicular fluid (GCF).

    Materials and Methods: A total of 60 patients were selected, which included 40 patients diagnosed with chronic periodontitis (20 bidi smokers and 20 non-bidi smokers) and 20 periodontal healthy controls. Diseased and healthy sites were selected from each of the chronic periodontitis subjects. Clinical parameters assessed were plaque index (PI), gingival index (GI), periodontal probing depth (PPD), recession (RC), and clinical attachment level (CAL). Pooled GCF samples were taken from the same site and analyzed for IL-1β and IL-8 using enzyme-linked immunosorbent assay.

    Results: Bidi smokers displayed decreased levels of IL-1β and IL-8 than non-bidi smokers for both healthy and diseased sites and significantly reduced IL-8 levels among bidi smokers when compared to controls. Among bidi smokers, the diseased site had significantly higher levels of IL-8 than the healthy site. Non-smoker subjects with chronic periodontitis especially diseased sites contained significantly higher amounts of IL-1β and IL-8 than smokers and controls. The PI scores were highest among bidi smokers with reduced BOP and GI scores.

    Conclusions: Bidi smoking influenced the cytokine profile among periodontitis patients exhibiting decreased levels of IL-1β and IL-8.

    Matched MeSH terms: Tobacco Products*
  18. Yong HH, Fong GT, Driezen P, Borland R, Quah AC, Sirirassamee B, et al.
    Nicotine Tob Res, 2013 Aug;15(8):1339-47.
    PMID: 23291637 DOI: 10.1093/ntr/nts241
    In this study, we aimed to examine, in Thailand, the impact on smokers' reported awareness of and their cognitive and behavioral reactions following the change from text-only to pictorial warnings printed on cigarette packs. We also sought to explore differences by type of cigarette smoked (roll-your-own [RYO] vs. factory-made [FM] cigarettes).
    Matched MeSH terms: Tobacco Products*
  19. Mat Rifin H, Jane Ling MY, Robert Lourdes TG, Saminathan TA, Rodzlan Hasani WS, Ab Majid NL, et al.
    Int J Environ Res Public Health, 2022 Sep 23;19(19).
    PMID: 36231349 DOI: 10.3390/ijerph191912051
    Background: Small cigarette pack sizes contain less than 20 cigarette sticks in a pack. Smaller packs may suggest lower costs, increasing affordability among lower-income users, especially the younger generation, which could lead to tobacco-related diseases and economic costs, including human capital lost results from tobacco-attributable morbidity and mortality. This concern has caused many countries to ban the sale of single cigarette sticks or kiddie packs. However, small cigarette pack sizes were proposed recently to be reintroduced by the tobacco industry with an excuse to prevent consumers from buying illicit cigarettes. This would demean efforts in combating tobacco consumption based on the existing tobacco control policies to prevent minors from purchasing cigarettes. Given the competing influences of affordability and availability of tobacco on consumption and the dearth of evidence-based review on the impact of pack size on smoking, this systematic review was conducted to identify the link between kiddie packs and smoking specifically on the initiation of smoking, urge/tendency to buy cigarettes among the general population and attempt to reduce cigarette consumption and prevalence of smoking using kiddie packs among current smokers. Methods: We include all studies except for reviews, guidelines, conference papers, commentaries, editorials, or opinion pieces. A database search was conducted in PubMed, EMBASE, CENTRAL, Web of Science and Scopus on 27 November 2021. The results were presented in the form of narrative synthesis under four groups: initiation of smoking; urge/tendency to buy cigarettes; the prevalence of smoking, and attempt to reduce cigarette consumption. The literature search identified 1601 articles, of which 21 articles had met the inclusion criteria. The methodological quality of all included articles was determined using a validated 16-item quality assessment tool (QATSDD). The average quality score for all papers was 34.8%. Discussion: Given the diverse study settings of the articles and despite the challenges of the methodological quality of some articles, this review provides some evidence that kiddie packs may increase the urge/tendency to buy cigarettes and mixed evidence on the attempt to reduce cigarette consumption. This review also found some evidence that kiddie pack purchasing among teenage smokers was higher compared to adults. However, we are uncertain about the link between kiddie packs and smoking initiation. Nevertheless, since most studies were of low quality, further high-quality studies are needed to conclude about the impact of kiddie packs on smoking to assist the policymakers and stakeholders in formulating new policies and strengthening existing strategies related to the kiddie packs.
    Matched MeSH terms: Tobacco Products*
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