Background Türkiye has one of the highest smoking prevalence rates among OECD countries, leading to quite increased exposure to secondhand smoke (SHS), which significantly contributes to indoor particulate matter (PM) that has substantial adverse effects on health. As a nation with a long-standing tradition of tobacco cultivation and consumption, Türkiye has historically struggled to implement effective tobacco control strategies. Methods In a closed 2.88 m 3 measuring chamber, tobacco smoke from 11 Turkish cigarette brands and, for comparison, four German equal brands, and the 3R4F reference cigarette was produced. PM 10 , PM 2.5 , and PM 1 were measured using laser aerosol spectroscopy. Pearson correlations assessed links between PM levels and tobacco weight, packing density, and filter and tobacco rod lengths. Results Concentrations of PM varied from 1044 to 1677 μg/m 3 for PM 10 and from 1043 to 1675 μg/m 3 for PM 2.5 , with most emissions originating from the detrimental PM 1 fraction, ranging from 994 to 1548 μg/m 3 . Five Turkish brands exhibited the highest emissions of PM 10 and PM 2.5 , four brands concerning PM 1 , respectively, surpassing the levels emitted by the reference cigarette. All four German brands produced lower PM. The study couldn’t report correlations between measured mean PM concentrations and measured tobacco weights, calculated filling densities, or measured filter and tobacco rod lengths. Conclusion PM measured for all tested cigarette brands was significantly high, particularly for the quite harmful PM 1 fraction. Smoking in cars, similar in size to the test chamber, puts passengers, often children, at risk. A global ban on smoking in vehicles would help protect them. While public smoking is often restricted, unregulated home smoking still exposes people to dangerous PM levels. The study findings highlight the urgent need for robust tobacco control policies in Türkiye and globally, as well as a heightened public awareness of indoor PM pollution resulting from smoking.
Objective Despite reductions in rates of smoking in pregnancy in most high-income countries, disparities persist between those from different socioeconomic backgrounds and ethnic groups. Our recent systematic review that sought to understand the equity impacts of psychosocial interventions indicated effectiveness of tailored interventions for prenatal smoking cessation and postnatal abstinence, but with significant unexplained heterogeneity. We conducted this review to explore how interventions were tailored and why some may work better than others. Methods We used intervention component analysis to characterise the features of tailored interventions. We conducted meta-analyses for prenatal smoking cessation (second or third trimester) and postnatal abstinence (<12 months from childbirth) and ran meta-regressions to explore how components may relate to effectiveness. Results We included 70 papers related to 54 randomised controlled trials. We identified 39 components common to both tailored and universal interventions and 26 components unique to tailored interventions. Equity focussed components sought to improve the relevance of the intervention, and to improve accessibility through intervention position. Meta-analyses indicated effectiveness for both prenatal smoking cessation and postnatal abstinence (odds ratio [OR] 1.47, 95% CI 1.32 - 1.63 and OR 1.30, 95% CI 1.13 - 1.49). However, meta-regressions showed no conclusive evidence that any individual tailored intervention component produced differential effectiveness. This may be due to insufficient statistical power resulting from the limited number of trials containing some of the components reported. Conclusion Our analysis provides a framework to understand what options could be used to tailor interventions to underserved groups. These include offering adapted communication, habit building approaches and social network support, improving relationships with providers, and reducing practical barriers to engagement. Further testing is warranted to more accurately assess how approaches may relate to effectiveness, and for who.
Introduction Smokeless tobacco (SLT) is used not only for recreation, but also for traditional healing, spiritual practices, and medicinal purposes. Understanding the motivations and lived experiences underlying these diverse forms of use is important for developing culturally-appropriate tobacco control interventions. This study explored the drivers, mode of use, perceived harms and lived experiences associated with traditional and non-traditional SLT use among adults in KwaZulu-Natal, South Africa. Methods A qualitative phenomenological design was used. In-depth interviews were conducted with 25 adults who used SLT primarily for traditional purposes (traditional health practitioners [THPs] and trainees/initiates [n=12]) or non-traditional purposes (n=13). Participants were recruited using convenience, purposive and snowball sampling. All interviews were audio-recorded, transcribed verbatim, translated where necessary, and analysed thematically using Braun and Clarke’s six-phase framework aided by NVivo v12. Results Four key themes emerged: motivations for SLT use, modes and practices of use, experienced harms, and perceptions of harmfulness. Traditional users described SLT use as part of ancestral communication, initiation into traditional healing, ritual practices, and traditional treatment. Non-traditional users reported using SLT for stress relief, perceived medicinal benefits, sexual enhancement, affordability compared with smoking, and social influence. Multiple modes of use were reported, including oral, nasal, intravaginal, and external ritual use. Participants described health-related, social, and financial harms associated with SLT use. However, some traditional users perceived SLT used within traditional healing contexts as protected from harm through ancestral or spiritual authority. Conclusion SLT use in KwaZulu-Natal is shaped by cultural, spiritual, medicinal, psychological, sexual, and economic motivations. Although participants reported multiple harms, cultural beliefs and perceptions of spiritual protection may influence risk perceptions and continued use. Public health interventions should address both the health risks of SLT and the cultural meanings attached to its use while engaging THPs and communities in developing culturally-acceptable prevention and cessation approaches.
Background:Smokeless tobacco (SLT) use is a growing public health concern among young adults in sub-Saharan Africa. Evidence on family-level factors associated with lifetime SLT use among university students in Ghana is lacking. This study estimated the lifetime prevalence of SLT use and identified associated factors, focusing on family structure, among undergraduates at the University for Development Studies (UDS), Tamale, Ghana. Methods:An analytical cross-sectional study was conducted (January-March 2023) among 600 undergraduate students at UDS (response rate 85.7%). Data were collected using a locally adapted WHO student drug-use survey. Subgroup prevalence was calculated with 95% Wilson score confidence intervals. Between-group differences were assessed using the chi-square test or Fisher's exact test where the corresponding expected cell count was fewer than five. Factors associated with lifetime SLT use were identified using Firth penalised logistic regression, with standard logistic and modified Poisson regression as sensitivity analyses. Results:Lifetime SLT prevalence was 9.67% (95% CI: 7.54-12.31%). In the primary multivariable analysis, having friends who used drugs during upbringing (aOR = 1.84; 95% CI: 1.02-3.32; p = 0.043) and having relatives who used drugs during upbringing (aOR = 1.82; 95% CI: 1.01-3.27; p = 0.045) were independently associated with lifetime SLT use. Associations were consistent across all three regression models. Conclusions:Early-life exposure to drug use within peer and family networks is independently associated with lifetime SLT use among university students at UDS, Ghana. Family-based and peer-focused prevention strategies may be useful in reducing SLT use in this context.
Background Smoking cessation aids are under-prescribed in primary care. General practitioners (GPs) might prescribe more smoking cessation aids if they focused on the choice between treatments as the default, rather than using motivational interviewing that focuses on whether to make a quit attempt. Objectives Explore the self-reported adoption and impressions of shared-decision making (SDM) for smoking cessation treatments using a decision aid amongst GPs who received intervention or control trainings. Design Mixed quantitative-qualitative convergent analysis of self-reported behaviours from GPs in a pragmatic, cluster-randomized trial conducted between 2021-2023 in Switzerland and France. Methods The intervention training encouraged GPs to offer a choice of smoking cessation aids as the default choice using a decision aid (sustained intervention). The control training presented cessation aids without encouraging GPs to change how they discuss smoking cessation. Implementation was measured using questionnaires before and after the trainings, then at 6- and 12-month follow-up. Self-reported behaviours were quantitatively analysed using logistic regression adjusting for baseline responses. Experiences using SDM and default choice were explored through semi-structured interviews. Results A total of 43 GPs completed questionnaires (26 women (60%), age range 30-59 years) and 12 an interview. The intervention group reported more sustained interventions (OR 8.2 (CI 1.9-50)), use of the decision aid (OR 19.7 (CI 4.1-135)), and offer of treatments as the default choice than the control group (OR 6.4 (CI 1.4-40)) at 12-month follow-up. Small sample size bias was addressed by using Firth’s methodology. In interviews, GPs in the intervention group highlighted the utility of the decision aid and the importance of adapting the default approach to the context of individual patients. Conclusion GPs in the intervention group reported more often initiating treatment discussions with patients who smoke using a decision aid, but not more prescriptions. The default approach was not appropriate for all patients.
Introduction Shisha smoking is common among young adults despite well-documented health risks. Evidence on factors linked to quit attempts among shisha smokers is limited. We examined sociodemographic, consumption-related, harm-perception, and behavioural-economic correlates of quit attempts in Germany. Methods We analysed baseline data from the SHISHA study (01/2024–12/2025), a pilot online survey of adults aged 18–40 years in Germany. Participants were recruited via social media, schools, and flyers. Associations with quit attempts were examined using univariable logistic regressions. Results Of 1,134 respondents, 570 identified themselves as current shisha smokers, and 504 provided valid data on quit attempts. The median age was 24 years; 68.3% were male and 30.2% female. Overall, 14.6% (95% CI = 11.9–17.8) of current shisha smokers reported having ever attempted to quit. Perceived dependence was the only variable significantly associated with quit attempts: those rating it unlikely to be or become addicted had higher odds of having attempted to quit than those rating it likely (OR = 2.05, 95% CI: 1.26–3.32). No significant associations were observed for sociodemographic characteristics, consumption patterns, perceived health risk, or behavioural-economic measures; descriptively, quit attempters showed more risk-averse choices. Discussion In Germany, people who smoke shisha are typically young adults and have never attempted to quit. The observed association between low perceived dependence and the absence of quit attempts leaves open whether perceived dependence drives cessation behaviour or whether previous quit attempts shape individuals’ perception of their own dependence.
Background Adolescent nicotine use remains a major public health concern, particularly in the context of increasing e-cigarette uptake and gaps in tobacco-control communication. Effective prevention requires evidence on the information channels through which adolescents prefer to receive risk information about tobacco and nicotine products. Objectives This study examined adolescents’ preferred sources for receiving information about the health risks of cigarettes, e-cigarettes, and waterpipes in Germany, and assessed differences by age, gender, school type, and nicotine-use status. Design Cross-sectional analysis of a large nationwide school-based survey across 14 of 16 German federal states. Methods Data were drawn from the 2024/2025 wave of the Präventionsradar study and included 21,841 adolescents aged 9–17 years from 116 schools and 1,712 classes across 14 German federal states. Weighted descriptive analyses and multilevel logistic regression models were used to examine preferred information sources and information refusal. Models were adjusted for age, gender, school type, and current nicotine-product use, with random intercepts at the class level. Results Parents (30.2%), social media (21.5%), and physicians (18.6%) were the most frequently selected information sources. Younger adolescents more often selected parents, whereas older adolescents more often selected social media and peers. Adolescents currently using at least one tobacco or nicotine product were more likely to select friends and less likely to select parents, teachers, or physicians. They were also more likely to report not wanting health information. Information refusal was additionally associated with male gender and lower academic track. Conclusion Adolescents’ preferred sources of tobacco- and nicotine-related health information differ substantially by sociodemographic characteristics and nicotine-use status. These findings may inform the development of differentiated and multimodal communication strategies.
Background:Arab Americans are one of the fastest-growing immigrant populations in the United States, yet they remain largely invisible in tobacco surveillance and prevention efforts due to their classification as "White" in national data. Despite evidence of elevated tobacco use and chronic disease burden, limited research has examined how cultural, psychological, and social factors shape tobacco-related health risks in this community. Objectives:This study examined associations between ethnic identity, tobacco use, and health outcomes (self-rated health, chronic disease diagnosis) among Arab American adults, and tested whether ethnic identity moderated the association between tobacco use and health outcomes. Methods:In a cross-sectional study, a convenience sample of 112 Arab American adults residing in Central California completed a survey assessing ethnic identity, tobacco use, and health. Ethnic identity was measured using an abbreviated, Arabic-translated adaptation of Phinney's Multigroup Ethnic Identity Measure. Tobacco use was categorized as non-use, single-product use, or multi-product use. Multivariable regression models assessed associations and potential moderating effects of ethnic identity on health outcomes. Results:Over 48% of study participants reported current use, defined as at least some use or more, of at least one tobacco or nicotine product, including cigarettes, e-cigarettes (which may contain synthetic rather than tobacco-derived nicotine), and hookah. Higher ethnic identity scores were associated with significantly lower odds of tobacco use (adjusted OR = 0.35, 95% CI: 0.15-0.83). Single-product users had 75% lower odds of reporting better self-rated health compared to non-users (OR = 0.25, 95% CI: 0.07-0.96). No significant associations were found for multi-product use or chronic disease in adjusted models, and ethnic identity did not significantly moderate associations with health outcomes. Conclusion:Ethnic identity is associated with lower tobacco use among Arab Americans, though its protective effects on health outcomes remain less clear. These findings underscore the need to move beyond acculturation-based frameworks and incorporate identity-informed, culturally responsive approaches to tobacco control in marginalized immigrant communities.
Background:In Vietnam, smoking remains highly prevalent among people living with HIV (PLWH), posing significant health risks. As PLWH receiving HIV care represent a selected population that may differ from the general smoking population, evidence on the psychosocial factors shaping readiness to quit in this group remains limited. This study examines the associations between tobacco-related risk perception, self-efficacy, and social norms with advanced readiness to quit among PLWH who smoke and were enrolled in a smoking cessation trial in Vietnam. Methods:We conducted a secondary cross-sectional analysis of baseline data from the VQUIT randomized controlled trial, including 672 PLWH who currently smoked cigarettes some days or every day, recruited from 13 HIV outpatient clinics in Hanoi, Vietnam. Advanced readiness to quit was defined as currently trying to quit or planning to quit within 30 days; all other responses were classified as lower or no readiness. Multivariable logistic regression models with robust standard errors, clustered at the clinic level, were fitted to examine associations between risk perception, self-efficacy, four social norm constructs, and advanced readiness to quit. Results:Overall, 76.6% of participants reported advanced readiness to quit. Higher risk perception was consistently associated with increased odds of advanced readiness to quit (aORs ranged 1.10 to 1.13 across models). Injunctive norms (aOR=1.11, 95% CI: 1.03-1.20) and internalized norms (aOR=1.40, 95% CI: 1.02-1.94) were positively associated with advanced readiness to quit, while descriptive and subjective norms were not. Self-efficacy showed no significant association. Conclusion:Among PLWH enrolled in a smoking cessation trial in Vietnam, higher risk perception and stronger injunctive and internalized norms were associated with advanced readiness to quit. Cessation interventions integrated into HIV care may benefit from addressing both perceived smoking-related risks and norm-based motivations to quit.
Background:Environmental tobacco smoke (ETS) exposure is a preventable risk factor for adverse health outcomes in early childhood. Urinary cotinine is widely used as a non-invasive biomarker of ETS exposure; however, variation in reported cut-off concentrations limits comparability across studies. No prior systematic review has quantitatively synthesised urinary cotinine cut-off values for children under five years. This review aimed to systematically summarise and evaluate these cut-off concentrations in early childhood. Methods:A systematic review and meta-analysis were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines and a prospectively published protocol (PROSPERO CRD42024556969). PubMed, Embase, Scopus, and the Cochrane Library were searched from inception to February 2025. Observational and experimental studies reporting urinary cotinine cut-off concentrations to classify ETS exposure among children under five years were included. Study quality was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses were performed to estimate pooled urinary cotinine cut-off concentrations for ETS exposure classification, stratified by unit of measurement (ng/mL vs ng/mg creatinine). Results:Twelve studies were included. Reported urinary cotinine cut-off concentrations ranged from 0.05 to 30 ng/mL for unadjusted values and from 2.47 to 120 ng/mg creatinine for creatinine-adjusted values. Meta-analysis yielded pooled reference values of 5.90 ng/mL (95% CI: 5.53-6.27) and 50.36 ng/mg creatinine (95% CI: 47.53-53.20), respectively. Conclusion:Urinary cotinine is a valid biomarker for assessing ETS in young children, but inconsistent cut-off values limit comparability. The pooled estimates may aid interpretation in surveillance and research but should not be used as universal thresholds. Standardized, age-appropriate cut-offs are needed to strengthen exposure assessment and inform child-focused tobacco control policies.
Background/objectives Staphylococcus aureus ( S. aureus ) can cause life-threatening infections, with colonization often preceding infection. Understanding the determinants of S. aureus carriage may improve infection prevention. While smoking has been associated with S. aureus carriage, studies on smokeless tobacco products remain scarce. This study aimed to investigate whether the use of snuff (Swedish snus), a smokeless tobacco product, is associated with S. aureus carriage in adolescents. Design We used data from Fit Futures 1, a population-based cross-sectional study including 1,038 participants (93% attendance). Methods A total of 457 boys and 443 girls had data on snuff use and two nasal and throat swab cultures for S. aureus carriage assessment. Snuff use was defined as occasional or daily use. Logistic regression analysis was used to examine the association between snuff use and S. aureus carriage, with odds ratios (ORs) adjusted for known risk factors. Results Snuff use was associated with a 64% higher odds of nasal carriage (95% CI = 1.18-2.26; carriage defined as one or two positive nasal cultures) compared to non-use. In sex-stratified analyses, this association was observed only among girls, with an adjusted OR of 1.62 (95% CI = 1.03-2.55; carriage defined as two positive nasal cultures) and an adjusted OR of 1.99 (95% CI = 1.25-3.16; carriage defined as one or two positive nasal cultures). Among girls using snuff, the adjusted OR for S. aureus throat carriage was 1.66 (95% CI 1.06-2.59; carriage defined as two positive throat cultures) compared to non-users. Conclusion We identified an association between snuff use and S. aureus nasal and throat carriage among adolescent girls. Girls who used snuff had higher odds of S. aureus nasal (62%) and throat (66%) carriage compared to female non-users. Futures longitudinal studies are needed to clarify whether the observed associations reflect casual relationships.
Background/objectives Staphylococcus aureus ( S. aureus ) can cause life-threatening infections, with colonization often preceding infection. Understanding the determinants of S. aureus carriage may improve infection prevention. While smoking has been associated with S. aureus carriage, studies on smokeless tobacco products remain scarce. This study aimed to investigate whether the use of snuff (Swedish snus), a smokeless tobacco product, is associated with S. aureus carriage in adolescents. Design We used data from Fit Futures 1, a population-based cross-sectional study including 1,038 participants (93% attendance). Methods A total of 457 boys and 443 girls had data on snuff use and two nasal and throat swab cultures for S. aureus carriage assessment. Snuff use was defined as occasional or daily use. Logistic regression analysis was used to examine the association between snuff use and S. aureus carriage, with odds ratios (ORs) adjusted for known risk factors. Results Snuff use was associated with a 64% higher odds of nasal carriage (95% CI = 1.18-2.26; carriage defined as one or two positive nasal cultures) compared to non-use. In sex-stratified analyses, this association was observed only among girls, with an adjusted OR of 1.62 (95% CI = 1.03-2.55; carriage defined as two positive nasal cultures) and an adjusted OR of 1.99 (95% CI = 1.25-3.16; carriage defined as one or two positive nasal cultures). Among girls using snuff, the adjusted OR for S. aureus throat carriage was 1.66 (95% CI 1.06-2.59; carriage defined as two positive throat cultures) compared to non-users. Conclusion We identified an association between snuff use and S. aureus nasal and throat carriage among adolescent girls. Girls who used snuff had higher odds of S. aureus nasal (62%) and throat (66%) carriage compared to female non-users. Futures longitudinal studies are needed to clarify whether the observed associations reflect casual relationships.
Introduction Adolescent electronic cigarette use is a significant public health concern due to its potential for negative health effects and prevalence among youth. The primary aim of the current study is to examine the moderation effect of perceived harm (i.e., low versus high) on the relation between passive and active social media use and past 30-day adolescent e-cigarette use. We hypothesized that the relation between type of social media use and e-cigarette use would be contingent on the level of perceived harm. Aims and Method This study was conducted via secondary data analysis with the public use files from the 2023 National Youth Tobacco Survey that provides a nationally representative sample (N = 22,069) of youth in the United States. The primary analysis consisted of logistic regression that accounted for complex survey sampling and missing data; primarily testing for a moderation effect. Results We found a significant omnibus interaction, F(2,37) = 3.83, p = 0.0307, confirming that high versus low perceived harm moderated the relationship between social media use type and past 30-day e-cigarette use. The difference in probabilities between levels of perceived harm for using e-cigarettes was significantly larger for those reporting high active social media use (i.e., Pr = 0.214) compared to those reporting passive social media use (i.e., Pr = 0.084). Conclusions We found that high versus low perceived harm moderated the relationship between passive and active engagement with e-cigarette-related social media content and past 30-day e-cigarette use for a nationally representative sample of adolescents in the U.S. Based on these findings, prevention strategies targeting adolescent e-cigarette use may be enhanced through tailoring educational messaging that focus on the potential effects of exposure to e-cigarette related social media content in conjunction with the known effects of using e-cigarettes on one’s health. Implications Examining the moderating effects of variables provides a greater understanding of the ways multiple factors interplay and influence adolescent e-cigarette use. The results of the current study demonstrated that differences between perceived levels of harm occurred at each category of social media use, while these differences were most pronounced between the passive use and the high active use social media categories. Prevention strategies targeting adolescent e-cigarette use may be enhanced through tailoring educational messaging and teaching strategies that focus on the potential effects of exposure to e-cigarette related social media content in conjunction with the known biological effects of using e-cigarettes on one’s health.
Background This study examines the prevalence and predictors of cigarette and hookah smoking among Syrian Americans, a growing U.S. immigrant population with historically high tobacco use. Objectives To assess tobacco use behaviors and identify demographic and behavioral predictors of cigarette and hookah use, as well as key motivators for tobacco use, among Syrian American adults. Design A cross-sectional survey study of Syrian American adults in 2 U.S. states. Methods Data were collected from 919 Syrian American adults in Southern California and Florida between 2018 and 2019. Multinomial regression analyses were used to identify demographic and behavioral predictors of cigarette and hookah use. Results Among participants, 16% were current cigarette users, and 37% were current hookah users, both exceeding U.S. national averages. Social occasions and flavored tobacco were key motivators for hookah use, with most participants perceiving hookah as equally or more harmful than cigarettes. Male gender, older age, longer U.S. residency among females, alcohol use, and lower education levels predicted cigarette smoking. Hookah use was associated with younger age, alcohol consumption, and the perception that hookah is less harmful than cigarettes, while health insurance and higher education were protective factors. Cigarette users were less likely to use hookah, whereas former cigarette users had a higher likelihood of hookah use. Education was a key factor in quitting both cigarettes and hookah. Individuals with health insurance were more likely to quit hookah, while those who perceived hookah as less harmful were less likely to quit. Conclusion These findings emphasize the need for culturally tailored tobacco prevention and cessation programs for Syrian Americans, addressing misperceptions of hookah harms and leveraging community-specific motivators to develop effective interventions.
Background The use of non-combustible tobacco-free nicotine (TFN) products has increased markedly among adolescents. Although often perceived as less harmful than traditional tobacco products, nicotine use has been associated with psychological distress. Aim This study examined whether TFN use is associated with symptoms of anxiety and depression in adolescents, whether these associations differ from those of traditional tobacco products, and whether gender identity affects the outcome. Methods Adolescents aged 17 to 19 years were invited to complete an online questionnaire assessing nicotine use and psychological distress, measured using the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using chi-square tests and logistic regression models. Results A total of 3730 adolescents participated, of whom 30% reported nicotine use. TFN use was more common than tobacco use, while dual use was more prevalent among boys. Both TFN and tobacco use were associated with increased odds of anxiety or depression symptoms, with similar effect sizes across product types. However, association were partly gender-dependent. Among girls using nicotine, 80% reported anxiety symptoms, with higher frequency of use associated with greater risk. Among boys, nicotine use was associated with depressive symptoms, and dual product use was associated with an increased risk of psychological distress. Conclusion Nicotine use is associated with psychological distress regardless of product type. Girls may be particularly vulnerable to anxiety-related symptoms, while dual use appears especially risky among boys. These findings highlight the need for gender-sensitive prevention strategies targeting dual use and the progression to regular nicotine use.
Background Smoking rates in Switzerland remain disproportionately high among people with a migration background and with a low socioeconomic status. These groups face multiple access barriers and are often labeled as “hard-to-reach”, underserved communities or disadvantaged in public health literature. Cessation strategies that are inclusive and setting-sensitive remain scarce and under-evaluated for these vulnerable populations. Objectives & Design The one arm pre-post non-clinical trial study aimed to implement and analyze a setting- and milieu-sensitive as well as a linguistically adapted community-based smoking cessation group intervention for disadvantaged groups with a migration background in Switzerland, and to assess its reach, acceptability, and behavioral effects. Methods A two-part workshop program, each lasting two hours, was delivered between 2022 and 2024 to 82 preexisting community groups in their native language across Switzerland. The intervention was conducted in 12 languages and embedded in daily life settings such as clubs and associations. Data was collected in six selected languages from 42 groups through telephone surveys at baseline (T1) and follow-up (T2, three months later). Key indicators included smoking status, quit attempts, reduction in daily cigarette consumption, and the activation of smoke-free social norms. Descriptive statistics were computed, and chi-square tests and paired-samples t-tests were used to analyze changes between baseline (T1) and follow-up (T2). Results Out of 795 participants from the 42 groups included in the analysis, N =184 completed the baseline survey, and 99 could be followed up at T2. Among smokers, 23% had quit cigarette smoking by follow-up, and 50% of those still smoking had made at least one quit attempt. Cigarette consumption decreased significantly. Over a quarter of non-smoking participants reported actively encouraging smokers in their environment to quit or reduce smoking, indicating normative diffusion through strong social ties. Conclusions The findings suggest the potential of short, community-embedded interventions may hold considerable potential. When tailored to the specific social target groups and delivered in everyday environments, such programs may achieve relevant individual outcomes and promote broader shifts toward smoke-free norms within disadvantaged communities.
Introduction:It is unclear why people of Mexican ancestry who smoke report relatively high rates of discussing quitting-related topics, which predicts cessation attempts. Methods:Using Ecological Momentary Assessment (EMA), adults from Mexico (n=40) and with Mexican heritage living in the US (n=52) who smoked daily were sent texts/emails each morning with cessation tips and cessation benefits over 15 days. At baseline, participants reported their personal network characteristics across up to eight different alters. Each evening of the 15 days, participants reported forgoing any cigarettes they normally would smoke (yes/no) and having had any quitting-related conversations (yes/no). Multilevel logistic models were estimated to regress these day-level outcomes of forgoing and, separately, quitting-related conversation on the number of EMA surveys participants had completed prior to that day, network characteristics, and baseline sociodemographic and smoking-related covariates. Results:Participants were more likely to forgo cigarettes if they reported a higher proportion of female alters (AOR = 2.20, 95% CI 1.16-4.18), had more quitter alters whose opinions they respected (AOR = 6.14, 95% CI 1.41-26.75), and as the number of prior EMA surveys completed increased (AOR = 1.19, 95% CI 1.14-1.25). Mexican Americans who preferred English were significantly less likely to forgo smoking (AOR = 0.20, 95% CI 0.04-0.99) compared to participants residing in Mexico. Greater social bonding (i.e., tightly knit networks) was positively associated with having quitting-related conversations (AOR = 1.45, 95% CI 1.05-1.99). Conclusions:Combining targeted messages with activation of quit-support within networks may influence intermediary behaviors that facilitate smoking cessation among Latino/a populations, including individuals not intending to quit soon.
