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Current Prevention Projects

OTRU prevention projects are investigating trends and use of contraband products, the effect of pricing on the brand preferences of young people, the influence of student and school level characteristics on student tobacco use behaviour, and the factors related to the retail environment that influence health outcomes.

Cigarette Brands Smoked by Ontario Youth

Start Date: April 2012
Expected Date of Completion: March 2013
Project Lead: K. Stephen Brown
Principal Investigators: K. Stephen Brown, Joanna Cohen, Robert Schwartz
Funding Source: Ministry of Health and Long-Term Care

Project Description

Tobacco use among Ontario youth continues to be influenced greatly by the availability of contraband; but other factors may also be at play in the brand choices made by youth. This project explores patterns of youth cigarette use across the last 3 cycles of the Youth Smoking Survey using information about purchase of different brands of cigarettes including contraband, premium brands, discount brands, roll your own. These analyses will help to inform strategies for countering tobacco marketing to youth.

Main Research Questions
  • What is the role of price among various youth who smoke?
  • What are the brand preferences of youth across Canadian provinces?

Methodology

Secondary survey analysis

Creating Healthy Retail Environments

Start Date: April 2012
Expected Date of Completion: March 2013
Project Lead: Michael Chaiton
Principal Investigators: Joanna Cohen, John Garcia, Roberta Ferrence, Robert Schwartz
Project Team: Cathy Mah
Funding Source: Ministry of Health and Long-Term Care

Project Description

The number one recommendation made by Tobacco Scientific Advisory Committee for the renewal of the Smoke-Free Ontario Strategy focused on the retailing of tobacco. This project explores a potential policy solution to work in partnership with retailers to develop or encourage healthy retail environments. Across North America, including in Ontario, jurisdictions are aiming to partner with small retailers to promote health, particularly in rural and underserviced neighbourhoods. However, most existing programs and policies have focused primarily on addressing food availability and research is needed to understand the impact of these policies and how they may be expanded to address tobacco control.

Scope

The project includes a literature review that explores current knowledge on how the retail environment (broadly defined) influences on population health outcomes and evaluate existing policy options for tobacco control.

This review is being leveraged into a research proposal to develop and assess interventions for the retail environment for tobacco and food in order to inform policy decisions aimed at creating healthy retail environments.

Main Research Questions

The proposal will develop into a mixed method research program to develop a better understanding of the retail environment for tobacco, alcohol, and food, including the role of retailers, economic and health impacts, and policy options.

Research Aims
  • Better understanding of the environment (broadly defined) and its influence on population health outcomes
  • Better understanding of retailers: health leaders (e.g., interviews with champions such as retailers who refuse to sell tobacco) and compliance and enforcement issues
  • Economic analysis of healthy environments
  • Potential policy or program interventions

Methodology

Literature Review leading to mixed methods including survey, and qualitative interviews

Estimating the Size of the Cigarette Contraband Market in Canada

Start Date: April 2012
Expected Date of Completion: March 2013
Project Lead: K. Stephen Brown
Principal Investigators: K. Stephen Brown, Sue Bondy, Joanna Cohen, Roberta Ferrence, Robert Schwartz
Funding Source: Ministry of Health and Long-Term Care

Project Description

Decades of research have produced overwhelming evidence that tobacco taxes can reduce tobacco use, save lives and increase government tax revenue. The effectiveness of taxes at reducing tobacco use provides a strong incentive for tobacco users and manufacturers to devise ways to avoid or evade tobacco taxes. This study documents levels and trends in tobacco users’ consumption of contraband cigarettes. Additionally, the size of the cigarette contraband market will be estimated by contrasting estimates of legal cigarettes sales with consumption estimates based on survey data.

Main Research Questions
  • What are the current levels and trends in tobacco users’ consumption of contraband cigarettes?
  • What is the size of the contraband market?

Methodology

Secondary Analysis of existing survey data from multiple sources

Formative Evaluation of Risk-Based Enforcement Pilot

Start Date: April 2011
Expected Date of Completion: September 2013
Project Lead: Maritt Kirst
Principal Investigators: Roberta Ferrence, Robert Schwartz
Project Team: Jolene Dubray
Source of Funding: Ministry of Health and Long-Term Care

Project Description

This project evaluates pilot projects for a new risk-based enforcement regime. OTRU, along with the Ministry of Health and Long-Term Care, Health Promotion Division, is working with three public health units to tailor and pilot new evidence-informed tobacco control enforcement approaches to youth access policy compliance. The project involves subsequent evaluation of this approach in the participating public health units.

Main Research Questions

What are the impacts of evidence informed tobacco control enforcement approaches on youth access policy compliance?

Methodology

Administrative data analyses and interviews with enforcement stakeholders.

Identifying High-Risk School Environments for Tobacco Use

Start Date: April 2012
Expected Date of Completion: March 2013
Project Lead: K. Stephen Brown
Principal Investigator: K. Stephen Brown, Robert Schwartz
Funding Source: Ministry of Health and Long-Term Care

Project Description

Determining the school-level characteristics that are associated with different youth tobacco use behaviours would provide valuable insight for informing the future development, tailoring and targeting of school-based tobacco control initiatives to where they are most likely to have impact. The 2010-11 Youth Smoking Survey (YSS) is a nationally representative sample of Canadian youth in grades 9 to12 attending public and private schools in 9 Canadian provinces. The present study will explore student-level data, and program and policy data, and built environment data for all of the secondary schools who participated in the 2010-11 YSS (school-level data).

Main Research Questions
  • What are the student- and school-level characteristics associated with student tobacco use?
  • What is the potential magnitude of the effect that school-level programs and policies may have on student tobacco use behaviour?

Methodology

Secondary survey analysis

Intervention Research on the New Rapidly Unfolding Ontario Tobacco Strategy: Policy Window for a Population Health Model of Tobacco Retail Sales

Start Date: April 2012
Expected Date of Completion: March 2013
Principal Investigator: Michael Chaiton
Co-investigators: Joanna Cohen, Kevin McDonald, Melodie Tilson, Bill Maga, Norman Giesbrecht
Project Team: Graham Mecredy
Source of Funding: Canadian Institutes of Health Research

Project Description

Despite advances, tobacco control policy has not yet addressed the physical availability of tobacco products in the retail environment. These products are sold in corner stores, grocery stores and gas stations putting them within easy reach of those most vulnerable to nicotine addiction, especially youth and lower socioeconomic groups.

There is a need to address the problem of widespread availability of tobacco products in the retail environment. However, more research is needed in order to be able to recommend specific policy interventions. This project addresses this need by analyzing and evaluating options for reducing tobacco retail outlet density.

Main Research Questions
  • What are the advantages, expected impacts and possible unintended consequences of the following three interventions for reducing tobacco retail outlet density
    • licensing system, with high cost of licenses, moratorium on new licenses and phased reduction in number of licenses
    • zoning laws to create tobacco retail-free zones (e.g., around schools)
    • designated tobacco retail outlets, with the number of allowable outlets standardized according to surrounding population or geographic area
  • Should elements of these three approaches be combined, and if so, how?

Methodology

  • Expert Panel to evaluate population intervention options for reducing tobacco retail density
  • A review of the international literature on tobacco and alcohol retail availability
  • A geographic information systems (GIS) map showing the relative distribution of tobacco outlets compared to that of other venues, e.g., alcohol and postal outlets
  • Expert Panel Report that presents evidence-informed recommendations for reducing tobacco retail outlet density

Smoking Co-morbidities during the Transition from High School Post-Graduation: A Scoping Review

Start Date: April 2012
Expected Date of Completion: March 2013
Project Leads: Michael Chaiton and Maritt Kirst
Principal Investigators: Sue Bondy, Steve Brown, Roberta Ferrence, Robert Schwartz
Project Team: Graham Mecredy, Tracey Borland
Source of Funding: Ministry of Health and Long-Term Care

Project Description

Cigarette smoking prevalence rates increase substantially during the transition from adolescence to young adulthood, and many young people initiate smoking after the age of 18. Young adulthood is also a time when co-occurring health risk behaviours and issues, such as problem drinking, illicit drug use, and mental health problems may begin to emerge.

This project undertakes a scoping review of existing evidence on tobacco use co-morbidities among young adults during the transition from high school post-graduation to contribute to a greater understanding of prevalence and predictors of tobacco use co-morbidities, co-use of other substances, and comorbid mental health problems.

Main Research Question

What is currently known about the prevalence and predictors of tobacco use co-morbidities among young adults transitioning from high school post-graduation?

Methodology

Scoping review