Publications by authors named "Alex C Liber"

Background: Terms such as 'natural', 'organic' and 'tobacco and water' on cigarette packs may communicate misleading reduced harm messages to consumers. This study describes sales volume and price for brands that used these misleading descriptors in the USA by year, brand and state.

Methods: The data come from Information Resources Incorporated sales data collected in 44 US states from January 2018 to January 2023.

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Introduction: While retail sales and retailer inspection studies generally indicate high compliance with state sales restrictions on Nicotine Vaping Products (NVPs) within the restricted area, studies using survey data generally indicate that most users could readily continue gaining access to restricted NVPs. Our study bridges a gap in the current literature and investigates the potential role of cross-state border purchases to evade state emergency NVP sales restrictions in 2019.

Aims And Methods: The study sample was restricted to NVP sales from the states neighboring Massachusetts, Rhode Island, and Washington, three states that implemented all NVP or flavored NVP sales restrictions in 2019.

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Public health campaigns have the potential to correct vaping misperceptions. However, campaigns highlighting vaping harms to youth may increase misperceptions that vaping is equally/more harmful than smoking. Vaping campaigns have been implemented in the United States and Canada since 2018 and in England since 2017 but with differing focus: youth vaping prevention (United States/Canada) and smoking cessation (England).

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Background: Simulation models play an increasingly important role in tobacco control. Models examining the impact of nicotine vaping products (NVPs) and smoking tend to be highly specialized and inaccessible. We present the Smoking and Vaping Model (SAVM),a user-friendly cohort-based simulation model, adaptable to any country, that projects the public health impact of smokers switching to NVPs.

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Introduction: Sales data analyses are increasingly used to guide tobacco regulatory science. However, such data do not cover specialist retailers like vape shops or tobacconists. Understanding the extent of the cigarette and electronic nicotine delivery system (ENDS) markets covered by sales data is critical to establishing such analyses' generalizability and potential biases.

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Article Synopsis
  • Philip Morris International (PMI) has acquired Swedish Match, signaling a significant shift towards noncombustible nicotine delivery products (NCNDPs) as PMI moves away from traditional cigarette sales.
  • This acquisition could influence other tobacco firms to focus on NCNDPs, especially in the U.S., where PMI is restricted from selling cigarettes.
  • The implications of this deal are broad, as PMI’s strategies could impact the use of nicotine pouches, e-cigarettes, and heated tobacco products while potentially reducing cigarette sales, necessitating further observation of tobacco industry transformations.
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Introduction: Tobacco companies frequently distribute coupons for their products. This marketing tactic may be particularly effective among young adults, who tend to be especially price-sensitive. Young adulthood is also a stage during which many individuals initiate established cigarette smoking and are especially vulnerable to the effects of tobacco marketing.

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  • The 2009 Tobacco Control Act allows the FDA to regulate tobacco products, and in 2019, General Snus became the first modified-risk tobacco product to be authorized, potentially increasing its usage in the U.S.
  • A study analyzing sales data revealed that while absolute sales of General Snus declined, it experienced a relative increase in sales compared to non-snus smokeless products after the MRTP authorization.
  • The study suggests that MRTP designation for General Snus may have positively influenced the entire snus category, indicating that consumers evaluate risk based on product categories rather than single items.
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Identifying determinants of smoking cessation is critical for developing optimal cessation treatments and interventions. Machine learning (ML) is becoming more prevalent for smoking cessation success prediction in treatment programs. However, only individuals with an intention to quit smoking cigarettes participate in such programs, which limits the generalizability of the results.

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Several nicotine vaping product (NVP) device types are available to consumers, and many people who smoke report vaping to help them quit. This study included data from the Wave 3 (2020) ITC Smoking and Vaping Survey in the US, Canada, and England and included 2324 adults who were smoking cigarettes and vaping at least weekly. Device types currently used most often (disposables, cartridges/pods, or tank systems) were assessed using weighted descriptive statistics.

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Introduction: Sales data analyses are increasingly used to guide tobacco regulatory science. However, such data do not cover specialist retailers like vape shops or tobacconists. Understanding the extent of the cigarette and electronic nicotine delivery system (ENDS) markets covered by sales data is critical to establishing such analyses' generalizability and potential biases.

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Article Synopsis
  • This systematic review investigates the effectiveness of electronic nicotine delivery systems (ENDS) flavors in helping individuals quit smoking, analyzing various studies on this topic.
  • A total of 29 studies were included, focusing on quit intentions, attempts, and success rates, but the overall certainty of evidence was low regarding the impact of ENDS flavors on smoking cessation.
  • The study concludes that the current evidence is inconclusive due to inconsistent definitions and methods across studies, highlighting the need for more robust research, particularly randomized controlled trials.
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Objective: To synthesize the outcomes of policy evaluations of flavoured electronic nicotine delivery systems (ENDS) restrictions.

Data Sources: PubMed, Scopus, Embase and Web of Science before May 3, 2022.

Study Selection: Studies that report sales, behaviour, or compliance outcomes related to implemented or hypothetical ENDS flavour restrictions.

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Markets for nicotine vaping products (NVPs) and heated tobacco products (HTPs) have grown as these products became positioned as harm-reduction alternatives to combusted tobacco products. Herein, we present a public health decision-theoretic framework incorporating different patterns of HTP, NVP, and cigarette use to examine their impacts on population health. Our framework demonstrates that, for individuals who would have otherwise smoked, HTP use may provide public health benefits by enabling cessation or by discouraging smoking initiation and relapse.

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Background: We model the potential impact of relaxing current nicotine vaping product (NVP) restrictions on public health in Australia.

Aims And Methods: A Restricted NVP Scenario was first developed to project current smoking and vaping rates, where a U.S.

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Growth in the market for electronic cigarettes (e-cigarettes) raises complex questions about the devices' public health implications and, hence, challenging policy issues. We propose a policy agenda addressing concerns about preventing youth uptake of e-cigarettes and the desire to realize the potential of e-cigarettes to increase adult cigarette smoking cessation. We organize interventions according to the "four Ps" of marketing: product, price, place, and promotion.

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Background: In May 2020, the European Union Tobacco Products Directive mandated that EU member states, including Poland, ban the sale of menthol cigarettes. With menthol making up 28% of cigarette sales before the ban, Poland is the country with likely the largest menthol cigarette sales share in the world to ban their sale. We analyze how this ban changed the Polish tobacco market.

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Unlabelled: Policy Points The commercial determinants of health (CDoH) concept, which currently focuses on markets that harm health, should be expanded to refer to the interface between commerce and health, which can sometimes have positive public health consequences. The regulatory stances framework helps us classify public health preferences for regulating specific markets related to CDoH, based on the intended effects of regulations on market size. The regulatory stances a jurisdiction can adopt can be classified as ranging from prohibitionist through contractionist, permissive, and expansionist, to universalist.

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Introduction: Little is known about the international impact of E-cigarette or Vaping-Associated Lung Injury ('EVALI') on youth perceptions of vaping harms.

Methods: Repeat cross-sectional online surveys of youth aged 16-19 years in England, Canada, and the United States before (2017, 2018), during (2019 August/September), and after (2020 February/March, 2020 August) the 'EVALI' outbreak (N = 63380). Logistic regressions assessed trends, country differences, and associations between exposure to negative news stories about vaping and vaping harm perceptions.

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Article Synopsis
  • Tobacco couponing remains a significant aspect of tobacco marketing in the U.S., and a systematic review was conducted to study its impact on tobacco use.
  • The review analyzed 27 studies, finding that coupon receipt and redemption were more common among young adults, women, and lower-education individuals, and noted a link between coupon receipt and increased tobacco initiation while reducing cessation rates.
  • The findings highlight that couponing targets price-sensitive groups and may result in greater tobacco use, indicating a potential area for public health intervention.
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Introduction: While much of the concern with tobacco industry marketing has focused on direct media advertising, a less explored form of marketing strategy is to discount prices. Price discounting is important because it keeps the purchase price low and can undermine the impact of tax increases.

Methods: We examine annual US marketing expenditures from 1975 to 2019 by the largest cigarette and smokeless tobacco companies as reported to the Federal Trade Commission.

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Background: The E-cigarette, or Vaping Product-Use Associated Lung Injury (EVALI) Outbreak of 2019 hospitalised thousands and killed dozens of people in the USA and raised perceptions of the dangers posed to health by electronic cigarettes (e-cigarettes). These illnesses along with continued increases in youth vaping rates lead to the passage of many state and federal laws intended to curtail the sale of flavoured e-cigarettes. Little is known about the impact of these events on US e-cigarette and cigarette retail sales.

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