Modelling a Two-Tier Tobacco Excise Tax Policy to Reduce Smoking by Focusing on the Addictive Component (Nicotine) More Than the Tobacco Weight.

Modelling a two-tier tobacco excise tax policy to reduce smoking by focusing on the addictive component (nicotine) more than the tobacco weight.

Filed under: Addiction Rehab

N Z Med J. 2012; 125(1367): 35-48
Laugesen M

To determine whether adding a low tax category for very-low nicotine content (denicotinised or Denic) cigarettes would facilitate higher excise and reduced consumption of addictive cigarettes (AddictiveCigs, defined as containing =2 mg nicotine per cigarette).Nicotine content was laboratory-tested to classify cigarettes into two tiers for excise. PubMed was searched for studies of low nicotine content cigarettes. Nicotine delivery studies and estimated current and future cigarette prices provided the basis for estimating the effect of smoking a mix of AddictiveCigs and Denics.The test results indicated that mean nicotine content per cigarette for the 22 most popular New Zealand brands was 8.7 mg (range 5.6-12.4 mg); only AddictiveCigs were sold. Annual 10% excise increases now legislated are estimated to increase price to $ 17.60 per 20s packet by 2016. A minority of smokers will quit, by abstaining from AddictiveCigs. Continuing smokers if able to buy lower-priced Denics ($ 11 a packet), could partly switch to these, which although no less toxic would relieve cravings, reduce nicotine inhaled by 68-86%, and contain smoking costs, without reducing total cigarettes smoked per day.Introducing a lower excise rate for Denics would: (1) allow smokers to select their own mix of AddictiveCigs and Denics; (2) make Denics available to reduce cravings, reduce addiction, and reduce smoking costs of continuing smokers; (3) increase the political feasibility of increasing excise on AddictiveCigs sufficiently to greatly reduce addictive smoking; and (4) enable smokers to reduce their addiction before they quit, and therefore probably become more likely to succeed when they do so.
HubMed – addiction

Social-structural factors associated with supportive service use among a cohort of HIV-positive individuals on antiretroviral therapy.

Filed under: Addiction Rehab

AIDS Care. 2013 Jan 15;
O’Brien N, Palmer AK, Zhang W, Michelow W, Shen A, Roth E, Rhodes CL, Salters KA, Montaner JS, Hogg RS

Abstract As mortality rates decrease in British Columbia, Canada, supportive services (e.g. housing, food, counseling, addiction treatment) are increasingly conceptualized as critical components of care for people living with HIV/AIDS. Our study investigates social and clinical correlates of supportive service use across differing levels of engagement. Among 915 participants from the Longitudinal Investigations into Supportive and Ancillary health services (LISA) cohort, 742 (81%) reported using supportive services. Participants were nearly twice as likely to engage daily in supportive services if they self-identified as straight (95% confidence interval [CI], adjusted odds ratio [AOR]: 1.69), had not completed high school (95% CI, AOR: 1.97), had an annual income of < $ 15,000 (95% CI, AOR: 1.81), were unstably housed (95% CI, AOR: 1.89), were currently using illicit drugs (95% CI, AOR: 1.60), or reported poor social capital in terms of perceived neighborhood problems (95% CI, AOR: 1.15) or standard of living (95% CI, AOR: 1.70). Of interest, after adjusting for sociodemographic and socioeconomic variables, no clinical markers remained an independent predictor of use of supportive services. High service use by those demonstrating social and clinical vulnerabilities reaffirms the need for continued expansion of supportive services to facilitate a more equitable distribution of health among persons living with HIV. HubMed – addiction

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