Papers by Ryan David Kennedy
Tobacco's attempt to re-invent herself hasn't impressed Fair Trade organizations, which want no p... more Tobacco's attempt to re-invent herself hasn't impressed Fair Trade organizations, which want no part of her deforesting ways.
This report presents the current science about health warning labels on tobacco products, includi... more This report presents the current science about health warning labels on tobacco products, including evidence to inform physical design elements, message content, and implementation strategies.
Journal of Health Communication, 2015
Journal of Community Health, 2015
In 2010, Waterloo Region Housing (Canada) enacted a smoke-free (SF) housing policy that made all ... more In 2010, Waterloo Region Housing (Canada) enacted a smoke-free (SF) housing policy that made all new leases in their community-housing portfolio (2722 units) 100 % SF. Existing lease holders were 'grandfathered'-meaning tenants could still smoke in their homes. A survey to measure support for the policy and how the policy had impacted smoking behaviour was delivered to all 2722 households in the Waterloo Region Housing portfolio in 2010 (pre-policy), 2011 and 2013 (post-policy). The proportion of households that completed the survey was 26 % (n = 717) in 2010, 25 % (n = 685) in 2011, and 23 % (n = 619) in 2013. Support for the SF housing policy was 72 % pre-enactment (2010), and increased to 78 % in 2011 and 79 % in 2013; however, most smokers do not support the policy. In 2010, prior to the SF policy, 65 % of tenants who smoke reported someone smoked inside their home; in 2013 this was reduced to approximately half of smokers (52 %). In 2013, 44 % of smokers reported smoking outside more often than before the SF policy was enacted, almost half of tenants with a smoke-free lease (46 %) and more than a third of tenants who have a grandfathered lease (34 %) reported they smoke less since the smoke-free policy. There has been no significant change in the proportion of respondents (>50 %) who reported being exposed to second-hand smoke in their home. This SF housing policy is associated with increased reported outdoor smoking and reduced smoking. Smoke-free policies may support smokers interested in quitting.
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2014
The 2009 Family Smoking Prevention and Tobacco Control Act prohibited the use of characterizing f... more The 2009 Family Smoking Prevention and Tobacco Control Act prohibited the use of characterizing flavors in cigarettes; however, some of these flavors are still used in cigarettes at varying levels. We reviewed tobacco industry internal documents to investigate the role of one of these flavors, cocoa, with the objective of understanding its relationship to sensory and risk perception, promotion of dependence, and enhancement of attractiveness and acceptability. We used the Legacy Tobacco Documents Library to identify documents relevant to our research questions. Initial search terms were generated following an examination of published literature on cocoa, other cigarette additives, and sensory and risk perception. Further research questions and search terms were generated based on review of documents generated from the initial search terms. Cocoa is widely applied to cigarettes and has been used by the tobacco industry as an additive since the early 20th century. Cocoa can alter the ...
Optometrists should be part of the healthcare team addressing tobacco prevention and cessation am... more Optometrists should be part of the healthcare team addressing tobacco prevention and cessation among patients. As part of a pilot Canadian study, we interviewed 18 optometry students and 11 community optometrists to identify the training they have received regarding tobacco use, dependence and cessation. Their training was limited to knowledge about tobacco-related ocular and systemic risks and some skills in asking about smoking behavior in patients older than 15 years. Their training left them lacking necessary: 1) knowledge about tobacco dependence and cessation, 2) skills in communicating tobacco advice, and 3) attitudes regarding their potential role in tobacco prevention and cessation.
Tobacco Control, 2014
Smoke-free policies not only reduce harm to non-smokers, they may also reduce harm to smokers by ... more Smoke-free policies not only reduce harm to non-smokers, they may also reduce harm to smokers by decreasing the number of cigarettes smoked and increasing the likelihood of a successful quit attempt. However, little is known about the impact of exposure to smoking on patios on smoking behaviour. Smokers from the Ontario Tobacco Survey, a longitudinal population representative cohort of smokers (2005-2011). There were 3460 current smokers who had completed one to six follow-ups and were asked at each follow-up whether or not they had been exposed to smoking on patios in the month. Generalised estimating equations and survival analysis were used to examine the association between exposure to patio smoking and smoking behaviour changes (making a quit attempt and time to relapse after a quit attempt), controlling for potential confounders. Smokers who were exposed to smoking on patios (adjusted incident rate ratio (aIRR) = 0.89; 95% CI 0.81 to 0.97) or had been to a patio (aIRR = 0.86; 95% CI 0.74 to 0.99) were less likely to have made a quit attempt than smokers who had not visited a patio. Smokers who were exposed to smoking on patios were more likely to relapse (adjusted HR=2.40; 95% CI 1.07 to 5.40)) after making a quit attempt than those who visited a patio but were not exposed to smoking. Exposure to smoking on patios of a bar or restaurant is associated with a lower likelihood of success in a quit attempt. Instituting smoke-free patio regulations may help smokers avoid relapse after quitting.
Optometry and Vision Science, 2014
Purpose. A national census survey of optometrists in Canada measured knowledge of ocular diseases... more Purpose. A national census survey of optometrists in Canada measured knowledge of ocular diseases associated with smoking cigarettes and current practice behaviors related to addressing tobacco use with patients, including prevention and cessation. Optometrists were also asked to identify tools to assist addressing tobacco use with patients.
Tobacco Induced Diseases, 2014
Background: In 2006, enclosed public and workplaces in Ontario were made smoke-free by the Smoke-... more Background: In 2006, enclosed public and workplaces in Ontario were made smoke-free by the Smoke-free Ontario Act (SFOA). Numerous area municipalities across the province have since developed local by-laws that are more restrictive than the SFOA and ban smoking in outdoor environments including parks, beaches, and patios. The current study measured reported costs associated with the implementation and enforcement of smoke-free outdoor municipal by-laws including materials and staffing costs. The study also assessed the number of warnings or tickets issued to smokers. Ontario communities with a by-law in force for at least 2 years were included in the sample (n = 42). The study was completed by 88% of area municipalities (n = 37). Municipal staff and managers completed a survey by telephone between June-September 2012.
Sociological Methods & Research, 2014
Prepaid monetary incentives are used to address declining response rates in random-digit-dial sur... more Prepaid monetary incentives are used to address declining response rates in random-digit-dial surveys. There is concern among researchers that some respondents will accept the prepayment but not complete the survey. There is little research to understand check cashing and survey completing behaviors among respondents who receive pre-payment. Data from the International Tobacco Control Four Country Study-a longitudinal survey of smokers in Canada, the US, the UK, and Australia, were used to examine the impact of prepayment (in the form of checks, approximately $10USD) on sample profile. Approximately 14% of respondents cashed their check, but did not complete the survey, while about 14% did not cash their checks, but completed the survey. Younger adults (Canada, US), those of minority status (US), and those who had been in the survey for only two waves or less (Canada, US) were more likely to cash their checks and not complete the survey.
Optometry - Journal of the American Optometric Association, 2011
Smoking is causally associated with certain prevalent visually impairing eye diseases, including ... more Smoking is causally associated with certain prevalent visually impairing eye diseases, including age-related macular degeneration and cataract. Studies have found that people are afraid of "going blind" and may be motivated to quit smoking if they know that vision loss is associated with smoking behavior. A random-digit dialed telephone survey was used to measure health knowledge of adult smokers in Canada (n = 2,765), the United States (n = 3,178), the United Kingdom (n = 2,767), and Australia (n = 2,623) as part of the International Tobacco Control Four-Country Project. A low proportion of smokers from Canada (13.0%), the United States (9.5%), and the United Kingdom (9.7%) believed that smoking can cause blindness. In contrast, 47.2% of Australian smokers believed that smoking causes blindness. Australia was the only country during the sampling period to have national awareness campaigns about smoking and its effects on eye health. These findings point to the need across countries to educate the public on this important consequence of smoking. There is an opportunity for the public health and eye health communities to work to educate the public about the impacts smoking has on eye health to improve quit rates and help discourage people from starting to smoke.
Optometry and Vision Science, 2011
The current pilot study sought to understand optometrists&amp... more The current pilot study sought to understand optometrists' attitudes toward addressing tobacco use within the scope of their practice, and to identify opportunities within Canada to integrate optometrists as health care partners into the national tobacco cessation network. A descriptive qualitative design was used to conduct this pilot study. Five focus groups were conducted with 29 informants, including 11 practicing community optometrists and 18 senior Doctor of Optometry students from the University of Waterloo. Rationales, barriers, and opportunities to practice patterns were identified. Optometrists and optometry students knew the association of smoking with eye diseases such as age-related macular degeneration and cataract; however, some informants selectively asked patients about smoking behavior based on patient age or visit type. Most informants indicated that they did inform their patients who smoke of their increased risk of developing certain eye diseases; however, very few informants assessed whether their patients wanted to stop smoking and no informants reported that they had ever provided a patient with explicit support for tobacco cessation. This limited role in smoking cessation support for patients due, in part, to insufficient: financial incentives, training and educational tools and materials, knowledge of community resources for cessation treatments, and time during appointments. Several opportunities were identified to better integrate optometry into tobacco control efforts such as optometrists' access to patients, patients' fear of blindness as a tool to motivate behavior changes, and practitioners' openness to change. Optometrists can be a helpful addition to a smoking cessation healthcare network that already involves more than a dozen health care professions including medicine, nursing, pharmacy, dentistry, and dental hygiene. The findings of this study will be used to develop a national survey of Canadian optometrists' practice patterns regarding tobacco use prevention efforts and cessation supports for their patients.
Nicotine & Tobacco Research, 2013
The tobacco industry has developed technologies to reduce the aversive qualities of cigarette smo... more The tobacco industry has developed technologies to reduce the aversive qualities of cigarette smoke, including secondhand smoke (SHS). While these product design changes may lessen concerns about SHS, they may not reduce health risks associated with SHS exposure. Tobacco industry patents were reviewed to understand recent industry strategies to mask or minimize cigarette smoke from traditional cigarettes. Patent records published between 1997 and 2008 that related to cigarette smoke were conducted using key word searches. The U.S. Patent and Trademark Office web site was used to obtain patent awards, and the World Intellectual Property Organization's Patentscope and Free Patents Online web sites were used to search international patents. The search identified 106 relevant patents published by Japan Tobacco Incorporated, British America Tobacco, Philip Morris International, and other tobacco manufacturers or suppliers. The patents were classified by their intended purpose, including reduced smoke constituents or quantity of smoke emitted by cigarettes (58%, n = 62), improved smoke odor (25%, n = 26), and reduced visibility of smoke (16%, n = 18). Innovations used a variety of strategies including trapping or filtering smoke constituents, chemically converting gases, adding perfumes, or altering paper to improve combustion. The tobacco industry continues to research and develop strategies to reduce perceptions of cigarette smoke, including the use of additives to improve smoke odor. Surveillance and regulatory response to industry strategies to reduce perceptions of SHS should be implemented to ensure that the public health is adequately protected.
Journal of Community Health, 2014
Very little is known about how smoking and other tobacco use is regulated in outdoor and semi-enc... more Very little is known about how smoking and other tobacco use is regulated in outdoor and semi-enclosed spaces across transit systems. The purpose of this study was to understand how American transit systems are regulating cigarettes and other tobacco products, including smokeless tobacco and e-cigarettes, in outdoor or quasi-outdoor spaces. Within four regions of the United States, a purposive convenience sample was taken of the top five volume American transit systems (n = 20) based on annual ridership. Each transit authority website was systematically reviewed to produce a cross-sectional study of the published policies regarding tobacco product use for indoor, outdoor, and quasioutdoor spaces of transit property; rules regarding cigarettes, smokeless tobacco and electronic cigarettes were identified. Policies regulating tobacco use were enacted by transit systems and/or the cities and states in which transit systems are located. The majority (80 %) of transit systems banned smoking in outdoor areas; few prohibited smokeless tobacco use (15 %, n = 3) and some disallowed e-cigarettes (30 %, n = 6). Violation consequences ranged widely from none to verbal warnings, ejection from transit property, fines, and imprisonment. Regulating smoking in outdoor or quasioutdoor environments is common in American transit environments. These policies can help protect vulnerable populations from exposure to secondhand smoke and communicate a tobacco-free norm.
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Papers by Ryan David Kennedy