To explore employers' decisions to base hiring policies on tobacco or nicotine use and community perspectives on such policies, and analyze the implications for organizational identity, community engagement, and health promotion.From 2013 to 2016, 11 executives from six health care organizations and one non-health-care organization with nonsmoker-only hiring policies were interviewed about why and how their policies were created and implemented, concerns about the policies, and perceptions of employee and public reactions. Focus groups were conducted with community members (n = 51) who lived in or near cities where participating employers were based, exploring participants' opinions about why an employer would stop hiring smokers and their support (or not) for such a policy.Most employers excluded from employment those using all forms of nicotine. Several explained their adoption of the policy as a natural extension of a smoke-free campus and as consistent with their identity as health care organizations. They regarded the policy as promoting health. No employer mentioned engaging in a community dialogue before adopting the policy or reported efforts to track the policy's impact on rejected applicants. Community members understood the cost-saving appeal of such policies, but most opposed them. They made few exceptions for health care organizations.Policy decisions undertaken by health care organizations have influence beyond their immediate setting and may establish precedents that others follow. Nonsmoker-only hiring policies may fit with a health care organization's institutional identity but may not be congruent with community values or promote public health.

Background: In California, some 40, 000 retailers sell tobacco products. Tobacco's ubiquitousness in retail settings normalizes use and cues smoking urges among former smokers and those attempting cessation. Thus, limiting the number of retailers is regarded as key to ending the tobacco epidemic. In the past decade, independent pharmacies and local grocery chains in California and elsewhere have voluntarily abandoned tobacco sales. No previous studies have examined the reasons for this emerging phenomenon. We sought to learn what motivated retailers to discontinue tobacco sales and what employees and customers thought about their decision. Methods. We conducted case studies of seven California retailers (three grocery stores, four pharmacies) that had voluntarily ceased tobacco sales within the past 7 years. We interviewed owners, managers, and employees, conducted consumer focus groups, unobtrusively observed businesses and the surrounding environment, and examined any media coverage of each retailer's decision. We analyzed data using qualitative content analysis. Results: For independent pharmacies, the only reason given for the decision to end tobacco sales was that tobacco caused disease and death. Grocers listed health among several factors, including regulatory pressures and wanting to be seen as "making a difference." Media coverage of stores' new policies was limited, and only three retailers alerted customers. Management reported few or no customer complaints and supportive or indifferent employees. Pharmacy employees were pleased to no longer be selling a deadly product. Grocery store management saw the decision to end tobacco sales as enhancing the stores' image and consistent with their inventory of healthy foods. Focus group participants (smokers and nonsmokers) were largely unaware that retailers had stopped selling tobacco; however, almost all supported the decision, viewing it as promoting public health. Many said knowing this made them more likely to shop at the store. Most thought that advertising the store's policy was essential to generate good public relations and tobacco norm changes. Conclusions: Voluntary retailer abandonment of tobacco sales both reflects and extends social norm changes that have problematized tobacco in California. Our findings suggest that such voluntary initiatives by retailers are welcomed by consumers and should be publicized, enhancing public health efforts. © 2011 Patricia A McDaniel.

Background: Tobacco control efforts in Japan have lagged other high income countries, possibly because the Japanese government partially owns Japan Tobacco, Inc. In Japan, tobacco use is still often regarded as an issue of manners rather than an issue of health. Information about tobacco is available, but may not always be accurate. We explored what information Japanese consumers might access by reading popular Japanese books about tobacco. Methods. We searched Amazon.com Japan using the term "Tobacco", identifying the top 12 books by "relevance" and "bestselling." We eliminated duplicates and books not concerned with tobacco use and classified the remaining books as pro-smoking, anti-smoking, or neutral. We reviewed the pro-smoking books, published 2004-2009, and analyzed examples of misinformation by theme. Results: Pro-smoking popular books conveyed five types of misinformation: doubt about science; suggestions that smoking increased health, longevity, virility, etc.; trivializing tobacco's effects; attacking public health advocates/authorities; and linking tobacco use with authenticity, history, or civil rights. At least one book was authored by a former Japan Tobacco employee; another used a popular Japan Tobacco advertising phrase. Conclusions: Creating doubt and confusion about tobacco serves tobacco industry interests and re-creates a strategy developed by US tobacco interests more than 40 years ago. Japanese readers may be misled by texts such as those reviewed. Tobacco control and public health advocates in Japan and globally should expose and counter such misinformation. "Naming and shaming" may be effective. © 2011 Kanamori and Malone; licensee BioMed Central Ltd.

Objectives. We sought to learn how employees reacted to changes in the corporate narrative of Philip Morris Companies (PMC) in the late 1990s and early 2000s. Methods. We analyzed archival internal tobacco industry documents about PMC's creation of a new corporate story. Results. In response to litigation and public opprobrium, PMC replaced its market success?oriented corporate narrative with a new one centered on responsibility. Although management sought to downplay inconsistencies between the old and new narratives, some employees reportedly had difficulty reconciling them, concerned that the responsibility focus might affect company profitability. However, others embraced the new narrative, suggesting radical ideas to prevent youth smoking. These ideas were not adopted. Conclusions. PMC's new narrative was unconvincing to many of its employees, who perceived it either as a threat to the company's continued profits or as incongruous with what they had previously been told. As it had done with the public, PMC misled its employees in explaining a narrative repositioning that would help the company continue business as usual. Moving toward a tobacco endgame will require ongoing discursive and symbolic efforts to disrupt this narrative.

Literature suggests that 'negative advertising' is an effective way to encourage behavioral changes, but it has enjoyed limited use in public health media campaigns. However, as public health increasingly focuses on non-communicable disease prevention, negative advertising could be more widely applied. This analysis considers an illustrative case from tobacco control. Relying on internal tobacco industry documents, surveys and experimental data and drawing from political advocacy literature, we describe tobacco industry and public health research on the American Legacy Foundation's "truth" campaign, an example of effective negative advertising in the service of public health. The tobacco industry determined that the most effective advertisements run by Legacy's "truth" campaign were negative advertisements. Although the tobacco industry's own research suggested that these negative ads identified and effectively reframed the cigarette as a harmful consumer product rather than focusing solely on tobacco companies, Philip Morris accused Legacy of 'vilifying' it. Public health researchers have demonstrated the effectiveness of the "truth" campaign in reducing smoking initiation. Research on political advocacy demonstrating the value of negative advertising has rarely been used in the development of public health media campaigns, but negative advertising can effectively communicate certain public health messages and serve to counter corporate disease promotion.

Background: Targeting of marginalized groups with aggressive tobacco marketing has been identified as exacerbating health disparities. However, interpretation of such targeting by groups varies, from surprise and outrage to regarding such marketing as evidence of social legitimacy. We sought to learn how an often-overlooked marginalized group, older adults, would respond to industry documents offering evidence of tobacco company target marketing. Methods. We conducted 10 focus groups in California cities with older (≥50 years) smokers and former smokers. A set of previously-undisclosed tobacco industry documents related to target marketing was shown to the group in sequence. Audiotaped discussions were transcribed and data analyzed using qualitative approaches. Results: Responses to evidence of tobacco industry targeting varied, with some regarding it as exploitive and others as normal business practice. However, in most groups, discussions turned to government's failure to protect the public - even though government action /inaction was not prompted nor addressed in the discussion documents. Conclusion: Given the Food and Drug Administration's new authority to regulate tobacco products, these findings suggest that some of the tobacco industry's "best customers" (older, established smokers and ex-smokers) may be strong supporters of government regulation of tobacco. © 2013 Yerger et al.; licensee BioMed Central Ltd.

© 2015 McDaniel et al. Background: Reducing the number of tobacco outlets may help reduce smoking uptake and use; public support for such action is essential. We explored how Twitter users responded to the announcement by US pharmacy chain CVS that it was voluntarily ending tobacco sales. Methods: We used Twitter's application programming interface to retrieve tweets and retweets posted over an 8-day period in February 2014 that contained two trending CVS-related hashtags (#cvs and #cvsquits). We manually coded 6,257 tweets as positive, negative, or neutral. Results: The majority of tweets were positive (56.0 %) or neutral (39.4 %). Conclusions: There was little disapproval of CVS's decision to end tobacco sales among Twitter users, possibly due to the voluntary nature of the decision. The level of support suggests that CVS's image and bottom line will not suffer as a result. Further voluntary actions to end tobacco sales - which may lay the groundwork for legislation -- should be incentivized and supported.

Background: Reducing the number of tobacco outlets may help reduce smoking uptake and use; public support for such action is essential. We explored how Twitter users responded to the announcement by US pharmacy chain CVS that it was voluntarily ending tobacco sales. Methods: We used Twitter's application programming interface to retrieve tweets and retweets posted over an 8-day period in February 2014 that contained two trending CVS-related hashtags (#cvs and #cvsquits). We manually coded 6,257 tweets as positive, negative, or neutral. Results: The majority of tweets were positive (56.0 %) or neutral (39.4 %). Conclusions: There was little disapproval of CVS's decision to end tobacco sales among Twitter users, possibly due to the voluntary nature of the decision. The level of support suggests that CVS's image and bottom line will not suffer as a result. Further voluntary actions to end tobacco sales - which may lay the groundwork for legislation - should be incentivized and supported.

© 2016, BMJ Publishing Group. All rights reserved.The tobacco endgame concept reorients discussion away from the persistent control of tobacco toward plans for ending the tobacco epidemic, and envisions a tobaccofree future. A variety of policy approaches