Transitions in product use during the implementation of the European Tobacco Products Directive: cohort study findings from the EUREST-PLUS ITC Europe Surveys
Authors: Vardavas Constantine I , Kyriakos Christina N , Driezen Pete , Girvalaki Charis , Nikitara Katerina , Filippidis Filippos T , Fernández Esteve , Mons Ute , Przewoźniak Krzysztof , Trofor Antigona C , Demjén Tibor , Katsaounou Paraskevi A , Zatoński Witold , Willemsen Marc , Fong Geoffrey T ,   the EUREST-PLUS Consortium, Vardavas Constantine I , Glahn Andrea , Kyriakos Christina N , Nguyen Dominick , Nikitara Katerina , Radu-Loghin Cornel , Tsatsakis Aristidis , Girvalaki Charis , Igoumenaki Chryssi , Papadakis Sophia , Papathanasaki Aikaterini , Tzatzarakis Manolis , Vardavas Alexander I , Bécuwe Nicolas , Deaconu Lavinia , Goudet Sophie , Hanley Christopher , Rivière Oscar , Demjén Tibor , Kiss Judit , Kovacs Anna Piroska , Fernández Esteve , Castellano Yolanda , Fu Marcela , Nogueira Sarah O , Tigova Olena , McNeill Ann , East Katherine , Hitchman Sara C , Mons Ute , Kahnert Sarah , Tountas Yannis , Behrakis Panagiotis , Filippidis Filippos T , Gratziou Christina , Katsaounou Paraskevi , Peleki Theodosia , Petroulia Ioanna , Tzavara Chara , Trofor Antigona Carmen , Eremia Marius , Lotrean Lucia , Mihaltan Florin , Rohde Gernot , Asano Tamaki , Cichon Claudia , Far Amy , Genton Céline , Jessner Melanie , Hedman Linnea , Janson Christer , Lindberg Ann , Maguire Beth , Ravara Sofia , Vaccaro Valérie , Ward Brian , Willemsen Marc , de Vries Hein , Hummel Karin , Nagelhout Gera E , Zatoński Witold A , Herbeć Aleksandra , Janik-Koncewicz Kinga , Przewoźniak Krzysztof , Zatoński Mateusz , Fong Geoffrey T , Agar Thomas K , Driezen Pete , Gravely Shannon , Quah Anne C K , Thompson Mary E 
Published: May 2020

AbstractBackgroundThe emergence of new types of tobacco and tobacco-related products on the European Union (EU) market has precipitated the possibility for both poly-tobacco use and transitions between products. In the EU, the regulatory environment has shifted with the implementation of the European Tobacco Products Directive (TPD) in May 2016, which may influence consumer transitions between products.MethodsThe aim of this paper was to examine trends and transitions in tobacco products from 2016 to 2018 -before and after implementation of the TPD in the EU. Data come from Wave 1 (pre-TPD) and Wave 2 (post-TPD) of the EUREST-PLUS ITC Six European Country Survey, a cohort study of adults who at the time of recruitment were smokers from six EU countries- Germany, Greece, Hungary, Poland, Romania, and Spain. D (N = 3195). Bivariate and logistic regression analyses of weighted data was conducted using SAS-callable SUDAANResultsOverall, among those who smoked factory-made cigarettes (FM) only at Wave 1, 4.3% switched to roll-your-own tobacco (RYO) only. Among RYO only users at Wave 1, 17.0% switched to FM only, however compared to all other countries, respondents from Hungary had the highest percentage of FM only users at Wave 1 switch to RYO only at Wave 2 (18.0%).ConclusionsThe most prominent transition overall was from smoking RYO exclusively at Wave 1 to smoking FM tobacco exclusively at Wave 2, however this varied across countries. As the tobacco control regulatory environment of the EU develops, it is important to continue to monitor transitions between types of products, as well as trends in cessation.