Terms: VLN = Very Low Nicotine VLNC = Very Low Nicotine Cigarettes CPD = Cigarettes Per Day RNC = Reduced Nicotine Cigarette (non-brand hypernym used in some papers) Studies 'In the overall population, 4.1% reported that low-nicotine cigarettes were much more addictive than typical cigarettes, 67.5% said they were equally addictive, while 28.4% reported they were slightly/much less addictive." "Harm and chemical information can be prioritised to ensure VLNCs are not misperceived as less harmful than regular cigarettes
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Smoking can be seen by prisoners as a way of helping to manage stressful situations such as prison transfers, court appearances and prison visits.[22] Missing friends and family and a lack of family support have been identified as further reasons why prisoners might feel the need to smoke.[23] Furthermore, boredom, prolonged periods locked in cells, bullying and stress have all been given as reasons for relapses by prisoners who attempted to quit smoking.[24] Cigarettes and tobacco are frequently used by prisoners as currency and reports indicate this may also apply to medicinal nicotine.[25] In some instances, prisoners have accessed smoking cessation programmes in order to obtain nicotine replacement therapy to sell to other prisoners, whilst they personally continue to smoke.[26] Nicotine patch exchange schemes have been introduced in some prisons in response to this problem, with some prisons insisting on the use of transparent patches to prevent the concealment of illicit substances.[27] Offenders often show other challenging issues in addition to smoking, including addiction to other substances and social and interpersonal difficulties that can affect motivation and the ability to quit smoking.[28] Learning difficulties and high levels of low educational attainment among prisoners can have an impact on an individuals ability to access services and to cope with complex health information materials, which often do not easily translate to the prison setting.[29] The transient nature of prisoners can provide additional challenges in terms of engaging and sustaining contact with stop smoking services and the continuation of support and counselling.[30] Therefore, stop smoking services should plan for the likelihood of transfers[31] by ensuring that medical records are transferred with prisoners, along with a short supply of pharmacotherapy until prescriptions can be renewed at the new location.[32] Linking community stop smoking services to prison programmes could also offer post-release support and thus reduce rates of relapse in a particularly stressful time of readjustment.[33] Mitigating stress and boredom should be included in stop smoking initiatives
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To regulate these purchases, the researchers suggest routine surveillance of online retailers that may identify opportunities to strengthen the implementation of existing public health laws designed to reduce sales of tobacco products to individuals aged 20 years or younger. There is a federal law that very clearly states that USPS cannot be used to ship tobacco products but it is clearly still being used frequently, Harati said
