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Twum F, Tome J, Ledel E, Roy V, Mallhi AK, Aguirre D, Wei Y, Zhang J. The Diverging Trend in Exposure to Environmental Tobacco Smoke Among US Children. J Racial Ethn Health Disparities 2024; 11:1718-1729. [PMID: 37326795 DOI: 10.1007/s40615-023-01645-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 05/14/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Environmental tobacco smoke exposure (ETSE) was race/ethnicity-specific, but how the race/ethnicity-specific ETSE has changed over time, diverging or converging, remains unclear. We examined ETSE trends by race/ethnicity in US children aged 3-11 years. METHODS We analyzed the data of 9678 children who participated in the biennial National Health and Nutrition Examination Surveys, 1999-2018. ETSE was defined as serum cotinine ≥ 0.05 ng/ml, with ≥ 1 ng/ml as heavy exposure. For trend description, adjusted biennial prevalence ratios (abiPR: the ratio associated with a 2-year increase in time) were estimated by race/ethnicity. The prevalence ratios between races/ethnicities were used to quantify ethnoracial differences in different survey periods. Analyses were performed in 2021. RESULTS The overall ETSE prevalence was cut by almost half, from 61.59% (95% confidence interval = 56.55%, 66.62%) in the 1999-2004 survey to 37.61% (33.90%, 41.31%) in 2013-2018, exceeding the national 2020 health target (47.0%). However, the decrease occurred unequally between races/ethnicities. Heavy ETSE declined significantly in white [abiPR = 0.80 (0.74, 0.86)] and Hispanic children [0.83 (0.74, 0.93)], but insignificantly in black children [0.97 (0.92, 1.03)]. Consequently, the adjusted prevalence ratio between black children and white children increased from 0.82 (0.47, 1.44) in 1999-2004 to 2.73 (1.51, 4.92) in 2013-2018 for heavy ETSE. Hispanic children remained at the lowest risk throughout the study period. CONCLUSION Overall ETSE prevalence was cut by half between 1999 and 2018. However, due to uneven declines, the gaps between black children and others have expanded in heavy ETSE. Special vigilance is needed in preventive medicine practice with black children.
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Affiliation(s)
- Felix Twum
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA.
- The Dr. Lynn Cook Hartwig Public Health Program, School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, 39406, USA.
| | - Joana Tome
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - Erica Ledel
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - Victoria Roy
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - Arshpreet Kaur Mallhi
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - Diana Aguirre
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - Yudan Wei
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA, 31207, USA
| | - Jian Zhang
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
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Nwaobi SO, Richmond HL, Babatunde DA, Twum F, Mallhi AK, Wei Y, Zhang J. Crossover Trends in Current Cigarette Smoking Between Racial and Ethnic Groups of US Adolescents Aged 12-19 Years Old, 1999-2018. J Racial Ethn Health Disparities 2023; 10:2114-2123. [PMID: 36006586 PMCID: PMC9406249 DOI: 10.1007/s40615-022-01391-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the racial difference and trends in cigarette smoking among adolescents from 1999 to 2018. METHODS We analyzed the data of 10,760 adolescents aged 12-19 who participated in the National Health and Nutrition Examination Surveys (NHANES), 1999-2018. Current tobacco smoking (CTS) was defined as participants with serum cotinine ≥10 ng/mL. Adjusted biennial prevalence ratios (abiPR: the ratio associated with a two-year increase in time) were estimated. RESULTS Diverging trends in CTS prevalence were revealed in adolescents. The steepest decrease occurred in Hispanics aged 12-17, with 15% declining every two calendar years [abiPR = 0.85(0.77, 0.94)]. The sharpest increase occurred with Blacks aged 18-19 years [abiPR = 1.06(0.99, 1.14)]. A crossover of prevalence trend between Blacks and Whites occurred in adolescents aged 18-19 years old due to the diverging trends. The average CTS prevalence was significantly higher in Whites than in Blacks in the early [(1999-2008, 13.65% (11.85%, 15.46%) vs. 8.80% (7.55%, 10.04%)], but Blacks had a higher average in recent years [(2009-2018, 8.32% (6.53%, 10.12%) vs. 7.77% (5.86%, 9.68%)]. For adolescents aged 18-19 years, the survey cycles or calendar years linearly explained 71% of the variations in the prevalence for Hispanics, 60% for Whites, but only 1% for Blacks. CONCLUSIONS A crossover in the trend of current tobacco smoking occurred between 1999 and 2018 due to an increase in prevalence among Black adolescents and a significant decrease in prevalence among other racial groups.
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Affiliation(s)
- Samuel O Nwaobi
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - Holly L Richmond
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - Doyinsola A Babatunde
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - Felix Twum
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
- School of Health Professions, Public Health Program, The University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Arshpreet Kaur Mallhi
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - Yudan Wei
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA, 31207, USA
| | - Jian Zhang
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA.
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Noar SM, Gottfredson N, Vereen RN, Kurtzman R, Sheldon JM, Adams E, Hall MG, Brewer NT. Development of the UNC Perceived Message Effectiveness Scale for Youth. Tob Control 2023; 32:553-558. [PMID: 34930810 PMCID: PMC9238328 DOI: 10.1136/tobaccocontrol-2021-056929] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/26/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE Tobacco prevention media campaigns are an important tool to address youth tobacco use. We developed a theory-based perceived message effectiveness (PME) Scale to use when vetting messages for campaigns. METHODS Participants were a national sample of N=623 US adolescents (ages 13-17 years) recruited from a national probability-based panel. In an online experiment, we randomised adolescents to view tobacco prevention ads. All participants viewed an ad on smoking or vaping from the US Food and Drug Administration's The Real Cost campaign and a control video, in a random order. After ad exposure, we assessed PME using nine candidate items and constructs for convergent and criterion validity analyses. We used confirmatory factor analysis and examined information curves to select the scale items. RESULTS A brief PME scale with three items (α=0.95) worked equally well for demographically diverse adolescents with different patterns of tobacco use. The Real Cost ads generated higher PME scores than the control videos for both vaping and smoking (convergent validity; p<0.05). Higher PME scores were associated with greater attention, fear, cognitive elaboration and anticipated social interactions (convergent validity; r=0.31-0.66), as well as more negative attitudes toward and lower susceptibility to vaping and smoking (criterion validity; r=-0.14 to -0.37). A single-item PME measure performed similarly to the three-item version. CONCLUSIONS The University of North Carolina PME Scale for Youth is a reliable and valid measure of the potential effectiveness of vaping and smoking prevention ads. Employing PME scales during message development and selection may help youth tobacco prevention campaigns deploy more effective ads.
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Affiliation(s)
- Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Nisha Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rhyan N Vereen
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rachel Kurtzman
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jennifer Mendel Sheldon
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Elizabeth Adams
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Marissa G Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Noel T Brewer
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
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Freeman B, Owen K, Rickards S, Brooks A, Clare PJ, Dessaix A. E-cigarette use by people who smoke or have recently quit, New South Wales, 2016-2020. Med J Aust 2023; 218:131-137. [PMID: 36494187 DOI: 10.5694/mja2.51811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To examine e-cigarette use by adults who smoke or have recently quit, and demographic characteristics associated with their use; to assess reasons for using e-cigarettes. DESIGN The Cancer Institute NSW Tobacco Tracking Survey (CITTS) is an ongoing, serial, cross-sectional telephone survey study (40 interviews each week). This report is based on interviews during 4 January 2016 - 31 December 2020. SETTING, PARTICIPANTS Randomly selected New South Wales adults who are current smokers (smoked cigarettes, pipes, or other tobacco products daily, weekly, or less often) or recent quitters (smoked tobacco products in the past twelve months but who no longer smoked). MAIN OUTCOMES E-cigarette use by age group; reasons for using e-cigarettes. RESULTS CITTS callers rang 1 494 233 randomly selected numbers; in 203 203 answered calls (13.6%), 11 125 people were eligible for the survey (5.5% of answered calls), of whom 10 004 completed the survey interview, including the question about whether they used e-cigarettes (89.9%). Overall e-cigarette use increased from 6.6% of respondents in 2016 to 13.0% in 2020 (adjusted odds ratio, 1.86; 95% confidence interval [CI], 1.47-2.36). The proportion of respondents aged 18-24 years who reported e-cigarette use increased from 18.4% (95% CI, 12.9-23.9%) in 2018 to 27.2% (95% CI, 20.5-33.9%) in 2020, a larger proportion than for any other age group. The leading reasons offered for e-cigarette use were "to help me quit smoking" (33%; 95% CI, 30-37%) and "to cut down on the number of cigarettes I smoke" (25%; 95% CI, 22-28%). CONCLUSION The increase between 2016 and 2020 in the proportions of young adults who smoke or have recently quit who use e-cigarettes undermines claims that these products are designed for older smokers who have struggled to quit using other methods.
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Affiliation(s)
- Becky Freeman
- Sydney School of Public Health, the University of Sydney, Sydney, NSW
| | - Katherine Owen
- Sydney School of Public Health, the University of Sydney, Sydney, NSW
| | | | | | - Philip J Clare
- Sydney School of Public Health, the University of Sydney, Sydney, NSW
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The great decline in adolescent risk behaviours: Unitary trend, separate trends, or cascade? Soc Sci Med 2023; 317:115616. [PMID: 36563586 DOI: 10.1016/j.socscimed.2022.115616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
In many high-income countries, the proportion of adolescents who smoke, drink, or engage in other risk behaviours has declined markedly over the past 25 years. We illustrate this behavioural shift by collating and presenting previously published data (1990-2019) on smoking, alcohol use, cannabis use, early sexual initiation and juvenile crime in Australia, England, the Netherlands, New Zealand, and the USA, also providing European averages where comparable data are available. Then we explore empirical evidence for and against hypothesised causes of these declines. Specifically, we explore whether the declines across risk behaviours can be considered 1) a 'unitary trend' caused by common underlying drivers; 2) separate trends with behaviour-specific causes; or 3) the result of a 'cascade' effect, with declines in one risk behaviour causing declines in others. We find the unitary trend hypothesis has theoretical and empirical support, and there is international evidence that decreasing unstructured face-to-face time with friends is a common underlying driver. Additionally, evidence suggests that behaviour-specific factors have played a role in the decline of tobacco smoking (e.g. decreasing adolescent approval of smoking, increasing strength of tobacco control policies) and drinking (e.g. more restrictive parental rules and attitudes toward adolescent drinking, decreasing ease of access to alcohol). Finally, declining tobacco and alcohol use may have suppressed adolescent cannabis use (and perhaps other risk behaviours), but evidence for such a cascade is equivocal. We conclude that the causal factors behind the great decline in adolescent risk behaviours are multiple. While broad contextual changes appear to have reduced the opportunities for risk behaviours in general, behaviour-specific factors have also played an important role in smoking and drinking declines, and 'knock-on' effect from these behavioural domains to others are possible. Many hypothesised explanations remain to be tested empirically.
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Valentino G, Ortigoza A, Rodriguez Osiac L, Doberti T, Mullachery P, Nazzal C. Smoking Ban Law in Chile: Impact in Newborns' Birth Weight by Women's Age Groups and by City Population Density. Int J Public Health 2022; 67:1605087. [PMID: 36579137 PMCID: PMC9791390 DOI: 10.3389/ijph.2022.1605087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives: We examined the short-term impact of the Smoking Ban Law (SBL) enacted in Chile in 2013 on low birth weight (LBW) rates in cities and its differential effects by different maternal age groups and city density. Methods: We included 885,880 live births from 21 Chilean cities of ≥100,000 inhabitants. We examined the smoking and LBW prevalence distribution before and after the SBL. Through Poisson mixed effect models, we determined whether a meaningful change in LBW rate occurred after SBL implementation in the whole sample and stratified by city population density and maternal age group. Results: LBW prevalence remained stable before and after the SBL implementation (6.1% and 6.3%, respectively), while women's smoking prevalence had a relative reduction of 25.9% (p < 0.00001). No significant changes in LBW rate occurred after the implementation of SBL in the total sample or stratified by city density tertiles or maternal age groups. Conclusion: SBL implementation did not show short-term impact on LBW rate in Chile. Further studies need to examine long-term impact of SBL on low birthweight.
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Affiliation(s)
- Giovanna Valentino
- Carrera de Nutrición, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,School of Public Health, University of Chile, Santiago, Chile
| | - Ana Ortigoza
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States,*Correspondence: Ana Ortigoza,
| | | | - Tamara Doberti
- School of Public Health, University of Chile, Santiago, Chile
| | - Pricila Mullachery
- Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, PA, United States
| | - Carolina Nazzal
- School of Public Health, University of Chile, Santiago, Chile
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Hall W, Gartner C. Australian policymakers do not have to choose between protecting youth and allowing smokers to use nicotine vaping products. Addiction 2021; 116:2257-2259. [PMID: 33822414 DOI: 10.1111/add.15512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Wayne Hall
- National Centre for Youth Substance Use Research, University of Queensland, QLD, Australia
| | - Coral Gartner
- School of Public Health, University of Queensland, QLD, Australia
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Noar SM, Rohde JA, Prentice-Dunn H, Kresovich A, Hall MG, Brewer NT. Evaluating the actual and perceived effectiveness of E-cigarette prevention advertisements among adolescents. Addict Behav 2020; 109:106473. [PMID: 32521287 DOI: 10.1016/j.addbeh.2020.106473] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/18/2020] [Accepted: 05/14/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND The efficacy of e-cigarette prevention ads among adolescents has seldom been studied. We examined the impact of ads from the The Real Cost vaping prevention media campaign on what adolescents think and believe about vaping. We also sought to test whether perceived message effectiveness (PME) served as a proxy for ad impact. METHODS Participants were 543 U.S. adolescents ages 13-17. In an online experiment, we randomized participants to either: 1) persuasive e-cigarette prevention video ads from the Food and Drug Administration's The Real Cost campaign that was targeted to adolescents or 2) information-only e-cigarette harms control videos (control condition). Participants in each condition viewed 2 videos in a random order. After ad exposure, the survey assessed PME (message and effects perceptions), risk beliefs about vaping, attitudes toward vaping, and intentions to vape. RESULTS The FDA's The Real Cost ads led to higher beliefs about the harms of vaping (p < .001), more negative attitudes toward vaping (p < .001), and lower intentions to vape (p < .05) compared to the control videos. The Real Cost ads also scored higher on both message perceptions (p < .001) and effects perceptions (p < .001) compared to control videos. Effects perceptions were associated with all three outcomes (all ps < 0.001, adjusting for both types of PME and covariates), but message perceptions did not offer additional predictive value. CONCLUSIONS Exposure to The Real Cost vaping prevention ads gave adolescents a more negative view of vaping and lowered their intentions to vape compared to control videos. Effects perceptions may be superior to message perceptions as a proxy for e-cigarette prevention ad impact.
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Affiliation(s)
- Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA; Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA.
| | - Jacob A Rohde
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA
| | - Hannah Prentice-Dunn
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Alex Kresovich
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA
| | - Marissa G Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
| | - Noel T Brewer
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Johannesen CK, Andersen S, Bast LS. Estimating future smoking in Danish youth – effects of three prevention strategies. Scand J Public Health 2020; 49:931-939. [DOI: 10.1177/1403494820942678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Aims: Preventing smoking and aiding cessation among youth and young adults carries the possibility of reducing future smoking prevalence significantly. This paper estimates the impact on future smoking prevalence of 25 year olds by increasing tobacco prices, securing indoor smoke-free homes and implementing school-based multi-tiered interventions. Methods: Utilizing a multi-state Markov model, a status quo projection of the smoking prevalence from years 2017 to 2030 were compared with projections of the smoking prevalence in 2030 considering the impact of the three prevention strategies. Results: In a status quo projection, 27.0% of Danish 25-year-old females are expected to be smokers in 2030, while 13.2% would be smokers in 2030 were all three prevention strategies in effect from 2019. By itself, increasing tobacco prices by 50% reduced the prevalence of smokers among 25-year-old females to 14.8% in 2030, a relative reduction of 47.5%. For 25-year-old males in 2030 the reductions were similar, with a prevalence of 16.6% when all three prevention strategies were in effect, a relative reduction of 51.5%. Conclusions: Implementing increasing tobacco prices, indoor smoke-free homes and school-based multi-tiered interventions in Denmark is likely to significantly decrease youth smoking prevalence in the future. However, these three strategies will not produce a smoke-free generation without other initiatives.
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Affiliation(s)
| | - Susan Andersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lotus Sofie Bast
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Tedeschi GJ, Zoref LS, Cummins SE, Zhu SH. Targeting Nonsmokers to Help Smokers Quit: Features of a Large-scale Intervention. Tob Use Insights 2020; 13:1179173X20943565. [PMID: 32753992 PMCID: PMC7378709 DOI: 10.1177/1179173x20943565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/25/2020] [Indexed: 12/01/2022] Open
Abstract
Smoking continues to be a major public health problem, despite a substantial
decline in prevalence rates over the last decades. Quit smoking interventions
typically target smokers, whether through individual or group treatment or
through broader public health campaigns. Yet, nonsmokers represent a vast and
largely untapped resource to help smokers quit. This article describes an
innovative approach that targeted nonsmokers through a media-style campaign with
repeated reminders about smoking cessation. We tested the nonsmoker intervention
in a large randomized trial and showed it to be effective in helping smokers
quit. Components of the intervention included repeated mailings with relevant
cessation messages over a 10-week period, 2 brief check-in telephone calls, and
access to a study Web site. In this article, we discuss details of the
intervention development, content, and implementation.
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Affiliation(s)
- Gary J Tedeschi
- Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Leslie S Zoref
- Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Sharon E Cummins
- Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Shu-Hong Zhu
- Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA.,Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
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Septiono W, Kuipers MAG, Ng N, Kunst AE. Changes in adolescent smoking with implementation of local smoke-free policies in Indonesia: Quasi-experimental repeat cross-sectional analysis of national surveys of 2007 and 2013. Drug Alcohol Depend 2020; 209:107954. [PMID: 32171158 DOI: 10.1016/j.drugalcdep.2020.107954] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Banning smoking from public places may prevent adolescent smoking, but there is little evidence on impact of smoke-free policies (SFPs) from low and middle-income countries. This study assessed to what extent the adoption of local SPFs in Indonesia between 2007 and 2013 associated with adolescent smoking. METHODS Data on 239,170 adolescents (12-17 years old) were derived from the 2007 and 2013 national health surveys in 497 districts and 33 provinces. This study compared 2013 survey respondents living in districts/provinces that adopted SFPs between 2007 and 2013, with 2007 respondents and 2013 respondents in districts/provinces that did not adopt policies. Multilevel logistic regression analysis assessed whether SFP was associated with daily and non-daily smoking. We controlled for survey year, SFP in 2007, socio-demographics, and district characteristics. RESULTS Strong district SFPs was significantly associated with lower odds of daily smoking (OR:0.81, 95 %CI:0.69-0.97), but non-significantly with non-daily smoking (OR:0.89, 95 %CI:0.76-1.05). Strong provincial SFPs was not associated with daily smoking (OR:1.02, 95 %CI:0.84-1.25), but was associated with higher odds of non-daily smoking (OR:1.22, 95 %CI:0.99-1.51). Moderately strong SFPs did not consistently show associations in the same direction. For example, moderately strong provincial SFP was associated with higher odds of daily smoking (OR:1.27, 95 %CI:1.11-1.46) and lower odds of non-daily smoking (OR:0.82, 95 %CI:0.72-0.93). CONCLUSION We did not detect a consistent short-term effect of district and province-level smoke-free policies on adolescent smoking in Indonesia. Weak implementation and poor compliance may compromise effectiveness, which would call for improvement of SFP implementation in Indonesia.
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Affiliation(s)
- Wahyu Septiono
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands, P.O. Box 22660, Amsterdam 1100DD, the Netherlands.
| | - Mirte A G Kuipers
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands, P.O. Box 22660, Amsterdam 1100DD, the Netherlands
| | - Nawi Ng
- School of Public Health and Community Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 463, 40530, Gothenburg, Sweden; Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Försörjningsvägen 7B, 90187, Umeå, Sweden
| | - Anton E Kunst
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands, P.O. Box 22660, Amsterdam 1100DD, the Netherlands
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Duke JC, MacMonegle AJ, Nonnemaker JM, Farrelly MC, Delahanty JC, Zhao X, Smith AA, Rao P, Allen JA. Impact of The Real Cost Media Campaign on Youth Smoking Initiation. Am J Prev Med 2019; 57:645-651. [PMID: 31443954 DOI: 10.1016/j.amepre.2019.06.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 06/05/2019] [Accepted: 06/06/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purpose of this study was to assess the relationship between youth exposure to the U.S. Food and Drug Administration's national tobacco public education campaign, The Real Cost, and changes in smoking initiation. METHODS From November 2013 to November 2016, a longitudinal study of youth was conducted with a baseline and 4 post-campaign follow-up surveys. The sample consisted of nonsmoking youths from 75 U.S. media markets (n=5,103) who completed a baseline and at least 1 follow-up survey. Exposure was measured by media market-level target rating points and self-reported ad exposure frequency. Smoking initiation was examined among youths who had never smoked at baseline and defined as first trial of a cigarette. Discrete-time survival models using logistic regression and controlling for confounding influences were estimated. Analyses were conducted in 2018. RESULTS The odds of reporting smoking initiation at follow-up was lower among youths in media markets with higher levels of campaign advertisements than among those with less. Both between-wave and cumulative target rating points were associated with decreased risk of smoking initiation (AOR=0.69 [p<0.01] and AOR=0.89 [p<0.05], respectively); for every 3,500 between-wave target rating points on air, there was an associated 30% reduction in the hazard of smoking initiation among youths. Results from self-reported recall of the campaign advertisements found similar dose-response effects. The campaign is associated with an estimated 380,000-587,000 youths aged 11-19 years being prevented from initiating smoking nationwide. CONCLUSIONS Sustained national tobacco public education campaigns like The Real Cost can change population-level smoking initiation among youths, preventing future generations from tobacco-related harms.
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Affiliation(s)
| | | | | | | | - Janine C Delahanty
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Xiaoquan Zhao
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland; Department of Communication, George Mason University, Fairfax, Virginia
| | - Alexandria A Smith
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Pamela Rao
- Kavali Consulting, Washington, District of Columbia
| | - Jane A Allen
- RTI International, Research Triangle Park, North Carolina
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13
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Fowler CD, Gipson CD, Kleykamp BA, Rupprecht LE, Harrell PT, Rees VW, Gould TJ, Oliver J, Bagdas D, Damaj MI, Schmidt HD, Duncan A, De Biasi M. Basic Science and Public Policy: Informed Regulation for Nicotine and Tobacco Products. Nicotine Tob Res 2019; 20:789-799. [PMID: 29065200 DOI: 10.1093/ntr/ntx175] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 08/01/2017] [Indexed: 12/25/2022]
Abstract
Introduction Scientific discoveries over the past few decades have provided significant insight into the abuse liability and negative health consequences associated with tobacco and nicotine-containing products. While many of these advances have led to the development of policies and laws that regulate access to and formulations of these products, further research is critical to guide future regulatory efforts, especially as novel nicotine-containing products are introduced and selectively marketed to vulnerable populations. Discussion In this narrative review, we provide an overview of the scientific findings that have impacted regulatory policy and discuss considerations for further translation of science into policy decisions. We propose that open, bidirectional communication between scientists and policy makers is essential to develop transformative preventive- and intervention-focused policies and programs to reduce appeal, abuse liability, and toxicity of the products. Conclusions Through these types of interactions, collaborative efforts to inform and modify policy have the potential to significantly decrease the use of tobacco and alternative nicotine products and thus enhance health outcomes for individuals. Implications This work addresses current topics in the nicotine and tobacco research field to emphasize the importance of basic science research and provide examples of how it can be utilized to inform public policy. In addition to relaying current thoughts on the topic from experts in the field, the article encourages continued efforts and communication between basic scientists and policy officials.
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Affiliation(s)
- Christie D Fowler
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA
| | | | | | - Laura E Rupprecht
- Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA
| | - Paul T Harrell
- Division of Community Health & Research, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA
| | - Vaughan W Rees
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Thomas J Gould
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA
| | - Jason Oliver
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC
| | - Deniz Bagdas
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA
| | - M Imad Damaj
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA
| | - Heath D Schmidt
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Alexander Duncan
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Mariella De Biasi
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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14
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A critical analysis of Australia’s ban on the sale of electronic nicotine delivery systems. NEUROETHICS-NETH 2019. [DOI: 10.1007/s12152-019-09402-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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15
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Santiago S, Mahoney C, Murray MP, Benoza G. "The Real Cost": Reaching At-Risk Youth in a Fragmented Media Environment. Am J Prev Med 2019; 56:S49-S56. [PMID: 30661525 DOI: 10.1016/j.amepre.2018.07.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/24/2018] [Accepted: 07/25/2018] [Indexed: 11/18/2022]
Abstract
In 2014, the U.S. Food and Drug Administration launched its first youth smoking prevention media campaign, "The Real Cost," with the goal of preventing cigarette smoking among at-risk youth aged 12-17 years in the U.S. This paper examines how the paid media strategy was developed, implemented, and refined between 2013 and 2016. Specifically, this paper discusses how research and best practices informed the media targeting strategy used to implement a multifaceted national campaign that successfully reached and influenced thousands of teens at risk for cigarette smoking. SUPPLEMENT INFORMATION: This article is part of a supplement entitled Fifth Anniversary Retrospective of "The Real Cost," the Food and Drug Administration's Historic Youth Smoking Prevention Media Campaign, which is sponsored by the U.S. Food and Drug Administration.
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Affiliation(s)
| | | | - Michael P Murray
- Office of Health Communication and Education, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Gem Benoza
- Office of Health Communication and Education, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland.
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16
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Ball J, Sim D, Edwards R. Why has adolescent smoking declined dramatically? Trend analysis using repeat cross-sectional data from New Zealand 2002-2015. BMJ Open 2018; 8:e020320. [PMID: 30366911 PMCID: PMC6224735 DOI: 10.1136/bmjopen-2017-020320] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Adolescent smoking has declined in New Zealand and in many other countries since the late 1990s, yet the reasons for the decline are not well understood. We investigated the extent to which established risk factors for adolescent smoking (parental, sibling and peer smoking, and exposure to smoking in the home) explained the downward trend. DESIGN Trend analysis of repeat cross-sectional data from an annual nationally representative survey. SETTING New Zealand. PARTICIPANTS Secondary school students aged 14-15 (n=398 221). OUTCOME MEASURE Regular (at least monthly) smoking. METHODS For each risk factor (parental smoking, best friend smoking, older sibling smoking and past week exposure to smoking in the home) we plotted prevalence of exposure, 2002-2015. Next, using multivariable logistic regression, we modelled the trend in regular smoking (expressed as an OR for year) adjusting for age, sex, ethnicity and socioeconomic position. The risk factors were added to the model-individually and collectively-to test whether they attenuated the OR for year. RESULTS Exposure to all risk factors except 'past week exposure to smoking in the home' decreased between 2002 and 2015. We observed a strong downward trend in regular smoking among adolescents (OR=0.88 per year, 95% CI 0.88 to 0.88, p<0.001). 'Best friend smoking' was the only risk factor that significantly attenuated the trend. However, due to circularity, this factor provides an unsatisfactory explanation for population level smoking decline. CONCLUSIONS The established risk factors that we explored do not appear to have contributed to the remarkable decline in adolescent smoking in New Zealand between 2003 and 2015. Further research is needed to assess the possible contribution of factors outside our model, such as changes in the policy context, the social meaning of smoking and broader social and economic conditions.
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Affiliation(s)
- Jude Ball
- Public Health Department, University of Otago, Wellington, Wellington, New Zealand
| | - Dalice Sim
- Dean's Department, University of Otago, Wellington, Wellington, New Zealand
| | - Richard Edwards
- Public Health Department, University of Otago, Wellington, Wellington, New Zealand
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17
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Laverty AA, Vamos EP, Millett C, Chang KCM, Filippidis FT, Hopkinson NS. Child awareness of and access to cigarettes: impacts of the point-of-sale display ban in England. Tob Control 2018; 28:526-531. [PMID: 30237314 DOI: 10.1136/tobaccocontrol-2018-054511] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/02/2018] [Accepted: 08/17/2018] [Indexed: 12/25/2022]
Abstract
INTRODUCTION England introduced a tobacco display ban for shops with >280 m2 floor area ('partial ban') in 2012, then a total ban in 2015. This study assessed whether these were linked to child awareness of and access to cigarettes. METHODS Data come from the Smoking, Drinking and Drug Use survey, an annual survey of children aged 11-15 years for 2010-2014 and 2016. Multivariate logistic regression models assessed changes in having seen cigarettes on display, usual sources and ease of access to cigarettes in shops RESULTS: During the partial display ban in 2012, 89.9% of children reported seeing cigarettes on display in the last year, which was reduced to 86.0% in 2016 after the total ban (adjusted OR 0.58, 95% CI 0.50 to 0.66). Reductions were similar in small shops (84.1% to 79.3%)%) and supermarkets (62.6% to 57.3%)%). Although the ban was associated with a reduction in the proportion of regular child smokers reporting that they bought cigarettes in shops (57.0% in 2010 to 39.8% in 2016), we did not find evidence of changes in perceived difficulty or being refused sale among those who still did. DISCUSSION Tobacco point-of-sale display bans in England reduced the exposure of children to cigarettes in shops and coincided with a decrease in buying cigarettes in shops. However, children do not report increased difficulty in obtaining cigarettes from shops, highlighting the need for additional measures to tackle tobacco advertising, stronger enforcement of existing laws and measures such as licencing for tobacco retailers.
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Affiliation(s)
- Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Eszter Panna Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Kiara C-M Chang
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Filippos T Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Nicholas S Hopkinson
- NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK
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18
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Kraus L, Seitz NN, Piontek D, Molinaro S, Siciliano V, Guttormsson U, Arpa S, Monshouwer K, Leifman H, Vicente J, Griffiths P, Clancy L, Feijão F, Florescu S, Lambrecht P, Nociar A, Raitasalo K, Spilka S, Vyshinskiy K, Hibell B. 'Are The Times A-Changin'? Trends in adolescent substance use in Europe. Addiction 2018; 113:1317-1332. [PMID: 29484751 DOI: 10.1111/add.14201] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/14/2017] [Accepted: 02/19/2018] [Indexed: 11/30/2022]
Abstract
AIMS To estimate temporal trends in adolescents' current cigarette, alcohol and cannabis use in Europe by gender and region, test for regional differences and evaluate regional convergence. DESIGN AND SETTING Five waves of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from 28 countries between 1999 and 2015. Countries were grouped into five regions [northern (NE), southern (SE), western (WE), eastern Europe (EE) and the Balkans (BK)]. PARTICIPANTS A total of 223 814 male and 211 712 female 15-16-year-old students. MEASUREMENTS Daily cigarette use, weekly alcohol use, monthly heavy episodic drinking (HED) and monthly cannabis use. Linear and quadratic trends were tested using multi-level mixed-effects logistic regression; regional differences were tested using pairwise Wald tests; mean absolute differences (MD) of predicted prevalence were used for evaluating conversion. FINDINGS Daily cigarette use among boys in EE showed a declining curvilinear trend, whereas in all other regions a declining linear trend was found. With the exception of BK, trends of weekly drinking decreased curvilinear in both genders in all regions. Among girls, trends in WE, EE and BK differed from trends in NE and SE. Monthly HED showed increasing curvilinear trends in all regions except in NE (both genders), WE and EE (boys each). In both genders, the trend in EE differed from the trend in SE. Trends of cannabis use increased in both genders in SE and BK; differences were found between the curvilinear trends in EE and BK. MD by substance and gender were generally somewhat stable over time. CONCLUSIONS Despite regional differences in prevalence of substance use among European adolescents from 1999 to 2015, trends showed remarkable similarities, with strong decreasing trends in cigarette use and moderate decreasing trends in alcohol use. Trends of cannabis use only increased in southern Europe and the Balkans. Trends across all substance use indicators suggest no regional convergence.
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Affiliation(s)
- Ludwig Kraus
- IFT Institut für Therapieforschung, München, Germany.,Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | | | | | - Sabrina Molinaro
- National Research Council, Institute of Clinical Physiology, Pisa, Italy
| | - Valeria Siciliano
- National Research Council, Institute of Clinical Physiology, Pisa, Italy
| | - Ulf Guttormsson
- The Swedish Council for Information on Alcohol and Other Drugs (CAN), Stockholm, Sweden
| | - Sharon Arpa
- Foundation for Social Welfare Services, Santa Venera, Malta
| | | | - Håkan Leifman
- The Swedish Council for Information on Alcohol and Other Drugs (CAN), Stockholm, Sweden
| | - Julian Vicente
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
| | - Paul Griffiths
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
| | - Luke Clancy
- TobaccoFree Research Institute Ireland, Dublin, Ireland
| | - Fernanda Feijão
- SICAD Serviço de Intervenção nos Comportamentos Aditivos e nas Dependências, Lisbon, Portugal
| | - Silvia Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - Patrick Lambrecht
- Department of Clinical and Lifespan Psychology (KLEP), Free University Brussels (VUB), Brussels, Belgium
| | - Alojz Nociar
- St Elisabeth University of Health and Social Work, Bratislava, Slovak Republic.,Research Institute for Child Psychology and Pathopsychology, Bratislava, Slovak Republic
| | | | - Stanislas Spilka
- French Monitoring Centre for Drugs and Drug Addiction (OFDT), Paris, France
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19
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Casswell S. Commentary on White et al. (2018): Decrease in adolescent drinking linked to direct and indirect effect of alcohol control policies. Addiction 2018; 113:1043-1044. [PMID: 29732698 DOI: 10.1111/add.14187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 02/08/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Sally Casswell
- SHORE and Whariki Research Centre, College of Health, Massey University, New Zealand
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20
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White V, Azar D, Faulkner A, Coomber K, Durkin S, Livingston M, Chikritzhs T, Room R, Wakefield M. Adolescents' alcohol use and strength of policy relating to youth access, trading hours and driving under the influence: findings from Australia. Addiction 2018; 113:1030-1042. [PMID: 29356174 DOI: 10.1111/add.14164] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/27/2017] [Accepted: 01/17/2018] [Indexed: 11/28/2022]
Abstract
AIMS To determine (i) whether the strength of Australian alcohol control policy in three domains (youth access, trading hours and drink driving) changed during the 2000s; and (ii) estimate associations between these policies and adolescent drinking after adjusting for television alcohol advertising exposures, alcohol outlet density, alcohol price changes, exposure to negative articles about alcohol in daily newspapers and adult drinking prevalence. DESIGN Repeated cross-sectional surveys conducted triennially from 2002 to 2011. Multi-level modelling examined the association between alcohol control policies and drinking prevalence after adjusting for covariates. SETTING Four Australian capital cities between 2002 and 2011. PARTICIPANTS Students aged 12-17 years participating in a triennial national representative school-based survey (sample size range/survey: 9805-13 119). MEASUREMENTS Outcome measures were: past month drinking and risky drinking (5+ drinks on a day) in the past 7 days. Policy strength in each of three domains (youth access, trading hours, drink-driving) were the key predictor variables. Covariates included: past 3-month television alcohol and alcohol-control advertising, alcohol outlet density, alcohol price change, negatively framed newspaper alcohol articles, adult drinking prevalence and student demographic characteristics. FINDINGS During the study period, the strength of youth access policies increased by 10%, trading hours policies by 14% and drink-driving policies by 58%. Past-month and risky drinking prevalence decreased (e.g. past-month: 2002: 47.4% to 2011: 26.3%). Multivariable analyses that included all policy variables and adjusted for year, student and other covariates showed past-month drinking to be associated inversely with stronger trading hours policies [odds ratio (OR) = 0.80, 95% confidence interval (CI) = 0.69, 0.94], but not youth access (OR = 0.92 95% CI = 0.81, 1.04) or drink-driving (OR = 1.00, 95% CI = 0.93, 1.09). Risky drinking was associated inversely with stronger youth access policies (OR = 0.82, 95% CI = 0.69, 0.98), but not trading hours (OR = 0.85, 95% CI = 0.66, 1.09) or drink-driving (OR = 1.02, 95% CI = 0.90, 1.14) policies. CONCLUSIONS Population-directed policies designed to reduce alcohol availability and promotion may reduce adolescents' alcohol use.
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Affiliation(s)
- Victoria White
- Centre for Behavioural Research in Cancer, Cancer Council, Victoria, Melbourne, Australia.,School of Psychology, Deakin University, Geelong, Australia
| | - Denise Azar
- Centre for Behavioural Research in Cancer, Cancer Council, Victoria, Melbourne, Australia
| | - Agatha Faulkner
- Centre for Behavioural Research in Cancer, Cancer Council, Victoria, Melbourne, Australia
| | - Kerri Coomber
- Centre for Behavioural Research in Cancer, Cancer Council, Victoria, Melbourne, Australia.,School of Psychology, Deakin University, Geelong, Australia
| | - Sarah Durkin
- Centre for Behavioural Research in Cancer, Cancer Council, Victoria, Melbourne, Australia.,School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, Australia.,Centre for Health and Society, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Tanya Chikritzhs
- Curtin University of Technology, Health Sciences, National Drug Research Institute, Perth, Western Australia, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, Australia.,Centre for Health and Society, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council, Victoria, Melbourne, Australia.,School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
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21
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El-Toukhy S, Choi K, Hitchman SC, Bansal-Travers M, Thrasher JF, Yong HH, O’Connor RJ, Shang C. Banning tobacco price promotions, smoking-related beliefs and behaviour: findings from the International Tobacco Control Four Country (ITC 4C) Survey. Tob Control 2018; 27:310-318. [PMID: 28701585 PMCID: PMC5766427 DOI: 10.1136/tobaccocontrol-2017-053648] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 04/21/2017] [Accepted: 05/08/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Ecological models emphasise multilevel influences on health behaviours. While studies show that exposure to price promotions is associated with smoking behaviour and its antecedents, less is known about whether these associations differ by macro-level factors such as national price promotion policies. METHODS Current and former smokers (N=4698) from the International Tobacco Control Policy Evaluation Project four-country cohort were included in weighted multivariate logistic regression models to examine individual-level associations between exposure to price promotions at waves 7 and 8 (conducted in 2008-2009 and 2010-2011) and beliefs (social and injunctive norms, functional value of smoking, misconceptions around smoking and beliefs of tobacco industry and its regulations) and behaviour at wave 8, stratified by whether countries allow (Australia and USA) or ban (Canada and UK) price promotions. RESULTS Associations between exposure to price promotions and smoking-related beliefs and behaviour differed by national price promotion policies. In countries that allow price promotions, participants repeatedly exposed to price promotions at waves 7 and 8 were more likely to associate functional values to smoking (ie, calms down when stressed (adjusted OR (AOR) 1.83) and to be current smokers at wave 8 (AOR 1.94). In countries that ban price promotions, participants repeatedly exposed to price promotions were less likely to hold misconceptions around smoking (ie, harsher smoke is more dangerous). CONCLUSIONS Differential associations emerged between exposure to price promotions, smoking-related beliefs and behaviour across countries with and without a price promotions ban. Adopting price promotion bans could ameliorate the associations between exposure to price promotions and smoking beliefs and behaviours.
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Affiliation(s)
- Sherine El-Toukhy
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Maryland, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Maryland, USA
| | - Sara C. Hitchman
- Department of Addictions, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, England; UK Centre for Tobacco and Alcohol Studies
| | - Maansi Bansal-Travers
- Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, New York, USA
| | - James F. Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, South Carolina, USA
| | - Hua-Hie Yong
- The Cancer Council Victoria, Victoria, Australia
| | - Richard J. O’Connor
- Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, New York, USA
| | - Ce Shang
- Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, Illinois, USA
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22
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Curtis J, Zhang C, McGuigan B, Pavel-Wood E, Morell R, Ward PB, Watkins A, Lappin J. y-QUIT: Smoking Prevalence, Engagement, and Effectiveness of an Individualized Smoking Cessation Intervention in Youth With Severe Mental Illness. Front Psychiatry 2018; 9:683. [PMID: 30618864 PMCID: PMC6302018 DOI: 10.3389/fpsyt.2018.00683] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 11/26/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: Young people with psychosis are six times more likely to be tobacco smokers than their gender- and age-matched peers. Smoking is a major contributor to the 15-year reduced life expectancy among people experiencing severe mental illness (SMI). There is a lack of evidence-supported interventions for smoking cessation among young people with SMI. Material and Methods: The study comprised two phases and aimed to assess (i) the prevalence of smoking among a community sample of young people with psychotic illness or at high risk of developing psychosis; (ii) the proportion who engaged in the intervention; (iii) the proportion who achieved smoking cessation; and (iv) secondary smoking-related outcomes. In phase one, prevalence of smoking was assessed among young people with psychotic illness or at high risk of developing psychosis attending a community-based youth mental health service between 16/5/2017 and 16/11/2017. In phase two, over a 1-year period, individuals identified as smokers were invited to participate in a 12-week tailored smoking cessation intervention program that included pharmacological treatment, motivational interviewing, and behavioral change techniques. Those unwilling to participate in a full intervention were offered a brief intervention. Participants of the full intervention were assessed at baseline and at week 12 endpoint on: daily cigarettes smoked (self-report), exhaled CO, nicotine dependence, readiness to quit, and confidence to quit. Results: In phase one, smoking prevalence was 48.2% (53 of 110) among clients of the youth mental health service. Smokers were significantly more likely to be male (X 2 = 6.41 p = 0.009). During phase two, 41 of 61 eligible clients engaged in a smoking cessation intervention (67.2%). Effectiveness: twenty-one clients participated in a full intervention (34.4%), of whom three (14.3%) received a brief intervention initially and during engagement converted to full intervention. Twenty participants (32.8%) received a brief intervention only. Ten participants in the full intervention (47.6%) and five in the brief intervention (25%) dropped out. Six (28.6% of full intervention) reported smoking cessation verified by CO monitoring. Participants who completed the full intervention (n = 9) reduced number of cigarettes smoked, nicotine dependence, and exhaled CO, while readiness to quit and confidence to quit increased. Pharmacotherapy was predominantly combination NRT (n = 18; 85.7%), varenicline (4.8%), oral NRT only (4.8%), or none (4.8%). No adverse events were reported. Conclusion: This pilot real-world study demonstrates that both screening for smoking and offering an effective smoking cessation intervention are achievable in youth experiencing or at risk of psychosis.
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Affiliation(s)
- Jackie Curtis
- Bondi Junction Youth Mental Health Services, South Eastern Sydney Local Health District, Sydney, NSW, Australia.,Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Charry Zhang
- Faculty of Medicine, Medical School, University of New South Wales, Sydney, NSW, Australia
| | - Bernadette McGuigan
- Bondi Junction Youth Mental Health Services, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Esther Pavel-Wood
- Bondi Junction Youth Mental Health Services, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Rachel Morell
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Philip B Ward
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Andrew Watkins
- Bondi Junction Youth Mental Health Services, South Eastern Sydney Local Health District, Sydney, NSW, Australia.,Faculty of Health, University of Technology, Sydney, NSW, Australia
| | - Julia Lappin
- Bondi Junction Youth Mental Health Services, South Eastern Sydney Local Health District, Sydney, NSW, Australia.,Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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24
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White V, Azar D, Faulkner A, Coomber K, Durkin S, Livingston M, Chikritzhs T, Room R, Wakefield M. Adolescents' exposure to paid alcohol advertising on television and their alcohol use: exploring associations during a 13-year period. Addiction 2017; 112:1742-1751. [PMID: 28544093 DOI: 10.1111/add.13873] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 10/13/2016] [Accepted: 05/16/2017] [Indexed: 11/30/2022]
Abstract
AIMS To determine (i) whether Australian adolescents' exposure to television alcohol advertisements changed between 1999 and 2011 and (ii) examine the association between television alcohol advertising and adolescent drinking behaviours. DESIGN Cross-sectional surveys conducted every 3 years between 1999 and 2011. Analyses examined associations between advertising exposures and reported drinking. SETTING Five Australian major cities. PARTICIPANTS Students aged 12-17 years participating in a triennial nationally representative school-based survey residing in the television advertising markets associated with the major cities (sample size range per survey: 12 644-16 004). MEASUREMENTS Outcome measures were: drinking in the past month, past week and past-week risky drinking (5+ drinks on a day). The key predictor variable was past-month adolescent-directed alcohol advertising Targeted Rating Points (TRPs, a measure of television advertising exposure). Control measures included student-level characteristics, government alcohol-control advertising TRPs, road safety (drink-driving) TRPs and time of survey. FINDINGS Average monthly adolescent alcohol TRPs increased between 1999 (mean = 2371) to 2005 (mean = 2679) (P < 0.01) then decreased between 2005 and 2011: (mean = 880) (P < 0.01). Multi-level logistic regression analyses that adjusted for survey timing, student level factors and alcohol-control advertising variables showed a significant association between past-month alcohol TRPs and past-month drinking [odds ratio (OR) = 1.11, 95% confidence interval (CI) = 1.07-1.15), past-week drinking (OR = 1.10, 95% CI = 1.06-1.14) and past-week risky drinking (OR = 1.15, 95% CI = 1.09-1.22). Past-week risky drinking was associated inversely with road safety TRPs (OR = 0.69, 95% CI = 0.49-0.98). CONCLUSIONS While Australian adolescents' exposure to alcohol advertising on television reduced between 1999 and 2011, higher levels of past-month television alcohol advertising were associated with an increased likelihood of adolescents' drinking. The reduction in television alcohol advertising in Australia in the late 2000s may have played a part in reducing adolescents' drinking prevalence.
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Affiliation(s)
- Victoria White
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia.,School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Denise Azar
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia
| | - Agatha Faulkner
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia
| | - Kerri Coomber
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia.,School of Psychology, Deakin University, Geelong, Australia
| | - Sarah Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia.,School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, Turning Point Alcohol and Drug Centre, Melbourne, Australia.,Centre for Health and Society, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Tanya Chikritzhs
- Curtin University of Technology, National Drug Research Institute, Perth, Western Australia, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, Turning Point Alcohol and Drug Centre, Melbourne, Australia.,Centre for Health and Society, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia
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Viner RM, Hargreaves DS, Motta JVDS, Horta B, Mokdad AH, Patton G. Adolescence and Later Life Disease Burden: Quantifying the Contribution of Adolescent Tobacco Initiation From Longitudinal Cohorts. J Adolesc Health 2017; 61:171-178. [PMID: 28734324 DOI: 10.1016/j.jadohealth.2017.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 02/23/2017] [Accepted: 02/24/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Adolescence is a time of initiation of behaviors leading to noncommunicable diseases (NCDs). We use tobacco to illustrate a novel method for assessing the contribution of adolescence to later burden. METHODS Data on initiation of regular smoking during adolescence (10-19 years) and current adult smoking were obtained from the 1958 British Birth Cohort, the U.S. National Longitudinal Study of Adolescent Health (Add Health), the Pelotas 1982 Birth Cohort, and the Victorian Adolescent Health Cohort Study. We estimated an "adolescent attributable fraction" (AAF) by calculating the proportion of persisting adult daily smoking initiated < age 20 years. We used findings to estimate AAFs for >155 countries using contemporary surveillance data. RESULTS In the 1958 British Birth Cohort, 81.6% of daily smokers at age 50 years initiated < age 20 years, with a risk ratio of 6.1 for adult smoking related to adolescent initiation. The adjusted AAF was 69.1. Proportions of smokers initiating <20 years, risk ratio, and AAFs were 83.3%, 7.0%, and 70.4% for Add Health; 75.5%, 3.7%, and 50.2% in Victorian Adolescent Health Cohort Study; and 70.9%, 5.8%, and 56.9% in Pelotas males and 89.9%, 6.4%, and 75.9% in females. Initiation <16 years resulted in the highest AAFs. Estimated AAFs globally ranged from 35% in China to 76% in Argentina. CONCLUSIONS The contribution of adolescent smoking initiation to adult smoking burden is high, suggesting a need to formulate and implement effective actions to reduce smoking initiation in adolescents. Similar trends in other NCD risks suggest that adolescents will be central to future efforts to control NCDs.
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Affiliation(s)
- Russell M Viner
- Population, Policy & Practice Research Programme, UCL Institute of Child Health, London, United Kingdom.
| | - Dougal S Hargreaves
- Population, Policy & Practice Research Programme, UCL Institute of Child Health, London, United Kingdom
| | | | - Bernardo Horta
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - George Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Melbourne, Victoria, Australia
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Duke JC, Farrelly MC, Alexander TN, MacMonegle AJ, Zhao X, Allen JA, Delahanty JC, Rao P, Nonnemaker J. Effect of a National Tobacco Public Education Campaign on Youth’s Risk Perceptions and Beliefs About Smoking. Am J Health Promot 2017; 32:1248-1256. [DOI: 10.1177/0890117117720745] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To assess the relationship between youth’s exposure to the Food and Drug Administration’s national tobacco public education campaign, The Real Cost, and changes in campaign-targeted beliefs. Design: Longitudinal design with baseline survey and 2 postcampaign follow-up surveys. Sample: Youth from 75 US media markets (N = 1680) who completed all 3 surveys and had experimented with or were susceptible to future cigarette smoking. Measures: Exposure was measured by self-reported frequency of ad exposure and media market–level target rating points. Agreement with 30 self-reported tobacco-related beliefs was assessed in 3 categories: (1) beliefs specifically targeted by campaign messages (campaign-targeted belief), (2) beliefs not targeted by the campaign (nontargeted beliefs), and (3) beliefs corresponding to other media campaigns on air concurrent with The Real Cost (ambiguous beliefs). Analysis: Descriptive analyses of aggregate changes in beliefs and logistic regressions to examine the association between campaign exposure and beliefs. Intervention: The Real Cost. Results: Agreement with campaign-targeted beliefs increased from baseline to first and second follow-ups, with a mean relative increase of 10.4% and 11.5%, respectively. Nontargeted beliefs did not change substantially. Both measures of campaign exposure were positively associated with increased odds of agreeing with 5 of 8 campaign-targeted beliefs. Exposure was not significantly associated with 12 of 14 nontargeted tobacco-related beliefs. Discussion: A sustained national tobacco public education campaign can change population-level perceptions of tobacco-related harms among youth.
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Affiliation(s)
| | | | - Tesfa N. Alexander
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | | | - Xiaoquan Zhao
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
- Department of Communication, George Mason University, Fairfax, VA, USA
| | | | - Janine C. Delahanty
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Pamela Rao
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
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Gould GS, Watt K, West R, Cadet-James Y, Clough AR. Can smoking initiation contexts predict how adult Aboriginal smokers assess their smoking risks? A cross-sectional study using the 'Smoking Risk Assessment Target'. BMJ Open 2016; 6:e010722. [PMID: 27388350 PMCID: PMC4947807 DOI: 10.1136/bmjopen-2015-010722] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Smoking prevalence is slow to reduce among Indigenous Australians of reproductive age. We analysed the relationships between age of smoking initiation, recalled initiation influences and self-assessment of smoking risks in Aboriginal smokers. DESIGN, SETTING AND PARTICIPANTS A community-based cross-sectional survey of Aboriginal smokers aged 18-45 years (N=121; 58 men) was undertaken, using single-item measures. The Smoking Risk Assessment Target (SRAT) as the primary outcome measure enabled self-assessment of smoking risks from 12 options, recategorised into 3 groups. Participants recalled influences on their smoking initiation. Multinomial logistic regression modelling included age, gender, strength of urges to smoke, age at initiation (regular uptake) and statistically significant initiation influences on χ(2) tests ('to be cool', alcohol and cannabis). RESULTS Frequent initiation influences included friends (74%; SD 0.44), family (57%; SD 0.5) and alcohol (40%; SD 0.49). 54% (n=65) of smokers had the highest risk perception on the SRAT, selected by those who cared about the smoking risks and intended to quit soon. On multivariate analyses, compared with the highest level of SRAT, male gender, lower age of uptake and strong urges to smoke were significantly associated with the lowest level of SRAT, selected by those who refuted risks or thought they could not quit. Lower age of uptake and alcohol were associated with mid-level of SRAT, selected by those who cared about smoking risks, but did not consider quitting as a priority. CONCLUSIONS Characteristics of smoking initiation in youth may have far-reaching associations with how smoking risks are assessed by adults of reproductive age, and their intentions to quit smoking. Becoming a regular smoker at under the age of 16 years, and influences of alcohol on smoking uptake, were inversely associated with high-level assessment of smoking risks and intention to quit in regional Aboriginal smokers. The SRAT may help tailor approaches to Indigenous smoking cessation.
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Affiliation(s)
- Gillian Sandra Gould
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Kerrianne Watt
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Robert West
- Health Behaviour Research Centre, Epidemiology and Public Health, University College London, London, UK
| | - Yvonne Cadet-James
- Australian Aboriginal and Torres Strait Islander Centre, James Cook University, Townsville, Queensland, Australia
| | - Alan R Clough
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
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28
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Pförtner TK, Hublet A, Schnohr CW, Rathmann K, Moor I, de Looze M, Baška T, Molcho M, Kannas L, Kunst AE, Richter M. Socioeconomic inequalities in the impact of tobacco control policies on adolescent smoking. A multilevel study in 29 European countries. Addict Behav 2016; 53:58-66. [PMID: 26454551 DOI: 10.1016/j.addbeh.2015.09.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 09/04/2015] [Accepted: 09/28/2015] [Indexed: 01/17/2023]
Abstract
INTRODUCTION There are concerns that tobacco control policies may be less effective in reducing smoking among disadvantaged socioeconomic groups and thus may contribute to inequalities in adolescent smoking. This study examines how the association between tobacco control policies and smoking of 15-year-old boys and girls among 29 European countries varies according to socioeconomic group. METHODS Data were used from the Health Behaviour in School-aged Children (HBSC) study conducted in 2005/2006 comprising 50,338 adolescents aged 15 years from 29 European countries. Multilevel logistic regression analyses were conducted to assess the association of weekly smoking with components of the Tobacco Control Scale (TCS), and to assess whether this association varied according to family affluence (FAS). Analyses were carried out per gender and adjusted for national wealth and general smoking rate. RESULTS For boys, tobacco price was negatively associated with weekly smoking rates. This association did not significantly differ between low and high FAS. Levels of tobacco-dependence treatment were significantly associated with weekly smoking. This association varied between low and high FAS, with higher treatment levels associated with higher probability of smoking only for low FAS boys. For girls, no tobacco policy was significantly associated with weekly smoking, irrespective of the FAS. CONCLUSIONS Results indicated that most tobacco control policies are not clearly related to adolescent weekly smoking across European countries. Only tobacco price seemed to be adequate decreasing smoking prevalence among boys, irrespective of their socioeconomic status.
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Affiliation(s)
- Timo-Kolja Pförtner
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Cologne, Germany; Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
| | - Anne Hublet
- Department of Public Health, Ghent University, Ghent, Belgium
| | | | - Katharina Rathmann
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Irene Moor
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | | | - Tibor Baška
- Department of Public Health, Jessenius Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | - Michal Molcho
- Health Promotion Research Centre, School of Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Lasse Kannas
- Department of Health Sciences, University of Jyväskylä, Finland
| | - Anton E Kunst
- Department of Public Health, AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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The impacts of media messaging and age and sex variance on adolescent smoking habits in Croatia. J Addict Med 2015; 9:147-54. [PMID: 25807453 DOI: 10.1097/adm.0000000000000070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To analyze the effects of age, sex, and media messages that encourage or discourage smoking, in conjunction with having 1 or more parents, close friends, teachers, or family members who smoke, on differences in patterns of adolescent smoking. METHODS This research is based on Croatian responses to the 2011 Global Youth Tobacco Survey. A total of 4245 Croatian youths responded to the Global Youth Tobacco Survey, of which individuals 3551 were aged 13 to 15 years. Of this cross section, 1644 individuals were male; 1856 were female; and 51 were of unknown sex. RESULTS There were significant differences among responses in terms of age. Older adolescents were more likely to smoke (P < 0.001) and more likely to experience the following: (1) outdoor exposure to other smokers, including teachers (P < 0.001) and fellow students (P < 0.001); (2) smoking in the presence of parents or guardians (P < 0.001) and best friends (P < 0.001). The most prominent predictor of smoking among male adolescents was the existence of a best friend who smokes, with an odds ratio of 6.38 and a corresponding 95% confidence interval of 3.69 to 11.01. Likewise, the most prominent predictor among female adolescents was also the existence of a best friend who smokes, with an odds ratio of 10.21 and a corresponding 95% confidence interval of 4.94 to 21.13. The majority of nonsmokers, 65.5% (n = 1640), and smokers, 58.8% (n = 506), have never seen advertisements for cigarettes broadcast during televised concerts, and 58.5% of nonsmokers (n = 1469) and 58.6% of smokers (n = 505) have never seen advertisements for cigarettes while attending concerts. CONCLUSIONS Our study shows that there is no sex difference between the number of nonsmokers and smokers. Older adolescents tend to smoke more, and students who smoke outside reported seeing other adolescents and their teachers smoking almost daily. A majority of youths who reported that they smoke have parents who smoke at home and have close friends who smoke; having a close or best friend who smokes is the highest prediction factor that both male and female youths will begin smoking. The majority of nonsmokers and smokers have never seen pro-smoking messages when going to concerts or during other community and social events. This lack of exposure to smoking-related advertising is the result of new legal restrictions imposed in 2008 on tobacco-product producers. There is no statistical significance among smokers' and nonsmokers' perceptions of antismoking media messaging. Peer pressure has been shown to be the second-most influential factor, after having a best friend who smokes, for the likelihood that an individual will become a smoker, among both male and female adolescents.
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Allen JA, Duke JC, Davis KC, Kim AE, Nonnemaker JM, Farrelly MC. Using Mass Media Campaigns to Reduce Youth Tobacco Use: A Review. Am J Health Promot 2015; 30:e71-82. [DOI: 10.4278/ajhp.130510-lit-237] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. This review synthesizes the published literature on using mass media campaigns to reduce youth tobacco use, with particular focus on effects within population subgroups and the relative effectiveness of campaign characteristics. Data Source. A search of PubMed and PsycINFO conducted in March of 2014 yielded 397 studies with 34 suitable for inclusion. Study Inclusion and Exclusion Criteria. Included were quantitative studies that evaluate an antitobacco media campaign intended to influence youth cognitions or behavior or explore the relative effectiveness of campaign characteristics among youth. Data Extraction. An automated search and assessment of suitability for inclusion was done. Data Synthesis. Study outcomes were compared and synthesized. Results. Antitobacco media campaigns can be effective across racial/ethnic populations, although the size of the campaign effect may differ by race/ethnicity. Evidence is insufficient to determine whether campaign outcomes differ by socioeconomic status (SES) and population density. Youth are more likely to recall and think about advertising that includes personal testimonials; a surprising narrative; and intense images, sound, and editing. Evidence in support of using a health consequences message theme is mixed; an industry manipulation theme may be effective in combination with a health consequences message. Research is insufficient to determine whether advertising with a secondhand smoke or social norms theme influences youth tobacco use. Conclusion. Our recommendation is to develop antitobacco campaigns designed to reach all at-risk youth, which can be effective across racial/ethnic populations. Research priorities include assessing campaign influence among lower SES and rural youth, disentangling the effects of message characteristics, and assessing the degree to which this body of evidence may have changed as a result of changes in youth culture and communication technology.
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Kvaavik E, Lund I, Nygård M, Hansen BT. Lifestyle Correlates of Female Snus Use and Smoking: A Large Population-Based Survey of Women in Norway. Nicotine Tob Res 2015; 18:431-6. [PMID: 26069033 DOI: 10.1093/ntr/ntv126] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 06/01/2015] [Indexed: 02/05/2023]
Abstract
INTRODUCTION While smoking in Norway has become less prevalent, snus use has increased, including among women. The aims of this study were to describe female snus use and its correlates, and to contrast patterns of snus use and smoking. METHODS In 2011-2012, data on tobacco use, age, education, alcohol consumption, sexual behaviors, and physical activity were collected from a population based sample of 13 756 Norwegian women aged 18-45 years, using a self-administered questionnaire. RESULTS Ever-use prevalence of snus ranged from 29.6% to 4.5% among those aged 18-19 years and 40-45 years, respectively. In contrast, the corresponding figures for smoking were 24.1% and 44.1%. Among snus users, 54.1% and 22.8% of 18-19 and 40 to 45-year-olds had never smoked, respectively. Debut age for snus use increased markedly with age, and was higher than debut age for smoking. Female snus use was positively associated with intermediate education, alcohol consumption, number of sexual partners, and hard physical activity. Smoking was also positively associated with alcohol consumption and number of sexual partners, but negatively associated with physical activity and education. CONCLUSION While most snus users among older women were former or current smokers, this was not the case among younger women. Low snus debut age and extensive snus use among younger women suggest that measures to reduce snus use should be targeted at young adolescents. The correlates of female snus use and smoking were not identical, and were similar to those previously documented for men.
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Affiliation(s)
- Elisabeth Kvaavik
- Department of Tobacco, Norwegian Institute for Alcohol and Drug Research, Oslo, Norway;
| | - Ingeborg Lund
- Department of Tobacco, Norwegian Institute for Alcohol and Drug Research, Oslo, Norway
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway, Oslo, Norway
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Durkin S, Brennan E, Coomber K, Zacher M, Scollo M, Wakefield M. Short-term changes in quitting-related cognitions and behaviours after the implementation of plain packaging with larger health warnings: findings from a national cohort study with Australian adult smokers. Tob Control 2015; 24:ii26-ii32. [PMID: 28407608 PMCID: PMC4392190 DOI: 10.1136/tobaccocontrol-2014-052058] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 12/12/2014] [Accepted: 01/13/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Plain packaging (PP) with larger graphic health warnings (GHWs) was implemented in Australia in late 2012. This study examined effects of these packaging changes on short-term changes in quitting-related cognitions and behaviours. METHODS We used a series of cohorts of Australian adult cigarette smokers originally sourced from a nationally representative cross-sectional tracking survey, followed up approximately 1 month after their baseline interview (n(weighted)=5441). Logistic regression analyses compared changes in seven quitting-related outcomes over this 1-month follow-up period for the cohorts surveyed before PP, over the period of transition to PP, and during the first year of PP, adjusting for baseline levels of the outcome and covariates. RESULTS Compared to the referent group of smokers who completed their follow-up survey pre-PP, those who were followed-up in the early transition period showed significantly greater increases in rates of stopping themselves from smoking (OR=1.51, 95% CI (1.08 to 2.10)) and higher quit attempt rates (OR=1.43, 95% CI (1.00 to 2.03)), those followed-up in the late transition period showed greater increases in intentions to quit (OR=1.42, 95% CI (1.06 to 1.92)) and pack concealment (OR=1.55, 95% CI (1.05 to 2.31)), and those followed-up in the first year of PP showed higher levels of pack concealment (OR=1.65, 95% CI (1.01 to 2.72)), more premature stubbing out of cigarettes (OR=1.55, 95% CI (1.01 to 2.36)), and higher quit attempt rates (OR=1.52, 95% CI (1.01 to 2.30)). CONCLUSIONS These findings provide some of the strongest evidence to date that implementation of PP with larger GHWs was associated with increased rates of quitting cognitions, microindicators of concern and quit attempts among adult cigarette smokers.
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Affiliation(s)
- Sarah Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Emily Brennan
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Kerri Coomber
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Meghan Zacher
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Michelle Scollo
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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Levy DT, Lindblom EN, Fleischer NL, Thrasher J, Mohlman MK, Zhang Y, Monshouwer K, Nagelhout GE. Public Health Effects of Restricting Retail Tobacco Product Displays and Ads. TOB REGUL SCI 2015; 1:61-75. [PMID: 26191538 PMCID: PMC4503383 DOI: 10.18001/trs.1.1.7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To estimate the public health impact from restricting US retail point-of-sale (POS) tobacco product displays and advertising. METHODS Based on existing research, this paper estimates the effects on initiation and cessation rates from restricting POS tobacco product displays and ads in the US and uses the SimSmoke simulation model to project related smoking declines and health benefits. RESULTS New comprehensive POS restrictions are projected to reduce smoking prevalence by approximately 16% [range=3%-31%] relative to the status quo by 2065, preventing about 630,000 smoking-attributable deaths [range=108,000-1,225,000], 215,000 low birth weight births [range=33,000-421,000], 140,000 preterm births [range=22,000-271,000], and 1900 infant deaths from SIDSs [range=300-3800]. CONCLUSIONS Federal, state, or local action to restrict POS tobacco product displays and ads would contribute to a substantial reduction in smoking-attributed death and disease.
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Affiliation(s)
- David T Levy
- Professor, Georgetown University, Lombardi Comprehensive Cancer Center, Washington, DC
| | - Eric N Lindblom
- Georgetown University, Law Center, O'Neill Institute for National & Global Health Law
| | - Nancy L Fleischer
- University of South Carolina, Department of Epidemiology and Biostatistics, Education, and Behavior, Columbia, SC
| | - James Thrasher
- University of South Carolina, Department of Health Promotion, Education, and Behavior, Columbia, SC
| | - Mary Kate Mohlman
- Epidemiologist, Georgetown University, Lombardi Comprehensive Cancer Center, Washington, DC
| | - Yian Zhang
- Research Assistant, Georgetown University, Lombardi Comprehensive Cancer Center, Washington, DC
| | - Karin Monshouwer
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - Gera E Nagelhout
- Maastricht University (CAPHRL), Department of Health Promotion, Maastricht, The Netherlands
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White VM, Durkin SJ, Coomber K, Wakefield MA. What is the role of tobacco control advertising intensity and duration in reducing adolescent smoking prevalence? Findings from 16 years of tobacco control mass media advertising in Australia. Tob Control 2015; 24:198-204. [PMID: 23988860 DOI: 10.1136/tobaccocontrol-2012-050945] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine how the intensity and duration of tobacco control advertising relate to adolescent smoking prevalence. METHODS Australian students (aged 12-17 years) participating in a national survey conducted triennially between 1993 and 2008 (sample size range 12 314-16 611). The outcome measure was students' smoking in the previous 4 weeks collected through anonymous, self-completed surveys. For each student, monthly targeted rating points (TRPs, a measure of television advertising exposure) for tobacco control advertising was calculated for the 3 and 12 months prior to surveying. For each time period, cumulative TRPs exposure and exposure to three intensity levels (≥100 TRPs/month; ≥400 TRPs/month; ≥800 TRPs/month) over increasing durations (eg, 1 month, 2 months, etc) were calculated. Logistic regression examined associations between TRPs and adolescent smoking after controlling for demographic and policy variables. RESULTS Past 3-month cumulative TRPs were found to have an inverse relationship with smoking prevalence. Low TRPs exposure in the past 12 months was positively associated with adolescent smoking prevalence. However, smoking prevalence reduced with cumulative exposure levels above 5800 cumulative TRPs. Additionally, exposure to ≥400 TRPs/month and ≥800 TRPs/month were associated with reduced likelihood of smoking, although the duration needed for this effect differed for the two intensity levels. When intensity was ≥400 TRPs/month, the odds of smoking only reduced with continuous exposure. When intensity was ≥800 TRPs/month, exposure at levels less than monthly was associated with reductions in smoking prevalence. CONCLUSIONS Both antismoking advertising intensity and duration are important for ensuring reductions in adolescent smoking prevalence.
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Affiliation(s)
- Victoria M White
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Sarah J Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Kerri Coomber
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Melanie A Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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Scollo M, Bayly M, Wakefield M. Plain packaging: a logical progression for tobacco control in one of the world's 'darkest markets'. Tob Control 2015; 24:ii3-ii8. [PMID: 28407604 PMCID: PMC4392189 DOI: 10.1136/tobaccocontrol-2014-052048] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 11/20/2014] [Accepted: 01/13/2015] [Indexed: 11/23/2022]
Abstract
The Australian approach to tobacco control has been a comprehensive one, encompassing mass media campaigns, consumer information, taxation policy, access for smokers to smoking cessation advice and pharmaceutical treatments, protection from exposure to tobacco smoke and regulation of promotion. World-first legislation to standardise the packaging of tobacco was a logical next step to further reduce misleadingly reassuring promotion of a product known for the past 50 years to kill a high proportion of its long-term users. Similarly, refreshed, larger pack warnings which started appearing on packs at the end of 2012 were a logical progression of efforts to ensure that consumers are better informed about the health risks associated with smoking. Regardless of the immediate effects of legislation, further progress will continue to require a comprehensive approach to maintain momentum and ensure that government efforts on one front are not undermined by more vigorous efforts and greater investment by tobacco companies elsewhere.
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Affiliation(s)
- Michelle Scollo
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Megan Bayly
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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Veeranki SP, Mamudu HM, Zheng S, John RM, Cao Y, Kioko D, Anderson J, Ouma AEO. Secondhand smoke exposure among never-smoking youth in 168 countries. J Adolesc Health 2015; 56:167-73. [PMID: 25529618 DOI: 10.1016/j.jadohealth.2014.09.014] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 09/24/2014] [Accepted: 09/24/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To estimate the prevalence of secondhand smoke (SHS) exposure among never-smoking adolescents and identify key factors associated with such exposure. METHODS Data were obtained from nationally representative Global Youth Tobacco Surveys conducted in 168 countries during 1999-2008. SHS exposure was ascertained in relation to the location-exposure inside home, outside home, and both inside and outside home, respectively. Independent variables included parental and/or peer smoking, knowledge about smoke harm, attitudes toward smoking ban, age, sex, and World Health Organization region. Simple and multiple logistic regression analyses were conducted. RESULTS Of 356,414 never-smoking adolescents included in the study, 30.4%, 44.2%, and 23.2% were exposed to SHS inside home, outside home, and both, respectively. Parental smoking, peer smoking, knowledge about smoke harm, and positive attitudes toward smoke ban were significantly associated with increased odds of SHS exposure. Approximately 14% of adolescents had both smoking parents and peers. Compared with never-smoking adolescents who did not have both smoking parents and peers, those who had both smoking parents and peers had 19 (adjusted odds ratio [aOR], 19.0; 95% confidence interval [CI], 16.86-21.41), eight (aOR, 7.71; 95% CI, 7.05-8.43), and 23 times (aOR, 23.16; 95% CI, 20.74-25.87) higher odds of exposure to SHS inside, outside, and both inside and outcome home, respectively. CONCLUSIONS Approximately one third and two fifths of never-smoking adolescents were exposed to SHS inside or outside home, and smoking parents and/or peers are the key factors. Study findings highlight the need to develop and implement comprehensive smoke-free policies consistent with the World Health Organization Framework Convention on Tobacco Control.
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Affiliation(s)
- Sreenivas P Veeranki
- Division of Epidemiology, Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas; Division of General Pediatrics, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee.
| | - Hadii M Mamudu
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, Tennessee
| | - Shimin Zheng
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee
| | - Rijo M John
- Indian Institute of Technology, Jodhpur, Rajasthan, India
| | - Yan Cao
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee
| | - David Kioko
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, Tennessee
| | - James Anderson
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee
| | - Ahmed E O Ouma
- Tobacco Control Programme, WHO Regional Office for Africa, Brazzaville, Congo
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Hebebrand J, Albayrak Ö, Adan R, Antel J, Dieguez C, de Jong J, Leng G, Menzies J, Mercer JG, Murphy M, van der Plasse G, Dickson SL. “Eating addiction”, rather than “food addiction”, better captures addictive-like eating behavior. Neurosci Biobehav Rev 2014; 47:295-306. [DOI: 10.1016/j.neubiorev.2014.08.016] [Citation(s) in RCA: 244] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/25/2014] [Accepted: 08/28/2014] [Indexed: 01/18/2023]
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Dunlop S, Kite J, Grunseit AC, Rissel C, Perez DA, Dessaix A, Cotter T, Bauman A, Young J, Currow D. Out of Sight and Out of Mind? Evaluating the Impact of Point-of-Sale Tobacco Display Bans on Smoking-Related Beliefs and Behaviors in a Sample of Australian Adolescents and Young Adults. Nicotine Tob Res 2014; 17:761-8. [DOI: 10.1093/ntr/ntu180] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 08/24/2014] [Indexed: 11/13/2022]
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Jones SE, Caraballo RS. Usual source of cigarettes and alcohol among US high school students. THE JOURNAL OF SCHOOL HEALTH 2014; 84:493-501. [PMID: 25040117 PMCID: PMC4572694 DOI: 10.1111/josh.12174] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 11/19/2013] [Accepted: 01/03/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Cigarette and alcohol use are common among youth. We examined sources of cigarettes and alcohol among youth who were current cigarette and alcohol users. METHODS We analyzed nationally representative data from the 2009 and 2011 national Youth Risk Behavior Surveys-biennial, school-based surveys of high school students in the United States. Students completed anonymous, self-administered questionnaires. Overall response rates were 71% for both years. RESULTS Among the 17.3% of current cigarette users <18 years, 27.3% usually gave someone else money to buy their cigarettes and 27.7% usually borrowed (bummed) them. Fewer (14.1%) usually bought their own cigarettes in a store. Among the 40.3% of current alcohol users, 24.3% usually gave someone else money to buy it and 41.2% usually had someone give it to them. A few (4.5%) usually bought their own alcohol in a store. Age and intensity of use were positively associated with students buying their own cigarettes or alcohol, but negatively associated with students borrowing or having someone else give it to them. CONCLUSIONS Because social and commercial sources of cigarettes and alcohol are common, multiple strategies are needed to reduce the ability for youth to obtain them and reduce their desire for them.
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Affiliation(s)
- Sherry Everett Jones
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE,MS E75, Atlanta, GA30329
| | - Ralph S. Caraballo
- Office on Smoking and Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE,MS F79, Atlanta, GA30341
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Huang YC, Ho CS, Lee SM, Gee MJ, Lan SJ, Hsieh YP. Intent to abuse addictive substances in regions with serious drug abuse among early adolescents. JOURNAL OF SUBSTANCE USE 2014. [DOI: 10.3109/14659891.2014.942399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Wakefield MA, Coomber K, Durkin SJ, Scollo M, Bayly M, Spittal MJ, Simpson JA, Hill D. Time series analysis of the impact of tobacco control policies on smoking prevalence among Australian adults, 2001-2011. Bull World Health Organ 2014; 92:413-22. [PMID: 24940015 PMCID: PMC4047797 DOI: 10.2471/blt.13.118448] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 12/08/2013] [Accepted: 12/15/2013] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To determine the impact of tobacco control policies and mass media campaigns on smoking prevalence in Australian adults. METHODS Data for calculating the average monthly prevalence of smoking between January 2001 and June 2011 were obtained via structured interviews of randomly sampled adults aged 18 years or older from Australia's five largest capital cities (monthly mean number of adults interviewed: 2375). The influence on smoking prevalence was estimated for increased tobacco taxes; strengthened smoke-free laws; increased monthly population exposure to televised tobacco control mass media campaigns and pharmaceutical company advertising for nicotine replacement therapy (NRT), using gross ratings points; monthly sales of NRT, bupropion and varenicline; and introduction of graphic health warnings on cigarette packs. Autoregressive integrated moving average (ARIMA) models were used to examine the influence of these interventions on smoking prevalence. FINDINGS The mean smoking prevalence for the study period was 19.9% (standard deviation: 2.0%), with a drop from 23.6% (in January 2001) to 17.3% (in June 2011). The best-fitting model showed that stronger smoke-free laws, tobacco price increases and greater exposure to mass media campaigns independently explained 76% of the decrease in smoking prevalence from February 2002 to June 2011. CONCLUSION Increased tobacco taxation, more comprehensive smoke-free laws and increased investment in mass media campaigns played a substantial role in reducing smoking prevalence among Australian adults between 2001 and 2011.
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Affiliation(s)
- Melanie A Wakefield
- Behavioural Science Division, Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Kerri Coomber
- Behavioural Science Division, Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Sarah J Durkin
- Behavioural Science Division, Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Michelle Scollo
- Behavioural Science Division, Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Megan Bayly
- Behavioural Science Division, Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Matthew J Spittal
- Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Australia
| | - Julie A Simpson
- Centre for Health Policy, University of Melbourne, Melbourne, Australia
| | - David Hill
- Behavioural Science Division, Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia
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Affiliation(s)
- Anthony A Laverty
- Department of Primary Care and Public Health, Imperial College London, London W5 2SE, UK.
| | - Hilary C Watt
- Department of Primary Care and Public Health, Imperial College London, London W5 2SE, UK
| | | | - Nicholas S Hopkinson
- NIHR Respiratory Biomedical Research Unit at Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, London, UK
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Huang SL, Lin IF, Chen CY, Tsai TI. Impact of tobacco control policies on adolescent smoking: findings from the Global Youth Tobacco Survey in Taiwan. Addiction 2013; 108:1829-35. [PMID: 23714267 DOI: 10.1111/add.12259] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 01/04/2013] [Accepted: 05/20/2013] [Indexed: 11/30/2022]
Abstract
AIMS To assess the impact of a set of comprehensive tobacco control policies implemented in Taiwan in 2009, including extensive smoke-free policy, advertisement ban, pictorial warning and price increase, on adolescent smoking prevalence. DESIGN Five waves of cross-sectional surveys. SETTING Taiwan, 2004-11. PARTICIPANTS Nationally representative sample of junior high schools aged 13-15 years, in a biennial survey, total sample size 101,100. MEASURES Core questionnaire of the Global Youth Tobacco Survey, including ever smoking, 30-day smoking and number of cigarettes smoked. The magnitude of prevalence change before and after the 2009 policy implementation was quantified by adjusted odds ratios estimated by piecewise logistic regression models. FINDINGS The 30-day smoking prevalence demonstrated an upward trend [odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.02-1.10] between 2004 and 2008. Significant decline in 30-day smoking prevalence after the 2009 law implementation was observed (OR = 0.84, 95% CI = 0.71-0.99). Those living in non-city areas demonstrated a greater magnitude of change. In addition to changes in prevalence, we observed some delay in the age starting smoking, reduction in smokers who smoke fewer than one cigarette per day, and decrease in smokers who did not buy cigarettes. The decline in smoking prevalence was contributed primarily by the reduction in experimenters. CONCLUSION The comprehensive tobacco control programme introduced in Taiwan in 2009 was associated with a reduction in adolescent smoking, particularly among those in earlier stages of smoking and those who resided in non-city areas.
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Affiliation(s)
- Song-Lih Huang
- Institute of Public Health, National Yang Ming University, Taipei, Taiwan
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Quantifying the effect of changes in state-level adult smoking rates on youth smoking. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2013; 20:E1-6. [PMID: 23760306 DOI: 10.1097/phh.0b013e31829aa28e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Quantify the degree to which changes in state-level adult smoking prevalence subsequently influence youth smoking prevalence. DESIGN Analysis of data from the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) collected from 1995 to 2006 and the National Youth Tobacco Survey (NYTS) collected from 1999 to 2006. SETTING AND PARTICIPANTS Adults 25 years or older who completed the TUS-CPS and youth in middle and high school who completed the NYTS. MAIN OUTCOME MEASURES Current smoking among middle and high school students as a function of the change in state-level adult smoking, controlling for individual-level sociodemographic characteristics and state-level tobacco control policy variables. RESULTS Among middle school students, declines in state-level adult smoking rates are associated with lower odds of current smoking (P < .05), and each doubling of the decline in adult smoking rates is associated with a 6.0% decrease in youth smoking. Among high school students, declines in state-level adult smoking rates are not associated with current smoking. Higher cigarette prices were associated with lower odds of smoking among middle and high school students. Greater population coverage by smoke-free air laws and greater funding for tobacco control programs were associated with lower odds of current smoking among high school students but not middle school students. Compliance with youth access laws was not associated with middle or high school smoking. CONCLUSION By quantifying the effect of changes in state-level adult smoking rates on youth smoking, this study enhances the precision with which the tobacco control community can assess the return on investment for adult-focused tobacco control programs.
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Lovato C, Watts A, Brown KS, Lee D, Sabiston C, Nykiforuk C, Eyles J, Manske S, Campbell HS, Thompson M. School and community predictors of smoking: a longitudinal study of Canadian high schools. Am J Public Health 2012; 103:362-8. [PMID: 23237165 DOI: 10.2105/ajph.2012.300922] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We identified the most effective mix of school-based policies, programs, and regional environments associated with low school smoking rates in a cohort of Canadian high schools over time. METHODS We collected a comprehensive set of student, school, and community data from a national cohort of 51 high schools in 2004 and 2007. Hierarchical linear modeling was used to predict school and community characteristics associated with school smoking prevalence. RESULTS Between 2004 and 2007, smoking prevalence decreased from 13.3% to 10.7% in cohort schools. Predictors of lower school smoking prevalence included both school characteristics related to prevention programming and community characteristics, including higher cigarette prices, a greater proportion of immigrants, higher education levels, and lower median household income. CONCLUSIONS Effective approaches to reduce adolescent smoking will require interventions that focus on multiple factors. In particular, prevention programming and high pricing for cigarettes sold near schools may contribute to lower school smoking rates, and these factors are amenable to change. A sustained focus on smoking prevention is needed to maintain low levels of adolescent smoking.
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Affiliation(s)
- Chris Lovato
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
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Abascal W, Esteves E, Goja B, González Mora F, Lorenzo A, Sica A, Triunfo P, Harris JE. Tobacco control campaign in Uruguay: a population-based trend analysis. Lancet 2012; 380:1575-82. [PMID: 22981904 DOI: 10.1016/s0140-6736(12)60826-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In 2005, Uruguay initiated a series of comprehensive anti-smoking measures. We aimed to assess the effect of Uruguay's anti-tobacco campaign. METHODS We did a population-based trend analysis, using neighbouring Argentina, which has not instituted such extensive anti-tobacco measures, as a control. We assessed three key endpoints in both countries: per-person consumption of cigarettes, as measured by tax records; the prevalence of tobacco use in adolescents, as measured by school-based surveys; and the prevalence of tobacco use in adults, as measured by nationwide household-based surveys. FINDINGS During 2005-11, per-person consumption of cigarettes in Uruguay decreased by 4·3% per year (95% CI 2·4 to 6·2), whereas per-person consumption in Argentina increased by 0·6% per year (-1·2 to 2·5; p=0·002 for difference in trends). During 2003-09, the 30-day prevalence of tobacco use in Uruguayan students aged 13 years, 15 years, and 17 years decreased by an estimated 8·0% per year (4·5 to 11·6), compared with a decrease of 2·5% annually (0·5 to 4·5) in Argentinian students during 2001-09 (p=0·02 for difference in trends). From 2005 to 2011, the prevalence of current tobacco use in Uruguay decreased annually by an estimated 3·3% (2·4 to 4·1), compared with an annual decrease in Argentina of 1·7% (0·8 to 2·6; p=0·02 for difference in trends). INTERPRETATION Uruguay's comprehensive tobacco-control campaign has been associated with a substantial, unprecedented decrease in tobacco use. Decreases in tobacco use in other low-income and middle-income countries of the magnitude seen in Uruguay would have a substantial effect on the future global burden of tobacco-related diseases. FUNDING J William Fulbright Foreign Scholarship Board and the US Department of State.
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Affiliation(s)
- Winston Abascal
- National Programme for Tobacco Control, Ministry of Public Health, Montevideo, Uruguay
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Germain D, Durkin S, Scollo M, Wakefield M. The long-term decline of adult tobacco use in Victoria: changes in smoking initiation and quitting over a quarter of a century of tobacco control. Aust N Z J Public Health 2012; 36:17-23. [PMID: 22313701 DOI: 10.1111/j.1753-6405.2011.00805.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To examine changes in regular smoking prevalence among demographic and socioeconomic groups of Victorian adults from 1984 to 2008. METHODS Data were drawn from face-to-face and telephone surveys of randomly sampled Victorians conducted annually from 1984 to 2008. RESULTS Regular smoking in Victoria declined from 33.2% in 1984 to 15.5% in 2008, a relative decline of 53%. This change was largely accounted for by significant drops in 'ever smoking' among 18-29 year olds (from 59% to 35%, a relative decline of 41%) and by increased quitting among those aged 30 and older (from a quit proportion [% of those ever smoked who have quit] of 37% to 61% among 30-49 year olds, a relative increase of 64%; and from 53% to 79% among 50+ years, an increase of 48%). Over time, smoking prevalence became more similar between males and females. Regular smoking declined significantly across all socioeconomic status (SES) groups. Victorians living in low SES areas experienced the greatest relative increase in quit proportions of 75% (from 34% to 60%), helping to reduce the gap between low and higher SES groups in terms of smoking prevalence. CONCLUSIONS Regular smoking in Victoria has declined substantially across all demographic groups. Victorians are taking up smoking at much lower levels than 25 years ago, while quit proportions have more than doubled. IMPLICATIONS The continuation and extension of comprehensive, multi-level approaches to tobacco control is likely to be required for the maintenance of the downward trend in smoking.
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Affiliation(s)
- Daniella Germain
- Centre for Behavioural Research in Cancer, Cancer Council Victoria
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Impact of tobacco control interventions on smoking initiation, cessation, and prevalence: a systematic review. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2012; 2012:961724. [PMID: 22719777 PMCID: PMC3376479 DOI: 10.1155/2012/961724] [Citation(s) in RCA: 167] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 03/08/2012] [Indexed: 01/10/2023]
Abstract
Background. Policymakers need estimates of the impact of tobacco control (TC) policies to set priorities and targets for reducing tobacco use. We systematically reviewed the independent effects of TC policies on smoking behavior. Methods. We searched MEDLINE (through January 2012) and EMBASE and other databases through February 2009, looking for studies published after 1989 in any language that assessed the effects of each TC intervention on smoking prevalence, initiation, cessation, or price participation elasticity. Paired reviewers extracted data from studies that isolated the impact of a single TC intervention. Findings. We included 84 studies. The strength of evidence quantifying the independent effect on smoking prevalence was high for increasing tobacco prices and moderate for smoking bans in public places and antitobacco mass media campaigns. Limited direct evidence was available to quantify the effects of health warning labels and bans on advertising and sponsorship. Studies were too heterogeneous to pool effect estimates. Interpretations. We found evidence of an independent effect for several TC policies on smoking prevalence. However, we could not derive precise estimates of the effects across different settings because of variability in the characteristics of the intervention, level of policy enforcement, and underlying tobacco control environment.
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Thomson G, Wilson N, Hoek J. Pro-tobacco content in social media: the devil does not have all the best tunes. J Adolesc Health 2012; 50:319-20. [PMID: 22443832 DOI: 10.1016/j.jadohealth.2012.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 02/01/2012] [Indexed: 11/25/2022]
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Abstract
Evidence of the causal role of marketing in the tobacco epidemic and the advent of the WHO Framework Convention on Tobacco Control have inspired more than half the countries in the world to ban some forms of tobacco marketing. This paper briefly describes the ways in which cigarette marketing is restricted and the tobacco industry's efforts to subvert restrictions. It reviews what is known about the impact of marketing regulations on smoking by adults and adolescents. It also addresses what little is known about the impact of marketing bans in relation to concurrent population-level interventions, such as price controls, anti-tobacco media campaigns and smoke-free laws. Point of sale is the least regulated channel and research is needed to address the immediate and long-term consequences of policies to ban retail advertising and pack displays. Comprehensive marketing restrictions require a global ban on all forms of promotion, elimination of packaging and price as marketing tools, and limitations on the quantity, type and location of tobacco retailers.
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Affiliation(s)
- Lisa Henriksen
- Stanford University School of Medicine, Palo Alto, CA 94304, USA.
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