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Barbalich I, Gartner C, Edwards R, Hoek J. New Zealand Smokers' Perceptions of Tobacco Endgame Measures: A Qualitative Analysis. Nicotine Tob Res 2022; 24:93-99. [PMID: 34498088 DOI: 10.1093/ntr/ntab161] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/06/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION New Zealand's equity-focused endgame goal (Smokefree 2025) aims to reduce smoking prevalence to minimal levels (ie, <5%) in all population groups by 2025. Inadequate progress has stimulated discussion of innovative measures to reduce prevalence; because few studies have explored how marginalized groups perceive these measures, we addressed this knowledge gap. AIMS AND METHODS In November and December 2020, we conducted 20 in-depth interviews with people who smoked daily, were aged between 21 and 53, earned less than the median income (NZD33 900), and had marginal or inadequate income sufficiency. We explored participants' smoking history and used an elicitation exercise to probe their views on smokefree policies, including potential endgame measures. We used qualitative descriptive analysis and reflexive thematic analysis to interpret the data. RESULTS Participants favored increasing personal support to quit and reducing nicotine levels in cigarettes, but generally opposed tobacco excise tax increases and paying people to quit. While many privileged their right to "choose," some recognized that stronger policies could restore the loss of agency addiction caused. Participants felt smoking's powerful addictiveness remained poorly understood, and called for smoking to be recognized and treated as an addiction. CONCLUSIONS Several participants supported intensifying existing measures or introducing new measures. However, their use of tobacco industry rhetoric to frame smoking as a choice they had made could inadvertently reinforce the stigma they experienced. Reframing cigarettes as an addictive product engineered by a deceptive industry, may make it easier for participants to access the expanded support and compassion they sought. IMPLICATIONS Policy measures, such as reducing the nicotine level in cigarettes, could support endgame goals; however, greater public understanding of addiction is needed to reduce stigma, support self-efficacy, and foster smoking cessation. Industry denormalization campaigns could challenge views of smoking as a personal choice, decrease self-blame among people who smoke, and present endgame goals as likely to enhance agency.
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Affiliation(s)
- Ivana Barbalich
- Otago School of Medicine, University of Otago, Dunedin, New Zealand
| | - Coral Gartner
- School of Public Health, University of Queensland, St Lucia, QLD, Australia
| | - Richard Edwards
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
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2
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Sakuma KLK, Pierce JP, Fagan P, Nguyen-Grozavu FT, Leas EC, Messer K, White MM, Tieu AS, Trinidad DR. Racial/Ethnic Disparities Across Indicators of Cigarette Smoking in the Era of Increased Tobacco Control, 1992-2019. Nicotine Tob Res 2021; 23:909-919. [PMID: 33196799 PMCID: PMC8522466 DOI: 10.1093/ntr/ntaa231] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 11/11/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This study compared tobacco use and cessation for African Americans (AA), Asians/Pacific Islanders (API), Hispanics/Latinos (H/L), American Indian/Alaskan Natives (AI/AN), and non-Hispanic Whites (NHW) in the United States to California (CA), the state with the longest continually funded tobacco control program. The purpose of this study was to identify tobacco use disparities across racial/ethnic groups across time. METHODS Cigarette use prevalence (uptake and current use), consumption (mean number of cigarettes smoked per day [CPD]), and quit ratios were calculated across survey years, and trends were examined within each race/ethnic group and comparing between CA and the United States, utilizing the 1992-2019 Tobacco Use Supplements to the Current Population Survey. RESULTS Prevalence decreased for all race/ethnic groups. Current use among CA NHW showed significant decline compared with US counterparts, whereas US H/L showed greater decline than CA counterparts. CPD decreased by approximately 30% across race/ethnic groups, with CA groups having lower numbers. The greatest decrease occurred among AA in CA (average 10.3 CPD [95% confidence interval (CI): 10.3, 12.6] in 1992/1993 to 3 CPD [95% CI: 2.4, 3.7] in 2018/2019). Quit ratios increased from 1992/1993 to 2018/2019 for CA H/L 52.4% (95% CI: 49.8, 53.0) to 59.3 (95% CI: 55.8, 62.5) and CA NHWs 61.5% (95% CI: 60.7, 61.9) to 63.8% (95% CI: 63.9, 66.9). CONCLUSIONS Although overall prevalence decreased over time for each racial/ethnic group, declines in CA outpaced the United States only for NHWs. Reductions in CPD were encouraging but the quit ratio points to the need to increase tobacco control efforts toward cessation. IMPLICATIONS The successes in reduced cigarette use uptake and prevalence across time for both California and the rest of the United States were observed largely among non-Hispanic White populations. Although reductions in the number of cigarettes smoked per day are a notable success, particularly among the Californian African Americans, efforts to support quitting across racial/ethnic groups, especially marginalized groups, need to be prioritized.
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Affiliation(s)
- Kari-Lyn K Sakuma
- Health Promotion and Health Behavior Program, School of Social and
Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State
University, Corvallis, OR
| | - John P Pierce
- Department of Family Medicine and Public Health, Moores Cancer
Center, University of California San Diego, La Jolla,
CA
| | - Pebbles Fagan
- Fay W. Boozman College of Public Health, University of Arkansas for
Medical Sciences, Little Rock, AR
| | - France T Nguyen-Grozavu
- Department of Family Medicine and Public Health, Moores Cancer
Center, University of California San Diego, La Jolla,
CA
| | - Eric C Leas
- Division of Health Policy, Department of Family Medicine and Public
Health, University of California San Diego, La Jolla,
CA
| | - Karen Messer
- Department of Family Medicine and Public Health, Moores Cancer
Center, University of California San Diego, La Jolla,
CA
| | - Martha M White
- Department of Family Medicine and Public Health, Moores Cancer
Center, University of California San Diego, La Jolla,
CA
| | - Amanda S Tieu
- Department of Family Medicine and Public Health, Moores Cancer
Center, University of California San Diego, La Jolla,
CA
| | - Dennis R Trinidad
- Department of Family Medicine and Public Health, Moores Cancer
Center, University of California San Diego, La Jolla,
CA
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3
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Similar softening across different racial and ethnic groups of smokers in California as smoking prevalence declined. Prev Med 2019; 120:144-149. [PMID: 30703378 PMCID: PMC6400071 DOI: 10.1016/j.ypmed.2019.01.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/31/2018] [Accepted: 01/26/2019] [Indexed: 11/23/2022]
Abstract
Smoking prevalence differs among different racial/ethnic groups. Previous research found that as smoking prevalence declined in the U.S., remaining smokers made more quit attempts and smoked fewer cigarettes per day (CPD), indicating so-called softening. We examined California, a state with a highly diverse population, to assess whether there is differential softening among remaining smokers in different racial/ethnic groups. We used the California Tobacco Survey (1990-2008, N: 145,128). We ran logistic and linear regressions for smoking prevalence, CPD, quit attempts and time to first cigarette (30 min) as a function of race/ethnicity (non-Hispanic White, Hispanic, African American, Japanese, Chinese, Filipino, Korean, other Asian/Pacific Islander, American Indian/Alaska Native) controlling for other demographics. Overall prevalence fell from 21.1% in 1990 to 12.3% in 2008 (p < 0.01), showing similar declining trends across all racial/ethnic groups (p = 0.44), albeit from different baseline prevalence levels. In terms of softening indicators the proportion with at least one quit attempt in the past 12 months increased from 46.2% to 59.3%, a factor of 1.25 per decade (95%CI = 1.17, 1.34) in the adjusted model. CPD declined from 16.9 to 10.9, by -2.95 CPD per decade (95%CI = -3.24, -2.67) in the adjusted model. There were no significant changes in the time to first cigarette. Interactions of race/ethnicity and time show similar trends among all subgroups expect Hispanics, whose CPD remained stable rather than declining. Although from different baseline levels, tobacco control policies have benefitted all subgroups of California smokers, exhibiting similar softening as prevalence fell. Interventions are still needed to reduce the baseline differences.
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Vedøy TF. The role of demographic and behavioural change for the long-term decline in daily smoking in Norway. Eur J Public Health 2019; 29:760-765. [DOI: 10.1093/eurpub/cky273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The aim of this paper was to compare the effects of demography (population aging and the increasing fraction of tertiary educated) and behaviour (intra-cohort ageing and inter-cohort change) on long-term change in the fraction of daily smokers (FrS), using a counterfactual framework.
Methods
Using aggregated data on smoking prevalence, education and population size from Norway 1978 to 2017, the probabilities of smoking for men and women were calculated using a pseudo-panel approach. From these estimates, four counterfactual scenarios of FrS were constructed by holding the age effect, the cohort effect and the distribution of age and education constant over time.
Results
FrS decreased from 45 to 14% among men, and from 33 to 14% among women over the study period. Holding the age distribution constant did not have any substantial effect on FrS. Holding the distribution of education constant led to a five percentage points increase in FrS among women, but not among men. In the case of no intra-cohort ageing, FrS would have been 11/12 percentage points higher among women/men. The corresponding figures for no inter-cohort change were 13 points for women and 27 points for men.
Conclusions
If the age distribution had remained stable over time, FrS would have been almost identical to the current level. In contrast, if smoking behaviour had remained stable over the life course or between birth cohorts, FrS would have been substantially higher than it is today. These results highlight the large cumulative effect of reducing smoking uptake in successive cohorts.
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Affiliation(s)
- Tord F Vedøy
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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Pierce JP, Shi Y, McMenamin SB, Benmarhnia T, Trinidad DR, Strong DR, White MM, Kealey S, Hendrickson EM, Stone MD, Villaseñor A, Kwong S, Zhang X, Messer K. Trends in Lung Cancer and Cigarette Smoking: California Compared to the Rest of the United States. Cancer Prev Res (Phila) 2018; 12:3-12. [PMID: 30305281 DOI: 10.1158/1940-6207.capr-18-0341] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/01/2018] [Accepted: 10/05/2018] [Indexed: 12/23/2022]
Abstract
Three cigarette smoking behaviors influence lung cancer rates: how many people start, the amount they smoke, and the age they quit. California has reduced smoking faster than the rest of the United States and trends in these three smoking behaviors should inform lung cancer trends. We examined trends in smoking behavior (initiation, intensity, and quitting) in California and the rest of United States by regression models using the 1974-2014 National Health Interview Surveys (n = 962,174). Lung cancer mortality data for 1970-2013 was obtained from the National Surveillance, Epidemiology, and End Results (SEER) Program. Among those aged 18 to 35 years, California had much larger declines than the rest of the United States in smoking initiation and intensity, and increased quitting. In 2012-2014, among this age group, only 18.6% [95% confidence interval (CI), 16.8%-20.3%] had ever smoked; smokers consumed only 6.3 cigarettes/day (95% CI, 5.6-7.0); and 45.7% (95% CI, 41.1%-50.4%) of ever-smokers had quit by age 35. Each of these metrics was at least 24% better than in the rest of the United States. There was no marked California effect on quitting or intensity among seniors. From 1986 to 2013, annual lung cancer mortality decreased more rapidly in California and by 2013 was 28% lower (62.6 vs. 87.5/100,000) than in the rest of the United States. California's tobacco control efforts were associated with a major reduction in cigarette smoking among those under age 35 years. These changes will further widen the lung cancer gap that already exists between California and the rest of the United States.
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Affiliation(s)
- John P Pierce
- Moores UC San Diego Cancer Center, San Diego, California. .,Department of Family Medicine and Public Health, University of California, San Diego, California
| | - Yuyan Shi
- Department of Family Medicine and Public Health, University of California, San Diego, California
| | - Sara B McMenamin
- Moores UC San Diego Cancer Center, San Diego, California.,Department of Family Medicine and Public Health, University of California, San Diego, California
| | - Tarik Benmarhnia
- Moores UC San Diego Cancer Center, San Diego, California.,Department of Family Medicine and Public Health, University of California, San Diego, California
| | - Dennis R Trinidad
- Moores UC San Diego Cancer Center, San Diego, California.,Department of Family Medicine and Public Health, University of California, San Diego, California
| | - David R Strong
- Moores UC San Diego Cancer Center, San Diego, California.,Department of Family Medicine and Public Health, University of California, San Diego, California
| | - Martha M White
- Department of Family Medicine and Public Health, University of California, San Diego, California
| | - Sheila Kealey
- Department of Family Medicine and Public Health, University of California, San Diego, California
| | | | - Matthew D Stone
- Department of Family Medicine and Public Health, University of California, San Diego, California
| | - Adriana Villaseñor
- Moores UC San Diego Cancer Center, San Diego, California.,Department of Family Medicine and Public Health, University of California, San Diego, California
| | - Sandy Kwong
- California Department of Public Health, California Cancer Registry, Sacramento, California
| | - Xueying Zhang
- California Department of Public Health, Tobacco Control Section, Sacramento, California
| | - Karen Messer
- Moores UC San Diego Cancer Center, San Diego, California.,Department of Family Medicine and Public Health, University of California, San Diego, California
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Tauras JA, Xu X, Huang J, King B, Lavinghouze SR, Sneegas KS, Chaloupka FJ. State tobacco control expenditures and tax paid cigarette sales. PLoS One 2018; 13:e0194914. [PMID: 29652890 PMCID: PMC5898722 DOI: 10.1371/journal.pone.0194914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 03/13/2018] [Indexed: 11/18/2022] Open
Abstract
This research is the first nationally representative study to examine the relationship between actual state-level tobacco control spending in each of the 5 CDC's Best Practices for Comprehensive Tobacco Control Program categories and cigarette sales. We employed several alternative two-way fixed-effects regression techniques to estimate the determinants of cigarette sales in the United States for the years 2008-2012. State spending on tobacco control was found to have a negative and significant impact on cigarette sales in all models that were estimated. Spending in the areas of cessation interventions, health communication interventions, and state and community interventions were found to have a negative impact on cigarette sales in all models that were estimated, whereas spending in the areas of surveillance and evaluation, and administration and management were found to have negative effects on cigarette sales in only some models. Our models predict that states that spend up to seven times their current levels could still see significant reductions in cigarette sales. The findings from this research could help inform further investments in state tobacco control programs.
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Affiliation(s)
- John A. Tauras
- Department of Economics, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Xin Xu
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Jidong Huang
- Department of Health Management and Policy, Georgia State University, Atlanta, GA, United States of America
| | - Brian King
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - S. Rene Lavinghouze
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Karla S. Sneegas
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Frank J. Chaloupka
- Division of Health Policy and Administration, University of Illinois at Chicago, Chicago, IL, United States of America
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7
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Pierce JP, Shi Y, Hendrickson EM, White MM, Noble ML, Kealey S, Strong DR, Trinidad DR, Hartman AM, Messer K. Tobacco control in California compared with the rest of the USA: trends in adult per capita cigarette consumption. Tob Control 2017; 27:e112-e117. [PMID: 29180534 DOI: 10.1136/tobaccocontrol-2017-053895] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 11/08/2017] [Accepted: 11/14/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND In the 1990s, California led the USA in state-level tobacco control strategies. However, after 2000, California lost ground on cigarette taxes, although it maintained higher levels of smoke-free homes among smokers. METHODS Trends in per capita cigarette consumption were assessed through taxed sales data and from self-report in repeated national cross-sectional surveys. Linear regressions identified changes in trends after year 2000 separately for California and the rest of the USA. Using data from each state, a linear regression tested the association between different tobacco control strategies and per capita consumption. Change in self-reported per capita consumption was partitioned into contributions associated with initiation, quitting and reduction in cigarette consumption level. RESULTS Both taxed cigarette sales and per capita consumption declined rapidly in the USA from 1985 to 2015. Declines were particularly fast in California before 2000 but slowed thereafter. In 2014, per capita consumption in California was 29.4 packs/adult/year, but 90% higher in the rest of the USA. Modelling state-level data, every $1 increase in cigarette taxes reduced consumption by 4.8 (95% CI 2.9 to 6.8) packs/adult/year. Every 5% increase in the proportion of smokers with smoke-free homes reduced consumption by 8.0 (95% CI 7.0 to 8.9) packs/adult/year. The different patterns in California and the rest of the USA are at least partially explained by these two variables. The slow down in per capita consumption in California can be attributed to changes in initiation, quitting and especially smokers reducing their consumption level. CONCLUSIONS Tobacco control strategies need to be continually updated to maintain momentum towards a smoke-free society.
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Affiliation(s)
- John P Pierce
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California, USA.,Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California, USA
| | - Yuyan Shi
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California, USA
| | - Erik M Hendrickson
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California, USA
| | - Martha M White
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California, USA
| | - Madison L Noble
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California, USA.,Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California, USA
| | - Sheila Kealey
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California, USA
| | - David R Strong
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California, USA.,Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California, USA
| | - Dennis R Trinidad
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California, USA.,Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California, USA
| | - Anne M Hartman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Karen Messer
- Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, California, USA.,Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California, USA
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Abstract
BACKGROUND Mass media tobacco control campaigns can reach large numbers of people. Much of the literature is focused on the effects of tobacco control advertising on young people, but there are also a number of evaluations of campaigns targeting adult smokers, which show mixed results. Campaigns may be local, regional or national, and may be combined with other components of a comprehensive tobacco control policy. OBJECTIVES To assess the effectiveness of mass media interventions in reducing smoking among adults. SEARCH METHODS The Cochrane Tobacco Addiction Group search strategy was combined with additional searches for any studies that referred to tobacco/smoking cessation, mass media and adults. We also searched the Cochrane Central Register of Controlled Trials (CENTRAL) and a number of electronic databases. The last search was carried out in November 2016. SELECTION CRITERIA Controlled trials allocating communities, regions or states to intervention or control conditions; interrupted time series.Adults, 25 years or older, who regularly smoke cigarettes. Studies which cover all adults as defined in studies were included.Mass media are defined here as channels of communication such as television, radio, newspapers, billboards, posters, leaflets or booklets intended to reach large numbers of people, and which are not dependent on person-to-person contact. The purpose of the mass media campaign must be primarily to encourage smokers to quit. They could be carried out alone or in conjunction with tobacco control programmes.The primary outcome was change in smoking behaviour. This could be reported as changes in prevalence, changes in cigarette consumption, quit rates, or odds of being a smoker. DATA COLLECTION AND ANALYSIS Two authors independently assessed all studies for inclusion criteria and for study quality (MB, LS, RTM). One author (MB) extracted data, and a second author (LS) checked them.Results were not pooled due to heterogeneity of the included studies and are presented narratively and in table form. MAIN RESULTS Eleven campaigns met the inclusion criteria for this review. Studies differed in design, settings, duration, content and intensity of intervention, length of follow-up, methods of evaluation and also in definitions and measures of smoking behaviour used. Among seven campaigns reporting smoking prevalence, significant decreases were observed in the California and Massachusetts statewide tobacco control campaigns compared with the rest of the USA. Some positive effects on prevalence in the whole population or in the subgroups were observed in three of the remaining seven studies. Three large-scale campaigns of the seven presenting results for tobacco consumption found statistically significant decreases. Among the eight studies presenting abstinence or quit rates, four showed some positive effect, although in one of them the effect was measured for quitting and cutting down combined. Among the three that did not show significant decreases, one demonstrated a significant intervention effect on smokers and ex-smokers combined. AUTHORS' CONCLUSIONS There is evidence that comprehensive tobacco control programmes which include mass media campaigns can be effective in changing smoking behaviour in adults, but the evidence comes from a heterogeneous group of studies of variable methodological quality. One state-wide tobacco control programme (Massachusetts) showed positive results up to eight years after the campaign. Another (California) showed positive results during the period of adequate funding and implementation and in final evaluation since the beginning of the programme. Six of nine studies carried out in communities or regions showed some positive effects on smoking behaviour and at least one significant change in smoking prevalence (Sydney). The intensity and duration of mass media campaigns may influence effectiveness, but length of follow-up and concurrent secular trends and events can make this difficult to quantify. No consistent relationship was observed between campaign effectiveness and age, education, ethnicity or gender.
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Affiliation(s)
- Malgorzata M Bala
- Jagiellonian University Medical CollegeChair of Epidemiology and Preventive Medicine; Department of Hygiene and Dietetics; Systematic Reviews Unit ‐ Polish Cochrane BranchKopernika 7KrakowPoland31‐034
| | | | - Roman Topor‐Madry
- Institute of Public Health, Jagiellonian University Medical CollegeDepartment of Epidemiology and Population StudiesGrzegórzecka 20KrakowPoland31‐531
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9
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Sakuma KLK, Felicitas-Perkins JQ, Blanco L, Fagan P, Pérez-Stable EJ, Pulvers K, Romero D, Trinidad DR. Tobacco use disparities by racial/ethnic groups: California compared to the United States. Prev Med 2016; 91:224-232. [PMID: 27575315 PMCID: PMC5554114 DOI: 10.1016/j.ypmed.2016.08.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/01/2016] [Accepted: 08/24/2016] [Indexed: 02/07/2023]
Abstract
Racial/ethnic disparities in cigarette use and cessation persist. This study compared cigarette consumption and former smoking trends in California (CA) with the rest of the United States (US) by racial/ethnic categories of non-Hispanic White, Black, Hispanic/Latino, and Asian/Pacific Islander groups. Data were analyzed from the 1992 to 2011 Tobacco Use Supplement to the Current Population Survey. Consumption levels across decades were examined and adjusted logistic regression models were fit to compare across CA and US. Results indicated steady declines in ever smoking prevalence for all groups with much lower magnitudes of change among US Blacks and Whites compared to their CA counterparts. After controlling for age, gender, and education, CA had significantly fewer heavy smokers (OR=0.45, 95% CI:0.38-0.54), more light and intermittent smokers (LITS; OR=1.68, 95%CI: 1.45-1.93), and a greater proportion of former smokers (OR=1.35, 95%CI: 1.24-1.48) than the rest of US. Data were stratified by race/ethnicity and the patterns shown were mostly consistent with CA performing statistically better than their US counterparts with the exception of Black LITS and Asian/Pacific Islander former smokers. California's success in reducing tobacco use disparities may serve as a prime example of tobacco control policy for the country. CA and the US will need to continue to address tobacco use and cessation in the context of the growing diversity of the population.
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Affiliation(s)
- Kari-Lyn K Sakuma
- Oregon State University, College of Public Health and Human Sciences, School of Social and Behavioral Health Sciences, Corvallis, OR, United States.
| | | | - Lyzette Blanco
- Claremont Graduate University, School of Community and Global Health, Claremont, CA, United States
| | - Pebbles Fagan
- University of Hawaii, Cancer Center, Honolulu, HI, United States
| | - Eliseo J Pérez-Stable
- Division of General Internal Medicine, Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, United States
| | - Kim Pulvers
- California State University San Marcos, San Marcos, CA, United States
| | - Devan Romero
- California State University San Marcos, San Marcos, CA, United States
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Jiang N, Lee YO, Ling PM. Association between tobacco and alcohol use among young adult bar patrons: a cross-sectional study in three cities. BMC Public Health 2014; 14:500. [PMID: 24886521 PMCID: PMC4055258 DOI: 10.1186/1471-2458-14-500] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 05/13/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bars and nightclubs are key public venues where young adults congregate and use both tobacco and alcohol, and young adult bar patrons are at high risk for substance use. This study examined the association between cigarette smoking and alcohol use among a random sample of young adult bar patrons from three different cities in the USA. METHODS Cross-sectional data was collected from a random sample of young adult bar patrons aged 18-29 in San Diego, CA (N = 1,150), Portland, ME (N = 1,019), and Tulsa, OK (N = 1,106) from 2007-2010 (response rate 88%) using randomized time location sampling. Respondents reported the number of days they smoked cigarettes, drank alcohol, and binge drank in the past 30 days. Multinomial logistic regression was used to analyze the association between smoking (nonsmoker, occasional smoker, and regular smoker) and drinking and binge drinking for each city controlling for age, gender, race/ethnicity, and education. Predicted probabilities of each smoking category were calculated by drinking and binge drinking status. The association between smoking and drinking and binge drinking among combined samples was also analyzed, controlling for demographic variables and city. RESULTS Respondents reported high current smoking rates, ranging from 51% in Portland to 58% in Tulsa. Respondents in Tulsa were more likely to report regular smoking than those in San Diego and Portland, with demographic variables being controlled. Young adult bar patrons also exhibited a strong association between smoking and drinking. In general, as the frequency of drinking and binge drinking increased, the predicted probability of being a smoker, especially a regular smoker, increased in each city. CONCLUSIONS Young adult bar patrons consistently reported a high smoking rate and a strong relationship between smoking and drinking, regardless of the different bar cultures and tobacco control contexts in each of the three cities. While smoke-free bar policies were negatively associated with regular smoking, these policies alone may not be enough to influence the association between smoking and drinking, particularly if tobacco marketing continues in these venues, or in the absence of programs specifically addressing the co-use of tobacco and alcohol.
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Affiliation(s)
- Nan Jiang
- School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, Room A5-08 21 Sassoon Road, Hong Kong, People’s Republic of China
| | - Youn Ok Lee
- Public Health and Environment Division, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA
| | - Pamela M Ling
- Center for Tobacco Control Research and Education and Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, 530 Parnassus Avenue, Suite 366, San Francisco, CA 94143, USA
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Bala MM, Strzeszynski L, Topor-Madry R, Cahill K. Mass media interventions for smoking cessation in adults. Cochrane Database Syst Rev 2013:CD004704. [PMID: 23744348 DOI: 10.1002/14651858.cd004704.pub3] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Mass media tobacco control campaigns can reach large numbers of people. Much of the literature is focused on the effects of tobacco control advertising on young people, but there are also a number of evaluations of campaigns targeting adult smokers, which show mixed results. Campaigns may be local, regional or national, and may be combined with other components of a comprehensive tobacco control policy. OBJECTIVES To assess the effectiveness of mass media interventions in reducing smoking among adults. SEARCH METHODS The Cochrane Tobacco Addiction Group search strategy was combined with additional searches for any studies that referred to tobacco/smoking cessation, mass media and adults. We also searched the Cochrane Register of Controlled Trials (CENTRAL) and a number of electronic databases. The last search was carried out in February 2013. SELECTION CRITERIA Controlled trials allocating communities, regions or states to intervention or control conditions; interrupted time series. Adults, 25 years or older, who regularly smoke cigarettes. Studies which cover all adults as defined in studies were included. Mass media are defined here as channels of communication such as television, radio, newspapers, billboards, posters, leaflets or booklets intended to reach large numbers of people, and which are not dependent on person-to-person contact. The purpose of the mass media campaign must be primarily to encourage smokers to quit. They could be carried out alone or in conjunction with tobacco control programmes. The primary outcome was change in smoking behaviour. This could be reported as changes in prevalence, changes in cigarette consumption, quit rates, odds of being a smoker. DATA COLLECTION AND ANALYSIS Two authors independently assessed all studies for inclusion criteria and for study quality. One author (MB) extracted data, and a second author (LS) checked them.Results were not pooled due to heterogeneity of the included studies and are presented narratively and in table form. MAIN RESULTS Eleven campaigns met the inclusion criteria for this review. Studies differed in design, settings, duration, content and intensity of intervention, length of follow-up, methods of evaluation and also in definitions and measures of smoking behaviour used. Among nine campaigns reporting smoking prevalence, significant decreases were observed in the California and Massachusetts statewide tobacco control campaigns compared with the rest of the USA. Some positive effects on prevalence in the whole population or in the subgroups were observed in three of the remaining seven studies. Three large-scale campaigns of the seven presenting results for tobacco consumption found statistically significant decreases. Among the seven studies presenting abstinence or quit rates, four showed some positive effect, although in one of them the effect was measured for quitting and cutting down combined. Among the three that did not show significant decreases, one demonstrated a significant intervention effect on smokers and ex-smokers combined. AUTHORS' CONCLUSIONS There is evidence that comprehensive tobacco control programmes which include mass media campaigns can be effective in changing smoking behaviour in adults, but the evidence comes from a heterogeneous group of studies of variable methodological quality. One state-wide tobacco control programme (Massachusetts) showed positive results up to eight years after the campaign. Another (California) showed positive results during the period of adequate funding and implementation and in final evaluation since the beginning of the programme. Six of nine studies carried out in communities or regions showed some positive effects on smoking behaviour and at least one significant change in smoking prevalence (Sydney). The intensity and duration of mass media campaigns may influence effectiveness, but length of follow-up and concurrent secular trends and events can make this difficult to quantify. No consistent relationship was observed between campaign effectiveness and age, education, ethnicity or gender.
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Affiliation(s)
- Malgorzata M Bala
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland.
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12
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Palmer PH, Lee C, Sablan-Santos L, Lepule JT, Pang VK, Tui'one V, Schmidt-Vaivao D, Sabado MD, Sur R, Tanjasiri SP. Eliminating tobacco disparities among native Hawaiian Pacific Islanders through policy change: the role of community-based organizations. Health Promot Pract 2013; 14:36S-9S. [PMID: 23667058 DOI: 10.1177/1524839913486150] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although cigarette smoking in the general U.S. population has decreased considerably over the past several decades, prevalence rates among Native Hawaiian Pacific Islanders (NHPI) have remained elevated by comparison with other groups. The aggregation of NHPI smoking data with that of Asians has drawn attention away from the serious smoking problems that NHPIs experience, thus, limiting funding, programs, and policies to reduce tobacco-related health disparities in their communities. In California, community-based organizations (CBOs) have played a major role in supporting the state's comprehensive tobacco control program, which is arguably one of the most successful in the nation. In this commentary, we describe the tobacco control activities of five NHPI-serving CBOs in Southern California and how they have provided anti-tobacco education for thousands of Native Hawaiians, Chamorros, Marshallese, Samoans, Tongans, and other Pacific Islander subgroups, and used advocacy and coalition building to promote smoke-free environment policies in their communities. The concerted efforts of the CBOs and their community members have made vital contributions to the reduction of tobacco-related disparities for NHPI populations in California.
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13
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Jiang N, Ling PM. Impact of alcohol use and bar attendance on smoking and quit attempts among young adult bar patrons. Am J Public Health 2013; 103:e53-61. [PMID: 23488485 DOI: 10.2105/ajph.2012.301014] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined cigarette smoking and quit attempts in the context of alcohol use and bar attendance among young adult bar patrons with different smoking patterns. Methods. We used randomized time location sampling to collect data among adult bar patrons aged 21 to 26 years in San Diego, California (n = 1235; response rate = 73%). We used multinomial and multivariate logistic regression models to analyze the association between smoking and quit attempts and both drinking and binge drinking among occasional, regular, very light, and heavier smokers, controlling for age, gender, race/ethnicity, and education. RESULTS Young adult bar patrons reported high rates of smoking and co-use of cigarettes and alcohol. Binge drinking predicted smoking status, especially occasional and very light smoking. All types of smokers reported alcohol use, and bar attendance made it harder to quit. Alcohol use was negatively associated with quit attempts for very light smokers, but positively associated with quitting among heavier smokers. CONCLUSIONS Smoking and co-use of cigarettes and alcohol are common among young adult bar patrons, but there are important differences by smoking patterns. Tobacco interventions for young adults should prioritize bars and address alcohol use.
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Affiliation(s)
- Nan Jiang
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143, USA
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14
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Jemal A, Ma J, Rosenberg PS, Siegel R, Anderson WF. Increasing lung cancer death rates among young women in southern and midwestern States. J Clin Oncol 2012; 30:2739-44. [PMID: 22734032 PMCID: PMC3402885 DOI: 10.1200/jco.2012.42.6098] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 05/07/2012] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Previous studies reported that declines in age-specific lung cancer death rates among women in the United States abruptly slowed in women younger than age 50 years (ie, women born after the 1950s). However, in view of substantial geographic differences in antitobacco measures and sociodemographic factors that affect smoking prevalence, it is unknown whether this change in the trend was similar across all states. METHODS We examined female age-specific lung cancer death rates (1973 through 2007) by year of death and birth in each state by using age-period-cohort models. Cohort relative risks adjusted for age and period effects were used to compare the lung cancer death rate for a given birth cohort to a referent birth cohort (ie, the 1933 cohort herein). RESULTS Age-specific lung cancer death rates declined continuously in white women in California, but the rates declined less quickly or even increased in the remaining states among women younger than age 50 years and women born after the 1950s, especially in several southern and midwestern states. For example, in some southern states (eg, Alabama), lung cancer death rates among women born in the 1960s were approximately double those of women born in the 1930s. CONCLUSION The unfavorable lung cancer trend in white women born after circa 1950 in southern and midwestern states underscores the need for additional interventions to promote smoking cessation in these high-risk populations, which could lead to more favorable future mortality trends for lung cancer and other smoking-related diseases.
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Affiliation(s)
- Ahmedin Jemal
- Surveillance Research Program, American Cancer Society, 250 Williams St, Atlanta, GA 30303, USA.
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15
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Filion KB, Steffen LM, Duval S, Jacobs DR, Blackburn H, Luepker RV. Trends in smoking among adults from 1980 to 2009: the Minnesota heart survey. Am J Public Health 2012; 102:705-13. [PMID: 21852651 PMCID: PMC3489364 DOI: 10.2105/ajph.2011.300162] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2011] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined population-based smoking trends in Minnesota between 1980 and 2009. METHODS The Minnesota Heart Survey (MHS) is a population-based, serial, cross-sectional study of cardiovascular risk factor trends among Minneapolis-Saint Paul metropolitan residents. The MHS recently completed its sixth survey (1980-1982 [n = 3799], 1985-1987 [n = 4641], 1990-1992 [n = 5159], 1995-1997 [n = 6690], 2000-2002 [n = 3281], and 2007-2009 [n = 3179]). We used MHS data to examine smoking trends among adults aged 25 to 74 years by means of age-adjusted generalized linear mixed models. RESULTS Between 1980 and 2009, the prevalence of current smoking decreased from 32.8% to 15.5% for men and from 32.7% to 12.2% for women (P < .001 for each). Greater decreases occurred among those with higher income and those with more education. Among currently smoking men, the number of cigarettes smoked per day decreased from 26.0 in the 1980-1982 survey to 16.0 in the 2007-2009 survey (P < .001). Similar trends were observed among women. CONCLUSIONS Although the prevalence of smoking and cigarette consumption decreased from the 1980-1982 period to the 2007-2009 period, interventions specifically designed for those of lower socioeconomic status are needed.
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Affiliation(s)
- Kristian B Filion
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis 55454, USA
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16
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Max W, Sung HY, Lightwood J. The impact of changes in tobacco control funding on healthcare expenditures in California, 2012–2016. Tob Control 2012; 22:e10-5. [DOI: 10.1136/tobaccocontrol-2011-050130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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17
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Satterlund TD, Lee JP, Moore RS. Changes in smoking-related norms in bars resulting from California's Smoke-Free Workplace Act. JOURNAL OF DRUG EDUCATION 2012; 42:315-26. [PMID: 23705511 PMCID: PMC3671496 DOI: 10.2190/de.42.3.d] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
California's Smoke-Free Workplace Act--CA Labor Code Sec. 6404.5(a)--was extended to bars in 1998. This article analyzes changes in normative beliefs and behaviors related to bar smoking in the decade following the adoption of the Act. In a series of studies evaluating the smoke-free workplace law in bars, researchers conducted extensive observations and interviews with bar staff and patrons, health officials, and law enforcement personnel in three California counties. Smoking outside became a normal pause in the social environment and created a new type of bar socializing for outside smokers. Although some bar owners and staff reported initially resenting the responsibility to uphold the law, once norms regarding cigarettes and smoking began changing, bar workers experienced less conflict in upholding the law. Non-smoking behavior within bars also became the normative behavior for bar patrons. California's Smoke-Free Workplace Act has both reflected and encouraged normative beliefs and behaviors related to smoking in bars. The findings indicate that such shifts are possible even in contexts where smoking behaviors and attitudes supporting smoking were deeply entrenched. Recommendations include attending to the synergistic effect of education and policy in effective tobacco control programs.
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Pierce JP, Messer K, White MM, Kealey S, Cowling DW. Forty years of faster decline in cigarette smoking in California explains current lower lung cancer rates. Cancer Epidemiol Biomarkers Prev 2010; 19:2801-10. [PMID: 20852009 DOI: 10.1158/1055-9965.epi-10-0563] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Declining lung cancer rates in California have been attributed to the California Tobacco Control Program, but may reflect earlier declines in smoking. METHODS Using state-taxed sales and three survey series, we assessed trends in smoking behavior for California and the rest of the nation from 1960 to 2008 and compared these with lung cancer mortality rates. We tested the validity of recent trends in state-taxed sales by projecting results from a model of the 1960 to 2002 data. RESULTS From 1960 to 2002, the state-taxed sales and survey data are consistent. Californians initially smoked more than the rest of the nation, but cigarette consumption declined earlier, dropping lower in 1971 with an ever widening gap over time. Lung cancer mortality follows a similar pattern, after a lag of 16 years. Introduction of the California Tobacco Control Program doubled the rate of decline in cigarette consumption. From 2002 to 2008, differences in enforcement and tax evasion may compromise the validity of the taxed sales data. In 2010, smoking prevalence is estimated to be 9.3% in California and 17.8% in the rest of the nation. However, in 2008, for the first time, both cigarette price and tobacco control expenditures were lower in California than the rest of the nation, suggesting that the gap in smoking behavior will start to narrow. CONCLUSION An effective Tobacco Control Program means that California will have faster declines in lung cancer than the rest of the nation for the next 2 decades, but possibly not beyond. IMPACT Tobacco control interventions need further dissemination.
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Affiliation(s)
- John P Pierce
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA 92093-0901, USA.
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Tang H, Abramsohn E, Park HY, Cowling DW, Al-Delaimy WK. Using a cessation-related outcome index to assess California's cessation progress at the population level. Tob Control 2010; 19 Suppl 1:i56-61. [PMID: 20382652 PMCID: PMC2976490 DOI: 10.1136/tc.2009.031047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background The California Tobacco Control Program (CTCP) has employed strategies to change social norms around smoking in order to decrease the prevalence of smoking and tobacco-related diseases. Research is scarce on CTCP's impact on overall smoking cessation in California. Methods Tobacco Use Supplement to the Current Population Survey (TUS-CPS) data from 1992–1993 to 2006–2007 was used to create a cessation-related outcome index (CROI), which was a summarised z score of the following determinants: plan to quit, quit attempt and recent quit rate for each of the 50 US states. CROI trends over the period of six separate TUS-CPSs were plotted for California and other comparison states, for 18–34 year olds and for those 35 years or older separately in the context of historical cigarette price z score trend. Results California had a consistently high CROI for both age groups. The CROI trend line increased moderately in California for both age groups despite a declining cigarette price z score trend. In contrast, other selected states with a declining cigarette price z score trend had a declining CROI trend for both age groups. Conclusions The increase of CROI in California while cigarette price z score trend declined suggests that the implementation of CTCP, even without a significant direct cessation component, has had a profound impact on cessation outcomes.
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Affiliation(s)
- Hao Tang
- Genetic Disease Screening Program, California Department of Public Health, 850 Marina Bay Parkway, MS 8200, Richmond, CA 94804, USA.
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20
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Miller LS, Max W, Sung HY, Rice D, Zaretsky M. Evaluation of the economic impact of California's Tobacco Control Program: a dynamic model approach. Tob Control 2010; 19 Suppl 1:i68-76. [PMID: 20382654 PMCID: PMC2976474 DOI: 10.1136/tc.2008.029421] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2008] [Accepted: 01/08/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the long-term net economic impact of the California Tobacco Control Program. METHODS This study developed a series of dynamic models of smoking-caused mortality, morbidity, health status and healthcare expenditures. The models were used to evaluate the impact of the tobacco control programme. Outcomes of interest in the evaluation include net healthcare expenditures saved, years of life saved, years of treating smoking-related diseases averted and the total economic value of net healthcare savings and life saved by the programme. These outcomes are evaluated to 2079. Due to data limitations, the evaluations are conducted only for men. RESULTS The California Tobacco Control Program resulted in over 700,000 person-years of life saved and over 150,000 person-years of treatment averted for the 14.7 million male California residents alive in 1990. The value of net healthcare savings and years of life saved resulting from the programme was $22 billion or $107 billion in 1990 dollars, depending on how a year of life is discounted. If women were included, the impact would likely be much greater. CONCLUSIONS The benefits of California's Tobacco Control Program are substantial and will continue to accrue for many years. Although the programme has resulted in increased longevity and additional healthcare resources for some, this impact is more than outweighed by the value of the additional years of life. Modelling the programme's impact in a dynamic framework makes it possible to evaluate the multiple impacts that the programme has on life, health and medical expenditures.
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Affiliation(s)
- Leonard S Miller
- School of Social Welfare, University of California, Berkeley, California, USA
| | - Wendy Max
- Institute for Health & Aging, Department of Social and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Hai-Yen Sung
- Institute for Health & Aging, Department of Social and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Dorothy Rice
- Institute for Health & Aging, Department of Social and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Malcolm Zaretsky
- Department of Molecular and Cell Biology, University of California, Berkeley, California, USA
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Thomas DP, Johnston V, Fitz JW, McDonnell J. Monitoring local trends in Indigenous tobacco consumption. Aust N Z J Public Health 2009; 33:64-6. [PMID: 19236361 DOI: 10.1111/j.1753-6405.2009.00340.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To compare two methods of monitoring tobacco consumption in remote Indigenous communities. METHODS We examined the monthly difference between wholesale invoice and point-of-sale data for tobacco products from three stores from remote Aboriginal communities in the Northern Territory. We assessed three measures of wholesale data. RESULTS The average monthly difference between the sale data and the average of wholesale invoices for the previous, same and following month was -33 cigarettes per day (95% CI -157, 92). This average of three months' wholesale invoices provided a more precise estimate than either wholesale invoices from the same or previous month. CONCLUSION Tobacco wholesale data provided a close estimate of sales data in these stores. IMPLICATIONS This wholesale data could be used to monitor local trends in remote Indigenous tobacco consumption, facilitating the evaluation of the impact of tobacco control activities and informing future work to reduce Indigenous smoking and its harms.
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Affiliation(s)
- David P Thomas
- Menzies School of Health Research and Institute of Advanced Studies, Charles Darwin University, Northern Territory.
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22
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Elliott JO, Lu B, Moore JL, McAuley JW, Long L. Exercise, diet, health behaviors, and risk factors among persons with epilepsy based on the California Health Interview Survey, 2005. Epilepsy Behav 2008; 13:307-15. [PMID: 18490199 DOI: 10.1016/j.yebeh.2008.04.003] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2008] [Revised: 04/07/2008] [Accepted: 04/08/2008] [Indexed: 01/22/2023]
Abstract
Based on the 2005 California Health Interview Survey, persons with a history of epilepsy report lower educational attainment, lower annual income, and poorer health status, similar to other state-based epidemiological surveys. Previous studies have found persons with epilepsy exercise less and smoke more than the nonepilepsy population. The medical literature has also shown that antiepileptic drugs may cause nutritional deficiencies. Persons with a history of epilepsy in the 2005 CHIS report they walk more for transportation, drink more soda, and eat less salad than the nonepilepsy population. Exercise and dietary behaviors at recommended levels have been found to reduce mortality from many comorbid conditions such as cardiovascular disease, stroke, depression, anxiety, and osteoporosis for which persons with epilepsy are at increased risk. Health professionals in the epilepsy field should step up their efforts to engage patients in health promotion, especially in the areas of exercise, diet, and smoking cessation.
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Affiliation(s)
- John O Elliott
- Department of Neurology, Ohio State University, Columbus, OH, USA.
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23
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Abstract
BACKGROUND Mass media tobacco control campaigns can reach large numbers of people. Much of the literature is focused on the effects of tobacco control advertising on young people, but there are also a number of evaluations of campaigns targeting adult smokers, which show mixed results. Campaigns may be local, regional or national, and may be combined with other components of a comprehensive tobacco control policy. OBJECTIVES To assess the effectiveness of mass media interventions in reducing smoking among adults. SEARCH STRATEGY The Cochrane Tobacco Addiction Group search strategy was combined with additional searches for any studies that referred to tobacco/smoking cessation, mass media and adults. We also searched the Cochrane Register of Controlled Trials (CENTRAL) and a number of electronic databases. The last search was carried out in March 2007. SELECTION CRITERIA Controlled trials allocating communities, regions or states to intervention or control conditions; interrupted time series.Adults, 25 years or older, who regularly smoke cigarettes. Studies which cover all adults as defined in studies were included. Mass media are defined here as channels of communication such as television, radio, newspapers, billboards, posters, leaflets or booklets intended to reach large numbers of people, and which are not dependent on person-to-person contact. The purpose of the mass media campaign must be primarily to encourage smokers to quit. They could be carried out alone or in conjunction with tobacco control programmes.The primary outcome was change in smoking behaviour. This could be reported as changes in prevalence, changes in cigarette consumption, quit rates, odds of being a smoker. DATA COLLECTION AND ANALYSIS Two authors independently assessed all studies for inclusion criteria and for study quality. One author (MB) extracted data, and a second author (LS) checked them.Results were not pooled due to heterogeneity of included studies and are presented narratively and in table form. MAIN RESULTS Eleven campaigns met the inclusion criteria for this review. Studies differed in design, settings, duration, content and intensity of intervention, length of follow up, methods of evaluation and also in definitions and measures of smoking behaviour used. Among nine campaigns reporting smoking prevalence, significant decreases were observed in the California and Massachusetts statewide tobacco control campaigns compared with the rest of the USA. Some positive effects on prevalence in the whole population or in the subgroups were observed in three of the remaining seven studies. Three large-scale campaigns of the seven presenting results for tobacco consumption found statistically significant decreases. Among the seven studies presenting abstinence or quit rates, four showed some positive effect, although in one of them the effect was measured for quitting and cutting down combined. Among the three that did not show significant decreases, one demonstrated a significant intervention effect on smokers and ex-smokers combined. AUTHORS' CONCLUSIONS There is evidence that comprehensive tobacco control programmes which include mass media campaigns can be effective in changing smoking behaviour in adults, but the evidence comes from a heterogeneous group of studies of variable methodological quality. One state-wide tobacco control programme (Massachusetts) showed positive results up to eight years after the campaign, while another (California) showed positive results only during the period of adequate funding and implementation. Six of nine studies carried out in communities or regions showed some positive effects on smoking behaviour and at least one significant change in smoking prevalence (Sydney). The intensity and duration of mass media campaigns may influence effectiveness, but length of follow up and concurrent secular trends and events can make this difficult to quantify. No consistent relationship was observed between campaign effectiveness and age, education, ethnicity or gender.
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Affiliation(s)
- M Bala
- Jagiellonian University Medical College, 2nd Department of Internal Medicine, 8 Skawinska St, Krakow, Poland, 31-066.
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Warner KE, Mendez D, Alshanqeety O. Tobacco control success versus demographic destiny: examining the causes of the low smoking prevalence in California. Am J Public Health 2008; 98:268-9. [PMID: 18172141 DOI: 10.2105/ajph.2007.112318] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We examined the effect of demographics on California's low smoking prevalence. We estimated that if the United States had the same demographics as California, then the US adult smoking prevalence in 2005 would have been 19.3%, 1.6 percentage points lower than the reported 20.9% for the United States, but 4.1 percentage points higher than California's prevalence of 15.2% in 2005. Tobacco control appears to be a much more important factor than demographics in determining California's low smoking rates.
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Affiliation(s)
- Kenneth E Warner
- Department of Health Management and Policy, University of Michigan, 109 Observatory Rd, Ann Arbor, MI 48109, USA.
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25
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Abstract
OBJECTIVE To estimate the relative contributions of trends in smoking prevalence and trends in smoking intensity (average number of cigarettes smoked per day) to the observed decline in per capita tobacco consumption in New Zealand from 1984 to 2004. METHOD Tobacco consumption and smoking prevalence time series data were sourced from Statistics New Zealand and the ACNielsen Omnibus Survey respectively and checked for accuracy against other sources. The contribution of changes in smoking prevalence to the observed decline in tobacco consumption was estimated by counterfactual modelling. The corresponding contribution of trends in smoking intensity was then calculated by difference. RESULTS Changes in smoking prevalence accounted for 48% of the decline in per capita tobacco consumption from 1984-89 and for 39% thereafter. Correspondingly, changes in smoking intensity accounted for 52% of the consumption decline during the first five years of the study period and 61% thereafter (i.e. from 1990 to 2004). DISCUSSION Understanding the relative contributions of trends in smoking prevalence and smoking intensity to the observed decline in per capita tobacco consumption is important, because the relationship between smoking intensity and health effects is non-linear. Our results indicate that the dramatic fall in tobacco consumption in New Zealand over the past 30 years will not be accompanied by an equivalent reduction in tobacco-attributable morbidity and mortality. Furthermore, our findings raise doubts as to how much longer tobacco consumption will continue to decline, given that smoking intensity is already low. The key message for the tobacco control program is to re-focus on helping smokers to quit and stay quit.
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Affiliation(s)
- Martin Tobias
- Public Health Intelligence, Ministry of Health, New Zealand.
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Al-Delaimy WK, Pierce JP, Messer K, White MM, Trinidad DR, Gilpin EA. The California Tobacco Control Program's effect on adult smokers: (2) Daily cigarette consumption levels. Tob Control 2007; 16:91-5. [PMID: 17400945 PMCID: PMC2598465 DOI: 10.1136/tc.2006.017061] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2006] [Accepted: 09/25/2006] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate the association of the California Comprehensive Tobacco Control Program with self-reported population trends of cigarette consumption during 1992-2002. SETTING AND PARTICIPANTS Participants were non-Hispanic white daily smokers (aged 20-64 years, n = 24 317) from the Tobacco Use Supplements to the Current Population Survey (1992-2002). We compared age-specific trends in consumption among daily smokers in three groups of states with differing tobacco control initiatives: California (CA; high cigarette price/comprehensive programme), New York and New Jersey (high cigarette price/no comprehensive programme), and tobacco-growing states (TGS; low cigarette price/no comprehensive programme). RESULTS There was a general decline in cigarette consumption across all age groups in each category of states between 1992 and 2002, except the oldest age group in the TGS. The largest annual decline in the average number of cigarettes per day was observed among daily smokers in CA who were aged > or = 35 years (-0.41 cigarettes/day/year (95% CI -0.52 to -0.3)). This rate was significantly higher than the -0.22 cigarettes/day/year (95% CI -0.3 to -0.16; p<0.02) observed in same-age daily smokers from New York and New Jersey, and significantly higher than the rate in same-age daily smokers from the TGS (-0.15 cigarettes/day/year (95% CI -0.22 to -0.08; p<0.002)). There were no significant differences across state groups in the decline observed in daily smokers aged 20-34 years. In 2002, only 12% of daily smokers in CA smoked more than a pack per day, which was significantly lower than the 17% in New York and New Jersey, which again was significantly lower than the 25% in the TGS. CONCLUSIONS The California Tobacco Control Program was associated with significant declines in cigarette consumption among daily smokers aged > or = 35 years of age, which in turn should lead to declines in tobacco-related health effects. The decline in consumption among young adult smokers was a national trend.
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Affiliation(s)
- Wael K Al-Delaimy
- Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego, La Jolla 92093-0901, California, USA.
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